{"aaData": [["01", "
MEDICARE PART D DEDUCTIBLE
\n"], ["80", "
NON-PART D/NON-QUALIFIED DRUG NOT PAID BY PART D PLAN BENEFIT, HOSPICE BENEFIT, OR ANY OTHER COMPONENT OF MEDICARE; PAID BY THE BENEFICIARY UNDER PLAN-SPONSORED NEGOTIATED PRICING.
\n"], ["90", "
ENHANCE OR OTC DRUG (PDE VALUE OF E/O) NOT APPLICABLE TO THE PART D DRUG SPEND, BUT IS COVERED BY THE PART D PLAN.
\n"], ["51", "
NOT PAID UNDER PART D, PAID UNDER PART C BENEFIT (FOR MA-PD PLAN). BENEFICIARY IS A QUALIFIED MEDICARE BENEFICIARY-PHARMACY SHOULD NOT ATTEMPT TO COLLECT COST-SHARE, BUT INSTEAD SHOULD ATTEMPT TO BILL COB TO MEDICAID COVERAGE.
\n"], ["91", "
PAID UNDER PART B BENEFIT OF A NON-MEDICARE ADVANTAGE PRESCRIPTION DRUG PLAN (MA-PD)
\n"], ["02", "
MEDICARE PART D INITIAL BENEFIT
\n"], ["03", "
MEDICARE PART D COVERAGE GAP
\n"], ["04", "
MEDICARE PART D CATASTROPHIC COVERAGE
\n"], ["50", "
NOT PAID UNDER PART D, PAID UNDER PART C BENEFIT (FOR MA-PD PLAN)
\n"], ["61", "
PART D DRUG NOT PAID BY PART D PLAN BENEFIT, PAID AS OR UNDER A CO-ADMINISTERED BENEFIT ONLY.
\n"], ["62", "
NON-PART D/NON-QUALIFIED DRUG NOT PAID BY PART D PLAN BENEFIT. PAID AS OR UNDER A CO-ADMINISTERED BENEFIT ONLY.
\n"], ["63", "
NON-PART D/NON-QUALIFIED DRUG NOT PAID BY PART D PLAN BENEFIT. PAID UNDER MEDICAID BENEFIT ONLY OF THE MEDICARE/MEDICAID (MMP) PLAN.
\n"], ["70", "
PART D DRUG NOT PAID BY PART D PLAN BENEFIT, PAID BY THE BENEFICIARY UNDER PLAN-SPONSORED NEGOTIATED PRICING.
\n"]]}