{"aaData": [["RX1", "1990-10-01 00:00:00\n", "PSO NSC RX COPAY NEW\n", "2\n", "", "", "2\n", "", ""], ["MEDICARE 4", "1992-01-01 00:00:00\n", "IB OPT MEDICARE RATE 4\n", "539\n", "", "", "", "S IBNOD=^IBE(350.2,DA,0) D VAR^IBAUTL1 Q:Y<0 S Y=(($P(Y,\"^\",2)*$P(IBNOD,\"^\",4))+(+Y*$P(Y,\"^\",3)*$P(IBNOD,\"^\",4))+$P(IBNOD,\"^\",6))+.005\\.01/100\n", ""], ["RX4", "2017-02-27 00:00:00\n", "PSO NSC RX COPAY UPDATE\n", "11\n", "", "", "3\n", "", ""], ["RX5", "2017-02-27 00:00:00\n", "PSO SC RX COPAY CANCEL\n", "11\n", "", "", "3\n", "", ""], ["RX6", "2017-02-27 00:00:00\n", "PSO SC RX COPAY UPDATE\n", "11\n", "", "", "3\n", "", ""], ["MEDICARE DEDUCTIBLE", "2017-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "1316\n", "", "", "", "", ""], ["FEE SERV RX1", "2017-02-27 00:00:00\n", "FEE SERV NSC RX COPAY NEW\n", "5\n", "", "", "1\n", "", ""], ["FEE SERV RX3", "2017-02-27 00:00:00\n", "FEE SERV NSC RX COPAY CANCEL\n", "5\n", "", "", "1\n", "", ""], ["FEE SERV RX4", "2017-02-27 00:00:00\n", "FEE SERV NSC RX COPAY UPDATE\n", "5\n", "", "", "1\n", "", ""], ["FEE SERV RX1", "2017-02-27 00:00:00\n", "FEE SERV NSC RX COPAY NEW\n", "8\n", "", "", "2\n", "", ""], ["FEE SERV RX3", "2017-02-27 00:00:00\n", "FEE SERV NSC RX COPAY CANCEL\n", "8\n", "", "", "2\n", "", ""], ["FEE SERV RX4", "2017-02-27 00:00:00\n", "FEE SERV NSC RX COPAY UPDATE\n", "8\n", "", "", "2\n", "", ""], ["MEDICARE 5", "1992-01-01 00:00:00\n", "IB OPT MEDICARE RATE 5\n", "615\n", "", "", "", "S IBNOD=^IBE(350.2,DA,0) D VAR^IBAUTL1 Q:Y<0 S Y=(($P(Y,\"^\",2)*$P(IBNOD,\"^\",4))+(+Y*$P(Y,\"^\",3)*$P(IBNOD,\"^\",4))+$P(IBNOD,\"^\",6))+.005\\.01/100\n", ""], ["FEE SERV RX1", "2017-02-27 00:00:00\n", "FEE SERV NSC RX COPAY NEW\n", "11\n", "", "", "3\n", "", ""], ["FEE SERV RX3", "2017-02-27 00:00:00\n", "FEE SERV NSC RX COPAY CANCEL\n", "11\n", "", "", "3\n", "", ""], ["FEE SERV RX4", "2017-02-27 00:00:00\n", "FEE SERV NSC RX COPAY UPDATE\n", "11\n", "", "", "3\n", "", ""], ["MEDICARE DEDUCTIBLE", "2018-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "1340\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "2019-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "1364\n", "", "", "", "", ""], ["FEE SERV INPT PER DIEM", "2014-03-12 00:00:00\n", "CHOICE (PER DIEM) NEW\n", "10\n", "", "", "", "", ""], ["FEE SERV INPT PER DIEM", "2014-03-12 00:00:00\n", "CC (PER DIEM) NEW\n", "10\n", "", "", "", "", ""], ["FEE SERV INPT PER DIEM", "2014-03-12 00:00:00\n", "CCN (PER DIEM) NEW\n", "10\n", "", "", "", "", ""], ["FEE SERV INPT PER DIEM", "2014-03-12 00:00:00\n", "CC MTF (PER DIEM) NEW\n", "10\n", "", "", "", "", ""], ["FEE LTC INPT CNH", "2002-07-26 00:00:00\n", "LTC CC INPT CNH NEW\n", "97\n", "", "", "", "", ""], ["MEDICARE 6", "1992-01-01 00:00:00\n", "IB OPT MEDICARE RATE 6\n", "580\n", "", "200\n", "", "S IBNOD=^IBE(350.2,DA,0) D VAR^IBAUTL1 Q:Y<0 S Y=(($P(Y,\"^\",2)*$P(IBNOD,\"^\",4))+(+Y*$P(Y,\"^\",3)*$P(IBNOD,\"^\",4))+$P(IBNOD,\"^\",6))+.005\\.01/100\n", ""], ["FEE LTC INPT CNH", "2002-07-26 00:00:00\n", "LTC CCN INPT CNH NEW\n", "97\n", "", "", "", "", ""], ["FEE LTC INPT CNH", "2002-07-26 00:00:00\n", "LTC CHOICE INPT CNH NEW\n", "97\n", "", "", "", "", ""], ["FEE LTC INPT RESPITE", "2002-07-26 00:00:00\n", "LTC CC INPT RESPITE NEW\n", "97\n", "", "", "", "", ""], ["FEE LTC INPT RESPITE", "2002-07-26 00:00:00\n", "LTC CCN INPT RESPITE NEW\n", "97\n", "", "", "", "", ""], ["FEE LTC INPT RESPITE", "2002-07-26 00:00:00\n", "LTC CHOICE INPT RESPITE NEW\n", "97\n", "", "", "", "", ""], ["FEE LTC OPT ADHC", "2002-07-26 00:00:00\n", "LTC CC OPT ADHC NEW\n", "15\n", "", "", "", "", ""], ["FEE LTC OPT ADHC", "2002-07-26 00:00:00\n", "LTC CCN OPT ADHC NEW\n", "15\n", "", "", "", "", ""], ["FEE LTC OPT ADHC", "2002-07-26 00:00:00\n", "LTC CHOICE OPT ADHC NEW\n", "15\n", "", "", "", "", ""], ["FEE LTC OPT RESPITE", "2002-07-26 00:00:00\n", "LTC CC OPT RESPITE NEW\n", "15\n", "", "", "", "", ""], ["FEE LTC OPT RESPITE", "2002-07-26 00:00:00\n", "LTC CCN OPT RESPITE NEW\n", "15\n", "", "", "", "", ""], ["MEDICARE 7", "1992-01-01 00:00:00\n", "IB OPT MEDICARE RATE 7\n", "853\n", "", "", "", "S IBNOD=^IBE(350.2,DA,0) D VAR^IBAUTL1 Q:Y<0 S Y=(($P(Y,\"^\",2)*$P(IBNOD,\"^\",4))+(+Y*$P(Y,\"^\",3)*$P(IBNOD,\"^\",4))+$P(IBNOD,\"^\",6))+.005\\.01/100\n", ""], ["FEE LTC OPT RESPITE", "2002-07-26 00:00:00\n", "LTC CHOICE OPT RESPITE NEW\n", "15\n", "", "", "", "", ""], ["FEE SERV RX1", "2014-03-12 00:00:00\n", "CHOICE (RX) NEW\n", "8\n", "", "1\n", "2\n", "", "I $G(DFN)>0,$$PRIORITY^DGENA(DFN)>6\n"], ["FEE SERV RX3", "2014-03-12 00:00:00\n", "CHOICE (RX) CANCEL\n", "8\n", "", "1\n", "2\n", "", "I $G(DFN)>0,$$PRIORITY^DGENA(DFN)>6\n"], ["FEE SERV RX4", "2014-03-12 00:00:00\n", "CHOICE (RX) UPDATE\n", "8\n", "", "1\n", "2\n", "", "I $G(DFN)>0,$$PRIORITY^DGENA(DFN)>6\n"], ["FEE SERV RX1", "2014-03-12 00:00:00\n", "CC (RX) NEW\n", "8\n", "", "1\n", "2\n", "", "I $G(DFN)>0,$$PRIORITY^DGENA(DFN)>6\n"], ["FEE SERV RX3", "2014-03-12 00:00:00\n", "CC (RX) CANCEL\n", "8\n", "", "1\n", "2\n", "", "I $G(DFN)>0,$$PRIORITY^DGENA(DFN)>6\n"], ["FEE SERV RX4", "2014-03-12 00:00:00\n", "CC (RX) UPDATE\n", "8\n", "", "1\n", "2\n", "", "I $G(DFN)>0,$$PRIORITY^DGENA(DFN)>6\n"], ["FEE SERV RX1", "2014-03-12 00:00:00\n", "CCN (RX) NEW\n", "8\n", "", "1\n", "2\n", "", "I $G(DFN)>0,$$PRIORITY^DGENA(DFN)>6\n"], ["FEE SERV RX3", "2014-03-12 00:00:00\n", "CCN (RX) CANCEL\n", "8\n", "", "1\n", "2\n", "", "I $G(DFN)>0,$$PRIORITY^DGENA(DFN)>6\n"], ["FEE SERV RX4", "2014-03-12 00:00:00\n", "CCN (RX) UPDATE\n", "8\n", "", "1\n", "2\n", "", "I $G(DFN)>0,$$PRIORITY^DGENA(DFN)>6\n"], ["MEDICARE 8", "1992-01-01 00:00:00\n", "IB OPT MEDICARE RATE 8\n", "705\n", "", "200\n", "", "S IBNOD=^IBE(350.2,DA,0) D VAR^IBAUTL1 Q:Y<0 S Y=(($P(Y,\"^\",2)*$P(IBNOD,\"^\",4))+(+Y*$P(Y,\"^\",3)*$P(IBNOD,\"^\",4))+$P(IBNOD,\"^\",6))+.005\\.01/100\n", ""], ["FEE SERV RX1", "2014-03-12 00:00:00\n", "CC MTF (RX) NEW\n", "8\n", "", "1\n", "2\n", "", "I $G(DFN)>0,$$PRIORITY^DGENA(DFN)>6\n"], ["FEE SERV RX3", "2014-03-12 00:00:00\n", "CC MTF (RX) CANCEL\n", "8\n", "", "1\n", "2\n", "", "I $G(DFN)>0,$$PRIORITY^DGENA(DFN)>6\n"], ["FEE SERV RX4", "2014-03-12 00:00:00\n", "CC MTF (RX) UPDATE\n", "8\n", "", "1\n", "2\n", "", "I $G(DFN)>0,$$PRIORITY^DGENA(DFN)>6\n"], ["FEE SERV RX1", "2017-02-27 00:00:00\n", "CHOICE (RX) NEW\n", "5\n", "", "", "1\n", "", ""], ["FEE SERV RX1", "2017-02-27 00:00:00\n", "CHOICE (RX) NEW\n", "8\n", "", "", "2\n", "", ""], ["FEE SERV RX1", "2017-02-27 00:00:00\n", "CHOICE (RX) NEW\n", "11\n", "", "", "3\n", "", ""], ["FEE SERV RX3", "2017-02-27 00:00:00\n", "CHOICE (RX) CANCEL\n", "5\n", "", "", "1\n", "", ""], ["FEE SERV RX3", "2017-02-27 00:00:00\n", "CHOICE (RX) CANCEL\n", "8\n", "", "", "2\n", "", ""], ["FEE SERV RX3", "2017-02-27 00:00:00\n", "CHOICE (RX) CANCEL\n", "11\n", "", "", "3\n", "", ""], ["FEE SERV RX4", "2017-02-27 00:00:00\n", "CHOICE (RX) UPDATE\n", "5\n", "", "", "1\n", "", ""], ["MEDICARE 9", "1992-01-01 00:00:00\n", "IB OPT MEDICARE RATE 9\n", "0\n", "", "", "", "S IBNOD=^IBE(350.2,DA,0) D VAR^IBAUTL1 Q:Y<0 S Y=(($P(Y,\"^\",2)*$P(IBNOD,\"^\",4))+(+Y*$P(Y,\"^\",3)*$P(IBNOD,\"^\",4))+$P(IBNOD,\"^\",6))+.005\\.01/100\n", ""], ["FEE SERV RX4", "2017-02-27 00:00:00\n", "CHOICE (RX) UPDATE\n", "8\n", "", "", "2\n", "", ""], ["FEE SERV RX4", "2017-02-27 00:00:00\n", "CHOICE (RX) UPDATE\n", "11\n", "", "", "3\n", "", ""], ["FEE SERV RX1", "2017-02-27 00:00:00\n", "CC (RX) NEW\n", "5\n", "", "", "1\n", "", ""], ["FEE SERV RX1", "2017-02-27 00:00:00\n", "CC (RX) NEW\n", "8\n", "", "", "2\n", "", ""], ["FEE SERV RX1", "2017-02-27 00:00:00\n", "CC (RX) NEW\n", "11\n", "", "", "3\n", "", ""], ["FEE SERV RX3", "2017-02-27 00:00:00\n", "CC (RX) CANCEL\n", "5\n", "", "", "1\n", "", ""], ["FEE SERV RX3", "2017-02-27 00:00:00\n", "CC (RX) CANCEL\n", "8\n", "", "", "2\n", "", ""], ["FEE SERV RX3", "2017-02-27 00:00:00\n", "CC (RX) CANCEL\n", "11\n", "", "", "3\n", "", ""], ["FEE SERV RX4", "2017-02-27 00:00:00\n", "CC (RX) UPDATE\n", "5\n", "", "", "1\n", "", ""], ["FEE SERV RX4", "2017-02-27 00:00:00\n", "CC (RX) UPDATE\n", "8\n", "", "", "2\n", "", ""], ["FEE SERV RX4", "2017-02-27 00:00:00\n", "CC (RX) UPDATE\n", "11\n", "", "", "3\n", "", ""], ["FEE SERV RX1", "2017-02-27 00:00:00\n", "CCN (RX) NEW\n", "5\n", "", "", "1\n", "", ""], ["FEE SERV RX1", "2017-02-27 00:00:00\n", "CCN (RX) NEW\n", "8\n", "", "", "2\n", "", ""], ["FEE SERV RX1", "2017-02-27 00:00:00\n", "CCN (RX) NEW\n", "11\n", "", "", "3\n", "", ""], ["FEE SERV RX3", "2017-02-27 00:00:00\n", "CCN (RX) CANCEL\n", "5\n", "", "", "1\n", "", ""], ["FEE SERV RX3", "2017-02-27 00:00:00\n", "CCN (RX) CANCEL\n", "8\n", "", "", "2\n", "", ""], ["FEE SERV RX3", "2017-02-27 00:00:00\n", "CCN (RX) CANCEL\n", "11\n", "", "", "3\n", "", ""], ["FEE SERV RX4", "2017-02-27 00:00:00\n", "CCN (RX) UPDATE\n", "5\n", "", "", "1\n", "", ""], ["FEE SERV RX4", "2017-02-27 00:00:00\n", "CCN (RX) UPDATE\n", "8\n", "", "", "2\n", "", ""], ["FEE SERV RX4", "2017-02-27 00:00:00\n", "CCN (RX) UPDATE\n", "11\n", "", "", "3\n", "", ""], ["FEE SERV RX1", "2017-02-27 00:00:00\n", "CC MTF (RX) NEW\n", "5\n", "", "", "1\n", "", ""], ["FEE SERV RX1", "2017-02-27 00:00:00\n", "CC MTF (RX) NEW\n", "8\n", "", "", "2\n", "", ""], ["FEE SERV RX1", "2017-02-27 00:00:00\n", "CC MTF (RX) NEW\n", "11\n", "", "", "3\n", "", ""], ["FEE SERV RX3", "2017-02-27 00:00:00\n", "CC MTF (RX) CANCEL\n", "5\n", "", "", "1\n", "", ""], ["FEE SERV RX3", "2017-02-27 00:00:00\n", "CC MTF (RX) CANCEL\n", "8\n", "", "", "2\n", "", ""], ["FEE SERV RX3", "2017-02-27 00:00:00\n", "CC MTF (RX) CANCEL\n", "11\n", "", "", "3\n", "", ""], ["FEE SERV RX4", "2017-02-27 00:00:00\n", "CC MTF (RX) UPDATE\n", "5\n", "", "", "1\n", "", ""], ["FEE SERV RX4", "2017-02-27 00:00:00\n", "CC MTF (RX) UPDATE\n", "8\n", "", "", "2\n", "", ""], ["FEE SERV RX4", "2017-02-27 00:00:00\n", "CC MTF (RX) UPDATE\n", "11\n", "", "", "3\n", "", ""], ["MEDICARE DEDUCTIBLE", "2020-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "1408\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "2021-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "1484\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "2022-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "1556\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "2023-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "1600\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "2024-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "1632\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "2025-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "1676\n", "", "", "", "", ""], ["INPT PER DIEM", "1990-10-01 00:00:00\n", "DG INPT PER DIEM NEW\n", "10\n", "", "", "", "", ""], ["RX2", "1990-10-01 00:00:00\n", "PSO SC RX COPAY NEW\n", "2\n", "", "", "2\n", "", ""], ["NHCU PER DIEM", "1990-10-01 00:00:00\n", "DG NHCU PER DIEM NEW\n", "5\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "1986-07-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "492\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "1987-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "520\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "1988-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "540\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "1989-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "560\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "1990-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "592\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "1991-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "628\n", "", "", "", "", ""], ["RX3", "1990-10-01 00:00:00\n", "PSO NSC RX COPAY CANCEL\n", "2\n", "", "", "2\n", "", ""], ["MEDICARE DEDUCTIBLE", "1992-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "652\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "1993-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "676\n", "", "", "", "", ""], ["CHAMPVA SUBSISTENCE LIMIT", "1991-10-01 00:00:00\n", "CHAMPVA SUBSISTENCE LIMIT\n", "25\n", "", "", "", "", ""], ["CHAMPVA PER DIEM", "1991-10-01 00:00:00\n", "DG CHAMPVA PER DIEM NEW\n", "8.95\n", "", "", "", "", ""], ["CHAMPVA PER DIEM", "1992-10-01 00:00:00\n", "DG CHAMPVA PER DIEM NEW\n", "9.30\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "1994-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "696\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "1995-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "716\n", "", "", "", "", ""], ["CHAMPVA PER DIEM", "1994-10-01 00:00:00\n", "DG CHAMPVA PER DIEM NEW\n", "9.50\n", "", "", "", "", ""], ["RX1", "2002-02-04 00:00:00\n", "PSO NSC RX COPAY NEW\n", "7\n", "", "", "2\n", "", ""], ["RX4", "1990-10-01 00:00:00\n", "PSO NSC RX COPAY UPDATE\n", "2\n", "", "", "2\n", "", ""], ["RX3", "2002-02-04 00:00:00\n", "PSO NSC RX COPAY CANCEL\n", "7\n", "", "", "2\n", "", ""], ["RX4", "2002-02-04 00:00:00\n", "PSO NSC RX COPAY UPDATE\n", "7\n", "", "", "2\n", "", ""], ["RX2", "2002-02-04 00:00:00\n", "PSO SC RX COPAY NEW\n", "7\n", "", "", "2\n", "", ""], ["RX5", "2002-02-04 00:00:00\n", "PSO SC RX COPAY CANCEL\n", "7\n", "", "", "2\n", "", ""], ["RX6", "2002-02-04 00:00:00\n", "PSO SC RX COPAY UPDATE\n", "7\n", "", "", "2\n", "", ""], ["LTC INPT NHCU", "2002-07-26 00:00:00\n", "DG LTC INPT NHCU NEW\n", "97\n", "", "", "", "", ""], ["LTC INPT GEM", "2002-07-26 00:00:00\n", "DG LTC INPT GEM NEW\n", "97\n", "", "", "", "", ""], ["LTC INPT RESPITE", "2002-07-26 00:00:00\n", "DG LTC INPT RESPITE NEW\n", "97\n", "", "", "", "", ""], ["LTC INPT DOM", "2002-07-26 00:00:00\n", "DG LTC INPT DOM NEW\n", "5\n", "", "", "", "", ""], ["LTC OPT ADHC", "2002-07-26 00:00:00\n", "DG LTC OPT ADHC NEW\n", "15\n", "", "", "", "", ""], ["RX5", "1990-10-01 00:00:00\n", "PSO SC RX COPAY CANCEL\n", "2\n", "", "", "2\n", "", ""], ["LTC OPT GEM", "2002-07-26 00:00:00\n", "DG LTC OPT GEM NEW\n", "15\n", "", "", "", "", ""], ["LTC OPT RESPITE", "2002-07-26 00:00:00\n", "DG LTC OPT RESPITE NEW\n", "15\n", "", "", "", "", ""], ["FEE LTC INPT CNH", "2002-07-26 00:00:00\n", "DG LTC FEE INPT CNH NEW\n", "97\n", "", "", "", "", ""], ["FEE LTC INPT RESPITE", "2002-07-26 00:00:00\n", "DG LTC FEE INPT RESPITE NEW\n", "97\n", "", "", "", "", ""], ["FEE LTC OPT ADHC", "2002-07-26 00:00:00\n", "DG LTC FEE OPT ADHC NEW\n", "15\n", "", "", "", "", ""], ["FEE LTC OPT RESPITE", "2002-07-26 00:00:00\n", "DG LTC FEE OPT RESPITE NEW\n", "15\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "2004-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "876\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "2005-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "912\n", "", "", "", "", ""], ["RX1", "2006-01-01 00:00:00\n", "PSO NSC RX COPAY NEW\n", "8\n", "", "", "2\n", "", ""], ["RX3", "2006-01-01 00:00:00\n", "PSO NSC RX COPAY CANCEL\n", "8\n", "", "", "2\n", "", ""], ["RX6", "1990-10-01 00:00:00\n", "PSO SC RX COPAY UPDATE\n", "2\n", "", "", "2\n", "", ""], ["RX4", "2006-01-01 00:00:00\n", "PSO NSC RX COPAY UPDATE\n", "8\n", "", "", "2\n", "", ""], ["RX2", "2006-01-01 00:00:00\n", "PSO SC RX COPAY NEW\n", "8\n", "", "", "2\n", "", ""], ["RX5", "2006-01-01 00:00:00\n", "PSO SC RX COPAY CANCEL\n", "8\n", "", "", "2\n", "", ""], ["RX6", "2006-01-01 00:00:00\n", "PSO SC RX COPAY UPDATE\n", "8\n", "", "", "2\n", "", ""], ["MEDICARE DEDUCTIBLE", "2006-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "952\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "2007-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "992\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "2008-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "1024\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "2009-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "1068\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "2010-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "1100\n", "", "", "", "", ""], ["RX1", "2010-07-01 00:00:00\n", "PSO NSC RX COPAY NEW\n", "8\n", "", "1\n", "2\n", "", "I $G(DFN)>0,$$PRIORITY^DGENA(DFN)>6\n"], ["MEDICARE 1", "1992-01-01 00:00:00\n", "IB OPT MEDICARE RATE 1\n", "285\n", "", "", "", "S IBNOD=^IBE(350.2,DA,0) D VAR^IBAUTL1 Q:Y<0 S Y=(($P(Y,\"^\",2)*$P(IBNOD,\"^\",4))+(+Y*$P(Y,\"^\",3)*$P(IBNOD,\"^\",4))+$P(IBNOD,\"^\",6))+.005\\.01/100\n", ""], ["RX2", "2010-07-01 00:00:00\n", "PSO SC RX COPAY NEW\n", "8\n", "", "1\n", "2\n", "", "I $G(DFN)>0,$$PRIORITY^DGENA(DFN)>6\n"], ["RX3", "2010-07-01 00:00:00\n", "PSO NSC RX COPAY CANCEL\n", "8\n", "", "1\n", "2\n", "", "I $G(DFN)>0,$$PRIORITY^DGENA(DFN)>6\n"], ["RX4", "2010-07-01 00:00:00\n", "PSO NSC RX COPAY UPDATE\n", "8\n", "", "1\n", "2\n", "", "I $G(DFN)>0,$$PRIORITY^DGENA(DFN)>6\n"], ["RX5", "2010-07-01 00:00:00\n", "PSO SC RX COPAY CANCEL\n", "8\n", "", "1\n", "2\n", "", "I $G(DFN)>0,$$PRIORITY^DGENA(DFN)>6\n"], ["RX6", "2010-07-01 00:00:00\n", "PSO SC RX COPAY UPDATE\n", "8\n", "", "1\n", "2\n", "", "I $G(DFN)>0,$$PRIORITY^DGENA(DFN)>6\n"], ["MEDICARE DEDUCTIBLE", "2011-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "1132\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "2012-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "1156\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "2013-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "1184\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "2014-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "1216\n", "", "", "", "", ""], ["FEE SERV INPT PER DIEM", "2014-03-12 00:00:00\n", "FEE SERV INPT PER DIEM NEW\n", "10\n", "", "", "", "", ""], ["MEDICARE 2", "1992-01-01 00:00:00\n", "IB OPT MEDICARE RATE 2\n", "382\n", "", "", "", "S IBNOD=^IBE(350.2,DA,0) D VAR^IBAUTL1 Q:Y<0 S Y=(($P(Y,\"^\",2)*$P(IBNOD,\"^\",4))+(+Y*$P(Y,\"^\",3)*$P(IBNOD,\"^\",4))+$P(IBNOD,\"^\",6))+.005\\.01/100\n", ""], ["FEE SERV RX1", "2014-03-12 00:00:00\n", "FEE SERV NSC RX COPAY NEW\n", "8\n", "", "1\n", "2\n", "", "I $G(DFN)>0,$$PRIORITY^DGENA(DFN)>6\n"], ["FEE SERV RX3", "2014-03-12 00:00:00\n", "FEE SERV NSC RX COPAY CANCEL\n", "8\n", "", "1\n", "2\n", "", "I $G(DFN)>0,$$PRIORITY^DGENA(DFN)>6\n"], ["FEE SERV RX4", "2014-03-12 00:00:00\n", "FEE SERV NSC RX COPAY UPDATE\n", "8\n", "", "1\n", "2\n", "", "I $G(DFN)>0,$$PRIORITY^DGENA(DFN)>6\n"], ["MEDICARE DEDUCTIBLE", "2015-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "1260\n", "", "", "", "", ""], ["MEDICARE DEDUCTIBLE", "2016-01-01 00:00:00\n", "MEDICARE DEDUCTIBLE\n", "1288\n", "", "", "", "", ""], ["RX1", "2017-02-27 00:00:00\n", "PSO NSC RX COPAY NEW\n", "5\n", "", "", "1\n", "", ""], ["RX2", "2017-02-27 00:00:00\n", "PSO SC RX COPAY NEW\n", "5\n", "", "", "1\n", "", ""], ["RX3", "2017-02-27 00:00:00\n", "PSO NSC RX COPAY CANCEL\n", "5\n", "", "", "1\n", "", ""], ["RX4", "2017-02-27 00:00:00\n", "PSO NSC RX COPAY UPDATE\n", "5\n", "", "", "1\n", "", ""], ["RX5", "2017-02-27 00:00:00\n", "PSO SC RX COPAY CANCEL\n", "5\n", "", "", "1\n", "", ""], ["MEDICARE 3", "1992-01-01 00:00:00\n", "IB OPT MEDICARE RATE 3\n", "438\n", "", "", "", "S IBNOD=^IBE(350.2,DA,0) D VAR^IBAUTL1 Q:Y<0 S Y=(($P(Y,\"^\",2)*$P(IBNOD,\"^\",4))+(+Y*$P(Y,\"^\",3)*$P(IBNOD,\"^\",4))+$P(IBNOD,\"^\",6))+.005\\.01/100\n", ""], ["RX6", "2017-02-27 00:00:00\n", "PSO SC RX COPAY UPDATE\n", "5\n", "", "", "1\n", "", ""], ["RX1", "2017-02-27 00:00:00\n", "PSO NSC RX COPAY NEW\n", "8\n", "", "", "2\n", "", ""], ["RX2", "2017-02-27 00:00:00\n", "PSO SC RX COPAY NEW\n", "8\n", "", "", "2\n", "", ""], ["RX3", "2017-02-27 00:00:00\n", "PSO NSC RX COPAY CANCEL\n", "8\n", "", "", "2\n", "", ""], ["RX4", "2017-02-27 00:00:00\n", "PSO NSC RX COPAY UPDATE\n", "8\n", "", "", "2\n", "", ""], ["RX5", "2017-02-27 00:00:00\n", "PSO SC RX COPAY CANCEL\n", "8\n", "", "", "2\n", "", ""], ["RX6", "2017-02-27 00:00:00\n", "PSO SC RX COPAY UPDATE\n", "8\n", "", "", "2\n", "", ""], ["RX1", "2017-02-27 00:00:00\n", "PSO NSC RX COPAY NEW\n", "11\n", "", "", "3\n", "", ""], ["RX2", "2017-02-27 00:00:00\n", "PSO SC RX COPAY NEW\n", "11\n", "", "", "3\n", "", ""], ["RX3", "2017-02-27 00:00:00\n", "PSO NSC RX COPAY CANCEL\n", "11\n", "", "", "3\n", "", ""]]}