{"text_format":"1","workbook":"xlsx","n_sheets":4,"sheets":["plans","EHB","CSR","Names"],"not_rendered":{"charts":0,"images":0,"macros":1,"external_links":0,"defined_names":21,"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":"plans","index":0,"n_rows":128,"n_cols":40,"rows_kept":128,"cut":false,"hidden":false,"merged":[[158,0,158,1],[153,0,153,1],[154,0,154,1],[155,0,155,1],[156,0,156,1],[157,0,157,1],[148,0,148,1],[149,0,149,1],[150,0,150,1],[151,0,151,1],[152,0,152,1],[143,0,143,1],[144,0,144,1],[145,0,145,1],[146,0,146,1],[147,0,147,1],[138,0,138,1],[139,0,139,1],[140,0,140,1],[141,0,141,1],[142,0,142,1],[70,0,70,1],[133,0,133,1],[134,0,134,1],[135,0,135,1],[136,0,136,1],[137,0,137,1],[128,0,128,1],[129,0,129,1],[130,0,130,1],[131,0,131,1],[132,0,132,1],[94,0,94,1],[83,0,83,1],[84,0,84,1],[85,0,85,1],[86,0,86,1],[87,0,87,1],[88,0,88,1],[89,0,89,1],[90,0,90,1],[91,0,91,1],[92,0,92,1],[93,0,93,1],[82,0,82,1],[6,37,6,39],[69,0,69,1],[6,0,6,6],[6,7,6,23],[6,30,6,31],[6,32,6,36],[64,0,64,1],[65,0,65,1],[66,0,66,1],[67,0,67,1],[68,0,68,1],[59,0,59,1],[60,0,60,1],[61,0,61,1],[62,0,62,1],[63,0,63,1],[58,0,58,3],[58,4,58,11],[71,0,71,1],[72,0,72,1],[73,0,73,1],[74,0,74,1],[75,0,75,1],[76,0,76,1],[77,0,77,1],[78,0,78,1],[79,0,79,1],[80,0,80,1],[81,0,81,1],[111,0,111,1],[105,0,105,1],[95,0,95,1],[96,0,96,1],[97,0,97,1],[98,0,98,1],[99,0,99,1],[100,0,100,1],[101,0,101,1],[102,0,102,1],[103,0,103,1],[104,0,104,1],[127,0,127,1],[120,0,120,1],[121,0,121,1],[122,0,122,1],[123,0,123,1],[124,0,124,1],[6,26,6,29],[58,12,58,15],[6,24,6,25],[125,0,125,1],[126,0,126,1],[115,0,115,1],[116,0,116,1],[117,0,117,1],[118,0,118,1],[119,0,119,1],[112,0,112,1],[113,0,113,1],[114,0,114,1],[106,0,106,1],[107,0,107,1],[108,0,108,1],[109,0,109,1],[110,0,110,1]]}
["Plans & Benefits Template v1.32",null,null,"To use this template, please review the user guide and instructions."]
["HIOS Issuer ID*",null,null,"You will need to save the latest version of the add-in file (PlansBenefitsAddIn.xlam) on your machine."]
["Issuer State*",null,null,"To create the cost share variance worksheet and enter the cost sharing amounts for both individual and SHOP (small group) markets, use the Create Cost Share Variances macro."]
["Market Coverage*",null,null,"To create additional Benefits Package worksheets, use the Create New Benefits Package macro."]
["Dental Only Plan*",null,null,"To populate the benefits on the Benefits Package worksheet with your State EHB Standards, use the Refresh EHB macro."]
["TIN*"]
["Plan Identifiers",null,null,null,null,null,null,"Plan Attributes",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Stand Alone Dental Only",null,"AV Calculator Additional Benefit Design",null,null,null,"Plan Dates",null,"Geographic Coverage",null,null,null,null,"URLs"]
["HIOS Plan ID*\n(Standard Component)","Plan Marketing Name*","HIOS Product ID*","HPID","Network ID*","Service Area ID*","Formulary ID*","New/Existing Plan?*","Plan Type*","Level of Coverage*","Unique Plan Design?*","QHP/Non-QHP*","Notice Required for Pregnancy*","Is a Referral Required for Specialist?*","Specialist(s) Requiring a Referral","Plan Level Exclusions","Limited Cost Sharing Plan Variation - Est Advanced Payment","HSA Eligible*","HSA/HRA Employer Contribution","HSA/HRA Employer Contribution Amount","Child-Only Offering*","Child Only Plan ID","Wellness Program Offered*","Disease Management Programs Offered","EHB Apportionment for Pediatric Dental ","Guaranteed vs. Estimated Rate ","Maximum Coinsurance for Specialty Drugs","Maximum Number of Days for Charging an Inpatient Copay?  ","Begin Primary Care Cost-Sharing After a Set Number of Visits? ","Begin Primary Care 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"]
[]
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["Benefit Information",null,null,null,"General Information",null,null,null,null,null,null,null,"Deductible and Out of Pocket Exceptions"]
["Benefits",null,"EHB","State\nMandate","Is this Benefit Covered?","Quantitative Limit on Service","Limit Quantity","Limit Unit","Minimum Stay","Exclusions","Explanation (text field)","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"]
["Primary Care Visit to Treat an Injury or Illness"]
["Specialist Visit"]
["Other Practitioner Office Visit (Nurse, Physician Assistant)"]
["Outpatient Facility Fee (e.g.,  Ambulatory Surgery Center)"]
["Outpatient Surgery Physician/Surgical Services"]
["Hospice Services"]
["Non-Emergency Care When Traveling Outside the U.S."]
["Routine Dental Services (Adult)"]
["Infertility Treatment"]
["Long-Term/Custodial Nursing Home Care"]
["Private-Duty Nursing"]
["Routine Eye Exam (Adult)"]
["Urgent Care Centers or Facilities"]
["Home Health Care Services"]
["Emergency Room Services"]
["Emergency Transportation/Ambulance"]
["Inpatient Hospital Services (e.g., Hospital Stay)"]
["Inpatient Physician and Surgical Services"]
["Bariatric Surgery"]
["Cosmetic Surgery"]
["Skilled Nursing Facility"]
["Prenatal and Postnatal Care"]
["Delivery and All Inpatient Services for Maternity Care"]
["Mental/Behavioral Health Outpatient Services"]
["Mental/Behavioral Health Inpatient Services"]
["Substance Abuse Disorder Outpatient Services"]
["Substance Abuse Disorder Inpatient Services"]
["Generic Drugs"]
["Preferred Brand Drugs"]
["Non-Preferred Brand Drugs"]
["Specialty Drugs"]
["Outpatient Rehabilitation Services"]
["Habilitation Services"]
["Chiropractic Care"]
["Durable Medical Equipment"]
["Hearing Aids"]
["Imaging (CT/PET Scans, MRIs)"]
["Preventive Care/Screening/Immunization"]
["Routine Foot Care"]
["Acupuncture"]
["Weight Loss Programs"]
["Routine Eye Exam for Children"]
["Eye Glasses for Children"]
["Dental Check-Up for Children"]
["Rehabilitative Speech Therapy"]
["Rehabilitative Occupational and Rehabilitative Physical Therapy"]
["Well Baby Visits and Care"]
["Laboratory Outpatient and Professional Services"]
["X-rays and Diagnostic Imaging"]
["Basic Dental Care – Child"]
["Orthodontia – Child"]
["Major Dental Care – Child"]
["Basic Dental Care – Adult"]
["Orthodontia – Adult"]
["Major Dental Care – Adult"]
["Abortion for Which Public Funding is Prohibited"]
["Transplant"]
["Accidental Dental"]
["Dialysis"]
["Allergy Testing"]
["Chemotherapy"]
["Radiation"]
["Diabetes Education"]
["Prosthetic Devices"]
["Infusion Therapy"]
["Treatment for Temporomandibular Joint Disorders"]
["Nutritional Counseling"]
["Reconstructive Surgery"]

{"sheet":"EHB","index":1,"n_rows":143,"n_cols":307,"rows_kept":143,"cut":false,"hidden":false,"merged":[]}
["State","AK",null,null,null,null,null,"AL",null,null,null,null,null,"AR",null,null,null,null,null,"CA",null,null,null,null,null,"CO",null,null,null,null,null,"CT",null,null,null,null,null,"DE",null,null,null,null,null,"FL",null,null,null,null,null,"GA",null,null,null,null,null,"HI",null,null,null,null,null,"IA",null,null,null,null,null,"ID",null,null,null,null,null,"IL",null,null,null,null,null,"IN",null,null,null,null,null,"KS",null,null,null,null,null,"KY",null,null,null,null,null,"LA",null,null,null,null,null,"MA",null,null,null,null,null,"MD",null,null,null,null,null,"ME",null,null,null,null,null,"MI",null,null,null,null,null,"MN",null,null,null,null,null,"MO",null,null,null,null,null,"MS",null,null,null,null,null,"MT",null,null,null,null,null,"NC",null,null,null,null,null,"ND",null,null,null,null,null,"NE",null,null,null,null,null,"NH",null,null,null,null,null,"NJ",null,null,null,null,null,"NM",null,null,null,null,null,"NV",null,null,null,null,null,"NY",null,null,null,null,null,"OH",null,null,null,null,null,"OK",null,null,null,null,null,"OR",null,null,null,null,null,"PA",null,null,null,null,null,"RI",null,null,null,null,null,"SC",null,null,null,null,null,"SD",null,null,null,null,null,"TN",null,null,null,null,null,"TX",null,null,null,null,null,"UT",null,null,null,null,null,"VA",null,null,null,null,null,"VT",null,null,null,null,null,"WA",null,null,null,null,null,"WI",null,null,null,null,null,"WV",null,null,null,null,null,"WY",null,null,null,null,null,"AZ",null,null,null,null,null,"DC"]
[null,"EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation","EHB","State Mandate","Limit Quantity","Limit Units","Minimum Stay","Explanation"]
["Primary Care Visit to Treat an Injury or Illness","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["Specialist Visit","EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,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,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB"]
["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","S",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","S",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","S",null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","S",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",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","S",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","S",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,"S",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","S",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","S",45,"Days per Year",null,null,"EHB","S",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","S",null,null,null,null,"EHB",null,null,null,null,null,"EHB","S",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","S",null,null,null,null,"EHB",null,null,null,null,null,"EHB","S",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","S",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","S",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","S",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","I",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","S",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","S",20,"Visit(s) per Benefit Period",null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","S",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","S",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","S",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,52,"Visit(s) per Year",null,null,"EHB","S",null,null,null,null,"EHB",null,null,null,null,null,"EHB","S",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","S",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","S",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","S",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,31,"Days per Year",null,null,"EHB","S",30,"Days per Benefit Period",null,null,"EHB","Both",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","S",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","S",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","S",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","S",null,null,null,null,"EHB",null,null,null,null,null,"EHB","S",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","S",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","S",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","S",null,null,null,null,"EHB","S",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","S",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","S",null,null,null,null,"EHB","S",null,null,null,null,"EHB","S",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","S",null,null,null,null,"EHB","S",null,null,null,null,"EHB","S",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","S",60,"Visit(s) per Year",null,null,"EHB","S",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","S",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","S",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","S",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","S",null,null,null,null,"EHB","S",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","S",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","S",null,null,null,null,"EHB","S",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","S",null,null,null,null,"EHB",null,null,null,null,null,"EHB","S",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","S",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","S",null,null,null,null,"EHB","S",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","S",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","S",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","S",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,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","S",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB","S",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,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","S",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",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","S",null,null,null,null,"EHB","Both",null,null,null,null,"EHB",null,null,null,null,null,"EHB","S",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"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","S",null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark","EHB","S",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,"S",null,null,null,null,"EHB","Both",null,null,null,null,"EHB","S",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","S",null,null,null,null,"EHB",null,null,null,null,"Quantitative limit units apply, see EHB benchmark.","EHB","Both",null,null,null,null,"EHB","S",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","S",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,"S",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","S",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","S",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","S",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","S",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","S",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","S",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","S",null,null,null,null,"EHB","S",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",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","S",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","S",null,null,null,null,"EHB","S",null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",null,null,null,null,null,"EHB",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","S",null,null,null,null,null,"I",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,"S",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,"S",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,"S",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,"S",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,"S",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,"I",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,"I",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,"S",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,"S",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,"S",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,"S",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,"S",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,"S",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,"I",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,"S"]
["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,"S",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,"I"]
["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,"S"]
["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,"I"]
["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,"S"]
["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,"S"]
["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,"S",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,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"]
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["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,"I"]
["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,"I"]
["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"]

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[null,"DC",null,"Well Child Care"]
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[null,"ME",null,"Wound Care for Individuals with Epidermolysis Bullosa"]
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[null,"MO",null,"Osteoporosis"]
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[null,"NJ",null,"Attention Deficit Disorder"]
["Covered","NM",null,"Bone Marrow Transplants for Treatment of Breast Cancer"]
["Not Covered","NV",null,"Cardiac Rehabilitation"]
[null,"NY",null,"Contraceptive Services"]
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["Zero Cost Sharing Plan Variation","PR",null,"Anesthetics"]
["Limited Cost Sharing Plan Variation","PW",null,"Treatment of Lyme Disease"]
[null,"RI",null,"Family Therapy"]
["Click here to select","SC",null,"Oral Surgery"]
[null,"SD",null,"Oxygen"]
["Above EHB","TN",null,"Port-Wine Stain Removal"]
["Substituted","TX",null,"Residential Treatment for Children with Emotional Disabilities"]
["Substantially Equal","UT",null,"Second Opinions Related to Chemical Dependency and Mental Health"]
["Using Alternate Benchmark","VA",null,"Second Surgical Opinion"]
["Other Law/Regulation","VI",null,"Services to Ventilator-Dependent Persons"]
["Additional EHB Benefit","VT",null,"Newborn Services Other"]
["Dental Only Plan Available","WA",null,"Cancer Treatments"]
[null,"WI",null,"Domestic Violence Treatment"]
["No Charge","WV",null,"Infant Formulas"]
["No Charge after deductible","WY",null,"Sickle Cell Anemia"]
["$X",null,null,"Third Opinion"]
["$X Copay after deductible",null,null,"Treatment of Hemophilia"]
["$X Copay before deductible",null,null,"Wilm's Tumor"]
[null,null,null,"Breast Reconstructive Surgery"]
["$X Copay per Day",null,null,"Drug Infusion Administration"]
["$X Copay per Stay",null,null,"Eating Disorder Treatment"]
[null,null,null,"Experimental or Investigational Services"]
["No Charge",null,null,"Brain Injury"]
["No Charge after deductible",null,null,"Transplant Surgery—Donor Charges"]
["X%",null,null,"Wigs"]
["X% Coinsurance after deductible",null,null,"Pediatric Services Other"]
[null,null,null,"Transplant Donor Coverage"]
["Asthma",null,null,"Rape and Incest Coverage"]
["Heart Disease",null,null,"Outpatient Contraceptive Services Including Sterilizations"]
["Depression"]
["Diabetes"]
["High Blood Pressure & High Cholesterol"]
["Low Back Pain"]
["Pain Management"]
["Pregnancy"]
[]
["Visit(s)"]
["Dollars"]
["Exam(s)"]
["Days"]
["Item(s)"]
["Months"]
["Treatment(s)"]
["Procedure(s)"]
["Hours"]
["Admission(s)"]
[]
["Year"]
["Benefit Period"]
["Lifetime"]
["Month"]
["Episode"]
["Stay"]
["Transplant"]
["6 Months"]
["2 Years"]
["3 Years"]
["Procedure"]
["Week"]
["Admission"]
[]
["Guaranteed Rate "]
["Estimated Rate "]