{"text_format":"1","workbook":"xlsx","n_sheets":22,"sheets":["Overview","Instructions","Reference","Menu","Validation_Errors","CrossCheck_Errors","Admin","BusinessRules","Drug","DrugList","ECP","Network","NCQA","P&B","ServiceArea","Rate","URAC","URR","Lookups","EHB_Mandates","ErrorLkup","Scratch"],"not_rendered":{"charts":0,"images":1,"macros":1,"external_links":10,"defined_names":156,"comments":0,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900"}

{"sheet":"Overview","index":0,"n_rows":27,"n_cols":3,"rows_kept":27,"cut":false,"hidden":false,"merged":[[7,1,7,2],[8,1,8,2],[1,1,1,2],[2,1,2,2],[3,1,3,2],[4,1,4,2],[5,1,5,2],[6,1,6,2]]}
[]
[null,"Overview of Data Integrity Tool (DIT), 2015 Version 1.3"]
[null,"The purpose of the Data Integrity Tool (DIT) is to provide a method for issuers to ensure that the data contained in their QHP templates is in the correct format and conforms to validity checks that will take place upon submission. Running the QHP templates through the DIT should provide issuers with immediate feedback regarding the quality of the templates before uploading the final version into HIOS or SERFF, which should reduce the number of resubmissions.  The tool approximates but does not replicate all the checks being done in HIOS or SERFF, and includes checks not found in HIOS or SERFF but that are necessary for correct template submission. "]
[null,"Use of this tool by issuers is optional. Issuers are encouraged to use this and other review tools proactively before submitting their QHP applications and can also reference them when a state or federal regulator requests corrections after an initial review. However, please note that issuers should respond to any deficiencies identified by a state or federal regulator even if the identified issue is different than the results an issuer obtained by using this tool. "]
[null,"Use of this tool by state regulators is optional. States may use whichever tools or parts of tools they believe will assist in their review process, whether that is all of them or none of them. This tool is one method for reviewing the validity of submitted template data."]
[null,"Use of this tool by CMS and states.  CMS will review plan data submission errors. Proper use of this tool may help issuers demonstrate an attempt to comply in good faith with program and operational requirements, absent any evidence to the contrary. For more details on the certification process and related standards, please see the “2015 Letter to Issuers in the Federally-facilitated Marketplaces” available on the CCIIO website under Regulations and Guidance.\n\nIssuers in states performing plan management functions may contact their state regulator to determine if one or more of these review tools will be part of their review processes. CMS will review and confirm the state's QHP certification recommendations and make final QHP certification decisions. CMS will work closely with states that are performing plan management functions to coordinate this process.\n"]
[null,"Disclaimer:  The ability to use this tool is contingent on any given state and issuer using the federally developed templates for QHP applications. The results generated in all review tools depend on complete and accurate QHP application data. It is recommended that issuers run this tool before using the other review tools, to ensure the validity of their data. \n\nFor the tool to run it is imperative that the worksheet names, format, and overall structure of the file is not changed (e.g. adding or deleting rows or columns, changing field names, copying or deleting worksheets), as this could severely impair the functioning of the tool macros. However, filters have been added to the table headings in the output reports, and these may be used without disrupting tool use.\n\nThis tool can be run for the following plan types: only plans that are offered on the exchange, only plans that are offered off the exchange, or for all submitted standard plans, both on and off the exchange. "]
[null,"Tool Tabs and Template Versions"]
[null,"The following explains how to use each of the tabs in this workbook. It also lists the template version numbers and template tab names that should be used to ensure the tool will run properly."]
[null,"DIT Tab Name","Use/Explanation"]
[null,"Instructions","This tab contains step by step instructions for how to use the tool."]
[null,"Reference","This tab has a diagram showing how key data elements are related among the various templates."]
[null,"Menu","This tab contains all of the buttons used to import and validate data. Clicking these buttons will run the automated Excel macros."]
[null,"Validation_Errors","This tab shows the output results from validating one or more templates."]
[null,"CrossCheck_Errors","This tab shows the output results from validating across two or more templates."]
[null,"Admin","This tab will be populated by the 'Import' button on the Menu tab.  It contains one line for each issuer and has general company and contact information.\nTemplate Version: 4.0\nTemplate Tab Name: Administrative Data"]
[null,"BusinessRules","This tab will be populated by the 'Import' button on the Menu tab.  It contains one line for each entry in the Business Rules template and describes the rules governing an issuer's rates.\nTemplate Version: 4.0\nTemplate Tab Name: Business Rules"]
[null,"Drug","This tab will be populated by the 'Import' button on the Menu tab.  It contains one line for each entry in the Prescription Drugs template and has formulary information.\nTemplate Version: 4.0\nTemplate Tab Name: Formulary Tiers"]
[null,"DrugList","This tab will be populated by the 'Import' button on the Menu tab.  It contains columns and rows that display the drug lists from the Prescription Drugs template.\nTemplate Version: 4.0\nTemplate Tab Name: Drug Lists"]
[null,"ECP","This tab will be populated by the 'Import' button on the Menu tab.  It contains one line for each entry in the ECP template and identifies the essential community providers.\nTemplate Version: 4.0\nTemplate Tab Name: Essential Community Providers"]
[null,"Network","This tab will be populated by the 'Import' button on the Menu tab.  It contains one line for each entry in the Network template and identifies the provider's network.\nTemplate Version: 4.0\nTemplate Tab Name: Networks"]
[null,"NCQA","This tab will be populated by the 'Import' button on the Menu tab.  It contains one line for each issuer and has information about the issuer's NCQA accreditation status.\nTemplate Version: 4.0\nTemplate Tab Name: NCQA"]
[null,"P&B","This tab will be populated by the 'Import' button on the Menu tab.  It contains one line for each standard plan and each associated plan variation and has columns detailing basic plan data, out of pocket maximum and deductible values, and cost sharing for each of the benefits.\nTemplate Version: 4.0\nTemplate Tab Names: Benefits Package 1, Cost Share Variances 1, etc."]
[null,"ServiceArea","This tab will be populated by the 'Import' button on the Menu tab.  It contains one line for each entry in the Service Area template and has information on the geographic service areas.\nTemplate Version: 4.0\nTemplate Tab Name: Service Areas"]
[null,"Rate","This tab will be populated by the 'Import' button on the Menu tab.  It contains one line for each entry in the Rates Table template and gives rates for each plan.\nTemplate Version: 4.0\nTemplate Tab Name: Rates Table"]
[null,"URAC","This tab will be populated by the 'Import' button on the Menu tab.  It contains one line for each issuer and has information about the issuer's URAC accreditation status.\nTemplate Version: 4.0\nTemplate Tab Name: URAC"]
[null,"URR","This tab will be populated by the 'Import' button on the Menu tab.  It contains one line for each QHP plan and has a subset of the rate review information. Only the fields involved in the cross checks with the QHP Application are imported.\nTemplate Version: 2.0.2\nTemplate Tab Names: Wksh 1 - Market Experience, Wksh 2 - Plan Product Info"]

{"sheet":"Instructions","index":1,"n_rows":30,"n_cols":3,"rows_kept":30,"cut":false,"hidden":false,"merged":[[20,1,20,2],[23,1,23,2],[26,1,26,2],[1,1,1,2],[2,1,2,2],[3,1,3,2],[4,1,4,2],[8,1,8,2],[15,1,15,2]]}
[]
[null,"Instructions for How to Use the Data Integrity Tool (DIT)"]
[null,"This tool can be used by an issuer to evaluate all of their plans or by a state to evaluate issuers (either individually or for all issuers that have submitted plans in that state). It will pull in data from the issuer templates and use that data to check that template validation rules were followed and that key fields are consistent across templates. The DIT also flags errors frequently found in the 2014 submission cycle. \nFollow the steps below to pull in and validate data for each template. Note: Be sure to save this file after each data import process has completed."]
[null,"For this tool, and all stand-alone tools, make sure you have macros enabled within Excel."]
[null,"Prepare Template Files"]
[null,"1.","For Issuers: Complete, validate, and save the Excel versions of the templates.\nFor States: Download the Excel versions of issuers' templates from HIOS or SERFF.  "]
[null,"2.","Place templates into separate folders for each type (e.g., Administrative, Plans and Benefits, Network). There are no restrictions on the folder location (local or shared drive) or naming convention for the folders or template files."]
[null,"3.","All template files in each folder will be imported into the DIT at the same time. Ensure there are no other Excel files in these folders other than the templates."]
[null,"Import Template Data"]
[null,"1.","On the Menu tab, click the button in the Import column (first column) for the template you wish to import.\nNote: If you have previously imported this type of template data into the DIT, importing it again will overwrite the data that is on the tab."]
[null,"2.","Navigate to the folder that contains the template file(s)."]
[null,"3.","Select/highlight the folder that contains the template file(s).\nNote: You will not see the template file(s) shown in the window. The DIT only requires the location of the folder where the templates are stored."]
[null,"4.","Click the 'Select Folder' button in the window. "]
[null,"5.","The import processes may take seconds or up to several minutes to run, depending on the file location and size of the templates that have to be processed. You will know that the import has finished processing when the message box appears telling you the data import is complete or you receive an error message stopping the import. Until one of these appears, please do not try to use Excel, as doing so may cause the tool to take longer and/or fail. If you receive an error message, either try to fix the problem on the template, or remove the associated template (or worksheets) from the folder until the issue has been resolved. If this happens you will need to restart the import process."]
[null,"6.","Click the 'OK' button."]
[null,"Validate Templates Individually"]
[null,"1.","On the Menu tab, click the button in the Validate column (second column) for the template you wish to validate."]
[null,"2.","Wait for the message to appear indicating the validation is complete. This could take several seconds or longer, depending on the complexity of the data integrity checks being performed."]
[null,"3.","Click the 'OK' button."]
[null,"4.","View the validation output. Each row contains the cell reference for the data element in the original template and a description of the error."]
[null," Correct Template Data"]
[null,"1.","Go back to your template file(s) and correct any errors."]
[null,"2.","Validation output rows labeled as Errors should be corrected before you submit your application. Warnings contain helpful information, but may not need to be corrected before template submission."]
[null,"Repeat Import and Validation"]
[null,"1.","On the Menu tab, use the buttons in the Import and Validate columns to import and validate your template file(s) until you no longer get Errors in your validation output.\nNote: If you have previously imported this type of template data into the DIT, importing it again will overwrite the data that is on the tab. \nNote: If you have previously validated this type of template data into the DIT, validating it again will add additional errors/warnings to the original list of errors. You should delete all previous validations before re-validating a template. Use the 'Clear Validation Errors' button on the Menu tab or manually delete the rows from the results table."]
[null,"2.","You can use the buttons in the third column to validate your templates in groups."]
[null,"Validate Data Elements across Templates"]
[null,"1.","Once you have loaded all templates into the DIT, click the button at the right to cross-validate. This will check that data elements are consistent across all templates. Use the diagram on the Reference tab to review how key fields are related among the various templates."]
[null,"2.","View the cross check error output. Each row contains the two templates that were compared and the data element that failed the consistency check."]
[null,"3.","Once you correct the appropriate data elements, reimport and revalidate to ensure that all the cross check errors have been removed."]

{"sheet":"Reference","index":2,"n_rows":3,"n_cols":2,"rows_kept":3,"cut":false,"hidden":false,"merged":[[1,1,1,8],[2,1,2,8]]}
[]
[null," Instructions on Cross Validations between Templates"]
[null,"The template crosswalk diagram below represents the key data elements that should be consistent across different templates. On the top axis is the list of template types, and within each column, the data fields in the template. Fields that should be consistent are colored the same and are found in the same horizontal line. \n\nIn some cases, the field values should be equal. For instance, on all templates the Issuer ID (highlighted in yellow and found on the first horizontal line) is a required field and should be the same. Similarly, the set of Network IDs defined in the Network template should match those used in the Plans & Benefits and ECP templates. \n\nOther fields should be consistent but not equal, as described in the NOTES section below the diagram. For examples, EHB Apportionment for Pediatric Dental($) is not the same as Individual Rate, but there is a rule governing how those fields interact. "]

{"sheet":"Menu","index":3,"n_rows":64,"n_cols":3,"rows_kept":64,"cut":false,"hidden":false,"merged":[]}
[null,"DIT Menu"]
[null,"2015 Version 1.3"]
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[null,"Perform Template Cross Checks on the following Templates:"]
[null,"Admin",false]
[null,"BusinessRules",true]
[null,"Drug",false]
[null,"DrugList",false]
[null,"ECP",false]
[null,"NCQA",false]
[null,"Network",false]
[null,"P&B",false]
[null,"Rate",true]
[null,"ServiceArea",false]
[null,"URAC",false]
[null,"URR",false]

{"sheet":"Validation_Errors","index":4,"n_rows":2,"n_cols":12,"rows_kept":2,"cut":false,"hidden":false,"merged":[]}
["Template Validation Errors"]
["Ref No.","Template","Issuer ID","Error Type","Error Message","Template Cell Ref","Template Worksheet","Template Filename","Field Name","DIT Cell Ref","DIT Error Code","DIT Worksheet"]

{"sheet":"CrossCheck_Errors","index":5,"n_rows":2,"n_cols":7,"rows_kept":2,"cut":false,"hidden":false,"merged":[]}
["Cross Check Validation Errors"]
["Ref No.","Error Type","Template1","Template2","Error Message","Issuer ID","Field Name"]

{"sheet":"Admin","index":6,"n_rows":2,"n_cols":178,"rows_kept":2,"cut":false,"hidden":false,"merged":[]}
["Administrative Template Data",null,null,null,null,null,"1. Administrative Data ",null,null,null,null,null,null,"2. Company Address ",null,null,null,null,"3. Issuer Address",null,null,null,null,null,"5. Issuer Individual Market Contact",null,null,null,null,"6. Issuer SHOP (Small Group) Contact",null,null,null,null,"7. CEO",null,null,null,null,"8. CFO ",null,null,null,null,"9.  Customer Service - Individual Market ",null,null,null,null,"10.  Customer Service - SHOP (Small Group)",null,null,null,null,"11.  Contacts - Enrollment Contact",null,null,null,null,"11.  Contacts - Online Enrollment Center Contact (Primary)",null,null,null,null,"11.  Contacts - Online Enrollment Center Contact (Backup)",null,null,null,null,"11.  Contacts - System Contact",null,null,null,null,"11.  Contacts - Appeals/Grievances Contact",null,null,null,null,"11.  Contacts - Customer Service Operations Contact",null,null,null,null,"11.  Contacts - User Access Contact",null,null,null,null,"11.  Contacts - Backup User Access Contact",null,null,null,null,"11.  Contacts - Marketing Contact",null,null,null,null,"11.  Contacts - Medical Director",null,null,null,null,"11.  Contacts - Chief Dental Director",null,null,null,null,"11.  Contacts - Pharmacy Benefit Manager",null,null,null,null,"11.  Contacts - Government Relations Contact",null,null,null,null,"11.  Contacts - HIPAA Security Officer",null,null,null,null,"11.  Contacts - Complaints Tracking Contact",null,null,null,null,"11.  Contacts - Quality Contact",null,null,null,null,"11.  Contacts - Compliance Officer",null,null,null,null,"11.  Contacts - Payment Contact",null,null,null,null,"11.  Contacts - APTC/CSR Contact",null,null,null,null,"11.  Contacts - Financial Reporting Contact",null,null,null,null,"11.  Contacts - Financial Transfers Contact",null,null,null,null,"11.  Contacts - Risk Corridors Contact",null,null,null,null,"11.  Contacts - Risk Adjustment Contact",null,null,null,null,"11.  Contacts - Reinsurance Contact",null,null,null,null,"12. Third Party Administrator(s):"]
["Workbook","Worksheet","Issuer ID","Issuer State1","Proposed Exchange Market Coverage","Current Sales Market","Company Legal Name","Issuer Legal Name","Issuer Marketing Name","Associated Health Plan ID","TIN","NAIC Company Code","NAIC Group Code","Company Address","Company Address 2","Company City","Company State","Company Zip Code","Issuer Address","Issuer Address 2","Issuer City","Issuer State2","Issuer Zip Code","Select Your Primary Contact","Issuer Individual Market Contact First Name","Issuer Individual Market Contact Last Name","Issuer Individual Market Contact Email Address","Issuer Individual Market Contact Phone Number","Issuer Individual Market Contact Phone Extension","Issuer SHOP (Small Group) Contact First Name","Issuer SHOP (Small Group) Contact Last Name","Issuer SHOP (Small Group) Contact Email Address","Issuer SHOP (Small Group) Contact Phone Number","Issuer SHOP (Small Group) Contact Phone Extension","CEO First Name","CEO Last Name","CEO Email Address","CEO Contact Phone Number","CEO Phone Extension","CFO First Name","CFO Last Name","CFO Email Address","CFO Contact Phone Number","CFO Phone Extension","Customer Service - Individual Market Customer Service Phone","Customer Service - Individual Market Customer Service Phone Extension","Customer Service - Individual Market Customer Service Toll Free","Customer Service - Individual Market Customer Service TTY","Customer Service - Individual Market Customer Service URL","Customer Service - SHOP (Small Group) Customer Service Phone","Customer Service - SHOP (Small Group) Customer Service Phone Extension","Customer Service - SHOP (Small Group) Customer Service Toll Free","Customer Service - SHOP (Small Group) Customer Service TTY","Customer Service - SHOP (Small Group) Customer Service URL","Enrollment Contact First Name","Enrollment Contact Last Name","Enrollment Contact Email Address","Enrollment Contact Phone Number","Enrollment Contact Extension","Online Enrollment Center Contact (Primary) First Name","Online Enrollment Center Contact (Primary) Last Name","Online Enrollment Center Contact (Primary) Email Address","Online Enrollment Center Contact (Primary) Phone Number","Online Enrollment Center Contact (Primary) Extension","Online Enrollment Center Contact (Backup) First Name","Online Enrollment Center Contact (Backup) Last Name","Online Enrollment Center Contact (Backup) Email Address","Online Enrollment Center Contact (Backup) Phone Number","Online Enrollment Center Contact (Backup) Extension","System Contact First Name","System Contact Last Name","System Contact Email Address","System Contact Phone Number","System Contact Extension","Appeals/Grievances Contact First Name","Appeals/Grievances Contact Last Name","Appeals/Grievances Contact Email Address","Appeals/Grievances Contact Phone Number","Appeals/Grievances Contact Extension","Customer Service Operations Contact First Name","Customer Service Operations Contact Last Name","Customer Service Operations Contact Email Address","Customer Service Operations Contact Phone Number","Customer Service Operations Contact Extension","User Access Contact First Name","User Access Contact Last Name","User Access Contact Email Address","User Access Contact Phone Number","User Access Contact Extension","Backup User Access Contact First Name","Backup User Access Contact Last Name","Backup User Access Contact Email Address","Backup User Access Contact Phone Number","Backup User Access Contact Extension","Marketing Contact First Name","Marketing Contact Last Name","Marketing Contact Email Address","Marketing Contact Phone Number","Marketing Contact Extension","Medical Director First Name","Medical Director Last Name","Medical Director Email Address","Medical Director Phone Number","Medical Director Extension","Chief Dental Director First Name","Chief Dental Director Last Name","Chief Dental Director Email Address","Chief Dental Director Phone Number","Chief Dental Director Extension","Pharmacy Benefit Manager First Name","Pharmacy Benefit Manager Last Name","Pharmacy Benefit Manager Email Address","Pharmacy Benefit Manager Phone Number","Pharmacy Benefit Manager Extension","Government Relations Contact First Name","Government Relations Contact Last Name","Government Relations Contact Email Address","Government Relations Contact Phone Number","Government Relations Contact Extension","HIPAA Security Contact First Name","HIPAA Security Contact Last Name","HIPAA Security Contact Email Address","HIPAA Security Contact Phone Number","HIPAA Security Contact Extension","Complaints Tracking Contact First Name","Complaints Tracking Contact Last Name","Complaints Tracking Contact Email Address","Complaints Tracking Contact Phone Number","Complaints Tracking Contact Extension","Quality Contact First Name","Quality Contact Last Name","Quality Contact Email Address","Quality Contact Phone Number","Quality Contact Extension","Compliance Officer First Name","Compliance Officer Last Name","Compliance Officer Email Address","Compliance Officer Phone Number","Compliance Officer Extension","Payment Contact First Name","Payment Contact Last Name","Payment Contact Email Address","Payment Contact Phone Number","Payment Contact Extension","APTC/CSR Contact First Name","APTC/CSR Contact Last Name","APTC/CSR Contact Email Address","APTC/CSR Contact Phone Number","APTC/CSR Contact Extension","Financial Reporting Contact First Name","Financial Reporting Contact Last Name","Financial Reporting Contact Email Address","Financial Reporting Contact Phone Number","Financial Reporting Contact Extension","Financial Transfers Contact First Name","Financial Transfers Contact Last Name","Financial Transfers Contact Email Address","Financial Transfers Contact Phone Number","Financial Transfers Contact Extension","Risk Corridors Contact First Name","Risk Corridors Contact Last Name","Risk Corridors Contact Email Address","Risk Corridors Contact Phone Number","Risk Corridors Contact Extension","Risk Adjustment Contact First Name","Risk Adjustment Contact Last Name","Risk Adjustment Contact Email Address","Risk Adjustment Contact Phone Number","Risk Adjustment Contact Extension","Reinsurance Contact First Name","Reinsurance Contact Last Name","Reinsurance Contact Email Address","Reinsurance Contact Phone Number","Reinsurance Contact Extension","Do you have a TPA for Enrollment","Do you have a TPA for Claims Processing","Do you have a TPA for Edge Server Host","DIT Row Ref"]

{"sheet":"BusinessRules","index":7,"n_rows":2,"n_cols":52,"rows_kept":2,"cut":false,"hidden":false,"merged":[]}
["Business Rules Data"]
["Workbook","Worksheet","HIOS Issuer ID*","TIN*","Product ID","Plan ID \n(Standard Component)","How are rates for contracts covering two or more enrollees calculated?","What are the maximum number of under age (under 21) dependents used to quote a two parent family?","What are the maximum number of under age (under 21) dependents used to quote a single parent family?","Is there a maximum age for a dependent?","What are the maximum number of children used to quote a children-only contract?","Are domestic partners treated the same as secondary subscribers?","Are same-sex partners treated the same as secondary subscribers?","How is age determined for rating and eligibility purposes?","How is tobacco status determined for subscribers and dependents?","What relationships between primary and dependent are allowed, and is the dependent required to live in the same household as the primary subscriber?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DIT Row Ref","Template Row Ref"]

{"sheet":"Drug","index":8,"n_rows":2,"n_cols":52,"rows_kept":2,"cut":false,"hidden":false,"merged":[]}
["Prescription Drugs Template Data"]
["Workbook","Worksheet","HIOS Issuer ID","Issuer State","Formulary ID","Formulary URL","Drug List ID","Number of Tiers","Drug Tier ID","Drug Tier Type","1 Month In Network Retail Pharmacy Cost Sharing Type","Copayment","Coinsurance","1 Month Out of Network Retail Pharmacy Benefit Offered?","1 Month Out of Network Retail Pharmacy Cost Sharing Type","Copayment","Coinsurance","3 Month in Network Mail Order Pharmacy Benefit Offered?","3 Months In Network Mail Order Pharmacy Cost Sharing Type","Copayment","Coinsurance","3 Month Out of Network Mail Order Pharmacy Benefit Offered?","3 Month Out of Network Mail Order Pharmacy Cost Sharing Type","Copayment","Coinsurance",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DIT Row Ref","Template Row Ref"]

{"sheet":"DrugList","index":9,"n_rows":2,"n_cols":8,"rows_kept":2,"cut":false,"hidden":false,"merged":[]}
["Drug List Template Data",null,null,null,null,"Drug List ID 1"]
["Workbook","Worksheet","HIOS Issuer ID* ","Issuer State* ","RXCUI*","Tier Level*","Prior Authorization Required","Step Therapy Required"]

{"sheet":"ECP","index":10,"n_rows":2,"n_cols":52,"rows_kept":2,"cut":false,"hidden":false,"merged":[]}
["Essential Community Providers Template Data"]
["Workbook","Worksheet","Company Legal Name","HIOS Issuer ID","Issuer State","National Provider Number (NPI)","Provider Name*","Provider Type*","ECP Category*","Street Address*","Street Address 2","City*","State*","Zip*","On ECP List?*","Network IDs*",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DIT Row Ref","Template Row Ref"]

{"sheet":"Network","index":11,"n_rows":2,"n_cols":52,"rows_kept":2,"cut":false,"hidden":false,"merged":[]}
["Network Template Data"]
["Workbook","Worksheet","HIOS Issuer ID*","Issuer State*","Network Name*","Network ID*","Network URL*",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DIT Row Ref","Template Row Ref"]

{"sheet":"NCQA","index":12,"n_rows":2,"n_cols":52,"rows_kept":2,"cut":false,"hidden":false,"merged":[]}
["Issuer NCQA Template Data"]
["Workbook","Worksheet","HIOS Issuer ID","NCQA Org ID","Market Type","NCQA Sub ID","Product Type","Product ID","Accreditation Status","Expiration Date",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DIT Row Ref","Template Row Ref"]

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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Maximum Out of Pocket for Medical EHB Benefits",null,null,null,null,null,null,null,"Maximum Out of Pocket for Drug EHB Benefits",null,null,null,null,null,null,null,"Maximum Out of Pocket for Medical and Drug EHB Benefits (Total)",null,null,null,null,null,null,null,"Medical EHB Deductible",null,null,null,null,null,null,null,null,null,"Drug EHB Deductible",null,null,null,null,null,null,null,null,null,"Combined Medical and Drug EHB Deductible",null,null,null,null,null,null,null,null,null,"SBC Scenario",null,null,null,null,null,null,null,"Primary Care Visit to Treat an Injury or Illness",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Specialist Visit",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Other Practitioner Office Visit (Nurse, Physician Assistant)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Outpatient Surgery Physician/Surgical Services",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Hospice Services",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Non-Emergency Care When Traveling Outside the U.S.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Routine Dental Services (Adult)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Infertility Treatment",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Long-Term/Custodial Nursing Home Care",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Private-Duty Nursing",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Routine Eye Exam (Adult)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Urgent Care Centers or Facilities",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Home Health Care Services",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Emergency Room Services",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Emergency Transportation/Ambulance",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Inpatient Hospital Services (e.g., Hospital Stay)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Inpatient Physician and Surgical Services",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Bariatric Surgery",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Cosmetic Surgery",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Skilled Nursing Facility",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Prenatal and Postnatal Care",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Delivery and All Inpatient Services for Maternity Care",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Mental/Behavioral Health Outpatient Services",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Mental/Behavioral Health Inpatient Services",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Substance Abuse Disorder Outpatient Services",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Substance Abuse Disorder Inpatient Services",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Generic Drugs",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Preferred Brand Drugs",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Non-Preferred Brand Drugs",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Specialty Drugs",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Outpatient Rehabilitation Services",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Habilitation Services",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Chiropractic Care",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Durable Medical Equipment",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Hearing Aids",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Imaging (CT/PET Scans, MRIs)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Preventive Care/Screening/Immunization",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Routine Foot Care",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Acupuncture",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Weight Loss Programs",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Routine Eye Exam for Children",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Eye Glasses for Children",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Dental Check-Up for Children",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Rehabilitative Speech Therapy",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Rehabilitative Occupational and Rehabilitative Physical Therapy",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Well Baby Visits and Care",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Laboratory Outpatient and Professional Services",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"X-rays and Diagnostic Imaging",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Basic Dental Care – Child",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Orthodontia – Child",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Major Dental Care – Child",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Basic Dental Care – Adult",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Orthodontia – Adult",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Major Dental Care – Adult",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Abortion for Which Public Funding is Prohibited",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Transplant",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Accidental Dental",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Dialysis",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Allergy Testing",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Chemotherapy",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Radiation",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Diabetes Education",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Prosthetic Devices",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Infusion Therapy",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Treatment for Temporomandibular Joint Disorders",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Nutritional Counseling",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Reconstructive Surgery",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Diabetes Care Management",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Inherited Metabolic Disorder - PKU",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Off Label Prescription Drugs",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Dental Anesthesia",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Mental Health Other",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Prescription Drugs Other",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Second Opinion",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Autism Spectrum Disorders",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Cancer Treatments",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Domestic Violence Treatment",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Infant Formulas",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Sickle Cell Anemia",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Third Opinion",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Treatment of Hemophilia",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Wilm's Tumor"]
["Plans & Benefits Template Data",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"In Network",null,"In Network (Tier 2)",null,"Out of Network",null,"Combined In/Out Network",null,"In Network",null,"In Network (Tier 2)",null,"Out of Network",null,"Combined In/Out Network",null,"In Network",null,"In Network (Tier 2)",null,"Out of Network",null,"Combined In/Out Network",null,"In Network",null,null,"In Network\n(Tier 2)",null,null,"Out of Network",null,"Combined In/Out Network",null,"In Network",null,null,"In Network (Tier 2)",null,null,"Out of Network",null,"Combined In/Out Network",null,"In Network",null,null,"In Network (Tier 2)",null,null,"Out of Network",null,"Combined In/Out Network",null,"Having a Baby",null,null,null,"Having 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Deductible/ Coinsurance After a Set Number of Copays?","Plan Effective Date","Plan Expiration Date","Out of Country Coverage","Out of Country Coverage Description","Out of Service Area Coverage","Out of Service Area Coverage Description","National Network","URL for Summary of Benefits & Coverage","URL for Enrollment Payment","Plan Brochure","HIOS Plan ID* \n(Standard Component + Variant)","CSR Variation Type*","Issuer Actuarial Value","AV Calculator Output Number*","Medical & Drug Deductibles Integrated?*","Medical & Drug Maximum Out of Pocket Integrated?*","Multiple In Network Tiers?*","1st Tier Utilization*","2nd Tier Utilization","Individual ","Family","Individual ","Family","Individual","Family","Individual","Family","Individual ","Family","Individual ","Family","Individual","Family","Individual","Family","Individual ","Family","Individual ","Family","Individual","Family","Individual","Family","Individual","Family","Default Coinsurance","Individual","Family","Default Coinsurance","Individual","Family","Individual","Family","Individual","Family","Default Coinsurance","Individual","Family","Default Coinsurance","Individual","Family","Individual","Family","Individual","Family","Default Coinsurance","Individual","Family","Default Coinsurance","Individual","Family","Individual","Family","Deductible","Copayment","Coinsurance","Limit","Deductible","Copayment","Coinsurance","Limit","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit Explanation","EHB Variance Reason","Subject to Deductible (Tier 1)","Subject to Deductible \n(Tier 2)","Excluded from In Network MOOP","Excluded from Out of Network MOOP","In Network (Tier 1)","In Network (Tier 2)","Out of Network","In Network (Tier 1)","In Network (Tier 2)","Out of Network","EHB","State Required Benefit","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Benefit 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["Service Area Template Data"]
["Workbook","Worksheet","HIOS Issuer ID","State","Service Area ID","Service Area Name","Is Entire State Covered?","Name of Covered County (if whole state isn't covered)","Partial County Coverage?","Service Area Zip Code(s) Covered\n(if partial county is yes)","Partial County Justification",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DIT Row Ref","Template Row Ref"]

{"sheet":"Rate","index":15,"n_rows":2,"n_cols":19,"rows_kept":2,"cut":false,"hidden":false,"merged":[]}
["Rate Data",null,null,null,null,null,null,null,null,null,null,null,"Family Tier"]
["Workbook","Worksheet","HIOS Issuer ID*","Federal TIN*","Rate Effective Date*","Rate Expiration Date*","Plan ID*","Rating Area ID*","Tobacco*","Age*","Individual Rate*","Individual Tobacco Rate*","Couple *","Primary Subscriber and One Dependent*","Primary Subscriber and Two Dependents*","Primary Subscriber and Three or More Dependents*","Couple and One Dependent*","Couple and Two Dependents*","Couple and Three or More Dependents*"]

{"sheet":"URAC","index":16,"n_rows":2,"n_cols":52,"rows_kept":2,"cut":false,"hidden":false,"merged":[]}
["Issuer URAC Template Data"]
["Workbook","Worksheet","HIOS Issuer ID","URAC Application Number","Market Type","Accreditation Status","Expiration Date",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DIT Row Ref","Template Row Ref"]

{"sheet":"URR","index":17,"n_rows":2,"n_cols":51,"rows_kept":2,"cut":false,"hidden":false,"merged":[]}
["URR Template Data"]
["Workbook","Plan Product Info Worksheet Name","Company Legal Name","HIOS Issuer ID","State","Market","Experience Period (Beginning Date)","Effective Date (of rate change)","Product ID","Metal","AV Metal Value","AV Pricing Value","Plan Type","Plan Name","Plan ID (Standard Component ID)","Exchange Plan?",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"DIT Row Ref"]

{"sheet":"Lookups","index":18,"n_rows":46224,"n_cols":72,"rows_kept":4500,"cut":true,"hidden":true,"merged":[],"bounds":{"rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0}}
["StateCode",null,null,null,null,"Visit(s)","Above EHB",null,"PPO Only",null,"Bronze",null,null,"Routine Dental Services (Adult)",null,null,"Tab","HeaderRow","TotCols","RefCol","Template RefCol"]
["AK",null,null,null,null,"Dollars","Substituted",null,"HMO Only",null,"Silver",null,null,"Dental Check-Up for Children",null,null,"P&B",3,{"$f":"MAX(IF(NOT(ISBLANK(INDIRECT(\"'\" & Q2 & \"'\" & \"!\" & \"A\" & R2 & \":\" & IF(T2-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T2-1-1,26)-26*27,26),26)-1),\"\")&IF(T2-1>26,CHAR(65+MOD(QUOTIENT(T2-1-1-26,26),26)),\"\")&CHAR(65+MOD(T2-1-1,26)) & R2 ))),COLUMN(INDIRECT(\"'\" & Q2 & \"'\" & \"!\" & \"A\" & R2 & \":\" & IF(T2-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T2-1-1,26)-26*27,26),26)-1),\"\")&IF(T2-1>26,CHAR(65+MOD(QUOTIENT(T2-1-1-26,26),26)),\"\")&CHAR(65+MOD(T2-1-1,26)) & R2 )),0))","v":1578},1579,1580]
["AL",null,null,"DIT Error Lookup:",{"$f":"IF(ISERROR(SEARCH(\"{\",VLOOKUP($K3,ErrorLookupTable,5,0))),VLOOKUP($K3,ErrorLookupTable,5,0),LEFT(VLOOKUP($K3,ErrorLookupTable,5,0),SEARCH(\"{\",VLOOKUP($K3,ErrorLookupTable,5,0))-1) & $M3 & MID(VLOOKUP($K3,ErrorLookupTable,5,0),SEARCH(\"}\",VLOOKUP($K3,ErrorLookupTable,5,0)) + 1, IF(ISERROR(SEARCH(\"{\",VLOOKUP($K3,ErrorLookupTable,5,0),SEARCH(\"}\",VLOOKUP($K3,ErrorLookupTable,5,0)))),1000,SEARCH(\"{\",VLOOKUP($K3,ErrorLookupTable,5,0),SEARCH(\"}\",VLOOKUP($K3,ErrorLookupTable,5,0)))-SEARCH(\"}\",VLOOKUP($K3,ErrorLookupTable,5,0))-1))& $N3 & IF(ISERROR(SEARCH(\"{\",VLOOKUP($K3,ErrorLookupTable,5,0),SEARCH(\"}\",VLOOKUP($K3,ErrorLookupTable,5,0)))),\"\",MID(VLOOKUP($K3,ErrorLookupTable,5,0),SEARCH(\"}\",VLOOKUP($K3,ErrorLookupTable,5,0),SEARCH(\"}\",VLOOKUP($K3,ErrorLookupTable,5,0))+1)+1,IF(ISERROR(SEARCH(\"{\",VLOOKUP($K3,ErrorLookupTable,5,0),SEARCH(\"}\",VLOOKUP($K3,ErrorLookupTable,5,0),SEARCH(\"}\",VLOOKUP($K3,ErrorLookupTable,5,0))+1))),1000,SEARCH(\"{\",VLOOKUP($K3,ErrorLookupTable,5,0),SEARCH(\"}\",VLOOKUP($K3,ErrorLookupTable,5,0),SEARCH(\"}\",VLOOKUP($K3,ErrorLookupTable,5,0))+1)) - SEARCH(\"}\",VLOOKUP($K3,ErrorLookupTable,5,0),SEARCH(\"}\",VLOOKUP($K3,ErrorLookupTable,5,0))+1) -1))& $O3 & IF(ISERROR(SEARCH(\"{\",VLOOKUP($K3,ErrorLookupTable,5,0),SEARCH(\"}\",VLOOKUP($K3,ErrorLookupTable,5,0),SEARCH(\"}\",VLOOKUP($K3,ErrorLookupTable,5,0))+1))),\"\",MID(VLOOKUP($K3,ErrorLookupTable,5,0),SEARCH(\"}\",VLOOKUP($K3,ErrorLookupTable,5,0),SEARCH(\"}\",VLOOKUP($K3,ErrorLookupTable,5,0),SEARCH(\"}\",VLOOKUP($K3,ErrorLookupTable,5,0))+1)+1)+1, LEN(VLOOKUP($K3,ErrorLookupTable,5,0)) - SEARCH(\"}\",VLOOKUP($K3,ErrorLookupTable,5,0),SEARCH(\"}\",VLOOKUP($K3,ErrorLookupTable,5,0),SEARCH(\"}\",VLOOKUP($K3,ErrorLookupTable,5,0))+1)+1)))))","v":{"$error":"#N/A"}},"Exam(s)","Substantially Equal",null,"POS Only",null,"Gold",null,null,"Basic Dental Care – Child",null,null,"Admin",2,{"$f":"MAX(IF(NOT(ISBLANK(INDIRECT(\"'\" & Q3 & \"'\" & \"!\" & \"A\" & R3 & \":\" & IF(T3-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T3-1-1,26)-26*27,26),26)-1),\"\")&IF(T3-1>26,CHAR(65+MOD(QUOTIENT(T3-1-1-26,26),26)),\"\")&CHAR(65+MOD(T3-1-1,26)) & R3 ))),COLUMN(INDIRECT(\"'\" & Q3 & \"'\" & \"!\" & \"A\" & R3 & \":\" & IF(T3-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T3-1-1,26)-26*27,26),26)-1),\"\")&IF(T3-1>26,CHAR(65+MOD(QUOTIENT(T3-1-1-26,26),26)),\"\")&CHAR(65+MOD(T3-1-1,26)) & R3 )),0))","v":177},178]
["AR",null,null,null,null,"Days","Using Alternate Benchmark",null,"HMO/POS Combined",null,"Platinum",null,null,"Orthodontia – Child",null,null,"Rate",2,{"$f":"MAX(IF(NOT(ISBLANK(INDIRECT(\"'\" & Q4 & \"'\" & \"!\" & \"A\" & R4 & \":\" & IF(T4-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T4-1-1,26)-26*27,26),26)-1),\"\")&IF(T4-1>26,CHAR(65+MOD(QUOTIENT(T4-1-1-26,26),26)),\"\")&CHAR(65+MOD(T4-1-1,26)) & R4 ))),COLUMN(INDIRECT(\"'\" & Q4 & \"'\" & \"!\" & \"A\" & R4 & \":\" & IF(T4-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T4-1-1,26)-26*27,26),26)-1),\"\")&IF(T4-1>26,CHAR(65+MOD(QUOTIENT(T4-1-1-26,26),26)),\"\")&CHAR(65+MOD(T4-1-1,26)) & R4 )),0))","v":19},51,52]
["AS",null,"No Charge","No Charge",null,"Item(s)","Other Law/Regulation",null,"PPO/POS Combined",null,"Catastrophic",null,null,"Major Dental Care – Child",null,null,"Drug",2,{"$f":"MAX(IF(NOT(ISBLANK(INDIRECT(\"'\" & Q5 & \"'\" & \"!\" & \"A\" & R5 & \":\" & IF(T5-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T5-1-1,26)-26*27,26),26)-1),\"\")&IF(T5-1>26,CHAR(65+MOD(QUOTIENT(T5-1-1-26,26),26)),\"\")&CHAR(65+MOD(T5-1-1,26)) & R5 ))),COLUMN(INDIRECT(\"'\" & Q5 & \"'\" & \"!\" & \"A\" & R5 & \":\" & IF(T5-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T5-1-1,26)-26*27,26),26)-1),\"\")&IF(T5-1>26,CHAR(65+MOD(QUOTIENT(T5-1-1-26,26),26)),\"\")&CHAR(65+MOD(T5-1-1,26)) & R5 )),0))","v":25},51,52]
["AZ",null,"No Charge after deductible","No Charge after deductible",null,"Months","Additional EHB Benefit",null,"HMO/POS/PPO Combined",null,null,null,null,"Basic Dental Care – Adult",null,null,"DrugList",2,{"$f":"MAX(IF(NOT(ISBLANK(INDIRECT(\"'\" & Q6 & \"'\" & \"!\" & \"A\" & R6 & \":\" & IF(T6-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T6-1-1,26)-26*27,26),26)-1),\"\")&IF(T6-1>26,CHAR(65+MOD(QUOTIENT(T6-1-1-26,26),26)),\"\")&CHAR(65+MOD(T6-1-1,26)) & R6 ))),COLUMN(INDIRECT(\"'\" & Q6 & \"'\" & \"!\" & \"A\" & R6 & \":\" & IF(T6-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T6-1-1,26)-26*27,26),26)-1),\"\")&IF(T6-1>26,CHAR(65+MOD(QUOTIENT(T6-1-1-26,26),26)),\"\")&CHAR(65+MOD(T6-1-1,26)) & R6 )),0))","v":8},51,52]
["CA",null,"$","%",null,"Treatment(s)","Dental Only Plan Available",null,null,null,null,null,null,"Orthodontia – Adult",null,null,"ECP",2,{"$f":"MAX(IF(NOT(ISBLANK(INDIRECT(\"'\" & Q7 & \"'\" & \"!\" & \"A\" & R7 & \":\" & IF(T7-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T7-1-1,26)-26*27,26),26)-1),\"\")&IF(T7-1>26,CHAR(65+MOD(QUOTIENT(T7-1-1-26,26),26)),\"\")&CHAR(65+MOD(T7-1-1,26)) & R7 ))),COLUMN(INDIRECT(\"'\" & Q7 & \"'\" & \"!\" & \"A\" & R7 & \":\" & IF(T7-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T7-1-1,26)-26*27,26),26)-1),\"\")&IF(T7-1>26,CHAR(65+MOD(QUOTIENT(T7-1-1-26,26),26)),\"\")&CHAR(65+MOD(T7-1-1,26)) & R7 )),0))","v":16},51,52]
["CO",null,"$ Copay after deductible","% Coinsurance after deductible",null,"Procedure(s)",null,null,"Excellent",null,"Individual",null,null,"Major Dental Care – Adult",null,null,"ServiceArea",2,{"$f":"MAX(IF(NOT(ISBLANK(INDIRECT(\"'\" & Q8 & \"'\" & \"!\" & \"A\" & R8 & \":\" & IF(T8-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T8-1-1,26)-26*27,26),26)-1),\"\")&IF(T8-1>26,CHAR(65+MOD(QUOTIENT(T8-1-1-26,26),26)),\"\")&CHAR(65+MOD(T8-1-1,26)) & R8 ))),COLUMN(INDIRECT(\"'\" & Q8 & \"'\" & \"!\" & \"A\" & R8 & \":\" & IF(T8-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T8-1-1,26)-26*27,26),26)-1),\"\")&IF(T8-1>26,CHAR(65+MOD(QUOTIENT(T8-1-1-26,26),26)),\"\")&CHAR(65+MOD(T8-1-1,26)) & R8 )),0))","v":11},51,52]
["CT",null,"$ Copay before deductible","% Coinsurance before deductible",null,"Hours","Indemnity",null,"Commendable",null,"Small Group",null,null,"Accidental Dental",null,null,"Network",2,{"$f":"MAX(IF(NOT(ISBLANK(INDIRECT(\"'\" & Q9 & \"'\" & \"!\" & \"A\" & R9 & \":\" & IF(T9-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T9-1-1,26)-26*27,26),26)-1),\"\")&IF(T9-1>26,CHAR(65+MOD(QUOTIENT(T9-1-1-26,26),26)),\"\")&CHAR(65+MOD(T9-1-1,26)) & R9 ))),COLUMN(INDIRECT(\"'\" & Q9 & \"'\" & \"!\" & \"A\" & R9 & \":\" & IF(T9-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T9-1-1,26)-26*27,26),26)-1),\"\")&IF(T9-1>26,CHAR(65+MOD(QUOTIENT(T9-1-1-26,26),26)),\"\")&CHAR(65+MOD(T9-1-1,26)) & R9 )),0))","v":7},51,52]
["DC",null,null,null,null,"Admission(s)","PPO",null,"Accredited",null,"Both",null,null,null,null,null,"NCQA",2,{"$f":"MAX(IF(NOT(ISBLANK(INDIRECT(\"'\" & Q10 & \"'\" & \"!\" & \"A\" & R10 & \":\" & IF(T10-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T10-1-1,26)-26*27,26),26)-1),\"\")&IF(T10-1>26,CHAR(65+MOD(QUOTIENT(T10-1-1-26,26),26)),\"\")&CHAR(65+MOD(T10-1-1,26)) & R10 ))),COLUMN(INDIRECT(\"'\" & Q10 & \"'\" & \"!\" & \"A\" & R10 & \":\" & IF(T10-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T10-1-1,26)-26*27,26),26)-1),\"\")&IF(T10-1>26,CHAR(65+MOD(QUOTIENT(T10-1-1-26,26),26)),\"\")&CHAR(65+MOD(T10-1-1,26)) & R10 )),0))","v":10},51,52]
["DE",null,"$ Copay per Stay",null,null,null,"HMO",null,"Interim",null,null,null,null,"Cross Check Field","Category",null,"URAC",2,{"$f":"MAX(IF(NOT(ISBLANK(INDIRECT(\"'\" & Q11 & \"'\" & \"!\" & \"A\" & R11 & \":\" & IF(T11-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T11-1-1,26)-26*27,26),26)-1),\"\")&IF(T11-1>26,CHAR(65+MOD(QUOTIENT(T11-1-1-26,26),26)),\"\")&CHAR(65+MOD(T11-1-1,26)) & R11 ))),COLUMN(INDIRECT(\"'\" & Q11 & \"'\" & \"!\" & \"A\" & R11 & \":\" & IF(T11-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T11-1-1,26)-26*27,26),26)-1),\"\")&IF(T11-1>26,CHAR(65+MOD(QUOTIENT(T11-1-1-26,26),26)),\"\")&CHAR(65+MOD(T11-1-1,26)) & R11 )),0))","v":7},51,52]
["FL",null,"$ Copay per Day",null,null,"Year","POS",null,null,null,"There are rates specifically for couples and for families (not just addition of individual rates)",null,null,"AV Calculator Output Number*","Actuarial Value",null,"URR",2,{"$f":"MAX(IF(NOT(ISBLANK(INDIRECT(\"'\" & Q12 & \"'\" & \"!\" & \"A\" & R12 & \":\" & IF(T12-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T12-1-1,26)-26*27,26),26)-1),\"\")&IF(T12-1>26,CHAR(65+MOD(QUOTIENT(T12-1-1-26,26),26)),\"\")&CHAR(65+MOD(T12-1-1,26)) & R12 ))),COLUMN(INDIRECT(\"'\" & Q12 & \"'\" & \"!\" & \"A\" & R12 & \":\" & IF(T12-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T12-1-1,26)-26*27,26),26)-1),\"\")&IF(T12-1>26,CHAR(65+MOD(QUOTIENT(T12-1-1-26,26),26)),\"\")&CHAR(65+MOD(T12-1-1,26)) & R12 )),0))","v":16},51]
["FM",null,null,null,null,"Benefit Period","EPO",null,"Full",null,"A different rate (specifically for parties of two or more)for each enrollee is added together",null,null,"AV Metal Value","Actuarial Value",null,"BusinessRules",2,{"$f":"MAX(IF(NOT(ISBLANK(INDIRECT(\"'\" & Q13 & \"'\" & \"!\" & \"A\" & R13 & \":\" & IF(T13-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T13-1-1,26)-26*27,26),26)-1),\"\")&IF(T13-1>26,CHAR(65+MOD(QUOTIENT(T13-1-1-26,26),26)),\"\")&CHAR(65+MOD(T13-1-1,26)) & R13 ))),COLUMN(INDIRECT(\"'\" & Q13 & \"'\" & \"!\" & \"A\" & R13 & \":\" & IF(T13-1>26*(26+1),CHAR(65+MOD(QUOTIENT(QUOTIENT(T13-1-1,26)-26*27,26),26)-1),\"\")&IF(T13-1>26,CHAR(65+MOD(QUOTIENT(T13-1-1-26,26),26)),\"\")&CHAR(65+MOD(T13-1-1,26)) & R13 )),0))","v":16},51,52]
["GA",null,"Primary Care",null,null,"Lifetime",null,null,"Conditional",null,null,null,null,"Actuarial Value","Actuarial Value"]
["GU",null,"Specialty Care",null,null,"Month","On the Exchange",null,"Provisional",null,1,null,null,"Issuer Actuarial Value","Actuarial Value"]
["HI",null,"Pharmacy",null,null,"Episode","Off the Exchange",null,null,null,2,null,null,"CountyFIPS","Service Area ID"]
["IA",null,"Hospital",null,null,"Stay","Both",null,"All Generics",null,"3 or more",null,null,"CountyFIPS associated with Rating Area","Service Area ID"]
["ID",null,"Ancillary Services",null,null,"Transplant",null,null,"All Preferred Generics",null,null,null,null,"Effective Date (of rate change)","Effective Date"]
["IL",null,"NA",null,null,"6 Months","Allows Adult and Child-Only",null,"All Non-Preferred Generics",null,"Age on effective date",null,null,"EHB Apportionment for Pediatric Dental","Pediatric Dental"]
["IN",null,null,null,null,"2 Years","Allows Adult-Only",null,"Only Select Generics",null,"Age on January 1st of the effective date year",null,null,"Exchange Plan?","On / Off Exchange"]
["KS",null,"FQHC",null,null,"3 Years","Allows Child-Only",null,"All Brands",null,"Age on insurance date (age on birthday nearest the effective date)",null,null,"Federal TIN*","TIN"]
["KY",null,"Hospital",null,null,"Procedure",null,null,"All Preferred Brands",null,"Age on January 1st or July 1st",null,null,"Formulary ID","Formulary ID"]
["LA",null,"Ryan White HIV Provider",null,null,"Week","Individual",null,"All Non-Preferred Brands",null,null,null,null,"HIOS Issuer ID","Issuer ID"]
["MA",null,"Indian Provider",null,null,"Admission","Small Group",null,"Only Select Brands",null,"Spouse",null,null,"HIOS Issuer ID*","Issuer ID"]
["MD",null,"Family Planning Provider",null,null,null,"Combined",null,null,null,"Adopted Child",null,null,"HIOS Issuer ID* ","Issuer ID"]
["ME",null,"Other ECP",null,null,"Asthma",null,null,"Copayment",null,"Foster Child",null,null,"HIOS Plan ID (Standard Component)","Plan ID"]
["MH",null,"NA",null,null,"Heart Disease","Commercial",null,"Coinsurance",null,"Ward",null,null,"HIOS Product ID","Product ID"]
["MI",null,null,null,null,"Depression","Exchange",null,"Lesser of Copayment or Coinsurance",null,"Stepson Or Stepdaughter",null,null,"How is tobacco status determined for subscribers and dependents?","Tobacco"]
["MN",null,null,null,null,"Diabetes","Medicaid",null,"Greater of Copayment or Coinsurance",null,"Self",null,null,"Individual Tobacco Rate*","Tobacco"]
["MO",null,null,null,null,"High Blood Pressure & High Cholesterol",null,null,null,null,"Child",null,null,"Issuer ID","Issuer ID"]
["MP",null,null,null,null,"Low Back Pain",null,null,"Yes",null,"Life Partner",null,null,"Issuer State","State"]
["MS",null,null,null,null,"Pain Management","Individual",null,"No",null,"Other Relationship",null,null,"Issuer State*","State"]
["MT",null,null,null,null,"Pregnancy","SHOP (Small Group)",null,null,null,null,null,null,"Issuer State1","State"]
["NC",null,null,null,null,null,"Both",null,null,null,null,null,null,"Level of Coverage","Metal"]
["ND",null,null,null,null,1,null,null,null,null,null,null,null,"Market","Market"]
["NE",null,null,null,null,2,null,null,null,null,null,null,null,"Market Coverage","Market"]
["NH",null,null,null,null,3,null,null,null,null,null,null,null,"Metal","Metal"]
["NJ",null,null,null,null,4,null,null,null,null,null,null,null,"Network ID","Network ID"]
["NM",null,null,null,null,5,null,null,null,null,null,null,null,"Network ID*","Network ID"]
["NV",null,null,null,null,7,null,null,null,null,null,null,null,"Network IDs*","Network ID"]
["NY",null,null,null,null,8,null,null,null,null,null,null,null,"Plan Effective Date","Effective Date"]
["OH",null,null,null,null,9,null,null,null,null,null,null,null,"Plan ID \n(Standard Component)","Plan ID"]
["OK",null,null,null,null,10,null,null,null,null,null,null,null,"Plan ID (Standard Component ID)","Plan ID"]
["OR",null,null,null,null,11,null,null,null,null,null,null,null,"Plan ID*","Plan ID"]
["PA",null,null,null,null,12,null,null,null,null,null,null,null,"Plan Type","Plan Type"]
["PR",null,null,null,null,13,null,null,null,null,null,null,null,"Product ID","Product ID"]
["PW",null,null,null,null,14,null,null,null,null,null,null,null,"QHP/Non-QHP","On / Off Exchange"]
["RI",null,null,null,null,15,null,null,null,null,null,null,null,"Rate Effective Date*","Effective Date"]
["SC",null,null,null,null,16,null,null,null,null,null,null,null,"Service Area ID","Service Area ID"]
["SD",null,null,null,null,17,null,null,null,null,null,null,null,"State","State"]
["TN",null,null,null,null,18,null,null,null,null,null,null,null,"TIN","TIN"]
["TX",null,null,null,null,19,null,null,null,null,null,null,null,"TIN*","TIN"]
["UT",null,null,null,null,20,null,null,null,null,null,null,null,"Tobacco*","Tobacco"]
["VA",null,null,null,null,21,null,null,null,null,null,null,null,"Age*","Age"]
["VI",null,null,null,null,22,null,null,null,null,null,null,null,"How are rates for contracts covering two or more enrollees calculated?","Age"]
["VT",null,null,null,null,23]
["WA",null,null,null,null,24]
["WI",null,null,null,null,25]
["WV",null,null,null,null,26]
["WY"]
[null,null,null,null,"Template Names should match the tab names EXACTLY - Reference for CrossChecks"]
[null,null,null,null,"Field names below should match the names in headers EXACTLY - Reference for CrossChecks",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Template Names should match the tab names EXACTLY - Reference for CrossChecks",null,null,null,null,null,null,null,null,null,null,null,null,null,"Template Names should match the tab names EXACTLY - Reference for CrossChecks"]
[null,null,null,null,"Yellow rows use unique rules for cross checks, please refer to the VBA code",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Field names below should match the names in headers EXACTLY - Reference for CrossChecks",null,null,null,null,null,null,null,null,null,null,null,null,null,"The following Cross Validations should be conducted between tabs of increasing indexes (e.g., 1 and 2, 1 and 11, 5 and 6)"]
["FIPScode","State","County",null,"Include?",{"$f":"IF(VLOOKUP(F66,CrossChecks,2,0) = TRUE, 1,0)","v":0},0,1,0,0,0,0,0,0,0,0,1,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"The language in the matrix indicates the error type to be used."]
["01001","AL","Autauga",null,"XCheck_Field1",1,2,3,4,5,6,7,8,9,10,11,12,null,"XCheck_Field2",1,2,3,4,5,6,7,8,9,10,11,12,null,"XCheck_Field3",1,2,3,4,5,6,7,8,9,10,11,12,null,"Fwd Xcheck",1,2,3,4,5,6,7,8,9,10,11,12]
["01003","AL","Baldwin",null,"RefNo.","P&B","Admin","Rate","Drug","DrugList","ECP","ServiceArea","Network","NCQA","URAC","URR","BusinessRules",null,"RefNo.","P&B","Admin","Rate","Drug","DrugList","ECP","ServiceArea","Network","NCQA","URAC","URR","BusinessRules",null,"RefNo.","P&B","Admin","Rate","Drug","DrugList","ECP","ServiceArea","Network","NCQA","URAC","URR","BusinessRules",null,"RefNo.","P&B","Admin","Rate","Drug","DrugList","ECP","ServiceArea","Network","NCQA","URAC","URR","BusinessRules",null,"Master Table (reference for Fwd and Bwd Xchecks)"]
["01005","AL","Barbour",null,1,"HIOS Issuer ID","Issuer ID","HIOS Issuer ID*","HIOS Issuer ID","HIOS Issuer ID* ","HIOS Issuer ID","HIOS Issuer ID","HIOS Issuer ID*","HIOS Issuer ID","HIOS Issuer ID","HIOS Issuer ID","HIOS Issuer ID*",null,1,"NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA",null,1,"NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA",null,1,"Error","Error","Error","Error","Error","Error","Error","Error","Error","Error","Error","X",null,"Error","Error","Error","Error","Error","Error","Error","Error","Error","Error","Error","Error"]
["01007","AL","Bibb",null,2,"TIN","TIN","Federal TIN*","NA","NA","NA","NA","NA","NA","NA","NA","TIN*",null,2,"HIOS Issuer ID","Issuer ID","HIOS Issuer ID*","NA","NA","NA","NA","NA","NA","NA","NA","HIOS Issuer ID*",null,2,"NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA",null,2,"Error","Error","Error","NA","NA","NA","NA","NA","NA","NA","NA","X",null,"Error","Error","Error","NA","NA","NA","NA","NA","NA","NA","NA","Error"]
["01009","AL","Blount",null,3,"State","Issuer State1","NA","Issuer State","NA","Issuer State","State","Issuer State*","NA","NA","State","NA",null,3,"HIOS Issuer ID","Issuer ID","NA","HIOS Issuer ID","NA","HIOS Issuer ID","HIOS Issuer ID","HIOS Issuer ID*","NA","NA","HIOS Issuer ID","NA",null,3,"NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA",null,3,"Error","Error","NA","Error","NA","Error","Error","Error","NA","NA","Error","X",null,"Error","Error","NA","Error","NA","Error","Error","Error","NA","NA","Error","NA"]
["01011","AL","Bullock",null,4,"Network ID","NA","NA","NA","NA","Network IDs*","NA","Network ID*","NA","NA","NA","NA",null,4,"HIOS Issuer ID","NA","NA","NA","NA","HIOS Issuer ID","NA","HIOS Issuer ID*","NA","NA","NA","NA",null,4,"NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA",null,4,"Error","NA","NA","NA","NA","Error","NA","Error","NA","NA","NA","X",null,"Error","NA","NA","NA","NA","Error","NA","Error","NA","NA","NA","NA"]
["01013","AL","Butler",null,5,"Plan Effective Date","NA","Rate Effective Date*","NA","NA","NA","NA","NA","NA","NA","Effective Date (of rate change)","NA",null,5,"HIOS Plan ID (Standard Component)","NA","Plan ID*","NA","NA","NA","NA","NA","NA","NA","Plan ID (Standard Component ID)","NA",null,5,"HIOS Issuer ID","NA","HIOS Issuer ID*","NA","NA","NA","NA","NA","NA","NA","HIOS Issuer ID","NA",null,5,"Error","NA","Error","NA","NA","NA","NA","NA","NA","NA","Error","X",null,"Error","NA","Error","NA","NA","NA","NA","NA","NA","NA","Error","NA"]
["01015","AL","Calhoun",null,6,"Market Coverage","NA","NA","NA","NA","NA","NA","NA","NA","NA","Market","NA",null,6,"HIOS Plan ID (Standard Component)","NA","NA","NA","NA","NA","NA","NA","NA","NA","Plan ID (Standard Component ID)","NA",null,6,"HIOS Issuer ID","NA","NA","NA","NA","NA","NA","NA","NA","NA","HIOS Issuer ID","NA",null,6,"Error","NA","NA","NA","NA","NA","NA","NA","NA","NA","Error","X",null,"Error","NA","NA","NA","NA","NA","NA","NA","NA","NA","Error","NA"]
["01017","AL","Chambers",null,7,"NA","NA","Tobacco*","NA","NA","NA","NA","NA","NA","NA","NA","How is tobacco status determined for subscribers and dependents?",null,7,"NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA",null,7,"NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA",null,7,"NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","X",null,{"$f":"IF(AV73<>\"NA\", \"Row \"&ROW()-66,\"NA\")","v":"NA"},"NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA"]
["01019","AL","Cherokee",null,7,"AV Calculator Output Number*","NA","NA","NA","NA","NA","NA","NA","NA","NA","AV Metal Value","NA",null,8,"HIOS Plan ID (Standard Component)","NA","NA","NA","NA","NA","NA","NA","NA","NA","Plan ID (Standard Component ID)","NA",null,8,"HIOS Issuer ID","NA","NA","NA","NA","NA","NA","NA","NA","NA","HIOS Issuer ID","NA",null,8,"Warning","NA","NA","NA","NA","NA","NA","NA","NA","NA","Warning","X",null,"Error","NA","NA","NA","NA","NA","NA","NA","NA","NA","Error","NA"]
["01021","AL","Chilton",null,9,"Formulary ID","NA","NA","Formulary ID","NA","NA","NA","NA","NA","NA","NA","NA",null,9,"HIOS Issuer ID","NA","NA","HIOS Issuer ID","NA","NA","NA","NA","NA","NA","NA","NA",null,9,"NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA",null,9,"Error","NA","NA","Error","NA","NA","NA","NA","NA","NA","NA","X",null,"Error","NA","NA","Error","NA","NA","NA","NA","NA","NA","NA","NA"]
["01023","AL","Choctaw",null,10,"HIOS Plan ID (Standard Component)","NA","Plan ID*","NA","NA","NA","NA","NA","NA","NA","Plan ID (Standard Component ID)","Plan ID \n(Standard Component)",null,10,"HIOS Issuer ID","NA","HIOS Issuer ID*","NA","NA","NA","NA","NA","NA","NA","HIOS Issuer ID","HIOS Issuer ID*",null,10,"NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA",null,10,"Error","NA","Error","NA","NA","NA","NA","NA","NA","NA","Error","X",null,"Error","NA","Error","NA","NA","NA","NA","NA","NA","NA","Error","NA"]
["01025","AL","Clarke",null,11,"Service Area ID","NA","NA","NA","NA","NA","Service Area ID","NA","NA","NA","NA","NA",null,11,"HIOS Issuer ID","NA","NA","NA","NA","NA","HIOS Issuer ID","NA","NA","NA","NA","NA",null,11,"NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA",null,11,"Error","NA","NA","NA","NA","NA","Error","NA","NA","NA","NA","X",null,"Error","NA","NA","NA","NA","NA","Error","NA","NA","NA","NA","NA"]
["01027","AL","Clay",null,12,"QHP/Non-QHP","NA","NA","NA","NA","NA","NA","NA","NA","NA","Exchange Plan?","NA",null,12,"HIOS Plan ID (Standard Component)","NA","NA","NA","NA","NA","NA","NA","NA","NA","Plan ID (Standard Component ID)","NA",null,12,"HIOS Issuer ID","NA","NA","NA","NA","NA","NA","NA","NA","NA","HIOS Issuer ID","NA",null,12,"Error","NA","NA","NA","NA","NA","NA","NA","NA","NA","Error","X",null,"Error","NA","NA","NA","NA","NA","NA","NA","NA","NA","Error","NA"]
["01029","AL","Cleburne",null,13,"Plan Type","NA","NA","NA","NA","NA","NA","NA","NA","NA","Plan Type","NA",null,13,"HIOS Plan ID (Standard Component)","NA","NA","NA","NA","NA","NA","NA","NA","NA","Plan ID (Standard Component ID)","NA",null,13,"HIOS Issuer ID","NA","NA","NA","NA","NA","NA","NA","NA","NA","HIOS Issuer ID","NA",null,13,"Error","NA","NA","NA","NA","NA","NA","NA","NA","NA","Error","X",null,"Error","NA","NA","NA","NA","NA","NA","NA","NA","NA","Error","NA"]
["01031","AL","Coffee",null,14,"HIOS Product ID","NA","NA","NA","NA","NA","NA","NA","Product ID","NA","Product ID","Product ID",null,14,"HIOS Issuer ID","NA","NA","NA","NA","NA","NA","NA","HIOS Issuer ID","NA","HIOS Issuer ID","HIOS Issuer ID*",null,14,"NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA",null,14,"Error","NA","NA","NA","NA","NA","NA","NA","Error","NA","Error","X",null,"Error","NA","NA","NA","NA","NA","NA","NA","Error","NA","Error","Error"]
["01033","AL","Colbert",null,15,"Level of Coverage","NA","NA","NA","NA","NA","NA","NA","NA","NA","Metal","NA",null,15,"HIOS Plan ID (Standard Component)","NA","NA","NA","NA","NA","NA","NA","NA","NA","Plan ID (Standard Component ID)","NA",null,15,"HIOS Issuer ID","NA","NA","NA","NA","NA","NA","NA","NA","NA","HIOS Issuer ID","NA",null,15,"Error","NA","NA","NA","NA","NA","NA","NA","NA","NA","Error","X",null,"Error","NA","NA","NA","NA","NA","NA","NA","NA","NA","Error","NA"]
["01035","AL","Conecuh",null,16,"EHB Apportionment for Pediatric Dental ","NA","Individual Rate*","NA","NA","NA","NA","NA","NA","NA","NA","NA",null,16,"HIOS Plan ID (Standard Component)","NA","Plan ID*","NA","NA","NA","NA","NA","NA","NA","NA","NA",null,16,"HIOS Issuer ID","NA","HIOS Issuer ID*","NA","NA","NA","NA","NA","NA","NA","NA","NA",null,16,{"$f":"IF(AJ82<>\"NA\", \"Row \"&ROW()-66,\"NA\")","v":"Row 16"},"NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","X",null,{"$f":"IF(AV82<>\"NA\", \"Row \"&ROW()-66,\"NA\")","v":"Row 16"},"NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA"]
["01037","AL","Coosa",null,17,"Plan Marketing Name","NA","NA","NA","NA","NA","NA","NA","NA","NA","Plan Name","NA",null,17,"HIOS Plan ID (Standard Component)","NA","NA","NA","NA","NA","NA","NA","NA","NA","Plan ID (Standard Component ID)","NA",null,17,"HIOS Issuer ID","NA","NA","NA","NA","NA","NA","NA","NA","NA","HIOS Issuer ID","NA",null,17,"Error","NA","NA","NA","NA","NA","NA","NA","NA","NA","Error","X",null,{"$f":"IF(AV83<>\"NA\", \"Row \"&ROW()-66,\"NA\")","v":"Row 17"},"NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA"]
["01039","AL","Covington",null,18,"NA","NA","Age*","NA","NA","NA","NA","NA","NA","NA","NA","How are rates for contracts covering two or more enrollees calculated?",null,18,"NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA",null,18,"NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA",null,18,{"$f":"IF(AJ84<>\"NA\", \"Row \"&ROW()-66,\"NA\")","v":"NA"},"NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","X",null,{"$f":"IF(AV84<>\"NA\", \"Row \"&ROW()-66,\"NA\")","v":"NA"},"NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA"]
["01041","AL","Crenshaw"]
["01043","AL","Cullman",null,"ColumNumbers listed below.  Minus 1 is fill-in for \"Not applicable.  Matrix updates dynamically based on values in XCheck_Field1 Matrix",null,null,null,null,null,null,null,null,null,null,null,null,null,"ColumNumbers listed below.  Minus 1 is fill-in for \"Not applicable.  Matrix updates dynamically based on values in XCheck_Field2 Matrix",null,null,null,null,null,null,null,null,null,null,null,null,null,"ColumNumbers listed below.  Minus 1 is fill-in for \"Not applicable.  Matrix updates dynamically based on values in XCheck_Field3 Matrix",null,null,null,null,null,null,null,null,null,null,null,null,null,"The following Cross Validations should be conducted between tabs of decreasing indexes (e.g., 2 and 1, 11 and 1, 6 and 5)"]
["01045","AL","Dale",null,"HeaderRange","A3:BD3","A2:M2","A2:S2","A2:Y2","A2:K2","A2:P2","A2:K2","A2:G2","A2:K2","A2:G2","A2:R2","A2:P2",null,"HeaderRange","A3:BD3","A2:M2","A2:S2","A2:Y2","A2:K2","A2:P2","A2:K2","A2:G2","A2:K2","A2:G2","A2:Q2","A2:P2",null,"HeaderRange","A3:BD3","A2:M2","A2:S2","A2:Y2","A2:K2","A2:P2","A2:K2","A2:G2","A2:K2","A2:G2","A2:Q2","A2:P2",null,"The language in the matrix indicates the error type to be used."]
["01047","AL","Dallas",null,"Columns",1,2,3,4,5,6,7,8,9,10,11,12,null,"Columns",1,2,3,4,5,6,7,8,9,10,11,12,null,"Columns",1,2,3,4,5,6,7,8,9,10,11,12,null,"Bckwd Xcheck",1,2,3,4,5,6,7,8,9,10,11,12]
["01049","AL","De Kalb",null,"RefNo.","P&B","Admin","Rate","Drug","DrugList","ECP","ServiceArea","Network","NCQA","URAC","URR","BusinessRules",null,"RefNo.","P&B","Admin","Rate","Drug","DrugList","ECP","ServiceArea","Network","NCQA","URAC","URR","BusinessRules",null,"RefNo.","P&B","Admin","Rate","Drug","DrugList","ECP","ServiceArea","Network","NCQA","URAC","URR","BusinessRules",null,"RefNo.","P&B","Admin","Rate","Drug","DrugList","ECP","ServiceArea","Network","NCQA","URAC","URR","BusinessRules"]
["01051","AL","Elmore",null,1,{"$f":"IF(F67=\"NA\",-1,MATCH(F67,INDIRECT(\"'\"&F$89&\"'!\"&F$87),0))","v":3},3,3,3,3,4,3,3,3,3,4,3,null,1,{"$f":"IF(T67=\"NA\",-1,MATCH(T67,INDIRECT(\"'\"&T$89&\"'!\"&T$87),0))","v":-1},-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,null,1,{"$f":"IF(AH67=\"NA\",-1,MATCH(AH67,INDIRECT(\"'\"&AH$89&\"'!\"&AH$87),0))","v":-1},-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,null,1,"X","Error","Error","Error","Error","Error","Error","Error","Error","Error","NA","Error"]
["01053","AL","Escambia",null,2,7,11,4,-1,-1,-1,-1,-1,-1,-1,-1,4,null,2,3,3,3,-1,-1,-1,-1,-1,-1,-1,-1,3,null,2,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,null,2,"X","Error","Error","NA","NA","NA","NA","NA","NA","NA","NA","Error"]
["01055","AL","Etowah",null,3,4,4,-1,4,-1,5,4,4,-1,-1,5,-1,null,3,3,3,-1,3,-1,4,3,3,-1,-1,4,-1,null,3,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,null,3,"X","Error","NA","Error","NA","Error","Error","Error","NA","NA","NA","NA"]
["01057","AL","Fayette",null,4,12,-1,-1,-1,-1,16,-1,6,-1,-1,-1,-1,null,4,3,-1,-1,-1,-1,4,-1,3,-1,-1,-1,-1,null,4,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,null,4,"X","NA","NA","NA","NA","Error","NA","NA","NA","NA","NA","NA"]
["01059","AL","Franklin",null,5,38,-1,5,-1,-1,-1,-1,-1,-1,-1,8,-1,null,5,8,-1,7,-1,-1,-1,-1,-1,-1,-1,15,-1,null,5,3,-1,3,-1,-1,-1,-1,-1,-1,-1,4,-1,null,5,"X","NA","Error","NA","NA","NA","NA","NA","NA","NA","NA","NA"]
["01061","AL","Geneva",null,6,5,-1,-1,-1,-1,-1,-1,-1,-1,-1,6,-1,null,6,8,-1,-1,-1,-1,-1,-1,-1,-1,-1,15,-1,null,6,3,-1,-1,-1,-1,-1,-1,-1,-1,-1,4,-1,null,6,"X","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA"]
["01063","AL","Greene",null,7,-1,-1,9,-1,-1,-1,-1,-1,-1,-1,-1,15,null,7,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,null,7,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,null,7,"X","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA"]
["01065","AL","Hale",null,8,51,-1,-1,-1,-1,-1,-1,-1,-1,-1,11,-1,null,8,8,-1,-1,-1,-1,-1,-1,-1,-1,-1,15,-1,null,8,3,-1,-1,-1,-1,-1,-1,-1,-1,-1,4,-1,null,8,"X","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA"]
["01067","AL","Henry",null,9,14,-1,-1,5,-1,-1,-1,-1,-1,-1,-1,-1,null,9,3,-1,-1,3,-1,-1,-1,-1,-1,-1,-1,-1,null,9,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,null,9,"X","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA"]
["01069","AL","Houston",null,10,8,-1,7,-1,-1,-1,-1,-1,-1,-1,15,6,null,10,3,-1,3,-1,-1,-1,-1,-1,-1,-1,4,3,null,10,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,null,10,"X","NA","Error","NA","NA","NA","NA","NA","NA","NA","NA","NA"]
["01071","AL","Jackson",null,11,13,-1,-1,-1,-1,-1,5,-1,-1,-1,-1,-1,null,11,3,-1,-1,-1,-1,-1,3,-1,-1,-1,-1,-1,null,11,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,null,11,"X","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA"]
["01073","AL","Jefferson",null,12,19,-1,-1,-1,-1,-1,-1,-1,-1,-1,16,-1,null,12,8,-1,-1,-1,-1,-1,-1,-1,-1,-1,15,-1,null,12,3,-1,-1,-1,-1,-1,-1,-1,-1,-1,4,-1,null,12,"X","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA"]
["01075","AL","Lamar",null,13,16,-1,-1,-1,-1,-1,-1,-1,-1,-1,13,-1,null,13,8,-1,-1,-1,-1,-1,-1,-1,-1,-1,15,-1,null,13,3,-1,-1,-1,-1,-1,-1,-1,-1,-1,4,-1,null,13,"X","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA"]
["01077","AL","Lauderdale",null,14,10,-1,-1,-1,-1,-1,-1,-1,8,-1,9,5,null,14,3,-1,-1,-1,-1,-1,-1,-1,3,-1,4,3,null,14,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,null,14,"X","NA","NA","NA","NA","NA","NA","NA","Error","NA","NA","Error"]
["01079","AL","Lawrence",null,15,17,-1,-1,-1,-1,-1,-1,-1,-1,-1,10,-1,null,15,8,-1,-1,-1,-1,-1,-1,-1,-1,-1,15,-1,null,15,3,-1,-1,-1,-1,-1,-1,-1,-1,-1,4,-1,null,15,"X","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA"]
["01081","AL","Lee",null,16,32,-1,11,-1,-1,-1,-1,-1,-1,-1,-1,-1,null,16,8,-1,7,-1,-1,-1,-1,-1,-1,-1,-1,-1,null,16,3,-1,3,-1,-1,-1,-1,-1,-1,-1,-1,-1,null,16,"X","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA"]
["01083","AL","Limestone",null,17,{"$f":"IF(F83=\"NA\",-1,MATCH(F83,INDIRECT(\"'\"&F$89&\"'!\"&F$87),0))","v":9},-1,-1,-1,-1,-1,-1,-1,-1,-1,14,-1,null,17,{"$f":"IF(T83=\"NA\",-1,MATCH(T83,INDIRECT(\"'\"&T$89&\"'!\"&T$87),0))","v":8},-1,-1,-1,-1,-1,-1,-1,-1,-1,15,-1,null,17,{"$f":"IF(AH83=\"NA\",-1,MATCH(AH83,INDIRECT(\"'\"&AH$89&\"'!\"&AH$87),0))","v":3},-1,-1,-1,-1,-1,-1,-1,-1,-1,4,-1,null,17,"X","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA"]
["01085","AL","Lowndes",null,18,-1,-1,10,-1,-1,-1,-1,-1,-1,-1,-1,7,null,18,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,null,18,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,-1,null,18,"X","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA","NA"]
["01087","AL","Macon"]
["01089","AL","Madison"]
["01091","AL","Marengo",null,"State & Federal Rate Curves, Normalized for Age 21",null,null,null,null,null,"Small Group Only",null,"Tobacco Rating Ratios (MUST have individual and small market ratios in columns N and O, respectively)"]
["01093","AL","Marion",null,"Age (years)","Federal","DC","MA","MN","UT","NJ",null,"State","Individual Ratio","Small Market Ratio"]
["01095","AL","Marshall",null,1,2,3,4,5,6,7,null,"AR",1.2,1.2]
["01097","AL","Mobile",null,"0-20",0.63500000000000001,0.89958734525447048,0.63482671174978866,0.89,0.79300000000000004,0.6,null,"CA",1,1]
["01099","AL","Monroe",null,21,1,1,1,1,1,1,null,"CO",1.1499999999999999,1.1499999999999999]
["01101","AL","Montgomery",null,22,1,1,1,1,1.05,1,null,"CT",1.5,1]
["01103","AL","Morgan",null,23,1,1,1,1,1.113,1,null,"DC",1,1]
["01105","AL","Perry",null,24,1,1,1,1,1.1910000000000001,1,null,"KY",1.4,1.4]
["01107","AL","Pickens",null,25,1.004,1,1,1.004,1.298,1,null,"MA",1,1]
["01109","AL","Pike",null,26,1.024,1,1,1.024,1.363,1,null,"NJ",1,1]
["01111","AL","Randolph",null,27,1.048,1,1.0312764158918004,1.048,1.39,1,null,"NY",1,1]
["01113","AL","Russell",null,28,1.087,1.0233837689133425,1.0566356720202874,1.087,1.39,1,null,"OR",1.5,1.5]
["01115","AL","St. Clair",null,29,1.119,1.0453920220082531,1.077768385460693,1.119,1.39,1.02,null,"RI",1,1]
["01117","AL","Shelby",null,30,1.135,1.0715268225584595,1.0879120879120878,1.135,1.39,1.0295999999999998,null,"VT",1,1]
["01119","AL","Sumter",null,31,1.159,1.0990371389270976,1.10312764158918,1.159,1.39,1.044]
["01121","AL","Talladega",null,32,1.1830000000000001,1.123796423658872,1.1183431952662721,1.1830000000000001,1.39,1.0584,null,"Community Rating Rates (Must be in column M with Couple starting in column N)"]
["01123","AL","Tallapoosa",null,33,1.198,1.1499312242090785,1.1276415891800506,1.198,1.39,1.0672000000000001,null,"State","Couple *","Primary Subscriber and One Dependent*","Primary Subscriber and Two Dependents*","Primary Subscriber and Three or More Dependents*","Couple and One Dependent*","Couple and Two Dependents*","Couple and Three or More Dependents*"]
["01125","AL","Tuscaloosa",null,34,1.214,1.1774415405777165,1.1377852916314455,1.214,1.39,1.0768,null,"NY",2,1.7,1.7,1.7,2.85,2.85,2.85]
["01127","AL","Walker",null,35,1.222,1.2049518569463549,1.1428571428571428,1.222,1.39,1.0816000000000001,null,"VT",2,1.93,1.93,1.93,2.81,2.81,2.81]
["01129","AL","Washington",null,36,1.23,1.2324621733149932,1.1479289940828403,1.23,1.39,1.0864]
["01131","AL","Wilcox",null,37,1.238,1.2599724896836315,1.1521555367709213,1.238,1.4039999999999999,1.0904]
["01133","AL","Winston",null,38,1.246,1.2751031636863825,1.1572273879966186,1.246,1.425,1.0952]
["02010","AK","Aleutian ",null,39,1.262,1.2902338376891334,1.1673710904480135,1.262,1.45,1.1048]
["02013","AK","Aleutians East",null,40,1.278,1.3411279229711142,1.1775147928994083,1.278,1.4790000000000001,1.1144000000000001]
["02016","AK","Aleutians West",null,41,1.302,1.3933975240715266,1.1918850380388841,1.302,1.516,1.1279999999999999]
["02020","AK","Anchorage",null,42,1.325,1.4484181568088033,1.2062552831783602,1.325,1.5620000000000001,1.1415999999999999]
["02030","AK","Angoon ",null,43,1.357,1.5048143053645118,1.2256973795435333,1.357,1.6160000000000001,1.1599999999999999]
["02040","AK","Barrow-North Slope ",null,44,1.397,1.563961485557084,1.2493660185967879,1.397,1.681,1.1823999999999999]
["02050","AK","Bethel",null,45,1.444,1.6244841815680882,1.2772612003381232,1.444,1.748,1.2087999999999999]
["02060","AK","Bristol Bay Borough",null,46,1.5,1.6877579092159563,1.3102282333051563,1.5,1.8180000000000001,1.24]
["02068","AK","Denali ",null,47,1.5629999999999999,1.7537826685006876,1.3465765004226542,1.5629999999999999,1.891,1.2744]
["02070","AK","Dillingham",null,48,1.635,1.8225584594222835,1.3871513102282333,1.635,1.966,1.3128]
["02080","AK","Cordova-Mc Carthy ",null,49,1.706,1.8940852819807428,1.4268808114961959,1.706,2.0449999999999999,1.3504]
["02090","AK","Fairbanks North Star",null,50,1.786,1.9683631361760661,1.4716821639898563,1.786,2.1269999999999998,1.3928]
["02100","AK","Haines",null,51,1.865,2.0453920220082531,1.514792899408284,1.865,2.2120000000000002,1.4336]
["02105","AK","Hoonah-Angoon",null,52,1.952,2.1251719394773039,1.5612848689771766,1.952,2.2999999999999998,1.4776]
["02110","AK","Juneau",null,53,2.04,2.2077028885832188,1.6077768385460691,2.04,2.3919999999999999,1.5215999999999998]
["02120","AK","Kenai-Cook Inlet ",null,54,2.1349999999999998,2.294360385144429,1.6576500422654268,2.1349999999999998,2.488,1.5688]
["02122","AK","Kenai Peninsula",null,55,2.23,2.3837689133425037,1.7066779374471683,2.23,2.5880000000000001,1.6152000000000002]
["02130","AK","Ketchikan Gateway",null,56,2.3330000000000002,2.4773039889958732,1.7582417582417582,2.3330000000000002,2.6909999999999998,1.6640000000000001]
["02140","AK","Kobuk ",null,57,2.4369999999999998,2.5735900962861074,1.8106508875739644,2.4369999999999998,2.7989999999999999,1.7136]
["02150","AK","Kodiak Island",null,58,2.548,2.6740027510316366,1.8647506339814031,2.548,2.911,1.7647999999999999]
["02160","AK","Kuskokwin ",null,59,2.6030000000000002,2.7785419532324624,1.9273034657650039,2.6030000000000002,3,1.8239999999999998]
["02164","AK","Lake And Peninsula",null,60,2.714,2.8872077028885834,1.9991546914623839,2.714,3,1.8239999999999998]
["02170","AK","Matanuska-Susitna",null,61,2.81,3,1.9991546914623839,2.81,3,1.8239999999999998]
["02180","AK","Nome",null,62,2.8730000000000002,3,1.9991546914623839,2.8730000000000002,3,1.8239999999999998]
["02185","AK","North Slope",null,63,2.952,3,1.9991546914623839,2.952,3,1.8239999999999998]
["02188","AK","Northwest Artic",null,64,3,3,1.9991546914623839,3,3,1.8239999999999998]
["02190","AK","Outer Ketchikan ",null,"65 and over",3,3,1.9991546914623839,3,3,1.8239999999999998]
["02195","AK","Petersburg",null,"Family Option",3,3,3,3,3,3]
["02198","AK","Prince Of Wales-Hyder"]
["02200","AK","Prince Of Wales ",null,"Admin Template Address Lookups"]
["02201","AK","Pr.Of Wales-Out.Ketchikan",null,"DIT Column","Field","TemplateAddress"]
["02210","AK","Seward ",null,3,"Issuer ID","B6"]
["02220","AK","Sitka",null,4,"Issuer State1","B7"]
["02230","AK","Skagway",null,5,"Proposed Exchange Market Coverage","D6"]
["02231","AK","Skagway-Yakutat-Angoon",null,6,"Current Sales Market","D7"]
["02232","AK","Skagway-Hoonan-Angoon",null,7,"Company Legal Name","A11"]
["02240","AK","Southeast Fairbanks",null,8,"Issuer Legal Name","B11"]
["02250","AK","Upper Yukon ",null,9,"Issuer Marketing Name","C11"]
["02260","AK","Valdz-Chitna-Whitier ",null,10,"Associated Health Plan ID","A14"]
["02261","AK","Valdez-Cordova",null,11,"TIN","B14"]
["02270","AK","Wade Hampton",null,12,"NAIC Company Code","C14"]
["02275","AK","Wrangell City And Borough",null,13,"NAIC Group Code","D14"]
["02280","AK","Wrangell-Petersburg",null,14,"Company Address","A18"]
["02282","AK","Yakutat Borough ",null,15,"Company Address 2","B18"]
["02290","AK","Yukon-Koyukuk",null,16,"Company City","C18"]
["04001","AZ","Apache",null,17,"Company State","D18"]
["04003","AZ","Cochise",null,18,"Company Zip Code","E18"]
["04005","AZ","Coconino",null,19,"Issuer Address","A19"]
["04007","AZ","Gila",null,20,"Issuer Address 2","B19"]
["04009","AZ","Graham",null,21,"Issuer City","C19"]
["04011","AZ","Greenlee",null,22,"Issuer State2","D19"]
["04012","AZ","Lapaz",null,23,"Issuer Zip Code","E19"]
["04013","AZ","Maricopa",null,24,"Select Your Primary Contact","A25"]
["04015","AZ","Mohave",null,25,"Issuer Individual Market Contact First Name","A29"]
["04017","AZ","Navajo",null,26,"Issuer Individual Market Contact Last Name","B29"]
["04019","AZ","Pima",null,27,"Issuer Individual Market Contact Email Address","C29"]
["04021","AZ","Pinal",null,28,"Issuer Individual Market Contact Phone Number","D29"]
["04021","AZ","Pinal - Partial",null,29,"Issuer Individual Market Contact Phone Extension","E29"]
["04023","AZ","Santa Cruz",null,30,"Issuer SHOP (Small Group) Contact First Name","A33"]
["04025","AZ","Yavapai",null,31,"Issuer SHOP (Small Group) Contact Last Name","B33"]
["04027","AZ","Yuma",null,32,"Issuer SHOP (Small Group) Contact Email Address","C33"]
["05001","AR","Arkansas",null,33,"Issuer SHOP (Small Group) Contact Phone Number","D33"]
["05003","AR","Ashley",null,34,"Issuer SHOP (Small Group) Contact Phone Extension","E33"]
["05005","AR","Baxter",null,35,"CEO First Name","A37"]
["05007","AR","Benton",null,36,"CEO Last Name","B37"]
["05009","AR","Boone",null,37,"CEO Email Address","C37"]
["05011","AR","Bradley",null,38,"CEO Contact Phone Number","D37"]
["05013","AR","Calhoun",null,39,"CEO Phone Extension","E37"]
["05015","AR","Carroll",null,40,"CFO First Name","A41"]
["05017","AR","Chicot",null,41,"CFO Last Name","B41"]
["05019","AR","Clark",null,42,"CFO Email Address","C41"]
["05021","AR","Clay",null,43,"CFO Contact Phone Number","D41"]
["05023","AR","Cleburne",null,44,"CFO Phone Extension","E41"]
["05025","AR","Cleveland",null,45,"Customer Service - Individual Market Customer Service Phone","A45"]
["05027","AR","Columbia",null,46,"Customer Service - Individual Market Customer Service Phone Extension","B45"]
["05029","AR","Conway",null,47,"Customer Service - Individual Market Customer Service Toll Free","C45"]
["05031","AR","Craighead",null,48,"Customer Service - Individual Market Customer Service TTY","D45"]
["05033","AR","Crawford",null,49,"Customer Service - Individual Market Customer Service URL","E45"]
["05035","AR","Crittenden",null,50,"Customer Service - SHOP (Small Group) Customer Service Phone","A49"]
["05037","AR","Cross",null,51,"Customer Service - SHOP (Small Group) Customer Service Phone Extension","B49"]
["05039","AR","Dallas",null,52,"Customer Service - SHOP (Small Group) Customer Service Toll Free","C49"]
["05041","AR","Desha",null,53,"Customer Service - SHOP (Small Group) Customer Service TTY","D49"]
["05043","AR","Drew",null,54,"Customer Service - SHOP (Small Group) Customer Service URL","E49"]
["05045","AR","Faulkner",null,55,"Enrollment Contact First Name","B53"]
["05047","AR","Franklin",null,56,"Enrollment Contact Last Name","C53"]
["05049","AR","Fulton",null,57,"Enrollment Contact Email Address","F53"]
["05051","AR","Garland",null,58,"Enrollment Contact Phone Number","D53"]
["05053","AR","Grant",null,59,"Enrollment Contact Extension","E53"]
["05055","AR","Greene",null,60,"Online Enrollment Center Contact (Primary) First Name","B54"]
["05057","AR","Hempstead",null,61,"Online Enrollment Center Contact (Primary) Last Name","C54"]
["05059","AR","Hot Spring",null,62,"Online Enrollment Center Contact (Primary) Email Address","F54"]
["05061","AR","Howard",null,63,"Online Enrollment Center Contact (Primary) Phone Number","D54"]
["05063","AR","Independence",null,64,"Online Enrollment Center Contact (Primary) Extension","E54"]
["05065","AR","Izard",null,65,"Online Enrollment Center Contact (Backup) First Name","B55"]
["05067","AR","Jackson",null,66,"Online Enrollment Center Contact (Backup) Last Name","C55"]
["05069","AR","Jefferson",null,67,"Online Enrollment Center Contact (Backup) Email Address","F55"]
["05071","AR","Johnson",null,68,"Online Enrollment Center Contact (Backup) Phone Number","D55"]
["05073","AR","Lafayette",null,69,"Online Enrollment Center Contact (Backup) Extension","E55"]
["05075","AR","Lawrence",null,70,"System Contact First Name","B56"]
["05077","AR","Lee",null,71,"System Contact Last Name","C56"]
["05079","AR","Lincoln",null,72,"System Contact Email Address","F56"]
["05081","AR","Little River",null,73,"System Contact Phone Number","D56"]
["05083","AR","Logan",null,74,"System Contact Extension","E56"]
["05085","AR","Lonoke",null,75,"Appeals/Grievances Contact First Name","B57"]
["05087","AR","Madison",null,76,"Appeals/Grievances Contact Last Name","C57"]
["05089","AR","Marion",null,77,"Appeals/Grievances Contact Email Address","F57"]
["05091","AR","Miller",null,78,"Appeals/Grievances Contact Phone Number","D57"]
["05093","AR","Mississippi",null,79,"Appeals/Grievances Contact Extension","E57"]
["05095","AR","Monroe",null,80,"Customer Service Operations Contact First Name","B58"]
["05097","AR","Montgomery",null,81,"Customer Service Operations Contact Last Name","C58"]
["05099","AR","Nevada",null,82,"Customer Service Operations Contact Email Address","F58"]
["05101","AR","Newton",null,83,"Customer Service Operations Contact Phone Number","D58"]
["05103","AR","Ouachita",null,84,"Customer Service Operations Contact Extension","E58"]
["05105","AR","Perry",null,85,"User Access Contact First Name","B59"]
["05107","AR","Phillips",null,86,"User Access Contact Last Name","C59"]
["05109","AR","Pike",null,87,"User Access Contact Email Address","F59"]
["05111","AR","Poinsett",null,88,"User Access Contact Phone Number","D59"]
["05113","AR","Polk",null,89,"User Access Contact Extension","E59"]
["05115","AR","Pope",null,90,"Backup User Access Contact First Name","B60"]
["05117","AR","Prairie",null,91,"Backup User Access Contact Last Name","C60"]
["05119","AR","Pulaski",null,92,"Backup User Access Contact Email Address","F60"]
["05121","AR","Randolph",null,93,"Backup User Access Contact Phone Number","D60"]
["05123","AR","St. Francis",null,94,"Backup User Access Contact Extension","E60"]
["05125","AR","Saline",null,95,"Marketing Contact First Name","B61"]
["05127","AR","Scott",null,96,"Marketing Contact Last Name","C61"]
["05129","AR","Searcy",null,97,"Marketing Contact Email Address","F61"]
["05131","AR","Sebastian",null,98,"Marketing Contact Phone Number","D61"]
["05133","AR","Sevier",null,99,"Marketing Contact Extension","E61"]
["05135","AR","Sharp",null,100,"Medical Director First Name","B62"]
["05137","AR","Stone",null,101,"Medical Director Last Name","C62"]
["05139","AR","Union",null,102,"Medical Director Email Address","F62"]
["05141","AR","Van Buren",null,103,"Medical Director Phone Number","D62"]
["05143","AR","Washington",null,104,"Medical Director Extension","E62"]
["05145","AR","White",null,105,"Chief Dental Director First Name","B63"]
["05147","AR","Woodruff",null,106,"Chief Dental Director Last Name","C63"]
["05149","AR","Yell",null,107,"Chief Dental Director Email Address","F63"]
["06001","CA","Alameda",null,108,"Chief Dental Director Phone Number","D63"]
["06003","CA","Alpine",null,109,"Chief Dental Director Extension","E63"]
["06005","CA","Amador",null,110,"Pharmacy Benefit Manager First Name","B64"]
["06007","CA","Butte",null,111,"Pharmacy Benefit Manager Last Name","C64"]
["06009","CA","Calaveras",null,112,"Pharmacy Benefit Manager Email Address","F64"]
["06011","CA","Colusa",null,113,"Pharmacy Benefit Manager Phone Number","D64"]
["06013","CA","Contra Costa",null,114,"Pharmacy Benefit Manager Extension","E64"]
["06015","CA","Del Norte",null,115,"Government Relations Contact First Name","B65"]
["06017","CA","El Dorado",null,116,"Government Relations Contact Last Name","C65"]
["06019","CA","Fresno",null,117,"Government Relations Contact Email Address","F65"]
["06021","CA","Glenn",null,118,"Government Relations Contact Phone Number","D65"]
["06023","CA","Humboldt",null,119,"Government Relations Contact Extension","E65"]
["06025","CA","Imperial",null,120,"HIPAA Security Contact First Name","B66"]
["06027","CA","Inyo",null,121,"HIPAA Security Contact Last Name","C66"]
["06029","CA","Kern",null,122,"HIPAA Security Contact Email Address","F66"]
["06031","CA","Kings",null,123,"HIPAA Security Contact Phone Number","D66"]
["06033","CA","Lake",null,124,"HIPAA Security Contact Extension","E66"]
["06035","CA","Lassen",null,125,"Complaints Tracking Contact First Name","B67"]
["06037","CA","Los Angeles",null,126,"Complaints Tracking Contact Last Name","C67"]
["06037","CA","Los Angeles - Partial",null,127,"Complaints Tracking Contact Email Address","F67"]
["06037","CA","Los Angeles",null,128,"Complaints Tracking Contact Phone Number","D67"]
["06039","CA","Madera",null,129,"Complaints Tracking Contact Extension","E67"]
["06041","CA","Marin",null,130,"Quality Contact First Name","B68"]
["06043","CA","Mariposa",null,131,"Quality Contact Last Name","C68"]
["06045","CA","Mendocino",null,132,"Quality Contact Email Address","F68"]
["06047","CA","Merced",null,133,"Quality Contact Phone Number","D68"]
["06049","CA","Modoc",null,134,"Quality Contact Extension","E68"]
["06051","CA","Mono",null,135,"Compliance Officer First Name","B69"]
["06053","CA","Monterey",null,136,"Compliance Officer Last Name","C69"]
["06055","CA","Napa",null,137,"Compliance Officer Email Address","F69"]
["06057","CA","Nevada",null,138,"Compliance Officer Phone Number","D69"]
["06059","CA","Orange",null,139,"Compliance Officer Extension","E69"]
["06059","CA","Orange - Partial",null,140,"Payment Contact First Name","B70"]
["06061","CA","Placer",null,141,"Payment Contact Last Name","C70"]
["06063","CA","Plumas",null,142,"Payment Contact Email Address","F70"]
["06065","CA","Riverside",null,143,"Payment Contact Phone Number","D70"]
["06065","CA","Riverside - Partial",null,144,"Payment Contact Extension","E70"]
["06067","CA","Sacramento",null,145,"APTC/CSR Contact First Name","B71"]
["06069","CA","San Benito",null,146,"APTC/CSR Contact Last Name","C71"]
["06071","CA","San Bernardino",null,147,"APTC/CSR Contact Email Address","F71"]
["06073","CA","San Diego",null,148,"APTC/CSR Contact Phone Number","D71"]
["06075","CA","San Francisco",null,149,"APTC/CSR Contact Extension","E71"]
["06077","CA","San Joaquin",null,150,"Financial Reporting Contact First Name","B72"]
["06079","CA","San Luis Obispo",null,151,"Financial Reporting Contact Last Name","C72"]
["06081","CA","San Mateo",null,152,"Financial Reporting Contact Email Address","F72"]
["06083","CA","Santa Barbara",null,153,"Financial Reporting Contact Phone Number","D72"]
["06085","CA","Santa Clara",null,154,"Financial Reporting Contact Extension","E72"]
["06087","CA","Santa Cruz",null,155,"Financial Transfers Contact First Name","B73"]
["06089","CA","Shasta",null,156,"Financial Transfers Contact Last Name","C73"]
["06091","CA","Sierra",null,157,"Financial Transfers Contact Email Address","F73"]
["06093","CA","Siskiyou",null,158,"Financial Transfers Contact Phone Number","D73"]
["06095","CA","Solano",null,159,"Financial Transfers Contact Extension","E73"]
["06097","CA","Sonoma",null,160,"Risk Corridors Contact First Name","B74"]
["06099","CA","Stanislaus",null,161,"Risk Corridors Contact Last Name","C74"]
["06101","CA","Sutter",null,162,"Risk Corridors Contact Email Address","F74"]
["06103","CA","Tehama",null,163,"Risk Corridors Contact Phone Number","D74"]
["06105","CA","Trinity",null,164,"Risk Corridors Contact Extension","E74"]
["06107","CA","Tulare",null,165,"Risk Adjustment Contact First Name","B75"]
["06109","CA","Tuolumne",null,166,"Risk Adjustment Contact Last Name","C75"]
["06111","CA","Ventura",null,167,"Risk Adjustment Contact Email Address","F75"]
["06113","CA","Yolo",null,168,"Risk Adjustment Contact Phone Number","D75"]
["06115","CA","Yuba",null,169,"Risk Adjustment Contact Extension","E75"]
["08001","CO","Adams",null,170,"Reinsurance Contact First Name","B76"]
["08003","CO","Alamosa",null,171,"Reinsurance Contact Last Name","C76"]
["08005","CO","Arapahoe",null,172,"Reinsurance Contact Email Address","F76"]
["08007","CO","Archuleta",null,173,"Reinsurance Contact Phone Number","D76"]
["08009","CO","Baca",null,174,"Reinsurance Contact Extension","E76"]
["08011","CO","Bent",null,175,"Do you have a TPA for Enrollment","B80"]
["08013","CO","Boulder",null,176,"Do you have a TPA for Claims Processing","B81"]
["08014","CO","Broomfield",null,177,"Do you have a TPA for Edge Server Host","B82"]
["08015","CO","Chaffee"]
["08017","CO","Cheyenne"]
["08019","CO","Clear Creek"]
["08021","CO","Conejos"]
["08023","CO","Costilla"]
["08025","CO","Crowley"]
["08027","CO","Custer"]
["08029","CO","Delta"]
["08031","CO","Denver"]
["08033","CO","Dolores"]
["08035","CO","Douglas"]
["08037","CO","Eagle"]
["08039","CO","Elbert"]
["08041","CO","El Paso"]
["08043","CO","Fremont"]
["08045","CO","Garfield"]
["08047","CO","Gilpin"]
["08049","CO","Grand"]
["08051","CO","Gunnison"]
["08053","CO","Hinsdale"]
["08055","CO","Huerfano"]
["08057","CO","Jackson"]
["08059","CO","Jefferson"]
["08061","CO","Kiowa"]
["08063","CO","Kit Carson"]
["08065","CO","Lake"]
["08067","CO","La Plata"]
["08069","CO","Larimer"]
["08071","CO","Las Animas"]
["08073","CO","Lincoln"]
["08075","CO","Logan"]
["08077","CO","Mesa"]
["08079","CO","Mineral"]
["08081","CO","Moffat"]
["08083","CO","Montezuma"]
["08085","CO","Montrose"]
["08087","CO","Morgan"]
["08089","CO","Otero"]
["08091","CO","Ouray"]
["08093","CO","Park"]
["08095","CO","Phillips"]
["08097","CO","Pitkin"]
["08099","CO","Prowers"]
["08101","CO","Pueblo"]
["08103","CO","Rio Blanco"]
["08105","CO","Rio Grande"]
["08107","CO","Routt"]
["08109","CO","Saguache"]
["08111","CO","San Juan"]
["08113","CO","San Miguel"]
["08115","CO","Sedgwick"]
["08117","CO","Summit"]
["08119","CO","Teller"]
["08121","CO","Washington"]
["08123","CO","Weld"]
["08125","CO","Yuma"]
["08014","CO","Broomfield"]
["09001","CT","Fairfield"]
["09003","CT","Hartford"]
["09005","CT","Litchfield"]
["09007","CT","Middlesex"]
["09009","CT","New Haven"]
["09011","CT","New London"]
["09013","CT","Tolland"]
["09015","CT","Windham"]
["10001","DE","Kent"]
["10003","DE","New Castle"]
["10005","DE","Sussex"]
["11001","DC","The District"]
["12001","FL","Alachua"]
["12003","FL","Baker"]
["12005","FL","Bay"]
["12007","FL","Bradford"]
["12009","FL","Brevard"]
["12011","FL","Broward"]
["12013","FL","Calhoun"]
["12015","FL","Charlotte"]
["12017","FL","Citrus"]
["12019","FL","Clay"]
["12021","FL","Collier"]
["12023","FL","Columbia"]
["12086","FL","Miami-Dade"]
["12027","FL","De Soto"]
["12029","FL","Dixie"]
["12031","FL","Duval"]
["12033","FL","Escambia"]
["12035","FL","Flagler"]
["12037","FL","Franklin"]
["12039","FL","Gadsden"]
["12041","FL","Gilchrist"]
["12043","FL","Glades"]
["12045","FL","Gulf"]
["12047","FL","Hamilton"]
["12049","FL","Hardee"]
["12051","FL","Hendry"]
["12053","FL","Hernando"]
["12055","FL","Highlands"]
["12057","FL","Hillsborough"]
["12059","FL","Holmes"]
["12061","FL","Indian River"]
["12063","FL","Jackson"]
["12065","FL","Jefferson"]
["12067","FL","Lafayette"]
["12069","FL","Lake"]
["12071","FL","Lee"]
["12073","FL","Leon"]
["12075","FL","Levy"]
["12077","FL","Liberty"]
["12079","FL","Madison"]
["12081","FL","Manatee"]
["12083","FL","Marion"]
["12085","FL","Martin"]
["12087","FL","Monroe"]
["12089","FL","Nassau"]
["12091","FL","Okaloosa"]
["12093","FL","Okeechobee"]
["12095","FL","Orange"]
["12097","FL","Osceola"]
["12099","FL","Palm Beach"]
["12101","FL","Pasco"]
["12103","FL","Pinellas"]
["12105","FL","Polk"]
["12107","FL","Putnam"]
["12109","FL","St. Johns"]
["12111","FL","St. Lucie"]
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["21223","KY","Trimble"]
["21225","KY","Union"]
["21227","KY","Warren"]
["21229","KY","Washington"]
["21231","KY","Wayne"]
["21233","KY","Webster"]
["21235","KY","Whitley"]
["21237","KY","Wolfe"]
["21239","KY","Woodford"]
["22001","LA","Acadia"]
["22003","LA","Allen"]
["22005","LA","Ascension"]
["22007","LA","Assumption"]
["22009","LA","Avoyelles"]
["22011","LA","Beauregard"]
["22013","LA","Bienville"]
["22015","LA","Bossier"]
["22017","LA","Caddo"]
["22019","LA","Calcasieu"]
["22021","LA","Caldwell"]
["22023","LA","Cameron"]
["22025","LA","Catahoula"]
["22027","LA","Claiborne"]
["22029","LA","Concordia"]
["22031","LA","De Soto"]
["22033","LA","E. Baton Rouge"]
["22035","LA","East Carroll"]
["22037","LA","East Feliciana"]
["22039","LA","Evangeline"]
["22041","LA","Franklin"]
["22043","LA","Grant"]
["22045","LA","Iberia"]
["22047","LA","Iberville"]
["22049","LA","Jackson"]
["22051","LA","Jefferson"]
["22053","LA","Jefferson Davis"]
["22055","LA","Lafayette"]
["22057","LA","Lafourche"]
["22059","LA","La Salle"]
["22061","LA","Lincoln"]
["22063","LA","Livingston"]
["22065","LA","Madison"]
["22067","LA","Morehouse"]
["22069","LA","Natchitoches"]
["22071","LA","Orleans"]
["22073","LA","Ouachita"]
["22075","LA","Plaquemines"]
["22077","LA","Pointe Coupee"]
["22079","LA","Rapides"]
["22081","LA","Red River"]
["22083","LA","Richland"]
["22085","LA","Sabine"]
["22087","LA","St. Bernard"]
["22089","LA","St. Charles"]
["22091","LA","St. Helena"]
["22093","LA","St. James"]
["22095","LA","St. John Baptist"]
["22097","LA","St. Landry"]
["22099","LA","St. Martin"]
["22101","LA","St. Mary"]
["22103","LA","St. Tammany"]
["22105","LA","Tangipahoa"]
["22107","LA","Tensas"]
["22109","LA","Terrebonne"]
["22111","LA","Union"]
["22113","LA","Vermilion"]
["22115","LA","Vernon"]
["22117","LA","Washington"]
["22119","LA","Webster"]
["22121","LA","W. Baton Rouge"]
["22123","LA","West Carroll"]
["22125","LA","West Feliciana"]
["22127","LA","Winn"]
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["23003","ME","Aroostook"]
["23005","ME","Cumberland"]
["23007","ME","Franklin"]
["23009","ME","Hancock"]
["23011","ME","Kennebec"]
["23013","ME","Knox"]
["23015","ME","Lincoln"]
["23017","ME","Oxford"]
["23019","ME","Penobscot"]
["23021","ME","Piscataquis"]
["23023","ME","Sagadahoc"]
["23025","ME","Somerset"]
["23027","ME","Waldo"]
["23029","ME","Washington"]
["23031","ME","York"]
["24001","MD","Allegany"]
["24003","MD","Anne Arundel"]
["24005","MD","Baltimore"]
["24510","MD","Baltimore City"]
["24009","MD","Calvert"]
["24011","MD","Caroline"]
["24013","MD","Carroll"]
["24015","MD","Cecil"]
["24017","MD","Charles"]
["24019","MD","Dorchester"]
["24021","MD","Frederick"]
["24023","MD","Garrett"]
["24025","MD","Harford"]
["24027","MD","Howard"]
["24029","MD","Kent"]
["24031","MD","Montgomery"]
["24033","MD","Prince Georges"]
["24035","MD","Queen Annes"]
["24037","MD","St. Marys"]
["24039","MD","Somerset"]
["24041","MD","Talbot"]
["24043","MD","Washington"]
["24045","MD","Wicomico"]
["24047","MD","Worcester"]
["25001","MA","Barnstable"]
["25003","MA","Berkshire"]
["25005","MA","Bristol"]
["25007","MA","Dukes"]
["25009","MA","Essex"]
["25011","MA","Franklin"]
["25013","MA","Hampden"]
["25015","MA","Hampshire"]
["25017","MA","Middlesex"]
["25019","MA","Nantucket"]
["25021","MA","Norfolk"]
["25023","MA","Plymouth"]
["25025","MA","Suffolk"]
["25027","MA","Worcester"]
["26001","MI","Alcona"]
["26003","MI","Alger"]
["26005","MI","Allegan"]
["26007","MI","Alpena"]
["26009","MI","Antrim"]
["26011","MI","Arenac"]
["26013","MI","Baraga"]
["26015","MI","Barry"]
["26017","MI","Bay"]
["26019","MI","Benzie"]
["26021","MI","Berrien"]
["26023","MI","Branch"]
["26025","MI","Calhoun"]
["26027","MI","Cass"]
["26029","MI","Charlevoix"]
["26031","MI","Cheboygan"]
["26033","MI","Chippewa"]
["26035","MI","Clare"]
["26037","MI","Clinton"]
["26039","MI","Crawford"]
["26041","MI","Delta"]
["26043","MI","Dickinson"]
["26045","MI","Eaton"]
["26047","MI","Emmet"]
["26049","MI","Genesee"]
["26051","MI","Gladwin"]
["26053","MI","Gogebic"]
["26055","MI","Grand Traverse"]
["26057","MI","Gratiot"]
["26059","MI","Hillsdale"]
["26061","MI","Houghton"]
["26063","MI","Huron"]
["26065","MI","Ingham"]
["26067","MI","Ionia"]
["26069","MI","Iosco"]
["26071","MI","Iron"]
["26073","MI","Isabella"]
["26075","MI","Jackson"]
["26077","MI","Kalamazoo"]
["26079","MI","Kalkaska"]
["26081","MI","Kent"]
["26083","MI","Keweenaw"]
["26085","MI","Lake"]
["26087","MI","Lapeer"]
["26089","MI","Leelanau"]
["26091","MI","Lenawee"]
["26093","MI","Livingston"]
["26095","MI","Luce"]
["26097","MI","Mackinac"]
["26099","MI","Macomb"]
["26101","MI","Manistee"]
["26103","MI","Marquette"]
["26105","MI","Mason"]
["26107","MI","Mecosta"]
["26109","MI","Menominee"]
["26111","MI","Midland"]
["26113","MI","Missaukee"]
["26115","MI","Monroe"]
["26117","MI","Montcalm"]
["26119","MI","Montmorency"]
["26121","MI","Muskegon"]
["26123","MI","Newaygo"]
["26125","MI","Oakland"]
["26127","MI","Oceana"]
["26129","MI","Ogemaw"]
["26131","MI","Ontonagon"]
["26133","MI","Osceola"]
["26135","MI","Oscoda"]
["26137","MI","Otsego"]
["26139","MI","Ottawa"]
["26141","MI","Presque Isle"]
["26143","MI","Roscommon"]
["26145","MI","Saginaw"]
["26147","MI","St. Clair"]
["26149","MI","St. Joseph"]
["26151","MI","Sanilac"]
["26153","MI","Schoolcraft"]
["26155","MI","Shiawassee"]
["26157","MI","Tuscola"]
["26159","MI","Van Buren"]
["26161","MI","Washtenaw"]
["26163","MI","Wayne"]
["26165","MI","Wexford"]
["27001","MN","Aitkin"]
["27003","MN","Anoka"]
["27005","MN","Becker"]
["27007","MN","Beltrami"]
["27009","MN","Benton"]
["27011","MN","Big Stone"]
["27013","MN","Blue Earth"]
["27015","MN","Brown"]
["27017","MN","Carlton"]
["27019","MN","Carver"]
["27021","MN","Cass"]
["27023","MN","Chippewa"]
["27025","MN","Chisago"]
["27027","MN","Clay"]
["27029","MN","Clearwater"]
["27031","MN","Cook"]
["27033","MN","Cottonwood"]
["27035","MN","Crow Wing"]
["27037","MN","Dakota"]
["27039","MN","Dodge"]
["27041","MN","Douglas"]
["27043","MN","Faribault"]
["27045","MN","Fillmore"]
["27047","MN","Freeborn"]
["27049","MN","Goodhue"]
["27051","MN","Grant"]
["27053","MN","Hennepin"]
["27055","MN","Houston"]
["27057","MN","Hubbard"]
["27059","MN","Isanti"]
["27061","MN","Itasca"]
["27063","MN","Jackson"]
["27065","MN","Kanabec"]
["27067","MN","Kandiyohi"]
["27069","MN","Kittson"]
["27071","MN","Koochiching"]
["27073","MN","Lac Qui Parle"]
["27075","MN","Lake"]
["27077","MN","Lake Of  Woods"]
["27079","MN","Le Sueur"]
["27081","MN","Lincoln"]
["27083","MN","Lyon"]
["27085","MN","Mc Leod"]
["27087","MN","Mahnomen"]
["27089","MN","Marshall"]
["27091","MN","Martin"]
["27093","MN","Meeker"]
["27095","MN","Mille Lacs"]
["27097","MN","Morrison"]
["27099","MN","Mower"]
["27101","MN","Murray"]
["27103","MN","Nicollet"]
["27105","MN","Nobles"]
["27107","MN","Norman"]
["27109","MN","Olmsted"]
["27111","MN","Otter Tail"]
["27113","MN","Pennington"]
["27115","MN","Pine"]
["27117","MN","Pipestone"]
["27119","MN","Polk"]
["27121","MN","Pope"]
["27123","MN","Ramsey"]
["27125","MN","Red Lake"]
["27127","MN","Redwood"]
["27129","MN","Renville"]
["27131","MN","Rice"]
["27133","MN","Rock"]
["27135","MN","Roseau"]
["27137","MN","St. Louis"]
["27139","MN","Scott"]
["27141","MN","Sherburne"]
["27143","MN","Sibley"]
["27145","MN","Stearns"]
["27147","MN","Steele"]
["27149","MN","Stevens"]
["27151","MN","Swift"]
["27153","MN","Todd"]
["27155","MN","Traverse"]
["27157","MN","Wabasha"]
["27159","MN","Wadena"]
["27161","MN","Waseca"]
["27163","MN","Washington"]
["27165","MN","Watonwan"]
["27167","MN","Wilkin"]
["27169","MN","Winona"]
["27171","MN","Wright"]
["27173","MN","Yellow Medcine"]
["28001","MS","Adams"]
["28003","MS","Alcorn"]
["28005","MS","Amite"]
["28007","MS","Attala"]
["28009","MS","Benton"]
["28011","MS","Bolivar"]
["28013","MS","Calhoun"]
["28015","MS","Carroll"]
["28017","MS","Chickasaw"]
["28019","MS","Choctaw"]
["28021","MS","Claiborne"]
["28023","MS","Clarke"]
["28025","MS","Clay"]
["28027","MS","Coahoma"]
["28029","MS","Copiah"]
["28031","MS","Covington"]
["28033","MS","De Soto"]
["28035","MS","Forrest"]
["28037","MS","Franklin"]
["28039","MS","George"]
["28041","MS","Greene"]
["28043","MS","Grenada"]
["28045","MS","Hancock"]
["28047","MS","Harrison"]
["28049","MS","Hinds"]
["28051","MS","Holmes"]
["28053","MS","Humphreys"]
["28055","MS","Issaquena"]
["28057","MS","Itawamba"]
["28059","MS","Jackson"]
["28061","MS","Jasper"]
["28063","MS","Jefferson"]
["28065","MS","Jefferson Davis"]
["28067","MS","Jones"]
["28069","MS","Kemper"]
["28071","MS","Lafayette"]
["28073","MS","Lamar"]
["28075","MS","Lauderdale"]
["28077","MS","Lawrence"]
["28079","MS","Leake"]
["28081","MS","Lee"]
["28083","MS","Leflore"]
["28085","MS","Lincoln"]
["28087","MS","Lowndes"]
["28089","MS","Madison"]
["28091","MS","Marion"]
["28093","MS","Marshall"]
["28095","MS","Monroe"]
["28097","MS","Montgomery"]
["28099","MS","Neshoba"]
["28101","MS","Newton"]
["28103","MS","Noxubee"]
["28105","MS","Oktibbeha"]
["28107","MS","Panola"]
["28109","MS","Pearl River"]
["28111","MS","Perry"]
["28113","MS","Pike"]
["28115","MS","Pontotoc"]
["28117","MS","Prentiss"]
["28119","MS","Quitman"]
["28121","MS","Rankin"]
["28123","MS","Scott"]
["28125","MS","Sharkey"]
["28127","MS","Simpson"]
["28129","MS","Smith"]
["28131","MS","Stone"]
["28133","MS","Sunflower"]
["28135","MS","Tallahatchie"]
["28137","MS","Tate"]
["28139","MS","Tippah"]
["28141","MS","Tishomingo"]
["28143","MS","Tunica"]
["28145","MS","Union"]
["28147","MS","Walthall"]
["28149","MS","Warren"]
["28151","MS","Washington"]
["28153","MS","Wayne"]
["28155","MS","Webster"]
["28157","MS","Wilkinson"]
["28159","MS","Winston"]
["28161","MS","Yalobusha"]
["28163","MS","Yazoo"]
["29001","MO","Adair"]
["29003","MO","Andrew"]
["29005","MO","Atchison"]
["29007","MO","Audrain"]
["29009","MO","Barry"]
["29011","MO","Barton"]
["29013","MO","Bates"]
["29015","MO","Benton"]
["29017","MO","Bollinger"]
["29019","MO","Boone"]
["29021","MO","Buchanan"]
["29023","MO","Butler"]
["29025","MO","Caldwell"]
["29027","MO","Callaway"]
["29029","MO","Camden"]
["29031","MO","Cape Girardeau"]
["29033","MO","Carroll"]
["29035","MO","Carter"]
["29037","MO","Cass"]
["29039","MO","Cedar"]
["29041","MO","Chariton"]
["29043","MO","Christian"]
["29045","MO","Clark"]
["29047","MO","Clay"]
["29049","MO","Clinton"]
["29051","MO","Cole"]
["29053","MO","Cooper"]
["29055","MO","Crawford"]
["29057","MO","Dade"]
["29059","MO","Dallas"]
["29061","MO","Daviess"]
["29063","MO","De Kalb"]
["29065","MO","Dent"]
["29067","MO","Douglas"]
["29069","MO","Dunklin"]
["29071","MO","Franklin"]
["29073","MO","Gasconade"]
["29075","MO","Gentry"]
["29077","MO","Greene"]
["29079","MO","Grundy"]
["29081","MO","Harrison"]
["29083","MO","Henry"]
["29085","MO","Hickory"]
["29087","MO","Holt"]
["29089","MO","Howard"]
["29091","MO","Howell"]
["29093","MO","Iron"]
["29095","MO","Jackson"]
["29097","MO","Jasper"]
["29099","MO","Jefferson"]
["29101","MO","Johnson"]
["29103","MO","Knox"]
["29105","MO","Laclede"]
["29107","MO","Lafayette"]
["29109","MO","Lawrence"]
["29111","MO","Lewis"]
["29113","MO","Lincoln"]
["29115","MO","Linn"]
["29117","MO","Livingston"]
["29119","MO","Mc Donald"]
["29121","MO","Macon"]
["29123","MO","Madison"]
["29125","MO","Maries"]
["29127","MO","Marion"]
["29129","MO","Mercer"]
["29131","MO","Miller"]
["29133","MO","Mississippi"]
["29135","MO","Moniteau"]
["29137","MO","Monroe"]
["29139","MO","Montgomery"]
["29141","MO","Morgan"]
["29143","MO","New Madrid"]
["29145","MO","Newton"]
["29147","MO","Nodaway"]
["29149","MO","Oregon"]
["29151","MO","Osage"]
["29153","MO","Ozark"]
["29155","MO","Pemiscot"]
["29157","MO","Perry"]
["29159","MO","Pettis"]
["29161","MO","Phelps"]
["29163","MO","Pike"]
["29165","MO","Platte"]
["29167","MO","Polk"]
["29169","MO","Pulaski"]
["29171","MO","Putnam"]
["29173","MO","Ralls"]
["29175","MO","Randolph"]
["29177","MO","Ray"]
["29179","MO","Reynolds"]
["29181","MO","Ripley"]
["29183","MO","St. Charles"]
["29185","MO","St. Clair"]
["29187","MO","St. Francois"]
["29189","MO","St. Louis"]
["29510","MO","St. Louis City"]
["29186","MO","Ste. Genevieve"]
["29195","MO","Saline"]
["29197","MO","Schuyler"]
["29199","MO","Scotland"]
["29201","MO","Scott"]
["29203","MO","Shannon"]
["29205","MO","Shelby"]
["29207","MO","Stoddard"]
["29209","MO","Stone"]
["29211","MO","Sullivan"]
["29213","MO","Taney"]
["29215","MO","Texas"]
["29217","MO","Vernon"]
["29219","MO","Warren"]
["29221","MO","Washington"]
["29223","MO","Wayne"]
["29225","MO","Webster"]
["29227","MO","Worth"]
["29229","MO","Wright"]
["30001","MT","Beaverhead"]
["30003","MT","Big Horn"]
["30005","MT","Blaine"]
["30007","MT","Broadwater"]
["30009","MT","Carbon"]
["30011","MT","Carter"]
["30013","MT","Cascade"]
["30015","MT","Chouteau"]
["30017","MT","Custer"]
["30019","MT","Daniels"]
["30021","MT","Dawson"]
["30023","MT","Deer Lodge"]
["30113","MT","Yellowstone Natl Park"]
["30025","MT","Fallon"]
["30027","MT","Fergus"]
["30029","MT","Flathead"]
["30031","MT","Gallatin"]
["30033","MT","Garfield"]
["30035","MT","Glacier"]
["30037","MT","Golden Valley"]
["30039","MT","Granite"]
["30041","MT","Hill"]
["30043","MT","Jefferson"]
["30045","MT","Judith Basin"]
["30047","MT","Lake"]
["30049","MT","Lewis And Clark"]
["30051","MT","Liberty"]
["30053","MT","Lincoln"]
["30055","MT","Mccone"]
["30057","MT","Madison"]
["30059","MT","Meagher"]
["30061","MT","Mineral"]
["30063","MT","Missoula"]
["30065","MT","Musselshell"]
["30067","MT","Park"]
["30069","MT","Petroleum"]
["30071","MT","Phillips"]
["30073","MT","Pondera"]
["30075","MT","Powder River"]
["30077","MT","Powell"]
["30079","MT","Prairie"]
["30081","MT","Ravalli"]
["30083","MT","Richland"]
["30085","MT","Roosevelt"]
["30087","MT","Rosebud"]
["30089","MT","Sanders"]
["30091","MT","Sheridan"]
["30093","MT","Silver Bow"]
["30095","MT","Stillwater"]
["30097","MT","Sweet Grass"]
["30099","MT","Teton"]
["30101","MT","Toole"]
["30103","MT","Treasure"]
["30105","MT","Valley"]
["30107","MT","Wheatland"]
["30109","MT","Wibaux"]
["30111","MT","Yellowstone"]
["31001","NE","Adams"]
["31003","NE","Antelope"]
["31005","NE","Arthur"]
["31007","NE","Banner"]
["31009","NE","Blaine"]
["31011","NE","Boone"]
["31013","NE","Box Butte"]
["31015","NE","Boyd"]
["31017","NE","Brown"]
["31019","NE","Buffalo"]
["31021","NE","Burt"]
["31023","NE","Butler"]
["31025","NE","Cass"]
["31027","NE","Cedar"]
["31029","NE","Chase"]
["31031","NE","Cherry"]
["31033","NE","Cheyenne"]
["31035","NE","Clay"]
["31037","NE","Colfax"]
["31039","NE","Cuming"]
["31041","NE","Custer"]
["31043","NE","Dakota"]
["31045","NE","Dawes"]
["31047","NE","Dawson"]
["31049","NE","Deuel"]
["31051","NE","Dixon"]
["31053","NE","Dodge"]
["31055","NE","Douglas"]
["31057","NE","Dundy"]
["31059","NE","Fillmore"]
["31061","NE","Franklin"]
["31063","NE","Frontier"]
["31065","NE","Furnas"]
["31067","NE","Gage"]
["31069","NE","Garden"]
["31071","NE","Garfield"]
["31073","NE","Gosper"]
["31075","NE","Grant"]
["31077","NE","Greeley"]
["31079","NE","Hall"]
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["31083","NE","Harlan"]
["31085","NE","Hayes"]
["31087","NE","Hitchcock"]
["31089","NE","Holt"]
["31091","NE","Hooker"]
["31093","NE","Howard"]
["31095","NE","Jefferson"]
["31097","NE","Johnson"]
["31099","NE","Kearney"]
["31101","NE","Keith"]
["31103","NE","Keya Paha"]
["31105","NE","Kimball"]
["31107","NE","Knox"]
["31109","NE","Lancaster"]
["31111","NE","Lincoln"]
["31113","NE","Logan"]
["31115","NE","Loup"]
["31117","NE","Mc Pherson"]
["31119","NE","Madison"]
["31121","NE","Merrick"]
["31123","NE","Morrill"]
["31125","NE","Nance"]
["31127","NE","Nemaha"]
["31129","NE","Nuckolls"]
["31131","NE","Otoe"]
["31133","NE","Pawnee"]
["31135","NE","Perkins"]
["31137","NE","Phelps"]
["31139","NE","Pierce"]
["31141","NE","Platte"]
["31143","NE","Polk"]
["31145","NE","Red Willow"]
["31147","NE","Richardson"]
["31149","NE","Rock"]
["31151","NE","Saline"]
["31153","NE","Sarpy"]
["31155","NE","Saunders"]
["31157","NE","Scott Bluff"]
["31159","NE","Seward"]
["31161","NE","Sheridan"]
["31163","NE","Sherman"]
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["31167","NE","Stanton"]
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["31173","NE","Thurston"]
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["31177","NE","Washington"]
["31179","NE","Wayne"]
["31181","NE","Webster"]
["31183","NE","Wheeler"]
["31185","NE","York"]
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["32003","NV","Clark"]
["32005","NV","Douglas"]
["32007","NV","Elko"]
["32009","NV","Esmeralda"]
["32011","NV","Eureka"]
["32013","NV","Humboldt"]
["32015","NV","Lander"]
["32017","NV","Lincoln"]
["32019","NV","Lyon"]
["32021","NV","Mineral"]
["32023","NV","Nye"]
["32510","NV","Carson City"]
["32027","NV","Pershing"]
["32029","NV","Storey"]
["32031","NV","Washoe"]
["32033","NV","White Pine"]
["33001","NH","Belknap"]
["33003","NH","Carroll"]
["33005","NH","Cheshire"]
["33007","NH","Coos"]
["33009","NH","Grafton"]
["33011","NH","Hillsborough"]
["33013","NH","Merrimack"]
["33015","NH","Rockingham"]
["33017","NH","Strafford"]
["33019","NH","Sullivan"]
["34001","NJ","Atlantic"]
["34003","NJ","Bergen"]
["34005","NJ","Burlington"]
["34007","NJ","Camden"]
["34009","NJ","Cape May"]
["34011","NJ","Cumberland"]
["34013","NJ","Essex"]
["34015","NJ","Gloucester"]
["34017","NJ","Hudson"]
["34019","NJ","Hunterdon"]
["34021","NJ","Mercer"]
["34023","NJ","Middlesex"]
["34025","NJ","Monmouth"]
["34027","NJ","Morris"]
["34029","NJ","Ocean"]
["34031","NJ","Passaic"]
["34033","NJ","Salem"]
["34035","NJ","Somerset"]
["34037","NJ","Sussex"]
["34039","NJ","Union"]
["34041","NJ","Warren"]
["35001","NM","Bernalillo"]
["35003","NM","Catron"]
["35005","NM","Chaves"]
["35006","NM","Cibola"]
["35007","NM","Colfax"]
["35009","NM","Curry"]
["35011","NM","De Baca"]
["35013","NM","Dona Ana"]
["35015","NM","Eddy"]
["35017","NM","Grant"]
["35019","NM","Guadalupe"]
["35021","NM","Harding"]
["35023","NM","Hidalgo"]
["35025","NM","Lea"]
["35027","NM","Lincoln"]
["35028","NM","Los Alamos"]
["35029","NM","Luna"]
["35031","NM","Mckinley"]
["35033","NM","Mora"]
["35035","NM","Otero"]
["35037","NM","Quay"]
["35039","NM","Rio Arriba"]
["35041","NM","Roosevelt"]
["35043","NM","Sandoval"]
["35045","NM","San Juan"]
["35047","NM","San Miguel"]
["35049","NM","Santa Fe"]
["35051","NM","Sierra"]
["35053","NM","Socorro"]
["35055","NM","Taos"]
["35057","NM","Torrance"]
["35059","NM","Union"]
["35061","NM","Valencia"]
["36001","NY","Albany"]
["36003","NY","Allegany"]
["36005","NY","Bronx"]
["36007","NY","Broome"]
["36009","NY","Cattaraugus"]
["36011","NY","Cayuga"]
["36013","NY","Chautauqua"]
["36015","NY","Chemung"]
["36017","NY","Chenango"]
["36019","NY","Clinton"]
["36021","NY","Columbia"]
["36023","NY","Cortland"]
["36025","NY","Delaware"]
["36027","NY","Dutchess"]
["36029","NY","Erie"]
["36031","NY","Essex"]
["36033","NY","Franklin"]
["36035","NY","Fulton"]
["36037","NY","Genesee"]
["36039","NY","Greene"]
["36041","NY","Hamilton"]
["36043","NY","Herkimer"]
["36045","NY","Jefferson"]
["36047","NY","Kings"]
["36049","NY","Lewis"]
["36051","NY","Livingston"]
["36053","NY","Madison"]
["36055","NY","Monroe"]
["36057","NY","Montgomery"]
["36059","NY","Nassau"]
["36061","NY","New York"]
["36063","NY","Niagara"]
["36065","NY","Oneida"]
["36067","NY","Onondaga"]
["36069","NY","Ontario"]
["36071","NY","Orange"]
["36073","NY","Orleans"]
["36075","NY","Oswego"]
["36077","NY","Otsego"]
["36079","NY","Putnam"]
["36081","NY","Queens"]
["36083","NY","Rensselaer"]
["36085","NY","Richmond"]
["36087","NY","Rockland"]
["36089","NY","St. Lawrence"]
["36091","NY","Saratoga"]
["36093","NY","Schenectady"]
["36095","NY","Schoharie"]
["36097","NY","Schuyler"]
["36099","NY","Seneca"]
["36101","NY","Steuben"]
["36103","NY","Suffolk"]
["36105","NY","Sullivan"]
["36107","NY","Tioga"]
["36109","NY","Tompkins"]
["36111","NY","Ulster"]
["36113","NY","Warren"]
["36115","NY","Washington"]
["36117","NY","Wayne"]
["36119","NY","Westchester"]
["36121","NY","Wyoming"]
["36123","NY","Yates"]
["37001","NC","Alamance"]
["37003","NC","Alexander"]
["37005","NC","Alleghany"]
["37007","NC","Anson"]
["37009","NC","Ashe"]
["37011","NC","Avery"]
["37013","NC","Beaufort"]
["37015","NC","Bertie"]
["37017","NC","Bladen"]
["37019","NC","Brunswick"]
["37021","NC","Buncombe"]
["37023","NC","Burke"]
["37025","NC","Cabarrus"]
["37027","NC","Caldwell"]
["37029","NC","Camden"]
["37031","NC","Carteret"]
["37033","NC","Caswell"]
["37035","NC","Catawba"]
["37037","NC","Chatham"]
["37039","NC","Cherokee"]
["37041","NC","Chowan"]
["37043","NC","Clay"]
["37045","NC","Cleveland"]
["37083","NC","Halifax"]
["37093","NC","Hoke"]
["37171","NC","Surry"]
["38013","ND","Burke"]
["38047","ND","Logan"]
["38081","ND","Sargent"]
["39017","OH","Butler"]
["39065","OH","Hardin"]
["39091","OH","Logan"]
["39169","OH","Wayne"]
["40027","OK","Cleveland"]
["40069","OK","Johnston"]
["40103","OK","Noble"]
["40137","OK","Stephens"]
["41023","OR","Grant"]
["42029","PA","Chester"]
["42071","PA","Lancaster"]
["42105","PA","Potter"]
["72005","PR","Aguadilla"]
["72047","PR","Corozal"]
["72079","PR","Lajas"]
["72145","PR","Vega Baja"]
["45031","SC","Darlington"]
["45065","SC","Mccormick"]
["46017","SD","Buffalo"]
["46051","SD","Grant"]
["46085","SD","Lyman"]
["46127","SD","Union"]
["47075","TN","Haywood"]
["47109","TN","Mc Nairy"]
["47143","TN","Rhea"]
["47177","TN","Warren"]
["48029","TX","Bexar"]
["48063","TX","Camp"]
["48141","TX","El Paso"]
["48183","TX","Gregg"]
["48205","TX","Hartley"]
["48257","TX","Kaufman"]
["48291","TX","Liberty"]
["48325","TX","Medina"]
["48411","TX","San Saba"]
["48445","TX","Terry"]
["48487","TX","Wilbarger"]
["49027","UT","Millard"]
["49045","UT","Tooele"]
["78010","VI","St. Croix"]
["51595","VA","Emporia City"]
["51079","VA","Greene"]
["51680","VA","Lynchburg City"]
["51135","VA","Nottoway"]
["51770","VA","Roanoke City"]
["51810","VA","Virginia Beach City"]
["53059","WA","Skamania"]
["54023","WV","Grant"]
["54057","WV","Mineral"]
["54099","WV","Wayne"]
["55023","WI","Crawford"]
["55079","WI","Milwaukee"]
["55095","WI","Polk"]
["56031","WY","Platte"]
["69120","MP","Tinian"]
["00606","72093",null,null,null,null,null,null,null,"AK","AKRating Area 2","02090","Fairbanks North Star"]
["00646","72051",null,null,null,null,null,null,null,"AK","AKRating Area 3","02195","Petersburg"]
["00685","72131",null,null,null,null,null,null,null,"AL","ALRating Area 13","01025","Clarke"]
["00719","72105",null,null,null,null,null,null,null,"AL","ALRating Area 13","01087","Macon"]
["00741","72069",null,null,null,null,null,null,null,"AL","ALRating Area 3","01115","St. Clair"]
["00840","78010",null,null,null,null,null,null,null,"AR","ARRating Area 2","05121","Randolph"]
["00917","72127",null,null,null,null,null,null,null,"AR","ARRating Area 4","05097","Montgomery"]
["00935","72127",null,null,null,null,null,null,null,"AR","ARRating Area 6","05057","Hempstead"]
["00965","72061",null,null,null,null,null,null,null,"AZ","AZRating Area 3","04012","La Paz"]
["00987","72031",null,null,null,null,null,null,null,"CA","CARating Area 1","06023","Humboldt"]
["01029","25003",null,null,null,null,null,null,null,"CA","CARating Area 11","06031","Kings"]
["01079","25013",null,null,null,null,null,null,null,"CO","CORating Area 10","08029","Delta"]
["01105","25013",null,null,null,null,null,null,null,"CO","CORating Area 3","08001","Adams"]
["01201","25003",null,null,null,null,null,null,null,"CO","CORating Area 8","08025","Crowley"]
["01242","25003",null,null,null,null,null,null,null,"CO","CORating Area 9","08121","Washington"]
["01302","25011",null,null,null,null,null,null,null,"FL","FLRating Area 16","12033","Escambia"]
["01355","25011",null,null,null,null,null,null,null,"FL","FLRating Area 31","12063","Jackson"]
["01475","25027",null,null,null,null,null,null,null,"FL","FLRating Area 67","12133","Washington"]
["01507","25027",null,null,null,null,null,null,null,"GA","GARating Area 1","13081","Crisp"]
["01546","25027",null,null,null,null,null,null,null,"GA","GARating Area 11","13309","Wheeler"]
["01588","25027",null,null,null,null,null,null,null,"GA","GARating Area 13","13129","Gordon"]
["01702","25017",null,null,null,null,null,null,null,"GA","GARating Area 15","13099","Early"]
["01749","25017",null,null,null,null,null,null,null,"GA","GARating Area 2","13105","Elbert"]
["01813","25017",null,null,null,null,null,null,null,"GA","GARating Area 3","13171","Lamar"]
["01890","25017",null,null,null,null,null,null,null,"GA","GARating Area 8","13215","Muscogee"]
["01929","25009",null,null,null,null,null,null,null,"IA","IARating Area 1","19015","Boone"]
["01982","25009",null,null,null,null,null,null,null,"IA","IARating Area 3","19047","Crawford"]
["02041","25023",null,null,null,null,null,null,null,"IA","IARating Area 4","19039","Clarke"]
["02065","25023",null,null,null,null,null,null,null,"IA","IARating Area 5","19101","Jefferson"]
["02113","25025",null,null,null,null,null,null,null,"IA","IARating Area 6","19097","Jackson"]
["02152","25025",null,null,null,null,null,null,null,"ID","IDRating Area 2","16053","Jerome"]
["02173","25017",null,null,null,null,null,null,null,"ID","IDRating Area 5","16039","Elmore"]
["02192","25021",null,null,null,null,null,null,null,"ID","IDRating Area 7","16079","Shoshone"]
["02266","25025",null,null,null,null,null,null,null,"IL","ILRating Area 12","17163","St. Clair"]
["02298","25025",null,null,null,null,null,null,null,"IL","ILRating Area 13","17065","Hamilton"]
["02339","25023",null,null,null,null,null,null,null,"IL","ILRating Area 13","17193","White"]
["02366","25023",null,null,null,null,null,null,null,"IL","ILRating Area 6","17073","Henry"]
["02476","25017",null,null,null,null,null,null,null,"IN","INRating Area 11","18065","Henry"]
["02540","25001",null,null,null,null,null,null,null,"IN","INRating Area 14","18137","Ripley"]
["02576","25023",null,null,null,null,null,null,null,"IN","INRating Area 17","18173","Warrick"]
["02648","25001",null,null,null,null,null,null,null,"IN","INRating Area 5","18181","White"]
["02664","25001",null,null,null,null,null,null,null,"IN","INRating Area 8","18009","Blackford"]
["02722","25005",null,null,null,null,null,null,null,"KS","KSRating Area 2","20085","Jackson"]
["02809","44001",null,null,null,null,null,null,null,"KS","KSRating Area 4","20165","Rush"]
["02836","44009",null,null,null,null,null,null,null,"KS","KSRating Area 5","20093","Kearny"]
["02865","44007",null,null,null,null,null,null,null,"KS","KSRating Area 6","20079","Harvey"]
["02888","44003",null,null,null,null,null,null,null,"KY","KYRating Area 1","21007","Ballard"]
["02908","44007",null,null,null,null,null,null,null,"KY","KYRating Area 2","21107","Hopkins"]
["03040","33015",null,null,null,null,null,null,null,"KY","KYRating Area 3","21215","Spencer"]
["03216","33013",null,null,null,null,null,null,null,"KY","KYRating Area 5","21239","Woodford"]
["03235","33013",null,null,null,null,null,null,null,"KY","KYRating Area 7","21165","Menifee"]
["03256","33001",null,null,null,null,null,null,null,"KY","KYRating Area 8","21159","Martin"]
["03282","33009",null,null,null,null,null,null,null,"LA","LARating Area 3","22097","St. Landry"]
["03435","33005",null,null,null,null,null,null,null,"LA","LARating Area 5","22117","Washington"]
["03469","33005",null,null,null,null,null,null,null,"LA","LARating Area 8","22017","Caddo"]
["03743","33019",null,null,null,null,null,null,null,"MA","MARating Area 7","25019","Nantucket"]
["03771","33009",null,null,null,null,null,null,null,"MD","MDRating Area 2","24045","Wicomico"]
["03815","33017",null,null,null,null,null,null,null,"ME","MERating Area 3","23027","Waldo"]
["03836","33003",null,null,null,null,null,null,null,"MI","MIRating Area 12","26121","Muskegon"]
["03853","33003",null,null,null,null,null,null,null,"MI","MIRating Area 14","26113","Missaukee"]
["03875","33003",null,null,null,null,null,null,null,"MI","MIRating Area 16","26071","Iron"]
["04019","23005",null,null,null,null,null,null,null,"MN","MNRating Area 1","27147","Steele"]
["04040","23005",null,null,null,null,null,null,null,"MN","MNRating Area 3","27131","Rice"]
["04070","23005",null,null,null,null,null,null,null,"MN","MNRating Area 5","27173","Yellow Medicine"]
["04088","23017",null,null,null,null,null,null,null,"MN","MNRating Area 7","27065","Kanabec"]
["04116","23005",null,null,null,null,null,null,null,"MN","MNRating Area 9","27089","Marshall"]
["04227","23007",null,null,null,null,null,null,null,"MO","MORating Area 1","29117","Livingston"]
["04284","23011",null,null,null,null,null,null,null,"MO","MORating Area 4","29107","Lafayette"]
["04347","23011",null,null,null,null,null,null,null,"MO","MORating Area 5","29175","Randolph"]
["04354","23027",null,null,null,null,null,null,null,"MO","MORating Area 6","29189","St. Louis"]
["04429","23009",null,null,null,null,null,null,null,"MO","MORating Area 9","29161","Phelps"]
["04456","23019",null,null,null,null,null,null,null,"MS","MSRating Area 3","28049","Hinds"]
["04478","23025",null,null,null,null,null,null,null,"MS","MSRating Area 6","28003","Alcorn"]
["04543","23015",null,null,null,null,null,null,null,"MS","MSRating Area 6","28069","Kemper"]
["04622","23029",null,null,null,null,null,null,null,"MT","MTRating Area 2","30013","Cascade"]
["04645","23013",null,null,null,null,null,null,null,"MT","MTRating Area 4","30019","Daniels"]
["04675","23009",null,null,null,null,null,null,null,"MT","MTRating Area 4","30085","Roosevelt"]
["04694","23029",null,null,null,null,null,null,null,"NC","NCRating Area 1","37075","Graham"]
["04757","23003",null,null,null,null,null,null,null,"NC","NCRating Area 11","37135","Orange"]
["04776","23003",null,null,null,null,null,null,null,"NC","NCRating Area 14","37079","Greene"]
["04917","23011",null,null,null,null,null,null,null,"NC","NCRating Area 6","37057","Davidson"]
["04941","23027",null,null,null,null,null,null,null,"ND","NDRating Area 2","38017","Cass"]
["04962","23011",null,null,null,null,null,null,null,"ND","NDRating Area 4","38037","Grant"]
["04981","23027",null,null,null,null,null,null,null,"ND","NDRating Area 4","38071","Ramsey"]
["05039","50017",null,null,null,null,null,null,null,"NE","NERating Area 1","31039","Cuming"]
["05058","50017",null,null,null,null,null,null,null,"NE","NERating Area 2","31097","Johnson"]
["05085","50017",null,null,null,null,null,null,null,"NE","NERating Area 3","31041","Custer"]
["05341","50025",null,null,null,null,null,null,null,"NE","NERating Area 4","31005","Arthur"]
["05361","50025",null,null,null,null,null,null,null,"NE","NERating Area 4","31075","Grant"]
["05449","50007",null,null,null,null,null,null,null,"NH","NHRating Area 1","33011","Hillsborough"]
["05466","50007",null,null,null,null,null,null,null,"NJ","NJRating Area 5","34005","Burlington"]
["05602","50023",null,null,null,null,null,null,null,"NM","NMRating Area 5","35027","Lincoln"]
["05648","50023",null,null,null,null,null,null,null,"NM","NMRating Area 5","35047","San Miguel"]
["05734","50001",null,null,null,null,null,null,null,"NY","NYRating Area 2","36073","Orleans"]
["05760","50001",null,null,null,null,null,null,null,"NY","NYRating Area 6","36007","Broome"]
["05778","50001",null,null,null,null,null,null,null,"NY","NYRating Area 7","36053","Madison"]
["05838","50005",null,null,null,null,null,null,null,"OH","OHRating Area 10","39141","Ross"]
["05863","50005",null,null,null,null,null,null,null,"OH","OHRating Area 16","39059","Guernsey"]
["06001","09003",null,null,null,null,null,null,null,"OH","OHRating Area 2","39065","Hardin"]
["06032","09003",null,null,null,null,null,null,null,"OH","OHRating Area 6","39043","Erie"]
["06080","09003",null,null,null,null,null,null,null,"OK","OKRating Area 5","40005","Atoka"]
["06101","09003",null,null,null,null,null,null,null,"OK","OKRating Area 5","40047","Garfield"]
["06128","09003",null,null,null,null,null,null,null,"OK","OKRating Area 5","40099","Murray"]
["06151","09003",null,null,null,null,null,null,null,"OK","OKRating Area 5","40149","Washita"]
["06238","09013",null,null,null,null,null,null,null,"OR","ORRating Area 6","41001","Baker"]
["06279","09013",null,null,null,null,null,null,null,"PA","PARating Area 3","42015","Bradford"]
["06370","09011",null,null,null,null,null,null,null,"PA","PARating Area 5","42033","Clearfield"]
["06403","09009",null,null,null,null,null,null,null,"PA","PARating Area 8","42091","Montgomery"]
["06423","09007",null,null,null,null,null,null,null,"PR","PRRating Area 1","72017","Barceloneta"]
["06451","09009",null,null,null,null,null,null,null,"PR","PRRating Area 1","72051","Dorado"]
["06481","09007",null,null,null,null,null,null,null,"PR","PRRating Area 1","72091","Manati"]
["06503","09009",null,null,null,null,null,null,null,"PR","PRRating Area 1","72125","San German"]
["06534","09009",null,null,null,null,null,null,null,"SC","SCRating Area 14","45027","Clarendon"]
["06723","09009",null,null,null,null,null,null,null,"SC","SCRating Area 45","45089","Williamsburg"]
["06770","09009",null,null,null,null,null,null,null,"SD","SDRating Area 1","46075","Jones"]
["06804","09001",null,null,null,null,null,null,null,"SD","SDRating Area 3","46011","Brookings"]
["06836","09001",null,null,null,null,null,null,null,"SD","SDRating Area 3","46129","Walworth"]
["06876","09001",null,null,null,null,null,null,null,"SD","SDRating Area 4","46135","Yankton"]
["06912","09001",null,null,null,null,null,null,null,"TN","TNRating Area 2","47145","Roane"]
["07031","34003",null,null,null,null,null,null,null,"TN","TNRating Area 5","47183","Weakley"]
["07050","34013",null,null,null,null,null,null,null,"TN","TNRating Area 7","47141","Putnam"]
["07074","34003",null,null,null,null,null,null,null,"TX","TXRating Area 1","48253","Jones"]
["07094","34017",null,null,null,null,null,null,null,"TX","TXRating Area 13","48401","Rusk"]
["07188","34013",null,null,null,null,null,null,null,"TX","TXRating Area 20","48181","Grayson"]
["07208","34039",null,null,null,null,null,null,null,"TX","TXRating Area 26","48033","Borden"]
["07452","34003",null,null,null,null,null,null,null,"TX","TXRating Area 26","48163","Frio"]
["07502","34031",null,null,null,null,null,null,null,"TX","TXRating Area 26","48213","Henderson"]
["07605","34003",null,null,null,null,null,null,null,"TX","TXRating Area 26","48277","Lamar"]
["07640","34003",null,null,null,null,null,null,null,"TX","TXRating Area 26","48311","Mc Mullen"]
["07662","34003",null,null,null,null,null,null,null,"TX","TXRating Area 26","48351","Newton"]
["07715","34025",null,null,null,null,null,null,null,"TX","TXRating Area 26","48399","Runnels"]
["07802","34027",null,null,null,null,null,null,null,"TX","TXRating Area 3","48491","Williamson"]
["07836","34027",null,null,null,null,null,null,null,"TX","TXRating Area 8","48251","Johnson"]
["07863","34041",null,null,null,null,null,null,null,"UT","UTRating Area 6","49007","Carbon"]
["07890","34037",null,null,null,null,null,null,null,"VA","VARating Area 1","51121","Montgomery"]
["07938","34035",null,null,null,null,null,null,null,"VA","VARating Area 10","51685","Manassus Park City"]
["08002","34007",null,null,null,null,null,null,null,"VA","VARating Area 12","51091","Highland"]
["08046","34005",null,null,null,null,null,null,null,"VA","VARating Area 2","51125","Nelson"]
["08069","34033",null,null,null,null,null,null,null,"VA","VARating Area 7","51075","Goochland"]
["08087","34029",null,null,null,null,null,null,null,"VA","VARating Area 8","51161","Roanoke"]
["08104","34007",null,null,null,null,null,null,null,"VA","VARating Area 9","51830","Williamsburg City"]
["08210","34009",null,null,null,null,null,null,null,"VT","VTRating Area 1","50017","Orange"]
["08247","34009",null,null,null,null,null,null,null,"WA","WARating Area 3","53059","Skamania"]
["08350","34001",null,null,null,null,null,null,null,"WI","WIRating Area 13","55067","Langlade"]
["08514","34025",null,null,null,null,null,null,null,"WI","WIRating Area 16","55115","Shawano"]
["08544","34021",null,null,null,null,null,null,null,"WI","WIRating Area 6","55063","La Crosse"]
["08608","34021",null,null,null,null,null,null,null,"WV","WVRating Area 1","54087","Roane"]
["08650","34021",null,null,null,null,null,null,null,"WV","WVRating Area 3","54109","Wyoming"]
["08735","34029",null,null,null,null,null,null,null,"WV","WVRating Area 8","54017","Doddridge"]
["08809","34019",null,null,null,null,null,null,null,"WY","WYRating Area 3","56015","Goshen"]
["08859","34023"]
["08880","34035"]
["10001","36061"]
["10018","36061"]
["10039","36061"]
["10081","36061"]
["10125","36061"]
["10166","36061"]
["10197","36061"]
["10273","36061"]
["10305","36085"]
["10458","36005"]
["10503","36119"]
["10535","36119"]
["10578","36119"]
["10606","36119"]
["10801","36119"]
["10925","36071"]
["10956","36087"]
["11005","36081"]
["11054","36059"]
["11206","36047"]
["11223","36047"]
["11245","36047"]
["11359","36081"]
["11381","36081"]
["11510","36059"]
["11553","36059"]
["11565","36059"]
["11691","36081"]
["11717","36103"]
["11737","36059"]
["11780","36103"]
["11805","36103"]
["11942","36103"]
["11964","36103"]
["12010","36057"]
["12035","36095"]
["12061","36083"]
["12120","36001"]
["12141","36093"]
["12167","36025"]
["12181","36083"]
["12209","36001"]
["12233","36001"]
["12404","36111"]
["12429","36111"]
["12449","36111"]
["12468","36039"]
["12504","36027"]
["12514","36027"]
["12569","36027"]
["12590","36027"]
["12727","36105"]
["12754","36105"]
["12778","36105"]
["12804","36113"]
["12855","36031"]
["12879","36031"]
["12923","36019"]
["12944","36019"]
["12966","36033"]
["12995","36033"]
["13066","36067"]
["13081","36011"]
["13120","36067"]
["13142","36075"]
["13167","36075"]
["13219","36067"]
["13331","36043"]
["13360","36041"]
["13416","36043"]
["13441","36065"]
["13471","36065"]
["13491","36043"]
["13613","36089"]
["13655","36033"]
["13677","36089"]
["13691","36045"]
["13746","36007"]
["13778","36017"]
["13806","36025"]
["13863","36023"]
["14024","36121"]
["14041","36009"]
["14069","36029"]
["14112","36029"]
["14132","36063"]
["14173","36009"]
["14267","36029"]
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["Other Practitioner Office Visit (Nurse, Physician Assistant)","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB","Both",null,null,null,null,"EHB"]
["Outpatient Surgery Physician/Surgical Services","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB"]
["Hospice Services","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,6,"Months per Year",null,null,"EHB",null,240,"Days per Episode",null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,10000,"Dollars per Lifetime",null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,5000,"Dollars per Lifetime",null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","SHOP",45,"Days per Year",null,null,"EHB",null,30,"Days per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,6,"Months per Lifetime",null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,180,"Days per Admission",null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,6,"Months per Episode",null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,6,"Months per 3 Years",null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,14,"Days per Lifetime",null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB"]
["Non-Emergency Care When Traveling Outside the U.S.","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["Routine Dental Services (Adult)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB"]
["Infertility Treatment",null,null,null,null,null,null,"EHB",null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB","Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",1,"Procedure(s) per Lifetime",null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,"6 Completed oocyte retrievals/Lifetime ",null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,5000,"Dollars per Lifetime",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"6 cycles per member per lifetime","EHB","Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB","Both",null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,4,"Months per Year",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB"]
["Long-Term/Custodial Nursing Home Care",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,60,"Days per Year",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Private-Duty Nursing",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"$50000 dollars per benefit period, up to $100,000 per lifetime","EHB",null,null,null,null,null,"EHB",null,2000,"Hours per Year",null,null,"EHB",null,5000,"Dollars per Benefit Period",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"SHOP",null,null,null,null,"EHB",null,null,null,null,"$50,000 per benefit period, up to $100,000 per lifetime",null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,60,"Visit(s) per Year",null,null,null,null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.",null,null,null,null,null,null,"EHB",null,null,null,null,"$5000 per benefit period, up to $100,000 per lifetime","EHB",null,85,"Visit(s) per Year",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,500,"Dollars per Year",null,null,"EHB",null,2000,"Dollars per Year",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,5000,"Dollars per Year",null,null,"EHB"]
["Routine Eye Exam (Adult)",null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,1,"Visit(s) per 2 Years",null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Exam(s) per 2 Years",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,1,"Visit(s) per Year",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,1,"Exam(s) per 2 Years",null,null,"EHB",null,1,"Exam(s) per Year",null,null,"EHB",null,1,"Exam(s) per 2 Years",null,null,"EHB",null,1,"Treatment(s) per Year",null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,1,"Visit(s) per Year",null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,1,"Visit(s) per 2 Years",null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,1,"Exam(s) per 2 Years",null,null,"EHB",null,1,"Visit(s) per Year",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,1,"Treatment(s) per Year",null,null,null,null,null,null,null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Exam(s) per Year",null,null,"EHB",null,1,"Treatment(s) per Year",null,null,"EHB",null,1,"Exam(s) per 2 Years",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB"]
["Urgent Care Centers or Facilities","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["Home Health Care Services","EHB",null,130,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,50,"Visit(s) per Year",null,null,"EHB",null,100,"Visit(s) per Year",null,null,"EHB",null,28,"Hours per Week",null,null,"EHB","Both",100,"Days per Year",null,null,"EHB",null,100,"Visit(s) per Year",null,null,"EHB","SHOP",null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,120,"Visit(s) per Year",null,null,"EHB",null,150,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,90,"Visit(s) per Year",null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB","Both",100,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","SHOP",45,"Days per Year",null,null,"EHB","SHOP",120,"Visit(s) per Year",null,null,"EHB",null,90,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,180,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,40,"Visit(s) per Year",null,null,"EHB",null,60,"Days per Year",null,null,"EHB",null,null,null,null,null,"EHB","Both",60,"Visit(s) per Year",null,null,"EHB",null,100,"Visit(s) per Year",null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",40,"Visit(s) per Year",null,null,"EHB",null,100,"Visit(s) per Year",null,null,"EHB",null,30,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,60,"Visit(s) per Year",null,null,"EHB","Both",null,null,null,null,"EHB",null,60,"Visit(s) per Benefit Period",null,null,"EHB",null,null,null,null,null,"EHB",null,60,"Visit(s) per Year",null,null,"EHB",null,60,"Visit(s) per Year",null,null,"EHB",null,30,"Days per Year",null,null,"EHB",null,100,"Visit(s) per Year",null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,130,"Visit(s) per Year",null,null,"EHB","Both",60,"Visit(s) per Year",null,null,"EHB",null,100,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB","Both",42,"Visit(s) per Year",null,null,"EHB"]
["Emergency Room Services","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both"]
["Emergency Transportation/Ambulance","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Transportation within a 500 mile radius","EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB"]
["Inpatient Hospital Services (e.g., Hospital Stay)","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",365,"Days per Admission",null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB","Both",365,"Days per Year",null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,1,"Days per Episode",null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB"]
["Inpatient Physician and Surgical Services","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",365,"Days per Admission",null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"One (1) Inpatient visit per day per Physican or other Professional Provider","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["Bariatric Surgery",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,1,"Procedure(s) per Lifetime",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,1,"Procedure(s) per Lifetime",null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,1,"Procedure(s) per Lifetime",null,null,"EHB",null,5000,"Dollars per Lifetime",null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,10000,"Dollars per Lifetime",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,1,"Procedure(s) per Lifetime",null,null,"EHB"]
["Cosmetic Surgery",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"1 attempt at cosmetic or reconstructive surgery within 18 months after the injury, surgery, scar, or defect first occurred",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["Skilled Nursing Facility","EHB",null,60,"Days per Year",null,null,null,null,null,null,null,null,"EHB",null,60,"Visit(s) per Year",null,null,"EHB",null,100,"Days per Benefit Period",null,null,"EHB",null,100,"Days per Year",null,null,"EHB",null,90,"Days per Year",null,null,"EHB",null,120,"Days per Admission",null,null,"EHB",null,60,"Days per Benefit Period",null,null,"EHB",null,30,"Days per Year",null,null,"EHB",null,120,"Days per Year",null,null,"EHB","Both",90,"Days per Year",null,null,"EHB",null,30,"Days per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,90,"Days per Year",null,null,null,null,null,null,null,null,"EHB",null,90,"Days per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,100,"Days per Year",null,null,"EHB","SHOP",100,"Days per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,45,"Days per Year",null,null,"EHB",null,120,"Days per Admission",null,null,"EHB",null,90,"Days per Year",null,null,null,null,null,null,null,null,"EHB",null,60,"Days per Year",null,null,"EHB",null,60,"Days per Year",null,null,"EHB",null,30,"Days per Year",null,null,"EHB",null,60,"Days per Year",null,null,"EHB",null,100,"Days per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,60,"Days per Year",null,null,"EHB",null,100,"Days per Year",null,null,"EHB",null,200,"Days per Year",null,null,"EHB",null,90,"Days per Year",null,null,"EHB",null,30,"Days per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,120,"Days per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,60,"Days per Benefit Period",null,null,"EHB",null,null,null,90,null,"EHB",null,60,"Days per Year",null,null,"EHB",null,25,"Days per Year",null,null,"EHB",null,30,"Days per Year",null,null,"EHB",null,100,"Days per Admission",null,null,"EHB",null,null,null,null,null,"EHB",null,60,"Days per Year",null,null,"EHB",null,30,"Days per Year",null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,90,"Days per Year",null,null,"EHB"]
["Prenatal and Postnatal Care","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["Delivery and All Inpatient Services for Maternity Care","EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,48,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,48,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,48,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,48,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,48,null,"EHB",null,null,null,48,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,48,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,48,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,48,null,"EHB","Both",null,null,48,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,48,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Individual",null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,48,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both"]
["Mental/Behavioral Health Outpatient Services","EHB",null,null,null,null,null,"EHB",null,20,"Visit(s) per Year",null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","SHOP",20,"Visit(s) per Benefit Period",null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","SHOP",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB","SHOP",null,null,null,null,"EHB","Both",null,null,null,"24 Visits per year for certain non biologically based conditions","EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,20,"Days per Year",null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,52,"Visit(s) per Year",null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,30,"Visit(s) per Year",null,null,"EHB","SHOP",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",25,"Visit(s) per Year",null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,25,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB","Both"]
["Mental/Behavioral Health Inpatient Services","EHB",null,null,null,null,null,"EHB",null,30,"Days per Year",null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,31,"Days per Year",null,null,"EHB","SHOP",30,"Days per Benefit Period",null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","SHOP",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB","SHOP",null,null,null,null,"EHB","Both",null,null,null,"60 Days per Year for certain non biologically based conditions","EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,20,"Days per Year",null,null,"EHB","SHOP",365,"Days per Admission",null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","SHOP",30,"Days per Year",null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","SHOP",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,10,"Days per Year",null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,15,"Days per Year",null,null,"EHB",null,null,null,null,null,"EHB","Both"]
["Substance Abuse Disorder Outpatient Services","EHB","SHOP",null,null,null,null,"EHB","SHOP",20,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","SHOP",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,20,"Visit(s) per Year",null,null,"EHB","SHOP",null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","SHOP",60,"Visit(s) per Year",null,null,"EHB","SHOP",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","SHOP",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","SHOP",null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB","Both",null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","SHOP",null,null,null,"3 Series of Treatment per lifetime","EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,25,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB","Both"]
["Substance Abuse Disorder Inpatient Services","EHB","SHOP",null,null,null,null,"EHB","SHOP",30,"Days per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","SHOP",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB","SHOP",365,"Days per Admission",null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,7,"Days per Year",null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","SHOP",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","SHOP",null,null,null,null,"EHB","SHOP",null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"3 Series of Treatment per lifetime","EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,15,"Days per Year",null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both"]
["Generic Drugs","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,34,"Days per Month",null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"30 day supply or 90 day mail order","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"30 Day supply per month","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["Preferred Brand Drugs","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,34,"Days per Month",null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"30 day supply or 90 day mail order","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"30 Day supply per month","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["Non-Preferred Brand Drugs","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,34,"Days per Month",null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"30 day supply or 90 day mail order","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,"30 Day supply per month","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark",null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["Specialty Drugs","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,1,"Treatment(s) per Month",null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"30 day supply or 90 day mail order","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,"30 Day supply per month","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["Outpatient Rehabilitation Services","EHB",null,45,"Visit(s) per Year",null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,40,"Visit(s) per Year",null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,35,"Visit(s) per Benefit Period ",null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","SHOP",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB","SHOP",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,20,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,30,"Treatment(s) per Year",null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,30,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,60,"Visit(s) per Year",null,null,"EHB",null,null,null,null,"60 vists per condition per lifetime","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,30,"Visit(s) per Year",null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,25,"Visit(s) per Year",null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,null,"EHB",null,20,"Visit(s) per Year",null,null,"EHB",null,60,"Visit(s) per Year",null,null,"EHB"]
["Habilitation Services","EHB",null,45,"Visit(s) per Year",null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.",null,"SHOP",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB","Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark",null,null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",null,null,null,null,"EHB","SHOP",null,null,null,"Quantitative limit units apply, see EHB benchmark.",null,null,null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",null,null,null,"For members age 19 and above: 30 visits per condition per contract year for each therapy (physical therapy, speech therapy, and occupational therapy)","EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark",null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,"50,000 for ABA services for members 0 through 8 years of age and 20,000 for aba services for members 9 through 18 years of age.",null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,"Habilitation services are subject to the limits applicable to rehabilitation services, other therapies, services and supplies. See Explanation.",null,"Both",null,null,null,null,null,"SHOP",null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.",null,null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,30,"Visit(s) per Year",null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB","Both",null,null,null,null,"EHB","SHOP",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB","Both"]
["Chiropractic Care","EHB",null,12,"Visit(s) per Year",null,null,"EHB",null,600,"Dollars per Year",null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark",null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,20,"Visit(s) per Year",null,null,"EHB",null,30,"Visit(s) per Year",null,null,"EHB",null,26,"Procedure(s) per Benefit Period",null,null,"EHB",null,20,"Visit(s) per Year",null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,800,"Dollars per Year",null,null,"EHB",null,1000,"Dollars per Benefit Period",null,null,"EHB",null,12,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,12,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB","Both",12,"Visit(s) per Year",null,null,"EHB","SHOP",null,null,null,"20 visits per condition per contract year","EHB","Both",40,"Visit(s) per Year",null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","SHOP",null,null,null,null,"EHB",null,26,"Visit(s) per Year",null,null,"EHB",null,20,"Visit(s) per Year",null,null,"EHB",null,null,null,null,"$600 maximum per benefit period for treatments, $100 maximum for office visit x-rays","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,20,"Visit(s) per Year",null,null,"EHB",null,20,"Visit(s) per Year",null,null,"EHB",null,12,"Visit(s) per Year",null,null,"EHB",null,30,"Visit(s) per Year",null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,"$1,000 per member per CY and $5,000 maximum lifetime benefit","EHB","Both",null,null,null,null,"EHB",null,12,"Visit(s) per Year",null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.",null,null,null,null,null,null,"EHB",null,20,"Visit(s) per Year",null,null,"EHB",null,12,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,20,"Visit(s) per Year",null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.",null,null,null,null,null,null,"EHB",null,30,"Visit(s) per Year",null,null,"EHB","Both",12,"Visit(s) per Year",null,null,"EHB",null,10,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,15,"Visit(s) per Year",null,null,"EHB","Both",20,"Visit(s) per Year"]
["Durable Medical Equipment","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Unit limits unique to type of DME defined per medical coverage policy ","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,1500,"Dollars per Year",null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",2500,"Dollars per Year",null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,"EHB",null,null,null,null,"1 Item(s) per 3 years, up to $2500 per year","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["Hearing Aids",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,"$1,000 per individual hearing aid, per ear, every three (3) years for children less than 24 years of age.",null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,"1 Hearing aid per ear every 60 months",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB","Both",null,null,null,"1 time per hearing impaired ear per 3 years","EHB","Both",null,null,null,"1 hearing aid per ear per 3 years, up to $1,400",null,"Both",null,null,null,null,"EHB","Both",null,null,null,"1 hearing aid per each hearing impaired ear every 36 months","EHB","Both",null,null,null,"1 hearing aid per affected ear per 3 years",null,null,null,null,null,null,"EHB","Both",1,"Item(s) per 3 Years",null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB","Both",null,null,null,"One hearing aid per hearing impaired ear, and replacement hearing aids. Once every 36 months. $2500 per hearing impaired ear every 36 months.",null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,"1 per ear each time prescription changes","EHB","Both",null,null,null,"One/hearing-impaired ear every 24-months","EHB","Both",null,null,null,null,"EHB",null,null,null,null,"$5000 per year. Limited to a single purchase. Repairs and replacement limited to once every 3 years.","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.",null,null,null,null,null,null,"EHB","SHOP",null,null,null,"1 hearing aid per ear every 48 months for Subscribers up to age 18","EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.",null,null,null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.",null,null,null,null,null,null,null,null,null,null,null,null,"EHB","Both",null,null,null,"$1000 per year every 3 years","EHB",null,1000,"Dollars per 3 Years",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.",null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark."]
["Imaging (CT/PET Scans, MRIs)","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["Preventive Care/Screening/Immunization","EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",1,"Visit(s) per Year",null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,"Preventive colonoscopy (age 50+) 1 every 10 years.  High risk colonoscopy 1 every 2 years.","EHB","Both",null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",null,null,null,"Age and frequency schedules may apply","EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,"Well Care visit limited to 1 per year except for Well child care under age 6. Alcohol misuse and tobacco use counseling limited to 8 visits annually; must be provided in the primary care setting; Dietary counseling for adults with hyperlipidemia, hypertension, Type 2 diabetes, coronary artery disease and congestive heart failure limited to 6 visits annually.","EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both"]
["Routine Foot Care",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,1,"Visit(s) per Year",null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB"]
["Acupuncture","EHB",null,12,"Visit(s) per Year",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,12,"Visit(s) per Year"]
["Weight Loss Programs",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,"$150 reimbursement per contract per calendar year",null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB"]
["Routine Eye Exam for Children","EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Exam(s) per 2 Years",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Exam(s) per Year",null,null,"EHB",null,1,"Treatment(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per Year"]
["Eye Glasses for Children","EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,null,null,null,"Lenses limited to one pair per calendar year.  Frames limited to one frame every 24 months.","EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,3,"Item(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,1,"Item(s) per Year",null,null,null,null,null,null,null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per 2 Years",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per 2 Years",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,null,null,null,"One pair of glasses per year.  Collection frames (up to $250) are covered in full.  Non-collection lenses are covered up to $150 and then 20% off.  Standard lenses are covered in full.","EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,150,"Dollars per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year",null,null,"EHB",null,1,"Item(s) per Year"]
["Dental Check-Up for Children","EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,2,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,2,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,null,null,null,"One every 6 months and one every 12 months in a school setting","EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,2,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,null,null,null,"Oral exams, cleanings, fluoride limited to twice in 12 months","EHB",null,2,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,2,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,2,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,2,"Visit(s) per Year",null,null,"EHB",null,2,"Visit(s) per Year",null,null,"EHB",null,2,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,null,null,null,"Periodic:  2 times per year.  Comprehensive:  1 time per year with the same provider; 2 times per year with different providers. Up to a lifetime maximum of $2000.","EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,2,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,2,"Visit(s) per Year",null,null,"EHB",null,2,"Visit(s) per Year",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months",null,null,"EHB",null,1,"Visit(s) per 6 Months"]
["Rehabilitative Speech Therapy",null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark",null,null,null,null,null,null,"EHB","Both",20,"Visit(s) per Year",null,null,null,null,null,null,null,null,"EHB",null,30,"Visit(s) per Year",null,null,null,null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark",null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,90,"Visit(s) per Year",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,20,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,30,"Visit(s) per Year",null,null,null,null,null,null,null,null,"EHB",null,45,"Visit(s) per Year",null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,20,"Visit(s) per Year",null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,"EHB",null,30,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,20,"Visit(s) per Year",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,30,"Visit(s) per Year",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,20,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,20,"Visit(s) per Year",null,null,null,null,null,null,null,null,"EHB"]
["Rehabilitative Occupational and Rehabilitative Physical Therapy",null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark",null,null,null,null,null,null,"EHB",null,40,"Visit(s) per Year",null,null,null,null,null,null,null,null,"EHB",null,30,"Visit(s) per Year",null,null,null,null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark",null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,60,"Visit(s) per Year",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,20,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,30,"Visit(s) per Year",null,null,null,null,null,null,null,null,"EHB",null,90,"Visit(s) per Year",null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,30,"Visit(s) per Year",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,40,"Visit(s) per Year",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,30,"Visit(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"30 Visits per benefit period for Physical Therapy",null,null,null,null,null,null,"EHB",null,40,"Visit(s) per Year",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,30,"Visit(s) per Year",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,40,"Visit(s) per Year",null,null,null,null,null,null,null,null,"EHB",null,60,"Visit(s) per Year"]
["Well Baby Visits and Care",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB"]
["Laboratory Outpatient and Professional Services","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["X-rays and Diagnostic Imaging","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB","SHOP",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["Basic Dental Care – Child","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,1,"Exam(s) per Year",null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["Major Dental Care – Child","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,"once every 2 years for the same restoration","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["Orthodontia – Child",null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["Basic Dental Care – Adult"]
["Orthodontia – Adult",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB"]
["Major Dental Care – Adult",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Abortion for Which Public Funding is Prohibited",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,1,"Treatment(s) per Year",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB"]
["Transplant",null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark",null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,35000,"Dollars per transplant",null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"$30,000/transplant (OON only)","EHB",null,null,null,null,"$150 per day for meal, transportation and lodging up to $10,000 for recipient and one additional adult (or 2 adults if patient is a minor)","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["Accidental Dental",null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,"Care must be completed within 12 months of the injury",null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,3000,"Dollars per Benefit Period",null,null,"EHB",null,null,null,null,null,"EHB",null,3000,"Dollars per Benefit Period",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,3000,"Dollars per Benefit Period",null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,3000,"Dollars per Benefit Period",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,3000,"Dollars per Year",null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB"]
["Dialysis",null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB"]
["Allergy Testing",null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["Chemotherapy",null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB"]
["Radiation",null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["Diabetes Education",null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"10 hours per year in the first year and two hours follow-up annually.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,1,"Visit(s) per Year",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"One time Evaluation / 3 Hours"]
["Prosthetic Devices",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,500,"Dollars per Year",null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,10000,"Dollars per Lifetime",null,null,"EHB",null,null,null,null,"1 external prosthetic device per limb per lifetime (limit does not apply to internal devices)",null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,350,"Dollars per Year",null,null,"EHB",null,50000,"Dollars per Benefit Period",null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,2500,"Dollars per Year",null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["Infusion Therapy",null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB"]
["Treatment for Temporomandibular Joint Disorders",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB","Both",null,null,null,"One splint in a six month period unless a more frequent replacement is determined to be medically necessary.",null,"Both",null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,"$1000 per course of treatment per 5 years",null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,"EHB","Both",null,null,null,"5000 Dollars","EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,"Total maximum benefit of $2500",null,null,null,null,null,null,"EHB",null,null,null,null,null,null,"Both",null,null,null,null,"EHB","Both",null,null,null,"Quantitative limit units apply, see EHB benchmark.",null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,"$1,250 per year for diagnostic\nprocedures and non-surgical\ntreatment","EHB",null,null,null,null,"Orthotics, splints and appliances are limited to one every 3 years.",null,null,null,null,null,null,"EHB"]
["Nutritional Counseling",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,250,"Dollars per Benefit Period",null,null,null,null,null,null,null,null,"EHB",null,null,null,null,"6 visits per condition per contract year",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,3,"Visit(s) per Year",null,null,"EHB",null,3,"Visit(s) per Lifetime",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["Reconstructive Surgery",null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,"EHB","Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,"EHB","Both",null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","SHOP",null,null,null,null,null,"Individual",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,"EHB","Both",null,null,null,null,null,null,null,null,null,null,"EHB","Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"SHOP",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,null,null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,null,"SHOP",null,null,null,null,"EHB","Both",null,null,null,null,null,"Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,null,"Both",null,null,null,null,"EHB","Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","Both",null,null,null,null,null,"Both"]
["Clinical Trials",null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"SHOP",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both"]
["Diabetes Care Management",null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"SHOP",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"SHOP",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Individual",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both"]
["Inherited Metabolic Disorder - PKU",null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Newborn Hearing Screening",null,"Both"]
["Off Label Prescription Drugs",null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Individual",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Dental Anesthesia",null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"SHOP",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"SHOP",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"SHOP",null,null,null,null,null,"Both",null,null,null,null,null,"Both"]
["Gastric Electrical Stimulation",null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Mental Health Other",null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"SHOP",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"SHOP",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"SHOP",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Individual",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"SHOP"]
["Well Child Care",null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Prescription Drugs Other",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"SHOP",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both"]
["Coverage for Effects of Diethylstilbestrol",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Organ Transplants",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Second Opinion",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Congenital Anomaly, including Cleft Lip/Palate",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Early Intervention Services",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Rehabilitative Occupational Therapy",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Rehabilitative Physical Therapy",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Accidental Ingestion of a Controlled Drug",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Bone Marrow Testing",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Bones/Joints",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both"]
["Developmental Needs of Children & Youth with Cancer",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Mental Health Parity",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Network Retail Pharmacy (60-90 Day Supply) Covered",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Post-Mastectomy Care",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Individual"]
["Wound Care for Individuals with Epidermolysis Bullosa",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Treatment of Medical Complications of Alcoholism",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"SHOP"]
["Bone Marrow Transplant",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,"Both"]
["Nutrition/Formulas",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Osteoporosis",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Individual"]
["Heart Transplant",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Morbid Obesity Treatment",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Autism Spectrum Disorders",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"SHOP"]
["Breast Implant Removal",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Multiple Sclerosis ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Applied Behavior Analysis Based Therapies",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"SHOP"]
["Cochlear Implants",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Attention Deficit Disorder",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Bone Marrow Transplants for Treatment of Breast Cancer",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Cardiac Rehabilitation",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Contraceptive Services",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Hormone Replacement Therapy (HRT)",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Human Leukocyte Antigen Testing",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Hypodermic Syringes or Needles ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Blood and Blood Services",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"SHOP",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Anesthetics"]
["Treatment of Lyme Disease",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Family Therapy"]
["Oral Surgery"]
["Oxygen"]
["Port-Wine Stain Removal",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Residential Treatment for Children with Emotional Disabilities",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Second Opinions Related to Chemical Dependency and Mental Health"]
["Second Surgical Opinion"]
["Services to Ventilator-Dependent Persons",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Newborn Services Other",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Cancer Treatments",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Domestic Violence Treatment",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Infant Formulas",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Sickle Cell Anemia",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Third Opinion",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Treatment of Hemophilia",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Wilm's Tumor",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Breast Reconstructive Surgery",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Drug Infusion Administration"]
["Eating Disorder Treatment"]
["Experimental or Investigational Services",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Brain Injury",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Transplant Surgery - Donor Charges",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Wigs",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Pediatric Services Other",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Individual"]
["Transplant Donor Coverage",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Individual"]
["Rape and Incest Coverage",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]
["Outpatient Contraceptive Services Including Sterilizations",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Both"]

{"sheet":"ErrorLkup","index":20,"n_rows":297,"n_cols":5,"rows_kept":297,"cut":false,"hidden":true,"merged":[]}
["a","Template","Category","ErrorType","Error Message Reading"]
["AD00001A","Administrative Data","None","Error","Field '{Field}' cannot be blank {when}"]
["AD00001B","Administrative Data","None","Error","Invalid issuer ID. Must be 5-digits and numeric."]
["AD00002A","Administrative Data","None","Error","State code not valid."]
["AD00003A","Administrative Data","None","Error","Field '{Field}' is required for plans with 'Proposed Exchange Market Coverage' = {market}."]
["AD00003B","Administrative Data","None","Error","Invalid selection for '{Field}.' Please use the drop down menu in the template."]
["AD00003C","Administrative Data","None","Error","Field '{Field}' must be blank{when}."]
["AD00009A","Administrative Data","None","Error","Invalid Tax Identification Number."]
["AD00016A","Administrative Data","None","Error","Invalid ZIP code format.  Enter as either xxxxx-xxxx OR xxxxx."]
["AD00025A","Administrative Data","None","Warning","Field '{Field}' does not appear to be a valid email address.  Please confirm that your entry is correct."]
["AD00026A","Administrative Data","None","Error","Field '{Field}' does not appear to be a valid 10- or 11-digit telephone number.  Please confirm that your entry is correct."]
["AD00047A","Administrative Data","None","Warning","The URL provided for field '{Field Name}' might not be valid.  Please re-verify its accuracy."]
["AD00053A","Administrative Data","None","Error","Fields within '11. Contacts - {Field}' must either all be blank or all be completed (exception: phone extension can be blank when all other fields are completed)."]
["ECP00011","Essential Community Providers","None","Error","Field 'National Provider Number' cannot be duplicate."]
["ECP00012","Essential Community Providers","None","Error","Field 'Provider Name' cannot be duplicate."]
["ECP00013","Essential Community Providers","None","Error","Fields 'Provider Type' and 'ECP Category' cannot both be blank, both be NA, or both be completed."]
["ECP00014","Essential Community Providers","None","Error","Invalid ZIP code format.  Enter as either xxxxx-xxxx OR xxxxx."]
["ECP00015","Essential Community Providers","None","Error","Invalid Network ID.  Must be 6 characters in length of the form State code + 'N' + 999, where 9's represent numeric values. The first two characters must match the issuer state. State code is case sensitive."]
["ECP00016","Essential Community Providers","None","Error","Invalid HIOS Issuer ID. Must be 5-digits and numeric."]
["ECP00017","Essential Community Providers","None","Error","State code not valid."]
["ECP00176A","Essential Community Providers","None","Error","Field '{Field}' is required {description of when}"]
["ECP00181A","Essential Community Providers","None","Error","Field '{Field}' is invalid.  Item '{Item}' is not from the dropdown menu.  Please try again."]
["IE00001A","Plans & Benefits","Benefits","Error","INTERNAL ERROR, '{Offending Field}'"]
["IE00002A","Rates","None","Warning","Valid '{Field}' field not found in Template '{TemplateName}' for when {Filter Arguments}."]
["IE00003A","Plans & Benefits","Benefits","Error","Field '{Offending Field}' is invalid.  {Details}"]
["IE00004A","Plans & Benefits","Benefits","Error","Could not retrieve a valid '{Field}' for this plan. {Details}"]
["IN00190A","IssuerNCQA","None","Error","Invalid issuer ID. Must be 5-digits and numeric."]
["IN00190B","IssuerNCQA","None","Error","Field '{FieldName}' must not be blank.  Please enter a value."]
["IN00191A","IssuerNCQA","None","Error","Invalid NCQA Org ID. Must be between 2 to 5 digits long and numeric."]
["IN00192A","IssuerNCQA","None","Error","Invalid selection for 'Market Type' field.  Please select a valid entry from the drop down menu."]
["IN00192B","IssuerNCQA","None","Error","When 'Market Type' = 'Medicaid,' 'Product Type' cannot be '{Field value that includes PPO}.'"]
["IN00192C","IssuerNCQA","None","Error","When 'Market Type' = 'Exchange,' 'NCQA Sub ID' must be blank."]
["IN00192D","IssuerNCQA","None","Error","When 'Market Type' is '{Market Type other than Exchange},' 'NCQA Sub ID' must NOT be blank."]
["IN00194A","IssuerNCQA","None","Error","Invalid selection for 'Product Type' field.  Please select a valid entry from the drop down menu."]
["IN00195A","IssuerNCQA","None","Error","Invalid Product ID.  Must be 10 characters in length.  Characters 1 to 5 and 8 to 10 must be numeric and characters 6 and 7 must be alpha.  First 5 characters must match Issuer ID; next 2 must match state. State code is case sensitive."]
["IN00196A","IssuerNCQA","None","Error","When 'Market Type' = 'Exchange,' 'Accreditation Status' must be 'Interim.'"]
["IN00196B","IssuerNCQA","None","Error","Invalid selection for 'Accreditation Status' field.  Please select a valid entry from the drop down menu."]
["IN00197A","IssuerNCQA","None","Error","Expiration date must be a valid date and should be in the future.  Please select another date."]
["IN00198A","IssuerNCQA","None","Warning","Expiration date cannot be earlier than 11/15/2014"]
["IU00198A","IssuerURAC","None","Error","Invalid issuer ID. Must be 5-digits and numeric."]
["IU00198B","IssuerURAC","None","Error","Field '{FieldName}' must not be blank.  Please enter a value."]
["IU00199A","IssuerURAC","None","Error","Invalid URAC Application Number.  The first 3 characters should be alpha, the next 6 characters should be numeric, and the final character (if applicable) should be 'R.'"]
["IU00200A","IssuerURAC","None","Error","Invalid selection for 'Market Type' field.  Please select a valid entry from the drop down menu."]
["IU00201A","IssuerURAC","None","Error","Invalid selection for 'Accreditation Status' field.  Please select a valid entry from the drop down menu."]
["IU00202A","IssuerURAC","None","Error","Expiration date must be some time in the future.  Please select another date."]
["IU00203A","IssuerURAC","None","Error","Invalid Expiration date"]
["IU00204A","IssuerURAC","None","Warning","Expiration date cannot be earlier than 11/15/2014"]
["NE00203A","Network","None","Error","Invalid HIOS Issuer ID. Must be 5-digits and numeric."]
["NE00203A","Network","None","Error","Invalid HIOS Issuer ID. Must be 5-digits and numeric."]
["NE00203B","Network","None","Error","Field '{Field}' is required {description of when}"]
["NE00204A","Network","None","Error","State code not valid."]
["NE00206A","Network","None","Error","Invalid Network ID.  Must be 6 characters in length of the form State code + 'N' + 999, where 9's represent numeric values. The first two characters must match the issuer state. State code is case sensitive."]
["NE00207A","Network","None","Error","Field 'Network URL' is required.  Please enter a valid URL."]
["PB00208A","Plans & Benefits","Header","Error","Invalid issuer ID. Must be 5-digits and numeric."]
["PB00213B","Plans & Benefits","Header","Error","Duplicative use of 'HIOS Plan ID (Standard Component).'  The same value CANNOT be used for separate plans with different 'Market Coverage' and/or 'Dental Only' status. (Plan ID: {Plan ID})"]
["PB00209A","Plans & Benefits","Header","Error","State code not valid."]
["PB00210A","Plans & Benefits","Header","Error","A single template cannot include plans with different Market Coverage, like {workbook name} does."]
["PB00211A","Plans & Benefits","Benefits","Error","Benefit '{Benefit}' is not a dental benefit and should not be included in Dental Only Plans."]
["PB00212A","Plans & Benefits","Header","Error","Invalid Tax Identification Number."]
["PB00213A","Plans & Benefits","Attributes","Error","Invalid HIOS Plan ID.  Must be 14 characters in length.  Characters 1 to 5 and 8 to 14 must be numeric and characters 6 and 7 must be alpha.  First 5 characters must match Issuer ID; next 2 must match state. State code is case sensitive."]
["PB00214A","Plans & Benefits","Attributes","Warning","Plan marketing name is greater than 255 characters and may not display properly to consumers."]
["PB00215A","Plans & Benefits","Attributes","Error","Invalid HIOS Product ID.  Must be 10 characters in length.  Characters 1 to 5 and 8 to 10 must be numeric and characters 6 and 7 must be alpha.  First 5 characters must match Issuer ID; next 2 must match state. State code is case sensitive."]
["PB00216A","Plans & Benefits","Attributes","Error","Invalid HPID.  Must be 10 characters in length and numeric only."]
["PB00217A","Plans & Benefits","Attributes","Error","Invalid Network ID.  Must be 6 characters in length of the form State code + 'N' + 999, where 9's represent numeric values. The first two characters must match the issuer state. State code is case sensitive."]
["PB00218A","Plans & Benefits","Attributes","Error","Invalid Service Area ID.  Must be 6 characters in length of the form State code + 'S' + 999, where 9's represent numeric values.  The first two characters must match the issuer state. State code is case sensitive."]
["PB00219A","Plans & Benefits","Attributes","Error","Invalid Formulary ID.  Must be 6 characters in length of the form State code + 'F' + 999, where 9's represent numeric values.  The first two characters must match the issuer state. State code is case sensitive."]
["PB00220A","Plans & Benefits","Attributes","Error","New / Existing Plan is a required field.  Please enter either 'New' or 'Existing' in the appropriate cell on the plans and benefits worksheet."]
["PB00221A","Plans & Benefits","Attributes","Error","Plan Type is a required field.  Please use the dropdown to select a value for the appropriate cell in the plans and benefits worksheet."]
["PB00222A","Plans & Benefits","Attributes","Error","CSR Variation Type does not match actuarial value (AV).  Zero Cost Share Plans should have AV values of 100%."]
["PB00222B","Plans & Benefits","Attributes","Error","Invalid Level of Coverage.  {Metal} plans must have actuarial values between {bottom%} and {top%}%.  [+-2%]"]
["PB00222C","Plans & Benefits","Attributes","Error","Invalid Level of Coverage.  {Silver Plan Type} plans must have actuarial values between {bottom%} and {top%}%.  [+-1%]"]
["PB00222D","Plans & Benefits","Attributes","Error","There appears to be no standard plan listed for this 73% AV silver plan.  Could not verify that 73% AV Silver plan is at least 2% greater than Standard Silver plan."]
["PB00222E","Plans & Benefits","Attributes","Error","73% AV silver plan ({HIOS Plan ID + variance}) does not have an actuarial value at least 2% greater than the standard silver plan ({HIOS Plan ID + variance})."]
["PB00222F","Plans & Benefits","Attributes","Error","Unrecognized CSR variation type for plan with silver level of coverage."]
["PB00222G","Plans & Benefits","Attributes","Error","Plans with catastrophic level of coverage do not require actuarial value calculation.  Please ensure that fields 'Issuer Actuarial Value' and 'AV Calculator Output Number\" are both blank."]
["PB00222H","Plans & Benefits","Attributes","Error","Invalid Level of Coverage.  Select a valid 'Level of Coverage' using the drop down menu."]
["PB00222I","Plans & Benefits","Attributes","Error","Dental Only Plans' must have level of coverage set to either 'High' or 'Low'."]
["PB00223A","Plans & Benefits","Attributes","Error","Dental Only Plans should have empty '{Field Name}' fields."]
["PB00223B","Plans & Benefits","Attributes","Warning","Plans with Unique Plan Design must be submitted with supporting documentation."]
["PB00224A","Plans & Benefits","Attributes","Error","Field 'QHP/non-QHP' value is required and should be selected from the drop down menu."]
["PB00224B","Plans & Benefits","Attributes","Error","For medical plans, 'QHP/Non-QHP' = On the Exchange should not be selected.  Under the guaranteed availability requirements in 45 C.F.R. §147.104, a plan offered through the Exchange must also be available to individuals in the state that apply for the plan outside the Exchange.  Issuers that offer a plan through the Exchange should select the “Both” option."]
["PB00227A","Plans & Benefits","Attributes","Error","Required field.  When 'Is a Referral Required for Specialist?' is 'Yes,' 'Specialist(s) Requiring a Referral' must be completed."]
["PB00228A","Plans & Benefits","Attributes","Warning","Field 'Plan Level Exclusions' exceeds 2,000 characters in length and may not display properly to consumers."]
["PB00229A","Plans & Benefits","Attributes","Error","Catastrophic plans require $0 'Limited Cost Sharing Plan Variation - Est. Advanced Payment.'"]
["PB00230A","Plans & Benefits","Attributes","Error","Field '{Field}' is required {description of when}"]
["PB00231A","Plans & Benefits","Attributes","Error","HSA/HRS Employer Contribution' must be completed for SHOP (Small Group) market plans."]
["PB00231B","Plans & Benefits","Attributes","Error","Field '{Field}' should be blank {When}"]
["PB00232A","Plans & Benefits","Attributes","Error","Plans with HSA/HRA Employer Contributions must specify a 'HSA/HRA Employer Contribution Amount.'"]
["PB00232C","Plans & Benefits","Attributes","Error","'HSA/HRA Employer Contribution Amounts must be whole dollar amounts."]
["PB00233A","Plans & Benefits","Attributes","Error","Invalid 'Child-Only Offering' value.  Please select a value from the drop down menu."]
["PB00233B","Plans & Benefits","Attributes","Error","Plans that 'Allows Adult-only' must have a valid matching Child Plan ID in 'Child-Only Plan ID' field."]
["PB00233C","Plans & Benefits","Attributes","Error","Stand Alone Dental Plans' cannot have 'Child-Only Offering' equal to 'Allows Adult-Only.'"]
["PB00233D","Plans & Benefits","Attributes","Warning","The Federally-Facilitated Small Group Health Options Program (FF-SHOP) and State Partnership Small Group Health Options Program (SP-SHOP) will not accommodate child-only plans.  To offer plans in the FF-SHOP or SP-SHOP, enter a value of “Allows Adult-Only. This error does not apply to off-exchange plans."]
["PB00234A","Plans & Benefits","Attributes","Error","Invalid Child Plan ID.  Must be 14 characters in length.  Characters 1 to 5 and 8 to 14 must be numeric and characters 6 and 7 must be alpha."]
["PB00234B","Plans & Benefits","Attributes","Error","Child Only Plan ID {Child Only Plan ID} is not found within the same benefits package tab."]
["PB00234C","Plans & Benefits","Attributes","Error","Field 'Child Only Plan ID' should be NULL unless field 'Child Only offering' is set to 'Allows Adult-only.'"]
["PB00236A","Plans & Benefits","Attributes","Error","'{Invalid Entry}' is not a valid 'Disease Management Program Offered.'  Please select from the drop down list."]
["PB00236C","Plans & Benefits","Attributes","Error","Field '{Field}' is required for individual market, on the exhange plans."]
["PB00237A","Plans & Benefits","Attributes","Error","Field '{Field}' is required for Dental Only Fields{When}."]
["PB00237B","Plans & Benefits","Attributes","Error","Field '{Field}' must be expressed as a percentage."]
["PB00237C","Plans & Benefits","Attributes","Error","Field 'EHB Apportionment for Pediatric Dental' must be numeric and greater than 0 for Individual Market Dental Only Plans."]
["PB00237D","Plans & Benefits","Attributes","Warning","The Federally-Facilitated Small Group Health Options Program (FF-SHOP) and State Partnership Small Group Health Options Program (SP-SHOP) will not accommodate estimated rates.  To offer plans in the FF-SHOP or SP-SHOP, enter a value of ”Guaranteed Rate.” This error does not apply to off-exchange plans."]
["PB00239A","Plans & Benefits","Attributes","Error","Field 'Maximum Coinsurance for Specialty Drugs' must be a whole dollar amount."]
["PB00240A","Plans & Benefits","Attributes","Error","Field '{Field}' must be a number between 1 and 10 or blank."]
["PB00243A","Plans & Benefits","Attributes","Error","Qualified Health plans on the individual market must have 'Plan effective dates' of 1/1/{Year}."]
["PB00243B","Plans & Benefits","Attributes","Error","'Plan Effective Date' must be before 'Plan Expiration Date.'"]
["PB00244A","Plans & Benefits","Attributes","Error","Qualified health plans on the individual market must have 'Plan expiration dates' of 12/31/{Year}."]
["PB00246A","Plans & Benefits","Attributes","Error","Field '{Description Element}' is required when '{Coverage Element}' is 'Yes.'  Please enter a value."]
["PB00251A","Plans & Benefits","None","Warning","The URL provided for field '{Field Name}' might not be valid.  Please re-verify its accuracy."]
["PB00253A","Plans & Benefits","Benefits","Error","EHB value is incorrect for {Benefit}.  Check to be sure you are using the latest versions of the templates and the Data Integrity Tool."]
["PB00254A","Plans & Benefits","Benefits","Error","State Required Benefit value is incorrect for {Benefit}.  Check to be sure you are using the latest versions of the templates and the Data Integrity Tool."]
["PB00255A","Plans & Benefits","Benefits","Error","Same benefit listed multiple times. Remove one or change one to a unique name."]
["PB00255B","Plans & Benefits","Benefits","Error","Essential health benefit ({Benefit}) is not covered and no EHB Variance reason is selected."]
["PB00255C","Plans & Benefits","Benefits","Warning","State Required Benefit ({Benefit}) is not covered.  Please verify this is not an error."]
["PB00255D","Plans & Benefits","Benefits","Error","Essential health benefits that are not covered require completion of the EHB variance field."]
["PB00255E","Plans & Benefits","Benefits","Error","Non-covered benefits should not have values for '{Benefits Information Field Name}.'"]
["PB00255F","Plans & Benefits","Benefits","Error","Non-EHB, Non-State required benefits that are covered, must also have a valid EHB Variance"]
["PB00257A","Plans & Benefits","Benefits","Error","The 'EHB Variance Reason' field must be completed if the 'Limit Quantity' field changes from the value originally populated in the template (benefit: {Benefit})"]
["PB00257B","Plans & Benefits","Benefits","Error","'Limit Quantity' required when there is a quantitative limit on service (benefit: {Benefit})"]
["PB00257C","Plans & Benefits","Benefits","Error","'Limit Quantity' must be greater than zero (benefit: {Benefit})"]
["PB00258B","Plans & Benefits","Benefits","Error","'Limit Unit' required when there is a quantitative limit on service (benefit: {Benefit})"]
["PB00258C","Plans & Benefits","Benefits","Error","Unrecognized limit unit OR limit unit not valid."]
["PB00258D","Plans & Benefits","Benefits","Error","Field 'EHB Variance Reason' must be completed when 'Limit Quantity' &/or 'Limit Unit' are provided for non-EHB and non-State Required Benefits."]
["PB00258E","Plans & Benefits","Benefits","Error","If either 'Limit Unit' or 'Limit Quantity' is completed, the other must also be completed."]
["PB00259A","Plans & Benefits","Benefits","Warning","Non-zero minimum stays might apply to 'Delivery and All Inpatient Services for Maternity Care' benefits and to select others such as special needs facilities.  Please be certain your entry is not an error."]
["PB00259B","Plans & Benefits","Benefits","Warning","Minimum stay value is less than the benchmark for 'Delivery and All Inpatient Services for Maternity Care' benefit."]
["PB00259C","Plans & Benefits","Benefits","Error","''Delivery and All Inpatient Services for Maternity Care' benefit requires a minimum stay greater than 0."]
["PB00260A","Plans & Benefits","Benefits","Warning","When 'Exclusions' field exceeds 2,000 characters in length, the risk of information loss due to truncation increases."]
["PB00261A","Plans & Benefits","Benefits","Warning","When 'Explanation (text field)' field exceeds 2,000 characters in length, the risk of information loss due to truncation increases."]
["PB00262A","Plans & Benefits","Benefits","Error","The 'EHB Variance Reason' field must be completed if the 'Limit Unit' field changes from the value originally populated in the template (benefit: {Benefit})"]
["PB00262B","Plans & Benefits","Benefits","Error","The 'EHB Variance Reason' field must be completed when 'Limit Quantity' is less than benchmark (benefit: {Benefit})"]
["PB00262C","Plans & Benefits","Benefits","Error","EHB variance field must be completed when Minimum Stay does not match benchmark (benefit: {Benefit})"]
["PB00262D","Plans & Benefits","Benefits","Error","EHB Variance field value is invalid.  Please choose from the options in the drop-down. (benefit: {Benefit})"]
["PB00262E","Plans & Benefits","Benefits","Error","EHB variance field is required for non-essential, covered health benefits (benefit: {Benefit})"]
["PB00262F","Plans & Benefits","Benefits","Error","Dental only plans cannot have an EHB variance of 'Dental Only Plan Available' (benefit: {Benefit})"]
["PB00263A","Plans & Benefits","Benefits","Error","Covered benefits require completion of the 'Subject to Deductible (Tier 1)' field."]
["PB00264A","Plans & Benefits","Benefits","Error","Covered benefits require completion of the 'Subject to Deductible (Tier 2)' field."]
["PB00265A","Plans & Benefits","Benefits","Error","Covered benefits require completion of the 'Excluded from In Network MOOP' field."]
["PB00265B","Plans & Benefits","Benefits","Warning","Essential health benefits cannot be excluded from in network MOOPs, and not all EHBs are up-to-date in the most recent templates.  Please make certain using external sources that this benefit is not an EHB."]
["PB00265C","Plans & Benefits","Benefits","Warning","State required benefits typically cannot be excluded from in network MOOPs."]
["PB00266A","Plans & Benefits","Benefits","Error","Covered benefits require completion of the 'Excluded from Out of Network MOOP' field."]
["PB00266B","Plans & Benefits","Benefits","Warning","Essential health or state required benefits typically cannot be excluded from Out of Network MOOPs."]
["PB01261B","Plans & Benefits","Cost Share","Error","'HIOS Plan ID (Standard Component)' is not a part of 'HIOS Plan ID (Standard Component + Variant).' Please regenerate the Cost Share Variances Worksheet to correct the error."]
["PB01264A","Plans & Benefits","Cost Share","Error","Mismatch between 'CSR Variation Type' and 'Level of Coverage.' Be sure to use the most recent version of the template and of the data integrity tool."]
["PB01264B","Plans & Benefits","Cost Share","Error","Mismatch between 'CSR Variation Type' and 'HIOS Plan ID (Standard Component + Variant).'  Be sure to use the most recent version of the template and of the data integrity tool."]
["PB01265A","Plans & Benefits","Cost Share","Error","Non-dental, non-catastrophic plans that {DO NOT}have 'Unique Plan Design' must {NOT}have blank values for field '{Field}.'"]
["PB01270A","Plans & Benefits","Cost Share","Error","Field '1st Tier Utilization*' must be 100% when 'Multiple In Network Tiers*\" is Yes."]
["PB01271A","Plans & Benefits","Cost Share","Error","Fields '1st Tier Utilization*' and '2nd Tier Utilization' must sum to 100%."]
["PB01280B","Plans & Benefits","Benefits","Error","Field 'Maximum Out of Pocket for Medical EHB Benefits - In Network (Tier 2) - {Individual/Family}' must be zero for Zero Cost Sharing plans."]
["PB01280C","Plans & Benefits","Benefits","Error","A plan must have a numeric value for 'Maximum Out of Pocket for Medical EHB Benefits - Combined In/Out Network - Individual' when  'Maximum Out of Pocket for Medical EHB Benefits - In Network - Individual' is \"Not Applicable\" and medical and drug MOOPs are NOT integrated."]
["PB01282A","Plans & Benefits","Benefits","Error","Field 'Maximum Out of Pocket for Medical EHB Benefits - In Network (Tier 2) - {Individual/Family}' must be blank for non-zero cost share plans when 'Medical & Drug Maximum Out of Pocket Integrated?' is 'No' and 'Multiple In Network Tiers?*' is 'No.'"]
["PB01282B","Plans & Benefits","Benefits","Error","Field 'Maximum Out of Pocket for Medical EHB Benefits - In Network (Tier 2) - {Individual/Family}' must not be blank or non-numeric (other than \"Not Applicable\") when 'Medical & Drug Maximum Out of Pocket Integrated?' is 'No' and 'Multiple In Network Tiers?*' is 'Yes.'"]
["PB01282C","Plans & Benefits","Benefits","Error","Field 'Maximum Out of Pocket for Medical EHB Benefits - In Network (Tier 2) - {Individual/Family}' should not also be not applicable when 'Maximum Out of Pocket for Medical EHB Benefits - In Network - {Individual/Family}' is not applicable and 'Multiple In Network Tiers?*' is 'Yes.'"]
["PB01282D","Plans & Benefits","Benefits","Error","Field '{Specific Field}' should be a completed, numeric value different from \"Not Applicable\" when 'Multiple In Network Tiers?' is 'Yes.'"]
["PB01282E","Plans & Benefits","Benefits","Error","Field '{Specific Field}' should also be 'Not Applicable' when its analogous 'In Network' value is 'Not Applicable' and 'Multiple In Network Tiers?*' is 'Yes.'"]
["PB01282F","Plans & Benefits","Benefits","Error","Field '{Specific Field}' should be blank when 'Multiple In Network Tiers?*' is 'No.'"]
["PB01288B","Plans & Benefits","Benefits","Error","Field 'Maximum Out of Pocket for Drug EHB Benefits - In Network (Tier 2) - {Individual/Family}' must be zero for Zero Cost Sharing plans."]
["PB01288C","Plans & Benefits","Benefits","Error","A plan must have a numeric value for 'Maximum Out of Pocket for Drug EHB Benefits - Combined In/Out Network - Individual' when  'Maximum Out of Pocket for Drug EHB Benefits - In Network - Individual' is \"Not Applicable\" and medical and drug MOOPs are NOT integrated."]
["PB01290A","Plans & Benefits","Benefits","Error","Field 'Maximum Out of Pocket for Drug EHB Benefits - In Network (Tier 2) - {Individual/Family}' must be blank for non-zero cost share plans when 'Medical & Drug Maximum Out of Pocket Integrated?' is 'No' and 'Multiple In Network Tiers?*' is 'No.'"]
["PB01290B","Plans & Benefits","Benefits","Error","Field 'Maximum Out of Pocket for Drug EHB Benefits - In Network (Tier 2) - {Individual/Family}' must not be blank or non-numeric (other than \"Not Applicable\") when 'Medical & Drug Maximum Out of Pocket Integrated?' is 'No' and 'Multiple In Network Tiers?*' is 'Yes.'"]
["PB01290C","Plans & Benefits","Benefits","Error","Field 'Maximum Out of Pocket for Drug EHB Benefits - In Network (Tier 2) - {Individual/Family}' should not also be not applicable when 'Maximum Out of Pocket for Drug EHB Benefits - In Network - {Individual/Family}' is not applicable and 'Multiple In Network Tiers?*' is 'Yes.'"]
["PB01296B","Plans & Benefits","Benefits","Error","Field 'Maximum Out of Pocket for Medical and Drug EHB Benefits - In Network (Tier 2) - {Individual/Family}' must be zero for Zero Cost Sharing plans."]
["PB01296C","Plans & Benefits","Benefits","Error","A plan must have a numeric value for 'Maximum Out of Pocket for Medical & Drug EHB Benefits - Combined In/Out Network - Individual' when  'Maximum Out of Pocket for Medical & Drug EHB Benefits - In Network - Individual' is \"Not Applicable\" and medical and drug MOOPs are integrated."]
["PB01298A","Plans & Benefits","Benefits","Error","Field 'Maximum Out of Pocket for Medical & Drug EHB Benefits - In Network (Tier 2) - {Individual/Family}' must be blank for non-zero cost share plans when 'Medical & Drug Maximum Out of Pocket Integrated?' is 'Yes' and 'Multiple In Network Tiers?*' is 'No.'"]
["PB01298B","Plans & Benefits","Benefits","Error","Field 'Maximum Out of Pocket for Medical & Drug EHB Benefits - In Network (Tier 2) - {Individual/Family}' must not be blank or non-numeric (other than \"Not Applicable\") when 'Medical & Drug Maximum Out of Pocket Integrated?' is 'Yes' and 'Multiple In Network Tiers?*' is 'Yes.'"]
["PB01298C","Plans & Benefits","Benefits","Error","Field 'Maximum Out of Pocket for Medical & Drug EHB Benefits - In Network (Tier 2) - {Individual/Family}' should not also be not applicable when 'Maximum Out of Pocket for Medical & Drug EHB Benefits - In Network - {Individual/Family}' is not applicable and 'Multiple In Network Tiers?*' is 'Yes.'"]
["PB01314B","Plans & Benefits","Benefits","Error","Field 'Medical EHB Deductible - In Network (Tier 2) - {Individual/Family}' must be zero for Zero Cost Sharing plans."]
["PB01314C","Plans & Benefits","Benefits","Error","A plan must have a numeric value for 'Medical EHB Deductible - Combined In/Out Network - Individual' when  'Medical EHB Deductible - In Network - Individual' is \"Not Applicable\" and medical and drug deductibles are NOT integrated."]
["PB01316A","Plans & Benefits","Benefits","Error","Field 'Medical EHB Deductibles - In Network (Tier 2) - {Individual/Family}' must be blank for non-zero cost share plans when 'Medical & Drug Deductibles Integrated?*' is 'No' and 'Multiple In Network Tiers?*' is 'No.'"]
["PB01316B","Plans & Benefits","Benefits","Error","Field 'Medical EHB Deductible - In Network (Tier 2) - {Individual/Family}' must not be blank or non-numeric (other than \"Not Applicable\") when 'Medical & Drug Deductibles Integrated?*' is 'No' and 'Multiple In Network Tiers?*' is 'Yes.'"]
["PB01316C","Plans & Benefits","Benefits","Error","Field 'Medical EHB Deductible - In Network (Tier 2) - {Individual/Family}' should not also be not applicable when 'Medical EHB Deductible - In Network - {Individual/Family}' is not applicable and 'Multiple In Network Tiers?*' is 'Yes.'"]
["PB01317A","Plans & Benefits","Benefits","Error","'Medical EHB Deductible - In Network - Default Coinsurance' should NOT be blank or non-numeric when 'Medical & Drug Deductibles Integrated?*' is 'No'"]
["PB01317B","Plans & Benefits","Benefits","Error","'Medical EHB Deductible - In Network (Tier 2) - Default Coinsurance' should NOT be blank or non-numeric when 'Medical & Drug Deductibles Integrated?*' is 'No' and 'Multiple In Network Tiers?*' is 'Yes'"]
["PB01322B","Plans & Benefits","Benefits","Error","Field 'Drug EHB Deductible - In Network (Tier 2) - {Individual/Family}' must be zero for Zero Cost Sharing plans."]
["PB01322C","Plans & Benefits","Benefits","Error","A plan must have a numeric value for 'Drug EHB Deductible - Combined In/Out Network - Individual' when  'Drug EHB Deductible - In Network - Individual' is \"Not Applicable\" and medical and drug deductibles are NOT integrated."]
["PB01324A","Plans & Benefits","Benefits","Error","Field 'Drug EHB Deductibles - In Network (Tier 2) - {Individual/Family}' must be blank for non-zero cost share plans when 'Medical & Drug Deductibles Integrated?*' is 'No' and 'Multiple In Network Tiers?*' is 'No.'"]
["PB01324B","Plans & Benefits","Benefits","Error","Field 'Drug EHB Deductible - In Network (Tier 2) - {Individual/Family}' must not be blank or non-numeric (other than \"Not Applicable\") when 'Medical & Drug Deductibles Integrated?*' is 'No' and 'Multiple In Network Tiers?*' is 'Yes.'"]
["PB01324C","Plans & Benefits","Benefits","Error","Field 'Drug EHB Deductible - In Network (Tier 2) - {Individual/Family}' should not also be not applicable when 'Drug EHB Deductible - In Network - {Individual/Family}' is not applicable and 'Multiple In Network Tiers?*' is 'Yes.'"]
["PB01325A","Plans & Benefits","Benefits","Error","Drug EHB Deductible - In Network - Default Coinsurance' should NOT be blank or non-numeric when 'Medical & Drug Deductibles Integrated?*' is 'No'"]
["PB01325B","Plans & Benefits","Benefits","Error","Drug EHB Deductible - In Network (Tier 2) - Default Coinsurance' should NOT be blank or non-numeric when 'Medical & Drug Deductibles Integrated?*' is 'No'"]
["PB01332B","Plans & Benefits","Benefits","Error","Field 'Medical & Drug EHB Deductible - In Network (Tier 2) - {Individual/Family}' must be zero for Zero Cost Sharing plans."]
["PB01332C","Plans & Benefits","Benefits","Error","A plan must have a numeric value for 'Medical & Drug EHB Deductible - Combined In/Out Network - Individual' when  'Medical & Drug EHB Deductible - In Network - Individual' is \"Not Applicable\" and medical and drug deductibles are integrated."]
["PB01334A","Plans & Benefits","Benefits","Error","Field 'Medical & Drug EHB Deductibles - In Network (Tier 2) - {Individual/Family}' must be blank for non-zero cost share plans when 'Medical & Drug Deductibles Integrated?*' is 'Yes' and 'Multiple In Network Tiers?*' is 'No.'"]
["PB01334B","Plans & Benefits","Benefits","Error","Field 'Medical & Drug EHB Deductible - In Network (Tier 2) - {Individual/Family}' must not be blank or non-numeric (other than \"Not Applicable\") when 'Medical & Drug Deductibles Integrated?*' is 'Yes' and 'Multiple In Network Tiers?*' is 'Yes.'"]
["PB01334C","Plans & Benefits","Benefits","Error","Field 'Medical & Drug EHB Deductible - In Network (Tier 2) - {Individual/Family}' should not also be not applicable when 'Medical & Drug EHB Deductible - In Network - {Individual/Family}' is not applicable and 'Multiple In Network Tiers?*' is 'No.'"]
["PB01335A","Plans & Benefits","Benefits","Error","'Medical & Drug EHB Deductible - In Network (Tier 2) - Default Coinsurance' should NOT be blank or non-numeric when 'Medical & Drug Deductibles Integrated?*' is 'Yes'"]
["PB01335B","Plans & Benefits","Benefits","Error","'Medical & Drug EHB Deductible - In Network (Tier 2) - Default Coinsurance' should NOT be blank or non-numeric when 'Medical & Drug Deductibles Integrated?*' is 'Yes' and 'Multiple In Network Tiers?*' is 'Yes.'"]
["PB01335D","Plans & Benefits","Benefits","Error","Medical & Drug EHB Deductible - In Network (Tier 2) - Default Coinsurance' should NOT be blank or non-numeric for Dental Only Plans."]
["PB01335E","Plans & Benefits","Benefits","Error","Medical & Drug EHB Deductible - In Network - Default Coinsurance' should NOT be blank or non-numeric for Dental Only Plans."]
["PB01342A","Plans & Benefits","Benefits","Error","Benefit '{Benefit}' 'In Network (Tier 1) Copay' must be 0 for zero cost share plans."]
["PB01343A","Plans & Benefits","Benefits","Error","Benefit '{Benefit}' 'In Network (Tier 2) Copay' must be 0 for zero cost share plans."]
["PB01343B","Plans & Benefits","Benefits","Error","Benefit '{Benefit}' must NOT have an 'In Network (Tier 2) {Copay or Coinsurance}' when 'Multiple In Network Tiers' is 'No.'"]
["PB01344A","Plans & Benefits","Benefits","Error","Benefit '{Benefit}' 'Out of Network Copay' must be 0 for zero cost share plans."]
["PB01345A","Plans & Benefits","Benefits","Error","Benefit '{Benefit}' 'In Network (Tier 1) Coinsurance' must be 0 for zero cost share plans."]
["PB01346A","Plans & Benefits","Benefits","Error","Benefit '{Benefit}' 'In Network (Tier 2) Coinsurance' must be 0 for zero cost share plans."]
["PB01347A","Plans & Benefits","Benefits","Error","Benefit '{Benefit}' 'Out of Network Coinsurance' must be 0 for zero cost share plans."]
["PB01342C","Plans & Benefits","Benefits","Error","Invalid entry for benefit '{Benefit}' '{Coinsurance/Copay}' '{Type}.'  Please select a value from drop down menu in the template."]
["PB01342D","Plans & Benefits","Benefits","Error","The numeric portion of benefit '{Benefit - Coinsurance/Copay}' '{Type}' must be a whole {dollar / percentage} value."]
["PB10001A","Plans & Benefits","Benefits","Warning","Benefit type '{Benefit}' is non-standard and will not be validated."]
["PB10002A","Plans & Benefits","Benefits","Error","If '{Specific MOOP/Deductible Medical Field}' is \"Not Applicable\", the corresponding '{Specific MOOP/Deductible Drug Field}' should not NOT be numeric (when medical and drug are NOT integrated)."]
["PB10002B","Plans & Benefits","Benefits","Error","If '{Specific MOOP/Deductible Medical Field}' is numeric, the corresponding '{Specific MOOP/Deductible Drug Field}' should be applicable (when medical and drug are NOT integrated)."]
["PD01776A","Prescription Drugs","None","Error","Invalid issuer ID. Must be 5-digits and numeric."]
["PD01776B","Prescription Drugs","None","Error","Field '{Field}' is required {description of when}"]
["PD01777A","Prescription Drugs","None","Error","State code not valid."]
["PD01778A","Prescription Drugs","None","Error","Invalid Formulary ID.  Must be 6 characters in length of the form State code + 'F' + 999, where 9's represent numeric values.  The first two characters must match the issuer state. State code is case sensitive."]
["PD01779A","Prescription Drugs","None","Error","Field 'Formulary URL' is required.  Please enter a valid URL."]
["PD01780A","Prescription Drugs","None","Error","Drug List {Number} is referenced in sheet 'Drug Lists' but not associated with any formulary in sheet 'Formulary Tiers.'  Please eliminate all drug lists that are not used."]
["PD01780B","Prescription Drugs","None","Error","Field 'Number of Tiers' is not consistent within Drug List ID {number}. Each drug list ID should have the same number of tiers.  (Issuer ID:  {Issuer ID})"]
["PD01780C","Prescription Drugs","None","Error","Field 'Drug Tier Type' is not consistent within Drug Tier ID {number}.  (Issuer ID:  {Issuer ID})"]
["PD01781A","Prescription Drugs","None","Error","Field 'Number of Tiers' must be a whole number between 1 and 7."]
["PD01781B","Prescription Drugs","None","Error","Field 'Drug Tier ID' must not exceed the 'Number of Tiers'."]
["PD01783A","Prescription Drugs","None","Error","Field 'Drug Tier Type' must be composed of one or more individual selections from the drop down menu.  Validate spelling and try again."]
["PD01784A","Prescription Drugs","None","Error","Field '{Copayment/Coinsurance}' should be zero if 1 Month In Network Retail Pharmacy Cost Sharing Type is '{Coinsurance/Copayment}.'"]
["PD01784B","Prescription Drugs","None","Error","Invalid selection for '{Field'}' field.  Please select a valid entry from the drop down menu."]
["PD01785A","Prescription Drugs","None","Error","Field '{Copayment/Coinsurance}' for '{Pharmacy Benefit Type}' should be a whole number."]
["PD01788A","Prescription Drugs","None","Error","Field '{Copayment/Coinsurance}' should be zero if 1 Month Out of Network Retail Pharmacy Cost Sharing Type is '{Coinsurance/Copayment}.'"]
["PD01792A","Prescription Drugs","None","Error","Field '{Copayment/Coinsurance}' should be zero if 3 Month In Network Retail Pharmacy Cost Sharing Type is '{Coinsurance/Copayment}.'"]
["PD01796A","Prescription Drugs","None","Error","Field '{Copayment/Coinsurance}' should be zero if 3 Month Out of Network Retail Pharmacy Cost Sharing Type is '{Coinsurance/Copayment}.'"]
["PD01799A","Prescription Drugs","None","Error","Invalid RXCUI.  RXCUIs must be between 1 and 8 numeric digits long."]
["PD01799B","Prescription Drugs","None","Error","RXCUI {RXCUI number} is not unique within the '{Issuer ID}' template.  All RXCUI numbers in 'Drugs List' must be unique within a given template."]
["PD01800A","Prescription Drugs","None","Error","Field 'Tier Level' must either be a number or 'NA'.  No other values are acceptable."]
["PD01801A","Prescription Drugs","None","Error","Field '{Prior Authorization Required / Step Therapy Required}' must be blank when 'Tier Level' for a given RXCUI is not applicable.  Please adjust accordingly."]
["RB01820A","BusinessRules","None","Error","Invalid issuer ID. Must be 5-digits and numeric."]
["RB01821A","BusinessRules","None","Error","Invalid Tax Identification Number."]
["RB01822A","BusinessRules","None","Error","Invalid HIOS Product ID.  Must be 10 characters in length.  Characters 1 to 5 and 8 to 10 must be numeric and characters 6 and 7 must be alpha.  First 5 characters must match Issuer ID; next 2 must match state. State code is case sensitive."]
["RB01822B","BusinessRules","None","Error","Only one issuer-level set of business rules is allowed.  Subsequent rows within a Business Rules template must have either 'Product ID' or 'Plan ID (Standard Component)' completed."]
["RB01822C","BusinessRules","None","Error","An issuer-level set of business rules is required."]
["RB01822D","BusinessRules","None","Error","Each business rule must apply either to a Product ID or to a Plan ID.  No business rule can apply to both."]
["RB01823A","BusinessRules","None","Error","Invalid Plan ID (Standard Component).  Must be 14 characters in length.  Characters 1 to 5 and 8 to 14 must be numeric and characters 6 and 7 must be alpha."]
["RB01824A","BusinessRules","None","Error","Field '{Field Name}' is required at the issuer level.  Please provide a value."]
["RB01824B","BusinessRules","None","Error","Field 'How are rates for contracts covering two or more enrollees calculated?' should be equal to 'A different rate (specifically for parties of two or more) for each enrollee is added together' for states that are not community rated. {Qualification}"]
["RB01824C","BusinessRules","None","Error","Field 'How are rates for contracts covering two or more enrollees calculated?' should be equal to 'There are rates specifically for couples and for families (not just addition of individual rates)' for states that are community rated. {Qualification}"]
["RB01824D","BusinessRules","None","Error","Field '{Field}' should be chosen from the dropdown menu.  Please reverify your selection. {Additional Information}"]
["RB01824E","BusinessRules","None","Warning","The Federally-Facilitated Small Group Health Options Program (FF-SHOP) and State Partnership Small Group Health Options Program (SP-SHOP) will not accommodate plans with family tiered rates.  To offer plans in the FF-SHOP or SP-SHOP, select “A different rate (specifically for parties of two or more) for each enrollee is added together. {Additional Information}  This error does not apply to off-exchange plans."]
["RB01827A","BusinessRules","None","Error","Field 'Is there a maximum age for a dependent?' must be selected from template dropdown menu. Please try again."]
["RB01827B","BusinessRules","None","Error","Field 'Is there a maximum age for a dependent?' must be greater than or equal to 25 for medical (i.e., non-SADP) plans. {Qualification}"]
["RB01829A","BusinessRules","None","Error","When field '{FieldName}' is 'Yes', 'Life Partner' must be an allowed relationship between primary and dependents."]
["RB01831A","BusinessRules","None","Warning","Qualified health plans must have field 'How is age determined for rating and eligibility purposes?' equal to 'Age on effective date.'  (NOTE:  This does not apply to dental only plans.)"]
["RB01831B","BusinessRules","None","Warning","The Federally-Facilitated Small Group Health Options Program (FF-SHOP) and State Partnership Small Group Health Options Program (SP-SHOP) will display all plans with rates based on age on effective date.  To make your product or plan consistent with the SHOP plan display, select the value of “Age on Effective Date. {Additional Information}  This error does not apply to off-exchange plans."]
["RB01832A","BusinessRules","None","Error","Field \"How is tobacco status determined for subscribers and dependents?\" should be between 0 and 6 months or \"Not Applicable\" for medical products or plans (does not apply to SADP products and plans)."]
["RB01832B","BusinessRules","None","Warning","The Federally-Facilitated Small Group Health Options Program (FF-SHOP) and State Partnership Small Group Health Options Program (SP-SHOP) will assume that all plans whose rates vary by tobacco use adhere to a 6 month look-back period to define tobacco use.  To make your product or plan consistent with the SHOP plan display, select a value of 6 to define the minimum number of months since last tobacco use. {Additional Information}  This error does not apply to off-exchange plans."]
["RB01833A","BusinessRules","None","Error","In field 'What relationships between primary and dependent are allowed, and is the dependent required to live in the same household as the primary subscriber?', each relationship should be separated from each requirement by a comma and each relationship-requirement pair should be separated by a semicolon.  Please verify this is the case."]
["RB01833B","BusinessRules","None","Error","The Federally-Facilitated Small Group Health Options Program (FF-SHOP) and State Partnership Small Group Health Options Program (SP-SHOP) will not accommodate '{Relationship(s)}' as dependent relationship(s).  Only the following relationships will be accommodated: Spouse, Adopted Child, Foster Child, Ward, Stepson or Stepdaughter, Self, Child, Life Partner and Other Relationship. {Additional Information}  This error does not apply to off-exchange plans."]
["RT01803A","Rates","None","Error","Invalid issuer ID. Must be 5-digits and numeric."]
["RT01804A","Rates","None","Error","Invalid Tax Identification Number."]
["RT01805A","Rates","None","Error","Field 'Rate Effective Date*' must be 1/1, 4/1, 7/1, or 10/1 of year {Year} for Small Group market plans and 1/1 of year {2015} for Individual market plans."]
["RT01805B","Rates","None","Warning","Field 'Rate Effective Date*' is {Entered value}, which is only allowed for Small Group market plans.  Please verify that this plan is a Small Group market plan."]
["RT01805C","Rates","None","Warning","Field '{Field}' is not a valid date.  Please try again."]
["RT01806A","Rates","None","Error","Rate Expiration Date must be after Rate Effective Date."]
["RT01807A","Rates","None","Error","Invalid HIOS Plan ID.  Must be 14 characters in length.  Characters 1 to 5 and 8 to 14 must be numeric and characters 6 and 7 must be alpha.  First 5 characters must match Issuer ID; next 2 must match state. State code is case sensitive."]
["RT01807B","Rates","None","Warning","Could not obtain State information from HIOS Plan ID.  Will not run Individual and Individual Tobacco Data Integrity Checks."]
["RT01808A","Rates","None","Error","Field 'Rating area ID' does not match those appropriate for the state found in the Field 'HIOS Plan ID'{Qualifications}."]
["RT01808B","Rates","None","Warning","Could not obtain Market information from P&B template for this NJ plan.  {Qualifications}"]
["RT01808C","Rates","None","Error","All combinations of the following fields: 'HIOS Issuer ID,' 'Plan ID,' 'Rating Area ID,' 'Age,' and 'Rate Effective Date' must be unique.  Please correct any duplicate values."]
["RT01808D","Rates","None","Error","Field '{Field}' not validated{Reason}."]
["RT01809A","Rates","None","Error","Field 'Tobacco' must have the same entry for all values of a given Plan ID. (Plan ID = '{PlanID}')"]
["RT01809B","Rates","None","Error","Plans inside community rated states must have field 'Tobacco*' set to \"No Preference.\""]
["RT01810A","Rates","None","Error","A given Plan ID cannot have both age bands and the family option for the 'Age' field.  You must consistently select one or the other for the same Plan ID.  (Plan ID = '{PlanID}')"]
["RT01810B","Rates","None","Error","Plans inside community rated states must have field 'Age*' set to \"Family Option.\""]
["RT01810C","Rates","None","Warning","The Federally-Facilitated Small Group Health Options Program (FF-SHOP) and State Partnership Small Group Health Options Program (SP-SHOP) will not accommodate plans with family tiered rates.  To offer plans in the FF-SHOP or SP-SHOP, select an individual age band value. {Additional Information}  This error does not apply to off-exchange plans."]
["RT01811A","Rates","None","Error","Individual {Tobacco}rates for Ages 0-20 must be lower than individual {Tobacco}rates for Age 21. {Conditions / Qualifications}"]
["RT01811B","Rates","None","Error","Individual {Tobacco}rates must follow the {Federal / State} curve, based on the age 21 rate. {More info}"]
["RT01811C","Rates","None","Error","Individual {Tobacco}rate must NOT be blank or negative{more info}"]
["RT01811D","Rates","None","Error","{State / Market} could not be retrieved for {PlanID}.  Federal rate curves were used by default."]
["RT01811E","Rates","None","Error","Individual {Tobacco}rate must NOT be blank or negative for child-only plan age bands 21+."]
["RT01811F","Rates","None","Error","Individual {Tobacco}rate must NOT be blank or negative for child-only plan age band 0-20."]
["RT01812A","Rates","None","Error","Field 'Individual Tobacco Rate' must not be blank when a plan has a tobacco use preference."]
["RT01812B","Rates","None","Error","The individual tobacco rate must not be more than {State-specific factor not to exceed 1.5} times the individual rate within the state of {State}. {Qualifications / Conditions}"]
["RT01813A","Rates","None","Error","Field '{Field Name}' must not be blank or zero when field 'Age' is \"Family Option.\""]
["RT01813B","Rates","None","Error","Field '{Field Name}' must not be larger than {community rating multiplicative factor} times the individual rate in the community rated state of {State}."]
["RU01844A","URR","None","Error","Invalid issuer ID. Must be 5-digits and numeric."]
["RU01846A","URR","None","Error","State code not valid."]
["RU01847A","URR","None","Error","Market not valid.  Please select from the dropdown list of available options."]
["RU01848A","URR","None","Error","Field 'Effective Date' must be 1 Jan for 'Individual' market plans."]
["RU01848B","URR","None","Error","Field 'Effective Date' must be either 1 Jan, 1 Apr, 1 Jul, or 1 Oct for 'Small Group' market plans."]
["RU02002A","URR","None","Error","Invalid Product ID.  Must be 10 characters in length.  Characters 1 to 5 and 8 to 10 must be numeric and characters 6 and 7 must be alpha.  First 5 characters must match Issuer ID; next 2 must match state. State code is case sensitive."]
["RU02002B","URR","None","Error","Field '{Field}' required{ when}."]
["RU02003A","URR","None","Error","Field '{Field}' does not match any of the drop down values.  Please select from the drop down list."]
["RU02004A","URR","None","Error","Invalid entry.  'AV Metal Value' must be a numeric value between 0 and 1."]
["RU02004B","URR","None","Error","{Metal} metal plans must have AV metal values between {Bottom} and {Top}."]
["RU02005A","URR","None","Error","Field '{Field}' cannot be blank, negative, or non-numeric."]
["RU02008A","URR","None","Error","Invalid HIOS Plan ID.  Must be 14 characters in length.  Characters 1 to 5 and 8 to 14 must be numeric and characters 6 and 7 must be alpha.  First 5 characters must match Issuer ID; next 2 must match state. State code is case sensitive."]
["RU02036A","URR","None","Error","Field '{Field}' is required and must be numeric, non-zero, and a percentage."]
["SA00001A","Service Area","None","Error","Invalid ZIP code format for '{ZIP Code}'. Enter as 5 digit numeric values separated by commas."]
["SA00208A","Service Area","None","Error","Invalid issuer ID. Must be 5-digits and numeric."]
["SA00209A","Service Area","None","Error","State code not valid."]
["SA00218A","Service Area","None","Error","Invalid Service Area ID.  Must be 6 characters in length of the form State code + 'S' + 999, where 9's represent numeric values.  The first two characters must match the issuer state. State code is case sensitive."]
["SA00230A","Service Area","None","Error","Field '{Field}' is required {description of when}"]
["SA00230B","Service Area","None","Warning","Since field 'Partial County Coverage?'  is 'Yes, the file name of the Partial County Justification should be entered into the Partial County Justification field. The justification file should be uploaded under \"Other Supporting Documents\" in the Benefits and Service Area module."]
["SA00231B","Service Area","None","Error","Field '{Field}' should be blank {When}"]
["SA01837A","Service Area","None","Error","Please enter a valid Service Area Name.  This field cannot be blank."]
["SA01838A","Service Area","None","Error","Invalid selection for '{Field}.' Please use the drop down menu in the template."]
["SA01838B","Service Area","None","Error","Invalid Service Area ID. Service Area ID {number} cannot be used for a service area that covers the entire state (Yes in template column C) and for a service area that covers part of the state (No in template column C). (HIOS Issuer ID:  {Issuer ID})"]
["SA01839A","Service Area","None","Error","County FIPS code does not match the issuer state.  Please re-verify. (NOTE:  Only FIPS code is validated.  County names are not.)"]
["SA01841A","Service Area","None","Warning","ZIP code '{ZIP Code}' does not appear to match the FIPS in County Name (i.e., {CountyFIPS}).  Please re-verify that both are accurate."]
["SA01841B","Service Area","None","Warning","ZIP code '{ZIP Code}' does not appear to be valid.  Please re-verify its accuracy."]
["PB10003A","Plans & Benefits","Attributes","Error","Field 'HIOS Product ID' can only have one 'Plan Type'."]

{"sheet":"Scratch","index":21,"n_rows":0,"n_cols":0,"rows_kept":0,"cut":false,"hidden":true,"merged":[]}