{"text_format":"3","workbook":"xlsx","n_sheets":18,"sheets":["WELCOME","MULTIPLE_PLAN_MODE","BENEFIT_DESIGN","PLAN_INPUT_DATA","HelperTab","BENEFIT_DESIGN_ERRORS","BENEFIT_PARAMETERS","PLAN_OUTPUT_DATA","RESULTS_SUMMARY","MATERNITY_SUMMARY","MATERNITY_LINE_ITEM","DIABETES_SUMMARY","MATERNITY_TIMELINE","DIABETES_TIMELINE","DIABETES_LINE_ITEM","FRACTURE_SUMMARY","FRACTURE_TIMELINE","FRACTURE_LINE_ITEM"],"not_rendered":{"images":2,"macros":1,"defined_names":191,"comments":2},"read":"whole","date_system":"1900"}

{"sheet":"WELCOME","index":0,"n_rows":17,"n_cols":4,"rows_kept":17,"merged":[[15,0,15,3]]}
[]
[null,"Welcome to the Coverage Examples Cost Sharing Calculator"]
[]
[null,"All insurer data entry fields are highlighted in orange."]
[]
[null,"The Cost Sharing Calculator operates in two modes."]
[null,"Click the button that corresponds to the mode you want to use."]
[]
[{"$nulls":3},"The user enters data for an individual plan and views the results."]
[]
[{"$nulls":3},"The user loads data for multiple plans and runs the calculator."]
[{"$nulls":3},"The user can then browse the results for the individual plans, save"]
[{"$nulls":3},"the results to an external file, or copy and paste the results for "]
[{"$nulls":3},"the individual plans to a separate worksheet."]
[]
["PRA Disclosure Statement:According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number.  The valid OMB control number for this information collection is 0938-1146.  The time required to complete this information collection is estimated to average XXX hours per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection.  If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850.\n"]
[null,"OMB Control Numbers 1545-2229, 1210-0147, and 0938-1146"]

{"sheet":"MULTIPLE_PLAN_MODE","index":1,"n_rows":20,"n_cols":4,"rows_kept":20,"hidden":true}
[]
[null,"Multiple Plan Mode"]
[null,null,"In multiple plan mode you load data for multiple plans into the calculator."]
[null,null,"The calculator will check your plan benefit design data for errors and calculate"]
[null,null,"subscriber cost sharing for each plan."]
[null,null,"After loading plan data you can browse the output and review the benefit design"]
[null,null,"parameters for each plan. You can also correct any errors that were identfied"]
[null,null,"and update your input data by switching to Single Plan Mode."]
[]
[]
[null,"You have three options for loading plan-level data."]
[null,"Select the option you want to use by clicking the appropriate button."]
[]
[null,null,"Import data from external file.  External file should reflect the plan input data worksheet, starting on Row 6."]
[]
[null,"Option 2: ","Copy and paste data from an external file into the plan input data worksheet."]
[]
[null,"Option 3:","Enter data for each plan in Single Plan Mode and save the data to the input data worksheet."]
[]
[{"$nulls":3},"Click the button to the left to switch to Single Plan Mode"]

{"sheet":"BENEFIT_DESIGN","index":2,"n_rows":43,"n_cols":9,"rows_kept":43,"hidden":true,"merged":[[7,1,8,1],[7,2,8,2]]}
[]
[null,"Single Plan Mode","Plan Selection:"]
[null,"Enter or modify data for each plan. "]
[null,"Data entry fields are highlighted in orange."]
[]
[null,"Plan Name","Plan 1"]
[]
[null,"Benefit category","Type of cost sharing that applies","Cost sharing¹",null,null,"Coverage Limits",null,"OOP"]
[{"$nulls":3},"Benefit Deductible","Co-payment","Co-insurance","per month","per year","limit applies?"]
[null,"Inpatient Hospital Care (Facility)","Not Covered"]
[null,"Other Facility Services","Not Covered"]
[null,"Emergency Department (Facility)","Not Covered"]
[null,"Ambulance","Not Covered"]
[null,"Professional Services: Primary Care","Not Covered"]
[null,"Professional Services: Emergency Department","Not Covered"]
[null,"Professional Services: Inpatient","Not Covered"]
[null,"Professional Services: Specialist","Not Covered"]
[null,"Professional Services: Obstetric Care (Bundled)","Not Covered"]
[null,"Professional Services: Procedures & Other","Not Covered"]
[null,"Professional Services: Physical Therapy","Not Covered"]
[null,"Diagnostic Services: Radiology","Not Covered"]
[null,"Diagnostic Services: Laboratory","Not Covered"]
[null,"Prescription Drugs: Generic","Not Covered"]
[null,"Prescription Drugs: Branded","Not Covered"]
[null,"Prescription Drugs: Insulin","Not Covered"]
[null,"Over-the-counter Drugs","Not Covered"]
[null,"Preventive Services & Vaccines","Not Covered"]
[null,"Durable Medical Equipment","Not Covered"]
[null,"Medical Supplies","Not Covered"]
[null,"Over-the-counter Medical Supplies","Not Covered"]
[null,"Other Items & Services","Not Covered"]
[null,"Plan Deductible"]
[null,"Rx Deductible"]
[null,"Deductible C"]
[null,"Deductible D"]
[null,"Individual Out-of-Pocket (OOP) Limit",null,null,{"v":0,"d":"$0"}]
[]
[null,"Additional Options","Applies?","# Visits"]
[null,"Begin Primary Care Cost-Sharing After A Set Number of Visits?","No"]
[null,"Begin Primary Care Cost-Sharing Deductible or Coinsurance After a Set Number of Copays?","No"]
[]
[null,"¹ The benefit-specific deductible, copayment amount, or coinsurance rate that determines consumer liability."]
[null,"² Outpatient services include non-professional Emergency Department services. Professional services fall under the Professional Services benefit categories."]

{"sheet":"PLAN_INPUT_DATA","index":3,"n_rows":13,"n_cols":164,"rows_kept":13,"hidden":true}
[]
[null,"This worksheet contains the benefit parameters for multiple plans."]
[null,"You can copy and paste data for individual plans from an external source starting on row 8."]
[]
[]
[{"$nulls":6},"Inpatient Hospital Care (Facility)",{"$nulls":6},"Other Facility Services",{"$nulls":6},"Emergency Department (Facility)",{"$nulls":6},"Ambulance",{"$nulls":6},"Professional Services: Primary Care",{"$nulls":6},"Professional Services: Emergency Department",{"$nulls":6},"Professional Services: Inpatient",{"$nulls":6},"Professional Services: Specialist",{"$nulls":6},"Professional Services: Obstetric Care (Bundled)",{"$nulls":6},"Professional Services: Procedures & Other",{"$nulls":6},"Professional Services: Physical Therapy",{"$nulls":6},"Diagnostic Services: Radiology",{"$nulls":6},"Diagnostic Services: Laboratory",{"$nulls":6},"Prescription Drugs: Generic",{"$nulls":6},"Prescription Drugs: Branded",{"$nulls":6},"Prescription Drugs: Insulin",{"$nulls":6},"Over-the-counter Drugs",{"$nulls":6},"Preventive Services & Vaccines",{"$nulls":6},"Durable Medical Equipment",{"$nulls":6},"Medical Supplies",{"$nulls":6},"Over-the-counter Medical Supplies",{"$nulls":6},"Other Items & Services",{"$nulls":6},"Begin Primary Care Cost-Sharing After A Set Number of Visits?",null,"Begin Primary Care Cost-Sharing Deductible or Coinsurance After a Set Number of Copays?"]
["PLAN_ID","Plan deductible","Rx deductible","Deductible C","Deductible D","OOP Limit","Cost sharing Type","Benefit Deductible","Co-payment","Co-insurance","Monthly Limits","Annual Limits","OOP Limit Applies","Cost sharing Type","Benefit Deductible","Co-payment","Co-insurance","Monthly Limits","Annual Limits","OOP Limit Applies","Cost sharing Type","Benefit Deductible","Co-payment","Co-insurance","Monthly Limits","Annual Limits","OOP Limit Applies","Cost sharing Type","Benefit Deductible","Co-payment","Co-insurance","Monthly Limits","Annual Limits","OOP Limit Applies","Cost sharing Type","Benefit Deductible","Co-payment","Co-insurance","Monthly Limits","Annual Limits","OOP Limit Applies","Cost sharing Type","Benefit Deductible","Co-payment","Co-insurance","Monthly Limits","Annual Limits","OOP Limit Applies","Cost sharing Type","Benefit Deductible","Co-payment","Co-insurance","Monthly Limits","Annual Limits","OOP Limit Applies","Cost sharing Type","Benefit Deductible","Co-payment","Co-insurance","Monthly Limits","Annual Limits","OOP Limit Applies","Cost sharing Type","Benefit Deductible","Co-payment","Co-insurance","Monthly Limits","Annual Limits","OOP Limit Applies","Cost sharing Type","Benefit Deductible","Co-payment","Co-insurance","Monthly Limits","Annual Limits","OOP Limit Applies","Cost sharing Type","Benefit Deductible","Co-payment","Co-insurance","Monthly Limits","Annual Limits","OOP Limit Applies","Cost sharing Type","Benefit Deductible","Co-payment","Co-insurance","Monthly Limits","Annual Limits","OOP Limit Applies","Cost sharing Type","Benefit Deductible","Co-payment","Co-insurance","Monthly Limits","Annual Limits","OOP Limit Applies","Cost sharing Type","Benefit Deductible","Co-payment","Co-insurance","Monthly Limits","Annual Limits","OOP Limit Applies","Cost sharing Type","Benefit Deductible","Co-payment","Co-insurance","Monthly Limits","Annual Limits","OOP Limit Applies","Cost sharing Type","Benefit Deductible","Co-payment","Co-insurance","Monthly Limits","Annual Limits","OOP Limit Applies","Cost sharing Type","Benefit Deductible","Co-payment","Co-insurance","Monthly Limits","Annual Limits","OOP Limit Applies","Cost sharing Type","Benefit Deductible","Co-payment","Co-insurance","Monthly Limits","Annual Limits","OOP Limit Applies","Cost sharing Type","Benefit Deductible","Co-payment","Co-insurance","Monthly Limits","Annual Limits","OOP Limit Applies","Cost sharing Type","Benefit Deductible","Co-payment","Co-insurance","Monthly Limits","Annual Limits","OOP Limit Applies","Cost sharing Type","Benefit Deductible","Co-payment","Co-insurance","Monthly Limits","Annual Limits","OOP Limit Applies","Cost sharing Type","Benefit Deductible","Co-payment","Co-insurance","Monthly Limits","Annual Limits","OOP Limit Applies","Applies?","# Visits","Applies?","# Visits"]
["Plan 1",{"$nulls":5},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"No",null,"No"]
["Plan 2",{"$nulls":5},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"No",null,"No"]
["Plan 3",{"$nulls":5},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"No",null,"No"]
["Plan 4",{"$nulls":5},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"No",null,"No"]
["Plan 5",{"$nulls":5},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"No",null,"No"]
["Plan 6",{"$nulls":5},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"Not Covered",{"$nulls":6},"No",null,"No"]

{"sheet":"HelperTab","index":4,"n_rows":20,"n_cols":4,"rows_kept":20,"hidden":true}
["BENEFIT_DESIGN Tab",null,null,"Cost sharing description"]
["Total Plan Count:",6,null,"Not Covered"]
["Current Plan:",1,null,"No Cost Sharing"]
["Curent Plan Name:","Plan 1",null,"Plan Deductible Only"]
["BENEFIT_DESIGN Parameters Changed?",false,null,"Rx Deductible Only"]
[{"$nulls":3},"Deductible C Only"]
["RESULTS_SUMMARY Tab",null,null,"Deductible D Only"]
["Total Plan Count:",6,null,"Benefit Deductible Only"]
["Current Plan:",1,null,"Copayment Only"]
["Curent Plan Name:","Plan 1",null,"Coinsurance Only"]
[{"$nulls":3},"Plan Deductible + Copay"]
[{"$nulls":3},"Rx Deductible + Copay"]
[{"$nulls":3},"Deductible C + Copay"]
[{"$nulls":3},"Deductible D + Copay"]
[{"$nulls":3},"Benefit Deductible + Copay"]
[{"$nulls":3},"Plan Deductible + Coins"]
[{"$nulls":3},"Rx Deductible + Coins"]
[{"$nulls":3},"Deductible C + Coins"]
[{"$nulls":3},"Deductible D + Coins"]
[{"$nulls":3},"Benefit Deductible + Coins"]

{"sheet":"BENEFIT_DESIGN_ERRORS","index":5,"n_rows":39,"n_cols":20,"rows_kept":39,"hidden":true}
[]
[]
[null,"Plan Design Errors"]
[]
[{"$nulls":14},"Parameters specified in plan benefit design"]
[null,"Plan 2",{"$nulls":5},"Cost sharing¹",null,null,"Coverage Limits",null,"OOP",null,"Cost sharing¹",null,null,"Coverage Limits"]
[null,"Benefit category","Coverage type","Plan Deductible","Rx Deductible","Deductible C","Deductible D","Benefit Deductible","Co-payment","Co-insurance","per month","per year","limit applies?",null,"Has benefit deductible","Has co-payment","Has co-insurance","Has monthly limit","Has annual limit","Has OOP limit"]
[null,{"$f":"BENEFIT_DESIGN!B10","v":"Inpatient Hospital Care (Facility)"},{"$f":"IF(BENEFIT_PARAMETERS!C4,FALSE,TRUE)","v":false},{"$f":"IF(BENEFIT_PARAMETERS!G4,IF(BENEFIT_PARAMETERS!C52>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!C52=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!H4,IF(BENEFIT_PARAMETERS!D52>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!D52=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!I4,IF(BENEFIT_PARAMETERS!E52>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!E52=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!J4,IF(BENEFIT_PARAMETERS!F52>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!F52=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!K4,IF(BENEFIT_PARAMETERS!H52>=0,FALSE,TRUE),IF(O8,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!L4,IF(BENEFIT_PARAMETERS!I52>=0,FALSE,TRUE),IF(P8,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!M4,IF(BENEFIT_PARAMETERS!J52>=0,FALSE,TRUE),IF(Q8,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!D4,IF(BENEFIT_PARAMETERS!K52=\"None\",FALSE,IF(BENEFIT_PARAMETERS!K52>=0,FALSE,TRUE)),IF(R8,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!E4,IF(BENEFIT_PARAMETERS!L52=\"None\",FALSE,IF(BENEFIT_PARAMETERS!L52>=0,FALSE,TRUE)),IF(S8,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!F4,IF(BENEFIT_PARAMETERS!M52=\"Yes\",FALSE,IF(BENEFIT_PARAMETERS!M52=\"No\",FALSE,TRUE)),IF(T8,FALSE,TRUE))","v":false},null,{"$f":"ISBLANK(BENEFIT_DESIGN!D10)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!E10)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!F10)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!G10)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!H10)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!I10)","v":true}]
[null,{"$f":"BENEFIT_DESIGN!B11","v":"Other Facility Services"},{"$f":"IF(BENEFIT_PARAMETERS!C5,FALSE,TRUE)","v":false},{"$f":"IF(BENEFIT_PARAMETERS!G5,IF(BENEFIT_PARAMETERS!C53>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!C53=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!H5,IF(BENEFIT_PARAMETERS!D53>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!D53=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!I5,IF(BENEFIT_PARAMETERS!E53>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!E53=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!J5,IF(BENEFIT_PARAMETERS!F53>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!F53=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!K5,IF(BENEFIT_PARAMETERS!H53>=0,FALSE,TRUE),IF(O9,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!L5,IF(BENEFIT_PARAMETERS!I53>=0,FALSE,TRUE),IF(P9,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!M5,IF(BENEFIT_PARAMETERS!J53>=0,FALSE,TRUE),IF(Q9,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!D5,IF(BENEFIT_PARAMETERS!K53=\"None\",FALSE,IF(BENEFIT_PARAMETERS!K53>=0,FALSE,TRUE)),IF(R9,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!E5,IF(BENEFIT_PARAMETERS!L53=\"None\",FALSE,IF(BENEFIT_PARAMETERS!L53>=0,FALSE,TRUE)),IF(S9,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!F5,IF(BENEFIT_PARAMETERS!M53=\"Yes\",FALSE,IF(BENEFIT_PARAMETERS!M53=\"No\",FALSE,TRUE)),IF(T9,FALSE,TRUE))","v":false},null,{"$f":"ISBLANK(BENEFIT_DESIGN!D11)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!E11)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!F11)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!G11)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!H11)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!I11)","v":true}]
[null,{"$f":"BENEFIT_DESIGN!B12","v":"Emergency Department (Facility)"},{"$f":"IF(BENEFIT_PARAMETERS!C6,FALSE,TRUE)","v":false},{"$f":"IF(BENEFIT_PARAMETERS!G6,IF(BENEFIT_PARAMETERS!C54>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!C54=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!H6,IF(BENEFIT_PARAMETERS!D54>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!D54=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!I6,IF(BENEFIT_PARAMETERS!E54>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!E54=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!J6,IF(BENEFIT_PARAMETERS!F54>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!F54=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!K6,IF(BENEFIT_PARAMETERS!H54>=0,FALSE,TRUE),IF(O10,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!L6,IF(BENEFIT_PARAMETERS!I54>=0,FALSE,TRUE),IF(P10,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!M6,IF(BENEFIT_PARAMETERS!J54>=0,FALSE,TRUE),IF(Q10,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!D6,IF(BENEFIT_PARAMETERS!K54=\"None\",FALSE,IF(BENEFIT_PARAMETERS!K54>=0,FALSE,TRUE)),IF(R10,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!E6,IF(BENEFIT_PARAMETERS!L54=\"None\",FALSE,IF(BENEFIT_PARAMETERS!L54>=0,FALSE,TRUE)),IF(S10,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!F6,IF(BENEFIT_PARAMETERS!M54=\"Yes\",FALSE,IF(BENEFIT_PARAMETERS!M54=\"No\",FALSE,TRUE)),IF(T10,FALSE,TRUE))","v":false},null,{"$f":"ISBLANK(BENEFIT_DESIGN!D12)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!E12)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!F12)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!G12)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!H12)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!I12)","v":true}]
[null,{"$f":"BENEFIT_DESIGN!B13","v":"Ambulance"},{"$f":"IF(BENEFIT_PARAMETERS!C7,FALSE,TRUE)","v":false},{"$f":"IF(BENEFIT_PARAMETERS!G7,IF(BENEFIT_PARAMETERS!C55>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!C55=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!H7,IF(BENEFIT_PARAMETERS!D55>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!D55=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!I7,IF(BENEFIT_PARAMETERS!E55>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!E55=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!J7,IF(BENEFIT_PARAMETERS!F55>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!F55=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!K7,IF(BENEFIT_PARAMETERS!H55>=0,FALSE,TRUE),IF(O11,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!L7,IF(BENEFIT_PARAMETERS!I55>=0,FALSE,TRUE),IF(P11,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!M7,IF(BENEFIT_PARAMETERS!J55>=0,FALSE,TRUE),IF(Q11,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!D7,IF(BENEFIT_PARAMETERS!K55=\"None\",FALSE,IF(BENEFIT_PARAMETERS!K55>=0,FALSE,TRUE)),IF(R11,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!E7,IF(BENEFIT_PARAMETERS!L55=\"None\",FALSE,IF(BENEFIT_PARAMETERS!L55>=0,FALSE,TRUE)),IF(S11,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!F7,IF(BENEFIT_PARAMETERS!M55=\"Yes\",FALSE,IF(BENEFIT_PARAMETERS!M55=\"No\",FALSE,TRUE)),IF(T11,FALSE,TRUE))","v":false},null,{"$f":"ISBLANK(BENEFIT_DESIGN!D13)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!E13)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!F13)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!G13)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!H13)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!I13)","v":true}]
[null,{"$f":"BENEFIT_DESIGN!B14","v":"Professional Services: Primary Care"},{"$f":"IF(BENEFIT_PARAMETERS!C8,FALSE,TRUE)","v":false},{"$f":"IF(BENEFIT_PARAMETERS!G8,IF(BENEFIT_PARAMETERS!C56>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!C56=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!H8,IF(BENEFIT_PARAMETERS!D56>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!D56=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!I8,IF(BENEFIT_PARAMETERS!E56>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!E56=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!J8,IF(BENEFIT_PARAMETERS!F56>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!F56=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!K8,IF(BENEFIT_PARAMETERS!H56>=0,FALSE,TRUE),IF(O12,FALSE,TRUE))","v":false},{"$f":"IF(OR(BENEFIT_PARAMETERS!L8,BENEFIT_PARAMETERS!C77=\"Yes\"),IF(BENEFIT_PARAMETERS!I56>=0,FALSE,TRUE),IF(P12,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!M8,IF(BENEFIT_PARAMETERS!J56>=0,FALSE,TRUE),IF(Q12,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!D8,IF(BENEFIT_PARAMETERS!K56=\"None\",FALSE,IF(BENEFIT_PARAMETERS!K56>=0,FALSE,TRUE)),IF(R12,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!E8,IF(BENEFIT_PARAMETERS!L56=\"None\",FALSE,IF(BENEFIT_PARAMETERS!L56>=0,FALSE,TRUE)),IF(S12,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!F8,IF(BENEFIT_PARAMETERS!M56=\"Yes\",FALSE,IF(BENEFIT_PARAMETERS!M56=\"No\",FALSE,TRUE)),IF(T12,FALSE,TRUE))","v":false},null,{"$f":"ISBLANK(BENEFIT_DESIGN!D14)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!E14)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!F14)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!G14)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!H14)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!I14)","v":true}]
[null,{"$f":"BENEFIT_DESIGN!B15","v":"Professional Services: Emergency Department"},{"$f":"IF(BENEFIT_PARAMETERS!C9,FALSE,TRUE)","v":false},{"$f":"IF(BENEFIT_PARAMETERS!G9,IF(BENEFIT_PARAMETERS!C57>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!C57=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!H9,IF(BENEFIT_PARAMETERS!D57>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!D57=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!I9,IF(BENEFIT_PARAMETERS!E57>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!E57=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!J9,IF(BENEFIT_PARAMETERS!F57>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!F57=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!K9,IF(BENEFIT_PARAMETERS!H57>=0,FALSE,TRUE),IF(O13,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!L9,IF(BENEFIT_PARAMETERS!I57>=0,FALSE,TRUE),IF(P13,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!M9,IF(BENEFIT_PARAMETERS!J57>=0,FALSE,TRUE),IF(Q13,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!D9,IF(BENEFIT_PARAMETERS!K57=\"None\",FALSE,IF(BENEFIT_PARAMETERS!K57>=0,FALSE,TRUE)),IF(R13,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!E9,IF(BENEFIT_PARAMETERS!L57=\"None\",FALSE,IF(BENEFIT_PARAMETERS!L57>=0,FALSE,TRUE)),IF(S13,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!F9,IF(BENEFIT_PARAMETERS!M57=\"Yes\",FALSE,IF(BENEFIT_PARAMETERS!M57=\"No\",FALSE,TRUE)),IF(T13,FALSE,TRUE))","v":false},null,{"$f":"ISBLANK(BENEFIT_DESIGN!D15)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!E15)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!F15)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!G15)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!H15)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!I15)","v":true}]
[null,{"$f":"BENEFIT_DESIGN!B17","v":"Professional Services: Specialist"},{"$f":"IF(BENEFIT_PARAMETERS!C11,FALSE,TRUE)","v":false},{"$f":"IF(BENEFIT_PARAMETERS!G11,IF(BENEFIT_PARAMETERS!C59>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!C59=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!H11,IF(BENEFIT_PARAMETERS!D59>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!D59=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!I11,IF(BENEFIT_PARAMETERS!E59>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!E59=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!J11,IF(BENEFIT_PARAMETERS!F59>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!F59=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!K11,IF(BENEFIT_PARAMETERS!H59>=0,FALSE,TRUE),IF(O14,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!L11,IF(BENEFIT_PARAMETERS!I59>=0,FALSE,TRUE),IF(P14,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!M11,IF(BENEFIT_PARAMETERS!J59>=0,FALSE,TRUE),IF(Q14,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!D11,IF(BENEFIT_PARAMETERS!K59=\"None\",FALSE,IF(BENEFIT_PARAMETERS!K59>=0,FALSE,TRUE)),IF(R14,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!E11,IF(BENEFIT_PARAMETERS!L59=\"None\",FALSE,IF(BENEFIT_PARAMETERS!L59>=0,FALSE,TRUE)),IF(S14,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!F11,IF(BENEFIT_PARAMETERS!M59=\"Yes\",FALSE,IF(BENEFIT_PARAMETERS!M59=\"No\",FALSE,TRUE)),IF(T14,FALSE,TRUE))","v":false},null,{"$f":"ISBLANK(BENEFIT_DESIGN!D17)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!E17)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!F17)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!G17)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!H17)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!I17)","v":true}]
[null,{"$f":"BENEFIT_DESIGN!B18","v":"Professional Services: Obstetric Care (Bundled)"},{"$f":"IF(BENEFIT_PARAMETERS!C12,FALSE,TRUE)","v":false},{"$f":"IF(BENEFIT_PARAMETERS!G12,IF(BENEFIT_PARAMETERS!C60>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!C60=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!H12,IF(BENEFIT_PARAMETERS!D60>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!D60=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!I12,IF(BENEFIT_PARAMETERS!E60>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!E60=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!J12,IF(BENEFIT_PARAMETERS!F60>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!F60=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!K12,IF(BENEFIT_PARAMETERS!H60>=0,FALSE,TRUE),IF(O15,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!L12,IF(BENEFIT_PARAMETERS!I60>=0,FALSE,TRUE),IF(P15,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!M12,IF(BENEFIT_PARAMETERS!J60>=0,FALSE,TRUE),IF(Q15,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!D12,IF(BENEFIT_PARAMETERS!K60=\"None\",FALSE,IF(BENEFIT_PARAMETERS!K60>=0,FALSE,TRUE)),IF(R15,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!E12,IF(BENEFIT_PARAMETERS!L60=\"None\",FALSE,IF(BENEFIT_PARAMETERS!L60>=0,FALSE,TRUE)),IF(S15,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!F12,IF(BENEFIT_PARAMETERS!M60=\"Yes\",FALSE,IF(BENEFIT_PARAMETERS!M60=\"No\",FALSE,TRUE)),IF(T15,FALSE,TRUE))","v":false},null,{"$f":"ISBLANK(BENEFIT_DESIGN!D18)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!E18)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!F18)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!G18)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!H18)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!I18)","v":true}]
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[null,{"$f":"BENEFIT_DESIGN!B26","v":"Over-the-counter Drugs"},{"$f":"IF(BENEFIT_PARAMETERS!C20,FALSE,TRUE)","v":false},{"$f":"IF(BENEFIT_PARAMETERS!G20,IF(BENEFIT_PARAMETERS!C68>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!C68=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!H20,IF(BENEFIT_PARAMETERS!D68>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!D68=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!I20,IF(BENEFIT_PARAMETERS!E68>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!E68=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!J20,IF(BENEFIT_PARAMETERS!F68>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!F68=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!K20,IF(BENEFIT_PARAMETERS!H68>=0,FALSE,TRUE),IF(O23,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!L20,IF(BENEFIT_PARAMETERS!I68>=0,FALSE,TRUE),IF(P23,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!M20,IF(BENEFIT_PARAMETERS!J68>=0,FALSE,TRUE),IF(Q23,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!D20,IF(BENEFIT_PARAMETERS!K68=\"None\",FALSE,IF(BENEFIT_PARAMETERS!K68>=0,FALSE,TRUE)),IF(R23,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!E20,IF(BENEFIT_PARAMETERS!L68=\"None\",FALSE,IF(BENEFIT_PARAMETERS!L68>=0,FALSE,TRUE)),IF(S23,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!F20,IF(BENEFIT_PARAMETERS!M68=\"Yes\",FALSE,IF(BENEFIT_PARAMETERS!M68=\"No\",FALSE,TRUE)),IF(T23,FALSE,TRUE))","v":false},null,{"$f":"ISBLANK(BENEFIT_DESIGN!D26)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!E26)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!F26)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!G26)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!H26)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!I26)","v":true}]
[null,{"$f":"BENEFIT_DESIGN!B27","v":"Preventive Services & Vaccines"},{"$f":"IF(BENEFIT_PARAMETERS!C21,FALSE,TRUE)","v":false},{"$f":"IF(BENEFIT_PARAMETERS!G21,IF(BENEFIT_PARAMETERS!C69>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!C69=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!H21,IF(BENEFIT_PARAMETERS!D69>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!D69=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!I21,IF(BENEFIT_PARAMETERS!E69>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!E69=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!J21,IF(BENEFIT_PARAMETERS!F69>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!F69=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!K21,IF(BENEFIT_PARAMETERS!H69>=0,FALSE,TRUE),IF(O24,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!L21,IF(BENEFIT_PARAMETERS!I69>=0,FALSE,TRUE),IF(P24,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!M21,IF(BENEFIT_PARAMETERS!J69>=0,FALSE,TRUE),IF(Q24,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!D21,IF(BENEFIT_PARAMETERS!K69=\"None\",FALSE,IF(BENEFIT_PARAMETERS!K69>=0,FALSE,TRUE)),IF(R24,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!E21,IF(BENEFIT_PARAMETERS!L69=\"None\",FALSE,IF(BENEFIT_PARAMETERS!L69>=0,FALSE,TRUE)),IF(S24,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!F21,IF(BENEFIT_PARAMETERS!M69=\"Yes\",FALSE,IF(BENEFIT_PARAMETERS!M69=\"No\",FALSE,TRUE)),IF(T24,FALSE,TRUE))","v":false},null,{"$f":"ISBLANK(BENEFIT_DESIGN!D27)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!E27)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!F27)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!G27)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!H27)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!I27)","v":true}]
[null,{"$f":"BENEFIT_DESIGN!B28","v":"Durable Medical Equipment"},{"$f":"IF(BENEFIT_PARAMETERS!C22,FALSE,TRUE)","v":false},{"$f":"IF(BENEFIT_PARAMETERS!G22,IF(BENEFIT_PARAMETERS!C70>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!C70=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!H22,IF(BENEFIT_PARAMETERS!D70>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!D70=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!I22,IF(BENEFIT_PARAMETERS!E70>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!E70=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!J22,IF(BENEFIT_PARAMETERS!F70>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!F70=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!K22,IF(BENEFIT_PARAMETERS!H70>=0,FALSE,TRUE),IF(O25,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!L22,IF(BENEFIT_PARAMETERS!I70>=0,FALSE,TRUE),IF(P25,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!M22,IF(BENEFIT_PARAMETERS!J70>=0,FALSE,TRUE),IF(Q25,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!D22,IF(BENEFIT_PARAMETERS!K70=\"None\",FALSE,IF(BENEFIT_PARAMETERS!K70>=0,FALSE,TRUE)),IF(R25,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!E22,IF(BENEFIT_PARAMETERS!L70=\"None\",FALSE,IF(BENEFIT_PARAMETERS!L70>=0,FALSE,TRUE)),IF(S25,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!F22,IF(BENEFIT_PARAMETERS!M70=\"Yes\",FALSE,IF(BENEFIT_PARAMETERS!M70=\"No\",FALSE,TRUE)),IF(T25,FALSE,TRUE))","v":false},null,{"$f":"ISBLANK(BENEFIT_DESIGN!D28)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!E28)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!F28)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!G28)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!H28)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!I28)","v":true}]
[null,{"$f":"BENEFIT_DESIGN!B29","v":"Medical Supplies"},{"$f":"IF(BENEFIT_PARAMETERS!C23,FALSE,TRUE)","v":false},{"$f":"IF(BENEFIT_PARAMETERS!G23,IF(BENEFIT_PARAMETERS!C71>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!C71=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!H23,IF(BENEFIT_PARAMETERS!D71>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!D71=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!I23,IF(BENEFIT_PARAMETERS!E71>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!E71=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!J23,IF(BENEFIT_PARAMETERS!F71>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!F71=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!K23,IF(BENEFIT_PARAMETERS!H71>=0,FALSE,TRUE),IF(O26,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!L23,IF(BENEFIT_PARAMETERS!I71>=0,FALSE,TRUE),IF(P26,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!M23,IF(BENEFIT_PARAMETERS!J71>=0,FALSE,TRUE),IF(Q26,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!D23,IF(BENEFIT_PARAMETERS!K71=\"None\",FALSE,IF(BENEFIT_PARAMETERS!K71>=0,FALSE,TRUE)),IF(R26,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!E23,IF(BENEFIT_PARAMETERS!L71=\"None\",FALSE,IF(BENEFIT_PARAMETERS!L71>=0,FALSE,TRUE)),IF(S26,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!F23,IF(BENEFIT_PARAMETERS!M71=\"Yes\",FALSE,IF(BENEFIT_PARAMETERS!M71=\"No\",FALSE,TRUE)),IF(T26,FALSE,TRUE))","v":false},null,{"$f":"ISBLANK(BENEFIT_DESIGN!D29)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!E29)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!F29)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!G29)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!H29)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!I29)","v":true}]
[null,{"$f":"BENEFIT_DESIGN!B30","v":"Over-the-counter Medical Supplies"},{"$f":"IF(BENEFIT_PARAMETERS!C24,FALSE,TRUE)","v":false},{"$f":"IF(BENEFIT_PARAMETERS!G24,IF(BENEFIT_PARAMETERS!C72>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!C72=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!H24,IF(BENEFIT_PARAMETERS!D72>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!D72=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!I24,IF(BENEFIT_PARAMETERS!E72>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!E72=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!J24,IF(BENEFIT_PARAMETERS!F72>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!F72=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!K24,IF(BENEFIT_PARAMETERS!H72>=0,FALSE,TRUE),IF(O27,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!L24,IF(BENEFIT_PARAMETERS!I72>=0,FALSE,TRUE),IF(P27,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!M24,IF(BENEFIT_PARAMETERS!J72>=0,FALSE,TRUE),IF(Q27,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!D24,IF(BENEFIT_PARAMETERS!K72=\"None\",FALSE,IF(BENEFIT_PARAMETERS!K72>=0,FALSE,TRUE)),IF(R27,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!E24,IF(BENEFIT_PARAMETERS!L72=\"None\",FALSE,IF(BENEFIT_PARAMETERS!L72>=0,FALSE,TRUE)),IF(S27,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!F24,IF(BENEFIT_PARAMETERS!M72=\"Yes\",FALSE,IF(BENEFIT_PARAMETERS!M72=\"No\",FALSE,TRUE)),IF(T27,FALSE,TRUE))","v":false},null,{"$f":"ISBLANK(BENEFIT_DESIGN!D30)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!E30)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!F30)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!G30)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!H30)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!I30)","v":true}]
[null,{"$f":"BENEFIT_DESIGN!B31","v":"Other Items & Services"},{"$f":"IF(BENEFIT_PARAMETERS!C25,FALSE,TRUE)","v":false},{"$f":"IF(BENEFIT_PARAMETERS!G25,IF(BENEFIT_PARAMETERS!C73>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!C73=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!H25,IF(BENEFIT_PARAMETERS!D73>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!D73=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!I25,IF(BENEFIT_PARAMETERS!E73>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!E73=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!J25,IF(BENEFIT_PARAMETERS!F73>=0,FALSE,TRUE),IF(BENEFIT_PARAMETERS!F73=\".\",FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!K25,IF(BENEFIT_PARAMETERS!H73>=0,FALSE,TRUE),IF(O28,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!L25,IF(BENEFIT_PARAMETERS!I73>=0,FALSE,TRUE),IF(P28,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!M25,IF(BENEFIT_PARAMETERS!J73>=0,FALSE,TRUE),IF(Q28,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!D25,IF(BENEFIT_PARAMETERS!K73=\"None\",FALSE,IF(BENEFIT_PARAMETERS!K73>=0,FALSE,TRUE)),IF(R28,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!E25,IF(BENEFIT_PARAMETERS!L73=\"None\",FALSE,IF(BENEFIT_PARAMETERS!L73>=0,FALSE,TRUE)),IF(S28,FALSE,TRUE))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!F25,IF(BENEFIT_PARAMETERS!M73=\"Yes\",FALSE,IF(BENEFIT_PARAMETERS!M73=\"No\",FALSE,TRUE)),IF(T28,FALSE,TRUE))","v":false},null,{"$f":"ISBLANK(BENEFIT_DESIGN!D31)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!E31)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!F31)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!G31)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!H31)","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!I31)","v":true}]
[null,{"$f":"BENEFIT_DESIGN!B32","v":"Plan Deductible"},{"$f":"IF(BENEFIT_PARAMETERS!G26,IF(BENEFIT_DESIGN!C32>=0,FALSE,TRUE),IF(ISBLANK(BENEFIT_DESIGN!C32),FALSE,TRUE))","v":false}]
[null,{"$f":"BENEFIT_DESIGN!B33","v":"Rx Deductible"},{"$f":"IF(BENEFIT_PARAMETERS!H26,IF(BENEFIT_DESIGN!C33>=0,FALSE,TRUE),IF(ISBLANK(BENEFIT_DESIGN!C33),FALSE,TRUE))","v":false}]
[null,{"$f":"BENEFIT_DESIGN!B34","v":"Deductible C"},{"$f":"IF(BENEFIT_PARAMETERS!I26,IF(BENEFIT_DESIGN!C34>=0,FALSE,TRUE),IF(ISBLANK(BENEFIT_DESIGN!C34),FALSE,TRUE))","v":false}]
[null,{"$f":"BENEFIT_DESIGN!B35","v":"Deductible D"},{"$f":"IF(BENEFIT_PARAMETERS!J26,IF(BENEFIT_DESIGN!C35>=0,FALSE,TRUE),IF(ISBLANK(BENEFIT_DESIGN!C35),FALSE,TRUE))","v":false}]
[null,{"$f":"BENEFIT_DESIGN!B36","v":"Individual Out-of-Pocket (OOP) Limit"},{"$f":"IF(BENEFIT_PARAMETERS!F26,IF(BENEFIT_DESIGN!C36>=0,FALSE,TRUE),IF(ISBLANK(BENEFIT_DESIGN!C36),FALSE,TRUE))","v":false},{"$nulls":5},{"v":0,"d":"$0"},{"$nulls":6},{"v":0,"d":"$0"}]
[]
[null,"Additional Options","Applies?","# Visits",{"$nulls":10},"Applies?","# Visits"]
[null,"Begin Primary Care Cost-Sharing After A Set Number of Visits?",{"$f":"IF(BENEFIT_PARAMETERS!B76,OR(BENEFIT_PARAMETERS!C76=\"Yes\",BENEFIT_PARAMETERS!C76=\"No\")=FALSE,NOT(BENEFIT_DESIGN_ERRORS!O36))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!C76=\"Yes\",IF(BENEFIT_PARAMETERS!D76>=0,FALSE,TRUE),NOT(BENEFIT_DESIGN_ERRORS!P36))","v":false},{"$nulls":10},{"$f":"BENEFIT_DESIGN!C39=\"No\"","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!D39)","v":true}]
[null,"Begin Primary Care Cost-Sharing Deductible or Coinsurance After a Set Number of Copays?",{"$f":"IF(BENEFIT_PARAMETERS!B77,OR(BENEFIT_PARAMETERS!C77=\"Yes\",BENEFIT_PARAMETERS!C77=\"No\")=FALSE,NOT(BENEFIT_DESIGN_ERRORS!O37))","v":false},{"$f":"IF(BENEFIT_PARAMETERS!C77=\"Yes\",IF(BENEFIT_PARAMETERS!D77>=0,FALSE,TRUE),NOT(BENEFIT_DESIGN_ERRORS!P37))","v":false},{"$nulls":4},{"v":0,"d":"$0"},{"$nulls":5},{"$f":"BENEFIT_DESIGN!C40=\"No\"","v":true},{"$f":"ISBLANK(BENEFIT_DESIGN!D40)","v":true}]
[]
[null,"Errors exist",{"$f":"IF(COUNTIF(C8:M37,TRUE)=0,FALSE,TRUE)","v":false},{"$f":"IF(COUNTIF(D8:D28,TRUE)=0,FALSE,TRUE)","v":false},{"$f":"IF(COUNTIF(E8:E28,TRUE)=0,FALSE,TRUE)","v":false},false,false,false,false,false,false,false,false,null,null,{"v":0,"d":"$0"}]

{"sheet":"BENEFIT_PARAMETERS","index":6,"n_rows":80,"n_cols":16,"rows_kept":80,"hidden":true}
[]
["Coverage Table"]
["Benefit category","Cost Sharing Type","Coverage type valid","Monthly limit valid","Annual limit valid","OOP limit valid","uses plan deductible","uses rx deductible","uses deductible C","uses deductible D","uses benefit deductible","uses copayment","uses coinsurance"]
[{"$f":"BENEFIT_DESIGN!B10","v":"Inpatient Hospital Care (Facility)"},{"$f":"BENEFIT_DESIGN!C10","v":"Not Covered"},{"$f":"IFERROR(IF(MATCH($B4,$A$30:$A$48,0)>0,TRUE,FALSE),FALSE)","v":true},{"$f":"IFERROR(IF(MATCH($B4,$A$30:$A$48,0)>1,TRUE,FALSE),FALSE)","v":false},{"$f":"$D4","v":false},false,{"$f":"IFERROR(VLOOKUP($B4,$A$30:$H$48,MATCH(G$3,$A$29:$H$29,0),FALSE),FALSE)","v":false},{"$f":"IFERROR(VLOOKUP($B4,$A$30:$H$48,MATCH(H$3,$A$29:$H$29,0),FALSE),FALSE)","v":false},false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!B11","v":"Other Facility Services"},{"$f":"BENEFIT_DESIGN!C11","v":"Not Covered"},{"$f":"IFERROR(IF(MATCH($B5,$A$30:$A$48,0)>0,TRUE,FALSE),FALSE)","v":true},{"$f":"IFERROR(IF(MATCH($B5,$A$30:$A$48,0)>1,TRUE,FALSE),FALSE)","v":false},false,false,{"$f":"IFERROR(VLOOKUP($B5,$A$30:$H$48,MATCH(G$3,$A$29:$H$29,0),FALSE),FALSE)","v":false},false,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!B12","v":"Emergency Department (Facility)"},{"$f":"BENEFIT_DESIGN!C12","v":"Not Covered"},true,false,false,false,false,false,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!B13","v":"Ambulance"},{"$f":"BENEFIT_DESIGN!C13","v":"Not Covered"},true,false,false,false,false,false,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!B14","v":"Professional Services: Primary Care"},{"$f":"BENEFIT_DESIGN!C14","v":"Not Covered"},true,false,false,false,false,false,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!B15","v":"Professional Services: Emergency Department"},{"$f":"BENEFIT_DESIGN!C15","v":"Not Covered"},true,false,false,false,false,false,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!B16","v":"Professional Services: Inpatient"},{"$f":"BENEFIT_DESIGN!C16","v":"Not Covered"},true,false,false,false,false,false,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!B17","v":"Professional Services: Specialist"},{"$f":"BENEFIT_DESIGN!C17","v":"Not Covered"},true,false,false,false,false,false,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!B18","v":"Professional Services: Obstetric Care (Bundled)"},{"$f":"BENEFIT_DESIGN!C18","v":"Not Covered"},true,false,false,false,false,false,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!B19","v":"Professional Services: Procedures & Other"},{"$f":"BENEFIT_DESIGN!C19","v":"Not Covered"},true,false,false,false,false,false,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!B20","v":"Professional Services: Physical Therapy"},{"$f":"BENEFIT_DESIGN!C20","v":"Not Covered"},true,false,false,false,false,false,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!B21","v":"Diagnostic Services: Radiology"},{"$f":"BENEFIT_DESIGN!C21","v":"Not Covered"},true,false,false,false,false,false,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!B22","v":"Diagnostic Services: Laboratory"},{"$f":"BENEFIT_DESIGN!C22","v":"Not Covered"},true,false,false,false,false,false,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!B23","v":"Prescription Drugs: Generic"},{"$f":"BENEFIT_DESIGN!C23","v":"Not Covered"},true,false,false,false,false,false,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!B24","v":"Prescription Drugs: Branded"},{"$f":"BENEFIT_DESIGN!C24","v":"Not Covered"},true,false,false,false,false,false,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!B25","v":"Prescription Drugs: Insulin"},{"$f":"BENEFIT_DESIGN!C25","v":"Not Covered"},true,false,false,false,false,false,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!B26","v":"Over-the-counter Drugs"},{"$f":"BENEFIT_DESIGN!C26","v":"Not Covered"},true,false,false,false,false,false,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!B27","v":"Preventive Services & Vaccines"},{"$f":"BENEFIT_DESIGN!C27","v":"Not Covered"},true,false,false,false,false,false,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!B28","v":"Durable Medical Equipment"},{"$f":"BENEFIT_DESIGN!C28","v":"Not Covered"},true,false,false,false,false,false,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!B29","v":"Medical Supplies"},{"$f":"BENEFIT_DESIGN!C29","v":"Not Covered"},true,false,false,false,false,false,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!B30","v":"Over-the-counter Medical Supplies"},{"$f":"BENEFIT_DESIGN!C30","v":"Not Covered"},true,false,false,false,false,false,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!B31","v":"Other Items & Services"},{"$f":"BENEFIT_DESIGN!C31","v":"Not Covered"},true,false,false,false,false,false,false,false,false,false,false]
[{"$nulls":5},{"$f":"COUNTIF(F4:F25,TRUE)>0","v":false},{"$f":"COUNTIF(G4:G25,TRUE)>0","v":false},{"$f":"COUNTIF(H4:H25,TRUE)>0","v":false},{"$f":"COUNTIF(I4:I25,TRUE)>0","v":false},{"$f":"COUNTIF(J4:J25,TRUE)>0","v":false}]
[]
["Coverage Options Table"]
["Cost sharing description","uses plan deductible","uses rx deductible","uses deductible C","uses deductible D","uses benefit deductible","uses copayment","uses coinsurance"]
["Not Covered",false,false,false,false,false,false,false]
["No Cost Sharing",false,false,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!$B$32&\" Only\"","v":"Plan Deductible Only"},true,false,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!$B$33&\" Only\"","v":"Rx Deductible Only"},false,true,false,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!$B$34&\" Only\"","v":"Deductible C Only"},false,false,true,false,false,false,false]
[{"$f":"BENEFIT_DESIGN!$B$35&\" Only\"","v":"Deductible D Only"},false,false,false,true,false,false,false]
["Benefit Deductible Only",false,false,false,false,true,false,false]
["Copayment Only",false,false,false,false,false,true,false]
["Coinsurance Only",false,false,false,false,false,false,true]
[{"$f":"BENEFIT_DESIGN!$B$32&\" + Copay\"","v":"Plan Deductible + Copay"},true,false,false,false,false,true,false]
[{"$f":"BENEFIT_DESIGN!$B$33&\" + Copay\"","v":"Rx Deductible + Copay"},false,true,false,false,false,true,false]
[{"$f":"BENEFIT_DESIGN!$B$34&\" + Copay\"","v":"Deductible C + Copay"},false,false,true,false,false,true,false]
[{"$f":"BENEFIT_DESIGN!$B$35&\" + Copay\"","v":"Deductible D + Copay"},false,false,false,true,false,true,false]
["Benefit Deductible + Copay",false,false,false,false,true,true,false]
[{"$f":"BENEFIT_DESIGN!$B$32&\" + Coins\"","v":"Plan Deductible + Coins"},true,false,false,false,false,false,true]
[{"$f":"BENEFIT_DESIGN!$B$33&\" + Coins\"","v":"Rx Deductible + Coins"},false,true,false,false,false,false,true]
[{"$f":"BENEFIT_DESIGN!$B$34&\" + Coins\"","v":"Deductible C + Coins"},false,false,true,false,false,false,true]
[{"$f":"BENEFIT_DESIGN!$B$35&\" + Coins\"","v":"Deductible D + Coins"},false,false,false,true,false,false,true]
["Benefit Deductible + Coins",false,false,false,false,true,false,true]
[]
["Plan Parameters"]
["Benefit category","Cost Sharing Type","Plan deductible","Rx deductible","Optional Deductible C","Optional Deductible D","Out of Pocket Limit","Benefit deductible","Copayment","Coinsurance","Coverage Limit per Month","Coverage Limit per Year","OOP limit applies","Maternity Spending","Diabetes Spending","Foot Fracture Spending"]
[{"$f":"BENEFIT_DESIGN!B10","v":"Inpatient Hospital Care (Facility)"},{"$f":"BENEFIT_DESIGN!C10","v":"Not Covered"},{"$f":"IF(AND(G4,ISNUMBER(BENEFIT_DESIGN!$C$32)),BENEFIT_DESIGN!$C$32,\".\")","v":"."},{"$f":"IF(AND(H4,ISNUMBER(BENEFIT_DESIGN!$C$33)),BENEFIT_DESIGN!$C$33,\".\")","v":"."},{"$f":"IF(AND(I4,ISNUMBER(BENEFIT_DESIGN!$C$34)),BENEFIT_DESIGN!$C$34,\".\")","v":"."},{"$f":"IF(AND(J4,ISNUMBER(BENEFIT_DESIGN!$C$35)),BENEFIT_DESIGN!$C$35,\".\")","v":"."},{"$f":"IF(AND(F4,OR(ISNUMBER(BENEFIT_DESIGN!$C$36),BENEFIT_DESIGN!$C$36=\"None\")),BENEFIT_DESIGN!$C$36,\".\")","v":"."},{"$f":"IF(AND(K4,ISNUMBER(BENEFIT_DESIGN!D10)),BENEFIT_DESIGN!D10,\".\")","v":"."},{"$f":"IF(AND(L4,ISNUMBER(BENEFIT_DESIGN!E10)),BENEFIT_DESIGN!E10,\".\")","v":"."},{"$f":"IF(AND(M4,ISNUMBER(BENEFIT_DESIGN!F10)),BENEFIT_DESIGN!F10,\".\")","v":"."},{"$f":"IF(AND(D4,OR(ISNUMBER(BENEFIT_DESIGN!G10),UPPER(BENEFIT_DESIGN!G10)=\"NONE\")),BENEFIT_DESIGN!G10,\".\")","v":"."},{"$f":"IF(AND(E4,OR(ISNUMBER(BENEFIT_DESIGN!H10),UPPER(BENEFIT_DESIGN!H10)=\"NONE\")),BENEFIT_DESIGN!H10,\".\")","v":"."},{"$f":"IF(AND(F4,OR(UPPER(BENEFIT_DESIGN!I10)=\"YES\",UPPER(BENEFIT_DESIGN!I10)=\"NO\")),BENEFIT_DESIGN!I10,\".\")","v":"."},{"$f":"VLOOKUP(A52,MATERNITY_SUMMARY!$B$6:$E$27,4,0)>0","v":true},{"$f":"VLOOKUP(A52,DIABETES_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A52,FRACTURE_SUMMARY!$B$6:$E$27,4,0)>0","v":false}]
[{"$f":"BENEFIT_DESIGN!B11","v":"Other Facility Services"},{"$f":"BENEFIT_DESIGN!C11","v":"Not Covered"},{"$f":"IF(AND(G5,ISNUMBER(BENEFIT_DESIGN!$C$32)),BENEFIT_DESIGN!$C$32,\".\")","v":"."},{"$f":"IF(AND(H5,ISNUMBER(BENEFIT_DESIGN!$C$33)),BENEFIT_DESIGN!$C$33,\".\")","v":"."},{"$f":"IF(AND(I5,ISNUMBER(BENEFIT_DESIGN!$C$34)),BENEFIT_DESIGN!$C$34,\".\")","v":"."},{"$f":"IF(AND(J5,ISNUMBER(BENEFIT_DESIGN!$C$35)),BENEFIT_DESIGN!$C$35,\".\")","v":"."},{"$f":"IF(AND(F5,OR(ISNUMBER(BENEFIT_DESIGN!$C$36),BENEFIT_DESIGN!$C$36=\"None\")),BENEFIT_DESIGN!$C$36,\".\")","v":"."},{"$f":"IF(AND(K5,ISNUMBER(BENEFIT_DESIGN!D11)),BENEFIT_DESIGN!D11,\".\")","v":"."},{"$f":"IF(AND(L5,ISNUMBER(BENEFIT_DESIGN!E11)),BENEFIT_DESIGN!E11,\".\")","v":"."},{"$f":"IF(AND(M5,ISNUMBER(BENEFIT_DESIGN!F11)),BENEFIT_DESIGN!F11,\".\")","v":"."},{"$f":"IF(AND(D5,OR(ISNUMBER(BENEFIT_DESIGN!G11),UPPER(BENEFIT_DESIGN!G11)=\"NONE\")),BENEFIT_DESIGN!G11,\".\")","v":"."},{"$f":"IF(AND(E5,OR(ISNUMBER(BENEFIT_DESIGN!H11),UPPER(BENEFIT_DESIGN!H11)=\"NONE\")),BENEFIT_DESIGN!H11,\".\")","v":"."},{"$f":"IF(AND(F5,OR(UPPER(BENEFIT_DESIGN!I11)=\"YES\",UPPER(BENEFIT_DESIGN!I11)=\"NO\")),BENEFIT_DESIGN!I11,\".\")","v":"."},{"$f":"VLOOKUP(A53,MATERNITY_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A53,DIABETES_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A53,FRACTURE_SUMMARY!$B$6:$E$27,4,0)>0","v":true}]
[{"$f":"BENEFIT_DESIGN!B12","v":"Emergency Department (Facility)"},{"$f":"BENEFIT_DESIGN!C12","v":"Not Covered"},{"$f":"IF(AND(G6,ISNUMBER(BENEFIT_DESIGN!$C$32)),BENEFIT_DESIGN!$C$32,\".\")","v":"."},{"$f":"IF(AND(H6,ISNUMBER(BENEFIT_DESIGN!$C$33)),BENEFIT_DESIGN!$C$33,\".\")","v":"."},{"$f":"IF(AND(I6,ISNUMBER(BENEFIT_DESIGN!$C$34)),BENEFIT_DESIGN!$C$34,\".\")","v":"."},{"$f":"IF(AND(J6,ISNUMBER(BENEFIT_DESIGN!$C$35)),BENEFIT_DESIGN!$C$35,\".\")","v":"."},{"$f":"IF(AND(F6,OR(ISNUMBER(BENEFIT_DESIGN!$C$36),BENEFIT_DESIGN!$C$36=\"None\")),BENEFIT_DESIGN!$C$36,\".\")","v":"."},{"$f":"IF(AND(K6,ISNUMBER(BENEFIT_DESIGN!D12)),BENEFIT_DESIGN!D12,\".\")","v":"."},{"$f":"IF(AND(L6,ISNUMBER(BENEFIT_DESIGN!E12)),BENEFIT_DESIGN!E12,\".\")","v":"."},{"$f":"IF(AND(M6,ISNUMBER(BENEFIT_DESIGN!F12)),BENEFIT_DESIGN!F12,\".\")","v":"."},{"$f":"IF(AND(D6,OR(ISNUMBER(BENEFIT_DESIGN!G12),UPPER(BENEFIT_DESIGN!G12)=\"NONE\")),BENEFIT_DESIGN!G12,\".\")","v":"."},{"$f":"IF(AND(E6,OR(ISNUMBER(BENEFIT_DESIGN!H12),UPPER(BENEFIT_DESIGN!H12)=\"NONE\")),BENEFIT_DESIGN!H12,\".\")","v":"."},{"$f":"IF(AND(F6,OR(UPPER(BENEFIT_DESIGN!I12)=\"YES\",UPPER(BENEFIT_DESIGN!I12)=\"NO\")),BENEFIT_DESIGN!I12,\".\")","v":"."},{"$f":"VLOOKUP(A54,MATERNITY_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A54,DIABETES_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A54,FRACTURE_SUMMARY!$B$6:$E$27,4,0)>0","v":true}]
[{"$f":"BENEFIT_DESIGN!B13","v":"Ambulance"},{"$f":"BENEFIT_DESIGN!C13","v":"Not Covered"},{"$f":"IF(AND(G7,ISNUMBER(BENEFIT_DESIGN!$C$32)),BENEFIT_DESIGN!$C$32,\".\")","v":"."},{"$f":"IF(AND(H7,ISNUMBER(BENEFIT_DESIGN!$C$33)),BENEFIT_DESIGN!$C$33,\".\")","v":"."},{"$f":"IF(AND(I7,ISNUMBER(BENEFIT_DESIGN!$C$34)),BENEFIT_DESIGN!$C$34,\".\")","v":"."},{"$f":"IF(AND(J7,ISNUMBER(BENEFIT_DESIGN!$C$35)),BENEFIT_DESIGN!$C$35,\".\")","v":"."},{"$f":"IF(AND(F7,OR(ISNUMBER(BENEFIT_DESIGN!$C$36),BENEFIT_DESIGN!$C$36=\"None\")),BENEFIT_DESIGN!$C$36,\".\")","v":"."},{"$f":"IF(AND(K7,ISNUMBER(BENEFIT_DESIGN!D13)),BENEFIT_DESIGN!D13,\".\")","v":"."},{"$f":"IF(AND(L7,ISNUMBER(BENEFIT_DESIGN!E13)),BENEFIT_DESIGN!E13,\".\")","v":"."},{"$f":"IF(AND(M7,ISNUMBER(BENEFIT_DESIGN!F13)),BENEFIT_DESIGN!F13,\".\")","v":"."},{"$f":"IF(AND(D7,OR(ISNUMBER(BENEFIT_DESIGN!G13),UPPER(BENEFIT_DESIGN!G13)=\"NONE\")),BENEFIT_DESIGN!G13,\".\")","v":"."},{"$f":"IF(AND(E7,OR(ISNUMBER(BENEFIT_DESIGN!H13),UPPER(BENEFIT_DESIGN!H13)=\"NONE\")),BENEFIT_DESIGN!H13,\".\")","v":"."},{"$f":"IF(AND(F7,OR(UPPER(BENEFIT_DESIGN!I13)=\"YES\",UPPER(BENEFIT_DESIGN!I13)=\"NO\")),BENEFIT_DESIGN!I13,\".\")","v":"."},{"$f":"VLOOKUP(A55,MATERNITY_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A55,DIABETES_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A55,FRACTURE_SUMMARY!$B$6:$E$27,4,0)>0","v":true}]
[{"$f":"BENEFIT_DESIGN!B14","v":"Professional Services: Primary Care"},{"$f":"BENEFIT_DESIGN!C14","v":"Not Covered"},{"$f":"IF(AND(G8,ISNUMBER(BENEFIT_DESIGN!$C$32)),BENEFIT_DESIGN!$C$32,\".\")","v":"."},{"$f":"IF(AND(H8,ISNUMBER(BENEFIT_DESIGN!$C$33)),BENEFIT_DESIGN!$C$33,\".\")","v":"."},{"$f":"IF(AND(I8,ISNUMBER(BENEFIT_DESIGN!$C$34)),BENEFIT_DESIGN!$C$34,\".\")","v":"."},{"$f":"IF(AND(J8,ISNUMBER(BENEFIT_DESIGN!$C$35)),BENEFIT_DESIGN!$C$35,\".\")","v":"."},{"$f":"IF(AND(F8,OR(ISNUMBER(BENEFIT_DESIGN!$C$36),BENEFIT_DESIGN!$C$36=\"None\")),BENEFIT_DESIGN!$C$36,\".\")","v":"."},{"$f":"IF(AND(K8,ISNUMBER(BENEFIT_DESIGN!D14)),BENEFIT_DESIGN!D14,\".\")","v":"."},{"$f":"IF(AND(OR(L8,C77=\"Yes\"),ISNUMBER(BENEFIT_DESIGN!E14)),BENEFIT_DESIGN!E14,\".\")","v":"."},{"$f":"IF(AND(M8,ISNUMBER(BENEFIT_DESIGN!F14)),BENEFIT_DESIGN!F14,\".\")","v":"."},{"$f":"IF(AND(D8,OR(ISNUMBER(BENEFIT_DESIGN!G14),UPPER(BENEFIT_DESIGN!G14)=\"NONE\")),BENEFIT_DESIGN!G14,\".\")","v":"."},{"$f":"IF(AND(E8,OR(ISNUMBER(BENEFIT_DESIGN!H14),UPPER(BENEFIT_DESIGN!H14)=\"NONE\")),BENEFIT_DESIGN!H14,\".\")","v":"."},{"$f":"IF(AND(F8,OR(UPPER(BENEFIT_DESIGN!I14)=\"YES\",UPPER(BENEFIT_DESIGN!I14)=\"NO\")),BENEFIT_DESIGN!I14,\".\")","v":"."},{"$f":"VLOOKUP(A56,MATERNITY_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A56,DIABETES_SUMMARY!$B$6:$E$27,4,0)>0","v":true},{"$f":"VLOOKUP(A56,FRACTURE_SUMMARY!$B$6:$E$27,4,0)>0","v":false}]
[{"$f":"BENEFIT_DESIGN!B15","v":"Professional Services: Emergency Department"},{"$f":"BENEFIT_DESIGN!C15","v":"Not Covered"},{"$f":"IF(AND(G9,ISNUMBER(BENEFIT_DESIGN!$C$32)),BENEFIT_DESIGN!$C$32,\".\")","v":"."},{"$f":"IF(AND(H9,ISNUMBER(BENEFIT_DESIGN!$C$33)),BENEFIT_DESIGN!$C$33,\".\")","v":"."},{"$f":"IF(AND(I9,ISNUMBER(BENEFIT_DESIGN!$C$34)),BENEFIT_DESIGN!$C$34,\".\")","v":"."},{"$f":"IF(AND(J9,ISNUMBER(BENEFIT_DESIGN!$C$35)),BENEFIT_DESIGN!$C$35,\".\")","v":"."},{"$f":"IF(AND(F9,OR(ISNUMBER(BENEFIT_DESIGN!$C$36),BENEFIT_DESIGN!$C$36=\"None\")),BENEFIT_DESIGN!$C$36,\".\")","v":"."},{"$f":"IF(AND(K9,ISNUMBER(BENEFIT_DESIGN!D15)),BENEFIT_DESIGN!D15,\".\")","v":"."},{"$f":"IF(AND(L9,ISNUMBER(BENEFIT_DESIGN!E15)),BENEFIT_DESIGN!E15,\".\")","v":"."},{"$f":"IF(AND(M9,ISNUMBER(BENEFIT_DESIGN!F15)),BENEFIT_DESIGN!F15,\".\")","v":"."},{"$f":"IF(AND(D9,OR(ISNUMBER(BENEFIT_DESIGN!G15),UPPER(BENEFIT_DESIGN!G15)=\"NONE\")),BENEFIT_DESIGN!G15,\".\")","v":"."},{"$f":"IF(AND(E9,OR(ISNUMBER(BENEFIT_DESIGN!H15),UPPER(BENEFIT_DESIGN!H15)=\"NONE\")),BENEFIT_DESIGN!H15,\".\")","v":"."},{"$f":"IF(AND(F9,OR(UPPER(BENEFIT_DESIGN!I15)=\"YES\",UPPER(BENEFIT_DESIGN!I15)=\"NO\")),BENEFIT_DESIGN!I15,\".\")","v":"."},{"$f":"VLOOKUP(A57,MATERNITY_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A57,DIABETES_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A57,FRACTURE_SUMMARY!$B$6:$E$27,4,0)>0","v":true}]
[{"$f":"BENEFIT_DESIGN!B16","v":"Professional Services: Inpatient"},{"$f":"BENEFIT_DESIGN!C16","v":"Not Covered"},{"$f":"IF(AND(G10,ISNUMBER(BENEFIT_DESIGN!$C$32)),BENEFIT_DESIGN!$C$32,\".\")","v":"."},{"$f":"IF(AND(H10,ISNUMBER(BENEFIT_DESIGN!$C$33)),BENEFIT_DESIGN!$C$33,\".\")","v":"."},{"$f":"IF(AND(I10,ISNUMBER(BENEFIT_DESIGN!$C$34)),BENEFIT_DESIGN!$C$34,\".\")","v":"."},{"$f":"IF(AND(J10,ISNUMBER(BENEFIT_DESIGN!$C$35)),BENEFIT_DESIGN!$C$35,\".\")","v":"."},{"$f":"IF(AND(F10,OR(ISNUMBER(BENEFIT_DESIGN!$C$36),BENEFIT_DESIGN!$C$36=\"None\")),BENEFIT_DESIGN!$C$36,\".\")","v":"."},{"$f":"IF(AND(K10,ISNUMBER(BENEFIT_DESIGN!D16)),BENEFIT_DESIGN!D16,\".\")","v":"."},{"$f":"IF(AND(L10,ISNUMBER(BENEFIT_DESIGN!E16)),BENEFIT_DESIGN!E16,\".\")","v":"."},{"$f":"IF(AND(M10,ISNUMBER(BENEFIT_DESIGN!F16)),BENEFIT_DESIGN!F16,\".\")","v":"."},{"$f":"IF(AND(D10,OR(ISNUMBER(BENEFIT_DESIGN!G16),UPPER(BENEFIT_DESIGN!G16)=\"NONE\")),BENEFIT_DESIGN!G16,\".\")","v":"."},{"$f":"IF(AND(E10,OR(ISNUMBER(BENEFIT_DESIGN!H16),UPPER(BENEFIT_DESIGN!H16)=\"NONE\")),BENEFIT_DESIGN!H16,\".\")","v":"."},{"$f":"IF(AND(F10,OR(UPPER(BENEFIT_DESIGN!I16)=\"YES\",UPPER(BENEFIT_DESIGN!I16)=\"NO\")),BENEFIT_DESIGN!I16,\".\")","v":"."},{"$f":"VLOOKUP(A58,MATERNITY_SUMMARY!$B$6:$E$27,4,0)>0","v":true},{"$f":"VLOOKUP(A58,DIABETES_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A58,FRACTURE_SUMMARY!$B$6:$E$27,4,0)>0","v":false}]
[{"$f":"BENEFIT_DESIGN!B17","v":"Professional Services: Specialist"},{"$f":"BENEFIT_DESIGN!C17","v":"Not Covered"},{"$f":"IF(AND(G11,ISNUMBER(BENEFIT_DESIGN!$C$32)),BENEFIT_DESIGN!$C$32,\".\")","v":"."},{"$f":"IF(AND(H11,ISNUMBER(BENEFIT_DESIGN!$C$33)),BENEFIT_DESIGN!$C$33,\".\")","v":"."},{"$f":"IF(AND(I11,ISNUMBER(BENEFIT_DESIGN!$C$34)),BENEFIT_DESIGN!$C$34,\".\")","v":"."},{"$f":"IF(AND(J11,ISNUMBER(BENEFIT_DESIGN!$C$35)),BENEFIT_DESIGN!$C$35,\".\")","v":"."},{"$f":"IF(AND(F11,OR(ISNUMBER(BENEFIT_DESIGN!$C$36),BENEFIT_DESIGN!$C$36=\"None\")),BENEFIT_DESIGN!$C$36,\".\")","v":"."},{"$f":"IF(AND(K11,ISNUMBER(BENEFIT_DESIGN!D17)),BENEFIT_DESIGN!D17,\".\")","v":"."},{"$f":"IF(AND(L11,ISNUMBER(BENEFIT_DESIGN!E17)),BENEFIT_DESIGN!E17,\".\")","v":"."},{"$f":"IF(AND(M11,ISNUMBER(BENEFIT_DESIGN!F17)),BENEFIT_DESIGN!F17,\".\")","v":"."},{"$f":"IF(AND(D11,OR(ISNUMBER(BENEFIT_DESIGN!G17),UPPER(BENEFIT_DESIGN!G17)=\"NONE\")),BENEFIT_DESIGN!G17,\".\")","v":"."},{"$f":"IF(AND(E11,OR(ISNUMBER(BENEFIT_DESIGN!H17),UPPER(BENEFIT_DESIGN!H17)=\"NONE\")),BENEFIT_DESIGN!H17,\".\")","v":"."},{"$f":"IF(AND(F11,OR(UPPER(BENEFIT_DESIGN!I17)=\"YES\",UPPER(BENEFIT_DESIGN!I17)=\"NO\")),BENEFIT_DESIGN!I17,\".\")","v":"."},{"$f":"VLOOKUP(A59,MATERNITY_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A59,DIABETES_SUMMARY!$B$6:$E$27,4,0)>0","v":true},{"$f":"VLOOKUP(A59,FRACTURE_SUMMARY!$B$6:$E$27,4,0)>0","v":true}]
[{"$f":"BENEFIT_DESIGN!B18","v":"Professional Services: Obstetric Care (Bundled)"},{"$f":"BENEFIT_DESIGN!C18","v":"Not Covered"},{"$f":"IF(AND(G12,ISNUMBER(BENEFIT_DESIGN!$C$32)),BENEFIT_DESIGN!$C$32,\".\")","v":"."},{"$f":"IF(AND(H12,ISNUMBER(BENEFIT_DESIGN!$C$33)),BENEFIT_DESIGN!$C$33,\".\")","v":"."},{"$f":"IF(AND(I12,ISNUMBER(BENEFIT_DESIGN!$C$34)),BENEFIT_DESIGN!$C$34,\".\")","v":"."},{"$f":"IF(AND(J12,ISNUMBER(BENEFIT_DESIGN!$C$35)),BENEFIT_DESIGN!$C$35,\".\")","v":"."},{"$f":"IF(AND(F12,OR(ISNUMBER(BENEFIT_DESIGN!$C$36),BENEFIT_DESIGN!$C$36=\"None\")),BENEFIT_DESIGN!$C$36,\".\")","v":"."},{"$f":"IF(AND(K12,ISNUMBER(BENEFIT_DESIGN!D18)),BENEFIT_DESIGN!D18,\".\")","v":"."},{"$f":"IF(AND(L12,ISNUMBER(BENEFIT_DESIGN!E18)),BENEFIT_DESIGN!E18,\".\")","v":"."},{"$f":"IF(AND(M12,ISNUMBER(BENEFIT_DESIGN!F18)),BENEFIT_DESIGN!F18,\".\")","v":"."},{"$f":"IF(AND(D12,OR(ISNUMBER(BENEFIT_DESIGN!G18),UPPER(BENEFIT_DESIGN!G18)=\"NONE\")),BENEFIT_DESIGN!G18,\".\")","v":"."},{"$f":"IF(AND(E12,OR(ISNUMBER(BENEFIT_DESIGN!H18),UPPER(BENEFIT_DESIGN!H18)=\"NONE\")),BENEFIT_DESIGN!H18,\".\")","v":"."},{"$f":"IF(AND(F12,OR(UPPER(BENEFIT_DESIGN!I18)=\"YES\",UPPER(BENEFIT_DESIGN!I18)=\"NO\")),BENEFIT_DESIGN!I18,\".\")","v":"."},{"$f":"VLOOKUP(A60,MATERNITY_SUMMARY!$B$6:$E$27,4,0)>0","v":true},{"$f":"VLOOKUP(A60,DIABETES_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A60,FRACTURE_SUMMARY!$B$6:$E$27,4,0)>0","v":false}]
[{"$f":"BENEFIT_DESIGN!B19","v":"Professional Services: Procedures & Other"},{"$f":"BENEFIT_DESIGN!C19","v":"Not Covered"},{"$f":"IF(AND(G13,ISNUMBER(BENEFIT_DESIGN!$C$32)),BENEFIT_DESIGN!$C$32,\".\")","v":"."},{"$f":"IF(AND(H13,ISNUMBER(BENEFIT_DESIGN!$C$33)),BENEFIT_DESIGN!$C$33,\".\")","v":"."},{"$f":"IF(AND(I13,ISNUMBER(BENEFIT_DESIGN!$C$34)),BENEFIT_DESIGN!$C$34,\".\")","v":"."},{"$f":"IF(AND(J13,ISNUMBER(BENEFIT_DESIGN!$C$35)),BENEFIT_DESIGN!$C$35,\".\")","v":"."},{"$f":"IF(AND(F13,OR(ISNUMBER(BENEFIT_DESIGN!$C$36),BENEFIT_DESIGN!$C$36=\"None\")),BENEFIT_DESIGN!$C$36,\".\")","v":"."},{"$f":"IF(AND(K13,ISNUMBER(BENEFIT_DESIGN!D19)),BENEFIT_DESIGN!D19,\".\")","v":"."},{"$f":"IF(AND(L13,ISNUMBER(BENEFIT_DESIGN!E19)),BENEFIT_DESIGN!E19,\".\")","v":"."},{"$f":"IF(AND(M13,ISNUMBER(BENEFIT_DESIGN!F19)),BENEFIT_DESIGN!F19,\".\")","v":"."},{"$f":"IF(AND(D13,OR(ISNUMBER(BENEFIT_DESIGN!G19),UPPER(BENEFIT_DESIGN!G19)=\"NONE\")),BENEFIT_DESIGN!G19,\".\")","v":"."},{"$f":"IF(AND(E13,OR(ISNUMBER(BENEFIT_DESIGN!H19),UPPER(BENEFIT_DESIGN!H19)=\"NONE\")),BENEFIT_DESIGN!H19,\".\")","v":"."},{"$f":"IF(AND(F13,OR(UPPER(BENEFIT_DESIGN!I19)=\"YES\",UPPER(BENEFIT_DESIGN!I19)=\"NO\")),BENEFIT_DESIGN!I19,\".\")","v":"."},{"$f":"VLOOKUP(A61,MATERNITY_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A61,DIABETES_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A61,FRACTURE_SUMMARY!$B$6:$E$27,4,0)>0","v":false}]
[{"$f":"BENEFIT_DESIGN!B20","v":"Professional Services: Physical Therapy"},{"$f":"BENEFIT_DESIGN!C20","v":"Not Covered"},{"$f":"IF(AND(G14,ISNUMBER(BENEFIT_DESIGN!$C$32)),BENEFIT_DESIGN!$C$32,\".\")","v":"."},{"$f":"IF(AND(H14,ISNUMBER(BENEFIT_DESIGN!$C$33)),BENEFIT_DESIGN!$C$33,\".\")","v":"."},{"$f":"IF(AND(I14,ISNUMBER(BENEFIT_DESIGN!$C$34)),BENEFIT_DESIGN!$C$34,\".\")","v":"."},{"$f":"IF(AND(J14,ISNUMBER(BENEFIT_DESIGN!$C$35)),BENEFIT_DESIGN!$C$35,\".\")","v":"."},{"$f":"IF(AND(F14,OR(ISNUMBER(BENEFIT_DESIGN!$C$36),BENEFIT_DESIGN!$C$36=\"None\")),BENEFIT_DESIGN!$C$36,\".\")","v":"."},{"$f":"IF(AND(K14,ISNUMBER(BENEFIT_DESIGN!D20)),BENEFIT_DESIGN!D20,\".\")","v":"."},{"$f":"IF(AND(L14,ISNUMBER(BENEFIT_DESIGN!E20)),BENEFIT_DESIGN!E20,\".\")","v":"."},{"$f":"IF(AND(M14,ISNUMBER(BENEFIT_DESIGN!F20)),BENEFIT_DESIGN!F20,\".\")","v":"."},{"$f":"IF(AND(D14,OR(ISNUMBER(BENEFIT_DESIGN!G20),UPPER(BENEFIT_DESIGN!G20)=\"NONE\")),BENEFIT_DESIGN!G20,\".\")","v":"."},{"$f":"IF(AND(E14,OR(ISNUMBER(BENEFIT_DESIGN!H20),UPPER(BENEFIT_DESIGN!H20)=\"NONE\")),BENEFIT_DESIGN!H20,\".\")","v":"."},{"$f":"IF(AND(F14,OR(UPPER(BENEFIT_DESIGN!I20)=\"YES\",UPPER(BENEFIT_DESIGN!I20)=\"NO\")),BENEFIT_DESIGN!I20,\".\")","v":"."},{"$f":"VLOOKUP(A62,MATERNITY_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A62,DIABETES_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A62,FRACTURE_SUMMARY!$B$6:$E$27,4,0)>0","v":true}]
[{"$f":"BENEFIT_DESIGN!B21","v":"Diagnostic Services: Radiology"},{"$f":"BENEFIT_DESIGN!C21","v":"Not Covered"},{"$f":"IF(AND(G15,ISNUMBER(BENEFIT_DESIGN!$C$32)),BENEFIT_DESIGN!$C$32,\".\")","v":"."},{"$f":"IF(AND(H15,ISNUMBER(BENEFIT_DESIGN!$C$33)),BENEFIT_DESIGN!$C$33,\".\")","v":"."},{"$f":"IF(AND(I15,ISNUMBER(BENEFIT_DESIGN!$C$34)),BENEFIT_DESIGN!$C$34,\".\")","v":"."},{"$f":"IF(AND(J15,ISNUMBER(BENEFIT_DESIGN!$C$35)),BENEFIT_DESIGN!$C$35,\".\")","v":"."},{"$f":"IF(AND(F15,OR(ISNUMBER(BENEFIT_DESIGN!$C$36),BENEFIT_DESIGN!$C$36=\"None\")),BENEFIT_DESIGN!$C$36,\".\")","v":"."},{"$f":"IF(AND(K15,ISNUMBER(BENEFIT_DESIGN!D21)),BENEFIT_DESIGN!D21,\".\")","v":"."},{"$f":"IF(AND(L15,ISNUMBER(BENEFIT_DESIGN!E21)),BENEFIT_DESIGN!E21,\".\")","v":"."},{"$f":"IF(AND(M15,ISNUMBER(BENEFIT_DESIGN!F21)),BENEFIT_DESIGN!F21,\".\")","v":"."},{"$f":"IF(AND(D15,OR(ISNUMBER(BENEFIT_DESIGN!G21),UPPER(BENEFIT_DESIGN!G21)=\"NONE\")),BENEFIT_DESIGN!G21,\".\")","v":"."},{"$f":"IF(AND(E15,OR(ISNUMBER(BENEFIT_DESIGN!H21),UPPER(BENEFIT_DESIGN!H21)=\"NONE\")),BENEFIT_DESIGN!H21,\".\")","v":"."},{"$f":"IF(AND(F15,OR(UPPER(BENEFIT_DESIGN!I21)=\"YES\",UPPER(BENEFIT_DESIGN!I21)=\"NO\")),BENEFIT_DESIGN!I21,\".\")","v":"."},{"$f":"VLOOKUP(A63,MATERNITY_SUMMARY!$B$6:$E$27,4,0)>0","v":true},{"$f":"VLOOKUP(A63,DIABETES_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A63,FRACTURE_SUMMARY!$B$6:$E$27,4,0)>0","v":true}]
[{"$f":"BENEFIT_DESIGN!B22","v":"Diagnostic Services: Laboratory"},{"$f":"BENEFIT_DESIGN!C22","v":"Not Covered"},{"$f":"IF(AND(G16,ISNUMBER(BENEFIT_DESIGN!$C$32)),BENEFIT_DESIGN!$C$32,\".\")","v":"."},{"$f":"IF(AND(H16,ISNUMBER(BENEFIT_DESIGN!$C$33)),BENEFIT_DESIGN!$C$33,\".\")","v":"."},{"$f":"IF(AND(I16,ISNUMBER(BENEFIT_DESIGN!$C$34)),BENEFIT_DESIGN!$C$34,\".\")","v":"."},{"$f":"IF(AND(J16,ISNUMBER(BENEFIT_DESIGN!$C$35)),BENEFIT_DESIGN!$C$35,\".\")","v":"."},{"$f":"IF(AND(F16,OR(ISNUMBER(BENEFIT_DESIGN!$C$36),BENEFIT_DESIGN!$C$36=\"None\")),BENEFIT_DESIGN!$C$36,\".\")","v":"."},{"$f":"IF(AND(K16,ISNUMBER(BENEFIT_DESIGN!D22)),BENEFIT_DESIGN!D22,\".\")","v":"."},{"$f":"IF(AND(L16,ISNUMBER(BENEFIT_DESIGN!E22)),BENEFIT_DESIGN!E22,\".\")","v":"."},{"$f":"IF(AND(M16,ISNUMBER(BENEFIT_DESIGN!F22)),BENEFIT_DESIGN!F22,\".\")","v":"."},{"$f":"IF(AND(D16,OR(ISNUMBER(BENEFIT_DESIGN!G22),UPPER(BENEFIT_DESIGN!G22)=\"NONE\")),BENEFIT_DESIGN!G22,\".\")","v":"."},{"$f":"IF(AND(E16,OR(ISNUMBER(BENEFIT_DESIGN!H22),UPPER(BENEFIT_DESIGN!H22)=\"NONE\")),BENEFIT_DESIGN!H22,\".\")","v":"."},{"$f":"IF(AND(F16,OR(UPPER(BENEFIT_DESIGN!I22)=\"YES\",UPPER(BENEFIT_DESIGN!I22)=\"NO\")),BENEFIT_DESIGN!I22,\".\")","v":"."},{"$f":"VLOOKUP(A64,MATERNITY_SUMMARY!$B$6:$E$27,4,0)>0","v":true},{"$f":"VLOOKUP(A64,DIABETES_SUMMARY!$B$6:$E$27,4,0)>0","v":true},{"$f":"VLOOKUP(A64,FRACTURE_SUMMARY!$B$6:$E$27,4,0)>0","v":false}]
[{"$f":"BENEFIT_DESIGN!B23","v":"Prescription Drugs: Generic"},{"$f":"BENEFIT_DESIGN!C23","v":"Not Covered"},{"$f":"IF(AND(G17,ISNUMBER(BENEFIT_DESIGN!$C$32)),BENEFIT_DESIGN!$C$32,\".\")","v":"."},{"$f":"IF(AND(H17,ISNUMBER(BENEFIT_DESIGN!$C$33)),BENEFIT_DESIGN!$C$33,\".\")","v":"."},{"$f":"IF(AND(I17,ISNUMBER(BENEFIT_DESIGN!$C$34)),BENEFIT_DESIGN!$C$34,\".\")","v":"."},{"$f":"IF(AND(J17,ISNUMBER(BENEFIT_DESIGN!$C$35)),BENEFIT_DESIGN!$C$35,\".\")","v":"."},{"$f":"IF(AND(F17,OR(ISNUMBER(BENEFIT_DESIGN!$C$36),BENEFIT_DESIGN!$C$36=\"None\")),BENEFIT_DESIGN!$C$36,\".\")","v":"."},{"$f":"IF(AND(K17,ISNUMBER(BENEFIT_DESIGN!D23)),BENEFIT_DESIGN!D23,\".\")","v":"."},{"$f":"IF(AND(L17,ISNUMBER(BENEFIT_DESIGN!E23)),BENEFIT_DESIGN!E23,\".\")","v":"."},{"$f":"IF(AND(M17,ISNUMBER(BENEFIT_DESIGN!F23)),BENEFIT_DESIGN!F23,\".\")","v":"."},{"$f":"IF(AND(D17,OR(ISNUMBER(BENEFIT_DESIGN!G23),UPPER(BENEFIT_DESIGN!G23)=\"NONE\")),BENEFIT_DESIGN!G23,\".\")","v":"."},{"$f":"IF(AND(E17,OR(ISNUMBER(BENEFIT_DESIGN!H23),UPPER(BENEFIT_DESIGN!H23)=\"NONE\")),BENEFIT_DESIGN!H23,\".\")","v":"."},{"$f":"IF(AND(F17,OR(UPPER(BENEFIT_DESIGN!I23)=\"YES\",UPPER(BENEFIT_DESIGN!I23)=\"NO\")),BENEFIT_DESIGN!I23,\".\")","v":"."},{"$f":"VLOOKUP(A65,MATERNITY_SUMMARY!$B$6:$E$27,4,0)>0","v":true},{"$f":"VLOOKUP(A65,DIABETES_SUMMARY!$B$6:$E$27,4,0)>0","v":true},{"$f":"VLOOKUP(A65,FRACTURE_SUMMARY!$B$6:$E$27,4,0)>0","v":true}]
[{"$f":"BENEFIT_DESIGN!B24","v":"Prescription Drugs: Branded"},{"$f":"BENEFIT_DESIGN!C24","v":"Not Covered"},{"$f":"IF(AND(G18,ISNUMBER(BENEFIT_DESIGN!$C$32)),BENEFIT_DESIGN!$C$32,\".\")","v":"."},{"$f":"IF(AND(H18,ISNUMBER(BENEFIT_DESIGN!$C$33)),BENEFIT_DESIGN!$C$33,\".\")","v":"."},{"$f":"IF(AND(I18,ISNUMBER(BENEFIT_DESIGN!$C$34)),BENEFIT_DESIGN!$C$34,\".\")","v":"."},{"$f":"IF(AND(J18,ISNUMBER(BENEFIT_DESIGN!$C$35)),BENEFIT_DESIGN!$C$35,\".\")","v":"."},{"$f":"IF(AND(F18,OR(ISNUMBER(BENEFIT_DESIGN!$C$36),BENEFIT_DESIGN!$C$36=\"None\")),BENEFIT_DESIGN!$C$36,\".\")","v":"."},{"$f":"IF(AND(K18,ISNUMBER(BENEFIT_DESIGN!D24)),BENEFIT_DESIGN!D24,\".\")","v":"."},{"$f":"IF(AND(L18,ISNUMBER(BENEFIT_DESIGN!E24)),BENEFIT_DESIGN!E24,\".\")","v":"."},{"$f":"IF(AND(M18,ISNUMBER(BENEFIT_DESIGN!F24)),BENEFIT_DESIGN!F24,\".\")","v":"."},{"$f":"IF(AND(D18,OR(ISNUMBER(BENEFIT_DESIGN!G24),UPPER(BENEFIT_DESIGN!G24)=\"NONE\")),BENEFIT_DESIGN!G24,\".\")","v":"."},{"$f":"IF(AND(E18,OR(ISNUMBER(BENEFIT_DESIGN!H24),UPPER(BENEFIT_DESIGN!H24)=\"NONE\")),BENEFIT_DESIGN!H24,\".\")","v":"."},{"$f":"IF(AND(F18,OR(UPPER(BENEFIT_DESIGN!I24)=\"YES\",UPPER(BENEFIT_DESIGN!I24)=\"NO\")),BENEFIT_DESIGN!I24,\".\")","v":"."},{"$f":"VLOOKUP(A66,MATERNITY_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A66,DIABETES_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A66,FRACTURE_SUMMARY!$B$6:$E$27,4,0)>0","v":false}]
[{"$f":"BENEFIT_DESIGN!B25","v":"Prescription Drugs: Insulin"},{"$f":"BENEFIT_DESIGN!C25","v":"Not Covered"},{"$f":"IF(AND(G19,ISNUMBER(BENEFIT_DESIGN!$C$32)),BENEFIT_DESIGN!$C$32,\".\")","v":"."},{"$f":"IF(AND(H19,ISNUMBER(BENEFIT_DESIGN!$C$33)),BENEFIT_DESIGN!$C$33,\".\")","v":"."},{"$f":"IF(AND(I19,ISNUMBER(BENEFIT_DESIGN!$C$34)),BENEFIT_DESIGN!$C$34,\".\")","v":"."},{"$f":"IF(AND(J19,ISNUMBER(BENEFIT_DESIGN!$C$35)),BENEFIT_DESIGN!$C$35,\".\")","v":"."},{"$f":"IF(AND(F19,OR(ISNUMBER(BENEFIT_DESIGN!$C$36),BENEFIT_DESIGN!$C$36=\"None\")),BENEFIT_DESIGN!$C$36,\".\")","v":"."},{"$f":"IF(AND(K19,ISNUMBER(BENEFIT_DESIGN!D25)),BENEFIT_DESIGN!D25,\".\")","v":"."},{"$f":"IF(AND(L19,ISNUMBER(BENEFIT_DESIGN!E25)),BENEFIT_DESIGN!E25,\".\")","v":"."},{"$f":"IF(AND(M19,ISNUMBER(BENEFIT_DESIGN!F25)),BENEFIT_DESIGN!F25,\".\")","v":"."},{"$f":"IF(AND(D19,OR(ISNUMBER(BENEFIT_DESIGN!G25),UPPER(BENEFIT_DESIGN!G25)=\"NONE\")),BENEFIT_DESIGN!G25,\".\")","v":"."},{"$f":"IF(AND(E19,OR(ISNUMBER(BENEFIT_DESIGN!H25),UPPER(BENEFIT_DESIGN!H25)=\"NONE\")),BENEFIT_DESIGN!H25,\".\")","v":"."},{"$f":"IF(AND(F19,OR(UPPER(BENEFIT_DESIGN!I25)=\"YES\",UPPER(BENEFIT_DESIGN!I25)=\"NO\")),BENEFIT_DESIGN!I25,\".\")","v":"."},{"$f":"VLOOKUP(A67,MATERNITY_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A67,DIABETES_SUMMARY!$B$6:$E$27,4,0)>0","v":true},{"$f":"VLOOKUP(A67,FRACTURE_SUMMARY!$B$6:$E$27,4,0)>0","v":false}]
[{"$f":"BENEFIT_DESIGN!B26","v":"Over-the-counter Drugs"},{"$f":"BENEFIT_DESIGN!C26","v":"Not Covered"},{"$f":"IF(AND(G20,ISNUMBER(BENEFIT_DESIGN!$C$32)),BENEFIT_DESIGN!$C$32,\".\")","v":"."},{"$f":"IF(AND(H20,ISNUMBER(BENEFIT_DESIGN!$C$33)),BENEFIT_DESIGN!$C$33,\".\")","v":"."},{"$f":"IF(AND(I20,ISNUMBER(BENEFIT_DESIGN!$C$34)),BENEFIT_DESIGN!$C$34,\".\")","v":"."},{"$f":"IF(AND(J20,ISNUMBER(BENEFIT_DESIGN!$C$35)),BENEFIT_DESIGN!$C$35,\".\")","v":"."},{"$f":"IF(AND(F20,OR(ISNUMBER(BENEFIT_DESIGN!$C$36),BENEFIT_DESIGN!$C$36=\"None\")),BENEFIT_DESIGN!$C$36,\".\")","v":"."},{"$f":"IF(AND(K20,ISNUMBER(BENEFIT_DESIGN!D26)),BENEFIT_DESIGN!D26,\".\")","v":"."},{"$f":"IF(AND(L20,ISNUMBER(BENEFIT_DESIGN!E26)),BENEFIT_DESIGN!E26,\".\")","v":"."},{"$f":"IF(AND(M20,ISNUMBER(BENEFIT_DESIGN!F26)),BENEFIT_DESIGN!F26,\".\")","v":"."},{"$f":"IF(AND(D20,OR(ISNUMBER(BENEFIT_DESIGN!G26),UPPER(BENEFIT_DESIGN!G26)=\"NONE\")),BENEFIT_DESIGN!G26,\".\")","v":"."},{"$f":"IF(AND(E20,OR(ISNUMBER(BENEFIT_DESIGN!H26),UPPER(BENEFIT_DESIGN!H26)=\"NONE\")),BENEFIT_DESIGN!H26,\".\")","v":"."},{"$f":"IF(AND(F20,OR(UPPER(BENEFIT_DESIGN!I26)=\"YES\",UPPER(BENEFIT_DESIGN!I26)=\"NO\")),BENEFIT_DESIGN!I26,\".\")","v":"."},{"$f":"VLOOKUP(A68,MATERNITY_SUMMARY!$B$6:$E$27,4,0)>0","v":true},{"$f":"VLOOKUP(A68,DIABETES_SUMMARY!$B$6:$E$27,4,0)>0","v":true},{"$f":"VLOOKUP(A68,FRACTURE_SUMMARY!$B$6:$E$27,4,0)>0","v":false}]
[{"$f":"BENEFIT_DESIGN!B27","v":"Preventive Services & Vaccines"},{"$f":"BENEFIT_DESIGN!C27","v":"Not Covered"},{"$f":"IF(AND(G21,ISNUMBER(BENEFIT_DESIGN!$C$32)),BENEFIT_DESIGN!$C$32,\".\")","v":"."},{"$f":"IF(AND(H21,ISNUMBER(BENEFIT_DESIGN!$C$33)),BENEFIT_DESIGN!$C$33,\".\")","v":"."},{"$f":"IF(AND(I21,ISNUMBER(BENEFIT_DESIGN!$C$34)),BENEFIT_DESIGN!$C$34,\".\")","v":"."},{"$f":"IF(AND(J21,ISNUMBER(BENEFIT_DESIGN!$C$35)),BENEFIT_DESIGN!$C$35,\".\")","v":"."},{"$f":"IF(AND(F21,OR(ISNUMBER(BENEFIT_DESIGN!$C$36),BENEFIT_DESIGN!$C$36=\"None\")),BENEFIT_DESIGN!$C$36,\".\")","v":"."},{"$f":"IF(AND(K21,ISNUMBER(BENEFIT_DESIGN!D27)),BENEFIT_DESIGN!D27,\".\")","v":"."},{"$f":"IF(AND(L21,ISNUMBER(BENEFIT_DESIGN!E27)),BENEFIT_DESIGN!E27,\".\")","v":"."},{"$f":"IF(AND(M21,ISNUMBER(BENEFIT_DESIGN!F27)),BENEFIT_DESIGN!F27,\".\")","v":"."},{"$f":"IF(AND(D21,OR(ISNUMBER(BENEFIT_DESIGN!G27),UPPER(BENEFIT_DESIGN!G27)=\"NONE\")),BENEFIT_DESIGN!G27,\".\")","v":"."},{"$f":"IF(AND(E21,OR(ISNUMBER(BENEFIT_DESIGN!H27),UPPER(BENEFIT_DESIGN!H27)=\"NONE\")),BENEFIT_DESIGN!H27,\".\")","v":"."},{"$f":"IF(AND(F21,OR(UPPER(BENEFIT_DESIGN!I27)=\"YES\",UPPER(BENEFIT_DESIGN!I27)=\"NO\")),BENEFIT_DESIGN!I27,\".\")","v":"."},{"$f":"VLOOKUP(A69,MATERNITY_SUMMARY!$B$6:$E$27,4,0)>0","v":true},{"$f":"VLOOKUP(A69,DIABETES_SUMMARY!$B$6:$E$27,4,0)>0","v":true},{"$f":"VLOOKUP(A69,FRACTURE_SUMMARY!$B$6:$E$27,4,0)>0","v":false}]
[{"$f":"BENEFIT_DESIGN!B28","v":"Durable Medical Equipment"},{"$f":"BENEFIT_DESIGN!C28","v":"Not Covered"},{"$f":"IF(AND(G22,ISNUMBER(BENEFIT_DESIGN!$C$32)),BENEFIT_DESIGN!$C$32,\".\")","v":"."},{"$f":"IF(AND(H22,ISNUMBER(BENEFIT_DESIGN!$C$33)),BENEFIT_DESIGN!$C$33,\".\")","v":"."},{"$f":"IF(AND(I22,ISNUMBER(BENEFIT_DESIGN!$C$34)),BENEFIT_DESIGN!$C$34,\".\")","v":"."},{"$f":"IF(AND(J22,ISNUMBER(BENEFIT_DESIGN!$C$35)),BENEFIT_DESIGN!$C$35,\".\")","v":"."},{"$f":"IF(AND(F22,OR(ISNUMBER(BENEFIT_DESIGN!$C$36),BENEFIT_DESIGN!$C$36=\"None\")),BENEFIT_DESIGN!$C$36,\".\")","v":"."},{"$f":"IF(AND(K22,ISNUMBER(BENEFIT_DESIGN!D28)),BENEFIT_DESIGN!D28,\".\")","v":"."},{"$f":"IF(AND(L22,ISNUMBER(BENEFIT_DESIGN!E28)),BENEFIT_DESIGN!E28,\".\")","v":"."},{"$f":"IF(AND(M22,ISNUMBER(BENEFIT_DESIGN!F28)),BENEFIT_DESIGN!F28,\".\")","v":"."},{"$f":"IF(AND(D22,OR(ISNUMBER(BENEFIT_DESIGN!G28),UPPER(BENEFIT_DESIGN!G28)=\"NONE\")),BENEFIT_DESIGN!G28,\".\")","v":"."},{"$f":"IF(AND(E22,OR(ISNUMBER(BENEFIT_DESIGN!H28),UPPER(BENEFIT_DESIGN!H28)=\"NONE\")),BENEFIT_DESIGN!H28,\".\")","v":"."},{"$f":"IF(AND(F22,OR(UPPER(BENEFIT_DESIGN!I28)=\"YES\",UPPER(BENEFIT_DESIGN!I28)=\"NO\")),BENEFIT_DESIGN!I28,\".\")","v":"."},{"$f":"VLOOKUP(A70,MATERNITY_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A70,DIABETES_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A70,FRACTURE_SUMMARY!$B$6:$E$27,4,0)>0","v":true}]
[{"$f":"BENEFIT_DESIGN!B29","v":"Medical Supplies"},{"$f":"BENEFIT_DESIGN!C29","v":"Not Covered"},{"$f":"IF(AND(G23,ISNUMBER(BENEFIT_DESIGN!$C$32)),BENEFIT_DESIGN!$C$32,\".\")","v":"."},{"$f":"IF(AND(H23,ISNUMBER(BENEFIT_DESIGN!$C$33)),BENEFIT_DESIGN!$C$33,\".\")","v":"."},{"$f":"IF(AND(I23,ISNUMBER(BENEFIT_DESIGN!$C$34)),BENEFIT_DESIGN!$C$34,\".\")","v":"."},{"$f":"IF(AND(J23,ISNUMBER(BENEFIT_DESIGN!$C$35)),BENEFIT_DESIGN!$C$35,\".\")","v":"."},{"$f":"IF(AND(F23,OR(ISNUMBER(BENEFIT_DESIGN!$C$36),BENEFIT_DESIGN!$C$36=\"None\")),BENEFIT_DESIGN!$C$36,\".\")","v":"."},{"$f":"IF(AND(K23,ISNUMBER(BENEFIT_DESIGN!D29)),BENEFIT_DESIGN!D29,\".\")","v":"."},{"$f":"IF(AND(L23,ISNUMBER(BENEFIT_DESIGN!E29)),BENEFIT_DESIGN!E29,\".\")","v":"."},{"$f":"IF(AND(M23,ISNUMBER(BENEFIT_DESIGN!F29)),BENEFIT_DESIGN!F29,\".\")","v":"."},{"$f":"IF(AND(D23,OR(ISNUMBER(BENEFIT_DESIGN!G29),UPPER(BENEFIT_DESIGN!G29)=\"NONE\")),BENEFIT_DESIGN!G29,\".\")","v":"."},{"$f":"IF(AND(E23,OR(ISNUMBER(BENEFIT_DESIGN!H29),UPPER(BENEFIT_DESIGN!H29)=\"NONE\")),BENEFIT_DESIGN!H29,\".\")","v":"."},{"$f":"IF(AND(F23,OR(UPPER(BENEFIT_DESIGN!I29)=\"YES\",UPPER(BENEFIT_DESIGN!I29)=\"NO\")),BENEFIT_DESIGN!I29,\".\")","v":"."},{"$f":"VLOOKUP(A71,MATERNITY_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A71,DIABETES_SUMMARY!$B$6:$E$27,4,0)>0","v":true},{"$f":"VLOOKUP(A71,FRACTURE_SUMMARY!$B$6:$E$27,4,0)>0","v":false}]
[{"$f":"BENEFIT_DESIGN!B30","v":"Over-the-counter Medical Supplies"},{"$f":"BENEFIT_DESIGN!C30","v":"Not Covered"},{"$f":"IF(AND(G24,ISNUMBER(BENEFIT_DESIGN!$C$32)),BENEFIT_DESIGN!$C$32,\".\")","v":"."},{"$f":"IF(AND(H24,ISNUMBER(BENEFIT_DESIGN!$C$33)),BENEFIT_DESIGN!$C$33,\".\")","v":"."},{"$f":"IF(AND(I24,ISNUMBER(BENEFIT_DESIGN!$C$34)),BENEFIT_DESIGN!$C$34,\".\")","v":"."},{"$f":"IF(AND(J24,ISNUMBER(BENEFIT_DESIGN!$C$35)),BENEFIT_DESIGN!$C$35,\".\")","v":"."},{"$f":"IF(AND(F24,OR(ISNUMBER(BENEFIT_DESIGN!$C$36),BENEFIT_DESIGN!$C$36=\"None\")),BENEFIT_DESIGN!$C$36,\".\")","v":"."},{"$f":"IF(AND(K24,ISNUMBER(BENEFIT_DESIGN!D30)),BENEFIT_DESIGN!D30,\".\")","v":"."},{"$f":"IF(AND(L24,ISNUMBER(BENEFIT_DESIGN!E30)),BENEFIT_DESIGN!E30,\".\")","v":"."},{"$f":"IF(AND(M24,ISNUMBER(BENEFIT_DESIGN!F30)),BENEFIT_DESIGN!F30,\".\")","v":"."},{"$f":"IF(AND(D24,OR(ISNUMBER(BENEFIT_DESIGN!G30),UPPER(BENEFIT_DESIGN!G30)=\"NONE\")),BENEFIT_DESIGN!G30,\".\")","v":"."},{"$f":"IF(AND(E24,OR(ISNUMBER(BENEFIT_DESIGN!H30),UPPER(BENEFIT_DESIGN!H30)=\"NONE\")),BENEFIT_DESIGN!H30,\".\")","v":"."},{"$f":"IF(AND(F24,OR(UPPER(BENEFIT_DESIGN!I30)=\"YES\",UPPER(BENEFIT_DESIGN!I30)=\"NO\")),BENEFIT_DESIGN!I30,\".\")","v":"."},{"$f":"VLOOKUP(A72,MATERNITY_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A72,DIABETES_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A72,FRACTURE_SUMMARY!$B$6:$E$27,4,0)>0","v":false}]
[{"$f":"BENEFIT_DESIGN!B31","v":"Other Items & Services"},{"$f":"BENEFIT_DESIGN!C31","v":"Not Covered"},{"$f":"IF(AND(G25,ISNUMBER(BENEFIT_DESIGN!$C$32)),BENEFIT_DESIGN!$C$32,\".\")","v":"."},{"$f":"IF(AND(H25,ISNUMBER(BENEFIT_DESIGN!$C$33)),BENEFIT_DESIGN!$C$33,\".\")","v":"."},{"$f":"IF(AND(I25,ISNUMBER(BENEFIT_DESIGN!$C$34)),BENEFIT_DESIGN!$C$34,\".\")","v":"."},{"$f":"IF(AND(J25,ISNUMBER(BENEFIT_DESIGN!$C$35)),BENEFIT_DESIGN!$C$35,\".\")","v":"."},{"$f":"IF(AND(F25,OR(ISNUMBER(BENEFIT_DESIGN!$C$36),BENEFIT_DESIGN!$C$36=\"None\")),BENEFIT_DESIGN!$C$36,\".\")","v":"."},{"$f":"IF(AND(K25,ISNUMBER(BENEFIT_DESIGN!D31)),BENEFIT_DESIGN!D31,\".\")","v":"."},{"$f":"IF(AND(L25,ISNUMBER(BENEFIT_DESIGN!E31)),BENEFIT_DESIGN!E31,\".\")","v":"."},{"$f":"IF(AND(M25,ISNUMBER(BENEFIT_DESIGN!F31)),BENEFIT_DESIGN!F31,\".\")","v":"."},{"$f":"IF(AND(D25,OR(ISNUMBER(BENEFIT_DESIGN!G31),UPPER(BENEFIT_DESIGN!G31)=\"NONE\")),BENEFIT_DESIGN!G31,\".\")","v":"."},{"$f":"IF(AND(E25,OR(ISNUMBER(BENEFIT_DESIGN!H31),UPPER(BENEFIT_DESIGN!H31)=\"NONE\")),BENEFIT_DESIGN!H31,\".\")","v":"."},{"$f":"IF(AND(F25,OR(UPPER(BENEFIT_DESIGN!I31)=\"YES\",UPPER(BENEFIT_DESIGN!I31)=\"NO\")),BENEFIT_DESIGN!I31,\".\")","v":"."},{"$f":"VLOOKUP(A73,MATERNITY_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A73,DIABETES_SUMMARY!$B$6:$E$27,4,0)>0","v":false},{"$f":"VLOOKUP(A73,FRACTURE_SUMMARY!$B$6:$E$27,4,0)>0","v":false}]
[]
["Additional Options","Can Option apply?","Applies?","# Visits",{"$nulls":8},"Spending when Plan Deduct Applies?",{"$f":"SUM(ISNUMBER($C$52:$C$73)*(N52:N73))>0","v":false},{"$f":"SUM(ISNUMBER($C$52:$C$73)*(O52:O73))>0","v":false},{"$f":"SUM(ISNUMBER($C$52:$C$73)*(P52:P73))>0","v":false}]
["Begin Primary Care Cost-Sharing After A Set Number of Visits?",{"$f":"VLOOKUP(\"Professional Services: Primary Care\",$A$51:$B$73,2,FALSE)<>\"Not Covered\"","v":false},{"$f":"IF(B76,BENEFIT_DESIGN!C39,\".\")","v":"."},{"$f":"IF(AND(B76,C76),BENEFIT_DESIGN!D39,\".\")","v":"."},{"$nulls":8},"Spending when Rx Deduct Applies?",{"$f":"SUM(ISNUMBER($D$52:$D$73)*(N52:N73))>0","v":false},{"$f":"SUM(ISNUMBER($D$52:$D$73)*(O52:O73))>0","v":false},{"$f":"SUM(ISNUMBER($D$52:$D$73)*(P52:P73))>0","v":false}]
["Begin Primary Care Cost-Sharing Deductible or Coinsurance After a Set Number of Copays?",{"$f":"VLOOKUP(\"Professional Services: Primary Care\",$A$51:$B$73,2,FALSE)<>\"Not Covered\"","v":false},{"$f":"IF(B77,BENEFIT_DESIGN!C40,\".\")","v":"."},{"$f":"IF(AND(B77,C77),BENEFIT_DESIGN!D40,\".\")","v":"."},{"$nulls":8},"Spending when Deduct C Applies?",{"$f":"SUM(ISNUMBER($E$52:$E$73)*(N52:N73))>0","v":false},{"$f":"SUM(ISNUMBER($E$52:$E$73)*(O52:O73))>0","v":false},{"$f":"SUM(ISNUMBER($E$52:$E$73)*(P52:P73))>0","v":false}]
[{"$nulls":12},"Spending when Deduct D Applies?",{"$f":"SUM(ISNUMBER($F$52:$F$73)*(N52:N73))>0","v":false},{"$f":"SUM(ISNUMBER($F$52:$F$73)*(O52:O73))>0","v":false},{"$f":"SUM(ISNUMBER($F$52:$F$73)*(P52:P73))>0","v":false}]
[{"$nulls":12},"Total Benefit Deductible In Categories with Spending",{"$f":"SUM(IFERROR($H$52:$H$73*N52:N73,0))","v":{"v":0,"d":"$0"}},{"$f":"SUM(IFERROR($H$52:$H$73*O52:O73,0))","v":{"v":0,"d":"$0"}},{"$f":"SUM(IFERROR($H$52:$H$73*P52:P73,0))","v":{"v":0,"d":"$0"}}]
[{"$nulls":12},"Sum of Applicable Deductibles",{"$f":"N75*BENEFIT_DESIGN!$C$32+N76*BENEFIT_DESIGN!$C$33+N77*BENEFIT_DESIGN!$C$34+N78*BENEFIT_DESIGN!$C$35+N79","v":{"v":0,"d":"$0"}},{"$f":"O75*BENEFIT_DESIGN!$C$32+O76*BENEFIT_DESIGN!$C$33+O77*BENEFIT_DESIGN!$C$34+O78*BENEFIT_DESIGN!$C$35+O79","v":{"v":0,"d":"$0"}},{"$f":"P75*BENEFIT_DESIGN!$C$32+P76*BENEFIT_DESIGN!$C$33+P77*BENEFIT_DESIGN!$C$34+P78*BENEFIT_DESIGN!$C$35+P79","v":{"v":0,"d":"$0"}}]

{"sheet":"PLAN_OUTPUT_DATA","index":7,"n_rows":13,"n_cols":19,"rows_kept":13,"hidden":true}
[]
[null,"This worksheet saves the results for the plans listed on the PLAN_OUTPUT_DATA worksheet."]
[null,"You can update the output by clicking on the button to the left."]
[null,"After the output data have been recalculated the RESULTS_SUMMARY worksheet will be displayed."]
[]
[null,"Maternity Example",{"$nulls":5},"Diabetes Example",{"$nulls":5},"Foot Fracture Example"]
["PLAN_ID","PLAN_PAYS","SUBSCRIBER_PAYS","SUBSCRIBER_DEDUC","SUBSCRIBER_COPAY","SUBSCRIBER_COINS","SUBSCRIBER_EXCL","PLAN_PAYS","SUBSCRIBER_PAYS","SUBSCRIBER_DEDUC","SUBSCRIBER_COPAY","SUBSCRIBER_COINS","SUBSCRIBER_EXCL","PLAN_PAYS","SUBSCRIBER_PAYS","SUBSCRIBER_DEDUC","SUBSCRIBER_COPAY","SUBSCRIBER_COINS","SUBSCRIBER_EXCL"]
["Plan 1",{"v":0,"d":"$0.00"},{"v":12700,"d":"$12,700.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":12700,"d":"$12,700.00"},{"v":0,"d":"$0.00"},{"v":5600,"d":"$5,600.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":5600,"d":"$5,600.00"},{"v":0,"d":"$0.00"},{"v":2800,"d":"$2,800.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":2800,"d":"$2,800.00"}]
["Plan 2",{"v":0,"d":"$0.00"},{"v":12700,"d":"$12,700.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":12700,"d":"$12,700.00"},{"v":0,"d":"$0.00"},{"v":5600,"d":"$5,600.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":5600,"d":"$5,600.00"},{"v":0,"d":"$0.00"},{"v":2800,"d":"$2,800.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":2800,"d":"$2,800.00"}]
["Plan 3",{"v":0,"d":"$0.00"},{"v":12700,"d":"$12,700.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":12700,"d":"$12,700.00"},{"v":0,"d":"$0.00"},{"v":5600,"d":"$5,600.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":5600,"d":"$5,600.00"},{"v":0,"d":"$0.00"},{"v":2800,"d":"$2,800.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":2800,"d":"$2,800.00"}]
["Plan 4",{"v":0,"d":"$0.00"},{"v":12700,"d":"$12,700.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":12700,"d":"$12,700.00"},{"v":0,"d":"$0.00"},{"v":5600,"d":"$5,600.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":5600,"d":"$5,600.00"},{"v":0,"d":"$0.00"},{"v":2800,"d":"$2,800.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":2800,"d":"$2,800.00"}]
["Plan 5",{"v":0,"d":"$0.00"},{"v":12700,"d":"$12,700.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":12700,"d":"$12,700.00"},{"v":0,"d":"$0.00"},{"v":5600,"d":"$5,600.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":5600,"d":"$5,600.00"},{"v":0,"d":"$0.00"},{"v":2800,"d":"$2,800.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":2800,"d":"$2,800.00"}]
["Plan 6",{"v":0,"d":"$0.00"},{"v":12700,"d":"$12,700.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":12700,"d":"$12,700.00"},{"v":0,"d":"$0.00"},{"v":5600,"d":"$5,600.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":5600,"d":"$5,600.00"},{"v":0,"d":"$0.00"},{"v":2800,"d":"$2,800.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":0,"d":"$0.00"},{"v":2800,"d":"$2,800.00"}]

{"sheet":"RESULTS_SUMMARY","index":8,"n_rows":36,"n_cols":9,"rows_kept":36,"hidden":true,"merged":[[35,1,37,9]]}
[]
[{"$nulls":5},"Summary of Subscriber & Plan Payments"]
[]
[{"$nulls":3},"Select Plan:"]
[]
[{"$nulls":5},{"$f":"\"Summary for \"&nrCBPlanNameRS","v":"Summary for Plan 1"}]
[]
[null,"Maternity Example",{"$nulls":4},"Diabetes Type 2 Example"]
[]
[null,null,"Plan Pays*:",{"v":0,"d":"$0"},{"$nulls":3},"Plan Pays*:",{"v":0,"d":"$0"}]
[]
[]
[null,null,"Patient Pays**:",{"v":12700,"d":"$12,700"},{"$nulls":3},"Patient Pays**:",{"v":5600,"d":"$5,600"}]
[null,null,"Deductibles",{"v":0,"d":"$0"},{"$nulls":3},"Deductibles",{"v":0,"d":"$0"}]
[null,null,"Copayments",{"v":0,"d":"$0"},{"$nulls":3},"Copayments",{"v":0,"d":"$0"}]
[null,null,"Coinsurance",{"v":0,"d":"$0"},{"$nulls":3},"Coinsurance",{"v":0,"d":"$0"}]
[null,null,"Exclusions & Limits",{"v":12700,"d":"$12,700"},{"$nulls":3},"Exclusions & Limits",{"v":5600,"d":"$5,600"}]
[]
[]
[]
[]
[null,"Foot Fracture Example"]
[]
[null,null,"Plan Pays*:",{"v":0,"d":"$0"}]
[]
[]
[null,null,"Patient Pays**:",{"v":2800,"d":"$2,800"}]
[null,null,"Deductibles",{"v":0,"d":"$0"}]
[null,null,"Copayments",{"v":0,"d":"$0"}]
[null,null,"Coinsurance",{"v":0,"d":"$0"}]
[null,null,"Exclusions & Limits",{"v":2800,"d":"$2,800"}]
[]
[]
[]
[]
[null,"*Note: Plan Pays Amount will display as empty if the amount is negative due to rounding.\n**Note: Patient Pays Amount is capped at the individual out of pocket limit.  Total Amounts may not add up due to rounding."]

{"sheet":"MATERNITY_SUMMARY","index":9,"n_rows":29,"n_cols":9,"rows_kept":29,"hidden":true,"merged":[[3,2,4,2],[3,3,4,3]]}
[]
[null,"Maternity Example: Summary of Subscriber and Plan Payments"]
[]
[null,{"$f":"nrCBPlanNameRS","v":"Plan 1"},"Allowed Amount","Plan Payment","Subscriber pays:"]
[null,"Benefit category","Allowed Amount (unrounded)",null,"Total subscriber payment","Subscriber-paid deductible","Subscriber-paid copayment","Subscriber-paid coinsurance","Non-covered and exclusions"]
[null,{"$f":"BENEFIT_DESIGN!B10","v":"Inpatient Hospital Care (Facility)"},{"$f":"SUMIFS(MATERNITY_TIMELINE!AllowedAmt,MATERNITY_TIMELINE!BenefitCategory,$B6)","v":{"v":7060.58,"d":"$7,061"}},{"$f":"SUMIFS(MATERNITY_TIMELINE!PlanPaymentAmt,MATERNITY_TIMELINE!BenefitCategory,$B6)","v":0},{"$f":"SUM(F6:I6)","v":{"v":7060.58,"d":"$7,061"}},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayDeduc,MATERNITY_TIMELINE!BenefitCategory,$B6)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCopay,MATERNITY_TIMELINE!BenefitCategory,$B6)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCoins,MATERNITY_TIMELINE!BenefitCategory,$B6)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayNonCov,MATERNITY_TIMELINE!BenefitCategory,$B6)+SUMIFS(MATERNITY_TIMELINE!SubscriberPayExclusion,MATERNITY_TIMELINE!BenefitCategory,$B6)","v":{"v":7060.58,"d":"$7,061"}}]
[null,{"$f":"BENEFIT_DESIGN!B11","v":"Other Facility Services"},{"$f":"SUMIFS(MATERNITY_TIMELINE!AllowedAmt,MATERNITY_TIMELINE!BenefitCategory,$B7)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!PlanPaymentAmt,MATERNITY_TIMELINE!BenefitCategory,$B7)","v":0},0,{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayDeduc,MATERNITY_TIMELINE!BenefitCategory,$B7)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCopay,MATERNITY_TIMELINE!BenefitCategory,$B7)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCoins,MATERNITY_TIMELINE!BenefitCategory,$B7)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayNonCov,MATERNITY_TIMELINE!BenefitCategory,$B7)+SUMIFS(MATERNITY_TIMELINE!SubscriberPayExclusion,MATERNITY_TIMELINE!BenefitCategory,$B7)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B12","v":"Emergency Department (Facility)"},{"$f":"SUMIFS(MATERNITY_TIMELINE!AllowedAmt,MATERNITY_TIMELINE!BenefitCategory,$B8)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!PlanPaymentAmt,MATERNITY_TIMELINE!BenefitCategory,$B8)","v":0},0,{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayDeduc,MATERNITY_TIMELINE!BenefitCategory,$B8)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCopay,MATERNITY_TIMELINE!BenefitCategory,$B8)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCoins,MATERNITY_TIMELINE!BenefitCategory,$B8)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayNonCov,MATERNITY_TIMELINE!BenefitCategory,$B8)+SUMIFS(MATERNITY_TIMELINE!SubscriberPayExclusion,MATERNITY_TIMELINE!BenefitCategory,$B8)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B13","v":"Ambulance"},{"$f":"SUMIFS(MATERNITY_TIMELINE!AllowedAmt,MATERNITY_TIMELINE!BenefitCategory,$B9)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!PlanPaymentAmt,MATERNITY_TIMELINE!BenefitCategory,$B9)","v":0},0,{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayDeduc,MATERNITY_TIMELINE!BenefitCategory,$B9)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCopay,MATERNITY_TIMELINE!BenefitCategory,$B9)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCoins,MATERNITY_TIMELINE!BenefitCategory,$B9)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayNonCov,MATERNITY_TIMELINE!BenefitCategory,$B9)+SUMIFS(MATERNITY_TIMELINE!SubscriberPayExclusion,MATERNITY_TIMELINE!BenefitCategory,$B9)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B14","v":"Professional Services: Primary Care"},{"$f":"SUMIFS(MATERNITY_TIMELINE!AllowedAmt,MATERNITY_TIMELINE!BenefitCategory,$B10)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!PlanPaymentAmt,MATERNITY_TIMELINE!BenefitCategory,$B10)","v":0},0,{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayDeduc,MATERNITY_TIMELINE!BenefitCategory,$B10)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCopay,MATERNITY_TIMELINE!BenefitCategory,$B10)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCoins,MATERNITY_TIMELINE!BenefitCategory,$B10)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayNonCov,MATERNITY_TIMELINE!BenefitCategory,$B10)+SUMIFS(MATERNITY_TIMELINE!SubscriberPayExclusion,MATERNITY_TIMELINE!BenefitCategory,$B10)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B15","v":"Professional Services: Emergency Department"},{"$f":"SUMIFS(MATERNITY_TIMELINE!AllowedAmt,MATERNITY_TIMELINE!BenefitCategory,$B11)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!PlanPaymentAmt,MATERNITY_TIMELINE!BenefitCategory,$B11)","v":0},0,{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayDeduc,MATERNITY_TIMELINE!BenefitCategory,$B11)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCopay,MATERNITY_TIMELINE!BenefitCategory,$B11)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCoins,MATERNITY_TIMELINE!BenefitCategory,$B11)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayNonCov,MATERNITY_TIMELINE!BenefitCategory,$B11)+SUMIFS(MATERNITY_TIMELINE!SubscriberPayExclusion,MATERNITY_TIMELINE!BenefitCategory,$B11)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B16","v":"Professional Services: Inpatient"},{"$f":"SUMIFS(MATERNITY_TIMELINE!AllowedAmt,MATERNITY_TIMELINE!BenefitCategory,$B12)","v":{"v":1399.34,"d":"$1,399"}},{"$f":"SUMIFS(MATERNITY_TIMELINE!PlanPaymentAmt,MATERNITY_TIMELINE!BenefitCategory,$B12)","v":0},{"$f":"SUM(F12:I12)","v":{"v":1399.34,"d":"$1,399"}},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayDeduc,MATERNITY_TIMELINE!BenefitCategory,$B12)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCopay,MATERNITY_TIMELINE!BenefitCategory,$B12)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCoins,MATERNITY_TIMELINE!BenefitCategory,$B12)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayNonCov,MATERNITY_TIMELINE!BenefitCategory,$B12)+SUMIFS(MATERNITY_TIMELINE!SubscriberPayExclusion,MATERNITY_TIMELINE!BenefitCategory,$B12)","v":{"v":1399.34,"d":"$1,399"}}]
[null,{"$f":"BENEFIT_DESIGN!B17","v":"Professional Services: Specialist"},{"$f":"SUMIFS(MATERNITY_TIMELINE!AllowedAmt,MATERNITY_TIMELINE!BenefitCategory,$B13)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!PlanPaymentAmt,MATERNITY_TIMELINE!BenefitCategory,$B13)","v":0},0,{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayDeduc,MATERNITY_TIMELINE!BenefitCategory,$B13)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCopay,MATERNITY_TIMELINE!BenefitCategory,$B13)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCoins,MATERNITY_TIMELINE!BenefitCategory,$B13)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayNonCov,MATERNITY_TIMELINE!BenefitCategory,$B13)+SUMIFS(MATERNITY_TIMELINE!SubscriberPayExclusion,MATERNITY_TIMELINE!BenefitCategory,$B13)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B18","v":"Professional Services: Obstetric Care (Bundled)"},{"$f":"SUMIFS(MATERNITY_TIMELINE!AllowedAmt,MATERNITY_TIMELINE!BenefitCategory,$B14)","v":{"v":2609.93,"d":"$2,610"}},{"$f":"SUMIFS(MATERNITY_TIMELINE!PlanPaymentAmt,MATERNITY_TIMELINE!BenefitCategory,$B14)","v":0},{"v":2609.93,"d":"$2,610"},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayDeduc,MATERNITY_TIMELINE!BenefitCategory,$B14)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCopay,MATERNITY_TIMELINE!BenefitCategory,$B14)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCoins,MATERNITY_TIMELINE!BenefitCategory,$B14)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayNonCov,MATERNITY_TIMELINE!BenefitCategory,$B14)+SUMIFS(MATERNITY_TIMELINE!SubscriberPayExclusion,MATERNITY_TIMELINE!BenefitCategory,$B14)","v":{"v":2609.93,"d":"$2,610"}}]
[null,{"$f":"BENEFIT_DESIGN!B19","v":"Professional Services: Procedures & Other"},{"$f":"SUMIFS(MATERNITY_TIMELINE!AllowedAmt,MATERNITY_TIMELINE!BenefitCategory,$B15)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!PlanPaymentAmt,MATERNITY_TIMELINE!BenefitCategory,$B15)","v":0},0,{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayDeduc,MATERNITY_TIMELINE!BenefitCategory,$B15)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCopay,MATERNITY_TIMELINE!BenefitCategory,$B15)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCoins,MATERNITY_TIMELINE!BenefitCategory,$B15)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayNonCov,MATERNITY_TIMELINE!BenefitCategory,$B15)+SUMIFS(MATERNITY_TIMELINE!SubscriberPayExclusion,MATERNITY_TIMELINE!BenefitCategory,$B15)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B20","v":"Professional Services: Physical Therapy"},{"$f":"SUMIFS(MATERNITY_TIMELINE!AllowedAmt,MATERNITY_TIMELINE!BenefitCategory,$B16)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!PlanPaymentAmt,MATERNITY_TIMELINE!BenefitCategory,$B16)","v":0},0,{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayDeduc,MATERNITY_TIMELINE!BenefitCategory,$B16)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCopay,MATERNITY_TIMELINE!BenefitCategory,$B16)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCoins,MATERNITY_TIMELINE!BenefitCategory,$B16)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayNonCov,MATERNITY_TIMELINE!BenefitCategory,$B16)+SUMIFS(MATERNITY_TIMELINE!SubscriberPayExclusion,MATERNITY_TIMELINE!BenefitCategory,$B16)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B21","v":"Diagnostic Services: Radiology"},{"$f":"SUMIFS(MATERNITY_TIMELINE!AllowedAmt,MATERNITY_TIMELINE!BenefitCategory,$B17)","v":{"v":343.40999999999997,"d":"$343"}},{"$f":"SUMIFS(MATERNITY_TIMELINE!PlanPaymentAmt,MATERNITY_TIMELINE!BenefitCategory,$B17)","v":0},{"v":343.40999999999997,"d":"$343"},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayDeduc,MATERNITY_TIMELINE!BenefitCategory,$B17)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCopay,MATERNITY_TIMELINE!BenefitCategory,$B17)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCoins,MATERNITY_TIMELINE!BenefitCategory,$B17)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayNonCov,MATERNITY_TIMELINE!BenefitCategory,$B17)+SUMIFS(MATERNITY_TIMELINE!SubscriberPayExclusion,MATERNITY_TIMELINE!BenefitCategory,$B17)","v":{"v":343.40999999999997,"d":"$343"}}]
[null,{"$f":"BENEFIT_DESIGN!B22","v":"Diagnostic Services: Laboratory"},{"$f":"SUMIFS(MATERNITY_TIMELINE!AllowedAmt,MATERNITY_TIMELINE!BenefitCategory,$B18)","v":{"v":1153.24,"d":"$1,153"}},{"$f":"SUMIFS(MATERNITY_TIMELINE!PlanPaymentAmt,MATERNITY_TIMELINE!BenefitCategory,$B18)","v":0},{"v":1153.24,"d":"$1,153"},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayDeduc,MATERNITY_TIMELINE!BenefitCategory,$B18)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCopay,MATERNITY_TIMELINE!BenefitCategory,$B18)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCoins,MATERNITY_TIMELINE!BenefitCategory,$B18)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayNonCov,MATERNITY_TIMELINE!BenefitCategory,$B18)+SUMIFS(MATERNITY_TIMELINE!SubscriberPayExclusion,MATERNITY_TIMELINE!BenefitCategory,$B18)","v":{"v":1153.24,"d":"$1,153"}}]
[null,{"$f":"BENEFIT_DESIGN!B23","v":"Prescription Drugs: Generic"},{"$f":"SUMIFS(MATERNITY_TIMELINE!AllowedAmt,MATERNITY_TIMELINE!BenefitCategory,$B19)","v":{"v":10.57,"d":"$11"}},{"$f":"SUMIFS(MATERNITY_TIMELINE!PlanPaymentAmt,MATERNITY_TIMELINE!BenefitCategory,$B19)","v":0},{"v":10.57,"d":"$11"},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayDeduc,MATERNITY_TIMELINE!BenefitCategory,$B19)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCopay,MATERNITY_TIMELINE!BenefitCategory,$B19)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCoins,MATERNITY_TIMELINE!BenefitCategory,$B19)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayNonCov,MATERNITY_TIMELINE!BenefitCategory,$B19)+SUMIFS(MATERNITY_TIMELINE!SubscriberPayExclusion,MATERNITY_TIMELINE!BenefitCategory,$B19)","v":{"v":10.57,"d":"$11"}}]
[null,{"$f":"BENEFIT_DESIGN!B24","v":"Prescription Drugs: Branded"},{"$f":"SUMIFS(MATERNITY_TIMELINE!AllowedAmt,MATERNITY_TIMELINE!BenefitCategory,$B20)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!PlanPaymentAmt,MATERNITY_TIMELINE!BenefitCategory,$B20)","v":0},0,{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayDeduc,MATERNITY_TIMELINE!BenefitCategory,$B20)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCopay,MATERNITY_TIMELINE!BenefitCategory,$B20)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCoins,MATERNITY_TIMELINE!BenefitCategory,$B20)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayNonCov,MATERNITY_TIMELINE!BenefitCategory,$B20)+SUMIFS(MATERNITY_TIMELINE!SubscriberPayExclusion,MATERNITY_TIMELINE!BenefitCategory,$B20)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B25","v":"Prescription Drugs: Insulin"},{"$f":"SUMIFS(MATERNITY_TIMELINE!AllowedAmt,MATERNITY_TIMELINE!BenefitCategory,$B21)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!PlanPaymentAmt,MATERNITY_TIMELINE!BenefitCategory,$B21)","v":0},{"$f":"SUM(F21:I21)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayDeduc,MATERNITY_TIMELINE!BenefitCategory,$B21)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCopay,MATERNITY_TIMELINE!BenefitCategory,$B21)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCoins,MATERNITY_TIMELINE!BenefitCategory,$B21)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayNonCov,MATERNITY_TIMELINE!BenefitCategory,$B21)+SUMIFS(MATERNITY_TIMELINE!SubscriberPayExclusion,MATERNITY_TIMELINE!BenefitCategory,$B21)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B26","v":"Over-the-counter Drugs"},{"$f":"SUMIFS(MATERNITY_TIMELINE!AllowedAmt,MATERNITY_TIMELINE!BenefitCategory,$B22)","v":{"v":61.02,"d":"$61"}},{"$f":"SUMIFS(MATERNITY_TIMELINE!PlanPaymentAmt,MATERNITY_TIMELINE!BenefitCategory,$B22)","v":0},{"v":61.02,"d":"$61"},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayDeduc,MATERNITY_TIMELINE!BenefitCategory,$B22)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCopay,MATERNITY_TIMELINE!BenefitCategory,$B22)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCoins,MATERNITY_TIMELINE!BenefitCategory,$B22)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayNonCov,MATERNITY_TIMELINE!BenefitCategory,$B22)+SUMIFS(MATERNITY_TIMELINE!SubscriberPayExclusion,MATERNITY_TIMELINE!BenefitCategory,$B22)","v":{"v":61.02,"d":"$61"}}]
[null,{"$f":"BENEFIT_DESIGN!B27","v":"Preventive Services & Vaccines"},{"$f":"SUMIFS(MATERNITY_TIMELINE!AllowedAmt,MATERNITY_TIMELINE!BenefitCategory,$B23)","v":{"v":48.76,"d":"$49"}},{"$f":"SUMIFS(MATERNITY_TIMELINE!PlanPaymentAmt,MATERNITY_TIMELINE!BenefitCategory,$B23)","v":0},{"v":48.76,"d":"$49"},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayDeduc,MATERNITY_TIMELINE!BenefitCategory,$B23)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCopay,MATERNITY_TIMELINE!BenefitCategory,$B23)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCoins,MATERNITY_TIMELINE!BenefitCategory,$B23)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayNonCov,MATERNITY_TIMELINE!BenefitCategory,$B23)+SUMIFS(MATERNITY_TIMELINE!SubscriberPayExclusion,MATERNITY_TIMELINE!BenefitCategory,$B23)","v":{"v":48.76,"d":"$49"}}]
[null,{"$f":"BENEFIT_DESIGN!B28","v":"Durable Medical Equipment"},{"$f":"SUMIFS(MATERNITY_TIMELINE!AllowedAmt,MATERNITY_TIMELINE!BenefitCategory,$B24)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!PlanPaymentAmt,MATERNITY_TIMELINE!BenefitCategory,$B24)","v":0},0,{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayDeduc,MATERNITY_TIMELINE!BenefitCategory,$B24)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCopay,MATERNITY_TIMELINE!BenefitCategory,$B24)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCoins,MATERNITY_TIMELINE!BenefitCategory,$B24)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayNonCov,MATERNITY_TIMELINE!BenefitCategory,$B24)+SUMIFS(MATERNITY_TIMELINE!SubscriberPayExclusion,MATERNITY_TIMELINE!BenefitCategory,$B24)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B29","v":"Medical Supplies"},{"$f":"SUMIFS(MATERNITY_TIMELINE!AllowedAmt,MATERNITY_TIMELINE!BenefitCategory,$B25)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!PlanPaymentAmt,MATERNITY_TIMELINE!BenefitCategory,$B25)","v":0},0,{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayDeduc,MATERNITY_TIMELINE!BenefitCategory,$B25)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCopay,MATERNITY_TIMELINE!BenefitCategory,$B25)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCoins,MATERNITY_TIMELINE!BenefitCategory,$B25)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayNonCov,MATERNITY_TIMELINE!BenefitCategory,$B25)+SUMIFS(MATERNITY_TIMELINE!SubscriberPayExclusion,MATERNITY_TIMELINE!BenefitCategory,$B25)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B30","v":"Over-the-counter Medical Supplies"},{"$f":"SUMIFS(MATERNITY_TIMELINE!AllowedAmt,MATERNITY_TIMELINE!BenefitCategory,$B26)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!PlanPaymentAmt,MATERNITY_TIMELINE!BenefitCategory,$B26)","v":0},0,{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayDeduc,MATERNITY_TIMELINE!BenefitCategory,$B26)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCopay,MATERNITY_TIMELINE!BenefitCategory,$B26)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCoins,MATERNITY_TIMELINE!BenefitCategory,$B26)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayNonCov,MATERNITY_TIMELINE!BenefitCategory,$B26)+SUMIFS(MATERNITY_TIMELINE!SubscriberPayExclusion,MATERNITY_TIMELINE!BenefitCategory,$B26)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B31","v":"Other Items & Services"},{"$f":"SUMIFS(MATERNITY_TIMELINE!AllowedAmt,MATERNITY_TIMELINE!BenefitCategory,$B27)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!PlanPaymentAmt,MATERNITY_TIMELINE!BenefitCategory,$B27)","v":0},0,{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayDeduc,MATERNITY_TIMELINE!BenefitCategory,$B27)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCopay,MATERNITY_TIMELINE!BenefitCategory,$B27)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayCoins,MATERNITY_TIMELINE!BenefitCategory,$B27)","v":0},{"$f":"SUMIFS(MATERNITY_TIMELINE!SubscriberPayNonCov,MATERNITY_TIMELINE!BenefitCategory,$B27)+SUMIFS(MATERNITY_TIMELINE!SubscriberPayExclusion,MATERNITY_TIMELINE!BenefitCategory,$B27)","v":0}]
[null,"Total (unrounded)",{"$f":"SUM(C6:C27)","v":{"v":12686.85,"d":"$12,687"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",SUM(D6:D27)),\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",SUM(E6:E27)),\"ERROR\")","v":{"v":12686.85,"d":"$12,687"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",SUM(F6:F27)),\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",SUM(G6:G27)),\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",SUM(H6:H27)),\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",SUM(I6:I27)),\"ERROR\")","v":{"v":12686.85,"d":"$12,687"}}]
[null,"Total (rounded)",{"$f":"MROUND(C28,IF(C28>=100,100,10))","v":{"v":12700,"d":"$12,700"}},{"$f":"IFERROR(C29-E29,\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",MIN(SUM(F29:H29),BENEFIT_DESIGN!C36)+I29),\"ERROR\")","v":{"v":12700,"d":"$12,700"}},{"$f":"IFERROR(\nIF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",\nMIN(\nMROUND(F28,IF(F28>=100,100,10)),\nBENEFIT_PARAMETERS!$N$80)\n),\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",MROUND(G28,IF(G28>=100,100,10))),\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",MROUND(H28,IF(H28>=100,100,10))),\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",MROUND(I28,IF(I28>=100,100,10))),\"ERROR\")","v":{"v":12700,"d":"$12,700"}}]

{"sheet":"MATERNITY_LINE_ITEM","index":10,"n_rows":33,"n_cols":10,"rows_kept":33,"hidden":true}
["Item or Service Code","Diagnosis Code \n(ICD-10)","CPT©, HCPCS, or\nOther Billing Code","Provider\nType","Benefit Category","Description","Allowed\nAmount","Notes","Valid Benefit Category","Timeline Count"]
[1,null,228298150,"Pharmacy Retail","Prescription Drugs: Generic","Oxycodone/APAP 5mg/325mg (Rx) [1 pill Q6H PRN;  30 pills]",{"v":6.8,"d":"$6.80"},null,{"$f":"IF(ISERROR(VLOOKUP(E2,BenefitCategoryList,1,FALSE)),FALSE,TRUE)","v":true},{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A2)","v":1}]
[2,null,53746046605,"Pharmacy Retail","Prescription Drugs: Generic","Ibuprofen 800mg (Rx) [1 pill Q8H PRN; 30 pills]",{"v":3.77,"d":"$3.77"},null,true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A3)","v":1}]
[5,"O80, Z370",1967,"Anesthesiology","Professional Services: Inpatient","Anesth/analg vag delivery",{"v":1399.34,"d":"$1,399.34"},null,true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A4)","v":1}]
[6,"O80, Z370",59400,"OBGYN","Professional Services: Obstetric Care (Bundled)","Obstetrical Care",{"v":2609.93,"d":"$2,609.93"},"59400 - Global OB package description/code",true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A5)","v":1}]
[7,null,51991045757,"Pharmacy Retail","Over-the-counter Drugs","Polyethylene Glycol 3350 [1 dose / 17 GM daily]",{"v":15.1,"d":"$15.10"},null,true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A6)","v":1}]
[8,null,44946104501,"Pharmacy Retail","Over-the-counter Drugs","Prenatal Vitamins (OTC - Bottle of 100) [1 pill daily; 30 pills/month]",{"v":11.48,"d":"$11.48"},null,true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A7)","v":4}]
[10,"Z23",90471,"OBGYN","Preventive Services & Vaccines"," Immunization Admin",{"v":28.56,"d":"$28.56"},null,true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A8)","v":1}]
[11,"Z23",90656,"OBGYN","Preventive Services & Vaccines","Flu Vaccine N0 Preserv 3 & >",{"v":20.2,"d":"$20.20"},null,true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A9)","v":1}]
[12,"Z3400",36415,"OBGYN","Diagnostic Services: Laboratory","Routine Venipuncture",{"v":5.3,"d":"$5.30"},"Cystic fibrosis screen",true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A10)","v":3}]
[13,"Z3400",76805,"Radiology","Diagnostic Services: Radiology","OB US >/= 14 WKS SNGL FETUS",{"v":209.73,"d":"$209.73"},null,true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A11)","v":1}]
[14,"Z3400",80055,"OBGYN","Diagnostic Services: Laboratory","Obstetric Panel",{"v":56.04,"d":"$56.04"},"80055 - Global OB panel code",true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A12)","v":1}]
[15,"Z3400",82105,"OBGYN","Diagnostic Services: Laboratory","Alpha-fetoprotein serum",{"v":23.21,"d":"$23.21"},"Maternal serum quad screen",true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A13)","v":1}]
[16,"Z3400",82677,"OBGYN","Diagnostic Services: Laboratory","Assay of estriol",{"v":28.67,"d":"$28.67"},"Maternal serum quad screen",true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A14)","v":1}]
[17,"Z3400",82947,"OBGYN","Diagnostic Services: Laboratory","Assay Glucose Blood Quant",{"v":8.21,"d":"$8.21"},null,true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A15)","v":1}]
[18,"Z3400",82950,"OBGYN","Diagnostic Services: Laboratory","Glucose Test",{"v":10.03,"d":"$10.03"},null,true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A16)","v":1}]
[25,"Z3400",84702,"OBGYN","Diagnostic Services: Laboratory","Chorionic gonadotropin test",{"v":24.94,"d":"$24.94"},"Maternal serum quad screen",true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A17)","v":1}]
[26,"Z3400",85025,"OBGYN","Diagnostic Services: Laboratory","Complete cbc w/auto diff wbc",{"v":13.99,"d":"$13.99"},null,true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A18)","v":1}]
[27,"Z3400",86336,"OBGYN","Diagnostic Services: Laboratory","Inhibin A",{"v":21.67,"d":"$21.67"},"Maternal serum quad screen",true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A19)","v":1}]
[28,"Z3400",86701,"OBGYN","Diagnostic Services: Laboratory","HIV-1",{"v":17.37,"d":"$17.37"},null,true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A20)","v":1}]
[29,"Z3400",87653,"OBGYN","Diagnostic Services: Laboratory","Strep B DNA Amp Probe",{"v":61.22,"d":"$61.22"},null,true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A21)","v":1}]
[30,"Z3400",87801,"OBGYN","Diagnostic Services: Laboratory","Detect agnt mult dna ampli ",{"v":119.67,"d":"$119.67"},"Gonorrhea / Chlamydia screen",true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A22)","v":1}]
[31,"Z3400",88175,"OBGYN","Diagnostic Services: Laboratory","Cytopath c/v auto fluid redo",{"v":36.94,"d":"$36.94"},"Pap smear",true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A23)","v":1}]
[32,"Z3400",59400,"OBGYN","Professional Services: Obstetric Care (Bundled)","Office/Outpatient Visit Est",null,"Bundled into 6",true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A24)","v":14}]
[33,"Z392",59400,"OBGYN","Professional Services: Obstetric Care (Bundled)","Office/Outpatient Visit Est",null,"Post partum visit; Bundled into 6",true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A25)","v":1}]
[34,"Z3800",775,"Inpatient Facility","Inpatient Hospital Care (Facility)","Vaginal delivery w/o complicating diagnoses",{"v":7060.58,"d":"$7,060.58"},null,true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A26)","v":1}]
[35,"Z3201",81025,"OBGYN","Diagnostic Services: Laboratory","Urine Pregnancy Test",{"v":9.86,"d":"$9.86"},null,true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A27)","v":1}]
[37,"Z3400",81220,"OBGYN","Diagnostic Services: Laboratory","CFTR gene analysis, common variants",{"v":595.43,"d":"$595.43"},null,true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A28)","v":1}]
[41,"Z3400",76815,"Radiology","Diagnostic Services: Radiology","Ultrasound of pregnant uterus, 1 or more fetus(es)",{"v":133.68,"d":"$133.68"},null,true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A29)","v":1}]
[42,"Z3400",87086,"OBGYN","Diagnostic Services: Laboratory","Urine culture/colony count",{"v":13.12,"d":"$13.12"},null,true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A30)","v":1}]
[43,"Z3400",81001,"OBGYN","Diagnostic Services: Laboratory","Urinalysis auto w/scope",{"v":8.67,"d":"$8.67"},null,true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A31)","v":1}]
[44,"Z3400",87491,"OBGYN","Diagnostic Services: Laboratory","Chylmd trach dna amp probe",{"v":44.48,"d":"$44.48"},null,true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A32)","v":1}]
[45,"Z3400",87591,"OBGYN","Diagnostic Services: Laboratory","N.gonorrhoeae dna amp prob",{"v":43.82,"d":"$43.82"},null,true,{"$f":"COUNTIF(MATERNITY_TIMELINE!ServiceCode,A33)","v":1}]

{"sheet":"DIABETES_SUMMARY","index":11,"n_rows":29,"n_cols":9,"rows_kept":29,"hidden":true,"merged":[[3,2,4,2],[3,3,4,3]]}
[]
[null,"Type 2 Diabetes Example: Summary of Subscriber and Plan Payments"]
[]
[null,{"$f":"nrCBPlanNameRS","v":"Plan 1"},"Allowed Amount","Plan Payment","Subscriber pays:"]
[null,"Benefit category",null,null,"Total subscriber payment","Subscriber-paid deductible","Subscriber-paid copayment","Subscriber-paid coinsurance","Non-covered and exclusions"]
[null,{"$f":"BENEFIT_DESIGN!B10","v":"Inpatient Hospital Care (Facility)"},{"$f":"SUMIFS(DIABETES_TIMELINE!AllowedAmt,DIABETES_TIMELINE!BenefitCategory,$B6)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!PlanPaymentAmt,DIABETES_TIMELINE!BenefitCategory,$B6)","v":0},{"$f":"SUM(F6:I6)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayDeduc,DIABETES_TIMELINE!BenefitCategory,$B6)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCopay,DIABETES_TIMELINE!BenefitCategory,$B6)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCoins,DIABETES_TIMELINE!BenefitCategory,$B6)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayNonCov,DIABETES_TIMELINE!BenefitCategory,$B6)+SUMIFS(DIABETES_TIMELINE!SubscriberPayExclusion,DIABETES_TIMELINE!BenefitCategory,$B6)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B11","v":"Other Facility Services"},{"$f":"SUMIFS(DIABETES_TIMELINE!AllowedAmt,DIABETES_TIMELINE!BenefitCategory,$B7)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!PlanPaymentAmt,DIABETES_TIMELINE!BenefitCategory,$B7)","v":0},{"$f":"SUM(F7:I7)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayDeduc,DIABETES_TIMELINE!BenefitCategory,$B7)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCopay,DIABETES_TIMELINE!BenefitCategory,$B7)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCoins,DIABETES_TIMELINE!BenefitCategory,$B7)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayNonCov,DIABETES_TIMELINE!BenefitCategory,$B7)+SUMIFS(DIABETES_TIMELINE!SubscriberPayExclusion,DIABETES_TIMELINE!BenefitCategory,$B7)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B12","v":"Emergency Department (Facility)"},{"$f":"SUMIFS(DIABETES_TIMELINE!AllowedAmt,DIABETES_TIMELINE!BenefitCategory,$B8)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!PlanPaymentAmt,DIABETES_TIMELINE!BenefitCategory,$B8)","v":0},0,{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayDeduc,DIABETES_TIMELINE!BenefitCategory,$B8)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCopay,DIABETES_TIMELINE!BenefitCategory,$B8)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCoins,DIABETES_TIMELINE!BenefitCategory,$B8)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayNonCov,DIABETES_TIMELINE!BenefitCategory,$B8)+SUMIFS(DIABETES_TIMELINE!SubscriberPayExclusion,DIABETES_TIMELINE!BenefitCategory,$B8)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B13","v":"Ambulance"},{"$f":"SUMIFS(DIABETES_TIMELINE!AllowedAmt,DIABETES_TIMELINE!BenefitCategory,$B9)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!PlanPaymentAmt,DIABETES_TIMELINE!BenefitCategory,$B9)","v":0},0,{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayDeduc,DIABETES_TIMELINE!BenefitCategory,$B9)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCopay,DIABETES_TIMELINE!BenefitCategory,$B9)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCoins,DIABETES_TIMELINE!BenefitCategory,$B9)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayNonCov,DIABETES_TIMELINE!BenefitCategory,$B9)+SUMIFS(DIABETES_TIMELINE!SubscriberPayExclusion,DIABETES_TIMELINE!BenefitCategory,$B9)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B14","v":"Professional Services: Primary Care"},{"$f":"SUMIFS(DIABETES_TIMELINE!AllowedAmt,DIABETES_TIMELINE!BenefitCategory,$B10)","v":{"v":716.1,"d":"$716"}},{"$f":"SUMIFS(DIABETES_TIMELINE!PlanPaymentAmt,DIABETES_TIMELINE!BenefitCategory,$B10)","v":0},{"v":716.1,"d":"$716"},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayDeduc,DIABETES_TIMELINE!BenefitCategory,$B10)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCopay,DIABETES_TIMELINE!BenefitCategory,$B10)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCoins,DIABETES_TIMELINE!BenefitCategory,$B10)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayNonCov,DIABETES_TIMELINE!BenefitCategory,$B10)+SUMIFS(DIABETES_TIMELINE!SubscriberPayExclusion,DIABETES_TIMELINE!BenefitCategory,$B10)","v":{"v":716.1,"d":"$716"}}]
[null,{"$f":"BENEFIT_DESIGN!B15","v":"Professional Services: Emergency Department"},{"$f":"SUMIFS(DIABETES_TIMELINE!AllowedAmt,DIABETES_TIMELINE!BenefitCategory,$B11)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!PlanPaymentAmt,DIABETES_TIMELINE!BenefitCategory,$B11)","v":0},0,{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayDeduc,DIABETES_TIMELINE!BenefitCategory,$B11)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCopay,DIABETES_TIMELINE!BenefitCategory,$B11)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCoins,DIABETES_TIMELINE!BenefitCategory,$B11)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayNonCov,DIABETES_TIMELINE!BenefitCategory,$B11)+SUMIFS(DIABETES_TIMELINE!SubscriberPayExclusion,DIABETES_TIMELINE!BenefitCategory,$B11)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B16","v":"Professional Services: Inpatient"},{"$f":"SUMIFS(DIABETES_TIMELINE!AllowedAmt,DIABETES_TIMELINE!BenefitCategory,$B12)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!PlanPaymentAmt,DIABETES_TIMELINE!BenefitCategory,$B12)","v":0},{"$f":"SUM(F12:I12)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayDeduc,DIABETES_TIMELINE!BenefitCategory,$B12)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCopay,DIABETES_TIMELINE!BenefitCategory,$B12)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCoins,DIABETES_TIMELINE!BenefitCategory,$B12)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayNonCov,DIABETES_TIMELINE!BenefitCategory,$B12)+SUMIFS(DIABETES_TIMELINE!SubscriberPayExclusion,DIABETES_TIMELINE!BenefitCategory,$B12)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B17","v":"Professional Services: Specialist"},{"$f":"SUMIFS(DIABETES_TIMELINE!AllowedAmt,DIABETES_TIMELINE!BenefitCategory,$B13)","v":{"v":300.74,"d":"$301"}},{"$f":"SUMIFS(DIABETES_TIMELINE!PlanPaymentAmt,DIABETES_TIMELINE!BenefitCategory,$B13)","v":0},{"v":300.74,"d":"$301"},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayDeduc,DIABETES_TIMELINE!BenefitCategory,$B13)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCopay,DIABETES_TIMELINE!BenefitCategory,$B13)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCoins,DIABETES_TIMELINE!BenefitCategory,$B13)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayNonCov,DIABETES_TIMELINE!BenefitCategory,$B13)+SUMIFS(DIABETES_TIMELINE!SubscriberPayExclusion,DIABETES_TIMELINE!BenefitCategory,$B13)","v":{"v":300.74,"d":"$301"}}]
[null,{"$f":"BENEFIT_DESIGN!B18","v":"Professional Services: Obstetric Care (Bundled)"},{"$f":"SUMIFS(DIABETES_TIMELINE!AllowedAmt,DIABETES_TIMELINE!BenefitCategory,$B14)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!PlanPaymentAmt,DIABETES_TIMELINE!BenefitCategory,$B14)","v":0},0,{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayDeduc,DIABETES_TIMELINE!BenefitCategory,$B14)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCopay,DIABETES_TIMELINE!BenefitCategory,$B14)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCoins,DIABETES_TIMELINE!BenefitCategory,$B14)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayNonCov,DIABETES_TIMELINE!BenefitCategory,$B14)+SUMIFS(DIABETES_TIMELINE!SubscriberPayExclusion,DIABETES_TIMELINE!BenefitCategory,$B14)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B19","v":"Professional Services: Procedures & Other"},{"$f":"SUMIFS(DIABETES_TIMELINE!AllowedAmt,DIABETES_TIMELINE!BenefitCategory,$B15)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!PlanPaymentAmt,DIABETES_TIMELINE!BenefitCategory,$B15)","v":0},0,{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayDeduc,DIABETES_TIMELINE!BenefitCategory,$B15)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCopay,DIABETES_TIMELINE!BenefitCategory,$B15)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCoins,DIABETES_TIMELINE!BenefitCategory,$B15)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayNonCov,DIABETES_TIMELINE!BenefitCategory,$B15)+SUMIFS(DIABETES_TIMELINE!SubscriberPayExclusion,DIABETES_TIMELINE!BenefitCategory,$B15)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B20","v":"Professional Services: Physical Therapy"},{"$f":"SUMIFS(DIABETES_TIMELINE!AllowedAmt,DIABETES_TIMELINE!BenefitCategory,$B16)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!PlanPaymentAmt,DIABETES_TIMELINE!BenefitCategory,$B16)","v":0},0,{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayDeduc,DIABETES_TIMELINE!BenefitCategory,$B16)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCopay,DIABETES_TIMELINE!BenefitCategory,$B16)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCoins,DIABETES_TIMELINE!BenefitCategory,$B16)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayNonCov,DIABETES_TIMELINE!BenefitCategory,$B16)+SUMIFS(DIABETES_TIMELINE!SubscriberPayExclusion,DIABETES_TIMELINE!BenefitCategory,$B16)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B21","v":"Diagnostic Services: Radiology"},{"$f":"SUMIFS(DIABETES_TIMELINE!AllowedAmt,DIABETES_TIMELINE!BenefitCategory,$B17)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!PlanPaymentAmt,DIABETES_TIMELINE!BenefitCategory,$B17)","v":0},0,{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayDeduc,DIABETES_TIMELINE!BenefitCategory,$B17)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCopay,DIABETES_TIMELINE!BenefitCategory,$B17)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCoins,DIABETES_TIMELINE!BenefitCategory,$B17)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayNonCov,DIABETES_TIMELINE!BenefitCategory,$B17)+SUMIFS(DIABETES_TIMELINE!SubscriberPayExclusion,DIABETES_TIMELINE!BenefitCategory,$B17)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B22","v":"Diagnostic Services: Laboratory"},{"$f":"SUMIFS(DIABETES_TIMELINE!AllowedAmt,DIABETES_TIMELINE!BenefitCategory,$B18)","v":{"v":122.47999999999999,"d":"$122"}},{"$f":"SUMIFS(DIABETES_TIMELINE!PlanPaymentAmt,DIABETES_TIMELINE!BenefitCategory,$B18)","v":0},{"v":122.47999999999999,"d":"$122"},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayDeduc,DIABETES_TIMELINE!BenefitCategory,$B18)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCopay,DIABETES_TIMELINE!BenefitCategory,$B18)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCoins,DIABETES_TIMELINE!BenefitCategory,$B18)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayNonCov,DIABETES_TIMELINE!BenefitCategory,$B18)+SUMIFS(DIABETES_TIMELINE!SubscriberPayExclusion,DIABETES_TIMELINE!BenefitCategory,$B18)","v":{"v":122.47999999999999,"d":"$122"}}]
[null,{"$f":"BENEFIT_DESIGN!B23","v":"Prescription Drugs: Generic"},{"$f":"SUMIFS(DIABETES_TIMELINE!AllowedAmt,DIABETES_TIMELINE!BenefitCategory,$B19)","v":{"v":365.3599999999998,"d":"$365"}},{"$f":"SUMIFS(DIABETES_TIMELINE!PlanPaymentAmt,DIABETES_TIMELINE!BenefitCategory,$B19)","v":0},{"v":365.3599999999998,"d":"$365"},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayDeduc,DIABETES_TIMELINE!BenefitCategory,$B19)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCopay,DIABETES_TIMELINE!BenefitCategory,$B19)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCoins,DIABETES_TIMELINE!BenefitCategory,$B19)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayNonCov,DIABETES_TIMELINE!BenefitCategory,$B19)+SUMIFS(DIABETES_TIMELINE!SubscriberPayExclusion,DIABETES_TIMELINE!BenefitCategory,$B19)","v":{"v":365.3599999999998,"d":"$365"}}]
[null,{"$f":"BENEFIT_DESIGN!B24","v":"Prescription Drugs: Branded"},{"$f":"SUMIFS(DIABETES_TIMELINE!AllowedAmt,DIABETES_TIMELINE!BenefitCategory,$B20)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!PlanPaymentAmt,DIABETES_TIMELINE!BenefitCategory,$B20)","v":0},0,{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayDeduc,DIABETES_TIMELINE!BenefitCategory,$B20)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCopay,DIABETES_TIMELINE!BenefitCategory,$B20)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCoins,DIABETES_TIMELINE!BenefitCategory,$B20)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayNonCov,DIABETES_TIMELINE!BenefitCategory,$B20)+SUMIFS(DIABETES_TIMELINE!SubscriberPayExclusion,DIABETES_TIMELINE!BenefitCategory,$B20)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B25","v":"Prescription Drugs: Insulin"},{"$f":"SUMIFS(DIABETES_TIMELINE!AllowedAmt,DIABETES_TIMELINE!BenefitCategory,$B21)","v":{"v":3124.809999999999,"d":"$3,125"}},{"$f":"SUMIFS(DIABETES_TIMELINE!PlanPaymentAmt,DIABETES_TIMELINE!BenefitCategory,$B21)","v":0},{"$f":"SUM(F21:I21)","v":{"v":3124.809999999999,"d":"$3,125"}},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayDeduc,DIABETES_TIMELINE!BenefitCategory,$B21)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCopay,DIABETES_TIMELINE!BenefitCategory,$B21)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCoins,DIABETES_TIMELINE!BenefitCategory,$B21)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayNonCov,DIABETES_TIMELINE!BenefitCategory,$B21)+SUMIFS(DIABETES_TIMELINE!SubscriberPayExclusion,DIABETES_TIMELINE!BenefitCategory,$B21)","v":{"v":3124.809999999999,"d":"$3,125"}}]
[null,{"$f":"BENEFIT_DESIGN!B26","v":"Over-the-counter Drugs"},{"$f":"SUMIFS(DIABETES_TIMELINE!AllowedAmt,DIABETES_TIMELINE!BenefitCategory,$B22)","v":{"v":22.349999999999998,"d":"$22"}},{"$f":"SUMIFS(DIABETES_TIMELINE!PlanPaymentAmt,DIABETES_TIMELINE!BenefitCategory,$B22)","v":0},{"v":22.349999999999998,"d":"$22"},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayDeduc,DIABETES_TIMELINE!BenefitCategory,$B22)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCopay,DIABETES_TIMELINE!BenefitCategory,$B22)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCoins,DIABETES_TIMELINE!BenefitCategory,$B22)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayNonCov,DIABETES_TIMELINE!BenefitCategory,$B22)+SUMIFS(DIABETES_TIMELINE!SubscriberPayExclusion,DIABETES_TIMELINE!BenefitCategory,$B22)","v":{"v":22.349999999999998,"d":"$22"}}]
[null,{"$f":"BENEFIT_DESIGN!B27","v":"Preventive Services & Vaccines"},{"$f":"SUMIFS(DIABETES_TIMELINE!AllowedAmt,DIABETES_TIMELINE!BenefitCategory,$B23)","v":{"v":158.95000000000002,"d":"$159"}},{"$f":"SUMIFS(DIABETES_TIMELINE!PlanPaymentAmt,DIABETES_TIMELINE!BenefitCategory,$B23)","v":0},{"v":158.95000000000002,"d":"$159"},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayDeduc,DIABETES_TIMELINE!BenefitCategory,$B23)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCopay,DIABETES_TIMELINE!BenefitCategory,$B23)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCoins,DIABETES_TIMELINE!BenefitCategory,$B23)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayNonCov,DIABETES_TIMELINE!BenefitCategory,$B23)+SUMIFS(DIABETES_TIMELINE!SubscriberPayExclusion,DIABETES_TIMELINE!BenefitCategory,$B23)","v":{"v":158.95000000000002,"d":"$159"}}]
[null,{"$f":"BENEFIT_DESIGN!B28","v":"Durable Medical Equipment"},{"$f":"SUMIFS(DIABETES_TIMELINE!AllowedAmt,DIABETES_TIMELINE!BenefitCategory,$B24)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!PlanPaymentAmt,DIABETES_TIMELINE!BenefitCategory,$B24)","v":0},0,{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayDeduc,DIABETES_TIMELINE!BenefitCategory,$B24)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCopay,DIABETES_TIMELINE!BenefitCategory,$B24)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCoins,DIABETES_TIMELINE!BenefitCategory,$B24)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayNonCov,DIABETES_TIMELINE!BenefitCategory,$B24)+SUMIFS(DIABETES_TIMELINE!SubscriberPayExclusion,DIABETES_TIMELINE!BenefitCategory,$B24)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B29","v":"Medical Supplies"},{"$f":"SUMIFS(DIABETES_TIMELINE!AllowedAmt,DIABETES_TIMELINE!BenefitCategory,$B25)","v":{"v":790.34,"d":"$790"}},{"$f":"SUMIFS(DIABETES_TIMELINE!PlanPaymentAmt,DIABETES_TIMELINE!BenefitCategory,$B25)","v":0},{"v":790.34,"d":"$790"},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayDeduc,DIABETES_TIMELINE!BenefitCategory,$B25)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCopay,DIABETES_TIMELINE!BenefitCategory,$B25)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCoins,DIABETES_TIMELINE!BenefitCategory,$B25)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayNonCov,DIABETES_TIMELINE!BenefitCategory,$B25)+SUMIFS(DIABETES_TIMELINE!SubscriberPayExclusion,DIABETES_TIMELINE!BenefitCategory,$B25)","v":{"v":790.34,"d":"$790"}}]
[null,{"$f":"BENEFIT_DESIGN!B30","v":"Over-the-counter Medical Supplies"},{"$f":"SUMIFS(DIABETES_TIMELINE!AllowedAmt,DIABETES_TIMELINE!BenefitCategory,$B26)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!PlanPaymentAmt,DIABETES_TIMELINE!BenefitCategory,$B26)","v":0},0,{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayDeduc,DIABETES_TIMELINE!BenefitCategory,$B26)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCopay,DIABETES_TIMELINE!BenefitCategory,$B26)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCoins,DIABETES_TIMELINE!BenefitCategory,$B26)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayNonCov,DIABETES_TIMELINE!BenefitCategory,$B26)+SUMIFS(DIABETES_TIMELINE!SubscriberPayExclusion,DIABETES_TIMELINE!BenefitCategory,$B26)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B31","v":"Other Items & Services"},{"$f":"SUMIFS(DIABETES_TIMELINE!AllowedAmt,DIABETES_TIMELINE!BenefitCategory,$B27)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!PlanPaymentAmt,DIABETES_TIMELINE!BenefitCategory,$B27)","v":0},0,{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayDeduc,DIABETES_TIMELINE!BenefitCategory,$B27)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCopay,DIABETES_TIMELINE!BenefitCategory,$B27)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayCoins,DIABETES_TIMELINE!BenefitCategory,$B27)","v":0},{"$f":"SUMIFS(DIABETES_TIMELINE!SubscriberPayNonCov,DIABETES_TIMELINE!BenefitCategory,$B27)+SUMIFS(DIABETES_TIMELINE!SubscriberPayExclusion,DIABETES_TIMELINE!BenefitCategory,$B27)","v":0}]
[null,"Total (unrounded)",{"$f":"SUM(C6:C27)","v":{"v":5601.129999999999,"d":"$5,601"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",SUM(D6:D27)),\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",SUM(E6:E27)),\"ERROR\")","v":{"v":5601.129999999999,"d":"$5,601"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",SUM(F6:F27)),\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",SUM(G6:G27)),\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",SUM(H6:H27)),\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",SUM(I6:I27)),\"ERROR\")","v":{"v":5601.129999999999,"d":"$5,601"}}]
[null,"Total (rounded)",{"$f":"MROUND(C28,IF(C28>=100,100,10))","v":{"v":5600,"d":"$5,600"}},{"$f":"IFERROR(C29-E29,\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",MIN(SUM(F29:H29),BENEFIT_DESIGN!C36)+I29),\"ERROR\")","v":{"v":5600,"d":"$5,600"}},{"$f":"IFERROR(\nIF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",\nMIN(\nMROUND(F28,IF(F28>=100,100,10)),\nBENEFIT_PARAMETERS!$O$80)\n),\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",MROUND(G28,IF(G28>=100,100,10))),\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",MROUND(H28,IF(H28>=100,100,10))),\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",MROUND(I28,IF(I28>=100,100,10))),\"ERROR\")","v":{"v":5600,"d":"$5,600"}}]

{"sheet":"MATERNITY_TIMELINE","index":12,"n_rows":53,"n_cols":80,"rows_kept":53,"hidden":true}
[{"$nulls":79},{"$f":"COUNTIF(CB4:CB53,FALSE)=0","v":true}]
[{"$nulls":7},"Phase 1: Determine Covered Amount",null,null,"Phase 2: Apply OOP Limit",{"$nulls":3},"Phase 3a: Apply Special cost sharing - Begin Primary Care cost-sharing after a set number of visits?",{"$nulls":5},"Phase 3b: Apply special cost sharing: Begin primary care cost sharing deductible or coinsurance after a set number of copays?",{"$nulls":8},"Phase 4: Apply monthly/annual limit",{"$nulls":9},"Phase 5: Plan deductible",{"$nulls":3},"Phase 5: Rx deductible",{"$nulls":3},"Phase 5: Optional deductible C",{"$nulls":3},"Phase 5: Optional deductible D",{"$nulls":3},"Phase 5: Benefit deductible",{"$nulls":3},"Phase 5 Summary",null,"Phase 6: Apply copay and coinsurance",{"$nulls":8},"Phase 7: Calculate total subscriber pays",null,null,"Phase 8: Summarize payments by payer and phase category"]
["Claim number","Date","Calendar Month","Item or Service Code","Description","Benefit Category","Cost-sharing type","Allowed amount","Service Not covered","Remaining Covered Amount","OPL Valid?","OPL applies","OPL","Remaining OPL after previous subscriber payments","Primary Care Visit?","Begin Primary Care Cost-Sharing After A Set Number of Visits?","# Visits","Primary Care Prior Use","Visit Covered at 100% by plan","Remaining Covered Amount","Primary Care Visit?","Begin Primary Care Cost-Sharing Deductible or Coinsurance After a Set Number of Copays?","# Visits","Primary Care Prior Copay Paid","Copay Value","Subscriber-Paid Copay","Plan Paid","Remaining OPL","Remaining Covered Amount","Monthly Limit Valid?","Monthly limit","Prior use (month)","Not Covered because monthly limit exceeded","Annual Limit Valid?","Annual limit","Prior use (annual)","Not Covered because use limit exceeded","Total Not Covered because use limit exceeded","Covered amount","Uses Plan deductible?","Plan Deductible","Remaining plan deductible after previous subscriber payments","subscriber pays toward plan deductible","Uses rx deductible?","Rx Deductible","Remaining Rx deductible after previous subscriber payments","subscriber pays toward Rx deductible","Uses deductible C?","Deductible C","Remaining deductible C after previous subscriber payments","subscriber pays toward deductible C","Uses deductible D?","Deductible D","Remaining deductible D after previous subscriber payments","subscriber pays toward deductible D","Uses benefit deductible?","Benefit deductible","Remaining benefit deductible after previous subcriber payments","subscriber pays toward benefit deductible","subscriber pays toward any deductible","Subscriber-paid deductible after applying OPL","Remaining OPL","Covered amount remaining after deductibles","Uses Copay?","Copay Value","Copay Paid","Uses Coinsurance?","Coinsurance Value","Coinsurance Paid","Subscriber-paid costsharing after OPL","Remaining OPL","Allowed amount after copayment or coinsurance","Total subscriber payment After OPL","plan payment","Service Not covered","Exclusions","Subscriber-paid deductible","Subscriber-paid copayment","Subscriber-paid coinsurance","Allowable Charge ChkSum"]
[1,"2016-01-07",1,8,{"$f":"VLOOKUP(ServiceCode,MaternityFeeSchedule,6,FALSE)","v":"Prenatal Vitamins (OTC - Bottle of 100) [1 pill daily; 30 pills/month]"},{"$f":"VLOOKUP(ServiceCode,MaternityFeeSchedule,5,FALSE)","v":"Over-the-counter Drugs"},{"$f":"VLOOKUP(BenefitCategory,BenefitDesignTable,COLUMN(BenefitCostSharing),FALSE)","v":"Not Covered"},{"$f":"VLOOKUP(D4,MaternityFeeSchedule,7,FALSE)","v":{"v":11.48,"d":"$11.48"}},{"$f":"IF(G4=\"Not Covered\",H4,0)","v":{"v":11.48,"d":"$11.48"}},{"$f":"H4-I4","v":0},{"$f":"VLOOKUP(F4,nrCoverageTable,COLUMN(nrOOPLimitValid),FALSE)","v":false},{"$f":"IF(K4,VLOOKUP(F4,BenefitDesignTable,COLUMN(BenefitOOPLimitApplies),FALSE),\"No\")","v":"No"},{"$f":"VLOOKUP(F4,BenefitDesignTable,COLUMN(OPLimit),FALSE)","v":"."},{"$f":"IFERROR(IF(AND(L4=\"Yes\",ISNUMBER(M4)),MAX(0,M4-SUMIFS(BU$3:BU3,L$3:L3,\"Yes\")),IF(OR(L4=\"No\",M4=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},{"$f":"IF(F4=\"Professional Services: Primary Care\",TRUE, FALSE)","v":false},{"$f":"IF(O4,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P4=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},{"$f":"IF(O4,COUNTIFS(BenefitCategory,\"Professional Services: Primary Care\",ClaimNumber,\"<\"&A4),\"N/A\")","v":"N/A"},{"$f":"IF(P4=\"Yes\",IF(R4<Q4,MIN(J4,N4),0),0)","v":0},{"$f":"J4-S4","v":{"v":0,"d":"$0.00"}},{"$f":"IF(F4=\"Professional Services: Primary Care\",TRUE, FALSE)","v":false},{"$f":"IF(O4,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V4=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O4,COUNTIF(Z$3:Z3,\">0\"),\"N/A\")","v":"N/A"},{"$f":"IF(V4=\"Yes\",VLOOKUP(\"Professional Services: Primary Care\",BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(V4=\"Yes\",U4=TRUE,X4<W4), MIN(Y4,T4,N4),\"N/A\")","v":"N/A"},{"$f":"IF(Z4=\"N/A\",0,T4-Z4)","v":0},{"$f":"IF(L4=\"Yes\",IF(Z4=\"N/A\",N4,N4-Z4),\"N/A\")","v":"N/A"},{"$f":"IF(Z4=\"N/A\",T4,0)","v":{"v":0,"d":"$0.00"}},{"$f":"VLOOKUP(F4,nrCoverageTable,COLUMN(nrMonthlyLimitValid),FALSE)","v":false},{"$f":"IF(AD4,VLOOKUP(F4,BenefitDesignTable,COLUMN(BenefitLimithMonth),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D4,ClaimMonth,C4,ClaimNumber,\"<\"&A4)","v":0},{"$f":"IF(AD4,IF(OR(AE4=\"None\",ISNUMBER(AE4)),IF(AF4>=AE4,H4,0),\"ERR\"),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F4,nrCoverageTable,COLUMN(nrAnnualLimitValid),FALSE)","v":false},{"$f":"IF(AH4,VLOOKUP(F4,BenefitDesignTable,COLUMN(BenefitLimitAnnual),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D4,ClaimNumber,\"<\"&A4)","v":0},{"$f":"IF(AH4,IF(OR(AI4=\"None\",ISNUMBER(AI4)),IF(AJ4>=AI4,H4,0),\"ERR\"),\"N/A\")","v":"N/A"},{"$f":"IF(OR(AG4=\"ERR\",AK4=\"ERR\"),\"ERR\",MAX(AG4,AK4))","v":0},{"$f":"IFERROR(AC4-AL4,\"ERR\")","v":0},{"$f":"VLOOKUP(F4,nrCoverageTable,COLUMN(nrUsesPlanDeduct),FALSE)","v":false},{"$f":"IF(AN4,VLOOKUP(F4,BenefitDesignTable,COLUMN(PlanDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(ISNUMBER(AO4),AN4=TRUE),MAX(0,AO4-SUMIFS($AM$3:$AM3,AN$3:AN3,TRUE)),IF(AND(AN4=TRUE,ISNUMBER(AO4)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AP4),MIN($AM4,AP4),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F4,nrCoverageTable,COLUMN(nrUsesRxDeduct),FALSE)","v":false},{"$f":"IF(AR4,VLOOKUP(F4,BenefitDesignTable,COLUMN(RxDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AR4=TRUE,ISNUMBER(AS4)),MAX(0,AS4-SUMIFS($AM$3:$AM3,AR$3:AR3,TRUE)),IF(AND(AR4=TRUE,ISNUMBER(AS4)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AT4),MIN($AM4,AT4),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F4,nrCoverageTable,COLUMN(nrUsesDeductC),FALSE)","v":false},{"$f":"IF(AV4,VLOOKUP(F4,BenefitDesignTable,COLUMN(OptDeductibleC),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AV4=TRUE,ISNUMBER(AW4)),MAX(0,AW4-SUMIFS($AM$3:$AM3,AV$3:AV3,TRUE)),IF(AND(AV4=TRUE,ISNUMBER(AW4)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AX4),MIN($AM4,AX4),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F4,nrCoverageTable,COLUMN(nrUsesDeductD),FALSE)","v":false},{"$f":"IF(AZ4,VLOOKUP(F4,BenefitDesignTable,COLUMN(OptDeductibleD),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AZ4=TRUE,ISNUMBER(BA4)),MAX(0,BA4-SUMIFS($AM$3:$AM3,AZ$3:AZ3,TRUE)),IF(AND(AZ4=TRUE,ISNUMBER(BA4)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BB4),MIN($AM4,BB4),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F4,nrCoverageTable,COLUMN(nrUsesBenDeduct),FALSE)","v":false},{"$f":"IF(BD4,VLOOKUP(F4,BenefitDesignTable,COLUMN(BenefitDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(BD4=TRUE,ISNUMBER(BE4)=TRUE),MAX(0,BE4-SUMIFS(AM$3:AM3,BD$3:BD3,TRUE,F$3:F3,F4)),IF(AND(BD4=TRUE,ISNUMBER(BE4)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BF4),MIN($AM4,BF4),\"N/A\")","v":"N/A"},{"$f":"SUM(AQ4,AU4,AY4,BC4,BG4)","v":0},{"$f":"IF(OR(AB4=\"ERR\",BH4=\"ERR\"),\"ERR\",MIN(BH4,AB4))","v":0},{"$f":"IF(AND(L4=\"Yes\",ISNUMBER(M4)),IF(OR(BI4=\"ERR\",AB4=\"ERR\"),\"ERR\",MAX($AB4-BI4,0)),\"N/A\")","v":"N/A"},{"$f":"IF(OR(BI4=\"ERR\",AM4=\"ERR\"),\"ERR\",MAX(0,AM4-BI4))","v":0},{"$f":"VLOOKUP(F4,nrCoverageTable,COLUMN(nrUsesCopay),FALSE)","v":false},{"$f":"IF(BL4,VLOOKUP(F4,BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(BK4=\"ERR\",\"ERR\",IF(AND(BL4=TRUE,ISNUMBER(BM4)),MIN(BK4,BM4,BJ4),IF(AND(BL4=TRUE,ISNUMBER(BM4)=FALSE),\"ERR\",\"N/A\")))","v":"N/A"},{"$f":"VLOOKUP(F4,nrCoverageTable,COLUMN(nrUsesCoins),FALSE)","v":false},{"$f":"IF(BO4,VLOOKUP(F4,BenefitDesignTable,COLUMN(BenefitCoins),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(BK4=\"ERR\",\"ERR\",IF(AND(BO4=TRUE,ISNUMBER(BP4)=TRUE),MIN(BJ4,BK4*BP4),IF(AND(BO4=TRUE,ISNUMBER(BP4)=FALSE),\"ERR\",\"N/A\")))","v":"N/A"},{"$f":"IF(OR(BJ4=\"ERR\",BN4=\"ERR\",BQ4=\"ERR\"),\"ERR\",MIN(BJ4,SUM(BN4,BQ4)))","v":0},{"$f":"IF(AND(L4=\"Yes\",ISNUMBER(M4)),IF(OR(BJ4=\"ERR\",BR4=\"ERR\"),\"ERR\",MAX(BJ4-BR4,0)),\"N/A\")","v":"N/A"},{"$f":"IF(OR(BK4=\"ERR\",BR4=\"ERR\"),\"ERR\",MAX(BK4-BR4,0))","v":0},{"$f":"IF(OR(BI4=\"ERR\",BR4=\"ERR\"),\"ERR\",SUM(BI4,BR4,Z4))","v":0},{"$f":"IF(OR(AM4=\"ERR\",BU4=\"ERR\"),\"ERR\",MAX(S4+AA4+AM4-BI4-BR4,0))","v":0},{"$f":"I4","v":{"v":11.48,"d":"$11.48"}},{"$f":"IF(OR(AG4=\"ERR\",AK4=\"ERR\"),\"ERR\",SUM(AG4,AK4))","v":0},{"$f":"BI4","v":0},{"$f":"IF(V4=\"Yes\",IF(Z4=\"N/A\",0,Z4),0)+IF(BL4,BN4,0)","v":0},{"$f":"IF(BO4,BQ4,0)","v":0},{"$f":"SUM(BV4:CA4)=H4","v":true}]
[2,"2016-04-01",4,14,"Obstetric Panel","Diagnostic Services: Laboratory","Not Covered",{"v":56.04,"d":"$56.04"},{"v":56.04,"d":"$56.04"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L5=\"Yes\",ISNUMBER(M5)),MAX(0,M5-SUMIFS(BU$3:BU4,L$3:L4,\"Yes\")),IF(OR(L5=\"No\",M5=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},{"$f":"IF(F5=\"Professional Services: Primary Care\",TRUE, FALSE)","v":false},{"$f":"IF(O5,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P5=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",{"$f":"IF(P5=\"Yes\",IF(R5<Q5,MIN(J5,N5),0),0)","v":0},0,{"$f":"IF(F5=\"Professional Services: Primary Care\",TRUE, FALSE)","v":false},{"$f":"IF(O5,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V5=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O5,COUNTIF(Z$3:Z4,\">0\"),\"N/A\")","v":"N/A"},"N/A",{"$f":"IF(AND(V5=\"Yes\",U5=TRUE,X5<W5), MIN(Y5,T5,N5),\"N/A\")","v":"N/A"},{"$f":"IF(Z5=\"N/A\",0,T5-Z5)","v":0},"N/A",{"$f":"IF(Z5=\"N/A\",T5,0)","v":0},false,".",0,"N/A",false,".",0,"N/A",{"$f":"IF(OR(AG5=\"ERR\",AK5=\"ERR\"),\"ERR\",MAX(AG5,AK5))","v":0},{"$f":"IFERROR(AC5-AL5,\"ERR\")","v":0},false,"N/A",{"$f":"IF(AND(ISNUMBER(AO5),AN5=TRUE),MAX(0,AO5-SUMIFS($AM$3:$AM4,AN$3:AN4,TRUE)),IF(AND(AN5=TRUE,ISNUMBER(AO5)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR5=TRUE,ISNUMBER(AS5)),MAX(0,AS5-SUMIFS($AM$3:$AM4,AR$3:AR4,TRUE)),IF(AND(AR5=TRUE,ISNUMBER(AS5)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV5=TRUE,ISNUMBER(AW5)),MAX(0,AW5-SUMIFS($AM$3:$AM4,AV$3:AV4,TRUE)),IF(AND(AV5=TRUE,ISNUMBER(AW5)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ5=TRUE,ISNUMBER(BA5)),MAX(0,BA5-SUMIFS($AM$3:$AM4,AZ$3:AZ4,TRUE)),IF(AND(AZ5=TRUE,ISNUMBER(BA5)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD5=TRUE,ISNUMBER(BE5)=TRUE),MAX(0,BE5-SUMIFS(AM$3:AM4,BD$3:BD4,TRUE,F$3:F4,F5)),IF(AND(BD5=TRUE,ISNUMBER(BE5)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,{"$f":"IF(OR(AB5=\"ERR\",BH5=\"ERR\"),\"ERR\",MIN(BH5,AB5))","v":0},{"$f":"IF(AND(L5=\"Yes\",ISNUMBER(M5)),IF(OR(BI5=\"ERR\",AB5=\"ERR\"),\"ERR\",MAX($AB5-BI5,0)),\"N/A\")","v":"N/A"},0,false,"N/A",{"$f":"IF(BK5=\"ERR\",\"ERR\",IF(AND(BL5=TRUE,ISNUMBER(BM5)),MIN(BK5,BM5,BJ5),IF(AND(BL5=TRUE,ISNUMBER(BM5)=FALSE),\"ERR\",\"N/A\")))","v":"N/A"},false,"N/A",{"$f":"IF(BK5=\"ERR\",\"ERR\",IF(AND(BO5=TRUE,ISNUMBER(BP5)=TRUE),MIN(BJ5,BK5*BP5),IF(AND(BO5=TRUE,ISNUMBER(BP5)=FALSE),\"ERR\",\"N/A\")))","v":"N/A"},{"$f":"IF(OR(BJ5=\"ERR\",BN5=\"ERR\",BQ5=\"ERR\"),\"ERR\",MIN(BJ5,SUM(BN5,BQ5)))","v":0},{"$f":"IF(AND(L5=\"Yes\",ISNUMBER(M5)),IF(OR(BJ5=\"ERR\",BR5=\"ERR\"),\"ERR\",MAX(BJ5-BR5,0)),\"N/A\")","v":"N/A"},{"$f":"IF(OR(BK5=\"ERR\",BR5=\"ERR\"),\"ERR\",MAX(BK5-BR5,0))","v":0},{"$f":"IF(OR(BI5=\"ERR\",BR5=\"ERR\"),\"ERR\",SUM(BI5,BR5,Z5))","v":0},{"$f":"IF(OR(AM5=\"ERR\",BU5=\"ERR\"),\"ERR\",MAX(S5+AA5+AM5-BI5-BR5,0))","v":0},{"v":56.04,"d":"$56.04"},0,{"$f":"BI5","v":0},0,{"$f":"IF(BO5,BQ5,0)","v":0},true]
[3,"2016-04-01",4,30,"Detect agnt mult dna ampli ","Diagnostic Services: Laboratory","Not Covered",{"v":119.67,"d":"$119.67"},{"v":119.67,"d":"$119.67"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L6=\"Yes\",ISNUMBER(M6)),MAX(0,M6-SUMIFS(BU$3:BU5,L$3:L5,\"Yes\")),IF(OR(L6=\"No\",M6=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O6,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P6=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O6,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V6=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O6,COUNTIF(Z$3:Z5,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO6),AN6=TRUE),MAX(0,AO6-SUMIFS($AM$3:$AM5,AN$3:AN5,TRUE)),IF(AND(AN6=TRUE,ISNUMBER(AO6)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR6=TRUE,ISNUMBER(AS6)),MAX(0,AS6-SUMIFS($AM$3:$AM5,AR$3:AR5,TRUE)),IF(AND(AR6=TRUE,ISNUMBER(AS6)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV6=TRUE,ISNUMBER(AW6)),MAX(0,AW6-SUMIFS($AM$3:$AM5,AV$3:AV5,TRUE)),IF(AND(AV6=TRUE,ISNUMBER(AW6)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ6=TRUE,ISNUMBER(BA6)),MAX(0,BA6-SUMIFS($AM$3:$AM5,AZ$3:AZ5,TRUE)),IF(AND(AZ6=TRUE,ISNUMBER(BA6)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD6=TRUE,ISNUMBER(BE6)=TRUE),MAX(0,BE6-SUMIFS(AM$3:AM5,BD$3:BD5,TRUE,F$3:F5,F6)),IF(AND(BD6=TRUE,ISNUMBER(BE6)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":119.67,"d":"$119.67"},0,0,0,0,true]
[4,"2016-04-01",4,31,"Cytopath c/v auto fluid redo","Diagnostic Services: Laboratory","Not Covered",{"v":36.94,"d":"$36.94"},{"v":36.94,"d":"$36.94"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L7=\"Yes\",ISNUMBER(M7)),MAX(0,M7-SUMIFS(BU$3:BU6,L$3:L6,\"Yes\")),IF(OR(L7=\"No\",M7=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O7,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P7=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O7,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V7=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O7,COUNTIF(Z$3:Z6,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO7),AN7=TRUE),MAX(0,AO7-SUMIFS($AM$3:$AM6,AN$3:AN6,TRUE)),IF(AND(AN7=TRUE,ISNUMBER(AO7)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR7=TRUE,ISNUMBER(AS7)),MAX(0,AS7-SUMIFS($AM$3:$AM6,AR$3:AR6,TRUE)),IF(AND(AR7=TRUE,ISNUMBER(AS7)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV7=TRUE,ISNUMBER(AW7)),MAX(0,AW7-SUMIFS($AM$3:$AM6,AV$3:AV6,TRUE)),IF(AND(AV7=TRUE,ISNUMBER(AW7)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ7=TRUE,ISNUMBER(BA7)),MAX(0,BA7-SUMIFS($AM$3:$AM6,AZ$3:AZ6,TRUE)),IF(AND(AZ7=TRUE,ISNUMBER(BA7)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD7=TRUE,ISNUMBER(BE7)=TRUE),MAX(0,BE7-SUMIFS(AM$3:AM6,BD$3:BD6,TRUE,F$3:F6,F7)),IF(AND(BD7=TRUE,ISNUMBER(BE7)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":36.94,"d":"$36.94"},0,0,0,0,true]
[5,"2016-04-01",4,28,"HIV-1","Diagnostic Services: Laboratory","Not Covered",{"v":17.37,"d":"$17.37"},{"v":17.37,"d":"$17.37"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L8=\"Yes\",ISNUMBER(M8)),MAX(0,M8-SUMIFS(BU$3:BU7,L$3:L7,\"Yes\")),IF(OR(L8=\"No\",M8=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O8,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P8=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O8,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V8=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O8,COUNTIF(Z$3:Z7,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO8),AN8=TRUE),MAX(0,AO8-SUMIFS($AM$3:$AM7,AN$3:AN7,TRUE)),IF(AND(AN8=TRUE,ISNUMBER(AO8)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR8=TRUE,ISNUMBER(AS8)),MAX(0,AS8-SUMIFS($AM$3:$AM7,AR$3:AR7,TRUE)),IF(AND(AR8=TRUE,ISNUMBER(AS8)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV8=TRUE,ISNUMBER(AW8)),MAX(0,AW8-SUMIFS($AM$3:$AM7,AV$3:AV7,TRUE)),IF(AND(AV8=TRUE,ISNUMBER(AW8)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ8=TRUE,ISNUMBER(BA8)),MAX(0,BA8-SUMIFS($AM$3:$AM7,AZ$3:AZ7,TRUE)),IF(AND(AZ8=TRUE,ISNUMBER(BA8)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD8=TRUE,ISNUMBER(BE8)=TRUE),MAX(0,BE8-SUMIFS(AM$3:AM7,BD$3:BD7,TRUE,F$3:F7,F8)),IF(AND(BD8=TRUE,ISNUMBER(BE8)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":17.37,"d":"$17.37"},0,0,0,0,true]
[6,"2016-04-01",4,12,"Routine Venipuncture","Diagnostic Services: Laboratory","Not Covered",{"v":5.3,"d":"$5.30"},{"v":5.3,"d":"$5.30"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L9=\"Yes\",ISNUMBER(M9)),MAX(0,M9-SUMIFS(BU$3:BU8,L$3:L8,\"Yes\")),IF(OR(L9=\"No\",M9=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O9,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P9=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O9,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V9=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O9,COUNTIF(Z$3:Z8,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO9),AN9=TRUE),MAX(0,AO9-SUMIFS($AM$3:$AM8,AN$3:AN8,TRUE)),IF(AND(AN9=TRUE,ISNUMBER(AO9)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR9=TRUE,ISNUMBER(AS9)),MAX(0,AS9-SUMIFS($AM$3:$AM8,AR$3:AR8,TRUE)),IF(AND(AR9=TRUE,ISNUMBER(AS9)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV9=TRUE,ISNUMBER(AW9)),MAX(0,AW9-SUMIFS($AM$3:$AM8,AV$3:AV8,TRUE)),IF(AND(AV9=TRUE,ISNUMBER(AW9)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ9=TRUE,ISNUMBER(BA9)),MAX(0,BA9-SUMIFS($AM$3:$AM8,AZ$3:AZ8,TRUE)),IF(AND(AZ9=TRUE,ISNUMBER(BA9)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD9=TRUE,ISNUMBER(BE9)=TRUE),MAX(0,BE9-SUMIFS(AM$3:AM8,BD$3:BD8,TRUE,F$3:F8,F9)),IF(AND(BD9=TRUE,ISNUMBER(BE9)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":5.3,"d":"$5.30"},0,0,0,0,true]
[7,"2016-04-01",4,35,"Urine Pregnancy Test","Diagnostic Services: Laboratory","Not Covered",{"v":9.86,"d":"$9.86"},{"v":9.86,"d":"$9.86"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L10=\"Yes\",ISNUMBER(M10)),MAX(0,M10-SUMIFS(BU$3:BU9,L$3:L9,\"Yes\")),IF(OR(L10=\"No\",M10=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O10,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P10=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O10,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V10=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O10,COUNTIF(Z$3:Z9,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO10),AN10=TRUE),MAX(0,AO10-SUMIFS($AM$3:$AM9,AN$3:AN9,TRUE)),IF(AND(AN10=TRUE,ISNUMBER(AO10)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR10=TRUE,ISNUMBER(AS10)),MAX(0,AS10-SUMIFS($AM$3:$AM9,AR$3:AR9,TRUE)),IF(AND(AR10=TRUE,ISNUMBER(AS10)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV10=TRUE,ISNUMBER(AW10)),MAX(0,AW10-SUMIFS($AM$3:$AM9,AV$3:AV9,TRUE)),IF(AND(AV10=TRUE,ISNUMBER(AW10)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ10=TRUE,ISNUMBER(BA10)),MAX(0,BA10-SUMIFS($AM$3:$AM9,AZ$3:AZ9,TRUE)),IF(AND(AZ10=TRUE,ISNUMBER(BA10)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD10=TRUE,ISNUMBER(BE10)=TRUE),MAX(0,BE10-SUMIFS(AM$3:AM9,BD$3:BD9,TRUE,F$3:F9,F10)),IF(AND(BD10=TRUE,ISNUMBER(BE10)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":9.86,"d":"$9.86"},0,0,0,0,true]
[8,"2016-04-01",4,6,"Obstetrical Care","Professional Services: Obstetric Care (Bundled)","Not Covered",{"v":2609.93,"d":"$2,609.93"},{"v":2609.93,"d":"$2,609.93"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L11=\"Yes\",ISNUMBER(M11)),MAX(0,M11-SUMIFS(BU$3:BU10,L$3:L10,\"Yes\")),IF(OR(L11=\"No\",M11=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O11,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P11=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O11,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V11=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O11,COUNTIF(Z$3:Z10,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO11),AN11=TRUE),MAX(0,AO11-SUMIFS($AM$3:$AM10,AN$3:AN10,TRUE)),IF(AND(AN11=TRUE,ISNUMBER(AO11)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR11=TRUE,ISNUMBER(AS11)),MAX(0,AS11-SUMIFS($AM$3:$AM10,AR$3:AR10,TRUE)),IF(AND(AR11=TRUE,ISNUMBER(AS11)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV11=TRUE,ISNUMBER(AW11)),MAX(0,AW11-SUMIFS($AM$3:$AM10,AV$3:AV10,TRUE)),IF(AND(AV11=TRUE,ISNUMBER(AW11)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ11=TRUE,ISNUMBER(BA11)),MAX(0,BA11-SUMIFS($AM$3:$AM10,AZ$3:AZ10,TRUE)),IF(AND(AZ11=TRUE,ISNUMBER(BA11)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD11=TRUE,ISNUMBER(BE11)=TRUE),MAX(0,BE11-SUMIFS(AM$3:AM10,BD$3:BD10,TRUE,F$3:F10,F11)),IF(AND(BD11=TRUE,ISNUMBER(BE11)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":2609.93,"d":"$2,609.93"},0,0,0,0,true]
[9,"2016-04-01",4,42,"Urine culture/colony count","Diagnostic Services: Laboratory","Not Covered",{"v":13.12,"d":"$13.12"},{"v":13.12,"d":"$13.12"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L12=\"Yes\",ISNUMBER(M12)),MAX(0,M12-SUMIFS(BU$3:BU11,L$3:L11,\"Yes\")),IF(OR(L12=\"No\",M12=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O12,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P12=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O12,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V12=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O12,COUNTIF(Z$3:Z11,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO12),AN12=TRUE),MAX(0,AO12-SUMIFS($AM$3:$AM11,AN$3:AN11,TRUE)),IF(AND(AN12=TRUE,ISNUMBER(AO12)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR12=TRUE,ISNUMBER(AS12)),MAX(0,AS12-SUMIFS($AM$3:$AM11,AR$3:AR11,TRUE)),IF(AND(AR12=TRUE,ISNUMBER(AS12)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV12=TRUE,ISNUMBER(AW12)),MAX(0,AW12-SUMIFS($AM$3:$AM11,AV$3:AV11,TRUE)),IF(AND(AV12=TRUE,ISNUMBER(AW12)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ12=TRUE,ISNUMBER(BA12)),MAX(0,BA12-SUMIFS($AM$3:$AM11,AZ$3:AZ11,TRUE)),IF(AND(AZ12=TRUE,ISNUMBER(BA12)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD12=TRUE,ISNUMBER(BE12)=TRUE),MAX(0,BE12-SUMIFS(AM$3:AM11,BD$3:BD11,TRUE,F$3:F11,F12)),IF(AND(BD12=TRUE,ISNUMBER(BE12)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":13.12,"d":"$13.12"},0,0,0,0,true]
[10,"2016-04-01",4,43,"Urinalysis auto w/scope","Diagnostic Services: Laboratory","Not Covered",{"v":8.67,"d":"$8.67"},{"v":8.67,"d":"$8.67"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L13=\"Yes\",ISNUMBER(M13)),MAX(0,M13-SUMIFS(BU$3:BU12,L$3:L12,\"Yes\")),IF(OR(L13=\"No\",M13=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O13,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P13=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O13,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V13=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O13,COUNTIF(Z$3:Z12,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO13),AN13=TRUE),MAX(0,AO13-SUMIFS($AM$3:$AM12,AN$3:AN12,TRUE)),IF(AND(AN13=TRUE,ISNUMBER(AO13)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR13=TRUE,ISNUMBER(AS13)),MAX(0,AS13-SUMIFS($AM$3:$AM12,AR$3:AR12,TRUE)),IF(AND(AR13=TRUE,ISNUMBER(AS13)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV13=TRUE,ISNUMBER(AW13)),MAX(0,AW13-SUMIFS($AM$3:$AM12,AV$3:AV12,TRUE)),IF(AND(AV13=TRUE,ISNUMBER(AW13)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ13=TRUE,ISNUMBER(BA13)),MAX(0,BA13-SUMIFS($AM$3:$AM12,AZ$3:AZ12,TRUE)),IF(AND(AZ13=TRUE,ISNUMBER(BA13)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD13=TRUE,ISNUMBER(BE13)=TRUE),MAX(0,BE13-SUMIFS(AM$3:AM12,BD$3:BD12,TRUE,F$3:F12,F13)),IF(AND(BD13=TRUE,ISNUMBER(BE13)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":8.67,"d":"$8.67"},0,0,0,0,true]
[11,"2016-04-01",4,44,"Chylmd trach dna amp probe","Diagnostic Services: Laboratory","Not Covered",{"v":44.48,"d":"$44.48"},{"v":44.48,"d":"$44.48"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L14=\"Yes\",ISNUMBER(M14)),MAX(0,M14-SUMIFS(BU$3:BU13,L$3:L13,\"Yes\")),IF(OR(L14=\"No\",M14=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O14,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P14=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O14,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V14=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O14,COUNTIF(Z$3:Z13,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO14),AN14=TRUE),MAX(0,AO14-SUMIFS($AM$3:$AM13,AN$3:AN13,TRUE)),IF(AND(AN14=TRUE,ISNUMBER(AO14)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR14=TRUE,ISNUMBER(AS14)),MAX(0,AS14-SUMIFS($AM$3:$AM13,AR$3:AR13,TRUE)),IF(AND(AR14=TRUE,ISNUMBER(AS14)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV14=TRUE,ISNUMBER(AW14)),MAX(0,AW14-SUMIFS($AM$3:$AM13,AV$3:AV13,TRUE)),IF(AND(AV14=TRUE,ISNUMBER(AW14)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ14=TRUE,ISNUMBER(BA14)),MAX(0,BA14-SUMIFS($AM$3:$AM13,AZ$3:AZ13,TRUE)),IF(AND(AZ14=TRUE,ISNUMBER(BA14)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD14=TRUE,ISNUMBER(BE14)=TRUE),MAX(0,BE14-SUMIFS(AM$3:AM13,BD$3:BD13,TRUE,F$3:F13,F14)),IF(AND(BD14=TRUE,ISNUMBER(BE14)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":44.48,"d":"$44.48"},0,0,0,0,true]
[12,"2016-04-01",4,45,"N.gonorrhoeae dna amp prob","Diagnostic Services: Laboratory","Not Covered",{"v":43.82,"d":"$43.82"},{"v":43.82,"d":"$43.82"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L15=\"Yes\",ISNUMBER(M15)),MAX(0,M15-SUMIFS(BU$3:BU14,L$3:L14,\"Yes\")),IF(OR(L15=\"No\",M15=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O15,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P15=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O15,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V15=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O15,COUNTIF(Z$3:Z14,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO15),AN15=TRUE),MAX(0,AO15-SUMIFS($AM$3:$AM14,AN$3:AN14,TRUE)),IF(AND(AN15=TRUE,ISNUMBER(AO15)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR15=TRUE,ISNUMBER(AS15)),MAX(0,AS15-SUMIFS($AM$3:$AM14,AR$3:AR14,TRUE)),IF(AND(AR15=TRUE,ISNUMBER(AS15)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV15=TRUE,ISNUMBER(AW15)),MAX(0,AW15-SUMIFS($AM$3:$AM14,AV$3:AV14,TRUE)),IF(AND(AV15=TRUE,ISNUMBER(AW15)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ15=TRUE,ISNUMBER(BA15)),MAX(0,BA15-SUMIFS($AM$3:$AM14,AZ$3:AZ14,TRUE)),IF(AND(AZ15=TRUE,ISNUMBER(BA15)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD15=TRUE,ISNUMBER(BE15)=TRUE),MAX(0,BE15-SUMIFS(AM$3:AM14,BD$3:BD14,TRUE,F$3:F14,F15)),IF(AND(BD15=TRUE,ISNUMBER(BE15)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":43.82,"d":"$43.82"},0,0,0,0,true]
[13,"2016-04-07",4,32,"Office/Outpatient Visit Est","Professional Services: Obstetric Care (Bundled)","Not Covered",0,0,0,false,"No",".",{"$f":"IFERROR(IF(AND(L16=\"Yes\",ISNUMBER(M16)),MAX(0,M16-SUMIFS(BU$3:BU15,L$3:L15,\"Yes\")),IF(OR(L16=\"No\",M16=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O16,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P16=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O16,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V16=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O16,COUNTIF(Z$3:Z15,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO16),AN16=TRUE),MAX(0,AO16-SUMIFS($AM$3:$AM15,AN$3:AN15,TRUE)),IF(AND(AN16=TRUE,ISNUMBER(AO16)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR16=TRUE,ISNUMBER(AS16)),MAX(0,AS16-SUMIFS($AM$3:$AM15,AR$3:AR15,TRUE)),IF(AND(AR16=TRUE,ISNUMBER(AS16)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV16=TRUE,ISNUMBER(AW16)),MAX(0,AW16-SUMIFS($AM$3:$AM15,AV$3:AV15,TRUE)),IF(AND(AV16=TRUE,ISNUMBER(AW16)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ16=TRUE,ISNUMBER(BA16)),MAX(0,BA16-SUMIFS($AM$3:$AM15,AZ$3:AZ15,TRUE)),IF(AND(AZ16=TRUE,ISNUMBER(BA16)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD16=TRUE,ISNUMBER(BE16)=TRUE),MAX(0,BE16-SUMIFS(AM$3:AM15,BD$3:BD15,TRUE,F$3:F15,F16)),IF(AND(BD16=TRUE,ISNUMBER(BE16)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,0,0,0,0,0,true]
[14,"2016-04-07",4,8,"Prenatal Vitamins (OTC - Bottle of 100) [1 pill daily; 30 pills/month]","Over-the-counter Drugs","Not Covered",{"v":11.48,"d":"$11.48"},{"v":11.48,"d":"$11.48"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L17=\"Yes\",ISNUMBER(M17)),MAX(0,M17-SUMIFS(BU$3:BU16,L$3:L16,\"Yes\")),IF(OR(L17=\"No\",M17=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O17,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P17=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O17,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V17=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O17,COUNTIF(Z$3:Z16,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",1,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO17),AN17=TRUE),MAX(0,AO17-SUMIFS($AM$3:$AM16,AN$3:AN16,TRUE)),IF(AND(AN17=TRUE,ISNUMBER(AO17)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR17=TRUE,ISNUMBER(AS17)),MAX(0,AS17-SUMIFS($AM$3:$AM16,AR$3:AR16,TRUE)),IF(AND(AR17=TRUE,ISNUMBER(AS17)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV17=TRUE,ISNUMBER(AW17)),MAX(0,AW17-SUMIFS($AM$3:$AM16,AV$3:AV16,TRUE)),IF(AND(AV17=TRUE,ISNUMBER(AW17)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ17=TRUE,ISNUMBER(BA17)),MAX(0,BA17-SUMIFS($AM$3:$AM16,AZ$3:AZ16,TRUE)),IF(AND(AZ17=TRUE,ISNUMBER(BA17)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD17=TRUE,ISNUMBER(BE17)=TRUE),MAX(0,BE17-SUMIFS(AM$3:AM16,BD$3:BD16,TRUE,F$3:F16,F17)),IF(AND(BD17=TRUE,ISNUMBER(BE17)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":11.48,"d":"$11.48"},0,0,0,0,true]
[15,"2016-05-27",5,32,"Office/Outpatient Visit Est","Professional Services: Obstetric Care (Bundled)","Not Covered",0,0,0,false,"No",".",{"$f":"IFERROR(IF(AND(L18=\"Yes\",ISNUMBER(M18)),MAX(0,M18-SUMIFS(BU$3:BU17,L$3:L17,\"Yes\")),IF(OR(L18=\"No\",M18=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O18,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P18=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O18,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V18=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O18,COUNTIF(Z$3:Z17,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",1,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO18),AN18=TRUE),MAX(0,AO18-SUMIFS($AM$3:$AM17,AN$3:AN17,TRUE)),IF(AND(AN18=TRUE,ISNUMBER(AO18)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR18=TRUE,ISNUMBER(AS18)),MAX(0,AS18-SUMIFS($AM$3:$AM17,AR$3:AR17,TRUE)),IF(AND(AR18=TRUE,ISNUMBER(AS18)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV18=TRUE,ISNUMBER(AW18)),MAX(0,AW18-SUMIFS($AM$3:$AM17,AV$3:AV17,TRUE)),IF(AND(AV18=TRUE,ISNUMBER(AW18)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ18=TRUE,ISNUMBER(BA18)),MAX(0,BA18-SUMIFS($AM$3:$AM17,AZ$3:AZ17,TRUE)),IF(AND(AZ18=TRUE,ISNUMBER(BA18)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD18=TRUE,ISNUMBER(BE18)=TRUE),MAX(0,BE18-SUMIFS(AM$3:AM17,BD$3:BD17,TRUE,F$3:F17,F18)),IF(AND(BD18=TRUE,ISNUMBER(BE18)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,0,0,0,0,0,true]
[16,"2016-06-24",6,15,"Alpha-fetoprotein serum","Diagnostic Services: Laboratory","Not Covered",{"v":23.21,"d":"$23.21"},{"v":23.21,"d":"$23.21"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L19=\"Yes\",ISNUMBER(M19)),MAX(0,M19-SUMIFS(BU$3:BU18,L$3:L18,\"Yes\")),IF(OR(L19=\"No\",M19=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O19,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P19=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O19,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V19=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O19,COUNTIF(Z$3:Z18,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO19),AN19=TRUE),MAX(0,AO19-SUMIFS($AM$3:$AM18,AN$3:AN18,TRUE)),IF(AND(AN19=TRUE,ISNUMBER(AO19)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR19=TRUE,ISNUMBER(AS19)),MAX(0,AS19-SUMIFS($AM$3:$AM18,AR$3:AR18,TRUE)),IF(AND(AR19=TRUE,ISNUMBER(AS19)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV19=TRUE,ISNUMBER(AW19)),MAX(0,AW19-SUMIFS($AM$3:$AM18,AV$3:AV18,TRUE)),IF(AND(AV19=TRUE,ISNUMBER(AW19)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ19=TRUE,ISNUMBER(BA19)),MAX(0,BA19-SUMIFS($AM$3:$AM18,AZ$3:AZ18,TRUE)),IF(AND(AZ19=TRUE,ISNUMBER(BA19)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD19=TRUE,ISNUMBER(BE19)=TRUE),MAX(0,BE19-SUMIFS(AM$3:AM18,BD$3:BD18,TRUE,F$3:F18,F19)),IF(AND(BD19=TRUE,ISNUMBER(BE19)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":23.21,"d":"$23.21"},0,0,0,0,true]
[17,"2016-06-24",6,16,"Assay of estriol","Diagnostic Services: Laboratory","Not Covered",{"v":28.67,"d":"$28.67"},{"v":28.67,"d":"$28.67"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L20=\"Yes\",ISNUMBER(M20)),MAX(0,M20-SUMIFS(BU$3:BU19,L$3:L19,\"Yes\")),IF(OR(L20=\"No\",M20=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O20,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P20=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O20,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V20=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O20,COUNTIF(Z$3:Z19,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO20),AN20=TRUE),MAX(0,AO20-SUMIFS($AM$3:$AM19,AN$3:AN19,TRUE)),IF(AND(AN20=TRUE,ISNUMBER(AO20)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR20=TRUE,ISNUMBER(AS20)),MAX(0,AS20-SUMIFS($AM$3:$AM19,AR$3:AR19,TRUE)),IF(AND(AR20=TRUE,ISNUMBER(AS20)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV20=TRUE,ISNUMBER(AW20)),MAX(0,AW20-SUMIFS($AM$3:$AM19,AV$3:AV19,TRUE)),IF(AND(AV20=TRUE,ISNUMBER(AW20)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ20=TRUE,ISNUMBER(BA20)),MAX(0,BA20-SUMIFS($AM$3:$AM19,AZ$3:AZ19,TRUE)),IF(AND(AZ20=TRUE,ISNUMBER(BA20)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD20=TRUE,ISNUMBER(BE20)=TRUE),MAX(0,BE20-SUMIFS(AM$3:AM19,BD$3:BD19,TRUE,F$3:F19,F20)),IF(AND(BD20=TRUE,ISNUMBER(BE20)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":28.67,"d":"$28.67"},0,0,0,0,true]
[18,"2016-06-24",6,25,"Chorionic gonadotropin test","Diagnostic Services: Laboratory","Not Covered",{"v":24.94,"d":"$24.94"},{"v":24.94,"d":"$24.94"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L21=\"Yes\",ISNUMBER(M21)),MAX(0,M21-SUMIFS(BU$3:BU20,L$3:L20,\"Yes\")),IF(OR(L21=\"No\",M21=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O21,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P21=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O21,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V21=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O21,COUNTIF(Z$3:Z20,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO21),AN21=TRUE),MAX(0,AO21-SUMIFS($AM$3:$AM20,AN$3:AN20,TRUE)),IF(AND(AN21=TRUE,ISNUMBER(AO21)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR21=TRUE,ISNUMBER(AS21)),MAX(0,AS21-SUMIFS($AM$3:$AM20,AR$3:AR20,TRUE)),IF(AND(AR21=TRUE,ISNUMBER(AS21)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV21=TRUE,ISNUMBER(AW21)),MAX(0,AW21-SUMIFS($AM$3:$AM20,AV$3:AV20,TRUE)),IF(AND(AV21=TRUE,ISNUMBER(AW21)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ21=TRUE,ISNUMBER(BA21)),MAX(0,BA21-SUMIFS($AM$3:$AM20,AZ$3:AZ20,TRUE)),IF(AND(AZ21=TRUE,ISNUMBER(BA21)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD21=TRUE,ISNUMBER(BE21)=TRUE),MAX(0,BE21-SUMIFS(AM$3:AM20,BD$3:BD20,TRUE,F$3:F20,F21)),IF(AND(BD21=TRUE,ISNUMBER(BE21)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":24.94,"d":"$24.94"},0,0,0,0,true]
[19,"2016-06-24",6,27,"Inhibin A","Diagnostic Services: Laboratory","Not Covered",{"v":21.67,"d":"$21.67"},{"v":21.67,"d":"$21.67"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L22=\"Yes\",ISNUMBER(M22)),MAX(0,M22-SUMIFS(BU$3:BU21,L$3:L21,\"Yes\")),IF(OR(L22=\"No\",M22=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O22,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P22=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O22,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V22=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O22,COUNTIF(Z$3:Z21,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO22),AN22=TRUE),MAX(0,AO22-SUMIFS($AM$3:$AM21,AN$3:AN21,TRUE)),IF(AND(AN22=TRUE,ISNUMBER(AO22)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR22=TRUE,ISNUMBER(AS22)),MAX(0,AS22-SUMIFS($AM$3:$AM21,AR$3:AR21,TRUE)),IF(AND(AR22=TRUE,ISNUMBER(AS22)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV22=TRUE,ISNUMBER(AW22)),MAX(0,AW22-SUMIFS($AM$3:$AM21,AV$3:AV21,TRUE)),IF(AND(AV22=TRUE,ISNUMBER(AW22)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ22=TRUE,ISNUMBER(BA22)),MAX(0,BA22-SUMIFS($AM$3:$AM21,AZ$3:AZ21,TRUE)),IF(AND(AZ22=TRUE,ISNUMBER(BA22)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD22=TRUE,ISNUMBER(BE22)=TRUE),MAX(0,BE22-SUMIFS(AM$3:AM21,BD$3:BD21,TRUE,F$3:F21,F22)),IF(AND(BD22=TRUE,ISNUMBER(BE22)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":21.67,"d":"$21.67"},0,0,0,0,true]
[20,"2016-06-24",6,37,"CFTR gene analysis, common variants","Diagnostic Services: Laboratory","Not Covered",{"v":595.43,"d":"$595.43"},{"v":595.43,"d":"$595.43"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L23=\"Yes\",ISNUMBER(M23)),MAX(0,M23-SUMIFS(BU$3:BU22,L$3:L22,\"Yes\")),IF(OR(L23=\"No\",M23=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O23,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P23=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O23,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V23=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O23,COUNTIF(Z$3:Z22,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO23),AN23=TRUE),MAX(0,AO23-SUMIFS($AM$3:$AM22,AN$3:AN22,TRUE)),IF(AND(AN23=TRUE,ISNUMBER(AO23)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR23=TRUE,ISNUMBER(AS23)),MAX(0,AS23-SUMIFS($AM$3:$AM22,AR$3:AR22,TRUE)),IF(AND(AR23=TRUE,ISNUMBER(AS23)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV23=TRUE,ISNUMBER(AW23)),MAX(0,AW23-SUMIFS($AM$3:$AM22,AV$3:AV22,TRUE)),IF(AND(AV23=TRUE,ISNUMBER(AW23)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ23=TRUE,ISNUMBER(BA23)),MAX(0,BA23-SUMIFS($AM$3:$AM22,AZ$3:AZ22,TRUE)),IF(AND(AZ23=TRUE,ISNUMBER(BA23)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD23=TRUE,ISNUMBER(BE23)=TRUE),MAX(0,BE23-SUMIFS(AM$3:AM22,BD$3:BD22,TRUE,F$3:F22,F23)),IF(AND(BD23=TRUE,ISNUMBER(BE23)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":595.43,"d":"$595.43"},0,0,0,0,true]
[21,"2016-06-24",6,12,"Routine Venipuncture","Diagnostic Services: Laboratory","Not Covered",{"v":5.3,"d":"$5.30"},{"v":5.3,"d":"$5.30"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L24=\"Yes\",ISNUMBER(M24)),MAX(0,M24-SUMIFS(BU$3:BU23,L$3:L23,\"Yes\")),IF(OR(L24=\"No\",M24=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O24,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P24=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O24,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V24=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O24,COUNTIF(Z$3:Z23,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",1,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO24),AN24=TRUE),MAX(0,AO24-SUMIFS($AM$3:$AM23,AN$3:AN23,TRUE)),IF(AND(AN24=TRUE,ISNUMBER(AO24)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR24=TRUE,ISNUMBER(AS24)),MAX(0,AS24-SUMIFS($AM$3:$AM23,AR$3:AR23,TRUE)),IF(AND(AR24=TRUE,ISNUMBER(AS24)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV24=TRUE,ISNUMBER(AW24)),MAX(0,AW24-SUMIFS($AM$3:$AM23,AV$3:AV23,TRUE)),IF(AND(AV24=TRUE,ISNUMBER(AW24)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ24=TRUE,ISNUMBER(BA24)),MAX(0,BA24-SUMIFS($AM$3:$AM23,AZ$3:AZ23,TRUE)),IF(AND(AZ24=TRUE,ISNUMBER(BA24)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD24=TRUE,ISNUMBER(BE24)=TRUE),MAX(0,BE24-SUMIFS(AM$3:AM23,BD$3:BD23,TRUE,F$3:F23,F24)),IF(AND(BD24=TRUE,ISNUMBER(BE24)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":5.3,"d":"$5.30"},0,0,0,0,true]
[22,"2016-06-24",6,32,"Office/Outpatient Visit Est","Professional Services: Obstetric Care (Bundled)","Not Covered",0,0,0,false,"No",".",{"$f":"IFERROR(IF(AND(L25=\"Yes\",ISNUMBER(M25)),MAX(0,M25-SUMIFS(BU$3:BU24,L$3:L24,\"Yes\")),IF(OR(L25=\"No\",M25=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O25,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P25=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O25,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V25=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O25,COUNTIF(Z$3:Z24,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",2,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO25),AN25=TRUE),MAX(0,AO25-SUMIFS($AM$3:$AM24,AN$3:AN24,TRUE)),IF(AND(AN25=TRUE,ISNUMBER(AO25)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR25=TRUE,ISNUMBER(AS25)),MAX(0,AS25-SUMIFS($AM$3:$AM24,AR$3:AR24,TRUE)),IF(AND(AR25=TRUE,ISNUMBER(AS25)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV25=TRUE,ISNUMBER(AW25)),MAX(0,AW25-SUMIFS($AM$3:$AM24,AV$3:AV24,TRUE)),IF(AND(AV25=TRUE,ISNUMBER(AW25)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ25=TRUE,ISNUMBER(BA25)),MAX(0,BA25-SUMIFS($AM$3:$AM24,AZ$3:AZ24,TRUE)),IF(AND(AZ25=TRUE,ISNUMBER(BA25)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD25=TRUE,ISNUMBER(BE25)=TRUE),MAX(0,BE25-SUMIFS(AM$3:AM24,BD$3:BD24,TRUE,F$3:F24,F25)),IF(AND(BD25=TRUE,ISNUMBER(BE25)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,0,0,0,0,0,true]
[23,"2016-07-06",7,8,"Prenatal Vitamins (OTC - Bottle of 100) [1 pill daily; 30 pills/month]","Over-the-counter Drugs","Not Covered",{"v":11.48,"d":"$11.48"},{"v":11.48,"d":"$11.48"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L26=\"Yes\",ISNUMBER(M26)),MAX(0,M26-SUMIFS(BU$3:BU25,L$3:L25,\"Yes\")),IF(OR(L26=\"No\",M26=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O26,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P26=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O26,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V26=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O26,COUNTIF(Z$3:Z25,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",2,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO26),AN26=TRUE),MAX(0,AO26-SUMIFS($AM$3:$AM25,AN$3:AN25,TRUE)),IF(AND(AN26=TRUE,ISNUMBER(AO26)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR26=TRUE,ISNUMBER(AS26)),MAX(0,AS26-SUMIFS($AM$3:$AM25,AR$3:AR25,TRUE)),IF(AND(AR26=TRUE,ISNUMBER(AS26)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV26=TRUE,ISNUMBER(AW26)),MAX(0,AW26-SUMIFS($AM$3:$AM25,AV$3:AV25,TRUE)),IF(AND(AV26=TRUE,ISNUMBER(AW26)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ26=TRUE,ISNUMBER(BA26)),MAX(0,BA26-SUMIFS($AM$3:$AM25,AZ$3:AZ25,TRUE)),IF(AND(AZ26=TRUE,ISNUMBER(BA26)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD26=TRUE,ISNUMBER(BE26)=TRUE),MAX(0,BE26-SUMIFS(AM$3:AM25,BD$3:BD25,TRUE,F$3:F25,F26)),IF(AND(BD26=TRUE,ISNUMBER(BE26)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":11.48,"d":"$11.48"},0,0,0,0,true]
[24,"2016-07-22",7,32,"Office/Outpatient Visit Est","Professional Services: Obstetric Care (Bundled)","Not Covered",0,0,0,false,"No",".",{"$f":"IFERROR(IF(AND(L27=\"Yes\",ISNUMBER(M27)),MAX(0,M27-SUMIFS(BU$3:BU26,L$3:L26,\"Yes\")),IF(OR(L27=\"No\",M27=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O27,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P27=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O27,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V27=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O27,COUNTIF(Z$3:Z26,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",3,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO27),AN27=TRUE),MAX(0,AO27-SUMIFS($AM$3:$AM26,AN$3:AN26,TRUE)),IF(AND(AN27=TRUE,ISNUMBER(AO27)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR27=TRUE,ISNUMBER(AS27)),MAX(0,AS27-SUMIFS($AM$3:$AM26,AR$3:AR26,TRUE)),IF(AND(AR27=TRUE,ISNUMBER(AS27)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV27=TRUE,ISNUMBER(AW27)),MAX(0,AW27-SUMIFS($AM$3:$AM26,AV$3:AV26,TRUE)),IF(AND(AV27=TRUE,ISNUMBER(AW27)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ27=TRUE,ISNUMBER(BA27)),MAX(0,BA27-SUMIFS($AM$3:$AM26,AZ$3:AZ26,TRUE)),IF(AND(AZ27=TRUE,ISNUMBER(BA27)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD27=TRUE,ISNUMBER(BE27)=TRUE),MAX(0,BE27-SUMIFS(AM$3:AM26,BD$3:BD26,TRUE,F$3:F26,F27)),IF(AND(BD27=TRUE,ISNUMBER(BE27)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,0,0,0,0,0,true]
[25,"2016-07-22",7,13,"OB US >/= 14 WKS SNGL FETUS","Diagnostic Services: Radiology","Not Covered",{"v":209.73,"d":"$209.73"},{"v":209.73,"d":"$209.73"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L28=\"Yes\",ISNUMBER(M28)),MAX(0,M28-SUMIFS(BU$3:BU27,L$3:L27,\"Yes\")),IF(OR(L28=\"No\",M28=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O28,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P28=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O28,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V28=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O28,COUNTIF(Z$3:Z27,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO28),AN28=TRUE),MAX(0,AO28-SUMIFS($AM$3:$AM27,AN$3:AN27,TRUE)),IF(AND(AN28=TRUE,ISNUMBER(AO28)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR28=TRUE,ISNUMBER(AS28)),MAX(0,AS28-SUMIFS($AM$3:$AM27,AR$3:AR27,TRUE)),IF(AND(AR28=TRUE,ISNUMBER(AS28)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV28=TRUE,ISNUMBER(AW28)),MAX(0,AW28-SUMIFS($AM$3:$AM27,AV$3:AV27,TRUE)),IF(AND(AV28=TRUE,ISNUMBER(AW28)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ28=TRUE,ISNUMBER(BA28)),MAX(0,BA28-SUMIFS($AM$3:$AM27,AZ$3:AZ27,TRUE)),IF(AND(AZ28=TRUE,ISNUMBER(BA28)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD28=TRUE,ISNUMBER(BE28)=TRUE),MAX(0,BE28-SUMIFS(AM$3:AM27,BD$3:BD27,TRUE,F$3:F27,F28)),IF(AND(BD28=TRUE,ISNUMBER(BE28)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":209.73,"d":"$209.73"},0,0,0,0,true]
[26,"2016-08-19",8,32,"Office/Outpatient Visit Est","Professional Services: Obstetric Care (Bundled)","Not Covered",0,0,0,false,"No",".",{"$f":"IFERROR(IF(AND(L29=\"Yes\",ISNUMBER(M29)),MAX(0,M29-SUMIFS(BU$3:BU28,L$3:L28,\"Yes\")),IF(OR(L29=\"No\",M29=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O29,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P29=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O29,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V29=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O29,COUNTIF(Z$3:Z28,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",4,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO29),AN29=TRUE),MAX(0,AO29-SUMIFS($AM$3:$AM28,AN$3:AN28,TRUE)),IF(AND(AN29=TRUE,ISNUMBER(AO29)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR29=TRUE,ISNUMBER(AS29)),MAX(0,AS29-SUMIFS($AM$3:$AM28,AR$3:AR28,TRUE)),IF(AND(AR29=TRUE,ISNUMBER(AS29)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV29=TRUE,ISNUMBER(AW29)),MAX(0,AW29-SUMIFS($AM$3:$AM28,AV$3:AV28,TRUE)),IF(AND(AV29=TRUE,ISNUMBER(AW29)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ29=TRUE,ISNUMBER(BA29)),MAX(0,BA29-SUMIFS($AM$3:$AM28,AZ$3:AZ28,TRUE)),IF(AND(AZ29=TRUE,ISNUMBER(BA29)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD29=TRUE,ISNUMBER(BE29)=TRUE),MAX(0,BE29-SUMIFS(AM$3:AM28,BD$3:BD28,TRUE,F$3:F28,F29)),IF(AND(BD29=TRUE,ISNUMBER(BE29)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,0,0,0,0,0,true]
[27,"2016-09-16",9,17,"Assay Glucose Blood Quant","Diagnostic Services: Laboratory","Not Covered",{"v":8.21,"d":"$8.21"},{"v":8.21,"d":"$8.21"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L30=\"Yes\",ISNUMBER(M30)),MAX(0,M30-SUMIFS(BU$3:BU29,L$3:L29,\"Yes\")),IF(OR(L30=\"No\",M30=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O30,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P30=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O30,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V30=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O30,COUNTIF(Z$3:Z29,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO30),AN30=TRUE),MAX(0,AO30-SUMIFS($AM$3:$AM29,AN$3:AN29,TRUE)),IF(AND(AN30=TRUE,ISNUMBER(AO30)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR30=TRUE,ISNUMBER(AS30)),MAX(0,AS30-SUMIFS($AM$3:$AM29,AR$3:AR29,TRUE)),IF(AND(AR30=TRUE,ISNUMBER(AS30)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV30=TRUE,ISNUMBER(AW30)),MAX(0,AW30-SUMIFS($AM$3:$AM29,AV$3:AV29,TRUE)),IF(AND(AV30=TRUE,ISNUMBER(AW30)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ30=TRUE,ISNUMBER(BA30)),MAX(0,BA30-SUMIFS($AM$3:$AM29,AZ$3:AZ29,TRUE)),IF(AND(AZ30=TRUE,ISNUMBER(BA30)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD30=TRUE,ISNUMBER(BE30)=TRUE),MAX(0,BE30-SUMIFS(AM$3:AM29,BD$3:BD29,TRUE,F$3:F29,F30)),IF(AND(BD30=TRUE,ISNUMBER(BE30)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":8.21,"d":"$8.21"},0,0,0,0,true]
[28,"2016-09-16",9,26,"Complete cbc w/auto diff wbc","Diagnostic Services: Laboratory","Not Covered",{"v":13.99,"d":"$13.99"},{"v":13.99,"d":"$13.99"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L31=\"Yes\",ISNUMBER(M31)),MAX(0,M31-SUMIFS(BU$3:BU30,L$3:L30,\"Yes\")),IF(OR(L31=\"No\",M31=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O31,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P31=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O31,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V31=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O31,COUNTIF(Z$3:Z30,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO31),AN31=TRUE),MAX(0,AO31-SUMIFS($AM$3:$AM30,AN$3:AN30,TRUE)),IF(AND(AN31=TRUE,ISNUMBER(AO31)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR31=TRUE,ISNUMBER(AS31)),MAX(0,AS31-SUMIFS($AM$3:$AM30,AR$3:AR30,TRUE)),IF(AND(AR31=TRUE,ISNUMBER(AS31)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV31=TRUE,ISNUMBER(AW31)),MAX(0,AW31-SUMIFS($AM$3:$AM30,AV$3:AV30,TRUE)),IF(AND(AV31=TRUE,ISNUMBER(AW31)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ31=TRUE,ISNUMBER(BA31)),MAX(0,BA31-SUMIFS($AM$3:$AM30,AZ$3:AZ30,TRUE)),IF(AND(AZ31=TRUE,ISNUMBER(BA31)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD31=TRUE,ISNUMBER(BE31)=TRUE),MAX(0,BE31-SUMIFS(AM$3:AM30,BD$3:BD30,TRUE,F$3:F30,F31)),IF(AND(BD31=TRUE,ISNUMBER(BE31)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":13.99,"d":"$13.99"},0,0,0,0,true]
[29,"2016-09-16",9,18,"Glucose Test","Diagnostic Services: Laboratory","Not Covered",{"v":10.03,"d":"$10.03"},{"v":10.03,"d":"$10.03"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L32=\"Yes\",ISNUMBER(M32)),MAX(0,M32-SUMIFS(BU$3:BU31,L$3:L31,\"Yes\")),IF(OR(L32=\"No\",M32=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O32,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P32=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O32,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V32=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O32,COUNTIF(Z$3:Z31,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO32),AN32=TRUE),MAX(0,AO32-SUMIFS($AM$3:$AM31,AN$3:AN31,TRUE)),IF(AND(AN32=TRUE,ISNUMBER(AO32)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR32=TRUE,ISNUMBER(AS32)),MAX(0,AS32-SUMIFS($AM$3:$AM31,AR$3:AR31,TRUE)),IF(AND(AR32=TRUE,ISNUMBER(AS32)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV32=TRUE,ISNUMBER(AW32)),MAX(0,AW32-SUMIFS($AM$3:$AM31,AV$3:AV31,TRUE)),IF(AND(AV32=TRUE,ISNUMBER(AW32)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ32=TRUE,ISNUMBER(BA32)),MAX(0,BA32-SUMIFS($AM$3:$AM31,AZ$3:AZ31,TRUE)),IF(AND(AZ32=TRUE,ISNUMBER(BA32)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD32=TRUE,ISNUMBER(BE32)=TRUE),MAX(0,BE32-SUMIFS(AM$3:AM31,BD$3:BD31,TRUE,F$3:F31,F32)),IF(AND(BD32=TRUE,ISNUMBER(BE32)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":10.03,"d":"$10.03"},0,0,0,0,true]
[30,"2016-09-16",9,12,{"$f":"VLOOKUP(ServiceCode,MaternityFeeSchedule,6,FALSE)","v":"Routine Venipuncture"},{"$f":"VLOOKUP(ServiceCode,MaternityFeeSchedule,5,FALSE)","v":"Diagnostic Services: Laboratory"},{"$f":"VLOOKUP(BenefitCategory,BenefitDesignTable,COLUMN(BenefitCostSharing),FALSE)","v":"Not Covered"},{"$f":"VLOOKUP(D33,MaternityFeeSchedule,7,FALSE)","v":{"v":5.3,"d":"$5.30"}},{"$f":"IF(G33=\"Not Covered\",H33,0)","v":{"v":5.3,"d":"$5.30"}},{"$f":"H33-I33","v":0},{"$f":"VLOOKUP(F33,nrCoverageTable,COLUMN(nrOOPLimitValid),FALSE)","v":false},{"$f":"IF(K33,VLOOKUP(F33,BenefitDesignTable,COLUMN(BenefitOOPLimitApplies),FALSE),\"No\")","v":"No"},{"$f":"VLOOKUP(F33,BenefitDesignTable,COLUMN(OPLimit),FALSE)","v":"."},{"$f":"IFERROR(IF(AND(L33=\"Yes\",ISNUMBER(M33)),MAX(0,M33-SUMIFS(BU$3:BU32,L$3:L32,\"Yes\")),IF(OR(L33=\"No\",M33=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O33,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P33=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,{"$f":"J33-S33","v":0},false,{"$f":"IF(O33,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V33=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O33,COUNTIF(Z$3:Z32,\">0\"),\"N/A\")","v":"N/A"},{"$f":"IF(V33=\"Yes\",VLOOKUP(\"Professional Services: Primary Care\",BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},"N/A",0,{"$f":"IF(L33=\"Yes\",IF(Z33=\"N/A\",N33,N33-Z33),\"N/A\")","v":"N/A"},0,{"$f":"VLOOKUP(F33,nrCoverageTable,COLUMN(nrMonthlyLimitValid),FALSE)","v":false},{"$f":"IF(AD33,VLOOKUP(F33,BenefitDesignTable,COLUMN(BenefitLimithMonth),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D33,ClaimMonth,C33,ClaimNumber,\"<\"&A33)","v":0},{"$f":"IF(AD33,IF(OR(AE33=\"None\",ISNUMBER(AE33)),IF(AF33>=AE33,H33,0),\"ERR\"),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F33,nrCoverageTable,COLUMN(nrAnnualLimitValid),FALSE)","v":false},{"$f":"IF(AH33,VLOOKUP(F33,BenefitDesignTable,COLUMN(BenefitLimitAnnual),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D33,ClaimNumber,\"<\"&A33)","v":2},{"$f":"IF(AH33,IF(OR(AI33=\"None\",ISNUMBER(AI33)),IF(AJ33>=AI33,H33,0),\"ERR\"),\"N/A\")","v":"N/A"},0,0,{"$f":"VLOOKUP(F33,nrCoverageTable,COLUMN(nrUsesPlanDeduct),FALSE)","v":false},{"$f":"IF(AN33,VLOOKUP(F33,BenefitDesignTable,COLUMN(PlanDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(ISNUMBER(AO33),AN33=TRUE),MAX(0,AO33-SUMIFS($AM$3:$AM32,AN$3:AN32,TRUE)),IF(AND(AN33=TRUE,ISNUMBER(AO33)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AP33),MIN($AM33,AP33),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F33,nrCoverageTable,COLUMN(nrUsesRxDeduct),FALSE)","v":false},{"$f":"IF(AR33,VLOOKUP(F33,BenefitDesignTable,COLUMN(RxDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AR33=TRUE,ISNUMBER(AS33)),MAX(0,AS33-SUMIFS($AM$3:$AM32,AR$3:AR32,TRUE)),IF(AND(AR33=TRUE,ISNUMBER(AS33)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AT33),MIN($AM33,AT33),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F33,nrCoverageTable,COLUMN(nrUsesDeductC),FALSE)","v":false},{"$f":"IF(AV33,VLOOKUP(F33,BenefitDesignTable,COLUMN(OptDeductibleC),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AV33=TRUE,ISNUMBER(AW33)),MAX(0,AW33-SUMIFS($AM$3:$AM32,AV$3:AV32,TRUE)),IF(AND(AV33=TRUE,ISNUMBER(AW33)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AX33),MIN($AM33,AX33),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F33,nrCoverageTable,COLUMN(nrUsesDeductD),FALSE)","v":false},{"$f":"IF(AZ33,VLOOKUP(F33,BenefitDesignTable,COLUMN(OptDeductibleD),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AZ33=TRUE,ISNUMBER(BA33)),MAX(0,BA33-SUMIFS($AM$3:$AM32,AZ$3:AZ32,TRUE)),IF(AND(AZ33=TRUE,ISNUMBER(BA33)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BB33),MIN($AM33,BB33),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F33,nrCoverageTable,COLUMN(nrUsesBenDeduct),FALSE)","v":false},{"$f":"IF(BD33,VLOOKUP(F33,BenefitDesignTable,COLUMN(BenefitDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(BD33=TRUE,ISNUMBER(BE33)=TRUE),MAX(0,BE33-SUMIFS(AM$3:AM32,BD$3:BD32,TRUE,F$3:F32,F33)),IF(AND(BD33=TRUE,ISNUMBER(BE33)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BF33),MIN($AM33,BF33),\"N/A\")","v":"N/A"},0,0,"N/A",{"$f":"IF(OR(BI33=\"ERR\",AM33=\"ERR\"),\"ERR\",MAX(0,AM33-BI33))","v":0},{"$f":"VLOOKUP(F33,nrCoverageTable,COLUMN(nrUsesCopay),FALSE)","v":false},{"$f":"IF(BL33,VLOOKUP(F33,BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},"N/A",{"$f":"VLOOKUP(F33,nrCoverageTable,COLUMN(nrUsesCoins),FALSE)","v":false},{"$f":"IF(BO33,VLOOKUP(F33,BenefitDesignTable,COLUMN(BenefitCoins),FALSE),\"N/A\")","v":"N/A"},"N/A",0,"N/A",0,0,0,{"$f":"I33","v":{"v":5.3,"d":"$5.30"}},{"$f":"IF(OR(AG33=\"ERR\",AK33=\"ERR\"),\"ERR\",SUM(AG33,AK33))","v":0},0,0,0,{"$f":"SUM(BV33:CA33)=H33","v":true}]
[31,"2016-09-16",9,32,"Office/Outpatient Visit Est","Professional Services: Obstetric Care (Bundled)","Not Covered",0,0,0,false,"No",".",{"$f":"IFERROR(IF(AND(L34=\"Yes\",ISNUMBER(M34)),MAX(0,M34-SUMIFS(BU$3:BU33,L$3:L33,\"Yes\")),IF(OR(L34=\"No\",M34=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O34,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P34=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O34,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V34=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O34,COUNTIF(Z$3:Z33,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",5,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO34),AN34=TRUE),MAX(0,AO34-SUMIFS($AM$3:$AM33,AN$3:AN33,TRUE)),IF(AND(AN34=TRUE,ISNUMBER(AO34)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR34=TRUE,ISNUMBER(AS34)),MAX(0,AS34-SUMIFS($AM$3:$AM33,AR$3:AR33,TRUE)),IF(AND(AR34=TRUE,ISNUMBER(AS34)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV34=TRUE,ISNUMBER(AW34)),MAX(0,AW34-SUMIFS($AM$3:$AM33,AV$3:AV33,TRUE)),IF(AND(AV34=TRUE,ISNUMBER(AW34)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ34=TRUE,ISNUMBER(BA34)),MAX(0,BA34-SUMIFS($AM$3:$AM33,AZ$3:AZ33,TRUE)),IF(AND(AZ34=TRUE,ISNUMBER(BA34)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD34=TRUE,ISNUMBER(BE34)=TRUE),MAX(0,BE34-SUMIFS(AM$3:AM33,BD$3:BD33,TRUE,F$3:F33,F34)),IF(AND(BD34=TRUE,ISNUMBER(BE34)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,0,0,0,0,0,true]
[32,"2016-09-16",9,41,"Ultrasound of pregnant uterus, 1 or more fetus(es)","Diagnostic Services: Radiology","Not Covered",{"v":133.68,"d":"$133.68"},{"v":133.68,"d":"$133.68"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L35=\"Yes\",ISNUMBER(M35)),MAX(0,M35-SUMIFS(BU$3:BU34,L$3:L34,\"Yes\")),IF(OR(L35=\"No\",M35=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O35,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P35=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O35,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V35=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O35,COUNTIF(Z$3:Z34,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO35),AN35=TRUE),MAX(0,AO35-SUMIFS($AM$3:$AM34,AN$3:AN34,TRUE)),IF(AND(AN35=TRUE,ISNUMBER(AO35)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR35=TRUE,ISNUMBER(AS35)),MAX(0,AS35-SUMIFS($AM$3:$AM34,AR$3:AR34,TRUE)),IF(AND(AR35=TRUE,ISNUMBER(AS35)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV35=TRUE,ISNUMBER(AW35)),MAX(0,AW35-SUMIFS($AM$3:$AM34,AV$3:AV34,TRUE)),IF(AND(AV35=TRUE,ISNUMBER(AW35)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ35=TRUE,ISNUMBER(BA35)),MAX(0,BA35-SUMIFS($AM$3:$AM34,AZ$3:AZ34,TRUE)),IF(AND(AZ35=TRUE,ISNUMBER(BA35)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD35=TRUE,ISNUMBER(BE35)=TRUE),MAX(0,BE35-SUMIFS(AM$3:AM34,BD$3:BD34,TRUE,F$3:F34,F35)),IF(AND(BD35=TRUE,ISNUMBER(BE35)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":133.68,"d":"$133.68"},0,0,0,0,true]
[33,"2016-09-30",9,32,"Office/Outpatient Visit Est","Professional Services: Obstetric Care (Bundled)","Not Covered",0,0,0,false,"No",".",{"$f":"IFERROR(IF(AND(L36=\"Yes\",ISNUMBER(M36)),MAX(0,M36-SUMIFS(BU$3:BU35,L$3:L35,\"Yes\")),IF(OR(L36=\"No\",M36=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O36,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P36=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},{"$f":"IF(O36,COUNTIFS(BenefitCategory,\"Professional Services: Primary Care\",ClaimNumber,\"<\"&A36),\"N/A\")","v":"N/A"},0,0,false,{"$f":"IF(O36,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V36=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O36,COUNTIF(Z$3:Z35,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",1,"N/A",false,".",6,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO36),AN36=TRUE),MAX(0,AO36-SUMIFS($AM$3:$AM35,AN$3:AN35,TRUE)),IF(AND(AN36=TRUE,ISNUMBER(AO36)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR36=TRUE,ISNUMBER(AS36)),MAX(0,AS36-SUMIFS($AM$3:$AM35,AR$3:AR35,TRUE)),IF(AND(AR36=TRUE,ISNUMBER(AS36)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV36=TRUE,ISNUMBER(AW36)),MAX(0,AW36-SUMIFS($AM$3:$AM35,AV$3:AV35,TRUE)),IF(AND(AV36=TRUE,ISNUMBER(AW36)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ36=TRUE,ISNUMBER(BA36)),MAX(0,BA36-SUMIFS($AM$3:$AM35,AZ$3:AZ35,TRUE)),IF(AND(AZ36=TRUE,ISNUMBER(BA36)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD36=TRUE,ISNUMBER(BE36)=TRUE),MAX(0,BE36-SUMIFS(AM$3:AM35,BD$3:BD35,TRUE,F$3:F35,F36)),IF(AND(BD36=TRUE,ISNUMBER(BE36)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,0,0,0,0,0,true]
[34,"2016-10-04",10,8,"Prenatal Vitamins (OTC - Bottle of 100) [1 pill daily; 30 pills/month]","Over-the-counter Drugs","Not Covered",{"$f":"VLOOKUP(D37,MaternityFeeSchedule,7,FALSE)","v":{"v":11.48,"d":"$11.48"}},{"$f":"IF(G37=\"Not Covered\",H37,0)","v":{"v":11.48,"d":"$11.48"}},{"$f":"H37-I37","v":0},{"$f":"VLOOKUP(F37,nrCoverageTable,COLUMN(nrOOPLimitValid),FALSE)","v":false},{"$f":"IF(K37,VLOOKUP(F37,BenefitDesignTable,COLUMN(BenefitOOPLimitApplies),FALSE),\"No\")","v":"No"},{"$f":"VLOOKUP(F37,BenefitDesignTable,COLUMN(OPLimit),FALSE)","v":"."},{"$f":"IFERROR(IF(AND(L37=\"Yes\",ISNUMBER(M37)),MAX(0,M37-SUMIFS(BU$3:BU36,L$3:L36,\"Yes\")),IF(OR(L37=\"No\",M37=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O37,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P37=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",{"$f":"IF(P37=\"Yes\",IF(R37<Q37,MIN(J37,N37),0),0)","v":0},{"$f":"J37-S37","v":0},false,{"$f":"IF(O37,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V37=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O37,COUNTIF(Z$3:Z36,\">0\"),\"N/A\")","v":"N/A"},{"$f":"IF(V37=\"Yes\",VLOOKUP(\"Professional Services: Primary Care\",BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(V37=\"Yes\",U37=TRUE,X37<W37), MIN(Y37,T37,N37),\"N/A\")","v":"N/A"},{"$f":"IF(Z37=\"N/A\",0,T37-Z37)","v":0},{"$f":"IF(L37=\"Yes\",IF(Z37=\"N/A\",N37,N37-Z37),\"N/A\")","v":"N/A"},{"$f":"IF(Z37=\"N/A\",T37,0)","v":0},{"$f":"VLOOKUP(F37,nrCoverageTable,COLUMN(nrMonthlyLimitValid),FALSE)","v":false},{"$f":"IF(AD37,VLOOKUP(F37,BenefitDesignTable,COLUMN(BenefitLimithMonth),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D37,ClaimMonth,C37,ClaimNumber,\"<\"&A37)","v":0},{"$f":"IF(AD37,IF(OR(AE37=\"None\",ISNUMBER(AE37)),IF(AF37>=AE37,H37,0),\"ERR\"),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F37,nrCoverageTable,COLUMN(nrAnnualLimitValid),FALSE)","v":false},{"$f":"IF(AH37,VLOOKUP(F37,BenefitDesignTable,COLUMN(BenefitLimitAnnual),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D37,ClaimNumber,\"<\"&A37)","v":3},{"$f":"IF(AH37,IF(OR(AI37=\"None\",ISNUMBER(AI37)),IF(AJ37>=AI37,H37,0),\"ERR\"),\"N/A\")","v":"N/A"},{"$f":"IF(OR(AG37=\"ERR\",AK37=\"ERR\"),\"ERR\",MAX(AG37,AK37))","v":0},{"$f":"IFERROR(AC37-AL37,\"ERR\")","v":0},{"$f":"VLOOKUP(F37,nrCoverageTable,COLUMN(nrUsesPlanDeduct),FALSE)","v":false},{"$f":"IF(AN37,VLOOKUP(F37,BenefitDesignTable,COLUMN(PlanDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(ISNUMBER(AO37),AN37=TRUE),MAX(0,AO37-SUMIFS($AM$3:$AM36,AN$3:AN36,TRUE)),IF(AND(AN37=TRUE,ISNUMBER(AO37)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AP37),MIN($AM37,AP37),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F37,nrCoverageTable,COLUMN(nrUsesRxDeduct),FALSE)","v":false},{"$f":"IF(AR37,VLOOKUP(F37,BenefitDesignTable,COLUMN(RxDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AR37=TRUE,ISNUMBER(AS37)),MAX(0,AS37-SUMIFS($AM$3:$AM36,AR$3:AR36,TRUE)),IF(AND(AR37=TRUE,ISNUMBER(AS37)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AT37),MIN($AM37,AT37),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F37,nrCoverageTable,COLUMN(nrUsesDeductC),FALSE)","v":false},{"$f":"IF(AV37,VLOOKUP(F37,BenefitDesignTable,COLUMN(OptDeductibleC),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AV37=TRUE,ISNUMBER(AW37)),MAX(0,AW37-SUMIFS($AM$3:$AM36,AV$3:AV36,TRUE)),IF(AND(AV37=TRUE,ISNUMBER(AW37)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AX37),MIN($AM37,AX37),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F37,nrCoverageTable,COLUMN(nrUsesDeductD),FALSE)","v":false},{"$f":"IF(AZ37,VLOOKUP(F37,BenefitDesignTable,COLUMN(OptDeductibleD),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AZ37=TRUE,ISNUMBER(BA37)),MAX(0,BA37-SUMIFS($AM$3:$AM36,AZ$3:AZ36,TRUE)),IF(AND(AZ37=TRUE,ISNUMBER(BA37)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BB37),MIN($AM37,BB37),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F37,nrCoverageTable,COLUMN(nrUsesBenDeduct),FALSE)","v":false},{"$f":"IF(BD37,VLOOKUP(F37,BenefitDesignTable,COLUMN(BenefitDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(BD37=TRUE,ISNUMBER(BE37)=TRUE),MAX(0,BE37-SUMIFS(AM$3:AM36,BD$3:BD36,TRUE,F$3:F36,F37)),IF(AND(BD37=TRUE,ISNUMBER(BE37)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BF37),MIN($AM37,BF37),\"N/A\")","v":"N/A"},{"$f":"SUM(AQ37,AU37,AY37,BC37,BG37)","v":0},{"$f":"IF(OR(AB37=\"ERR\",BH37=\"ERR\"),\"ERR\",MIN(BH37,AB37))","v":0},"N/A",{"$f":"IF(OR(BI37=\"ERR\",AM37=\"ERR\"),\"ERR\",MAX(0,AM37-BI37))","v":0},{"$f":"VLOOKUP(F37,nrCoverageTable,COLUMN(nrUsesCopay),FALSE)","v":false},{"$f":"IF(BL37,VLOOKUP(F37,BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(BK37=\"ERR\",\"ERR\",IF(AND(BL37=TRUE,ISNUMBER(BM37)),MIN(BK37,BM37,BJ37),IF(AND(BL37=TRUE,ISNUMBER(BM37)=FALSE),\"ERR\",\"N/A\")))","v":"N/A"},{"$f":"VLOOKUP(F37,nrCoverageTable,COLUMN(nrUsesCoins),FALSE)","v":false},{"$f":"IF(BO37,VLOOKUP(F37,BenefitDesignTable,COLUMN(BenefitCoins),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(BK37=\"ERR\",\"ERR\",IF(AND(BO37=TRUE,ISNUMBER(BP37)=TRUE),MIN(BJ37,BK37*BP37),IF(AND(BO37=TRUE,ISNUMBER(BP37)=FALSE),\"ERR\",\"N/A\")))","v":"N/A"},{"$f":"IF(OR(BJ37=\"ERR\",BN37=\"ERR\",BQ37=\"ERR\"),\"ERR\",MIN(BJ37,SUM(BN37,BQ37)))","v":0},"N/A",{"$f":"IF(OR(BK37=\"ERR\",BR37=\"ERR\"),\"ERR\",MAX(BK37-BR37,0))","v":0},0,0,{"$f":"I37","v":{"v":11.48,"d":"$11.48"}},{"$f":"IF(OR(AG37=\"ERR\",AK37=\"ERR\"),\"ERR\",SUM(AG37,AK37))","v":0},{"$f":"BI37","v":0},{"$f":"IF(V37=\"Yes\",IF(Z37=\"N/A\",0,Z37),0)+IF(BL37,BN37,0)","v":0},{"$f":"IF(BO37,BQ37,0)","v":0},{"$f":"SUM(BV37:CA37)=H37","v":true}]
[35,"2016-10-14",10,32,"Office/Outpatient Visit Est","Professional Services: Obstetric Care (Bundled)","Not Covered",0,0,0,false,"No",".",{"$f":"IFERROR(IF(AND(L38=\"Yes\",ISNUMBER(M38)),MAX(0,M38-SUMIFS(BU$3:BU37,L$3:L37,\"Yes\")),IF(OR(L38=\"No\",M38=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O38,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P38=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O38,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V38=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O38,COUNTIF(Z$3:Z37,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",7,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO38),AN38=TRUE),MAX(0,AO38-SUMIFS($AM$3:$AM37,AN$3:AN37,TRUE)),IF(AND(AN38=TRUE,ISNUMBER(AO38)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR38=TRUE,ISNUMBER(AS38)),MAX(0,AS38-SUMIFS($AM$3:$AM37,AR$3:AR37,TRUE)),IF(AND(AR38=TRUE,ISNUMBER(AS38)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV38=TRUE,ISNUMBER(AW38)),MAX(0,AW38-SUMIFS($AM$3:$AM37,AV$3:AV37,TRUE)),IF(AND(AV38=TRUE,ISNUMBER(AW38)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ38=TRUE,ISNUMBER(BA38)),MAX(0,BA38-SUMIFS($AM$3:$AM37,AZ$3:AZ37,TRUE)),IF(AND(AZ38=TRUE,ISNUMBER(BA38)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD38=TRUE,ISNUMBER(BE38)=TRUE),MAX(0,BE38-SUMIFS(AM$3:AM37,BD$3:BD37,TRUE,F$3:F37,F38)),IF(AND(BD38=TRUE,ISNUMBER(BE38)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,0,0,0,0,0,true]
[36,"2016-10-28",10,29,"Strep B DNA Amp Probe","Diagnostic Services: Laboratory","Not Covered",{"v":61.22,"d":"$61.22"},{"v":61.22,"d":"$61.22"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L39=\"Yes\",ISNUMBER(M39)),MAX(0,M39-SUMIFS(BU$3:BU38,L$3:L38,\"Yes\")),IF(OR(L39=\"No\",M39=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O39,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P39=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O39,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V39=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O39,COUNTIF(Z$3:Z38,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO39),AN39=TRUE),MAX(0,AO39-SUMIFS($AM$3:$AM38,AN$3:AN38,TRUE)),IF(AND(AN39=TRUE,ISNUMBER(AO39)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR39=TRUE,ISNUMBER(AS39)),MAX(0,AS39-SUMIFS($AM$3:$AM38,AR$3:AR38,TRUE)),IF(AND(AR39=TRUE,ISNUMBER(AS39)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV39=TRUE,ISNUMBER(AW39)),MAX(0,AW39-SUMIFS($AM$3:$AM38,AV$3:AV38,TRUE)),IF(AND(AV39=TRUE,ISNUMBER(AW39)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ39=TRUE,ISNUMBER(BA39)),MAX(0,BA39-SUMIFS($AM$3:$AM38,AZ$3:AZ38,TRUE)),IF(AND(AZ39=TRUE,ISNUMBER(BA39)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD39=TRUE,ISNUMBER(BE39)=TRUE),MAX(0,BE39-SUMIFS(AM$3:AM38,BD$3:BD38,TRUE,F$3:F38,F39)),IF(AND(BD39=TRUE,ISNUMBER(BE39)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":61.22,"d":"$61.22"},0,0,0,0,true]
[37,"2016-10-28",10,32,"Office/Outpatient Visit Est","Professional Services: Obstetric Care (Bundled)","Not Covered",0,0,0,false,"No",".",{"$f":"IFERROR(IF(AND(L40=\"Yes\",ISNUMBER(M40)),MAX(0,M40-SUMIFS(BU$3:BU39,L$3:L39,\"Yes\")),IF(OR(L40=\"No\",M40=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O40,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P40=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O40,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V40=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O40,COUNTIF(Z$3:Z39,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",1,"N/A",false,".",8,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO40),AN40=TRUE),MAX(0,AO40-SUMIFS($AM$3:$AM39,AN$3:AN39,TRUE)),IF(AND(AN40=TRUE,ISNUMBER(AO40)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR40=TRUE,ISNUMBER(AS40)),MAX(0,AS40-SUMIFS($AM$3:$AM39,AR$3:AR39,TRUE)),IF(AND(AR40=TRUE,ISNUMBER(AS40)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV40=TRUE,ISNUMBER(AW40)),MAX(0,AW40-SUMIFS($AM$3:$AM39,AV$3:AV39,TRUE)),IF(AND(AV40=TRUE,ISNUMBER(AW40)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ40=TRUE,ISNUMBER(BA40)),MAX(0,BA40-SUMIFS($AM$3:$AM39,AZ$3:AZ39,TRUE)),IF(AND(AZ40=TRUE,ISNUMBER(BA40)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD40=TRUE,ISNUMBER(BE40)=TRUE),MAX(0,BE40-SUMIFS(AM$3:AM39,BD$3:BD39,TRUE,F$3:F39,F40)),IF(AND(BD40=TRUE,ISNUMBER(BE40)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,0,0,0,0,0,true]
[38,"2016-10-28",10,10," Immunization Admin","Preventive Services & Vaccines","Not Covered",{"v":28.56,"d":"$28.56"},{"v":28.56,"d":"$28.56"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L41=\"Yes\",ISNUMBER(M41)),MAX(0,M41-SUMIFS(BU$3:BU40,L$3:L40,\"Yes\")),IF(OR(L41=\"No\",M41=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O41,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P41=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O41,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V41=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O41,COUNTIF(Z$3:Z40,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO41),AN41=TRUE),MAX(0,AO41-SUMIFS($AM$3:$AM40,AN$3:AN40,TRUE)),IF(AND(AN41=TRUE,ISNUMBER(AO41)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR41=TRUE,ISNUMBER(AS41)),MAX(0,AS41-SUMIFS($AM$3:$AM40,AR$3:AR40,TRUE)),IF(AND(AR41=TRUE,ISNUMBER(AS41)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV41=TRUE,ISNUMBER(AW41)),MAX(0,AW41-SUMIFS($AM$3:$AM40,AV$3:AV40,TRUE)),IF(AND(AV41=TRUE,ISNUMBER(AW41)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ41=TRUE,ISNUMBER(BA41)),MAX(0,BA41-SUMIFS($AM$3:$AM40,AZ$3:AZ40,TRUE)),IF(AND(AZ41=TRUE,ISNUMBER(BA41)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD41=TRUE,ISNUMBER(BE41)=TRUE),MAX(0,BE41-SUMIFS(AM$3:AM40,BD$3:BD40,TRUE,F$3:F40,F41)),IF(AND(BD41=TRUE,ISNUMBER(BE41)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":28.56,"d":"$28.56"},0,0,0,0,true]
[39,"2016-10-28",10,11,"Flu Vaccine N0 Preserv 3 & >","Preventive Services & Vaccines","Not Covered",{"v":20.2,"d":"$20.20"},{"v":20.2,"d":"$20.20"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L42=\"Yes\",ISNUMBER(M42)),MAX(0,M42-SUMIFS(BU$3:BU41,L$3:L41,\"Yes\")),IF(OR(L42=\"No\",M42=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O42,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P42=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O42,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V42=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O42,COUNTIF(Z$3:Z41,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO42),AN42=TRUE),MAX(0,AO42-SUMIFS($AM$3:$AM41,AN$3:AN41,TRUE)),IF(AND(AN42=TRUE,ISNUMBER(AO42)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR42=TRUE,ISNUMBER(AS42)),MAX(0,AS42-SUMIFS($AM$3:$AM41,AR$3:AR41,TRUE)),IF(AND(AR42=TRUE,ISNUMBER(AS42)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV42=TRUE,ISNUMBER(AW42)),MAX(0,AW42-SUMIFS($AM$3:$AM41,AV$3:AV41,TRUE)),IF(AND(AV42=TRUE,ISNUMBER(AW42)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ42=TRUE,ISNUMBER(BA42)),MAX(0,BA42-SUMIFS($AM$3:$AM41,AZ$3:AZ41,TRUE)),IF(AND(AZ42=TRUE,ISNUMBER(BA42)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD42=TRUE,ISNUMBER(BE42)=TRUE),MAX(0,BE42-SUMIFS(AM$3:AM41,BD$3:BD41,TRUE,F$3:F41,F42)),IF(AND(BD42=TRUE,ISNUMBER(BE42)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":20.2,"d":"$20.20"},0,0,0,0,true]
[40,"2016-11-11",11,32,"Office/Outpatient Visit Est","Professional Services: Obstetric Care (Bundled)","Not Covered",0,0,0,false,"No",".",{"$f":"IFERROR(IF(AND(L43=\"Yes\",ISNUMBER(M43)),MAX(0,M43-SUMIFS(BU$3:BU42,L$3:L42,\"Yes\")),IF(OR(L43=\"No\",M43=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O43,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P43=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O43,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V43=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O43,COUNTIF(Z$3:Z42,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",9,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO43),AN43=TRUE),MAX(0,AO43-SUMIFS($AM$3:$AM42,AN$3:AN42,TRUE)),IF(AND(AN43=TRUE,ISNUMBER(AO43)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR43=TRUE,ISNUMBER(AS43)),MAX(0,AS43-SUMIFS($AM$3:$AM42,AR$3:AR42,TRUE)),IF(AND(AR43=TRUE,ISNUMBER(AS43)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV43=TRUE,ISNUMBER(AW43)),MAX(0,AW43-SUMIFS($AM$3:$AM42,AV$3:AV42,TRUE)),IF(AND(AV43=TRUE,ISNUMBER(AW43)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ43=TRUE,ISNUMBER(BA43)),MAX(0,BA43-SUMIFS($AM$3:$AM42,AZ$3:AZ42,TRUE)),IF(AND(AZ43=TRUE,ISNUMBER(BA43)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD43=TRUE,ISNUMBER(BE43)=TRUE),MAX(0,BE43-SUMIFS(AM$3:AM42,BD$3:BD42,TRUE,F$3:F42,F43)),IF(AND(BD43=TRUE,ISNUMBER(BE43)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,0,0,0,0,0,true]
[41,"2016-11-18",11,32,"Office/Outpatient Visit Est","Professional Services: Obstetric Care (Bundled)","Not Covered",0,0,0,false,"No",".",{"$f":"IFERROR(IF(AND(L44=\"Yes\",ISNUMBER(M44)),MAX(0,M44-SUMIFS(BU$3:BU43,L$3:L43,\"Yes\")),IF(OR(L44=\"No\",M44=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O44,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P44=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O44,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V44=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O44,COUNTIF(Z$3:Z43,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",1,"N/A",false,".",10,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO44),AN44=TRUE),MAX(0,AO44-SUMIFS($AM$3:$AM43,AN$3:AN43,TRUE)),IF(AND(AN44=TRUE,ISNUMBER(AO44)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR44=TRUE,ISNUMBER(AS44)),MAX(0,AS44-SUMIFS($AM$3:$AM43,AR$3:AR43,TRUE)),IF(AND(AR44=TRUE,ISNUMBER(AS44)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV44=TRUE,ISNUMBER(AW44)),MAX(0,AW44-SUMIFS($AM$3:$AM43,AV$3:AV43,TRUE)),IF(AND(AV44=TRUE,ISNUMBER(AW44)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ44=TRUE,ISNUMBER(BA44)),MAX(0,BA44-SUMIFS($AM$3:$AM43,AZ$3:AZ43,TRUE)),IF(AND(AZ44=TRUE,ISNUMBER(BA44)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD44=TRUE,ISNUMBER(BE44)=TRUE),MAX(0,BE44-SUMIFS(AM$3:AM43,BD$3:BD43,TRUE,F$3:F43,F44)),IF(AND(BD44=TRUE,ISNUMBER(BE44)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,0,0,0,0,0,true]
[42,"2016-11-25",11,32,"Office/Outpatient Visit Est","Professional Services: Obstetric Care (Bundled)","Not Covered",0,0,0,false,"No",".",{"$f":"IFERROR(IF(AND(L45=\"Yes\",ISNUMBER(M45)),MAX(0,M45-SUMIFS(BU$3:BU44,L$3:L44,\"Yes\")),IF(OR(L45=\"No\",M45=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O45,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P45=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O45,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V45=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O45,COUNTIF(Z$3:Z44,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",2,"N/A",false,".",11,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO45),AN45=TRUE),MAX(0,AO45-SUMIFS($AM$3:$AM44,AN$3:AN44,TRUE)),IF(AND(AN45=TRUE,ISNUMBER(AO45)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR45=TRUE,ISNUMBER(AS45)),MAX(0,AS45-SUMIFS($AM$3:$AM44,AR$3:AR44,TRUE)),IF(AND(AR45=TRUE,ISNUMBER(AS45)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV45=TRUE,ISNUMBER(AW45)),MAX(0,AW45-SUMIFS($AM$3:$AM44,AV$3:AV44,TRUE)),IF(AND(AV45=TRUE,ISNUMBER(AW45)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ45=TRUE,ISNUMBER(BA45)),MAX(0,BA45-SUMIFS($AM$3:$AM44,AZ$3:AZ44,TRUE)),IF(AND(AZ45=TRUE,ISNUMBER(BA45)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD45=TRUE,ISNUMBER(BE45)=TRUE),MAX(0,BE45-SUMIFS(AM$3:AM44,BD$3:BD44,TRUE,F$3:F44,F45)),IF(AND(BD45=TRUE,ISNUMBER(BE45)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,0,0,0,0,0,true]
[43,"2016-12-02",12,32,"Office/Outpatient Visit Est","Professional Services: Obstetric Care (Bundled)","Not Covered",0,0,0,false,"No",".",{"$f":"IFERROR(IF(AND(L46=\"Yes\",ISNUMBER(M46)),MAX(0,M46-SUMIFS(BU$3:BU45,L$3:L45,\"Yes\")),IF(OR(L46=\"No\",M46=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O46,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P46=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O46,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V46=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O46,COUNTIF(Z$3:Z45,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",12,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO46),AN46=TRUE),MAX(0,AO46-SUMIFS($AM$3:$AM45,AN$3:AN45,TRUE)),IF(AND(AN46=TRUE,ISNUMBER(AO46)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR46=TRUE,ISNUMBER(AS46)),MAX(0,AS46-SUMIFS($AM$3:$AM45,AR$3:AR45,TRUE)),IF(AND(AR46=TRUE,ISNUMBER(AS46)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV46=TRUE,ISNUMBER(AW46)),MAX(0,AW46-SUMIFS($AM$3:$AM45,AV$3:AV45,TRUE)),IF(AND(AV46=TRUE,ISNUMBER(AW46)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ46=TRUE,ISNUMBER(BA46)),MAX(0,BA46-SUMIFS($AM$3:$AM45,AZ$3:AZ45,TRUE)),IF(AND(AZ46=TRUE,ISNUMBER(BA46)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD46=TRUE,ISNUMBER(BE46)=TRUE),MAX(0,BE46-SUMIFS(AM$3:AM45,BD$3:BD45,TRUE,F$3:F45,F46)),IF(AND(BD46=TRUE,ISNUMBER(BE46)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,0,0,0,0,0,true]
[44,"2016-12-09",12,5,"Anesth/analg vag delivery","Professional Services: Inpatient","Not Covered",{"$f":"VLOOKUP(D47,MaternityFeeSchedule,7,FALSE)","v":{"v":1399.34,"d":"$1,399.34"}},{"$f":"IF(G47=\"Not Covered\",H47,0)","v":{"v":1399.34,"d":"$1,399.34"}},{"$f":"H47-I47","v":0},{"$f":"VLOOKUP(F47,nrCoverageTable,COLUMN(nrOOPLimitValid),FALSE)","v":false},{"$f":"IF(K47,VLOOKUP(F47,BenefitDesignTable,COLUMN(BenefitOOPLimitApplies),FALSE),\"No\")","v":"No"},{"$f":"VLOOKUP(F47,BenefitDesignTable,COLUMN(OPLimit),FALSE)","v":"."},{"$f":"IFERROR(IF(AND(L47=\"Yes\",ISNUMBER(M47)),MAX(0,M47-SUMIFS(BU$3:BU46,L$3:L46,\"Yes\")),IF(OR(L47=\"No\",M47=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O47,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P47=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",{"$f":"IF(P47=\"Yes\",IF(R47<Q47,MIN(J47,N47),0),0)","v":0},{"$f":"J47-S47","v":0},false,{"$f":"IF(O47,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V47=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O47,COUNTIF(Z$3:Z46,\">0\"),\"N/A\")","v":"N/A"},{"$f":"IF(V47=\"Yes\",VLOOKUP(\"Professional Services: Primary Care\",BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(V47=\"Yes\",U47=TRUE,X47<W47), MIN(Y47,T47,N47),\"N/A\")","v":"N/A"},{"$f":"IF(Z47=\"N/A\",0,T47-Z47)","v":0},{"$f":"IF(L47=\"Yes\",IF(Z47=\"N/A\",N47,N47-Z47),\"N/A\")","v":"N/A"},{"$f":"IF(Z47=\"N/A\",T47,0)","v":0},{"$f":"VLOOKUP(F47,nrCoverageTable,COLUMN(nrMonthlyLimitValid),FALSE)","v":false},{"$f":"IF(AD47,VLOOKUP(F47,BenefitDesignTable,COLUMN(BenefitLimithMonth),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D47,ClaimMonth,C47,ClaimNumber,\"<\"&A47)","v":0},{"$f":"IF(AD47,IF(OR(AE47=\"None\",ISNUMBER(AE47)),IF(AF47>=AE47,H47,0),\"ERR\"),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F47,nrCoverageTable,COLUMN(nrAnnualLimitValid),FALSE)","v":false},{"$f":"IF(AH47,VLOOKUP(F47,BenefitDesignTable,COLUMN(BenefitLimitAnnual),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D47,ClaimNumber,\"<\"&A47)","v":0},{"$f":"IF(AH47,IF(OR(AI47=\"None\",ISNUMBER(AI47)),IF(AJ47>=AI47,H47,0),\"ERR\"),\"N/A\")","v":"N/A"},{"$f":"IF(OR(AG47=\"ERR\",AK47=\"ERR\"),\"ERR\",MAX(AG47,AK47))","v":0},{"$f":"IFERROR(AC47-AL47,\"ERR\")","v":0},{"$f":"VLOOKUP(F47,nrCoverageTable,COLUMN(nrUsesPlanDeduct),FALSE)","v":false},{"$f":"IF(AN47,VLOOKUP(F47,BenefitDesignTable,COLUMN(PlanDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(ISNUMBER(AO47),AN47=TRUE),MAX(0,AO47-SUMIFS($AM$3:$AM46,AN$3:AN46,TRUE)),IF(AND(AN47=TRUE,ISNUMBER(AO47)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AP47),MIN($AM47,AP47),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F47,nrCoverageTable,COLUMN(nrUsesRxDeduct),FALSE)","v":false},{"$f":"IF(AR47,VLOOKUP(F47,BenefitDesignTable,COLUMN(RxDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AR47=TRUE,ISNUMBER(AS47)),MAX(0,AS47-SUMIFS($AM$3:$AM46,AR$3:AR46,TRUE)),IF(AND(AR47=TRUE,ISNUMBER(AS47)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AT47),MIN($AM47,AT47),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F47,nrCoverageTable,COLUMN(nrUsesDeductC),FALSE)","v":false},{"$f":"IF(AV47,VLOOKUP(F47,BenefitDesignTable,COLUMN(OptDeductibleC),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AV47=TRUE,ISNUMBER(AW47)),MAX(0,AW47-SUMIFS($AM$3:$AM46,AV$3:AV46,TRUE)),IF(AND(AV47=TRUE,ISNUMBER(AW47)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AX47),MIN($AM47,AX47),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F47,nrCoverageTable,COLUMN(nrUsesDeductD),FALSE)","v":false},{"$f":"IF(AZ47,VLOOKUP(F47,BenefitDesignTable,COLUMN(OptDeductibleD),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AZ47=TRUE,ISNUMBER(BA47)),MAX(0,BA47-SUMIFS($AM$3:$AM46,AZ$3:AZ46,TRUE)),IF(AND(AZ47=TRUE,ISNUMBER(BA47)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BB47),MIN($AM47,BB47),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F47,nrCoverageTable,COLUMN(nrUsesBenDeduct),FALSE)","v":false},{"$f":"IF(BD47,VLOOKUP(F47,BenefitDesignTable,COLUMN(BenefitDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(BD47=TRUE,ISNUMBER(BE47)=TRUE),MAX(0,BE47-SUMIFS(AM$3:AM46,BD$3:BD46,TRUE,F$3:F46,F47)),IF(AND(BD47=TRUE,ISNUMBER(BE47)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BF47),MIN($AM47,BF47),\"N/A\")","v":"N/A"},{"$f":"SUM(AQ47,AU47,AY47,BC47,BG47)","v":0},{"$f":"IF(OR(AB47=\"ERR\",BH47=\"ERR\"),\"ERR\",MIN(BH47,AB47))","v":0},{"$f":"IF(AND(L47=\"Yes\",ISNUMBER(M47)),IF(OR(BI47=\"ERR\",AB47=\"ERR\"),\"ERR\",MAX($AB47-BI47,0)),\"N/A\")","v":"N/A"},{"$f":"IF(OR(BI47=\"ERR\",AM47=\"ERR\"),\"ERR\",MAX(0,AM47-BI47))","v":0},{"$f":"VLOOKUP(F47,nrCoverageTable,COLUMN(nrUsesCopay),FALSE)","v":false},{"$f":"IF(BL47,VLOOKUP(F47,BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(BK47=\"ERR\",\"ERR\",IF(AND(BL47=TRUE,ISNUMBER(BM47)),MIN(BK47,BM47,BJ47),IF(AND(BL47=TRUE,ISNUMBER(BM47)=FALSE),\"ERR\",\"N/A\")))","v":"N/A"},{"$f":"VLOOKUP(F47,nrCoverageTable,COLUMN(nrUsesCoins),FALSE)","v":false},{"$f":"IF(BO47,VLOOKUP(F47,BenefitDesignTable,COLUMN(BenefitCoins),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(BK47=\"ERR\",\"ERR\",IF(AND(BO47=TRUE,ISNUMBER(BP47)=TRUE),MIN(BJ47,BK47*BP47),IF(AND(BO47=TRUE,ISNUMBER(BP47)=FALSE),\"ERR\",\"N/A\")))","v":"N/A"},{"$f":"IF(OR(BJ47=\"ERR\",BN47=\"ERR\",BQ47=\"ERR\"),\"ERR\",MIN(BJ47,SUM(BN47,BQ47)))","v":0},{"$f":"IF(AND(L47=\"Yes\",ISNUMBER(M47)),IF(OR(BJ47=\"ERR\",BR47=\"ERR\"),\"ERR\",MAX(BJ47-BR47,0)),\"N/A\")","v":"N/A"},{"$f":"IF(OR(BK47=\"ERR\",BR47=\"ERR\"),\"ERR\",MAX(BK47-BR47,0))","v":0},0,0,{"$f":"I47","v":{"v":1399.34,"d":"$1,399.34"}},{"$f":"IF(OR(AG47=\"ERR\",AK47=\"ERR\"),\"ERR\",SUM(AG47,AK47))","v":0},{"$f":"BI47","v":0},{"$f":"IF(V47=\"Yes\",IF(Z47=\"N/A\",0,Z47),0)+IF(BL47,BN47,0)","v":0},{"$f":"IF(BO47,BQ47,0)","v":0},{"$f":"SUM(BV47:CA47)=H47","v":true}]
[45,"2016-12-09",12,34,"Vaginal delivery w/o complicating diagnoses","Inpatient Hospital Care (Facility)","Not Covered",{"v":7060.58,"d":"$7,060.58"},{"v":7060.58,"d":"$7,060.58"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L48=\"Yes\",ISNUMBER(M48)),MAX(0,M48-SUMIFS(BU$3:BU47,L$3:L47,\"Yes\")),IF(OR(L48=\"No\",M48=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O48,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P48=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O48,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V48=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O48,COUNTIF(Z$3:Z47,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO48),AN48=TRUE),MAX(0,AO48-SUMIFS($AM$3:$AM47,AN$3:AN47,TRUE)),IF(AND(AN48=TRUE,ISNUMBER(AO48)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR48=TRUE,ISNUMBER(AS48)),MAX(0,AS48-SUMIFS($AM$3:$AM47,AR$3:AR47,TRUE)),IF(AND(AR48=TRUE,ISNUMBER(AS48)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV48=TRUE,ISNUMBER(AW48)),MAX(0,AW48-SUMIFS($AM$3:$AM47,AV$3:AV47,TRUE)),IF(AND(AV48=TRUE,ISNUMBER(AW48)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ48=TRUE,ISNUMBER(BA48)),MAX(0,BA48-SUMIFS($AM$3:$AM47,AZ$3:AZ47,TRUE)),IF(AND(AZ48=TRUE,ISNUMBER(BA48)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD48=TRUE,ISNUMBER(BE48)=TRUE),MAX(0,BE48-SUMIFS(AM$3:AM47,BD$3:BD47,TRUE,F$3:F47,F48)),IF(AND(BD48=TRUE,ISNUMBER(BE48)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":7060.58,"d":"$7,060.58"},0,0,0,0,true]
[46,"2016-12-09",12,32,"Office/Outpatient Visit Est","Professional Services: Obstetric Care (Bundled)","Not Covered",0,0,0,false,"No",".",{"$f":"IFERROR(IF(AND(L49=\"Yes\",ISNUMBER(M49)),MAX(0,M49-SUMIFS(BU$3:BU48,L$3:L48,\"Yes\")),IF(OR(L49=\"No\",M49=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O49,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P49=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O49,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V49=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O49,COUNTIF(Z$3:Z48,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",1,"N/A",false,".",13,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO49),AN49=TRUE),MAX(0,AO49-SUMIFS($AM$3:$AM48,AN$3:AN48,TRUE)),IF(AND(AN49=TRUE,ISNUMBER(AO49)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR49=TRUE,ISNUMBER(AS49)),MAX(0,AS49-SUMIFS($AM$3:$AM48,AR$3:AR48,TRUE)),IF(AND(AR49=TRUE,ISNUMBER(AS49)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV49=TRUE,ISNUMBER(AW49)),MAX(0,AW49-SUMIFS($AM$3:$AM48,AV$3:AV48,TRUE)),IF(AND(AV49=TRUE,ISNUMBER(AW49)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ49=TRUE,ISNUMBER(BA49)),MAX(0,BA49-SUMIFS($AM$3:$AM48,AZ$3:AZ48,TRUE)),IF(AND(AZ49=TRUE,ISNUMBER(BA49)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD49=TRUE,ISNUMBER(BE49)=TRUE),MAX(0,BE49-SUMIFS(AM$3:AM48,BD$3:BD48,TRUE,F$3:F48,F49)),IF(AND(BD49=TRUE,ISNUMBER(BE49)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,0,0,0,0,0,true]
[47,"2016-12-11",12,7,"Polyethylene Glycol 3350 [1 dose / 17 GM daily]","Over-the-counter Drugs","Not Covered",{"v":15.1,"d":"$15.10"},{"v":15.1,"d":"$15.10"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L50=\"Yes\",ISNUMBER(M50)),MAX(0,M50-SUMIFS(BU$3:BU49,L$3:L49,\"Yes\")),IF(OR(L50=\"No\",M50=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O50,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P50=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O50,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V50=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O50,COUNTIF(Z$3:Z49,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO50),AN50=TRUE),MAX(0,AO50-SUMIFS($AM$3:$AM49,AN$3:AN49,TRUE)),IF(AND(AN50=TRUE,ISNUMBER(AO50)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR50=TRUE,ISNUMBER(AS50)),MAX(0,AS50-SUMIFS($AM$3:$AM49,AR$3:AR49,TRUE)),IF(AND(AR50=TRUE,ISNUMBER(AS50)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV50=TRUE,ISNUMBER(AW50)),MAX(0,AW50-SUMIFS($AM$3:$AM49,AV$3:AV49,TRUE)),IF(AND(AV50=TRUE,ISNUMBER(AW50)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ50=TRUE,ISNUMBER(BA50)),MAX(0,BA50-SUMIFS($AM$3:$AM49,AZ$3:AZ49,TRUE)),IF(AND(AZ50=TRUE,ISNUMBER(BA50)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD50=TRUE,ISNUMBER(BE50)=TRUE),MAX(0,BE50-SUMIFS(AM$3:AM49,BD$3:BD49,TRUE,F$3:F49,F50)),IF(AND(BD50=TRUE,ISNUMBER(BE50)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":15.1,"d":"$15.10"},0,0,0,0,true]
[48,"2016-12-11",12,2,"Ibuprofen 800mg (Rx) [1 pill Q8H PRN; 30 pills]","Prescription Drugs: Generic","Not Covered",{"$f":"VLOOKUP(D51,MaternityFeeSchedule,7,FALSE)","v":{"v":3.77,"d":"$3.77"}},{"$f":"IF(G51=\"Not Covered\",H51,0)","v":{"v":3.77,"d":"$3.77"}},{"$f":"H51-I51","v":0},{"$f":"VLOOKUP(F51,nrCoverageTable,COLUMN(nrOOPLimitValid),FALSE)","v":false},{"$f":"IF(K51,VLOOKUP(F51,BenefitDesignTable,COLUMN(BenefitOOPLimitApplies),FALSE),\"No\")","v":"No"},{"$f":"VLOOKUP(F51,BenefitDesignTable,COLUMN(OPLimit),FALSE)","v":"."},{"$f":"IFERROR(IF(AND(L51=\"Yes\",ISNUMBER(M51)),MAX(0,M51-SUMIFS(BU$3:BU50,L$3:L50,\"Yes\")),IF(OR(L51=\"No\",M51=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},{"$f":"IF(F51=\"Professional Services: Primary Care\",TRUE, FALSE)","v":false},{"$f":"IF(O51,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P51=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},{"$f":"IF(O51,COUNTIFS(BenefitCategory,\"Professional Services: Primary Care\",ClaimNumber,\"<\"&A51),\"N/A\")","v":"N/A"},{"$f":"IF(P51=\"Yes\",IF(R51<Q51,MIN(J51,N51),0),0)","v":0},{"$f":"J51-S51","v":0},{"$f":"IF(F51=\"Professional Services: Primary Care\",TRUE, FALSE)","v":false},{"$f":"IF(O51,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V51=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O51,COUNTIF(Z$3:Z50,\">0\"),\"N/A\")","v":"N/A"},{"$f":"IF(V51=\"Yes\",VLOOKUP(\"Professional Services: Primary Care\",BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(V51=\"Yes\",U51=TRUE,X51<W51), MIN(Y51,T51,N51),\"N/A\")","v":"N/A"},{"$f":"IF(Z51=\"N/A\",0,T51-Z51)","v":0},{"$f":"IF(L51=\"Yes\",IF(Z51=\"N/A\",N51,N51-Z51),\"N/A\")","v":"N/A"},{"$f":"IF(Z51=\"N/A\",T51,0)","v":0},{"$f":"VLOOKUP(F51,nrCoverageTable,COLUMN(nrMonthlyLimitValid),FALSE)","v":false},{"$f":"IF(AD51,VLOOKUP(F51,BenefitDesignTable,COLUMN(BenefitLimithMonth),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D51,ClaimMonth,C51,ClaimNumber,\"<\"&A51)","v":0},{"$f":"IF(AD51,IF(OR(AE51=\"None\",ISNUMBER(AE51)),IF(AF51>=AE51,H51,0),\"ERR\"),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F51,nrCoverageTable,COLUMN(nrAnnualLimitValid),FALSE)","v":false},{"$f":"IF(AH51,VLOOKUP(F51,BenefitDesignTable,COLUMN(BenefitLimitAnnual),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D51,ClaimNumber,\"<\"&A51)","v":0},{"$f":"IF(AH51,IF(OR(AI51=\"None\",ISNUMBER(AI51)),IF(AJ51>=AI51,H51,0),\"ERR\"),\"N/A\")","v":"N/A"},{"$f":"IF(OR(AG51=\"ERR\",AK51=\"ERR\"),\"ERR\",MAX(AG51,AK51))","v":0},{"$f":"IFERROR(AC51-AL51,\"ERR\")","v":0},{"$f":"VLOOKUP(F51,nrCoverageTable,COLUMN(nrUsesPlanDeduct),FALSE)","v":false},{"$f":"IF(AN51,VLOOKUP(F51,BenefitDesignTable,COLUMN(PlanDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(ISNUMBER(AO51),AN51=TRUE),MAX(0,AO51-SUMIFS($AM$3:$AM50,AN$3:AN50,TRUE)),IF(AND(AN51=TRUE,ISNUMBER(AO51)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AP51),MIN($AM51,AP51),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F51,nrCoverageTable,COLUMN(nrUsesRxDeduct),FALSE)","v":false},{"$f":"IF(AR51,VLOOKUP(F51,BenefitDesignTable,COLUMN(RxDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AR51=TRUE,ISNUMBER(AS51)),MAX(0,AS51-SUMIFS($AM$3:$AM50,AR$3:AR50,TRUE)),IF(AND(AR51=TRUE,ISNUMBER(AS51)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AT51),MIN($AM51,AT51),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F51,nrCoverageTable,COLUMN(nrUsesDeductC),FALSE)","v":false},{"$f":"IF(AV51,VLOOKUP(F51,BenefitDesignTable,COLUMN(OptDeductibleC),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AV51=TRUE,ISNUMBER(AW51)),MAX(0,AW51-SUMIFS($AM$3:$AM50,AV$3:AV50,TRUE)),IF(AND(AV51=TRUE,ISNUMBER(AW51)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AX51),MIN($AM51,AX51),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F51,nrCoverageTable,COLUMN(nrUsesDeductD),FALSE)","v":false},{"$f":"IF(AZ51,VLOOKUP(F51,BenefitDesignTable,COLUMN(OptDeductibleD),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AZ51=TRUE,ISNUMBER(BA51)),MAX(0,BA51-SUMIFS($AM$3:$AM50,AZ$3:AZ50,TRUE)),IF(AND(AZ51=TRUE,ISNUMBER(BA51)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BB51),MIN($AM51,BB51),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F51,nrCoverageTable,COLUMN(nrUsesBenDeduct),FALSE)","v":false},{"$f":"IF(BD51,VLOOKUP(F51,BenefitDesignTable,COLUMN(BenefitDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(BD51=TRUE,ISNUMBER(BE51)=TRUE),MAX(0,BE51-SUMIFS(AM$3:AM50,BD$3:BD50,TRUE,F$3:F50,F51)),IF(AND(BD51=TRUE,ISNUMBER(BE51)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BF51),MIN($AM51,BF51),\"N/A\")","v":"N/A"},{"$f":"SUM(AQ51,AU51,AY51,BC51,BG51)","v":0},{"$f":"IF(OR(AB51=\"ERR\",BH51=\"ERR\"),\"ERR\",MIN(BH51,AB51))","v":0},{"$f":"IF(AND(L51=\"Yes\",ISNUMBER(M51)),IF(OR(BI51=\"ERR\",AB51=\"ERR\"),\"ERR\",MAX($AB51-BI51,0)),\"N/A\")","v":"N/A"},{"$f":"IF(OR(BI51=\"ERR\",AM51=\"ERR\"),\"ERR\",MAX(0,AM51-BI51))","v":0},{"$f":"VLOOKUP(F51,nrCoverageTable,COLUMN(nrUsesCopay),FALSE)","v":false},{"$f":"IF(BL51,VLOOKUP(F51,BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(BK51=\"ERR\",\"ERR\",IF(AND(BL51=TRUE,ISNUMBER(BM51)),MIN(BK51,BM51,BJ51),IF(AND(BL51=TRUE,ISNUMBER(BM51)=FALSE),\"ERR\",\"N/A\")))","v":"N/A"},{"$f":"VLOOKUP(F51,nrCoverageTable,COLUMN(nrUsesCoins),FALSE)","v":false},{"$f":"IF(BO51,VLOOKUP(F51,BenefitDesignTable,COLUMN(BenefitCoins),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(BK51=\"ERR\",\"ERR\",IF(AND(BO51=TRUE,ISNUMBER(BP51)=TRUE),MIN(BJ51,BK51*BP51),IF(AND(BO51=TRUE,ISNUMBER(BP51)=FALSE),\"ERR\",\"N/A\")))","v":"N/A"},{"$f":"IF(OR(BJ51=\"ERR\",BN51=\"ERR\",BQ51=\"ERR\"),\"ERR\",MIN(BJ51,SUM(BN51,BQ51)))","v":0},{"$f":"IF(AND(L51=\"Yes\",ISNUMBER(M51)),IF(OR(BJ51=\"ERR\",BR51=\"ERR\"),\"ERR\",MAX(BJ51-BR51,0)),\"N/A\")","v":"N/A"},{"$f":"IF(OR(BK51=\"ERR\",BR51=\"ERR\"),\"ERR\",MAX(BK51-BR51,0))","v":0},0,0,{"$f":"I51","v":{"v":3.77,"d":"$3.77"}},{"$f":"IF(OR(AG51=\"ERR\",AK51=\"ERR\"),\"ERR\",SUM(AG51,AK51))","v":0},{"$f":"BI51","v":0},{"$f":"IF(V51=\"Yes\",IF(Z51=\"N/A\",0,Z51),0)+IF(BL51,BN51,0)","v":0},{"$f":"IF(BO51,BQ51,0)","v":0},{"$f":"SUM(BV51:CA51)=H51","v":true}]
[49,"2016-12-11",12,1,"Oxycodone/APAP 5mg/325mg (Rx) [1 pill Q6H PRN;  30 pills]","Prescription Drugs: Generic","Not Covered",{"v":6.8,"d":"$6.80"},{"v":6.8,"d":"$6.80"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L52=\"Yes\",ISNUMBER(M52)),MAX(0,M52-SUMIFS(BU$3:BU51,L$3:L51,\"Yes\")),IF(OR(L52=\"No\",M52=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O52,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P52=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O52,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V52=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O52,COUNTIF(Z$3:Z51,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO52),AN52=TRUE),MAX(0,AO52-SUMIFS($AM$3:$AM51,AN$3:AN51,TRUE)),IF(AND(AN52=TRUE,ISNUMBER(AO52)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR52=TRUE,ISNUMBER(AS52)),MAX(0,AS52-SUMIFS($AM$3:$AM51,AR$3:AR51,TRUE)),IF(AND(AR52=TRUE,ISNUMBER(AS52)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV52=TRUE,ISNUMBER(AW52)),MAX(0,AW52-SUMIFS($AM$3:$AM51,AV$3:AV51,TRUE)),IF(AND(AV52=TRUE,ISNUMBER(AW52)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ52=TRUE,ISNUMBER(BA52)),MAX(0,BA52-SUMIFS($AM$3:$AM51,AZ$3:AZ51,TRUE)),IF(AND(AZ52=TRUE,ISNUMBER(BA52)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD52=TRUE,ISNUMBER(BE52)=TRUE),MAX(0,BE52-SUMIFS(AM$3:AM51,BD$3:BD51,TRUE,F$3:F51,F52)),IF(AND(BD52=TRUE,ISNUMBER(BE52)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":6.8,"d":"$6.80"},0,0,0,0,true]
[50,"2016-12-23",12,33,"Office/Outpatient Visit Est","Professional Services: Obstetric Care (Bundled)","Not Covered",0,0,0,false,"No",".",{"$f":"IFERROR(IF(AND(L53=\"Yes\",ISNUMBER(M53)),MAX(0,M53-SUMIFS(BU$3:BU52,L$3:L52,\"Yes\")),IF(OR(L53=\"No\",M53=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O53,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P53=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O53,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V53=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O53,COUNTIF(Z$3:Z52,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO53),AN53=TRUE),MAX(0,AO53-SUMIFS($AM$3:$AM52,AN$3:AN52,TRUE)),IF(AND(AN53=TRUE,ISNUMBER(AO53)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR53=TRUE,ISNUMBER(AS53)),MAX(0,AS53-SUMIFS($AM$3:$AM52,AR$3:AR52,TRUE)),IF(AND(AR53=TRUE,ISNUMBER(AS53)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV53=TRUE,ISNUMBER(AW53)),MAX(0,AW53-SUMIFS($AM$3:$AM52,AV$3:AV52,TRUE)),IF(AND(AV53=TRUE,ISNUMBER(AW53)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ53=TRUE,ISNUMBER(BA53)),MAX(0,BA53-SUMIFS($AM$3:$AM52,AZ$3:AZ52,TRUE)),IF(AND(AZ53=TRUE,ISNUMBER(BA53)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD53=TRUE,ISNUMBER(BE53)=TRUE),MAX(0,BE53-SUMIFS(AM$3:AM52,BD$3:BD52,TRUE,F$3:F52,F53)),IF(AND(BD53=TRUE,ISNUMBER(BE53)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,0,0,0,0,0,true]

{"sheet":"DIABETES_TIMELINE","index":13,"n_rows":100,"n_cols":80,"rows_kept":100,"hidden":true}
[{"$nulls":79},{"$f":"COUNTIF(CB4:CB100,FALSE)=0","v":true}]
[{"$nulls":7},"Phase 1: Determine Covered Amount",null,null,"Phase 2: Apply OOP Limit",{"$nulls":3},"Phase 3a: Apply Special cost sharing - Begin Primary Care cost-sharing after a set number of visits?",{"$nulls":5},"Phase 3b: Apply special cost sharing: Begin primary care cost sharing deductible or coinsurance after a set number of copays?",{"$nulls":8},"Phase 4: Apply monthly/annual limit",{"$nulls":9},"Phase 5: Plan deductible",{"$nulls":3},"Phase 5: Rx deductible",{"$nulls":3},"Phase 5: Optional deductible C",{"$nulls":3},"Phase 5: Optional deductible D",{"$nulls":3},"Phase 5: Benefit deductible",{"$nulls":3},"Phase 5 Summary",null,"Phase 6: Apply copay and coinsurance",{"$nulls":8},"Phase 7: Calculate total subscriber pays",null,null,"Phase 8: Summarize payments by payer and phase category"]
["Claim number","Date","Calendar Month","Item or Service Code","Description","Benefit Category","Cost-sharing type","Allowed amount","Service Not covered","Remaining Covered Amount","OPL Valid?","OPL applies","OPL","Remaining OPL after previous subscriber payments","Primary Care Visit?","Begin Primary Care Cost-Sharing After A Set Number of Visits?","# Visits","Primary Care Prior Use","Visit Covered at 100% by plan","Remaining Covered Amount","Primary Care Visit?","Begin Primary Care Cost-Sharing Deductible or Coinsurance After a Set Number of Copays?","# Visits","Primary Care Prior Copay Paid","Copay Value","Subscriber-Paid Copay","Plan Paid","Remaining OPL","Remaining Covered Amount","Monthly Limit Valid?","Monthly limit","Prior use (month)","Not Covered because monthly limit exceeded","Annual Limit Valid?","Annual limit","Prior use (annual)","Not Covered because use limit exceeded","Total Not Covered because use limit exceeded","Covered amount","Uses Plan deductible?","Plan Deductible","Remaining plan deductible after previous subscriber payments","subscriber pays toward plan deductible","Uses rx deductible?","Rx Deductible","Remaining Rx deductible after previous subscriber payments","subscriber pays toward Rx deductible","Uses deductible C?","Deductible C","Remaining deductible C after previous subscriber payments","subscriber pays toward deductible C","Uses deductible D?","Deductible D","Remaining deductible D after previous subscriber payments","subscriber pays toward deductible D","Uses benefit deductible?","Benefit deductible","Remaining benefit deductible after previous subcriber payments","subscriber pays toward benefit deductible","subscriber pays toward any deductible","Subscriber-paid deductible after applying OPL","Remaining OPL","Covered amount remaining after deductibles","Uses Copay?","Copay Value","Copay Paid","Uses Coinsurance?","Coinsurance Value","Coinsurance Paid","Subscriber-paid costsharing after OPL","Remaining OPL","Allowed amount after copayment or coinsurance","Total subscriber payment After OPL","plan payment","Service Not covered","Exclusions","Subscriber-paid deductible","Subscriber-paid copayment","Subscriber-paid coinsurance","Allowable Charge ChkSum"]
[1,"2016-01-03",1,14,{"$f":"VLOOKUP(ServiceCode,DiabetesFeeSchedule,6,FALSE)","v":"BD Ultrafine Insulin Syringes / 30G/ 0.5cc  [usage = 30 syringes per month]"},{"$f":"VLOOKUP(D4,DiabetesFeeSchedule,5,FALSE)","v":"Medical Supplies"},{"$f":"VLOOKUP(F4,BenefitDesignTable,COLUMN(BenefitCostSharing),FALSE)","v":"Not Covered"},{"$f":"VLOOKUP(D4,DiabetesFeeSchedule,7,FALSE)","v":{"v":20.62,"d":"$20.62"}},{"$f":"IF(G4=\"Not Covered\",H4,0)","v":{"v":20.62,"d":"$20.62"}},{"$f":"H4-I4","v":0},{"$f":"VLOOKUP(F4,nrCoverageTable,COLUMN(nrOOPLimitValid),FALSE)","v":false},{"$f":"IF(K4,VLOOKUP(F4,BenefitDesignTable,COLUMN(BenefitOOPLimitApplies),FALSE),\"No\")","v":"No"},{"$f":"VLOOKUP(F4,BenefitDesignTable,COLUMN(OPLimit),FALSE)","v":"."},{"$f":"IFERROR(IF(AND(L4=\"Yes\",ISNUMBER(M4)),MAX(0,M4-SUMIFS(BU$3:BU3,L$3:L3,\"Yes\")),IF(OR(L4=\"No\",M4=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},{"$f":"IF(F4=\"Professional Services: Primary Care\",TRUE, FALSE)","v":false},{"$f":"IF(O4,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P4=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},{"$f":"IF(O4,COUNTIFS(BenefitCategory,\"Professional Services: Primary Care\",ClaimNumber,\"<\"&A4),\"N/A\")","v":"N/A"},{"$f":"IF(P4=\"Yes\",IF(R4<Q4,MIN(J4,N4),0),0)","v":0},{"$f":"J4-S4","v":{"v":0,"d":"$0.00"}},{"$f":"IF(F4=\"Professional Services: Primary Care\",TRUE, FALSE)","v":false},{"$f":"IF(O4,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V4=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O4,COUNTIF(Z$3:Z3,\">0\"),\"N/A\")","v":"N/A"},{"$f":"IF(V4=\"Yes\",VLOOKUP(\"Professional Services: Primary Care\",BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(V4=\"Yes\",U4=TRUE,X4<W4), 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[2,"2016-01-03",1,5,"OneTouch Delica Lancets (100 per box)  [usage = 60 lancets per month]",{"$f":"VLOOKUP(ServiceCode,DiabetesFeeSchedule,5,FALSE)","v":"Medical Supplies"},{"$f":"VLOOKUP(BenefitCategory,BenefitDesignTable,COLUMN(BenefitCostSharing),FALSE)","v":"Not Covered"},{"v":8.73,"d":"$8.73"},{"v":8.73,"d":"$8.73"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L5=\"Yes\",ISNUMBER(M5)),MAX(0,M5-SUMIFS(BU$3:BU4,L$3:L4,\"Yes\")),IF(OR(L5=\"No\",M5=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},{"$f":"IF(F5=\"Professional Services: Primary Care\",TRUE, FALSE)","v":false},{"$f":"IF(O5,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P5=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",{"$f":"IF(P5=\"Yes\",IF(R5<Q5,MIN(J5,N5),0),0)","v":0},0,{"$f":"IF(F5=\"Professional Services: Primary Care\",TRUE, FALSE)","v":false},{"$f":"IF(O5,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V5=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O5,COUNTIF(Z$3:Z4,\">0\"),\"N/A\")","v":"N/A"},"N/A",{"$f":"IF(AND(V5=\"Yes\",U5=TRUE,X5<W5), MIN(Y5,T5,N5),\"N/A\")","v":"N/A"},{"$f":"IF(Z5=\"N/A\",0,T5-Z5)","v":0},"N/A",{"$f":"IF(Z5=\"N/A\",T5,0)","v":0},false,".",0,"N/A",false,".",0,"N/A",{"$f":"IF(OR(AG5=\"ERR\",AK5=\"ERR\"),\"ERR\",MAX(AG5,AK5))","v":0},{"$f":"IFERROR(AC5-AL5,\"ERR\")","v":0},false,"N/A",{"$f":"IF(AND(ISNUMBER(AO5),AN5=TRUE),MAX(0,AO5-SUMIFS($AM$3:$AM4,AN$3:AN4,TRUE)),IF(AND(AN5=TRUE,ISNUMBER(AO5)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR5=TRUE,ISNUMBER(AS5)),MAX(0,AS5-SUMIFS($AM$3:$AM4,AR$3:AR4,TRUE)),IF(AND(AR5=TRUE,ISNUMBER(AS5)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV5=TRUE,ISNUMBER(AW5)),MAX(0,AW5-SUMIFS($AM$3:$AM4,AV$3:AV4,TRUE)),IF(AND(AV5=TRUE,ISNUMBER(AW5)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ5=TRUE,ISNUMBER(BA5)),MAX(0,BA5-SUMIFS($AM$3:$AM4,AZ$3:AZ4,TRUE)),IF(AND(AZ5=TRUE,ISNUMBER(BA5)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD5=TRUE,ISNUMBER(BE5)=TRUE),MAX(0,BE5-SUMIFS(AM$3:AM4,BD$3:BD4,TRUE,F$3:F4,F5)),IF(AND(BD5=TRUE,ISNUMBER(BE5)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,{"$f":"IF(OR(AB5=\"ERR\",BH5=\"ERR\"),\"ERR\",MIN(BH5,AB5))","v":0},{"$f":"IF(AND(L5=\"Yes\",ISNUMBER(M5)),IF(OR(BI5=\"ERR\",AB5=\"ERR\"),\"ERR\",MAX($AB5-BI5,0)),\"N/A\")","v":"N/A"},0,false,"N/A",{"$f":"IF(BK5=\"ERR\",\"ERR\",IF(AND(BL5=TRUE,ISNUMBER(BM5)),MIN(BK5,BM5,BJ5),IF(AND(BL5=TRUE,ISNUMBER(BM5)=FALSE),\"ERR\",\"N/A\")))","v":"N/A"},false,"N/A",{"$f":"IF(BK5=\"ERR\",\"ERR\",IF(AND(BO5=TRUE,ISNUMBER(BP5)=TRUE),MIN(BJ5,BK5*BP5),IF(AND(BO5=TRUE,ISNUMBER(BP5)=FALSE),\"ERR\",\"N/A\")))","v":"N/A"},{"$f":"IF(OR(BJ5=\"ERR\",BN5=\"ERR\",BQ5=\"ERR\"),\"ERR\",MIN(BJ5,SUM(BN5,BQ5)))","v":0},{"$f":"IF(AND(L5=\"Yes\",ISNUMBER(M5)),IF(OR(BJ5=\"ERR\",BR5=\"ERR\"),\"ERR\",MAX(BJ5-BR5,0)),\"N/A\")","v":"N/A"},{"$f":"IF(OR(BK5=\"ERR\",BR5=\"ERR\"),\"ERR\",MAX(BK5-BR5,0))","v":0},{"$f":"IF(OR(BI5=\"ERR\",BR5=\"ERR\"),\"ERR\",SUM(BI5,BR5,Z5))","v":0},{"$f":"IF(OR(AM5=\"ERR\",BU5=\"ERR\"),\"ERR\",MAX(S5+AA5+AM5-BI5-BR5,0))","v":0},{"v":8.73,"d":"$8.73"},0,{"$f":"BI5","v":0},0,{"$f":"IF(BO5,BQ5,0)","v":0},true]
[3,"2016-01-03",1,3,"OneTouch Delica Lancing Device ","Medical Supplies","Not Covered",{"v":14.33,"d":"$14.33"},{"v":14.33,"d":"$14.33"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L6=\"Yes\",ISNUMBER(M6)),MAX(0,M6-SUMIFS(BU$3:BU5,L$3:L5,\"Yes\")),IF(OR(L6=\"No\",M6=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O6,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P6=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O6,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V6=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O6,COUNTIF(Z$3:Z5,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO6),AN6=TRUE),MAX(0,AO6-SUMIFS($AM$3:$AM5,AN$3:AN5,TRUE)),IF(AND(AN6=TRUE,ISNUMBER(AO6)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR6=TRUE,ISNUMBER(AS6)),MAX(0,AS6-SUMIFS($AM$3:$AM5,AR$3:AR5,TRUE)),IF(AND(AR6=TRUE,ISNUMBER(AS6)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV6=TRUE,ISNUMBER(AW6)),MAX(0,AW6-SUMIFS($AM$3:$AM5,AV$3:AV5,TRUE)),IF(AND(AV6=TRUE,ISNUMBER(AW6)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ6=TRUE,ISNUMBER(BA6)),MAX(0,BA6-SUMIFS($AM$3:$AM5,AZ$3:AZ5,TRUE)),IF(AND(AZ6=TRUE,ISNUMBER(BA6)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD6=TRUE,ISNUMBER(BE6)=TRUE),MAX(0,BE6-SUMIFS(AM$3:AM5,BD$3:BD5,TRUE,F$3:F5,F6)),IF(AND(BD6=TRUE,ISNUMBER(BE6)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":14.33,"d":"$14.33"},0,0,0,0,true]
[4,"2016-01-03",1,7,"OneTouch Ultra 2 Blood Glucose Meter Kit","Medical Supplies","Not Covered",{"v":14.7,"d":"$14.70"},{"v":14.7,"d":"$14.70"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L7=\"Yes\",ISNUMBER(M7)),MAX(0,M7-SUMIFS(BU$3:BU6,L$3:L6,\"Yes\")),IF(OR(L7=\"No\",M7=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O7,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P7=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O7,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V7=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O7,COUNTIF(Z$3:Z6,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO7),AN7=TRUE),MAX(0,AO7-SUMIFS($AM$3:$AM6,AN$3:AN6,TRUE)),IF(AND(AN7=TRUE,ISNUMBER(AO7)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR7=TRUE,ISNUMBER(AS7)),MAX(0,AS7-SUMIFS($AM$3:$AM6,AR$3:AR6,TRUE)),IF(AND(AR7=TRUE,ISNUMBER(AS7)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV7=TRUE,ISNUMBER(AW7)),MAX(0,AW7-SUMIFS($AM$3:$AM6,AV$3:AV6,TRUE)),IF(AND(AV7=TRUE,ISNUMBER(AW7)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ7=TRUE,ISNUMBER(BA7)),MAX(0,BA7-SUMIFS($AM$3:$AM6,AZ$3:AZ6,TRUE)),IF(AND(AZ7=TRUE,ISNUMBER(BA7)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD7=TRUE,ISNUMBER(BE7)=TRUE),MAX(0,BE7-SUMIFS(AM$3:AM6,BD$3:BD6,TRUE,F$3:F6,F7)),IF(AND(BD7=TRUE,ISNUMBER(BE7)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":14.7,"d":"$14.70"},0,0,0,0,true]
[5,"2016-01-03",1,4,"OneTouch Ultra Blue Test Strips (Rx - box of 100) [usage = 2 strips/day; 60 per month] ","Medical Supplies","Not Covered",{"v":109.61,"d":"$109.61"},{"v":109.61,"d":"$109.61"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L8=\"Yes\",ISNUMBER(M8)),MAX(0,M8-SUMIFS(BU$3:BU7,L$3:L7,\"Yes\")),IF(OR(L8=\"No\",M8=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O8,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P8=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O8,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V8=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O8,COUNTIF(Z$3:Z7,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO8),AN8=TRUE),MAX(0,AO8-SUMIFS($AM$3:$AM7,AN$3:AN7,TRUE)),IF(AND(AN8=TRUE,ISNUMBER(AO8)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR8=TRUE,ISNUMBER(AS8)),MAX(0,AS8-SUMIFS($AM$3:$AM7,AR$3:AR7,TRUE)),IF(AND(AR8=TRUE,ISNUMBER(AS8)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV8=TRUE,ISNUMBER(AW8)),MAX(0,AW8-SUMIFS($AM$3:$AM7,AV$3:AV7,TRUE)),IF(AND(AV8=TRUE,ISNUMBER(AW8)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ8=TRUE,ISNUMBER(BA8)),MAX(0,BA8-SUMIFS($AM$3:$AM7,AZ$3:AZ7,TRUE)),IF(AND(AZ8=TRUE,ISNUMBER(BA8)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD8=TRUE,ISNUMBER(BE8)=TRUE),MAX(0,BE8-SUMIFS(AM$3:AM7,BD$3:BD7,TRUE,F$3:F7,F8)),IF(AND(BD8=TRUE,ISNUMBER(BE8)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":109.61,"d":"$109.61"},0,0,0,0,true]
[6,"2016-01-03",1,6,"OneTouch Ultra Control Solution (2 vials/box)","Medical Supplies","Not Covered",{"v":6.63,"d":"$6.63"},{"v":6.63,"d":"$6.63"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L9=\"Yes\",ISNUMBER(M9)),MAX(0,M9-SUMIFS(BU$3:BU8,L$3:L8,\"Yes\")),IF(OR(L9=\"No\",M9=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O9,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P9=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O9,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V9=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O9,COUNTIF(Z$3:Z8,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO9),AN9=TRUE),MAX(0,AO9-SUMIFS($AM$3:$AM8,AN$3:AN8,TRUE)),IF(AND(AN9=TRUE,ISNUMBER(AO9)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR9=TRUE,ISNUMBER(AS9)),MAX(0,AS9-SUMIFS($AM$3:$AM8,AR$3:AR8,TRUE)),IF(AND(AR9=TRUE,ISNUMBER(AS9)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV9=TRUE,ISNUMBER(AW9)),MAX(0,AW9-SUMIFS($AM$3:$AM8,AV$3:AV8,TRUE)),IF(AND(AV9=TRUE,ISNUMBER(AW9)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ9=TRUE,ISNUMBER(BA9)),MAX(0,BA9-SUMIFS($AM$3:$AM8,AZ$3:AZ8,TRUE)),IF(AND(AZ9=TRUE,ISNUMBER(BA9)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD9=TRUE,ISNUMBER(BE9)=TRUE),MAX(0,BE9-SUMIFS(AM$3:AM8,BD$3:BD8,TRUE,F$3:F8,F9)),IF(AND(BD9=TRUE,ISNUMBER(BE9)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":6.63,"d":"$6.63"},0,0,0,0,true]
[7,"2016-01-03",1,26,"Aspirin 81mg (OTC - bottle 100) [usage = 1 QD; #30 pills per month]","Over-the-counter Drugs","Not Covered",{"v":4.47,"d":"$4.47"},{"v":4.47,"d":"$4.47"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L10=\"Yes\",ISNUMBER(M10)),MAX(0,M10-SUMIFS(BU$3:BU9,L$3:L9,\"Yes\")),IF(OR(L10=\"No\",M10=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O10,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P10=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O10,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V10=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O10,COUNTIF(Z$3:Z9,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO10),AN10=TRUE),MAX(0,AO10-SUMIFS($AM$3:$AM9,AN$3:AN9,TRUE)),IF(AND(AN10=TRUE,ISNUMBER(AO10)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR10=TRUE,ISNUMBER(AS10)),MAX(0,AS10-SUMIFS($AM$3:$AM9,AR$3:AR9,TRUE)),IF(AND(AR10=TRUE,ISNUMBER(AS10)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV10=TRUE,ISNUMBER(AW10)),MAX(0,AW10-SUMIFS($AM$3:$AM9,AV$3:AV9,TRUE)),IF(AND(AV10=TRUE,ISNUMBER(AW10)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ10=TRUE,ISNUMBER(BA10)),MAX(0,BA10-SUMIFS($AM$3:$AM9,AZ$3:AZ9,TRUE)),IF(AND(AZ10=TRUE,ISNUMBER(BA10)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD10=TRUE,ISNUMBER(BE10)=TRUE),MAX(0,BE10-SUMIFS(AM$3:AM9,BD$3:BD9,TRUE,F$3:F9,F10)),IF(AND(BD10=TRUE,ISNUMBER(BE10)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":4.47,"d":"$4.47"},0,0,0,0,true]
[8,"2016-01-03",1,1,"Glucagon Emergency Kit","Prescription Drugs: Generic","Not Covered",{"v":241.05,"d":"$241.05"},{"v":241.05,"d":"$241.05"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L11=\"Yes\",ISNUMBER(M11)),MAX(0,M11-SUMIFS(BU$3:BU10,L$3:L10,\"Yes\")),IF(OR(L11=\"No\",M11=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O11,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P11=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O11,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V11=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O11,COUNTIF(Z$3:Z10,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO11),AN11=TRUE),MAX(0,AO11-SUMIFS($AM$3:$AM10,AN$3:AN10,TRUE)),IF(AND(AN11=TRUE,ISNUMBER(AO11)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR11=TRUE,ISNUMBER(AS11)),MAX(0,AS11-SUMIFS($AM$3:$AM10,AR$3:AR10,TRUE)),IF(AND(AR11=TRUE,ISNUMBER(AS11)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV11=TRUE,ISNUMBER(AW11)),MAX(0,AW11-SUMIFS($AM$3:$AM10,AV$3:AV10,TRUE)),IF(AND(AV11=TRUE,ISNUMBER(AW11)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ11=TRUE,ISNUMBER(BA11)),MAX(0,BA11-SUMIFS($AM$3:$AM10,AZ$3:AZ10,TRUE)),IF(AND(AZ11=TRUE,ISNUMBER(BA11)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD11=TRUE,ISNUMBER(BE11)=TRUE),MAX(0,BE11-SUMIFS(AM$3:AM10,BD$3:BD10,TRUE,F$3:F10,F11)),IF(AND(BD11=TRUE,ISNUMBER(BE11)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":241.05,"d":"$241.05"},0,0,0,0,true]
[9,"2016-01-03",1,17,"Insulin glargine 100 unit/ml injectable solution (Rx - 10ml vial)  [20 units QD; expires 28 days after first use]","Prescription Drugs: Insulin","Not Covered",{"v":240.37,"d":"$240.37"},{"v":240.37,"d":"$240.37"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L12=\"Yes\",ISNUMBER(M12)),MAX(0,M12-SUMIFS(BU$3:BU11,L$3:L11,\"Yes\")),IF(OR(L12=\"No\",M12=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O12,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P12=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O12,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V12=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O12,COUNTIF(Z$3:Z11,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO12),AN12=TRUE),MAX(0,AO12-SUMIFS($AM$3:$AM11,AN$3:AN11,TRUE)),IF(AND(AN12=TRUE,ISNUMBER(AO12)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR12=TRUE,ISNUMBER(AS12)),MAX(0,AS12-SUMIFS($AM$3:$AM11,AR$3:AR11,TRUE)),IF(AND(AR12=TRUE,ISNUMBER(AS12)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV12=TRUE,ISNUMBER(AW12)),MAX(0,AW12-SUMIFS($AM$3:$AM11,AV$3:AV11,TRUE)),IF(AND(AV12=TRUE,ISNUMBER(AW12)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ12=TRUE,ISNUMBER(BA12)),MAX(0,BA12-SUMIFS($AM$3:$AM11,AZ$3:AZ11,TRUE)),IF(AND(AZ12=TRUE,ISNUMBER(BA12)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD12=TRUE,ISNUMBER(BE12)=TRUE),MAX(0,BE12-SUMIFS(AM$3:AM11,BD$3:BD11,TRUE,F$3:F11,F12)),IF(AND(BD12=TRUE,ISNUMBER(BE12)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":240.37,"d":"$240.37"},0,0,0,0,true]
[10,"2016-01-03",1,32,"Metformin Hydrochloride 500 MG TABLET [ #60 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.21,"d":"$3.21"},{"v":3.21,"d":"$3.21"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L13=\"Yes\",ISNUMBER(M13)),MAX(0,M13-SUMIFS(BU$3:BU12,L$3:L12,\"Yes\")),IF(OR(L13=\"No\",M13=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O13,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P13=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O13,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V13=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O13,COUNTIF(Z$3:Z12,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO13),AN13=TRUE),MAX(0,AO13-SUMIFS($AM$3:$AM12,AN$3:AN12,TRUE)),IF(AND(AN13=TRUE,ISNUMBER(AO13)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR13=TRUE,ISNUMBER(AS13)),MAX(0,AS13-SUMIFS($AM$3:$AM12,AR$3:AR12,TRUE)),IF(AND(AR13=TRUE,ISNUMBER(AS13)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV13=TRUE,ISNUMBER(AW13)),MAX(0,AW13-SUMIFS($AM$3:$AM12,AV$3:AV12,TRUE)),IF(AND(AV13=TRUE,ISNUMBER(AW13)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ13=TRUE,ISNUMBER(BA13)),MAX(0,BA13-SUMIFS($AM$3:$AM12,AZ$3:AZ12,TRUE)),IF(AND(AZ13=TRUE,ISNUMBER(BA13)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD13=TRUE,ISNUMBER(BE13)=TRUE),MAX(0,BE13-SUMIFS(AM$3:AM12,BD$3:BD12,TRUE,F$3:F12,F13)),IF(AND(BD13=TRUE,ISNUMBER(BE13)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.21,"d":"$3.21"},0,0,0,0,true]
[11,"2016-01-03",1,19,"Lisinopril 20mg (Rx) [1 QD; #30 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.38,"d":"$3.38"},{"v":3.38,"d":"$3.38"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L14=\"Yes\",ISNUMBER(M14)),MAX(0,M14-SUMIFS(BU$3:BU13,L$3:L13,\"Yes\")),IF(OR(L14=\"No\",M14=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O14,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P14=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O14,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V14=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O14,COUNTIF(Z$3:Z13,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO14),AN14=TRUE),MAX(0,AO14-SUMIFS($AM$3:$AM13,AN$3:AN13,TRUE)),IF(AND(AN14=TRUE,ISNUMBER(AO14)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR14=TRUE,ISNUMBER(AS14)),MAX(0,AS14-SUMIFS($AM$3:$AM13,AR$3:AR13,TRUE)),IF(AND(AR14=TRUE,ISNUMBER(AS14)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV14=TRUE,ISNUMBER(AW14)),MAX(0,AW14-SUMIFS($AM$3:$AM13,AV$3:AV13,TRUE)),IF(AND(AV14=TRUE,ISNUMBER(AW14)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ14=TRUE,ISNUMBER(BA14)),MAX(0,BA14-SUMIFS($AM$3:$AM13,AZ$3:AZ13,TRUE)),IF(AND(AZ14=TRUE,ISNUMBER(BA14)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD14=TRUE,ISNUMBER(BE14)=TRUE),MAX(0,BE14-SUMIFS(AM$3:AM13,BD$3:BD13,TRUE,F$3:F13,F14)),IF(AND(BD14=TRUE,ISNUMBER(BE14)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.38,"d":"$3.38"},0,0,0,0,true]
[12,"2016-01-03",1,33,"Atorvastatin 40 MG tablet 90 CT [ #30 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":9.66,"d":"$9.66"},{"v":9.66,"d":"$9.66"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L15=\"Yes\",ISNUMBER(M15)),MAX(0,M15-SUMIFS(BU$3:BU14,L$3:L14,\"Yes\")),IF(OR(L15=\"No\",M15=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O15,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P15=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O15,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V15=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O15,COUNTIF(Z$3:Z14,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO15),AN15=TRUE),MAX(0,AO15-SUMIFS($AM$3:$AM14,AN$3:AN14,TRUE)),IF(AND(AN15=TRUE,ISNUMBER(AO15)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR15=TRUE,ISNUMBER(AS15)),MAX(0,AS15-SUMIFS($AM$3:$AM14,AR$3:AR14,TRUE)),IF(AND(AR15=TRUE,ISNUMBER(AS15)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV15=TRUE,ISNUMBER(AW15)),MAX(0,AW15-SUMIFS($AM$3:$AM14,AV$3:AV14,TRUE)),IF(AND(AV15=TRUE,ISNUMBER(AW15)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ15=TRUE,ISNUMBER(BA15)),MAX(0,BA15-SUMIFS($AM$3:$AM14,AZ$3:AZ14,TRUE)),IF(AND(AZ15=TRUE,ISNUMBER(BA15)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD15=TRUE,ISNUMBER(BE15)=TRUE),MAX(0,BE15-SUMIFS(AM$3:AM14,BD$3:BD14,TRUE,F$3:F14,F15)),IF(AND(BD15=TRUE,ISNUMBER(BE15)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":9.66,"d":"$9.66"},0,0,0,0,true]
[13,"2016-01-03",1,13,"Assay of Urine Creatinine","Diagnostic Services: Laboratory","Not Covered",{"v":9.53,"d":"$9.53"},{"v":9.53,"d":"$9.53"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L16=\"Yes\",ISNUMBER(M16)),MAX(0,M16-SUMIFS(BU$3:BU15,L$3:L15,\"Yes\")),IF(OR(L16=\"No\",M16=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O16,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P16=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O16,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V16=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O16,COUNTIF(Z$3:Z15,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO16),AN16=TRUE),MAX(0,AO16-SUMIFS($AM$3:$AM15,AN$3:AN15,TRUE)),IF(AND(AN16=TRUE,ISNUMBER(AO16)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR16=TRUE,ISNUMBER(AS16)),MAX(0,AS16-SUMIFS($AM$3:$AM15,AR$3:AR15,TRUE)),IF(AND(AR16=TRUE,ISNUMBER(AS16)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV16=TRUE,ISNUMBER(AW16)),MAX(0,AW16-SUMIFS($AM$3:$AM15,AV$3:AV15,TRUE)),IF(AND(AV16=TRUE,ISNUMBER(AW16)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ16=TRUE,ISNUMBER(BA16)),MAX(0,BA16-SUMIFS($AM$3:$AM15,AZ$3:AZ15,TRUE)),IF(AND(AZ16=TRUE,ISNUMBER(BA16)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD16=TRUE,ISNUMBER(BE16)=TRUE),MAX(0,BE16-SUMIFS(AM$3:AM15,BD$3:BD15,TRUE,F$3:F15,F16)),IF(AND(BD16=TRUE,ISNUMBER(BE16)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":9.53,"d":"$9.53"},0,0,0,0,true]
[14,"2016-01-03",1,8,"Comprehen Metabolic Panel","Diagnostic Services: Laboratory","Not Covered",{"v":29.63,"d":"$29.63"},{"v":29.63,"d":"$29.63"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L17=\"Yes\",ISNUMBER(M17)),MAX(0,M17-SUMIFS(BU$3:BU16,L$3:L16,\"Yes\")),IF(OR(L17=\"No\",M17=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O17,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P17=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O17,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V17=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O17,COUNTIF(Z$3:Z16,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO17),AN17=TRUE),MAX(0,AO17-SUMIFS($AM$3:$AM16,AN$3:AN16,TRUE)),IF(AND(AN17=TRUE,ISNUMBER(AO17)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR17=TRUE,ISNUMBER(AS17)),MAX(0,AS17-SUMIFS($AM$3:$AM16,AR$3:AR16,TRUE)),IF(AND(AR17=TRUE,ISNUMBER(AS17)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV17=TRUE,ISNUMBER(AW17)),MAX(0,AW17-SUMIFS($AM$3:$AM16,AV$3:AV16,TRUE)),IF(AND(AV17=TRUE,ISNUMBER(AW17)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ17=TRUE,ISNUMBER(BA17)),MAX(0,BA17-SUMIFS($AM$3:$AM16,AZ$3:AZ16,TRUE)),IF(AND(AZ17=TRUE,ISNUMBER(BA17)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD17=TRUE,ISNUMBER(BE17)=TRUE),MAX(0,BE17-SUMIFS(AM$3:AM16,BD$3:BD16,TRUE,F$3:F16,F17)),IF(AND(BD17=TRUE,ISNUMBER(BE17)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":29.63,"d":"$29.63"},0,0,0,0,true]
[15,"2016-01-03",1,16,"Glycosylated Hemoglobin Test","Diagnostic Services: Laboratory","Not Covered",{"v":16.98,"d":"$16.98"},{"v":16.98,"d":"$16.98"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L18=\"Yes\",ISNUMBER(M18)),MAX(0,M18-SUMIFS(BU$3:BU17,L$3:L17,\"Yes\")),IF(OR(L18=\"No\",M18=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O18,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P18=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O18,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V18=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O18,COUNTIF(Z$3:Z17,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO18),AN18=TRUE),MAX(0,AO18-SUMIFS($AM$3:$AM17,AN$3:AN17,TRUE)),IF(AND(AN18=TRUE,ISNUMBER(AO18)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR18=TRUE,ISNUMBER(AS18)),MAX(0,AS18-SUMIFS($AM$3:$AM17,AR$3:AR17,TRUE)),IF(AND(AR18=TRUE,ISNUMBER(AS18)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV18=TRUE,ISNUMBER(AW18)),MAX(0,AW18-SUMIFS($AM$3:$AM17,AV$3:AV17,TRUE)),IF(AND(AV18=TRUE,ISNUMBER(AW18)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ18=TRUE,ISNUMBER(BA18)),MAX(0,BA18-SUMIFS($AM$3:$AM17,AZ$3:AZ17,TRUE)),IF(AND(AZ18=TRUE,ISNUMBER(BA18)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD18=TRUE,ISNUMBER(BE18)=TRUE),MAX(0,BE18-SUMIFS(AM$3:AM17,BD$3:BD17,TRUE,F$3:F17,F18)),IF(AND(BD18=TRUE,ISNUMBER(BE18)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":16.98,"d":"$16.98"},0,0,0,0,true]
[16,"2016-01-03",1,9,"Lipid panel","Diagnostic Services: Laboratory","Not Covered",{"v":23.4,"d":"$23.40"},{"v":23.4,"d":"$23.40"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L19=\"Yes\",ISNUMBER(M19)),MAX(0,M19-SUMIFS(BU$3:BU18,L$3:L18,\"Yes\")),IF(OR(L19=\"No\",M19=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O19,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P19=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O19,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V19=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O19,COUNTIF(Z$3:Z18,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO19),AN19=TRUE),MAX(0,AO19-SUMIFS($AM$3:$AM18,AN$3:AN18,TRUE)),IF(AND(AN19=TRUE,ISNUMBER(AO19)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR19=TRUE,ISNUMBER(AS19)),MAX(0,AS19-SUMIFS($AM$3:$AM18,AR$3:AR18,TRUE)),IF(AND(AR19=TRUE,ISNUMBER(AS19)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV19=TRUE,ISNUMBER(AW19)),MAX(0,AW19-SUMIFS($AM$3:$AM18,AV$3:AV18,TRUE)),IF(AND(AV19=TRUE,ISNUMBER(AW19)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ19=TRUE,ISNUMBER(BA19)),MAX(0,BA19-SUMIFS($AM$3:$AM18,AZ$3:AZ18,TRUE)),IF(AND(AZ19=TRUE,ISNUMBER(BA19)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD19=TRUE,ISNUMBER(BE19)=TRUE),MAX(0,BE19-SUMIFS(AM$3:AM18,BD$3:BD18,TRUE,F$3:F18,F19)),IF(AND(BD19=TRUE,ISNUMBER(BE19)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":23.4,"d":"$23.40"},0,0,0,0,true]
[17,"2016-01-03",1,12,"Microalbumin Quantitative","Diagnostic Services: Laboratory","Not Covered",{"v":13.1,"d":"$13.10"},{"v":13.1,"d":"$13.10"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L20=\"Yes\",ISNUMBER(M20)),MAX(0,M20-SUMIFS(BU$3:BU19,L$3:L19,\"Yes\")),IF(OR(L20=\"No\",M20=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O20,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P20=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O20,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V20=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O20,COUNTIF(Z$3:Z19,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO20),AN20=TRUE),MAX(0,AO20-SUMIFS($AM$3:$AM19,AN$3:AN19,TRUE)),IF(AND(AN20=TRUE,ISNUMBER(AO20)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR20=TRUE,ISNUMBER(AS20)),MAX(0,AS20-SUMIFS($AM$3:$AM19,AR$3:AR19,TRUE)),IF(AND(AR20=TRUE,ISNUMBER(AS20)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV20=TRUE,ISNUMBER(AW20)),MAX(0,AW20-SUMIFS($AM$3:$AM19,AV$3:AV19,TRUE)),IF(AND(AV20=TRUE,ISNUMBER(AW20)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ20=TRUE,ISNUMBER(BA20)),MAX(0,BA20-SUMIFS($AM$3:$AM19,AZ$3:AZ19,TRUE)),IF(AND(AZ20=TRUE,ISNUMBER(BA20)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD20=TRUE,ISNUMBER(BE20)=TRUE),MAX(0,BE20-SUMIFS(AM$3:AM19,BD$3:BD19,TRUE,F$3:F19,F20)),IF(AND(BD20=TRUE,ISNUMBER(BE20)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":13.1,"d":"$13.10"},0,0,0,0,true]
[18,"2016-01-03",1,2,"Routine Venipuncture","Diagnostic Services: Laboratory","Not Covered",{"v":6.43,"d":"$6.43"},{"v":6.43,"d":"$6.43"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L21=\"Yes\",ISNUMBER(M21)),MAX(0,M21-SUMIFS(BU$3:BU20,L$3:L20,\"Yes\")),IF(OR(L21=\"No\",M21=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O21,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P21=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O21,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V21=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O21,COUNTIF(Z$3:Z20,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO21),AN21=TRUE),MAX(0,AO21-SUMIFS($AM$3:$AM20,AN$3:AN20,TRUE)),IF(AND(AN21=TRUE,ISNUMBER(AO21)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR21=TRUE,ISNUMBER(AS21)),MAX(0,AS21-SUMIFS($AM$3:$AM20,AR$3:AR20,TRUE)),IF(AND(AR21=TRUE,ISNUMBER(AS21)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV21=TRUE,ISNUMBER(AW21)),MAX(0,AW21-SUMIFS($AM$3:$AM20,AV$3:AV20,TRUE)),IF(AND(AV21=TRUE,ISNUMBER(AW21)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ21=TRUE,ISNUMBER(BA21)),MAX(0,BA21-SUMIFS($AM$3:$AM20,AZ$3:AZ20,TRUE)),IF(AND(AZ21=TRUE,ISNUMBER(BA21)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD21=TRUE,ISNUMBER(BE21)=TRUE),MAX(0,BE21-SUMIFS(AM$3:AM20,BD$3:BD20,TRUE,F$3:F20,F21)),IF(AND(BD21=TRUE,ISNUMBER(BE21)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":6.43,"d":"$6.43"},0,0,0,0,true]
[19,"2016-01-03",1,24,"Office/Outpatient Visit Est","Professional Services: Primary Care","Not Covered",{"v":121.7,"d":"$121.70"},{"v":121.7,"d":"$121.70"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L22=\"Yes\",ISNUMBER(M22)),MAX(0,M22-SUMIFS(BU$3:BU21,L$3:L21,\"Yes\")),IF(OR(L22=\"No\",M22=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},true,{"$f":"IF(O22,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"."},{"$f":"IF(P22=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},0,0,0,true,{"$f":"IF(O22,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"."},{"$f":"IF(V22=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O22,COUNTIF(Z$3:Z21,\">0\"),\"N/A\")","v":0},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO22),AN22=TRUE),MAX(0,AO22-SUMIFS($AM$3:$AM21,AN$3:AN21,TRUE)),IF(AND(AN22=TRUE,ISNUMBER(AO22)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR22=TRUE,ISNUMBER(AS22)),MAX(0,AS22-SUMIFS($AM$3:$AM21,AR$3:AR21,TRUE)),IF(AND(AR22=TRUE,ISNUMBER(AS22)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV22=TRUE,ISNUMBER(AW22)),MAX(0,AW22-SUMIFS($AM$3:$AM21,AV$3:AV21,TRUE)),IF(AND(AV22=TRUE,ISNUMBER(AW22)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ22=TRUE,ISNUMBER(BA22)),MAX(0,BA22-SUMIFS($AM$3:$AM21,AZ$3:AZ21,TRUE)),IF(AND(AZ22=TRUE,ISNUMBER(BA22)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD22=TRUE,ISNUMBER(BE22)=TRUE),MAX(0,BE22-SUMIFS(AM$3:AM21,BD$3:BD21,TRUE,F$3:F21,F22)),IF(AND(BD22=TRUE,ISNUMBER(BE22)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":121.7,"d":"$121.70"},0,0,0,0,true]
[20,"2016-01-04",1,21,"Diabetes outpatient self-management training services, individual, per 30 minutes","Professional Services: Primary Care","Not Covered",{"v":77.82,"d":"$77.82"},{"v":77.82,"d":"$77.82"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L23=\"Yes\",ISNUMBER(M23)),MAX(0,M23-SUMIFS(BU$3:BU22,L$3:L22,\"Yes\")),IF(OR(L23=\"No\",M23=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},true,{"$f":"IF(O23,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"."},{"$f":"IF(P23=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},1,0,0,true,{"$f":"IF(O23,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"."},{"$f":"IF(V23=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O23,COUNTIF(Z$3:Z22,\">0\"),\"N/A\")","v":0},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO23),AN23=TRUE),MAX(0,AO23-SUMIFS($AM$3:$AM22,AN$3:AN22,TRUE)),IF(AND(AN23=TRUE,ISNUMBER(AO23)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR23=TRUE,ISNUMBER(AS23)),MAX(0,AS23-SUMIFS($AM$3:$AM22,AR$3:AR22,TRUE)),IF(AND(AR23=TRUE,ISNUMBER(AS23)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV23=TRUE,ISNUMBER(AW23)),MAX(0,AW23-SUMIFS($AM$3:$AM22,AV$3:AV22,TRUE)),IF(AND(AV23=TRUE,ISNUMBER(AW23)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ23=TRUE,ISNUMBER(BA23)),MAX(0,BA23-SUMIFS($AM$3:$AM22,AZ$3:AZ22,TRUE)),IF(AND(AZ23=TRUE,ISNUMBER(BA23)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD23=TRUE,ISNUMBER(BE23)=TRUE),MAX(0,BE23-SUMIFS(AM$3:AM22,BD$3:BD22,TRUE,F$3:F22,F23)),IF(AND(BD23=TRUE,ISNUMBER(BE23)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":77.82,"d":"$77.82"},0,0,0,0,true]
[21,"2016-01-04",1,20,"Med Nutrition Indiv Subseq","Professional Services: Primary Care","Not Covered",{"v":36.83,"d":"$36.83"},{"v":36.83,"d":"$36.83"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L24=\"Yes\",ISNUMBER(M24)),MAX(0,M24-SUMIFS(BU$3:BU23,L$3:L23,\"Yes\")),IF(OR(L24=\"No\",M24=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},true,{"$f":"IF(O24,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"."},{"$f":"IF(P24=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},2,0,0,true,{"$f":"IF(O24,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"."},{"$f":"IF(V24=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O24,COUNTIF(Z$3:Z23,\">0\"),\"N/A\")","v":0},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO24),AN24=TRUE),MAX(0,AO24-SUMIFS($AM$3:$AM23,AN$3:AN23,TRUE)),IF(AND(AN24=TRUE,ISNUMBER(AO24)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR24=TRUE,ISNUMBER(AS24)),MAX(0,AS24-SUMIFS($AM$3:$AM23,AR$3:AR23,TRUE)),IF(AND(AR24=TRUE,ISNUMBER(AS24)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV24=TRUE,ISNUMBER(AW24)),MAX(0,AW24-SUMIFS($AM$3:$AM23,AV$3:AV23,TRUE)),IF(AND(AV24=TRUE,ISNUMBER(AW24)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ24=TRUE,ISNUMBER(BA24)),MAX(0,BA24-SUMIFS($AM$3:$AM23,AZ$3:AZ23,TRUE)),IF(AND(AZ24=TRUE,ISNUMBER(BA24)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD24=TRUE,ISNUMBER(BE24)=TRUE),MAX(0,BE24-SUMIFS(AM$3:AM23,BD$3:BD23,TRUE,F$3:F23,F24)),IF(AND(BD24=TRUE,ISNUMBER(BE24)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":36.83,"d":"$36.83"},0,0,0,0,true]
[22,"2016-01-06",1,23,"Office/Outpatient Visit New","Professional Services: Specialist","Not Covered",{"v":182.19,"d":"$182.19"},{"v":182.19,"d":"$182.19"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L25=\"Yes\",ISNUMBER(M25)),MAX(0,M25-SUMIFS(BU$3:BU24,L$3:L24,\"Yes\")),IF(OR(L25=\"No\",M25=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O25,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P25=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O25,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V25=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O25,COUNTIF(Z$3:Z24,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO25),AN25=TRUE),MAX(0,AO25-SUMIFS($AM$3:$AM24,AN$3:AN24,TRUE)),IF(AND(AN25=TRUE,ISNUMBER(AO25)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR25=TRUE,ISNUMBER(AS25)),MAX(0,AS25-SUMIFS($AM$3:$AM24,AR$3:AR24,TRUE)),IF(AND(AR25=TRUE,ISNUMBER(AS25)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV25=TRUE,ISNUMBER(AW25)),MAX(0,AW25-SUMIFS($AM$3:$AM24,AV$3:AV24,TRUE)),IF(AND(AV25=TRUE,ISNUMBER(AW25)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ25=TRUE,ISNUMBER(BA25)),MAX(0,BA25-SUMIFS($AM$3:$AM24,AZ$3:AZ24,TRUE)),IF(AND(AZ25=TRUE,ISNUMBER(BA25)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD25=TRUE,ISNUMBER(BE25)=TRUE),MAX(0,BE25-SUMIFS(AM$3:AM24,BD$3:BD24,TRUE,F$3:F24,F25)),IF(AND(BD25=TRUE,ISNUMBER(BE25)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":182.19,"d":"$182.19"},0,0,0,0,true]
[23,"2016-01-07",1,22,{"$f":"VLOOKUP(ServiceCode,DiabetesFeeSchedule,6,FALSE)","v":"Ophthalmological services: medical examination & evaluation, with initiation or continuation of diagnostic and treatment program, comprehensive, established patient, 1 or more visits"},{"$f":"VLOOKUP(ServiceCode,DiabetesFeeSchedule,5,FALSE)","v":"Professional Services: Specialist"},{"$f":"VLOOKUP(BenefitCategory,BenefitDesignTable,COLUMN(BenefitCostSharing),FALSE)","v":"Not Covered"},{"$f":"VLOOKUP(D26,DiabetesFeeSchedule,7,FALSE)","v":{"v":118.55,"d":"$118.55"}},{"$f":"IF(G26=\"Not Covered\",H26,0)","v":{"v":118.55,"d":"$118.55"}},{"$f":"H26-I26","v":0},{"$f":"VLOOKUP(F26,nrCoverageTable,COLUMN(nrOOPLimitValid),FALSE)","v":false},{"$f":"IF(K26,VLOOKUP(F26,BenefitDesignTable,COLUMN(BenefitOOPLimitApplies),FALSE),\"No\")","v":"No"},{"$f":"VLOOKUP(F26,BenefitDesignTable,COLUMN(OPLimit),FALSE)","v":"."},{"$f":"IFERROR(IF(AND(L26=\"Yes\",ISNUMBER(M26)),MAX(0,M26-SUMIFS(BU$3:BU25,L$3:L25,\"Yes\")),IF(OR(L26=\"No\",M26=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O26,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P26=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,{"$f":"J26-S26","v":0},false,{"$f":"IF(O26,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V26=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O26,COUNTIF(Z$3:Z25,\">0\"),\"N/A\")","v":"N/A"},{"$f":"IF(V26=\"Yes\",VLOOKUP(\"Professional Services: Primary Care\",BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},"N/A",0,{"$f":"IF(L26=\"Yes\",IF(Z26=\"N/A\",N26,N26-Z26),\"N/A\")","v":"N/A"},0,{"$f":"VLOOKUP(F26,nrCoverageTable,COLUMN(nrMonthlyLimitValid),FALSE)","v":false},{"$f":"IF(AD26,VLOOKUP(F26,BenefitDesignTable,COLUMN(BenefitLimithMonth),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D26,ClaimMonth,C26,ClaimNumber,\"<\"&A26)","v":0},{"$f":"IF(AD26,IF(OR(AE26=\"None\",ISNUMBER(AE26)),IF(AF26>=AE26,H26,0),\"ERR\"),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F26,nrCoverageTable,COLUMN(nrAnnualLimitValid),FALSE)","v":false},{"$f":"IF(AH26,VLOOKUP(F26,BenefitDesignTable,COLUMN(BenefitLimitAnnual),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D26,ClaimNumber,\"<\"&A26)","v":0},{"$f":"IF(AH26,IF(OR(AI26=\"None\",ISNUMBER(AI26)),IF(AJ26>=AI26,H26,0),\"ERR\"),\"N/A\")","v":"N/A"},0,0,{"$f":"VLOOKUP(F26,nrCoverageTable,COLUMN(nrUsesPlanDeduct),FALSE)","v":false},{"$f":"IF(AN26,VLOOKUP(F26,BenefitDesignTable,COLUMN(PlanDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(ISNUMBER(AO26),AN26=TRUE),MAX(0,AO26-SUMIFS($AM$3:$AM25,AN$3:AN25,TRUE)),IF(AND(AN26=TRUE,ISNUMBER(AO26)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AP26),MIN($AM26,AP26),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F26,nrCoverageTable,COLUMN(nrUsesRxDeduct),FALSE)","v":false},{"$f":"IF(AR26,VLOOKUP(F26,BenefitDesignTable,COLUMN(RxDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AR26=TRUE,ISNUMBER(AS26)),MAX(0,AS26-SUMIFS($AM$3:$AM25,AR$3:AR25,TRUE)),IF(AND(AR26=TRUE,ISNUMBER(AS26)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AT26),MIN($AM26,AT26),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F26,nrCoverageTable,COLUMN(nrUsesDeductC),FALSE)","v":false},{"$f":"IF(AV26,VLOOKUP(F26,BenefitDesignTable,COLUMN(OptDeductibleC),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AV26=TRUE,ISNUMBER(AW26)),MAX(0,AW26-SUMIFS($AM$3:$AM25,AV$3:AV25,TRUE)),IF(AND(AV26=TRUE,ISNUMBER(AW26)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AX26),MIN($AM26,AX26),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F26,nrCoverageTable,COLUMN(nrUsesDeductD),FALSE)","v":false},{"$f":"IF(AZ26,VLOOKUP(F26,BenefitDesignTable,COLUMN(OptDeductibleD),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AZ26=TRUE,ISNUMBER(BA26)),MAX(0,BA26-SUMIFS($AM$3:$AM25,AZ$3:AZ25,TRUE)),IF(AND(AZ26=TRUE,ISNUMBER(BA26)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BB26),MIN($AM26,BB26),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F26,nrCoverageTable,COLUMN(nrUsesBenDeduct),FALSE)","v":false},{"$f":"IF(BD26,VLOOKUP(F26,BenefitDesignTable,COLUMN(BenefitDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(BD26=TRUE,ISNUMBER(BE26)=TRUE),MAX(0,BE26-SUMIFS(AM$3:AM25,BD$3:BD25,TRUE,F$3:F25,F26)),IF(AND(BD26=TRUE,ISNUMBER(BE26)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BF26),MIN($AM26,BF26),\"N/A\")","v":"N/A"},{"$f":"SUM(AQ26,AU26,AY26,BC26,BG26)","v":0},0,"N/A",{"$f":"IF(OR(BI26=\"ERR\",AM26=\"ERR\"),\"ERR\",MAX(0,AM26-BI26))","v":0},{"$f":"VLOOKUP(F26,nrCoverageTable,COLUMN(nrUsesCopay),FALSE)","v":false},{"$f":"IF(BL26,VLOOKUP(F26,BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},"N/A",{"$f":"VLOOKUP(F26,nrCoverageTable,COLUMN(nrUsesCoins),FALSE)","v":false},{"$f":"IF(BO26,VLOOKUP(F26,BenefitDesignTable,COLUMN(BenefitCoins),FALSE),\"N/A\")","v":"N/A"},"N/A",0,"N/A",0,0,0,{"$f":"I26","v":{"v":118.55,"d":"$118.55"}},{"$f":"IF(OR(AG26=\"ERR\",AK26=\"ERR\"),\"ERR\",SUM(AG26,AK26))","v":0},0,0,0,{"$f":"SUM(BV26:CA26)=H26","v":true}]
[24,"2016-01-31",1,17,"Insulin glargine 100 unit/ml injectable solution (Rx - 10ml vial)  [20 units QD; expires 28 days after first use]","Prescription Drugs: Insulin","Not Covered",{"v":240.37,"d":"$240.37"},{"v":240.37,"d":"$240.37"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L27=\"Yes\",ISNUMBER(M27)),MAX(0,M27-SUMIFS(BU$3:BU26,L$3:L26,\"Yes\")),IF(OR(L27=\"No\",M27=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O27,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P27=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O27,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V27=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O27,COUNTIF(Z$3:Z26,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",1,"N/A",false,".",1,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO27),AN27=TRUE),MAX(0,AO27-SUMIFS($AM$3:$AM26,AN$3:AN26,TRUE)),IF(AND(AN27=TRUE,ISNUMBER(AO27)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR27=TRUE,ISNUMBER(AS27)),MAX(0,AS27-SUMIFS($AM$3:$AM26,AR$3:AR26,TRUE)),IF(AND(AR27=TRUE,ISNUMBER(AS27)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV27=TRUE,ISNUMBER(AW27)),MAX(0,AW27-SUMIFS($AM$3:$AM26,AV$3:AV26,TRUE)),IF(AND(AV27=TRUE,ISNUMBER(AW27)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ27=TRUE,ISNUMBER(BA27)),MAX(0,BA27-SUMIFS($AM$3:$AM26,AZ$3:AZ26,TRUE)),IF(AND(AZ27=TRUE,ISNUMBER(BA27)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD27=TRUE,ISNUMBER(BE27)=TRUE),MAX(0,BE27-SUMIFS(AM$3:AM26,BD$3:BD26,TRUE,F$3:F26,F27)),IF(AND(BD27=TRUE,ISNUMBER(BE27)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":240.37,"d":"$240.37"},0,0,0,0,true]
[25,"2016-02-02",2,14,"BD Ultrafine Insulin Syringes / 30G/ 0.5cc  [usage = 30 syringes per month]","Medical Supplies","Not Covered",{"v":20.62,"d":"$20.62"},{"v":20.62,"d":"$20.62"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L28=\"Yes\",ISNUMBER(M28)),MAX(0,M28-SUMIFS(BU$3:BU27,L$3:L27,\"Yes\")),IF(OR(L28=\"No\",M28=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O28,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P28=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O28,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V28=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O28,COUNTIF(Z$3:Z27,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",1,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO28),AN28=TRUE),MAX(0,AO28-SUMIFS($AM$3:$AM27,AN$3:AN27,TRUE)),IF(AND(AN28=TRUE,ISNUMBER(AO28)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR28=TRUE,ISNUMBER(AS28)),MAX(0,AS28-SUMIFS($AM$3:$AM27,AR$3:AR27,TRUE)),IF(AND(AR28=TRUE,ISNUMBER(AS28)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV28=TRUE,ISNUMBER(AW28)),MAX(0,AW28-SUMIFS($AM$3:$AM27,AV$3:AV27,TRUE)),IF(AND(AV28=TRUE,ISNUMBER(AW28)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ28=TRUE,ISNUMBER(BA28)),MAX(0,BA28-SUMIFS($AM$3:$AM27,AZ$3:AZ27,TRUE)),IF(AND(AZ28=TRUE,ISNUMBER(BA28)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD28=TRUE,ISNUMBER(BE28)=TRUE),MAX(0,BE28-SUMIFS(AM$3:AM27,BD$3:BD27,TRUE,F$3:F27,F28)),IF(AND(BD28=TRUE,ISNUMBER(BE28)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":20.62,"d":"$20.62"},0,0,0,0,true]
[26,"2016-02-02",2,32,"Metformin Hydrochloride 500 MG TABLET [ #60 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.21,"d":"$3.21"},{"v":3.21,"d":"$3.21"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L29=\"Yes\",ISNUMBER(M29)),MAX(0,M29-SUMIFS(BU$3:BU28,L$3:L28,\"Yes\")),IF(OR(L29=\"No\",M29=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O29,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P29=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O29,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V29=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O29,COUNTIF(Z$3:Z28,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",1,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO29),AN29=TRUE),MAX(0,AO29-SUMIFS($AM$3:$AM28,AN$3:AN28,TRUE)),IF(AND(AN29=TRUE,ISNUMBER(AO29)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR29=TRUE,ISNUMBER(AS29)),MAX(0,AS29-SUMIFS($AM$3:$AM28,AR$3:AR28,TRUE)),IF(AND(AR29=TRUE,ISNUMBER(AS29)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV29=TRUE,ISNUMBER(AW29)),MAX(0,AW29-SUMIFS($AM$3:$AM28,AV$3:AV28,TRUE)),IF(AND(AV29=TRUE,ISNUMBER(AW29)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ29=TRUE,ISNUMBER(BA29)),MAX(0,BA29-SUMIFS($AM$3:$AM28,AZ$3:AZ28,TRUE)),IF(AND(AZ29=TRUE,ISNUMBER(BA29)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD29=TRUE,ISNUMBER(BE29)=TRUE),MAX(0,BE29-SUMIFS(AM$3:AM28,BD$3:BD28,TRUE,F$3:F28,F29)),IF(AND(BD29=TRUE,ISNUMBER(BE29)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.21,"d":"$3.21"},0,0,0,0,true]
[27,"2016-02-02",2,19,"Lisinopril 20mg (Rx) [1 QD; #30 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.38,"d":"$3.38"},{"v":3.38,"d":"$3.38"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L30=\"Yes\",ISNUMBER(M30)),MAX(0,M30-SUMIFS(BU$3:BU29,L$3:L29,\"Yes\")),IF(OR(L30=\"No\",M30=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O30,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P30=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O30,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V30=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O30,COUNTIF(Z$3:Z29,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",1,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO30),AN30=TRUE),MAX(0,AO30-SUMIFS($AM$3:$AM29,AN$3:AN29,TRUE)),IF(AND(AN30=TRUE,ISNUMBER(AO30)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR30=TRUE,ISNUMBER(AS30)),MAX(0,AS30-SUMIFS($AM$3:$AM29,AR$3:AR29,TRUE)),IF(AND(AR30=TRUE,ISNUMBER(AS30)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV30=TRUE,ISNUMBER(AW30)),MAX(0,AW30-SUMIFS($AM$3:$AM29,AV$3:AV29,TRUE)),IF(AND(AV30=TRUE,ISNUMBER(AW30)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ30=TRUE,ISNUMBER(BA30)),MAX(0,BA30-SUMIFS($AM$3:$AM29,AZ$3:AZ29,TRUE)),IF(AND(AZ30=TRUE,ISNUMBER(BA30)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD30=TRUE,ISNUMBER(BE30)=TRUE),MAX(0,BE30-SUMIFS(AM$3:AM29,BD$3:BD29,TRUE,F$3:F29,F30)),IF(AND(BD30=TRUE,ISNUMBER(BE30)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.38,"d":"$3.38"},0,0,0,0,true]
[28,"2016-02-28",2,17,"Insulin glargine 100 unit/ml injectable solution (Rx - 10ml vial)  [20 units QD; expires 28 days after first use]","Prescription Drugs: Insulin","Not Covered",{"v":240.37,"d":"$240.37"},{"v":240.37,"d":"$240.37"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L31=\"Yes\",ISNUMBER(M31)),MAX(0,M31-SUMIFS(BU$3:BU30,L$3:L30,\"Yes\")),IF(OR(L31=\"No\",M31=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O31,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P31=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O31,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V31=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O31,COUNTIF(Z$3:Z30,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",2,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO31),AN31=TRUE),MAX(0,AO31-SUMIFS($AM$3:$AM30,AN$3:AN30,TRUE)),IF(AND(AN31=TRUE,ISNUMBER(AO31)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR31=TRUE,ISNUMBER(AS31)),MAX(0,AS31-SUMIFS($AM$3:$AM30,AR$3:AR30,TRUE)),IF(AND(AR31=TRUE,ISNUMBER(AS31)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV31=TRUE,ISNUMBER(AW31)),MAX(0,AW31-SUMIFS($AM$3:$AM30,AV$3:AV30,TRUE)),IF(AND(AV31=TRUE,ISNUMBER(AW31)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ31=TRUE,ISNUMBER(BA31)),MAX(0,BA31-SUMIFS($AM$3:$AM30,AZ$3:AZ30,TRUE)),IF(AND(AZ31=TRUE,ISNUMBER(BA31)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD31=TRUE,ISNUMBER(BE31)=TRUE),MAX(0,BE31-SUMIFS(AM$3:AM30,BD$3:BD30,TRUE,F$3:F30,F31)),IF(AND(BD31=TRUE,ISNUMBER(BE31)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":240.37,"d":"$240.37"},0,0,0,0,true]
[29,"2016-03-04",3,14,"BD Ultrafine Insulin Syringes / 30G/ 0.5cc  [usage = 30 syringes per month]","Medical Supplies","Not Covered",{"v":20.62,"d":"$20.62"},{"v":20.62,"d":"$20.62"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L32=\"Yes\",ISNUMBER(M32)),MAX(0,M32-SUMIFS(BU$3:BU31,L$3:L31,\"Yes\")),IF(OR(L32=\"No\",M32=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O32,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P32=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O32,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V32=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O32,COUNTIF(Z$3:Z31,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",2,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO32),AN32=TRUE),MAX(0,AO32-SUMIFS($AM$3:$AM31,AN$3:AN31,TRUE)),IF(AND(AN32=TRUE,ISNUMBER(AO32)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR32=TRUE,ISNUMBER(AS32)),MAX(0,AS32-SUMIFS($AM$3:$AM31,AR$3:AR31,TRUE)),IF(AND(AR32=TRUE,ISNUMBER(AS32)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV32=TRUE,ISNUMBER(AW32)),MAX(0,AW32-SUMIFS($AM$3:$AM31,AV$3:AV31,TRUE)),IF(AND(AV32=TRUE,ISNUMBER(AW32)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ32=TRUE,ISNUMBER(BA32)),MAX(0,BA32-SUMIFS($AM$3:$AM31,AZ$3:AZ31,TRUE)),IF(AND(AZ32=TRUE,ISNUMBER(BA32)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD32=TRUE,ISNUMBER(BE32)=TRUE),MAX(0,BE32-SUMIFS(AM$3:AM31,BD$3:BD31,TRUE,F$3:F31,F32)),IF(AND(BD32=TRUE,ISNUMBER(BE32)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":20.62,"d":"$20.62"},0,0,0,0,true]
[30,"2016-03-04",3,32,"Metformin Hydrochloride 500 MG TABLET [ #60 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.21,"d":"$3.21"},{"v":3.21,"d":"$3.21"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L33=\"Yes\",ISNUMBER(M33)),MAX(0,M33-SUMIFS(BU$3:BU32,L$3:L32,\"Yes\")),IF(OR(L33=\"No\",M33=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O33,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P33=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O33,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V33=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O33,COUNTIF(Z$3:Z32,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",2,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO33),AN33=TRUE),MAX(0,AO33-SUMIFS($AM$3:$AM32,AN$3:AN32,TRUE)),IF(AND(AN33=TRUE,ISNUMBER(AO33)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR33=TRUE,ISNUMBER(AS33)),MAX(0,AS33-SUMIFS($AM$3:$AM32,AR$3:AR32,TRUE)),IF(AND(AR33=TRUE,ISNUMBER(AS33)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV33=TRUE,ISNUMBER(AW33)),MAX(0,AW33-SUMIFS($AM$3:$AM32,AV$3:AV32,TRUE)),IF(AND(AV33=TRUE,ISNUMBER(AW33)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ33=TRUE,ISNUMBER(BA33)),MAX(0,BA33-SUMIFS($AM$3:$AM32,AZ$3:AZ32,TRUE)),IF(AND(AZ33=TRUE,ISNUMBER(BA33)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD33=TRUE,ISNUMBER(BE33)=TRUE),MAX(0,BE33-SUMIFS(AM$3:AM32,BD$3:BD32,TRUE,F$3:F32,F33)),IF(AND(BD33=TRUE,ISNUMBER(BE33)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.21,"d":"$3.21"},0,0,0,0,true]
[31,"2016-03-04",3,19,"Lisinopril 20mg (Rx) [1 QD; #30 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.38,"d":"$3.38"},{"v":3.38,"d":"$3.38"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L34=\"Yes\",ISNUMBER(M34)),MAX(0,M34-SUMIFS(BU$3:BU33,L$3:L33,\"Yes\")),IF(OR(L34=\"No\",M34=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O34,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P34=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O34,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V34=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O34,COUNTIF(Z$3:Z33,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",2,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO34),AN34=TRUE),MAX(0,AO34-SUMIFS($AM$3:$AM33,AN$3:AN33,TRUE)),IF(AND(AN34=TRUE,ISNUMBER(AO34)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR34=TRUE,ISNUMBER(AS34)),MAX(0,AS34-SUMIFS($AM$3:$AM33,AR$3:AR33,TRUE)),IF(AND(AR34=TRUE,ISNUMBER(AS34)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV34=TRUE,ISNUMBER(AW34)),MAX(0,AW34-SUMIFS($AM$3:$AM33,AV$3:AV33,TRUE)),IF(AND(AV34=TRUE,ISNUMBER(AW34)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ34=TRUE,ISNUMBER(BA34)),MAX(0,BA34-SUMIFS($AM$3:$AM33,AZ$3:AZ33,TRUE)),IF(AND(AZ34=TRUE,ISNUMBER(BA34)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD34=TRUE,ISNUMBER(BE34)=TRUE),MAX(0,BE34-SUMIFS(AM$3:AM33,BD$3:BD33,TRUE,F$3:F33,F34)),IF(AND(BD34=TRUE,ISNUMBER(BE34)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.38,"d":"$3.38"},0,0,0,0,true]
[32,"2016-03-28",3,26,"Aspirin 81mg (OTC - bottle 100) [usage = 1 QD; #30 pills per month]","Over-the-counter Drugs","Not Covered",{"v":4.47,"d":"$4.47"},{"v":4.47,"d":"$4.47"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L35=\"Yes\",ISNUMBER(M35)),MAX(0,M35-SUMIFS(BU$3:BU34,L$3:L34,\"Yes\")),IF(OR(L35=\"No\",M35=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O35,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P35=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O35,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V35=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O35,COUNTIF(Z$3:Z34,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",1,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO35),AN35=TRUE),MAX(0,AO35-SUMIFS($AM$3:$AM34,AN$3:AN34,TRUE)),IF(AND(AN35=TRUE,ISNUMBER(AO35)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR35=TRUE,ISNUMBER(AS35)),MAX(0,AS35-SUMIFS($AM$3:$AM34,AR$3:AR34,TRUE)),IF(AND(AR35=TRUE,ISNUMBER(AS35)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV35=TRUE,ISNUMBER(AW35)),MAX(0,AW35-SUMIFS($AM$3:$AM34,AV$3:AV34,TRUE)),IF(AND(AV35=TRUE,ISNUMBER(AW35)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ35=TRUE,ISNUMBER(BA35)),MAX(0,BA35-SUMIFS($AM$3:$AM34,AZ$3:AZ34,TRUE)),IF(AND(AZ35=TRUE,ISNUMBER(BA35)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD35=TRUE,ISNUMBER(BE35)=TRUE),MAX(0,BE35-SUMIFS(AM$3:AM34,BD$3:BD34,TRUE,F$3:F34,F35)),IF(AND(BD35=TRUE,ISNUMBER(BE35)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":4.47,"d":"$4.47"},0,0,0,0,true]
[33,"2016-03-28",3,17,"Insulin glargine 100 unit/ml injectable solution (Rx - 10ml vial)  [20 units QD; expires 28 days after first use]","Prescription Drugs: Insulin","Not Covered",{"v":240.37,"d":"$240.37"},{"v":240.37,"d":"$240.37"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L36=\"Yes\",ISNUMBER(M36)),MAX(0,M36-SUMIFS(BU$3:BU35,L$3:L35,\"Yes\")),IF(OR(L36=\"No\",M36=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O36,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P36=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},{"$f":"IF(O36,COUNTIFS(BenefitCategory,\"Professional Services: Primary Care\",ClaimNumber,\"<\"&A36),\"N/A\")","v":"N/A"},0,0,false,{"$f":"IF(O36,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V36=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O36,COUNTIF(Z$3:Z35,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",3,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO36),AN36=TRUE),MAX(0,AO36-SUMIFS($AM$3:$AM35,AN$3:AN35,TRUE)),IF(AND(AN36=TRUE,ISNUMBER(AO36)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR36=TRUE,ISNUMBER(AS36)),MAX(0,AS36-SUMIFS($AM$3:$AM35,AR$3:AR35,TRUE)),IF(AND(AR36=TRUE,ISNUMBER(AS36)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV36=TRUE,ISNUMBER(AW36)),MAX(0,AW36-SUMIFS($AM$3:$AM35,AV$3:AV35,TRUE)),IF(AND(AV36=TRUE,ISNUMBER(AW36)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ36=TRUE,ISNUMBER(BA36)),MAX(0,BA36-SUMIFS($AM$3:$AM35,AZ$3:AZ35,TRUE)),IF(AND(AZ36=TRUE,ISNUMBER(BA36)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD36=TRUE,ISNUMBER(BE36)=TRUE),MAX(0,BE36-SUMIFS(AM$3:AM35,BD$3:BD35,TRUE,F$3:F35,F36)),IF(AND(BD36=TRUE,ISNUMBER(BE36)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":240.37,"d":"$240.37"},0,0,0,0,true]
[34,"2016-03-28",3,24,"Office/Outpatient Visit Est","Professional Services: Primary Care","Not Covered",{"v":121.7,"d":"$121.70"},{"v":121.7,"d":"$121.70"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L37=\"Yes\",ISNUMBER(M37)),MAX(0,M37-SUMIFS(BU$3:BU36,L$3:L36,\"Yes\")),IF(OR(L37=\"No\",M37=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},true,{"$f":"IF(O37,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"."},{"$f":"IF(P37=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},3,0,0,true,{"$f":"IF(O37,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"."},{"$f":"IF(V37=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O37,COUNTIF(Z$3:Z36,\">0\"),\"N/A\")","v":0},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",1,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO37),AN37=TRUE),MAX(0,AO37-SUMIFS($AM$3:$AM36,AN$3:AN36,TRUE)),IF(AND(AN37=TRUE,ISNUMBER(AO37)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR37=TRUE,ISNUMBER(AS37)),MAX(0,AS37-SUMIFS($AM$3:$AM36,AR$3:AR36,TRUE)),IF(AND(AR37=TRUE,ISNUMBER(AS37)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV37=TRUE,ISNUMBER(AW37)),MAX(0,AW37-SUMIFS($AM$3:$AM36,AV$3:AV36,TRUE)),IF(AND(AV37=TRUE,ISNUMBER(AW37)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ37=TRUE,ISNUMBER(BA37)),MAX(0,BA37-SUMIFS($AM$3:$AM36,AZ$3:AZ36,TRUE)),IF(AND(AZ37=TRUE,ISNUMBER(BA37)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD37=TRUE,ISNUMBER(BE37)=TRUE),MAX(0,BE37-SUMIFS(AM$3:AM36,BD$3:BD36,TRUE,F$3:F36,F37)),IF(AND(BD37=TRUE,ISNUMBER(BE37)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":121.7,"d":"$121.70"},0,0,0,0,true]
[35,"2016-04-03",4,14,"BD Ultrafine Insulin Syringes / 30G/ 0.5cc  [usage = 30 syringes per month]","Medical Supplies","Not Covered",{"v":20.62,"d":"$20.62"},{"v":20.62,"d":"$20.62"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L38=\"Yes\",ISNUMBER(M38)),MAX(0,M38-SUMIFS(BU$3:BU37,L$3:L37,\"Yes\")),IF(OR(L38=\"No\",M38=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O38,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P38=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O38,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V38=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O38,COUNTIF(Z$3:Z37,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",3,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO38),AN38=TRUE),MAX(0,AO38-SUMIFS($AM$3:$AM37,AN$3:AN37,TRUE)),IF(AND(AN38=TRUE,ISNUMBER(AO38)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR38=TRUE,ISNUMBER(AS38)),MAX(0,AS38-SUMIFS($AM$3:$AM37,AR$3:AR37,TRUE)),IF(AND(AR38=TRUE,ISNUMBER(AS38)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV38=TRUE,ISNUMBER(AW38)),MAX(0,AW38-SUMIFS($AM$3:$AM37,AV$3:AV37,TRUE)),IF(AND(AV38=TRUE,ISNUMBER(AW38)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ38=TRUE,ISNUMBER(BA38)),MAX(0,BA38-SUMIFS($AM$3:$AM37,AZ$3:AZ37,TRUE)),IF(AND(AZ38=TRUE,ISNUMBER(BA38)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD38=TRUE,ISNUMBER(BE38)=TRUE),MAX(0,BE38-SUMIFS(AM$3:AM37,BD$3:BD37,TRUE,F$3:F37,F38)),IF(AND(BD38=TRUE,ISNUMBER(BE38)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":20.62,"d":"$20.62"},0,0,0,0,true]
[36,"2016-04-03",4,32,"Metformin Hydrochloride 500 MG TABLET [ #60 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.21,"d":"$3.21"},{"v":3.21,"d":"$3.21"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L39=\"Yes\",ISNUMBER(M39)),MAX(0,M39-SUMIFS(BU$3:BU38,L$3:L38,\"Yes\")),IF(OR(L39=\"No\",M39=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O39,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P39=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O39,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V39=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O39,COUNTIF(Z$3:Z38,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",3,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO39),AN39=TRUE),MAX(0,AO39-SUMIFS($AM$3:$AM38,AN$3:AN38,TRUE)),IF(AND(AN39=TRUE,ISNUMBER(AO39)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR39=TRUE,ISNUMBER(AS39)),MAX(0,AS39-SUMIFS($AM$3:$AM38,AR$3:AR38,TRUE)),IF(AND(AR39=TRUE,ISNUMBER(AS39)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV39=TRUE,ISNUMBER(AW39)),MAX(0,AW39-SUMIFS($AM$3:$AM38,AV$3:AV38,TRUE)),IF(AND(AV39=TRUE,ISNUMBER(AW39)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ39=TRUE,ISNUMBER(BA39)),MAX(0,BA39-SUMIFS($AM$3:$AM38,AZ$3:AZ38,TRUE)),IF(AND(AZ39=TRUE,ISNUMBER(BA39)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD39=TRUE,ISNUMBER(BE39)=TRUE),MAX(0,BE39-SUMIFS(AM$3:AM38,BD$3:BD38,TRUE,F$3:F38,F39)),IF(AND(BD39=TRUE,ISNUMBER(BE39)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.21,"d":"$3.21"},0,0,0,0,true]
[37,"2016-04-03",4,19,"Lisinopril 20mg (Rx) [1 QD; #30 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.38,"d":"$3.38"},{"v":3.38,"d":"$3.38"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L40=\"Yes\",ISNUMBER(M40)),MAX(0,M40-SUMIFS(BU$3:BU39,L$3:L39,\"Yes\")),IF(OR(L40=\"No\",M40=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O40,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P40=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O40,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V40=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O40,COUNTIF(Z$3:Z39,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",3,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO40),AN40=TRUE),MAX(0,AO40-SUMIFS($AM$3:$AM39,AN$3:AN39,TRUE)),IF(AND(AN40=TRUE,ISNUMBER(AO40)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR40=TRUE,ISNUMBER(AS40)),MAX(0,AS40-SUMIFS($AM$3:$AM39,AR$3:AR39,TRUE)),IF(AND(AR40=TRUE,ISNUMBER(AS40)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV40=TRUE,ISNUMBER(AW40)),MAX(0,AW40-SUMIFS($AM$3:$AM39,AV$3:AV39,TRUE)),IF(AND(AV40=TRUE,ISNUMBER(AW40)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ40=TRUE,ISNUMBER(BA40)),MAX(0,BA40-SUMIFS($AM$3:$AM39,AZ$3:AZ39,TRUE)),IF(AND(AZ40=TRUE,ISNUMBER(BA40)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD40=TRUE,ISNUMBER(BE40)=TRUE),MAX(0,BE40-SUMIFS(AM$3:AM39,BD$3:BD39,TRUE,F$3:F39,F40)),IF(AND(BD40=TRUE,ISNUMBER(BE40)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.38,"d":"$3.38"},0,0,0,0,true]
[38,"2016-04-03",4,33,"Atorvastatin 40 MG tablet 90 CT [ #30 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":9.66,"d":"$9.66"},{"v":9.66,"d":"$9.66"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L41=\"Yes\",ISNUMBER(M41)),MAX(0,M41-SUMIFS(BU$3:BU40,L$3:L40,\"Yes\")),IF(OR(L41=\"No\",M41=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O41,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P41=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O41,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V41=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O41,COUNTIF(Z$3:Z40,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",1,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO41),AN41=TRUE),MAX(0,AO41-SUMIFS($AM$3:$AM40,AN$3:AN40,TRUE)),IF(AND(AN41=TRUE,ISNUMBER(AO41)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR41=TRUE,ISNUMBER(AS41)),MAX(0,AS41-SUMIFS($AM$3:$AM40,AR$3:AR40,TRUE)),IF(AND(AR41=TRUE,ISNUMBER(AS41)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV41=TRUE,ISNUMBER(AW41)),MAX(0,AW41-SUMIFS($AM$3:$AM40,AV$3:AV40,TRUE)),IF(AND(AV41=TRUE,ISNUMBER(AW41)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ41=TRUE,ISNUMBER(BA41)),MAX(0,BA41-SUMIFS($AM$3:$AM40,AZ$3:AZ40,TRUE)),IF(AND(AZ41=TRUE,ISNUMBER(BA41)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD41=TRUE,ISNUMBER(BE41)=TRUE),MAX(0,BE41-SUMIFS(AM$3:AM40,BD$3:BD40,TRUE,F$3:F40,F41)),IF(AND(BD41=TRUE,ISNUMBER(BE41)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":9.66,"d":"$9.66"},0,0,0,0,true]
[39,"2016-04-12",4,5,"OneTouch Delica Lancets (100 per box)  [usage = 60 lancets per month]","Medical Supplies","Not Covered",{"v":8.73,"d":"$8.73"},{"v":8.73,"d":"$8.73"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L42=\"Yes\",ISNUMBER(M42)),MAX(0,M42-SUMIFS(BU$3:BU41,L$3:L41,\"Yes\")),IF(OR(L42=\"No\",M42=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O42,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P42=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O42,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V42=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O42,COUNTIF(Z$3:Z41,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",1,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO42),AN42=TRUE),MAX(0,AO42-SUMIFS($AM$3:$AM41,AN$3:AN41,TRUE)),IF(AND(AN42=TRUE,ISNUMBER(AO42)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR42=TRUE,ISNUMBER(AS42)),MAX(0,AS42-SUMIFS($AM$3:$AM41,AR$3:AR41,TRUE)),IF(AND(AR42=TRUE,ISNUMBER(AS42)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV42=TRUE,ISNUMBER(AW42)),MAX(0,AW42-SUMIFS($AM$3:$AM41,AV$3:AV41,TRUE)),IF(AND(AV42=TRUE,ISNUMBER(AW42)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ42=TRUE,ISNUMBER(BA42)),MAX(0,BA42-SUMIFS($AM$3:$AM41,AZ$3:AZ41,TRUE)),IF(AND(AZ42=TRUE,ISNUMBER(BA42)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD42=TRUE,ISNUMBER(BE42)=TRUE),MAX(0,BE42-SUMIFS(AM$3:AM41,BD$3:BD41,TRUE,F$3:F41,F42)),IF(AND(BD42=TRUE,ISNUMBER(BE42)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":8.73,"d":"$8.73"},0,0,0,0,true]
[40,"2016-04-12",4,4,"OneTouch Ultra Blue Test Strips (Rx - box of 100) [usage = 2 strips/day; 60 per month] ","Medical Supplies","Not Covered",{"v":109.61,"d":"$109.61"},{"v":109.61,"d":"$109.61"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L43=\"Yes\",ISNUMBER(M43)),MAX(0,M43-SUMIFS(BU$3:BU42,L$3:L42,\"Yes\")),IF(OR(L43=\"No\",M43=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O43,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P43=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O43,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V43=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O43,COUNTIF(Z$3:Z42,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",1,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO43),AN43=TRUE),MAX(0,AO43-SUMIFS($AM$3:$AM42,AN$3:AN42,TRUE)),IF(AND(AN43=TRUE,ISNUMBER(AO43)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR43=TRUE,ISNUMBER(AS43)),MAX(0,AS43-SUMIFS($AM$3:$AM42,AR$3:AR42,TRUE)),IF(AND(AR43=TRUE,ISNUMBER(AS43)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV43=TRUE,ISNUMBER(AW43)),MAX(0,AW43-SUMIFS($AM$3:$AM42,AV$3:AV42,TRUE)),IF(AND(AV43=TRUE,ISNUMBER(AW43)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ43=TRUE,ISNUMBER(BA43)),MAX(0,BA43-SUMIFS($AM$3:$AM42,AZ$3:AZ42,TRUE)),IF(AND(AZ43=TRUE,ISNUMBER(BA43)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD43=TRUE,ISNUMBER(BE43)=TRUE),MAX(0,BE43-SUMIFS(AM$3:AM42,BD$3:BD42,TRUE,F$3:F42,F43)),IF(AND(BD43=TRUE,ISNUMBER(BE43)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":109.61,"d":"$109.61"},0,0,0,0,true]
[41,"2016-04-25",4,17,"Insulin glargine 100 unit/ml injectable solution (Rx - 10ml vial)  [20 units QD; expires 28 days after first use]","Prescription Drugs: Insulin","Not Covered",{"v":240.37,"d":"$240.37"},{"v":240.37,"d":"$240.37"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L44=\"Yes\",ISNUMBER(M44)),MAX(0,M44-SUMIFS(BU$3:BU43,L$3:L43,\"Yes\")),IF(OR(L44=\"No\",M44=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O44,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P44=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O44,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V44=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O44,COUNTIF(Z$3:Z43,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",4,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO44),AN44=TRUE),MAX(0,AO44-SUMIFS($AM$3:$AM43,AN$3:AN43,TRUE)),IF(AND(AN44=TRUE,ISNUMBER(AO44)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR44=TRUE,ISNUMBER(AS44)),MAX(0,AS44-SUMIFS($AM$3:$AM43,AR$3:AR43,TRUE)),IF(AND(AR44=TRUE,ISNUMBER(AS44)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV44=TRUE,ISNUMBER(AW44)),MAX(0,AW44-SUMIFS($AM$3:$AM43,AV$3:AV43,TRUE)),IF(AND(AV44=TRUE,ISNUMBER(AW44)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ44=TRUE,ISNUMBER(BA44)),MAX(0,BA44-SUMIFS($AM$3:$AM43,AZ$3:AZ43,TRUE)),IF(AND(AZ44=TRUE,ISNUMBER(BA44)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD44=TRUE,ISNUMBER(BE44)=TRUE),MAX(0,BE44-SUMIFS(AM$3:AM43,BD$3:BD43,TRUE,F$3:F43,F44)),IF(AND(BD44=TRUE,ISNUMBER(BE44)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":240.37,"d":"$240.37"},0,0,0,0,true]
[42,"2016-05-03",5,14,"BD Ultrafine Insulin Syringes / 30G/ 0.5cc  [usage = 30 syringes per month]","Medical Supplies","Not Covered",{"v":20.62,"d":"$20.62"},{"v":20.62,"d":"$20.62"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L45=\"Yes\",ISNUMBER(M45)),MAX(0,M45-SUMIFS(BU$3:BU44,L$3:L44,\"Yes\")),IF(OR(L45=\"No\",M45=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O45,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P45=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O45,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V45=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O45,COUNTIF(Z$3:Z44,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",4,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO45),AN45=TRUE),MAX(0,AO45-SUMIFS($AM$3:$AM44,AN$3:AN44,TRUE)),IF(AND(AN45=TRUE,ISNUMBER(AO45)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR45=TRUE,ISNUMBER(AS45)),MAX(0,AS45-SUMIFS($AM$3:$AM44,AR$3:AR44,TRUE)),IF(AND(AR45=TRUE,ISNUMBER(AS45)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV45=TRUE,ISNUMBER(AW45)),MAX(0,AW45-SUMIFS($AM$3:$AM44,AV$3:AV44,TRUE)),IF(AND(AV45=TRUE,ISNUMBER(AW45)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ45=TRUE,ISNUMBER(BA45)),MAX(0,BA45-SUMIFS($AM$3:$AM44,AZ$3:AZ44,TRUE)),IF(AND(AZ45=TRUE,ISNUMBER(BA45)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD45=TRUE,ISNUMBER(BE45)=TRUE),MAX(0,BE45-SUMIFS(AM$3:AM44,BD$3:BD44,TRUE,F$3:F44,F45)),IF(AND(BD45=TRUE,ISNUMBER(BE45)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":20.62,"d":"$20.62"},0,0,0,0,true]
[43,"2016-05-03",5,32,"Metformin Hydrochloride 500 MG TABLET [ #60 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.21,"d":"$3.21"},{"v":3.21,"d":"$3.21"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L46=\"Yes\",ISNUMBER(M46)),MAX(0,M46-SUMIFS(BU$3:BU45,L$3:L45,\"Yes\")),IF(OR(L46=\"No\",M46=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O46,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P46=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O46,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V46=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O46,COUNTIF(Z$3:Z45,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",4,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO46),AN46=TRUE),MAX(0,AO46-SUMIFS($AM$3:$AM45,AN$3:AN45,TRUE)),IF(AND(AN46=TRUE,ISNUMBER(AO46)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR46=TRUE,ISNUMBER(AS46)),MAX(0,AS46-SUMIFS($AM$3:$AM45,AR$3:AR45,TRUE)),IF(AND(AR46=TRUE,ISNUMBER(AS46)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV46=TRUE,ISNUMBER(AW46)),MAX(0,AW46-SUMIFS($AM$3:$AM45,AV$3:AV45,TRUE)),IF(AND(AV46=TRUE,ISNUMBER(AW46)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ46=TRUE,ISNUMBER(BA46)),MAX(0,BA46-SUMIFS($AM$3:$AM45,AZ$3:AZ45,TRUE)),IF(AND(AZ46=TRUE,ISNUMBER(BA46)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD46=TRUE,ISNUMBER(BE46)=TRUE),MAX(0,BE46-SUMIFS(AM$3:AM45,BD$3:BD45,TRUE,F$3:F45,F46)),IF(AND(BD46=TRUE,ISNUMBER(BE46)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.21,"d":"$3.21"},0,0,0,0,true]
[44,"2016-05-03",5,19,"Lisinopril 20mg (Rx) [1 QD; #30 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.38,"d":"$3.38"},{"v":3.38,"d":"$3.38"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L47=\"Yes\",ISNUMBER(M47)),MAX(0,M47-SUMIFS(BU$3:BU46,L$3:L46,\"Yes\")),IF(OR(L47=\"No\",M47=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O47,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P47=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O47,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V47=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O47,COUNTIF(Z$3:Z46,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",4,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO47),AN47=TRUE),MAX(0,AO47-SUMIFS($AM$3:$AM46,AN$3:AN46,TRUE)),IF(AND(AN47=TRUE,ISNUMBER(AO47)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR47=TRUE,ISNUMBER(AS47)),MAX(0,AS47-SUMIFS($AM$3:$AM46,AR$3:AR46,TRUE)),IF(AND(AR47=TRUE,ISNUMBER(AS47)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV47=TRUE,ISNUMBER(AW47)),MAX(0,AW47-SUMIFS($AM$3:$AM46,AV$3:AV46,TRUE)),IF(AND(AV47=TRUE,ISNUMBER(AW47)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ47=TRUE,ISNUMBER(BA47)),MAX(0,BA47-SUMIFS($AM$3:$AM46,AZ$3:AZ46,TRUE)),IF(AND(AZ47=TRUE,ISNUMBER(BA47)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD47=TRUE,ISNUMBER(BE47)=TRUE),MAX(0,BE47-SUMIFS(AM$3:AM46,BD$3:BD46,TRUE,F$3:F46,F47)),IF(AND(BD47=TRUE,ISNUMBER(BE47)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.38,"d":"$3.38"},0,0,0,0,true]
[45,"2016-05-23",5,17,"Insulin glargine 100 unit/ml injectable solution (Rx - 10ml vial)  [20 units QD; expires 28 days after first use]","Prescription Drugs: Insulin","Not Covered",{"v":240.37,"d":"$240.37"},{"v":240.37,"d":"$240.37"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L48=\"Yes\",ISNUMBER(M48)),MAX(0,M48-SUMIFS(BU$3:BU47,L$3:L47,\"Yes\")),IF(OR(L48=\"No\",M48=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O48,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P48=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O48,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V48=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O48,COUNTIF(Z$3:Z47,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",5,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO48),AN48=TRUE),MAX(0,AO48-SUMIFS($AM$3:$AM47,AN$3:AN47,TRUE)),IF(AND(AN48=TRUE,ISNUMBER(AO48)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR48=TRUE,ISNUMBER(AS48)),MAX(0,AS48-SUMIFS($AM$3:$AM47,AR$3:AR47,TRUE)),IF(AND(AR48=TRUE,ISNUMBER(AS48)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV48=TRUE,ISNUMBER(AW48)),MAX(0,AW48-SUMIFS($AM$3:$AM47,AV$3:AV47,TRUE)),IF(AND(AV48=TRUE,ISNUMBER(AW48)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ48=TRUE,ISNUMBER(BA48)),MAX(0,BA48-SUMIFS($AM$3:$AM47,AZ$3:AZ47,TRUE)),IF(AND(AZ48=TRUE,ISNUMBER(BA48)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD48=TRUE,ISNUMBER(BE48)=TRUE),MAX(0,BE48-SUMIFS(AM$3:AM47,BD$3:BD47,TRUE,F$3:F47,F48)),IF(AND(BD48=TRUE,ISNUMBER(BE48)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":240.37,"d":"$240.37"},0,0,0,0,true]
[46,"2016-06-02",6,14,"BD Ultrafine Insulin Syringes / 30G/ 0.5cc  [usage = 30 syringes per month]","Medical Supplies","Not Covered",{"v":20.62,"d":"$20.62"},{"v":20.62,"d":"$20.62"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L49=\"Yes\",ISNUMBER(M49)),MAX(0,M49-SUMIFS(BU$3:BU48,L$3:L48,\"Yes\")),IF(OR(L49=\"No\",M49=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O49,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P49=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O49,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V49=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O49,COUNTIF(Z$3:Z48,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",5,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO49),AN49=TRUE),MAX(0,AO49-SUMIFS($AM$3:$AM48,AN$3:AN48,TRUE)),IF(AND(AN49=TRUE,ISNUMBER(AO49)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR49=TRUE,ISNUMBER(AS49)),MAX(0,AS49-SUMIFS($AM$3:$AM48,AR$3:AR48,TRUE)),IF(AND(AR49=TRUE,ISNUMBER(AS49)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV49=TRUE,ISNUMBER(AW49)),MAX(0,AW49-SUMIFS($AM$3:$AM48,AV$3:AV48,TRUE)),IF(AND(AV49=TRUE,ISNUMBER(AW49)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ49=TRUE,ISNUMBER(BA49)),MAX(0,BA49-SUMIFS($AM$3:$AM48,AZ$3:AZ48,TRUE)),IF(AND(AZ49=TRUE,ISNUMBER(BA49)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD49=TRUE,ISNUMBER(BE49)=TRUE),MAX(0,BE49-SUMIFS(AM$3:AM48,BD$3:BD48,TRUE,F$3:F48,F49)),IF(AND(BD49=TRUE,ISNUMBER(BE49)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":20.62,"d":"$20.62"},0,0,0,0,true]
[47,"2016-06-02",6,32,"Metformin Hydrochloride 500 MG TABLET [ #60 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.21,"d":"$3.21"},{"v":3.21,"d":"$3.21"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L50=\"Yes\",ISNUMBER(M50)),MAX(0,M50-SUMIFS(BU$3:BU49,L$3:L49,\"Yes\")),IF(OR(L50=\"No\",M50=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O50,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P50=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O50,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V50=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O50,COUNTIF(Z$3:Z49,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",5,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO50),AN50=TRUE),MAX(0,AO50-SUMIFS($AM$3:$AM49,AN$3:AN49,TRUE)),IF(AND(AN50=TRUE,ISNUMBER(AO50)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR50=TRUE,ISNUMBER(AS50)),MAX(0,AS50-SUMIFS($AM$3:$AM49,AR$3:AR49,TRUE)),IF(AND(AR50=TRUE,ISNUMBER(AS50)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV50=TRUE,ISNUMBER(AW50)),MAX(0,AW50-SUMIFS($AM$3:$AM49,AV$3:AV49,TRUE)),IF(AND(AV50=TRUE,ISNUMBER(AW50)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ50=TRUE,ISNUMBER(BA50)),MAX(0,BA50-SUMIFS($AM$3:$AM49,AZ$3:AZ49,TRUE)),IF(AND(AZ50=TRUE,ISNUMBER(BA50)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD50=TRUE,ISNUMBER(BE50)=TRUE),MAX(0,BE50-SUMIFS(AM$3:AM49,BD$3:BD49,TRUE,F$3:F49,F50)),IF(AND(BD50=TRUE,ISNUMBER(BE50)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.21,"d":"$3.21"},0,0,0,0,true]
[48,"2016-06-02",6,19,"Lisinopril 20mg (Rx) [1 QD; #30 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.38,"d":"$3.38"},{"v":3.38,"d":"$3.38"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L51=\"Yes\",ISNUMBER(M51)),MAX(0,M51-SUMIFS(BU$3:BU50,L$3:L50,\"Yes\")),IF(OR(L51=\"No\",M51=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O51,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P51=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O51,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V51=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O51,COUNTIF(Z$3:Z50,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",5,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO51),AN51=TRUE),MAX(0,AO51-SUMIFS($AM$3:$AM50,AN$3:AN50,TRUE)),IF(AND(AN51=TRUE,ISNUMBER(AO51)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR51=TRUE,ISNUMBER(AS51)),MAX(0,AS51-SUMIFS($AM$3:$AM50,AR$3:AR50,TRUE)),IF(AND(AR51=TRUE,ISNUMBER(AS51)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV51=TRUE,ISNUMBER(AW51)),MAX(0,AW51-SUMIFS($AM$3:$AM50,AV$3:AV50,TRUE)),IF(AND(AV51=TRUE,ISNUMBER(AW51)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ51=TRUE,ISNUMBER(BA51)),MAX(0,BA51-SUMIFS($AM$3:$AM50,AZ$3:AZ50,TRUE)),IF(AND(AZ51=TRUE,ISNUMBER(BA51)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD51=TRUE,ISNUMBER(BE51)=TRUE),MAX(0,BE51-SUMIFS(AM$3:AM50,BD$3:BD50,TRUE,F$3:F50,F51)),IF(AND(BD51=TRUE,ISNUMBER(BE51)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.38,"d":"$3.38"},0,0,0,0,true]
[49,"2016-06-20",6,26,"Aspirin 81mg (OTC - bottle 100) [usage = 1 QD; #30 pills per month]","Over-the-counter Drugs","Not Covered",{"v":4.47,"d":"$4.47"},{"v":4.47,"d":"$4.47"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L52=\"Yes\",ISNUMBER(M52)),MAX(0,M52-SUMIFS(BU$3:BU51,L$3:L51,\"Yes\")),IF(OR(L52=\"No\",M52=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O52,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P52=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O52,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V52=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O52,COUNTIF(Z$3:Z51,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",2,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO52),AN52=TRUE),MAX(0,AO52-SUMIFS($AM$3:$AM51,AN$3:AN51,TRUE)),IF(AND(AN52=TRUE,ISNUMBER(AO52)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR52=TRUE,ISNUMBER(AS52)),MAX(0,AS52-SUMIFS($AM$3:$AM51,AR$3:AR51,TRUE)),IF(AND(AR52=TRUE,ISNUMBER(AS52)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV52=TRUE,ISNUMBER(AW52)),MAX(0,AW52-SUMIFS($AM$3:$AM51,AV$3:AV51,TRUE)),IF(AND(AV52=TRUE,ISNUMBER(AW52)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ52=TRUE,ISNUMBER(BA52)),MAX(0,BA52-SUMIFS($AM$3:$AM51,AZ$3:AZ51,TRUE)),IF(AND(AZ52=TRUE,ISNUMBER(BA52)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD52=TRUE,ISNUMBER(BE52)=TRUE),MAX(0,BE52-SUMIFS(AM$3:AM51,BD$3:BD51,TRUE,F$3:F51,F52)),IF(AND(BD52=TRUE,ISNUMBER(BE52)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":4.47,"d":"$4.47"},0,0,0,0,true]
[50,"2016-06-20",6,17,"Insulin glargine 100 unit/ml injectable solution (Rx - 10ml vial)  [20 units QD; expires 28 days after first use]","Prescription Drugs: Insulin","Not Covered",{"v":240.37,"d":"$240.37"},{"v":240.37,"d":"$240.37"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L53=\"Yes\",ISNUMBER(M53)),MAX(0,M53-SUMIFS(BU$3:BU52,L$3:L52,\"Yes\")),IF(OR(L53=\"No\",M53=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O53,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P53=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O53,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V53=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O53,COUNTIF(Z$3:Z52,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",6,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO53),AN53=TRUE),MAX(0,AO53-SUMIFS($AM$3:$AM52,AN$3:AN52,TRUE)),IF(AND(AN53=TRUE,ISNUMBER(AO53)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR53=TRUE,ISNUMBER(AS53)),MAX(0,AS53-SUMIFS($AM$3:$AM52,AR$3:AR52,TRUE)),IF(AND(AR53=TRUE,ISNUMBER(AS53)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV53=TRUE,ISNUMBER(AW53)),MAX(0,AW53-SUMIFS($AM$3:$AM52,AV$3:AV52,TRUE)),IF(AND(AV53=TRUE,ISNUMBER(AW53)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ53=TRUE,ISNUMBER(BA53)),MAX(0,BA53-SUMIFS($AM$3:$AM52,AZ$3:AZ52,TRUE)),IF(AND(AZ53=TRUE,ISNUMBER(BA53)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD53=TRUE,ISNUMBER(BE53)=TRUE),MAX(0,BE53-SUMIFS(AM$3:AM52,BD$3:BD52,TRUE,F$3:F52,F53)),IF(AND(BD53=TRUE,ISNUMBER(BE53)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":240.37,"d":"$240.37"},0,0,0,0,true]
[51,"2016-06-27",6,16,"Glycosylated Hemoglobin Test","Diagnostic Services: Laboratory","Not Covered",{"v":16.98,"d":"$16.98"},{"v":16.98,"d":"$16.98"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L54=\"Yes\",ISNUMBER(M54)),MAX(0,M54-SUMIFS(BU$3:BU53,L$3:L53,\"Yes\")),IF(OR(L54=\"No\",M54=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O54,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P54=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O54,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V54=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O54,COUNTIF(Z$3:Z53,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",1,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO54),AN54=TRUE),MAX(0,AO54-SUMIFS($AM$3:$AM53,AN$3:AN53,TRUE)),IF(AND(AN54=TRUE,ISNUMBER(AO54)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR54=TRUE,ISNUMBER(AS54)),MAX(0,AS54-SUMIFS($AM$3:$AM53,AR$3:AR53,TRUE)),IF(AND(AR54=TRUE,ISNUMBER(AS54)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV54=TRUE,ISNUMBER(AW54)),MAX(0,AW54-SUMIFS($AM$3:$AM53,AV$3:AV53,TRUE)),IF(AND(AV54=TRUE,ISNUMBER(AW54)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ54=TRUE,ISNUMBER(BA54)),MAX(0,BA54-SUMIFS($AM$3:$AM53,AZ$3:AZ53,TRUE)),IF(AND(AZ54=TRUE,ISNUMBER(BA54)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD54=TRUE,ISNUMBER(BE54)=TRUE),MAX(0,BE54-SUMIFS(AM$3:AM53,BD$3:BD53,TRUE,F$3:F53,F54)),IF(AND(BD54=TRUE,ISNUMBER(BE54)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":16.98,"d":"$16.98"},0,0,0,0,true]
[52,"2016-06-27",6,2,"Routine Venipuncture","Diagnostic Services: Laboratory","Not Covered",{"v":6.43,"d":"$6.43"},{"v":6.43,"d":"$6.43"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L55=\"Yes\",ISNUMBER(M55)),MAX(0,M55-SUMIFS(BU$3:BU54,L$3:L54,\"Yes\")),IF(OR(L55=\"No\",M55=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O55,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P55=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O55,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V55=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O55,COUNTIF(Z$3:Z54,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",1,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO55),AN55=TRUE),MAX(0,AO55-SUMIFS($AM$3:$AM54,AN$3:AN54,TRUE)),IF(AND(AN55=TRUE,ISNUMBER(AO55)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR55=TRUE,ISNUMBER(AS55)),MAX(0,AS55-SUMIFS($AM$3:$AM54,AR$3:AR54,TRUE)),IF(AND(AR55=TRUE,ISNUMBER(AS55)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV55=TRUE,ISNUMBER(AW55)),MAX(0,AW55-SUMIFS($AM$3:$AM54,AV$3:AV54,TRUE)),IF(AND(AV55=TRUE,ISNUMBER(AW55)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ55=TRUE,ISNUMBER(BA55)),MAX(0,BA55-SUMIFS($AM$3:$AM54,AZ$3:AZ54,TRUE)),IF(AND(AZ55=TRUE,ISNUMBER(BA55)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD55=TRUE,ISNUMBER(BE55)=TRUE),MAX(0,BE55-SUMIFS(AM$3:AM54,BD$3:BD54,TRUE,F$3:F54,F55)),IF(AND(BD55=TRUE,ISNUMBER(BE55)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":6.43,"d":"$6.43"},0,0,0,0,true]
[53,"2016-06-27",6,24,"Office/Outpatient Visit Est","Professional Services: Primary Care","Not Covered",{"v":121.7,"d":"$121.70"},{"v":121.7,"d":"$121.70"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L56=\"Yes\",ISNUMBER(M56)),MAX(0,M56-SUMIFS(BU$3:BU55,L$3:L55,\"Yes\")),IF(OR(L56=\"No\",M56=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},true,{"$f":"IF(O56,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"."},{"$f":"IF(P56=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},4,0,0,true,{"$f":"IF(O56,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"."},{"$f":"IF(V56=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O56,COUNTIF(Z$3:Z55,\">0\"),\"N/A\")","v":0},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",2,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO56),AN56=TRUE),MAX(0,AO56-SUMIFS($AM$3:$AM55,AN$3:AN55,TRUE)),IF(AND(AN56=TRUE,ISNUMBER(AO56)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR56=TRUE,ISNUMBER(AS56)),MAX(0,AS56-SUMIFS($AM$3:$AM55,AR$3:AR55,TRUE)),IF(AND(AR56=TRUE,ISNUMBER(AS56)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV56=TRUE,ISNUMBER(AW56)),MAX(0,AW56-SUMIFS($AM$3:$AM55,AV$3:AV55,TRUE)),IF(AND(AV56=TRUE,ISNUMBER(AW56)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ56=TRUE,ISNUMBER(BA56)),MAX(0,BA56-SUMIFS($AM$3:$AM55,AZ$3:AZ55,TRUE)),IF(AND(AZ56=TRUE,ISNUMBER(BA56)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD56=TRUE,ISNUMBER(BE56)=TRUE),MAX(0,BE56-SUMIFS(AM$3:AM55,BD$3:BD55,TRUE,F$3:F55,F56)),IF(AND(BD56=TRUE,ISNUMBER(BE56)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":121.7,"d":"$121.70"},0,0,0,0,true]
[54,"2016-06-28",6,21,"Diabetes outpatient self-management training services, individual, per 30 minutes","Professional Services: Primary Care","Not Covered",{"v":77.82,"d":"$77.82"},{"v":77.82,"d":"$77.82"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L57=\"Yes\",ISNUMBER(M57)),MAX(0,M57-SUMIFS(BU$3:BU56,L$3:L56,\"Yes\")),IF(OR(L57=\"No\",M57=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},true,{"$f":"IF(O57,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"."},{"$f":"IF(P57=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},5,0,0,true,{"$f":"IF(O57,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"."},{"$f":"IF(V57=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O57,COUNTIF(Z$3:Z56,\">0\"),\"N/A\")","v":0},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",1,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO57),AN57=TRUE),MAX(0,AO57-SUMIFS($AM$3:$AM56,AN$3:AN56,TRUE)),IF(AND(AN57=TRUE,ISNUMBER(AO57)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR57=TRUE,ISNUMBER(AS57)),MAX(0,AS57-SUMIFS($AM$3:$AM56,AR$3:AR56,TRUE)),IF(AND(AR57=TRUE,ISNUMBER(AS57)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV57=TRUE,ISNUMBER(AW57)),MAX(0,AW57-SUMIFS($AM$3:$AM56,AV$3:AV56,TRUE)),IF(AND(AV57=TRUE,ISNUMBER(AW57)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ57=TRUE,ISNUMBER(BA57)),MAX(0,BA57-SUMIFS($AM$3:$AM56,AZ$3:AZ56,TRUE)),IF(AND(AZ57=TRUE,ISNUMBER(BA57)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD57=TRUE,ISNUMBER(BE57)=TRUE),MAX(0,BE57-SUMIFS(AM$3:AM56,BD$3:BD56,TRUE,F$3:F56,F57)),IF(AND(BD57=TRUE,ISNUMBER(BE57)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":77.82,"d":"$77.82"},0,0,0,0,true]
[55,"2016-06-28",6,20,{"$f":"VLOOKUP(ServiceCode,DiabetesFeeSchedule,6,FALSE)","v":"Med Nutrition Indiv Subseq"},{"$f":"VLOOKUP(ServiceCode,DiabetesFeeSchedule,5,FALSE)","v":"Professional Services: Primary Care"},{"$f":"VLOOKUP(BenefitCategory,BenefitDesignTable,COLUMN(BenefitCostSharing),FALSE)","v":"Not Covered"},{"$f":"VLOOKUP(D58,DiabetesFeeSchedule,7,FALSE)","v":{"v":36.83,"d":"$36.83"}},{"$f":"IF(G58=\"Not Covered\",H58,0)","v":{"v":36.83,"d":"$36.83"}},{"$f":"H58-I58","v":0},{"$f":"VLOOKUP(F58,nrCoverageTable,COLUMN(nrOOPLimitValid),FALSE)","v":false},{"$f":"IF(K58,VLOOKUP(F58,BenefitDesignTable,COLUMN(BenefitOOPLimitApplies),FALSE),\"No\")","v":"No"},{"$f":"VLOOKUP(F58,BenefitDesignTable,COLUMN(OPLimit),FALSE)","v":"."},{"$f":"IFERROR(IF(AND(L58=\"Yes\",ISNUMBER(M58)),MAX(0,M58-SUMIFS(BU$3:BU57,L$3:L57,\"Yes\")),IF(OR(L58=\"No\",M58=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},true,{"$f":"IF(O58,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"."},{"$f":"IF(P58=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},6,0,{"$f":"J58-S58","v":0},true,{"$f":"IF(O58,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"."},{"$f":"IF(V58=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O58,COUNTIF(Z$3:Z57,\">0\"),\"N/A\")","v":0},{"$f":"IF(V58=\"Yes\",VLOOKUP(\"Professional Services: Primary Care\",BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},"N/A",0,{"$f":"IF(L58=\"Yes\",IF(Z58=\"N/A\",N58,N58-Z58),\"N/A\")","v":"N/A"},0,{"$f":"VLOOKUP(F58,nrCoverageTable,COLUMN(nrMonthlyLimitValid),FALSE)","v":false},{"$f":"IF(AD58,VLOOKUP(F58,BenefitDesignTable,COLUMN(BenefitLimithMonth),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D58,ClaimMonth,C58,ClaimNumber,\"<\"&A58)","v":0},{"$f":"IF(AD58,IF(OR(AE58=\"None\",ISNUMBER(AE58)),IF(AF58>=AE58,H58,0),\"ERR\"),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F58,nrCoverageTable,COLUMN(nrAnnualLimitValid),FALSE)","v":false},{"$f":"IF(AH58,VLOOKUP(F58,BenefitDesignTable,COLUMN(BenefitLimitAnnual),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D58,ClaimNumber,\"<\"&A58)","v":1},{"$f":"IF(AH58,IF(OR(AI58=\"None\",ISNUMBER(AI58)),IF(AJ58>=AI58,H58,0),\"ERR\"),\"N/A\")","v":"N/A"},0,0,{"$f":"VLOOKUP(F58,nrCoverageTable,COLUMN(nrUsesPlanDeduct),FALSE)","v":false},{"$f":"IF(AN58,VLOOKUP(F58,BenefitDesignTable,COLUMN(PlanDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(ISNUMBER(AO58),AN58=TRUE),MAX(0,AO58-SUMIFS($AM$3:$AM57,AN$3:AN57,TRUE)),IF(AND(AN58=TRUE,ISNUMBER(AO58)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AP58),MIN($AM58,AP58),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F58,nrCoverageTable,COLUMN(nrUsesRxDeduct),FALSE)","v":false},{"$f":"IF(AR58,VLOOKUP(F58,BenefitDesignTable,COLUMN(RxDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AR58=TRUE,ISNUMBER(AS58)),MAX(0,AS58-SUMIFS($AM$3:$AM57,AR$3:AR57,TRUE)),IF(AND(AR58=TRUE,ISNUMBER(AS58)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AT58),MIN($AM58,AT58),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F58,nrCoverageTable,COLUMN(nrUsesDeductC),FALSE)","v":false},{"$f":"IF(AV58,VLOOKUP(F58,BenefitDesignTable,COLUMN(OptDeductibleC),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AV58=TRUE,ISNUMBER(AW58)),MAX(0,AW58-SUMIFS($AM$3:$AM57,AV$3:AV57,TRUE)),IF(AND(AV58=TRUE,ISNUMBER(AW58)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AX58),MIN($AM58,AX58),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F58,nrCoverageTable,COLUMN(nrUsesDeductD),FALSE)","v":false},{"$f":"IF(AZ58,VLOOKUP(F58,BenefitDesignTable,COLUMN(OptDeductibleD),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AZ58=TRUE,ISNUMBER(BA58)),MAX(0,BA58-SUMIFS($AM$3:$AM57,AZ$3:AZ57,TRUE)),IF(AND(AZ58=TRUE,ISNUMBER(BA58)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BB58),MIN($AM58,BB58),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F58,nrCoverageTable,COLUMN(nrUsesBenDeduct),FALSE)","v":false},{"$f":"IF(BD58,VLOOKUP(F58,BenefitDesignTable,COLUMN(BenefitDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(BD58=TRUE,ISNUMBER(BE58)=TRUE),MAX(0,BE58-SUMIFS(AM$3:AM57,BD$3:BD57,TRUE,F$3:F57,F58)),IF(AND(BD58=TRUE,ISNUMBER(BE58)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BF58),MIN($AM58,BF58),\"N/A\")","v":"N/A"},{"$f":"SUM(AQ58,AU58,AY58,BC58,BG58)","v":0},0,"N/A",{"$f":"IF(OR(BI58=\"ERR\",AM58=\"ERR\"),\"ERR\",MAX(0,AM58-BI58))","v":0},{"$f":"VLOOKUP(F58,nrCoverageTable,COLUMN(nrUsesCopay),FALSE)","v":false},{"$f":"IF(BL58,VLOOKUP(F58,BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},"N/A",{"$f":"VLOOKUP(F58,nrCoverageTable,COLUMN(nrUsesCoins),FALSE)","v":false},{"$f":"IF(BO58,VLOOKUP(F58,BenefitDesignTable,COLUMN(BenefitCoins),FALSE),\"N/A\")","v":"N/A"},"N/A",0,"N/A",0,0,0,{"$f":"I58","v":{"v":36.83,"d":"$36.83"}},{"$f":"IF(OR(AG58=\"ERR\",AK58=\"ERR\"),\"ERR\",SUM(AG58,AK58))","v":0},0,{"$f":"IF(V58=\"Yes\",IF(Z58=\"N/A\",0,Z58),0)+IF(BL58,BN58,0)","v":0},0,{"$f":"SUM(BV58:CA58)=H58","v":true}]
[56,"2016-07-02",7,14,"BD Ultrafine Insulin Syringes / 30G/ 0.5cc  [usage = 30 syringes per month]","Medical Supplies","Not Covered",{"v":20.62,"d":"$20.62"},{"v":20.62,"d":"$20.62"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L59=\"Yes\",ISNUMBER(M59)),MAX(0,M59-SUMIFS(BU$3:BU58,L$3:L58,\"Yes\")),IF(OR(L59=\"No\",M59=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O59,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P59=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",{"$f":"IF(P59=\"Yes\",IF(R59<Q59,MIN(J59,N59),0),0)","v":0},0,false,{"$f":"IF(O59,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V59=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O59,COUNTIF(Z$3:Z58,\">0\"),\"N/A\")","v":"N/A"},"N/A",{"$f":"IF(AND(V59=\"Yes\",U59=TRUE,X59<W59), MIN(Y59,T59,N59),\"N/A\")","v":"N/A"},{"$f":"IF(Z59=\"N/A\",0,T59-Z59)","v":0},"N/A",{"$f":"IF(Z59=\"N/A\",T59,0)","v":0},false,".",0,"N/A",false,".",6,"N/A",{"$f":"IF(OR(AG59=\"ERR\",AK59=\"ERR\"),\"ERR\",MAX(AG59,AK59))","v":0},{"$f":"IFERROR(AC59-AL59,\"ERR\")","v":0},false,"N/A",{"$f":"IF(AND(ISNUMBER(AO59),AN59=TRUE),MAX(0,AO59-SUMIFS($AM$3:$AM58,AN$3:AN58,TRUE)),IF(AND(AN59=TRUE,ISNUMBER(AO59)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR59=TRUE,ISNUMBER(AS59)),MAX(0,AS59-SUMIFS($AM$3:$AM58,AR$3:AR58,TRUE)),IF(AND(AR59=TRUE,ISNUMBER(AS59)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV59=TRUE,ISNUMBER(AW59)),MAX(0,AW59-SUMIFS($AM$3:$AM58,AV$3:AV58,TRUE)),IF(AND(AV59=TRUE,ISNUMBER(AW59)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ59=TRUE,ISNUMBER(BA59)),MAX(0,BA59-SUMIFS($AM$3:$AM58,AZ$3:AZ58,TRUE)),IF(AND(AZ59=TRUE,ISNUMBER(BA59)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD59=TRUE,ISNUMBER(BE59)=TRUE),MAX(0,BE59-SUMIFS(AM$3:AM58,BD$3:BD58,TRUE,F$3:F58,F59)),IF(AND(BD59=TRUE,ISNUMBER(BE59)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,{"$f":"IF(OR(AB59=\"ERR\",BH59=\"ERR\"),\"ERR\",MIN(BH59,AB59))","v":0},"N/A",0,false,"N/A",{"$f":"IF(BK59=\"ERR\",\"ERR\",IF(AND(BL59=TRUE,ISNUMBER(BM59)),MIN(BK59,BM59,BJ59),IF(AND(BL59=TRUE,ISNUMBER(BM59)=FALSE),\"ERR\",\"N/A\")))","v":"N/A"},false,"N/A",{"$f":"IF(BK59=\"ERR\",\"ERR\",IF(AND(BO59=TRUE,ISNUMBER(BP59)=TRUE),MIN(BJ59,BK59*BP59),IF(AND(BO59=TRUE,ISNUMBER(BP59)=FALSE),\"ERR\",\"N/A\")))","v":"N/A"},{"$f":"IF(OR(BJ59=\"ERR\",BN59=\"ERR\",BQ59=\"ERR\"),\"ERR\",MIN(BJ59,SUM(BN59,BQ59)))","v":0},"N/A",{"$f":"IF(OR(BK59=\"ERR\",BR59=\"ERR\"),\"ERR\",MAX(BK59-BR59,0))","v":0},0,0,{"v":20.62,"d":"$20.62"},0,{"$f":"BI59","v":0},0,{"$f":"IF(BO59,BQ59,0)","v":0},true]
[57,"2016-07-02",7,6,"OneTouch Ultra Control Solution (2 vials/box)","Medical Supplies","Not Covered",{"v":6.63,"d":"$6.63"},{"v":6.63,"d":"$6.63"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L60=\"Yes\",ISNUMBER(M60)),MAX(0,M60-SUMIFS(BU$3:BU59,L$3:L59,\"Yes\")),IF(OR(L60=\"No\",M60=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O60,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P60=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O60,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V60=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O60,COUNTIF(Z$3:Z59,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",1,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO60),AN60=TRUE),MAX(0,AO60-SUMIFS($AM$3:$AM59,AN$3:AN59,TRUE)),IF(AND(AN60=TRUE,ISNUMBER(AO60)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR60=TRUE,ISNUMBER(AS60)),MAX(0,AS60-SUMIFS($AM$3:$AM59,AR$3:AR59,TRUE)),IF(AND(AR60=TRUE,ISNUMBER(AS60)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV60=TRUE,ISNUMBER(AW60)),MAX(0,AW60-SUMIFS($AM$3:$AM59,AV$3:AV59,TRUE)),IF(AND(AV60=TRUE,ISNUMBER(AW60)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ60=TRUE,ISNUMBER(BA60)),MAX(0,BA60-SUMIFS($AM$3:$AM59,AZ$3:AZ59,TRUE)),IF(AND(AZ60=TRUE,ISNUMBER(BA60)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD60=TRUE,ISNUMBER(BE60)=TRUE),MAX(0,BE60-SUMIFS(AM$3:AM59,BD$3:BD59,TRUE,F$3:F59,F60)),IF(AND(BD60=TRUE,ISNUMBER(BE60)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":6.63,"d":"$6.63"},0,0,0,0,true]
[58,"2016-07-02",7,32,"Metformin Hydrochloride 500 MG TABLET [ #60 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.21,"d":"$3.21"},{"v":3.21,"d":"$3.21"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L61=\"Yes\",ISNUMBER(M61)),MAX(0,M61-SUMIFS(BU$3:BU60,L$3:L60,\"Yes\")),IF(OR(L61=\"No\",M61=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O61,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P61=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O61,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V61=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O61,COUNTIF(Z$3:Z60,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",6,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO61),AN61=TRUE),MAX(0,AO61-SUMIFS($AM$3:$AM60,AN$3:AN60,TRUE)),IF(AND(AN61=TRUE,ISNUMBER(AO61)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR61=TRUE,ISNUMBER(AS61)),MAX(0,AS61-SUMIFS($AM$3:$AM60,AR$3:AR60,TRUE)),IF(AND(AR61=TRUE,ISNUMBER(AS61)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV61=TRUE,ISNUMBER(AW61)),MAX(0,AW61-SUMIFS($AM$3:$AM60,AV$3:AV60,TRUE)),IF(AND(AV61=TRUE,ISNUMBER(AW61)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ61=TRUE,ISNUMBER(BA61)),MAX(0,BA61-SUMIFS($AM$3:$AM60,AZ$3:AZ60,TRUE)),IF(AND(AZ61=TRUE,ISNUMBER(BA61)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD61=TRUE,ISNUMBER(BE61)=TRUE),MAX(0,BE61-SUMIFS(AM$3:AM60,BD$3:BD60,TRUE,F$3:F60,F61)),IF(AND(BD61=TRUE,ISNUMBER(BE61)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.21,"d":"$3.21"},0,0,0,0,true]
[59,"2016-07-02",7,19,"Lisinopril 20mg (Rx) [1 QD; #30 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.38,"d":"$3.38"},{"v":3.38,"d":"$3.38"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L62=\"Yes\",ISNUMBER(M62)),MAX(0,M62-SUMIFS(BU$3:BU61,L$3:L61,\"Yes\")),IF(OR(L62=\"No\",M62=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O62,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P62=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O62,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V62=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O62,COUNTIF(Z$3:Z61,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",6,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO62),AN62=TRUE),MAX(0,AO62-SUMIFS($AM$3:$AM61,AN$3:AN61,TRUE)),IF(AND(AN62=TRUE,ISNUMBER(AO62)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR62=TRUE,ISNUMBER(AS62)),MAX(0,AS62-SUMIFS($AM$3:$AM61,AR$3:AR61,TRUE)),IF(AND(AR62=TRUE,ISNUMBER(AS62)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV62=TRUE,ISNUMBER(AW62)),MAX(0,AW62-SUMIFS($AM$3:$AM61,AV$3:AV61,TRUE)),IF(AND(AV62=TRUE,ISNUMBER(AW62)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ62=TRUE,ISNUMBER(BA62)),MAX(0,BA62-SUMIFS($AM$3:$AM61,AZ$3:AZ61,TRUE)),IF(AND(AZ62=TRUE,ISNUMBER(BA62)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD62=TRUE,ISNUMBER(BE62)=TRUE),MAX(0,BE62-SUMIFS(AM$3:AM61,BD$3:BD61,TRUE,F$3:F61,F62)),IF(AND(BD62=TRUE,ISNUMBER(BE62)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.38,"d":"$3.38"},0,0,0,0,true]
[60,"2016-07-02",7,33,"Atorvastatin 40 MG tablet 90 CT [ #30 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":9.66,"d":"$9.66"},{"v":9.66,"d":"$9.66"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L63=\"Yes\",ISNUMBER(M63)),MAX(0,M63-SUMIFS(BU$3:BU62,L$3:L62,\"Yes\")),IF(OR(L63=\"No\",M63=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O63,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P63=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O63,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V63=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O63,COUNTIF(Z$3:Z62,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",2,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO63),AN63=TRUE),MAX(0,AO63-SUMIFS($AM$3:$AM62,AN$3:AN62,TRUE)),IF(AND(AN63=TRUE,ISNUMBER(AO63)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR63=TRUE,ISNUMBER(AS63)),MAX(0,AS63-SUMIFS($AM$3:$AM62,AR$3:AR62,TRUE)),IF(AND(AR63=TRUE,ISNUMBER(AS63)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV63=TRUE,ISNUMBER(AW63)),MAX(0,AW63-SUMIFS($AM$3:$AM62,AV$3:AV62,TRUE)),IF(AND(AV63=TRUE,ISNUMBER(AW63)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ63=TRUE,ISNUMBER(BA63)),MAX(0,BA63-SUMIFS($AM$3:$AM62,AZ$3:AZ62,TRUE)),IF(AND(AZ63=TRUE,ISNUMBER(BA63)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD63=TRUE,ISNUMBER(BE63)=TRUE),MAX(0,BE63-SUMIFS(AM$3:AM62,BD$3:BD62,TRUE,F$3:F62,F63)),IF(AND(BD63=TRUE,ISNUMBER(BE63)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":9.66,"d":"$9.66"},0,0,0,0,true]
[61,"2016-07-18",7,17,"Insulin glargine 100 unit/ml injectable solution (Rx - 10ml vial)  [20 units QD; expires 28 days after first use]","Prescription Drugs: Insulin","Not Covered",{"v":240.37,"d":"$240.37"},{"v":240.37,"d":"$240.37"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L64=\"Yes\",ISNUMBER(M64)),MAX(0,M64-SUMIFS(BU$3:BU63,L$3:L63,\"Yes\")),IF(OR(L64=\"No\",M64=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O64,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P64=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O64,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V64=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O64,COUNTIF(Z$3:Z63,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",7,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO64),AN64=TRUE),MAX(0,AO64-SUMIFS($AM$3:$AM63,AN$3:AN63,TRUE)),IF(AND(AN64=TRUE,ISNUMBER(AO64)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR64=TRUE,ISNUMBER(AS64)),MAX(0,AS64-SUMIFS($AM$3:$AM63,AR$3:AR63,TRUE)),IF(AND(AR64=TRUE,ISNUMBER(AS64)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV64=TRUE,ISNUMBER(AW64)),MAX(0,AW64-SUMIFS($AM$3:$AM63,AV$3:AV63,TRUE)),IF(AND(AV64=TRUE,ISNUMBER(AW64)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ64=TRUE,ISNUMBER(BA64)),MAX(0,BA64-SUMIFS($AM$3:$AM63,AZ$3:AZ63,TRUE)),IF(AND(AZ64=TRUE,ISNUMBER(BA64)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD64=TRUE,ISNUMBER(BE64)=TRUE),MAX(0,BE64-SUMIFS(AM$3:AM63,BD$3:BD63,TRUE,F$3:F63,F64)),IF(AND(BD64=TRUE,ISNUMBER(BE64)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":240.37,"d":"$240.37"},0,0,0,0,true]
[62,"2016-07-21",7,5,"OneTouch Delica Lancets (100 per box)  [usage = 60 lancets per month]","Medical Supplies","Not Covered",{"v":8.73,"d":"$8.73"},{"v":8.73,"d":"$8.73"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L65=\"Yes\",ISNUMBER(M65)),MAX(0,M65-SUMIFS(BU$3:BU64,L$3:L64,\"Yes\")),IF(OR(L65=\"No\",M65=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O65,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P65=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O65,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V65=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O65,COUNTIF(Z$3:Z64,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",2,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO65),AN65=TRUE),MAX(0,AO65-SUMIFS($AM$3:$AM64,AN$3:AN64,TRUE)),IF(AND(AN65=TRUE,ISNUMBER(AO65)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR65=TRUE,ISNUMBER(AS65)),MAX(0,AS65-SUMIFS($AM$3:$AM64,AR$3:AR64,TRUE)),IF(AND(AR65=TRUE,ISNUMBER(AS65)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV65=TRUE,ISNUMBER(AW65)),MAX(0,AW65-SUMIFS($AM$3:$AM64,AV$3:AV64,TRUE)),IF(AND(AV65=TRUE,ISNUMBER(AW65)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ65=TRUE,ISNUMBER(BA65)),MAX(0,BA65-SUMIFS($AM$3:$AM64,AZ$3:AZ64,TRUE)),IF(AND(AZ65=TRUE,ISNUMBER(BA65)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD65=TRUE,ISNUMBER(BE65)=TRUE),MAX(0,BE65-SUMIFS(AM$3:AM64,BD$3:BD64,TRUE,F$3:F64,F65)),IF(AND(BD65=TRUE,ISNUMBER(BE65)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":8.73,"d":"$8.73"},0,0,0,0,true]
[63,"2016-07-21",7,4,"OneTouch Ultra Blue Test Strips (Rx - box of 100) [usage = 2 strips/day; 60 per month] ","Medical Supplies","Not Covered",{"v":109.61,"d":"$109.61"},{"v":109.61,"d":"$109.61"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L66=\"Yes\",ISNUMBER(M66)),MAX(0,M66-SUMIFS(BU$3:BU65,L$3:L65,\"Yes\")),IF(OR(L66=\"No\",M66=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O66,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P66=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O66,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V66=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O66,COUNTIF(Z$3:Z65,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",2,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO66),AN66=TRUE),MAX(0,AO66-SUMIFS($AM$3:$AM65,AN$3:AN65,TRUE)),IF(AND(AN66=TRUE,ISNUMBER(AO66)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR66=TRUE,ISNUMBER(AS66)),MAX(0,AS66-SUMIFS($AM$3:$AM65,AR$3:AR65,TRUE)),IF(AND(AR66=TRUE,ISNUMBER(AS66)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV66=TRUE,ISNUMBER(AW66)),MAX(0,AW66-SUMIFS($AM$3:$AM65,AV$3:AV65,TRUE)),IF(AND(AV66=TRUE,ISNUMBER(AW66)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ66=TRUE,ISNUMBER(BA66)),MAX(0,BA66-SUMIFS($AM$3:$AM65,AZ$3:AZ65,TRUE)),IF(AND(AZ66=TRUE,ISNUMBER(BA66)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD66=TRUE,ISNUMBER(BE66)=TRUE),MAX(0,BE66-SUMIFS(AM$3:AM65,BD$3:BD65,TRUE,F$3:F65,F66)),IF(AND(BD66=TRUE,ISNUMBER(BE66)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":109.61,"d":"$109.61"},0,0,0,0,true]
[64,"2016-08-01",8,14,"BD Ultrafine Insulin Syringes / 30G/ 0.5cc  [usage = 30 syringes per month]","Medical Supplies","Not Covered",{"v":20.62,"d":"$20.62"},{"v":20.62,"d":"$20.62"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L67=\"Yes\",ISNUMBER(M67)),MAX(0,M67-SUMIFS(BU$3:BU66,L$3:L66,\"Yes\")),IF(OR(L67=\"No\",M67=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O67,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P67=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O67,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V67=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O67,COUNTIF(Z$3:Z66,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",7,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO67),AN67=TRUE),MAX(0,AO67-SUMIFS($AM$3:$AM66,AN$3:AN66,TRUE)),IF(AND(AN67=TRUE,ISNUMBER(AO67)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR67=TRUE,ISNUMBER(AS67)),MAX(0,AS67-SUMIFS($AM$3:$AM66,AR$3:AR66,TRUE)),IF(AND(AR67=TRUE,ISNUMBER(AS67)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV67=TRUE,ISNUMBER(AW67)),MAX(0,AW67-SUMIFS($AM$3:$AM66,AV$3:AV66,TRUE)),IF(AND(AV67=TRUE,ISNUMBER(AW67)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ67=TRUE,ISNUMBER(BA67)),MAX(0,BA67-SUMIFS($AM$3:$AM66,AZ$3:AZ66,TRUE)),IF(AND(AZ67=TRUE,ISNUMBER(BA67)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD67=TRUE,ISNUMBER(BE67)=TRUE),MAX(0,BE67-SUMIFS(AM$3:AM66,BD$3:BD66,TRUE,F$3:F66,F67)),IF(AND(BD67=TRUE,ISNUMBER(BE67)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":20.62,"d":"$20.62"},0,0,0,0,true]
[65,"2016-08-01",8,32,"Metformin Hydrochloride 500 MG TABLET [ #60 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.21,"d":"$3.21"},{"v":3.21,"d":"$3.21"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L68=\"Yes\",ISNUMBER(M68)),MAX(0,M68-SUMIFS(BU$3:BU67,L$3:L67,\"Yes\")),IF(OR(L68=\"No\",M68=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O68,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P68=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},{"$f":"IF(O68,COUNTIFS(BenefitCategory,\"Professional Services: Primary Care\",ClaimNumber,\"<\"&A68),\"N/A\")","v":"N/A"},0,0,false,{"$f":"IF(O68,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V68=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O68,COUNTIF(Z$3:Z67,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",7,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO68),AN68=TRUE),MAX(0,AO68-SUMIFS($AM$3:$AM67,AN$3:AN67,TRUE)),IF(AND(AN68=TRUE,ISNUMBER(AO68)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR68=TRUE,ISNUMBER(AS68)),MAX(0,AS68-SUMIFS($AM$3:$AM67,AR$3:AR67,TRUE)),IF(AND(AR68=TRUE,ISNUMBER(AS68)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV68=TRUE,ISNUMBER(AW68)),MAX(0,AW68-SUMIFS($AM$3:$AM67,AV$3:AV67,TRUE)),IF(AND(AV68=TRUE,ISNUMBER(AW68)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ68=TRUE,ISNUMBER(BA68)),MAX(0,BA68-SUMIFS($AM$3:$AM67,AZ$3:AZ67,TRUE)),IF(AND(AZ68=TRUE,ISNUMBER(BA68)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD68=TRUE,ISNUMBER(BE68)=TRUE),MAX(0,BE68-SUMIFS(AM$3:AM67,BD$3:BD67,TRUE,F$3:F67,F68)),IF(AND(BD68=TRUE,ISNUMBER(BE68)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.21,"d":"$3.21"},0,0,0,0,true]
[66,"2016-08-01",8,19,"Lisinopril 20mg (Rx) [1 QD; #30 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.38,"d":"$3.38"},{"v":3.38,"d":"$3.38"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L69=\"Yes\",ISNUMBER(M69)),MAX(0,M69-SUMIFS(BU$3:BU68,L$3:L68,\"Yes\")),IF(OR(L69=\"No\",M69=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},{"$f":"IF(F69=\"Professional Services: Primary Care\",TRUE, FALSE)","v":false},{"$f":"IF(O69,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P69=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,{"$f":"IF(F69=\"Professional Services: Primary Care\",TRUE, FALSE)","v":false},{"$f":"IF(O69,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V69=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O69,COUNTIF(Z$3:Z68,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",7,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO69),AN69=TRUE),MAX(0,AO69-SUMIFS($AM$3:$AM68,AN$3:AN68,TRUE)),IF(AND(AN69=TRUE,ISNUMBER(AO69)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR69=TRUE,ISNUMBER(AS69)),MAX(0,AS69-SUMIFS($AM$3:$AM68,AR$3:AR68,TRUE)),IF(AND(AR69=TRUE,ISNUMBER(AS69)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV69=TRUE,ISNUMBER(AW69)),MAX(0,AW69-SUMIFS($AM$3:$AM68,AV$3:AV68,TRUE)),IF(AND(AV69=TRUE,ISNUMBER(AW69)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ69=TRUE,ISNUMBER(BA69)),MAX(0,BA69-SUMIFS($AM$3:$AM68,AZ$3:AZ68,TRUE)),IF(AND(AZ69=TRUE,ISNUMBER(BA69)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD69=TRUE,ISNUMBER(BE69)=TRUE),MAX(0,BE69-SUMIFS(AM$3:AM68,BD$3:BD68,TRUE,F$3:F68,F69)),IF(AND(BD69=TRUE,ISNUMBER(BE69)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,{"$f":"IF(AND(L69=\"Yes\",ISNUMBER(M69)),IF(OR(BI69=\"ERR\",AB69=\"ERR\"),\"ERR\",MAX($AB69-BI69,0)),\"N/A\")","v":"N/A"},0,false,"N/A","N/A",false,"N/A","N/A",0,{"$f":"IF(AND(L69=\"Yes\",ISNUMBER(M69)),IF(OR(BJ69=\"ERR\",BR69=\"ERR\"),\"ERR\",MAX(BJ69-BR69,0)),\"N/A\")","v":"N/A"},0,{"$f":"IF(OR(BI69=\"ERR\",BR69=\"ERR\"),\"ERR\",SUM(BI69,BR69,Z69))","v":0},{"$f":"IF(OR(AM69=\"ERR\",BU69=\"ERR\"),\"ERR\",MAX(S69+AA69+AM69-BI69-BR69,0))","v":0},{"v":3.38,"d":"$3.38"},0,0,0,0,true]
[67,"2016-08-15",8,17,"Insulin glargine 100 unit/ml injectable solution (Rx - 10ml vial)  [20 units QD; expires 28 days after first use]","Prescription Drugs: Insulin","Not Covered",{"v":240.37,"d":"$240.37"},{"v":240.37,"d":"$240.37"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L70=\"Yes\",ISNUMBER(M70)),MAX(0,M70-SUMIFS(BU$3:BU69,L$3:L69,\"Yes\")),IF(OR(L70=\"No\",M70=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O70,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P70=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O70,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V70=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O70,COUNTIF(Z$3:Z69,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",8,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO70),AN70=TRUE),MAX(0,AO70-SUMIFS($AM$3:$AM69,AN$3:AN69,TRUE)),IF(AND(AN70=TRUE,ISNUMBER(AO70)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR70=TRUE,ISNUMBER(AS70)),MAX(0,AS70-SUMIFS($AM$3:$AM69,AR$3:AR69,TRUE)),IF(AND(AR70=TRUE,ISNUMBER(AS70)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV70=TRUE,ISNUMBER(AW70)),MAX(0,AW70-SUMIFS($AM$3:$AM69,AV$3:AV69,TRUE)),IF(AND(AV70=TRUE,ISNUMBER(AW70)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ70=TRUE,ISNUMBER(BA70)),MAX(0,BA70-SUMIFS($AM$3:$AM69,AZ$3:AZ69,TRUE)),IF(AND(AZ70=TRUE,ISNUMBER(BA70)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD70=TRUE,ISNUMBER(BE70)=TRUE),MAX(0,BE70-SUMIFS(AM$3:AM69,BD$3:BD69,TRUE,F$3:F69,F70)),IF(AND(BD70=TRUE,ISNUMBER(BE70)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":240.37,"d":"$240.37"},0,0,0,0,true]
[68,"2016-08-31",8,14,"BD Ultrafine Insulin Syringes / 30G/ 0.5cc  [usage = 30 syringes per month]","Medical Supplies","Not Covered",{"v":20.62,"d":"$20.62"},{"v":20.62,"d":"$20.62"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L71=\"Yes\",ISNUMBER(M71)),MAX(0,M71-SUMIFS(BU$3:BU70,L$3:L70,\"Yes\")),IF(OR(L71=\"No\",M71=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O71,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P71=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O71,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V71=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O71,COUNTIF(Z$3:Z70,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",1,"N/A",false,".",8,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO71),AN71=TRUE),MAX(0,AO71-SUMIFS($AM$3:$AM70,AN$3:AN70,TRUE)),IF(AND(AN71=TRUE,ISNUMBER(AO71)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR71=TRUE,ISNUMBER(AS71)),MAX(0,AS71-SUMIFS($AM$3:$AM70,AR$3:AR70,TRUE)),IF(AND(AR71=TRUE,ISNUMBER(AS71)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV71=TRUE,ISNUMBER(AW71)),MAX(0,AW71-SUMIFS($AM$3:$AM70,AV$3:AV70,TRUE)),IF(AND(AV71=TRUE,ISNUMBER(AW71)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ71=TRUE,ISNUMBER(BA71)),MAX(0,BA71-SUMIFS($AM$3:$AM70,AZ$3:AZ70,TRUE)),IF(AND(AZ71=TRUE,ISNUMBER(BA71)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD71=TRUE,ISNUMBER(BE71)=TRUE),MAX(0,BE71-SUMIFS(AM$3:AM70,BD$3:BD70,TRUE,F$3:F70,F71)),IF(AND(BD71=TRUE,ISNUMBER(BE71)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":20.62,"d":"$20.62"},0,0,0,0,true]
[69,"2016-08-31",8,32,"Metformin Hydrochloride 500 MG TABLET [ #60 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.21,"d":"$3.21"},{"v":3.21,"d":"$3.21"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L72=\"Yes\",ISNUMBER(M72)),MAX(0,M72-SUMIFS(BU$3:BU71,L$3:L71,\"Yes\")),IF(OR(L72=\"No\",M72=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O72,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P72=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O72,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V72=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O72,COUNTIF(Z$3:Z71,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",1,"N/A",false,".",8,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO72),AN72=TRUE),MAX(0,AO72-SUMIFS($AM$3:$AM71,AN$3:AN71,TRUE)),IF(AND(AN72=TRUE,ISNUMBER(AO72)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR72=TRUE,ISNUMBER(AS72)),MAX(0,AS72-SUMIFS($AM$3:$AM71,AR$3:AR71,TRUE)),IF(AND(AR72=TRUE,ISNUMBER(AS72)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV72=TRUE,ISNUMBER(AW72)),MAX(0,AW72-SUMIFS($AM$3:$AM71,AV$3:AV71,TRUE)),IF(AND(AV72=TRUE,ISNUMBER(AW72)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ72=TRUE,ISNUMBER(BA72)),MAX(0,BA72-SUMIFS($AM$3:$AM71,AZ$3:AZ71,TRUE)),IF(AND(AZ72=TRUE,ISNUMBER(BA72)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD72=TRUE,ISNUMBER(BE72)=TRUE),MAX(0,BE72-SUMIFS(AM$3:AM71,BD$3:BD71,TRUE,F$3:F71,F72)),IF(AND(BD72=TRUE,ISNUMBER(BE72)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.21,"d":"$3.21"},0,0,0,0,true]
[70,"2016-08-31",8,19,"Lisinopril 20mg (Rx) [1 QD; #30 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.38,"d":"$3.38"},{"v":3.38,"d":"$3.38"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L73=\"Yes\",ISNUMBER(M73)),MAX(0,M73-SUMIFS(BU$3:BU72,L$3:L72,\"Yes\")),IF(OR(L73=\"No\",M73=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O73,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P73=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O73,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V73=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O73,COUNTIF(Z$3:Z72,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",1,"N/A",false,".",8,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO73),AN73=TRUE),MAX(0,AO73-SUMIFS($AM$3:$AM72,AN$3:AN72,TRUE)),IF(AND(AN73=TRUE,ISNUMBER(AO73)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR73=TRUE,ISNUMBER(AS73)),MAX(0,AS73-SUMIFS($AM$3:$AM72,AR$3:AR72,TRUE)),IF(AND(AR73=TRUE,ISNUMBER(AS73)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV73=TRUE,ISNUMBER(AW73)),MAX(0,AW73-SUMIFS($AM$3:$AM72,AV$3:AV72,TRUE)),IF(AND(AV73=TRUE,ISNUMBER(AW73)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ73=TRUE,ISNUMBER(BA73)),MAX(0,BA73-SUMIFS($AM$3:$AM72,AZ$3:AZ72,TRUE)),IF(AND(AZ73=TRUE,ISNUMBER(BA73)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD73=TRUE,ISNUMBER(BE73)=TRUE),MAX(0,BE73-SUMIFS(AM$3:AM72,BD$3:BD72,TRUE,F$3:F72,F73)),IF(AND(BD73=TRUE,ISNUMBER(BE73)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.38,"d":"$3.38"},0,0,0,0,true]
[71,"2016-09-12",9,26,"Aspirin 81mg (OTC - bottle 100) [usage = 1 QD; #30 pills per month]","Over-the-counter Drugs","Not Covered",{"v":4.47,"d":"$4.47"},{"v":4.47,"d":"$4.47"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L74=\"Yes\",ISNUMBER(M74)),MAX(0,M74-SUMIFS(BU$3:BU73,L$3:L73,\"Yes\")),IF(OR(L74=\"No\",M74=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O74,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P74=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O74,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V74=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O74,COUNTIF(Z$3:Z73,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",3,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO74),AN74=TRUE),MAX(0,AO74-SUMIFS($AM$3:$AM73,AN$3:AN73,TRUE)),IF(AND(AN74=TRUE,ISNUMBER(AO74)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR74=TRUE,ISNUMBER(AS74)),MAX(0,AS74-SUMIFS($AM$3:$AM73,AR$3:AR73,TRUE)),IF(AND(AR74=TRUE,ISNUMBER(AS74)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV74=TRUE,ISNUMBER(AW74)),MAX(0,AW74-SUMIFS($AM$3:$AM73,AV$3:AV73,TRUE)),IF(AND(AV74=TRUE,ISNUMBER(AW74)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ74=TRUE,ISNUMBER(BA74)),MAX(0,BA74-SUMIFS($AM$3:$AM73,AZ$3:AZ73,TRUE)),IF(AND(AZ74=TRUE,ISNUMBER(BA74)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD74=TRUE,ISNUMBER(BE74)=TRUE),MAX(0,BE74-SUMIFS(AM$3:AM73,BD$3:BD73,TRUE,F$3:F73,F74)),IF(AND(BD74=TRUE,ISNUMBER(BE74)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":4.47,"d":"$4.47"},0,0,0,0,true]
[72,"2016-09-12",9,17,"Insulin glargine 100 unit/ml injectable solution (Rx - 10ml vial)  [20 units QD; expires 28 days after first use]","Prescription Drugs: Insulin","Not Covered",{"v":240.37,"d":"$240.37"},{"v":240.37,"d":"$240.37"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L75=\"Yes\",ISNUMBER(M75)),MAX(0,M75-SUMIFS(BU$3:BU74,L$3:L74,\"Yes\")),IF(OR(L75=\"No\",M75=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O75,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P75=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O75,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V75=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O75,COUNTIF(Z$3:Z74,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",9,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO75),AN75=TRUE),MAX(0,AO75-SUMIFS($AM$3:$AM74,AN$3:AN74,TRUE)),IF(AND(AN75=TRUE,ISNUMBER(AO75)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR75=TRUE,ISNUMBER(AS75)),MAX(0,AS75-SUMIFS($AM$3:$AM74,AR$3:AR74,TRUE)),IF(AND(AR75=TRUE,ISNUMBER(AS75)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV75=TRUE,ISNUMBER(AW75)),MAX(0,AW75-SUMIFS($AM$3:$AM74,AV$3:AV74,TRUE)),IF(AND(AV75=TRUE,ISNUMBER(AW75)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ75=TRUE,ISNUMBER(BA75)),MAX(0,BA75-SUMIFS($AM$3:$AM74,AZ$3:AZ74,TRUE)),IF(AND(AZ75=TRUE,ISNUMBER(BA75)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD75=TRUE,ISNUMBER(BE75)=TRUE),MAX(0,BE75-SUMIFS(AM$3:AM74,BD$3:BD74,TRUE,F$3:F74,F75)),IF(AND(BD75=TRUE,ISNUMBER(BE75)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":240.37,"d":"$240.37"},0,0,0,0,true]
[73,"2016-09-26",9,24,"Office/Outpatient Visit Est","Professional Services: Primary Care","Not Covered",{"v":121.7,"d":"$121.70"},{"v":121.7,"d":"$121.70"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L76=\"Yes\",ISNUMBER(M76)),MAX(0,M76-SUMIFS(BU$3:BU75,L$3:L75,\"Yes\")),IF(OR(L76=\"No\",M76=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},true,{"$f":"IF(O76,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"."},{"$f":"IF(P76=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},7,0,0,true,{"$f":"IF(O76,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"."},{"$f":"IF(V76=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O76,COUNTIF(Z$3:Z75,\">0\"),\"N/A\")","v":0},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",3,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO76),AN76=TRUE),MAX(0,AO76-SUMIFS($AM$3:$AM75,AN$3:AN75,TRUE)),IF(AND(AN76=TRUE,ISNUMBER(AO76)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR76=TRUE,ISNUMBER(AS76)),MAX(0,AS76-SUMIFS($AM$3:$AM75,AR$3:AR75,TRUE)),IF(AND(AR76=TRUE,ISNUMBER(AS76)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV76=TRUE,ISNUMBER(AW76)),MAX(0,AW76-SUMIFS($AM$3:$AM75,AV$3:AV75,TRUE)),IF(AND(AV76=TRUE,ISNUMBER(AW76)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ76=TRUE,ISNUMBER(BA76)),MAX(0,BA76-SUMIFS($AM$3:$AM75,AZ$3:AZ75,TRUE)),IF(AND(AZ76=TRUE,ISNUMBER(BA76)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD76=TRUE,ISNUMBER(BE76)=TRUE),MAX(0,BE76-SUMIFS(AM$3:AM75,BD$3:BD75,TRUE,F$3:F75,F76)),IF(AND(BD76=TRUE,ISNUMBER(BE76)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":121.7,"d":"$121.70"},0,0,0,0,true]
[74,"2016-09-30",9,14,"BD Ultrafine Insulin Syringes / 30G/ 0.5cc  [usage = 30 syringes per month]","Medical Supplies","Not Covered",{"v":20.62,"d":"$20.62"},{"v":20.62,"d":"$20.62"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L77=\"Yes\",ISNUMBER(M77)),MAX(0,M77-SUMIFS(BU$3:BU76,L$3:L76,\"Yes\")),IF(OR(L77=\"No\",M77=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O77,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P77=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O77,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V77=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O77,COUNTIF(Z$3:Z76,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",9,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO77),AN77=TRUE),MAX(0,AO77-SUMIFS($AM$3:$AM76,AN$3:AN76,TRUE)),IF(AND(AN77=TRUE,ISNUMBER(AO77)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR77=TRUE,ISNUMBER(AS77)),MAX(0,AS77-SUMIFS($AM$3:$AM76,AR$3:AR76,TRUE)),IF(AND(AR77=TRUE,ISNUMBER(AS77)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV77=TRUE,ISNUMBER(AW77)),MAX(0,AW77-SUMIFS($AM$3:$AM76,AV$3:AV76,TRUE)),IF(AND(AV77=TRUE,ISNUMBER(AW77)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ77=TRUE,ISNUMBER(BA77)),MAX(0,BA77-SUMIFS($AM$3:$AM76,AZ$3:AZ76,TRUE)),IF(AND(AZ77=TRUE,ISNUMBER(BA77)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD77=TRUE,ISNUMBER(BE77)=TRUE),MAX(0,BE77-SUMIFS(AM$3:AM76,BD$3:BD76,TRUE,F$3:F76,F77)),IF(AND(BD77=TRUE,ISNUMBER(BE77)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":20.62,"d":"$20.62"},0,0,0,0,true]
[75,"2016-09-30",9,32,"Metformin Hydrochloride 500 MG TABLET [ #60 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.21,"d":"$3.21"},{"v":3.21,"d":"$3.21"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L78=\"Yes\",ISNUMBER(M78)),MAX(0,M78-SUMIFS(BU$3:BU77,L$3:L77,\"Yes\")),IF(OR(L78=\"No\",M78=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O78,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P78=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O78,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V78=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O78,COUNTIF(Z$3:Z77,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",9,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO78),AN78=TRUE),MAX(0,AO78-SUMIFS($AM$3:$AM77,AN$3:AN77,TRUE)),IF(AND(AN78=TRUE,ISNUMBER(AO78)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR78=TRUE,ISNUMBER(AS78)),MAX(0,AS78-SUMIFS($AM$3:$AM77,AR$3:AR77,TRUE)),IF(AND(AR78=TRUE,ISNUMBER(AS78)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV78=TRUE,ISNUMBER(AW78)),MAX(0,AW78-SUMIFS($AM$3:$AM77,AV$3:AV77,TRUE)),IF(AND(AV78=TRUE,ISNUMBER(AW78)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ78=TRUE,ISNUMBER(BA78)),MAX(0,BA78-SUMIFS($AM$3:$AM77,AZ$3:AZ77,TRUE)),IF(AND(AZ78=TRUE,ISNUMBER(BA78)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD78=TRUE,ISNUMBER(BE78)=TRUE),MAX(0,BE78-SUMIFS(AM$3:AM77,BD$3:BD77,TRUE,F$3:F77,F78)),IF(AND(BD78=TRUE,ISNUMBER(BE78)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.21,"d":"$3.21"},0,0,0,0,true]
[76,"2016-09-30",9,19,"Lisinopril 20mg (Rx) [1 QD; #30 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.38,"d":"$3.38"},{"v":3.38,"d":"$3.38"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L79=\"Yes\",ISNUMBER(M79)),MAX(0,M79-SUMIFS(BU$3:BU78,L$3:L78,\"Yes\")),IF(OR(L79=\"No\",M79=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O79,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P79=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O79,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V79=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O79,COUNTIF(Z$3:Z78,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",9,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO79),AN79=TRUE),MAX(0,AO79-SUMIFS($AM$3:$AM78,AN$3:AN78,TRUE)),IF(AND(AN79=TRUE,ISNUMBER(AO79)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR79=TRUE,ISNUMBER(AS79)),MAX(0,AS79-SUMIFS($AM$3:$AM78,AR$3:AR78,TRUE)),IF(AND(AR79=TRUE,ISNUMBER(AS79)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV79=TRUE,ISNUMBER(AW79)),MAX(0,AW79-SUMIFS($AM$3:$AM78,AV$3:AV78,TRUE)),IF(AND(AV79=TRUE,ISNUMBER(AW79)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ79=TRUE,ISNUMBER(BA79)),MAX(0,BA79-SUMIFS($AM$3:$AM78,AZ$3:AZ78,TRUE)),IF(AND(AZ79=TRUE,ISNUMBER(BA79)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD79=TRUE,ISNUMBER(BE79)=TRUE),MAX(0,BE79-SUMIFS(AM$3:AM78,BD$3:BD78,TRUE,F$3:F78,F79)),IF(AND(BD79=TRUE,ISNUMBER(BE79)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.38,"d":"$3.38"},0,0,0,0,true]
[77,"2016-10-03",10,28,"Immunization admin each add ","Preventive Services & Vaccines","Not Covered",{"v":15.88,"d":"$15.88"},{"v":15.88,"d":"$15.88"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L80=\"Yes\",ISNUMBER(M80)),MAX(0,M80-SUMIFS(BU$3:BU79,L$3:L79,\"Yes\")),IF(OR(L80=\"No\",M80=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O80,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P80=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O80,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V80=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O80,COUNTIF(Z$3:Z79,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO80),AN80=TRUE),MAX(0,AO80-SUMIFS($AM$3:$AM79,AN$3:AN79,TRUE)),IF(AND(AN80=TRUE,ISNUMBER(AO80)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR80=TRUE,ISNUMBER(AS80)),MAX(0,AS80-SUMIFS($AM$3:$AM79,AR$3:AR79,TRUE)),IF(AND(AR80=TRUE,ISNUMBER(AS80)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV80=TRUE,ISNUMBER(AW80)),MAX(0,AW80-SUMIFS($AM$3:$AM79,AV$3:AV79,TRUE)),IF(AND(AV80=TRUE,ISNUMBER(AW80)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ80=TRUE,ISNUMBER(BA80)),MAX(0,BA80-SUMIFS($AM$3:$AM79,AZ$3:AZ79,TRUE)),IF(AND(AZ80=TRUE,ISNUMBER(BA80)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD80=TRUE,ISNUMBER(BE80)=TRUE),MAX(0,BE80-SUMIFS(AM$3:AM79,BD$3:BD79,TRUE,F$3:F79,F80)),IF(AND(BD80=TRUE,ISNUMBER(BE80)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":15.88,"d":"$15.88"},0,0,{"$f":"IF(V80=\"Yes\",IF(Z80=\"N/A\",0,Z80),0)+IF(BL80,BN80,0)","v":0},0,true]
[78,"2016-10-03",10,27,{"$f":"VLOOKUP(ServiceCode,DiabetesFeeSchedule,6,FALSE)","v":"Immunization Admin ADMIN"},{"$f":"VLOOKUP(ServiceCode,DiabetesFeeSchedule,5,FALSE)","v":"Preventive Services & Vaccines"},{"$f":"VLOOKUP(BenefitCategory,BenefitDesignTable,COLUMN(BenefitCostSharing),FALSE)","v":"Not Covered"},{"$f":"VLOOKUP(D81,DiabetesFeeSchedule,7,FALSE)","v":{"v":28.31,"d":"$28.31"}},{"$f":"IF(G81=\"Not Covered\",H81,0)","v":{"v":28.31,"d":"$28.31"}},{"$f":"H81-I81","v":0},{"$f":"VLOOKUP(F81,nrCoverageTable,COLUMN(nrOOPLimitValid),FALSE)","v":false},{"$f":"IF(K81,VLOOKUP(F81,BenefitDesignTable,COLUMN(BenefitOOPLimitApplies),FALSE),\"No\")","v":"No"},{"$f":"VLOOKUP(F81,BenefitDesignTable,COLUMN(OPLimit),FALSE)","v":"."},{"$f":"IFERROR(IF(AND(L81=\"Yes\",ISNUMBER(M81)),MAX(0,M81-SUMIFS(BU$3:BU80,L$3:L80,\"Yes\")),IF(OR(L81=\"No\",M81=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O81,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P81=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,{"$f":"J81-S81","v":0},false,{"$f":"IF(O81,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V81=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O81,COUNTIF(Z$3:Z80,\">0\"),\"N/A\")","v":"N/A"},{"$f":"IF(V81=\"Yes\",VLOOKUP(\"Professional Services: Primary Care\",BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},"N/A",0,{"$f":"IF(L81=\"Yes\",IF(Z81=\"N/A\",N81,N81-Z81),\"N/A\")","v":"N/A"},0,{"$f":"VLOOKUP(F81,nrCoverageTable,COLUMN(nrMonthlyLimitValid),FALSE)","v":false},{"$f":"IF(AD81,VLOOKUP(F81,BenefitDesignTable,COLUMN(BenefitLimithMonth),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D81,ClaimMonth,C81,ClaimNumber,\"<\"&A81)","v":0},{"$f":"IF(AD81,IF(OR(AE81=\"None\",ISNUMBER(AE81)),IF(AF81>=AE81,H81,0),\"ERR\"),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F81,nrCoverageTable,COLUMN(nrAnnualLimitValid),FALSE)","v":false},{"$f":"IF(AH81,VLOOKUP(F81,BenefitDesignTable,COLUMN(BenefitLimitAnnual),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D81,ClaimNumber,\"<\"&A81)","v":0},{"$f":"IF(AH81,IF(OR(AI81=\"None\",ISNUMBER(AI81)),IF(AJ81>=AI81,H81,0),\"ERR\"),\"N/A\")","v":"N/A"},0,0,{"$f":"VLOOKUP(F81,nrCoverageTable,COLUMN(nrUsesPlanDeduct),FALSE)","v":false},{"$f":"IF(AN81,VLOOKUP(F81,BenefitDesignTable,COLUMN(PlanDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(ISNUMBER(AO81),AN81=TRUE),MAX(0,AO81-SUMIFS($AM$3:$AM80,AN$3:AN80,TRUE)),IF(AND(AN81=TRUE,ISNUMBER(AO81)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AP81),MIN($AM81,AP81),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F81,nrCoverageTable,COLUMN(nrUsesRxDeduct),FALSE)","v":false},{"$f":"IF(AR81,VLOOKUP(F81,BenefitDesignTable,COLUMN(RxDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AR81=TRUE,ISNUMBER(AS81)),MAX(0,AS81-SUMIFS($AM$3:$AM80,AR$3:AR80,TRUE)),IF(AND(AR81=TRUE,ISNUMBER(AS81)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AT81),MIN($AM81,AT81),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F81,nrCoverageTable,COLUMN(nrUsesDeductC),FALSE)","v":false},{"$f":"IF(AV81,VLOOKUP(F81,BenefitDesignTable,COLUMN(OptDeductibleC),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AV81=TRUE,ISNUMBER(AW81)),MAX(0,AW81-SUMIFS($AM$3:$AM80,AV$3:AV80,TRUE)),IF(AND(AV81=TRUE,ISNUMBER(AW81)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AX81),MIN($AM81,AX81),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F81,nrCoverageTable,COLUMN(nrUsesDeductD),FALSE)","v":false},{"$f":"IF(AZ81,VLOOKUP(F81,BenefitDesignTable,COLUMN(OptDeductibleD),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AZ81=TRUE,ISNUMBER(BA81)),MAX(0,BA81-SUMIFS($AM$3:$AM80,AZ$3:AZ80,TRUE)),IF(AND(AZ81=TRUE,ISNUMBER(BA81)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BB81),MIN($AM81,BB81),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F81,nrCoverageTable,COLUMN(nrUsesBenDeduct),FALSE)","v":false},{"$f":"IF(BD81,VLOOKUP(F81,BenefitDesignTable,COLUMN(BenefitDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(BD81=TRUE,ISNUMBER(BE81)=TRUE),MAX(0,BE81-SUMIFS(AM$3:AM80,BD$3:BD80,TRUE,F$3:F80,F81)),IF(AND(BD81=TRUE,ISNUMBER(BE81)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BF81),MIN($AM81,BF81),\"N/A\")","v":"N/A"},{"$f":"SUM(AQ81,AU81,AY81,BC81,BG81)","v":0},0,"N/A",{"$f":"IF(OR(BI81=\"ERR\",AM81=\"ERR\"),\"ERR\",MAX(0,AM81-BI81))","v":0},{"$f":"VLOOKUP(F81,nrCoverageTable,COLUMN(nrUsesCopay),FALSE)","v":false},{"$f":"IF(BL81,VLOOKUP(F81,BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},"N/A",{"$f":"VLOOKUP(F81,nrCoverageTable,COLUMN(nrUsesCoins),FALSE)","v":false},{"$f":"IF(BO81,VLOOKUP(F81,BenefitDesignTable,COLUMN(BenefitCoins),FALSE),\"N/A\")","v":"N/A"},"N/A",0,"N/A",0,0,0,{"$f":"I81","v":{"v":28.31,"d":"$28.31"}},{"$f":"IF(OR(AG81=\"ERR\",AK81=\"ERR\"),\"ERR\",SUM(AG81,AK81))","v":0},0,{"$f":"IF(V81=\"Yes\",IF(Z81=\"N/A\",0,Z81),0)+IF(BL81,BN81,0)","v":0},0,{"$f":"SUM(BV81:CA81)=H81","v":true}]
[79,"2016-10-03",10,29,"Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older","Preventive Services & Vaccines","Not Covered",{"v":93.74,"d":"$93.74"},{"v":93.74,"d":"$93.74"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L82=\"Yes\",ISNUMBER(M82)),MAX(0,M82-SUMIFS(BU$3:BU81,L$3:L81,\"Yes\")),IF(OR(L82=\"No\",M82=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O82,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P82=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O82,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V82=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O82,COUNTIF(Z$3:Z81,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO82),AN82=TRUE),MAX(0,AO82-SUMIFS($AM$3:$AM81,AN$3:AN81,TRUE)),IF(AND(AN82=TRUE,ISNUMBER(AO82)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR82=TRUE,ISNUMBER(AS82)),MAX(0,AS82-SUMIFS($AM$3:$AM81,AR$3:AR81,TRUE)),IF(AND(AR82=TRUE,ISNUMBER(AS82)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV82=TRUE,ISNUMBER(AW82)),MAX(0,AW82-SUMIFS($AM$3:$AM81,AV$3:AV81,TRUE)),IF(AND(AV82=TRUE,ISNUMBER(AW82)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ82=TRUE,ISNUMBER(BA82)),MAX(0,BA82-SUMIFS($AM$3:$AM81,AZ$3:AZ81,TRUE)),IF(AND(AZ82=TRUE,ISNUMBER(BA82)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD82=TRUE,ISNUMBER(BE82)=TRUE),MAX(0,BE82-SUMIFS(AM$3:AM81,BD$3:BD81,TRUE,F$3:F81,F82)),IF(AND(BD82=TRUE,ISNUMBER(BE82)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":93.74,"d":"$93.74"},0,0,0,0,true]
[80,"2016-10-03",10,30,"Flu Vaccine No Preserv 3 & >","Preventive Services & Vaccines","Not Covered",{"v":21.02,"d":"$21.02"},{"v":21.02,"d":"$21.02"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L83=\"Yes\",ISNUMBER(M83)),MAX(0,M83-SUMIFS(BU$3:BU82,L$3:L82,\"Yes\")),IF(OR(L83=\"No\",M83=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O83,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P83=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O83,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V83=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O83,COUNTIF(Z$3:Z82,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO83),AN83=TRUE),MAX(0,AO83-SUMIFS($AM$3:$AM82,AN$3:AN82,TRUE)),IF(AND(AN83=TRUE,ISNUMBER(AO83)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR83=TRUE,ISNUMBER(AS83)),MAX(0,AS83-SUMIFS($AM$3:$AM82,AR$3:AR82,TRUE)),IF(AND(AR83=TRUE,ISNUMBER(AS83)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV83=TRUE,ISNUMBER(AW83)),MAX(0,AW83-SUMIFS($AM$3:$AM82,AV$3:AV82,TRUE)),IF(AND(AV83=TRUE,ISNUMBER(AW83)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ83=TRUE,ISNUMBER(BA83)),MAX(0,BA83-SUMIFS($AM$3:$AM82,AZ$3:AZ82,TRUE)),IF(AND(AZ83=TRUE,ISNUMBER(BA83)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD83=TRUE,ISNUMBER(BE83)=TRUE),MAX(0,BE83-SUMIFS(AM$3:AM82,BD$3:BD82,TRUE,F$3:F82,F83)),IF(AND(BD83=TRUE,ISNUMBER(BE83)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":21.02,"d":"$21.02"},0,0,0,0,true]
[81,"2016-10-03",10,33,"Atorvastatin 40 MG tablet 90 CT [ #30 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":9.66,"d":"$9.66"},{"v":9.66,"d":"$9.66"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L84=\"Yes\",ISNUMBER(M84)),MAX(0,M84-SUMIFS(BU$3:BU83,L$3:L83,\"Yes\")),IF(OR(L84=\"No\",M84=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O84,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P84=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O84,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V84=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O84,COUNTIF(Z$3:Z83,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",3,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO84),AN84=TRUE),MAX(0,AO84-SUMIFS($AM$3:$AM83,AN$3:AN83,TRUE)),IF(AND(AN84=TRUE,ISNUMBER(AO84)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR84=TRUE,ISNUMBER(AS84)),MAX(0,AS84-SUMIFS($AM$3:$AM83,AR$3:AR83,TRUE)),IF(AND(AR84=TRUE,ISNUMBER(AS84)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV84=TRUE,ISNUMBER(AW84)),MAX(0,AW84-SUMIFS($AM$3:$AM83,AV$3:AV83,TRUE)),IF(AND(AV84=TRUE,ISNUMBER(AW84)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ84=TRUE,ISNUMBER(BA84)),MAX(0,BA84-SUMIFS($AM$3:$AM83,AZ$3:AZ83,TRUE)),IF(AND(AZ84=TRUE,ISNUMBER(BA84)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD84=TRUE,ISNUMBER(BE84)=TRUE),MAX(0,BE84-SUMIFS(AM$3:AM83,BD$3:BD83,TRUE,F$3:F83,F84)),IF(AND(BD84=TRUE,ISNUMBER(BE84)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":9.66,"d":"$9.66"},0,0,0,0,true]
[82,"2016-10-10",10,17,"Insulin glargine 100 unit/ml injectable solution (Rx - 10ml vial)  [20 units QD; expires 28 days after first use]","Prescription Drugs: Insulin","Not Covered",{"v":240.37,"d":"$240.37"},{"v":240.37,"d":"$240.37"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L85=\"Yes\",ISNUMBER(M85)),MAX(0,M85-SUMIFS(BU$3:BU84,L$3:L84,\"Yes\")),IF(OR(L85=\"No\",M85=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O85,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P85=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O85,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V85=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O85,COUNTIF(Z$3:Z84,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",10,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO85),AN85=TRUE),MAX(0,AO85-SUMIFS($AM$3:$AM84,AN$3:AN84,TRUE)),IF(AND(AN85=TRUE,ISNUMBER(AO85)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR85=TRUE,ISNUMBER(AS85)),MAX(0,AS85-SUMIFS($AM$3:$AM84,AR$3:AR84,TRUE)),IF(AND(AR85=TRUE,ISNUMBER(AS85)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV85=TRUE,ISNUMBER(AW85)),MAX(0,AW85-SUMIFS($AM$3:$AM84,AV$3:AV84,TRUE)),IF(AND(AV85=TRUE,ISNUMBER(AW85)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ85=TRUE,ISNUMBER(BA85)),MAX(0,BA85-SUMIFS($AM$3:$AM84,AZ$3:AZ84,TRUE)),IF(AND(AZ85=TRUE,ISNUMBER(BA85)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD85=TRUE,ISNUMBER(BE85)=TRUE),MAX(0,BE85-SUMIFS(AM$3:AM84,BD$3:BD84,TRUE,F$3:F84,F85)),IF(AND(BD85=TRUE,ISNUMBER(BE85)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":240.37,"d":"$240.37"},0,0,0,0,true]
[83,"2016-10-29",10,5,"OneTouch Delica Lancets (100 per box)  [usage = 60 lancets per month]","Medical Supplies","Not Covered",{"v":8.73,"d":"$8.73"},{"v":8.73,"d":"$8.73"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L86=\"Yes\",ISNUMBER(M86)),MAX(0,M86-SUMIFS(BU$3:BU85,L$3:L85,\"Yes\")),IF(OR(L86=\"No\",M86=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O86,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P86=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O86,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V86=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O86,COUNTIF(Z$3:Z85,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",3,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO86),AN86=TRUE),MAX(0,AO86-SUMIFS($AM$3:$AM85,AN$3:AN85,TRUE)),IF(AND(AN86=TRUE,ISNUMBER(AO86)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR86=TRUE,ISNUMBER(AS86)),MAX(0,AS86-SUMIFS($AM$3:$AM85,AR$3:AR85,TRUE)),IF(AND(AR86=TRUE,ISNUMBER(AS86)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV86=TRUE,ISNUMBER(AW86)),MAX(0,AW86-SUMIFS($AM$3:$AM85,AV$3:AV85,TRUE)),IF(AND(AV86=TRUE,ISNUMBER(AW86)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ86=TRUE,ISNUMBER(BA86)),MAX(0,BA86-SUMIFS($AM$3:$AM85,AZ$3:AZ85,TRUE)),IF(AND(AZ86=TRUE,ISNUMBER(BA86)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD86=TRUE,ISNUMBER(BE86)=TRUE),MAX(0,BE86-SUMIFS(AM$3:AM85,BD$3:BD85,TRUE,F$3:F85,F86)),IF(AND(BD86=TRUE,ISNUMBER(BE86)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":8.73,"d":"$8.73"},0,0,0,0,true]
[84,"2016-10-29",10,4,"OneTouch Ultra Blue Test Strips (Rx - box of 100) [usage = 2 strips/day; 60 per month] ","Medical Supplies","Not Covered",{"v":109.61,"d":"$109.61"},{"v":109.61,"d":"$109.61"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L87=\"Yes\",ISNUMBER(M87)),MAX(0,M87-SUMIFS(BU$3:BU86,L$3:L86,\"Yes\")),IF(OR(L87=\"No\",M87=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O87,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P87=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O87,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V87=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O87,COUNTIF(Z$3:Z86,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",3,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO87),AN87=TRUE),MAX(0,AO87-SUMIFS($AM$3:$AM86,AN$3:AN86,TRUE)),IF(AND(AN87=TRUE,ISNUMBER(AO87)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR87=TRUE,ISNUMBER(AS87)),MAX(0,AS87-SUMIFS($AM$3:$AM86,AR$3:AR86,TRUE)),IF(AND(AR87=TRUE,ISNUMBER(AS87)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV87=TRUE,ISNUMBER(AW87)),MAX(0,AW87-SUMIFS($AM$3:$AM86,AV$3:AV86,TRUE)),IF(AND(AV87=TRUE,ISNUMBER(AW87)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ87=TRUE,ISNUMBER(BA87)),MAX(0,BA87-SUMIFS($AM$3:$AM86,AZ$3:AZ86,TRUE)),IF(AND(AZ87=TRUE,ISNUMBER(BA87)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD87=TRUE,ISNUMBER(BE87)=TRUE),MAX(0,BE87-SUMIFS(AM$3:AM86,BD$3:BD86,TRUE,F$3:F86,F87)),IF(AND(BD87=TRUE,ISNUMBER(BE87)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":109.61,"d":"$109.61"},0,0,0,0,true]
[85,"2016-10-30",10,14,"BD Ultrafine Insulin Syringes / 30G/ 0.5cc  [usage = 30 syringes per month]","Medical Supplies","Not Covered",{"v":20.62,"d":"$20.62"},{"v":20.62,"d":"$20.62"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L88=\"Yes\",ISNUMBER(M88)),MAX(0,M88-SUMIFS(BU$3:BU87,L$3:L87,\"Yes\")),IF(OR(L88=\"No\",M88=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O88,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P88=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O88,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V88=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O88,COUNTIF(Z$3:Z87,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",10,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO88),AN88=TRUE),MAX(0,AO88-SUMIFS($AM$3:$AM87,AN$3:AN87,TRUE)),IF(AND(AN88=TRUE,ISNUMBER(AO88)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR88=TRUE,ISNUMBER(AS88)),MAX(0,AS88-SUMIFS($AM$3:$AM87,AR$3:AR87,TRUE)),IF(AND(AR88=TRUE,ISNUMBER(AS88)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV88=TRUE,ISNUMBER(AW88)),MAX(0,AW88-SUMIFS($AM$3:$AM87,AV$3:AV87,TRUE)),IF(AND(AV88=TRUE,ISNUMBER(AW88)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ88=TRUE,ISNUMBER(BA88)),MAX(0,BA88-SUMIFS($AM$3:$AM87,AZ$3:AZ87,TRUE)),IF(AND(AZ88=TRUE,ISNUMBER(BA88)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD88=TRUE,ISNUMBER(BE88)=TRUE),MAX(0,BE88-SUMIFS(AM$3:AM87,BD$3:BD87,TRUE,F$3:F87,F88)),IF(AND(BD88=TRUE,ISNUMBER(BE88)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":20.62,"d":"$20.62"},0,0,0,0,true]
[86,"2016-10-30",10,32,"Metformin Hydrochloride 500 MG TABLET [ #60 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.21,"d":"$3.21"},{"v":3.21,"d":"$3.21"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L89=\"Yes\",ISNUMBER(M89)),MAX(0,M89-SUMIFS(BU$3:BU88,L$3:L88,\"Yes\")),IF(OR(L89=\"No\",M89=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O89,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P89=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O89,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V89=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O89,COUNTIF(Z$3:Z88,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",10,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO89),AN89=TRUE),MAX(0,AO89-SUMIFS($AM$3:$AM88,AN$3:AN88,TRUE)),IF(AND(AN89=TRUE,ISNUMBER(AO89)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR89=TRUE,ISNUMBER(AS89)),MAX(0,AS89-SUMIFS($AM$3:$AM88,AR$3:AR88,TRUE)),IF(AND(AR89=TRUE,ISNUMBER(AS89)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV89=TRUE,ISNUMBER(AW89)),MAX(0,AW89-SUMIFS($AM$3:$AM88,AV$3:AV88,TRUE)),IF(AND(AV89=TRUE,ISNUMBER(AW89)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ89=TRUE,ISNUMBER(BA89)),MAX(0,BA89-SUMIFS($AM$3:$AM88,AZ$3:AZ88,TRUE)),IF(AND(AZ89=TRUE,ISNUMBER(BA89)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD89=TRUE,ISNUMBER(BE89)=TRUE),MAX(0,BE89-SUMIFS(AM$3:AM88,BD$3:BD88,TRUE,F$3:F88,F89)),IF(AND(BD89=TRUE,ISNUMBER(BE89)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.21,"d":"$3.21"},0,0,0,0,true]
[87,"2016-10-30",10,19,"Lisinopril 20mg (Rx) [1 QD; #30 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.38,"d":"$3.38"},{"v":3.38,"d":"$3.38"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L90=\"Yes\",ISNUMBER(M90)),MAX(0,M90-SUMIFS(BU$3:BU89,L$3:L89,\"Yes\")),IF(OR(L90=\"No\",M90=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O90,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P90=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O90,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V90=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O90,COUNTIF(Z$3:Z89,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",10,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO90),AN90=TRUE),MAX(0,AO90-SUMIFS($AM$3:$AM89,AN$3:AN89,TRUE)),IF(AND(AN90=TRUE,ISNUMBER(AO90)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR90=TRUE,ISNUMBER(AS90)),MAX(0,AS90-SUMIFS($AM$3:$AM89,AR$3:AR89,TRUE)),IF(AND(AR90=TRUE,ISNUMBER(AS90)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV90=TRUE,ISNUMBER(AW90)),MAX(0,AW90-SUMIFS($AM$3:$AM89,AV$3:AV89,TRUE)),IF(AND(AV90=TRUE,ISNUMBER(AW90)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ90=TRUE,ISNUMBER(BA90)),MAX(0,BA90-SUMIFS($AM$3:$AM89,AZ$3:AZ89,TRUE)),IF(AND(AZ90=TRUE,ISNUMBER(BA90)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD90=TRUE,ISNUMBER(BE90)=TRUE),MAX(0,BE90-SUMIFS(AM$3:AM89,BD$3:BD89,TRUE,F$3:F89,F90)),IF(AND(BD90=TRUE,ISNUMBER(BE90)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.38,"d":"$3.38"},0,0,0,0,true]
[88,"2016-11-07",11,17,"Insulin glargine 100 unit/ml injectable solution (Rx - 10ml vial)  [20 units QD; expires 28 days after first use]","Prescription Drugs: Insulin","Not Covered",{"v":240.37,"d":"$240.37"},{"v":240.37,"d":"$240.37"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L91=\"Yes\",ISNUMBER(M91)),MAX(0,M91-SUMIFS(BU$3:BU90,L$3:L90,\"Yes\")),IF(OR(L91=\"No\",M91=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O91,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P91=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O91,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V91=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O91,COUNTIF(Z$3:Z90,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",11,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO91),AN91=TRUE),MAX(0,AO91-SUMIFS($AM$3:$AM90,AN$3:AN90,TRUE)),IF(AND(AN91=TRUE,ISNUMBER(AO91)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR91=TRUE,ISNUMBER(AS91)),MAX(0,AS91-SUMIFS($AM$3:$AM90,AR$3:AR90,TRUE)),IF(AND(AR91=TRUE,ISNUMBER(AS91)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV91=TRUE,ISNUMBER(AW91)),MAX(0,AW91-SUMIFS($AM$3:$AM90,AV$3:AV90,TRUE)),IF(AND(AV91=TRUE,ISNUMBER(AW91)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ91=TRUE,ISNUMBER(BA91)),MAX(0,BA91-SUMIFS($AM$3:$AM90,AZ$3:AZ90,TRUE)),IF(AND(AZ91=TRUE,ISNUMBER(BA91)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD91=TRUE,ISNUMBER(BE91)=TRUE),MAX(0,BE91-SUMIFS(AM$3:AM90,BD$3:BD90,TRUE,F$3:F90,F91)),IF(AND(BD91=TRUE,ISNUMBER(BE91)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":240.37,"d":"$240.37"},0,0,0,0,true]
[89,"2016-11-29",11,14,"BD Ultrafine Insulin Syringes / 30G/ 0.5cc  [usage = 30 syringes per month]","Medical Supplies","Not Covered",{"v":20.62,"d":"$20.62"},{"v":20.62,"d":"$20.62"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L92=\"Yes\",ISNUMBER(M92)),MAX(0,M92-SUMIFS(BU$3:BU91,L$3:L91,\"Yes\")),IF(OR(L92=\"No\",M92=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O92,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P92=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O92,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V92=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O92,COUNTIF(Z$3:Z91,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",11,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO92),AN92=TRUE),MAX(0,AO92-SUMIFS($AM$3:$AM91,AN$3:AN91,TRUE)),IF(AND(AN92=TRUE,ISNUMBER(AO92)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR92=TRUE,ISNUMBER(AS92)),MAX(0,AS92-SUMIFS($AM$3:$AM91,AR$3:AR91,TRUE)),IF(AND(AR92=TRUE,ISNUMBER(AS92)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV92=TRUE,ISNUMBER(AW92)),MAX(0,AW92-SUMIFS($AM$3:$AM91,AV$3:AV91,TRUE)),IF(AND(AV92=TRUE,ISNUMBER(AW92)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ92=TRUE,ISNUMBER(BA92)),MAX(0,BA92-SUMIFS($AM$3:$AM91,AZ$3:AZ91,TRUE)),IF(AND(AZ92=TRUE,ISNUMBER(BA92)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD92=TRUE,ISNUMBER(BE92)=TRUE),MAX(0,BE92-SUMIFS(AM$3:AM91,BD$3:BD91,TRUE,F$3:F91,F92)),IF(AND(BD92=TRUE,ISNUMBER(BE92)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":20.62,"d":"$20.62"},0,0,0,0,true]
[90,"2016-11-29",11,32,"Metformin Hydrochloride 500 MG TABLET [ #60 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.21,"d":"$3.21"},{"v":3.21,"d":"$3.21"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L93=\"Yes\",ISNUMBER(M93)),MAX(0,M93-SUMIFS(BU$3:BU92,L$3:L92,\"Yes\")),IF(OR(L93=\"No\",M93=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O93,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P93=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O93,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V93=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O93,COUNTIF(Z$3:Z92,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",11,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO93),AN93=TRUE),MAX(0,AO93-SUMIFS($AM$3:$AM92,AN$3:AN92,TRUE)),IF(AND(AN93=TRUE,ISNUMBER(AO93)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR93=TRUE,ISNUMBER(AS93)),MAX(0,AS93-SUMIFS($AM$3:$AM92,AR$3:AR92,TRUE)),IF(AND(AR93=TRUE,ISNUMBER(AS93)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV93=TRUE,ISNUMBER(AW93)),MAX(0,AW93-SUMIFS($AM$3:$AM92,AV$3:AV92,TRUE)),IF(AND(AV93=TRUE,ISNUMBER(AW93)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ93=TRUE,ISNUMBER(BA93)),MAX(0,BA93-SUMIFS($AM$3:$AM92,AZ$3:AZ92,TRUE)),IF(AND(AZ93=TRUE,ISNUMBER(BA93)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD93=TRUE,ISNUMBER(BE93)=TRUE),MAX(0,BE93-SUMIFS(AM$3:AM92,BD$3:BD92,TRUE,F$3:F92,F93)),IF(AND(BD93=TRUE,ISNUMBER(BE93)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.21,"d":"$3.21"},0,0,0,0,true]
[91,"2016-11-29",11,19,"Lisinopril 20mg (Rx) [1 QD; #30 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.38,"d":"$3.38"},{"v":3.38,"d":"$3.38"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L94=\"Yes\",ISNUMBER(M94)),MAX(0,M94-SUMIFS(BU$3:BU93,L$3:L93,\"Yes\")),IF(OR(L94=\"No\",M94=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O94,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P94=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O94,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V94=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O94,COUNTIF(Z$3:Z93,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",11,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO94),AN94=TRUE),MAX(0,AO94-SUMIFS($AM$3:$AM93,AN$3:AN93,TRUE)),IF(AND(AN94=TRUE,ISNUMBER(AO94)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR94=TRUE,ISNUMBER(AS94)),MAX(0,AS94-SUMIFS($AM$3:$AM93,AR$3:AR93,TRUE)),IF(AND(AR94=TRUE,ISNUMBER(AS94)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV94=TRUE,ISNUMBER(AW94)),MAX(0,AW94-SUMIFS($AM$3:$AM93,AV$3:AV93,TRUE)),IF(AND(AV94=TRUE,ISNUMBER(AW94)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ94=TRUE,ISNUMBER(BA94)),MAX(0,BA94-SUMIFS($AM$3:$AM93,AZ$3:AZ93,TRUE)),IF(AND(AZ94=TRUE,ISNUMBER(BA94)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD94=TRUE,ISNUMBER(BE94)=TRUE),MAX(0,BE94-SUMIFS(AM$3:AM93,BD$3:BD93,TRUE,F$3:F93,F94)),IF(AND(BD94=TRUE,ISNUMBER(BE94)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.38,"d":"$3.38"},0,0,0,0,true]
[92,"2016-12-05",12,26,"Aspirin 81mg (OTC - bottle 100) [usage = 1 QD; #30 pills per month]","Over-the-counter Drugs","Not Covered",{"v":4.47,"d":"$4.47"},{"v":4.47,"d":"$4.47"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L95=\"Yes\",ISNUMBER(M95)),MAX(0,M95-SUMIFS(BU$3:BU94,L$3:L94,\"Yes\")),IF(OR(L95=\"No\",M95=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O95,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P95=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O95,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V95=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O95,COUNTIF(Z$3:Z94,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",4,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO95),AN95=TRUE),MAX(0,AO95-SUMIFS($AM$3:$AM94,AN$3:AN94,TRUE)),IF(AND(AN95=TRUE,ISNUMBER(AO95)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR95=TRUE,ISNUMBER(AS95)),MAX(0,AS95-SUMIFS($AM$3:$AM94,AR$3:AR94,TRUE)),IF(AND(AR95=TRUE,ISNUMBER(AS95)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV95=TRUE,ISNUMBER(AW95)),MAX(0,AW95-SUMIFS($AM$3:$AM94,AV$3:AV94,TRUE)),IF(AND(AV95=TRUE,ISNUMBER(AW95)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ95=TRUE,ISNUMBER(BA95)),MAX(0,BA95-SUMIFS($AM$3:$AM94,AZ$3:AZ94,TRUE)),IF(AND(AZ95=TRUE,ISNUMBER(BA95)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD95=TRUE,ISNUMBER(BE95)=TRUE),MAX(0,BE95-SUMIFS(AM$3:AM94,BD$3:BD94,TRUE,F$3:F94,F95)),IF(AND(BD95=TRUE,ISNUMBER(BE95)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":4.47,"d":"$4.47"},0,0,0,0,true]
[93,"2016-12-05",12,17,"Insulin glargine 100 unit/ml injectable solution (Rx - 10ml vial)  [20 units QD; expires 28 days after first use]","Prescription Drugs: Insulin","Not Covered",{"v":240.37,"d":"$240.37"},{"v":240.37,"d":"$240.37"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L96=\"Yes\",ISNUMBER(M96)),MAX(0,M96-SUMIFS(BU$3:BU95,L$3:L95,\"Yes\")),IF(OR(L96=\"No\",M96=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O96,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P96=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O96,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V96=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O96,COUNTIF(Z$3:Z95,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",12,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO96),AN96=TRUE),MAX(0,AO96-SUMIFS($AM$3:$AM95,AN$3:AN95,TRUE)),IF(AND(AN96=TRUE,ISNUMBER(AO96)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR96=TRUE,ISNUMBER(AS96)),MAX(0,AS96-SUMIFS($AM$3:$AM95,AR$3:AR95,TRUE)),IF(AND(AR96=TRUE,ISNUMBER(AS96)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV96=TRUE,ISNUMBER(AW96)),MAX(0,AW96-SUMIFS($AM$3:$AM95,AV$3:AV95,TRUE)),IF(AND(AV96=TRUE,ISNUMBER(AW96)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ96=TRUE,ISNUMBER(BA96)),MAX(0,BA96-SUMIFS($AM$3:$AM95,AZ$3:AZ95,TRUE)),IF(AND(AZ96=TRUE,ISNUMBER(BA96)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD96=TRUE,ISNUMBER(BE96)=TRUE),MAX(0,BE96-SUMIFS(AM$3:AM95,BD$3:BD95,TRUE,F$3:F95,F96)),IF(AND(BD96=TRUE,ISNUMBER(BE96)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":240.37,"d":"$240.37"},0,0,0,0,true]
[94,"2016-12-29",12,14,"BD Ultrafine Insulin Syringes / 30G/ 0.5cc  [usage = 30 syringes per month]","Medical Supplies","Not Covered",{"v":20.62,"d":"$20.62"},{"v":20.62,"d":"$20.62"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L97=\"Yes\",ISNUMBER(M97)),MAX(0,M97-SUMIFS(BU$3:BU96,L$3:L96,\"Yes\")),IF(OR(L97=\"No\",M97=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O97,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P97=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O97,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V97=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O97,COUNTIF(Z$3:Z96,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",12,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO97),AN97=TRUE),MAX(0,AO97-SUMIFS($AM$3:$AM96,AN$3:AN96,TRUE)),IF(AND(AN97=TRUE,ISNUMBER(AO97)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR97=TRUE,ISNUMBER(AS97)),MAX(0,AS97-SUMIFS($AM$3:$AM96,AR$3:AR96,TRUE)),IF(AND(AR97=TRUE,ISNUMBER(AS97)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV97=TRUE,ISNUMBER(AW97)),MAX(0,AW97-SUMIFS($AM$3:$AM96,AV$3:AV96,TRUE)),IF(AND(AV97=TRUE,ISNUMBER(AW97)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ97=TRUE,ISNUMBER(BA97)),MAX(0,BA97-SUMIFS($AM$3:$AM96,AZ$3:AZ96,TRUE)),IF(AND(AZ97=TRUE,ISNUMBER(BA97)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD97=TRUE,ISNUMBER(BE97)=TRUE),MAX(0,BE97-SUMIFS(AM$3:AM96,BD$3:BD96,TRUE,F$3:F96,F97)),IF(AND(BD97=TRUE,ISNUMBER(BE97)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":20.62,"d":"$20.62"},0,0,0,0,true]
[95,"2016-12-29",12,6,"OneTouch Ultra Control Solution (2 vials/box)","Medical Supplies","Not Covered",{"v":6.63,"d":"$6.63"},{"v":6.63,"d":"$6.63"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L98=\"Yes\",ISNUMBER(M98)),MAX(0,M98-SUMIFS(BU$3:BU97,L$3:L97,\"Yes\")),IF(OR(L98=\"No\",M98=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O98,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P98=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O98,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V98=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O98,COUNTIF(Z$3:Z97,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",2,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO98),AN98=TRUE),MAX(0,AO98-SUMIFS($AM$3:$AM97,AN$3:AN97,TRUE)),IF(AND(AN98=TRUE,ISNUMBER(AO98)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR98=TRUE,ISNUMBER(AS98)),MAX(0,AS98-SUMIFS($AM$3:$AM97,AR$3:AR97,TRUE)),IF(AND(AR98=TRUE,ISNUMBER(AS98)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV98=TRUE,ISNUMBER(AW98)),MAX(0,AW98-SUMIFS($AM$3:$AM97,AV$3:AV97,TRUE)),IF(AND(AV98=TRUE,ISNUMBER(AW98)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ98=TRUE,ISNUMBER(BA98)),MAX(0,BA98-SUMIFS($AM$3:$AM97,AZ$3:AZ97,TRUE)),IF(AND(AZ98=TRUE,ISNUMBER(BA98)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD98=TRUE,ISNUMBER(BE98)=TRUE),MAX(0,BE98-SUMIFS(AM$3:AM97,BD$3:BD97,TRUE,F$3:F97,F98)),IF(AND(BD98=TRUE,ISNUMBER(BE98)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":6.63,"d":"$6.63"},0,0,0,0,true]
[96,"2016-12-29",12,32,"Metformin Hydrochloride 500 MG TABLET [ #60 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.21,"d":"$3.21"},{"v":3.21,"d":"$3.21"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L99=\"Yes\",ISNUMBER(M99)),MAX(0,M99-SUMIFS(BU$3:BU98,L$3:L98,\"Yes\")),IF(OR(L99=\"No\",M99=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O99,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P99=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O99,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V99=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O99,COUNTIF(Z$3:Z98,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",12,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO99),AN99=TRUE),MAX(0,AO99-SUMIFS($AM$3:$AM98,AN$3:AN98,TRUE)),IF(AND(AN99=TRUE,ISNUMBER(AO99)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR99=TRUE,ISNUMBER(AS99)),MAX(0,AS99-SUMIFS($AM$3:$AM98,AR$3:AR98,TRUE)),IF(AND(AR99=TRUE,ISNUMBER(AS99)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV99=TRUE,ISNUMBER(AW99)),MAX(0,AW99-SUMIFS($AM$3:$AM98,AV$3:AV98,TRUE)),IF(AND(AV99=TRUE,ISNUMBER(AW99)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ99=TRUE,ISNUMBER(BA99)),MAX(0,BA99-SUMIFS($AM$3:$AM98,AZ$3:AZ98,TRUE)),IF(AND(AZ99=TRUE,ISNUMBER(BA99)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD99=TRUE,ISNUMBER(BE99)=TRUE),MAX(0,BE99-SUMIFS(AM$3:AM98,BD$3:BD98,TRUE,F$3:F98,F99)),IF(AND(BD99=TRUE,ISNUMBER(BE99)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.21,"d":"$3.21"},0,0,0,0,true]
[97,"2016-12-29",12,19,"Lisinopril 20mg (Rx) [1 QD; #30 pills/month]","Prescription Drugs: Generic","Not Covered",{"v":3.38,"d":"$3.38"},{"v":3.38,"d":"$3.38"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L100=\"Yes\",ISNUMBER(M100)),MAX(0,M100-SUMIFS(BU$3:BU99,L$3:L99,\"Yes\")),IF(OR(L100=\"No\",M100=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O100,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P100=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O100,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V100=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O100,COUNTIF(Z$3:Z99,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",12,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO100),AN100=TRUE),MAX(0,AO100-SUMIFS($AM$3:$AM99,AN$3:AN99,TRUE)),IF(AND(AN100=TRUE,ISNUMBER(AO100)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR100=TRUE,ISNUMBER(AS100)),MAX(0,AS100-SUMIFS($AM$3:$AM99,AR$3:AR99,TRUE)),IF(AND(AR100=TRUE,ISNUMBER(AS100)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV100=TRUE,ISNUMBER(AW100)),MAX(0,AW100-SUMIFS($AM$3:$AM99,AV$3:AV99,TRUE)),IF(AND(AV100=TRUE,ISNUMBER(AW100)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ100=TRUE,ISNUMBER(BA100)),MAX(0,BA100-SUMIFS($AM$3:$AM99,AZ$3:AZ99,TRUE)),IF(AND(AZ100=TRUE,ISNUMBER(BA100)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD100=TRUE,ISNUMBER(BE100)=TRUE),MAX(0,BE100-SUMIFS(AM$3:AM99,BD$3:BD99,TRUE,F$3:F99,F100)),IF(AND(BD100=TRUE,ISNUMBER(BE100)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":3.38,"d":"$3.38"},0,0,0,0,true]

{"sheet":"DIABETES_LINE_ITEM","index":14,"n_rows":28,"n_cols":10,"rows_kept":28,"hidden":true}
["Item or Service Code","Diagnosis Code \n(ICD-10)","CPT©, HCPCS, or\nOther Billing Code","Provider\nType","Benefit Category","Description","Allowed\nAmount","Notes","Valid Benefit Category","Timeline Count"]
[1,"E119.00, Z7982, Z794",2803101,"Pharmacy Retail","Prescription Drugs: Generic","Glucagon Emergency Kit",241.05,null,{"$f":"IF(ISERROR(VLOOKUP(E2,BenefitCategoryList,1,FALSE)),FALSE,TRUE)","v":true},{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A2)","v":1}]
[2,"E119.00, Z7982, Z794",36415,"Primary","Diagnostic Services: Laboratory","Routine Venipuncture",6.43,null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A3)","v":2}]
[3,"E119.00, Z7982, Z794",53885014201,"Pharmacy Retail","Medical Supplies","OneTouch Delica Lancing Device ",14.33,null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A4)","v":1}]
[4,"E119.00, Z7982, Z794",53885024510,"Pharmacy Retail","Medical Supplies","OneTouch Ultra Blue Test Strips (Rx - box of 100) [usage = 2 strips/day; 60 per month] ",109.61,null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A5)","v":4}]
[5,"E119.00, Z7982, Z794",53885039310,"Pharmacy Retail","Medical Supplies","OneTouch Delica Lancets (100 per box)  [usage = 60 lancets per month]",8.73,null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A6)","v":4}]
[6,"E119.00, Z7982, Z794",53885045802,"Pharmacy Retail","Medical Supplies","OneTouch Ultra Control Solution (2 vials/box)",6.63,null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A7)","v":3}]
[7,"E119.00, Z7982, Z794",53885044801,"Pharmacy Retail","Medical Supplies","OneTouch Ultra 2 Blood Glucose Meter Kit",{"v":14.7,"d":"14.70"},null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A8)","v":1}]
[8,"E119.00, Z7982, Z794",80053,"Primary","Diagnostic Services: Laboratory","Comprehen Metabolic Panel",29.63,null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A9)","v":1}]
[9,"E119.00, Z7982, Z794",80061,"Primary","Diagnostic Services: Laboratory","Lipid panel",{"v":23.4,"d":"23.40"},null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A10)","v":1}]
[12,"E119.00, Z7982, Z794",82043,"Primary","Diagnostic Services: Laboratory","Microalbumin Quantitative",{"v":13.1,"d":"13.10"},null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A11)","v":1}]
[13,"E119.00, Z7982, Z794",82570,"Primary","Diagnostic Services: Laboratory","Assay of Urine Creatinine",9.53,null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A12)","v":1}]
[14,"E119.00, Z7982, Z794",8290328279,"Pharmacy Retail","Medical Supplies","BD Ultrafine Insulin Syringes / 30G/ 0.5cc  [usage = 30 syringes per month]",20.62,null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A13)","v":13}]
[16,"E119.00, Z7982, Z794",83036,"Primary","Diagnostic Services: Laboratory","Glycosylated Hemoglobin Test",16.98,null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A14)","v":2}]
[17,"E119.00, Z7982, Z794",88222033,"Pharmacy Retail","Prescription Drugs: Insulin","Insulin glargine 100 unit/ml injectable solution (Rx - 10ml vial)  [20 units QD; expires 28 days after first use]",240.37,null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A15)","v":13}]
[19,"E119.00, Z7982, Z794",68180051503,"Pharmacy Retail","Prescription Drugs: Generic","Lisinopril 20mg (Rx) [1 QD; #30 pills/month]",3.38,null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A16)","v":13}]
[20,"E119.00, Z7982, Z794",97803,"Dietician","Professional Services: Primary Care","Med Nutrition Indiv Subseq",36.83,null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A17)","v":2}]
[21,"E119.00, Z7982, Z794","G0108","Diabetes Educator","Professional Services: Primary Care","Diabetes outpatient self-management training services, individual, per 30 minutes",77.82,null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A18)","v":2}]
[22,"E119.00, Z7982, Z794",92014,"Ophthalmology","Professional Services: Specialist","Ophthalmological services: medical examination & evaluation, with initiation or continuation of diagnostic and treatment program, comprehensive, established patient, 1 or more visits",118.55,null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A19)","v":1}]
[23,"E119.00, Z7982, Z794",99204,"Podiatry","Professional Services: Specialist","Office/Outpatient Visit New",182.19,null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A20)","v":1}]
[24,"E119.00, Z7982, Z794",99214,"Primary","Professional Services: Primary Care","Office/Outpatient Visit Est",{"v":121.7,"d":"121.70"},null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A21)","v":4}]
[26,"E119.00, Z7982, Z794",603002632,"Pharmacy Retail","Over-the-counter Drugs","Aspirin 81mg (OTC - bottle 100) [usage = 1 QD; #30 pills per month]",4.47,null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A22)","v":5}]
[27,"Z23",90471,"Primary","Preventive Services & Vaccines","Immunization Admin ADMIN",28.31,null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A23)","v":1}]
[28,"Z23",90472,"Primary","Preventive Services & Vaccines","Immunization admin each add ",15.88,null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A24)","v":1}]
[29,"Z23",90732,"Primary","Preventive Services & Vaccines","Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older",93.74,null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A25)","v":1}]
[30,"Z23",90656,"Primary","Preventive Services & Vaccines","Flu Vaccine No Preserv 3 & >",21.02,null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A26)","v":1}]
[32,null,68382075810,"Pharmacy Retail","Prescription Drugs: Generic","Metformin Hydrochloride 500 MG TABLET [ #60 pills/month]",3.21,null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A27)","v":13}]
[33,null,378395277,"Pharmacy Retail","Prescription Drugs: Generic","Atorvastatin 40 MG tablet 90 CT [ #30 pills/month]",9.66,null,true,{"$f":"COUNTIF(DIABETES_TIMELINE!ServiceCode,A28)","v":4}]

{"sheet":"FRACTURE_SUMMARY","index":15,"n_rows":29,"n_cols":9,"rows_kept":29,"hidden":true,"merged":[[3,2,4,2],[3,3,4,3]]}
[]
[null,"Foot Fracture Example: Summary of Subscriber and Plan Payments"]
[]
[null,{"$f":"nrCBPlanNameRS","v":"Plan 1"},"Allowed Amount","Plan Payment","Subscriber pays:"]
[null,"Benefit category","Allowed Amount (unrounded)","Plan payment (unrounded)","Total subscriber payment","Subscriber-paid deductible","Subscriber-paid copayment","Subscriber-paid coinsurance","Non-covered and exclusions"]
[null,{"$f":"BENEFIT_DESIGN!B10","v":"Inpatient Hospital Care (Facility)"},{"$f":"SUMIFS(FRACTURE_TIMELINE!AllowedAmt,FRACTURE_TIMELINE!BenefitCategory,$B6)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!PlanPaymentAmt,FRACTURE_TIMELINE!BenefitCategory,$B6)","v":0},{"$f":"SUM(F6:I6)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayDeduc,FRACTURE_TIMELINE!BenefitCategory,$B6)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCopay,FRACTURE_TIMELINE!BenefitCategory,$B6)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCoins,FRACTURE_TIMELINE!BenefitCategory,$B6)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayNonCov,FRACTURE_TIMELINE!BenefitCategory,$B6)+SUMIFS(FRACTURE_TIMELINE!SubscriberPayExclusion,FRACTURE_TIMELINE!BenefitCategory,$B6)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B11","v":"Other Facility Services"},{"$f":"SUMIFS(FRACTURE_TIMELINE!AllowedAmt,FRACTURE_TIMELINE!BenefitCategory,$B7)","v":{"v":43.22,"d":"$43"}},{"$f":"SUMIFS(FRACTURE_TIMELINE!PlanPaymentAmt,FRACTURE_TIMELINE!BenefitCategory,$B7)","v":0},{"v":43.22,"d":"$43"},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayDeduc,FRACTURE_TIMELINE!BenefitCategory,$B7)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCopay,FRACTURE_TIMELINE!BenefitCategory,$B7)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCoins,FRACTURE_TIMELINE!BenefitCategory,$B7)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayNonCov,FRACTURE_TIMELINE!BenefitCategory,$B7)+SUMIFS(FRACTURE_TIMELINE!SubscriberPayExclusion,FRACTURE_TIMELINE!BenefitCategory,$B7)","v":{"v":43.22,"d":"$43"}}]
[null,{"$f":"BENEFIT_DESIGN!B12","v":"Emergency Department (Facility)"},{"$f":"SUMIFS(FRACTURE_TIMELINE!AllowedAmt,FRACTURE_TIMELINE!BenefitCategory,$B8)","v":{"v":357.31,"d":"$357"}},{"$f":"SUMIFS(FRACTURE_TIMELINE!PlanPaymentAmt,FRACTURE_TIMELINE!BenefitCategory,$B8)","v":0},{"v":357.31,"d":"$357"},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayDeduc,FRACTURE_TIMELINE!BenefitCategory,$B8)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCopay,FRACTURE_TIMELINE!BenefitCategory,$B8)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCoins,FRACTURE_TIMELINE!BenefitCategory,$B8)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayNonCov,FRACTURE_TIMELINE!BenefitCategory,$B8)+SUMIFS(FRACTURE_TIMELINE!SubscriberPayExclusion,FRACTURE_TIMELINE!BenefitCategory,$B8)","v":{"v":357.31,"d":"$357"}}]
[null,{"$f":"BENEFIT_DESIGN!B13","v":"Ambulance"},{"$f":"SUMIFS(FRACTURE_TIMELINE!AllowedAmt,FRACTURE_TIMELINE!BenefitCategory,$B9)","v":{"v":943.87,"d":"$944"}},{"$f":"SUMIFS(FRACTURE_TIMELINE!PlanPaymentAmt,FRACTURE_TIMELINE!BenefitCategory,$B9)","v":0},{"v":943.87,"d":"$944"},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayDeduc,FRACTURE_TIMELINE!BenefitCategory,$B9)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCopay,FRACTURE_TIMELINE!BenefitCategory,$B9)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCoins,FRACTURE_TIMELINE!BenefitCategory,$B9)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayNonCov,FRACTURE_TIMELINE!BenefitCategory,$B9)+SUMIFS(FRACTURE_TIMELINE!SubscriberPayExclusion,FRACTURE_TIMELINE!BenefitCategory,$B9)","v":{"v":943.87,"d":"$944"}}]
[null,{"$f":"BENEFIT_DESIGN!B14","v":"Professional Services: Primary Care"},{"$f":"SUMIFS(FRACTURE_TIMELINE!AllowedAmt,FRACTURE_TIMELINE!BenefitCategory,$B10)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!PlanPaymentAmt,FRACTURE_TIMELINE!BenefitCategory,$B10)","v":0},0,{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayDeduc,FRACTURE_TIMELINE!BenefitCategory,$B10)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCopay,FRACTURE_TIMELINE!BenefitCategory,$B10)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCoins,FRACTURE_TIMELINE!BenefitCategory,$B10)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayNonCov,FRACTURE_TIMELINE!BenefitCategory,$B10)+SUMIFS(FRACTURE_TIMELINE!SubscriberPayExclusion,FRACTURE_TIMELINE!BenefitCategory,$B10)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B15","v":"Professional Services: Emergency Department"},{"$f":"SUMIFS(FRACTURE_TIMELINE!AllowedAmt,FRACTURE_TIMELINE!BenefitCategory,$B11)","v":{"v":384.88,"d":"$385"}},{"$f":"SUMIFS(FRACTURE_TIMELINE!PlanPaymentAmt,FRACTURE_TIMELINE!BenefitCategory,$B11)","v":0},{"v":384.88,"d":"$385"},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayDeduc,FRACTURE_TIMELINE!BenefitCategory,$B11)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCopay,FRACTURE_TIMELINE!BenefitCategory,$B11)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCoins,FRACTURE_TIMELINE!BenefitCategory,$B11)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayNonCov,FRACTURE_TIMELINE!BenefitCategory,$B11)+SUMIFS(FRACTURE_TIMELINE!SubscriberPayExclusion,FRACTURE_TIMELINE!BenefitCategory,$B11)","v":{"v":384.88,"d":"$385"}}]
[null,{"$f":"BENEFIT_DESIGN!B16","v":"Professional Services: Inpatient"},{"$f":"SUMIFS(FRACTURE_TIMELINE!AllowedAmt,FRACTURE_TIMELINE!BenefitCategory,$B12)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!PlanPaymentAmt,FRACTURE_TIMELINE!BenefitCategory,$B12)","v":0},{"$f":"SUM(F12:I12)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayDeduc,FRACTURE_TIMELINE!BenefitCategory,$B12)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCopay,FRACTURE_TIMELINE!BenefitCategory,$B12)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCoins,FRACTURE_TIMELINE!BenefitCategory,$B12)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayNonCov,FRACTURE_TIMELINE!BenefitCategory,$B12)+SUMIFS(FRACTURE_TIMELINE!SubscriberPayExclusion,FRACTURE_TIMELINE!BenefitCategory,$B12)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B17","v":"Professional Services: Specialist"},{"$f":"SUMIFS(FRACTURE_TIMELINE!AllowedAmt,FRACTURE_TIMELINE!BenefitCategory,$B13)","v":{"v":341.20000000000005,"d":"$341"}},{"$f":"SUMIFS(FRACTURE_TIMELINE!PlanPaymentAmt,FRACTURE_TIMELINE!BenefitCategory,$B13)","v":0},{"v":341.20000000000005,"d":"$341"},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayDeduc,FRACTURE_TIMELINE!BenefitCategory,$B13)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCopay,FRACTURE_TIMELINE!BenefitCategory,$B13)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCoins,FRACTURE_TIMELINE!BenefitCategory,$B13)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayNonCov,FRACTURE_TIMELINE!BenefitCategory,$B13)+SUMIFS(FRACTURE_TIMELINE!SubscriberPayExclusion,FRACTURE_TIMELINE!BenefitCategory,$B13)","v":{"v":341.20000000000005,"d":"$341"}}]
[null,{"$f":"BENEFIT_DESIGN!B18","v":"Professional Services: Obstetric Care (Bundled)"},{"$f":"SUMIFS(FRACTURE_TIMELINE!AllowedAmt,FRACTURE_TIMELINE!BenefitCategory,$B14)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!PlanPaymentAmt,FRACTURE_TIMELINE!BenefitCategory,$B14)","v":0},0,{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayDeduc,FRACTURE_TIMELINE!BenefitCategory,$B14)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCopay,FRACTURE_TIMELINE!BenefitCategory,$B14)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCoins,FRACTURE_TIMELINE!BenefitCategory,$B14)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayNonCov,FRACTURE_TIMELINE!BenefitCategory,$B14)+SUMIFS(FRACTURE_TIMELINE!SubscriberPayExclusion,FRACTURE_TIMELINE!BenefitCategory,$B14)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B19","v":"Professional Services: Procedures & Other"},{"$f":"SUMIFS(FRACTURE_TIMELINE!AllowedAmt,FRACTURE_TIMELINE!BenefitCategory,$B15)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!PlanPaymentAmt,FRACTURE_TIMELINE!BenefitCategory,$B15)","v":0},0,{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayDeduc,FRACTURE_TIMELINE!BenefitCategory,$B15)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCopay,FRACTURE_TIMELINE!BenefitCategory,$B15)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCoins,FRACTURE_TIMELINE!BenefitCategory,$B15)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayNonCov,FRACTURE_TIMELINE!BenefitCategory,$B15)+SUMIFS(FRACTURE_TIMELINE!SubscriberPayExclusion,FRACTURE_TIMELINE!BenefitCategory,$B15)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B20","v":"Professional Services: Physical Therapy"},{"$f":"SUMIFS(FRACTURE_TIMELINE!AllowedAmt,FRACTURE_TIMELINE!BenefitCategory,$B16)","v":{"v":364.02,"d":"$364"}},{"$f":"SUMIFS(FRACTURE_TIMELINE!PlanPaymentAmt,FRACTURE_TIMELINE!BenefitCategory,$B16)","v":0},{"v":364.02,"d":"$364"},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayDeduc,FRACTURE_TIMELINE!BenefitCategory,$B16)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCopay,FRACTURE_TIMELINE!BenefitCategory,$B16)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCoins,FRACTURE_TIMELINE!BenefitCategory,$B16)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayNonCov,FRACTURE_TIMELINE!BenefitCategory,$B16)+SUMIFS(FRACTURE_TIMELINE!SubscriberPayExclusion,FRACTURE_TIMELINE!BenefitCategory,$B16)","v":{"v":364.02,"d":"$364"}}]
[null,{"$f":"BENEFIT_DESIGN!B21","v":"Diagnostic Services: Radiology"},{"$f":"SUMIFS(FRACTURE_TIMELINE!AllowedAmt,FRACTURE_TIMELINE!BenefitCategory,$B17)","v":{"v":112.9,"d":"$113"}},{"$f":"SUMIFS(FRACTURE_TIMELINE!PlanPaymentAmt,FRACTURE_TIMELINE!BenefitCategory,$B17)","v":0},{"v":112.9,"d":"$113"},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayDeduc,FRACTURE_TIMELINE!BenefitCategory,$B17)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCopay,FRACTURE_TIMELINE!BenefitCategory,$B17)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCoins,FRACTURE_TIMELINE!BenefitCategory,$B17)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayNonCov,FRACTURE_TIMELINE!BenefitCategory,$B17)+SUMIFS(FRACTURE_TIMELINE!SubscriberPayExclusion,FRACTURE_TIMELINE!BenefitCategory,$B17)","v":{"v":112.9,"d":"$113"}}]
[null,{"$f":"BENEFIT_DESIGN!B22","v":"Diagnostic Services: Laboratory"},{"$f":"SUMIFS(FRACTURE_TIMELINE!AllowedAmt,FRACTURE_TIMELINE!BenefitCategory,$B18)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!PlanPaymentAmt,FRACTURE_TIMELINE!BenefitCategory,$B18)","v":0},0,{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayDeduc,FRACTURE_TIMELINE!BenefitCategory,$B18)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCopay,FRACTURE_TIMELINE!BenefitCategory,$B18)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCoins,FRACTURE_TIMELINE!BenefitCategory,$B18)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayNonCov,FRACTURE_TIMELINE!BenefitCategory,$B18)+SUMIFS(FRACTURE_TIMELINE!SubscriberPayExclusion,FRACTURE_TIMELINE!BenefitCategory,$B18)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B23","v":"Prescription Drugs: Generic"},{"$f":"SUMIFS(FRACTURE_TIMELINE!AllowedAmt,FRACTURE_TIMELINE!BenefitCategory,$B19)","v":{"v":5.24,"d":"$5"}},{"$f":"SUMIFS(FRACTURE_TIMELINE!PlanPaymentAmt,FRACTURE_TIMELINE!BenefitCategory,$B19)","v":0},{"v":5.24,"d":"$5"},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayDeduc,FRACTURE_TIMELINE!BenefitCategory,$B19)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCopay,FRACTURE_TIMELINE!BenefitCategory,$B19)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCoins,FRACTURE_TIMELINE!BenefitCategory,$B19)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayNonCov,FRACTURE_TIMELINE!BenefitCategory,$B19)+SUMIFS(FRACTURE_TIMELINE!SubscriberPayExclusion,FRACTURE_TIMELINE!BenefitCategory,$B19)","v":{"v":5.24,"d":"$5"}}]
[null,{"$f":"BENEFIT_DESIGN!B24","v":"Prescription Drugs: Branded"},{"$f":"SUMIFS(FRACTURE_TIMELINE!AllowedAmt,FRACTURE_TIMELINE!BenefitCategory,$B20)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!PlanPaymentAmt,FRACTURE_TIMELINE!BenefitCategory,$B20)","v":0},0,{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayDeduc,FRACTURE_TIMELINE!BenefitCategory,$B20)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCopay,FRACTURE_TIMELINE!BenefitCategory,$B20)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCoins,FRACTURE_TIMELINE!BenefitCategory,$B20)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayNonCov,FRACTURE_TIMELINE!BenefitCategory,$B20)+SUMIFS(FRACTURE_TIMELINE!SubscriberPayExclusion,FRACTURE_TIMELINE!BenefitCategory,$B20)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B25","v":"Prescription Drugs: Insulin"},{"$f":"SUMIFS(FRACTURE_TIMELINE!AllowedAmt,FRACTURE_TIMELINE!BenefitCategory,$B21)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!PlanPaymentAmt,FRACTURE_TIMELINE!BenefitCategory,$B21)","v":0},{"$f":"SUM(F21:I21)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayDeduc,FRACTURE_TIMELINE!BenefitCategory,$B21)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCopay,FRACTURE_TIMELINE!BenefitCategory,$B21)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCoins,FRACTURE_TIMELINE!BenefitCategory,$B21)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayNonCov,FRACTURE_TIMELINE!BenefitCategory,$B21)+SUMIFS(FRACTURE_TIMELINE!SubscriberPayExclusion,FRACTURE_TIMELINE!BenefitCategory,$B21)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B26","v":"Over-the-counter Drugs"},{"$f":"SUMIFS(FRACTURE_TIMELINE!AllowedAmt,FRACTURE_TIMELINE!BenefitCategory,$B22)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!PlanPaymentAmt,FRACTURE_TIMELINE!BenefitCategory,$B22)","v":0},0,{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayDeduc,FRACTURE_TIMELINE!BenefitCategory,$B22)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCopay,FRACTURE_TIMELINE!BenefitCategory,$B22)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCoins,FRACTURE_TIMELINE!BenefitCategory,$B22)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayNonCov,FRACTURE_TIMELINE!BenefitCategory,$B22)+SUMIFS(FRACTURE_TIMELINE!SubscriberPayExclusion,FRACTURE_TIMELINE!BenefitCategory,$B22)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B27","v":"Preventive Services & Vaccines"},{"$f":"SUMIFS(FRACTURE_TIMELINE!AllowedAmt,FRACTURE_TIMELINE!BenefitCategory,$B23)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!PlanPaymentAmt,FRACTURE_TIMELINE!BenefitCategory,$B23)","v":0},0,{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayDeduc,FRACTURE_TIMELINE!BenefitCategory,$B23)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCopay,FRACTURE_TIMELINE!BenefitCategory,$B23)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCoins,FRACTURE_TIMELINE!BenefitCategory,$B23)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayNonCov,FRACTURE_TIMELINE!BenefitCategory,$B23)+SUMIFS(FRACTURE_TIMELINE!SubscriberPayExclusion,FRACTURE_TIMELINE!BenefitCategory,$B23)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B28","v":"Durable Medical Equipment"},{"$f":"SUMIFS(FRACTURE_TIMELINE!AllowedAmt,FRACTURE_TIMELINE!BenefitCategory,$B24)","v":{"v":247.53,"d":"$248"}},{"$f":"SUMIFS(FRACTURE_TIMELINE!PlanPaymentAmt,FRACTURE_TIMELINE!BenefitCategory,$B24)","v":0},{"v":247.53,"d":"$248"},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayDeduc,FRACTURE_TIMELINE!BenefitCategory,$B24)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCopay,FRACTURE_TIMELINE!BenefitCategory,$B24)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCoins,FRACTURE_TIMELINE!BenefitCategory,$B24)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayNonCov,FRACTURE_TIMELINE!BenefitCategory,$B24)+SUMIFS(FRACTURE_TIMELINE!SubscriberPayExclusion,FRACTURE_TIMELINE!BenefitCategory,$B24)","v":{"v":247.53,"d":"$248"}}]
[null,{"$f":"BENEFIT_DESIGN!B29","v":"Medical Supplies"},{"$f":"SUMIFS(FRACTURE_TIMELINE!AllowedAmt,FRACTURE_TIMELINE!BenefitCategory,$B25)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!PlanPaymentAmt,FRACTURE_TIMELINE!BenefitCategory,$B25)","v":0},0,{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayDeduc,FRACTURE_TIMELINE!BenefitCategory,$B25)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCopay,FRACTURE_TIMELINE!BenefitCategory,$B25)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCoins,FRACTURE_TIMELINE!BenefitCategory,$B25)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayNonCov,FRACTURE_TIMELINE!BenefitCategory,$B25)+SUMIFS(FRACTURE_TIMELINE!SubscriberPayExclusion,FRACTURE_TIMELINE!BenefitCategory,$B25)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B30","v":"Over-the-counter Medical Supplies"},{"$f":"SUMIFS(FRACTURE_TIMELINE!AllowedAmt,FRACTURE_TIMELINE!BenefitCategory,$B26)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!PlanPaymentAmt,FRACTURE_TIMELINE!BenefitCategory,$B26)","v":0},0,{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayDeduc,FRACTURE_TIMELINE!BenefitCategory,$B26)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCopay,FRACTURE_TIMELINE!BenefitCategory,$B26)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCoins,FRACTURE_TIMELINE!BenefitCategory,$B26)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayNonCov,FRACTURE_TIMELINE!BenefitCategory,$B26)+SUMIFS(FRACTURE_TIMELINE!SubscriberPayExclusion,FRACTURE_TIMELINE!BenefitCategory,$B26)","v":0}]
[null,{"$f":"BENEFIT_DESIGN!B31","v":"Other Items & Services"},{"$f":"SUMIFS(FRACTURE_TIMELINE!AllowedAmt,FRACTURE_TIMELINE!BenefitCategory,$B27)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!PlanPaymentAmt,FRACTURE_TIMELINE!BenefitCategory,$B27)","v":0},0,{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayDeduc,FRACTURE_TIMELINE!BenefitCategory,$B27)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCopay,FRACTURE_TIMELINE!BenefitCategory,$B27)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayCoins,FRACTURE_TIMELINE!BenefitCategory,$B27)","v":0},{"$f":"SUMIFS(FRACTURE_TIMELINE!SubscriberPayNonCov,FRACTURE_TIMELINE!BenefitCategory,$B27)+SUMIFS(FRACTURE_TIMELINE!SubscriberPayExclusion,FRACTURE_TIMELINE!BenefitCategory,$B27)","v":0}]
[null,"Total (unrounded)",{"$f":"SUM(C6:C27)","v":{"v":2800.1700000000005,"d":"$2,800"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",SUM(D6:D27)),\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",SUM(E6:E27)),\"ERROR\")","v":{"v":2800.1700000000005,"d":"$2,800"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",SUM(F6:F27)),\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",SUM(G6:G27)),\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",SUM(H6:H27)),\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",SUM(I6:I27)),\"ERROR\")","v":{"v":2800.1700000000005,"d":"$2,800"}}]
[null,"Total (rounded)",{"$f":"MROUND(C28,IF(C28>=100,100,10))","v":{"v":2800,"d":"$2,800"}},{"$f":"IFERROR(C29-E29,\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",MIN(SUM(F29:H29),BENEFIT_DESIGN!C36)+I29),\"ERROR\")","v":{"v":2800,"d":"$2,800"}},{"$f":"IFERROR(\nIF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",\nMIN(\nMROUND(F28,IF(F28>=100,100,10)),\nBENEFIT_PARAMETERS!$P$80)\n),\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",MROUND(G28,IF(G28>=100,100,10))),\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",MROUND(H28,IF(H28>=100,100,10))),\"ERROR\")","v":{"v":0,"d":"$0"}},{"$f":"IFERROR(IF(BENEFIT_DESIGN_ERRORS!$C$39,\"ERROR\",MROUND(I28,IF(I28>=100,100,10))),\"ERROR\")","v":{"v":2800,"d":"$2,800"}}]

{"sheet":"FRACTURE_TIMELINE","index":16,"n_rows":21,"n_cols":80,"rows_kept":21,"hidden":true}
[{"$nulls":79},{"$f":"COUNTIF(CB4:CB21,FALSE)=0","v":true}]
[{"$nulls":7},"Phase 1: Determine Covered Amount",null,null,"Phase 2: Apply OOP Limit",{"$nulls":3},"Phase 3a: Apply Special cost sharing - Begin Primary Care cost-sharing after a set number of visits?",{"$nulls":5},"Phase 3b: Apply special cost sharing: Begin primary care cost sharing deductible or coinsurance after a set number of copays?",{"$nulls":8},"Phase 4: Apply monthly/annual limit",{"$nulls":9},"Phase 5: Plan deductible",{"$nulls":3},"Phase 5: Rx deductible",{"$nulls":3},"Phase 5: Optional deductible C",{"$nulls":3},"Phase 5: Optional deductible D",{"$nulls":3},"Phase 5: Benefit deductible",{"$nulls":3},"Phase 5 Summary",null,"Phase 6: Apply copay and coinsurance",{"$nulls":8},"Phase 7: Calculate total subscriber pays",null,null,"Phase 8: Summarize payments by payer and phase category"]
["Claim number","Date","Calendar Month","Item or Service Code","Description","Benefit Category","Cost-sharing type","Allowed amount","Service Not covered","Remaining Covered Amount","OPL Valid?","OPL applies","OPL","Remaining OPL after previous subscriber payments","Primary Care Visit?","Begin Primary Care Cost-Sharing After A Set Number of Visits?","# Visits","Primary Care Prior Use","Visit Covered at 100% by plan","Remaining Covered Amount","Primary Care Visit?","Begin Primary Care Cost-Sharing Deductible or Coinsurance After a Set Number of Copays?","# Visits","Primary Care Prior Copay Paid","Copay Value","Subscriber-Paid Copay","Plan Paid","Remaining OPL","Remaining Covered Amount","Monthly Limit Valid?","Monthly limit","Prior use (month)","Not Covered because monthly limit exceeded","Annual Limit Valid?","Annual limit","Prior use (annual)","Not Covered because use limit exceeded","Total Not Covered because use limit exceeded","Covered amount","Uses Plan deductible?","Plan Deductible","Remaining plan deductible after previous subscriber payments","subscriber pays toward plan deductible","Uses rx deductible?","Rx Deductible","Remaining Rx deductible after previous subscriber payments","subscriber pays toward Rx deductible","Uses deductible C?","Deductible C","Remaining deductible C after previous subscriber payments","subscriber pays toward deductible C","Uses deductible D?","Deductible D","Remaining deductible D after previous subscriber payments","subscriber pays toward deductible D","Uses benefit deductible?","Benefit deductible","Remaining benefit deductible after previous subcriber payments","subscriber pays toward benefit deductible","subscriber pays toward any deductible","Subscriber-paid deductible after applying OPL","Remaining OPL","Covered amount remaining after deductibles","Uses Copay?","Copay Value","Copay Paid","Uses Coinsurance?","Coinsurance Value","Coinsurance Paid","Subscriber-paid costsharing after OPL","Remaining OPL","Allowed amount after copayment or coinsurance","Total subscriber payment After OPL","plan payment","Service Not covered","Exclusions","Subscriber-paid deductible","Subscriber-paid copayment","Subscriber-paid coinsurance","Allowable Charge ChkSum"]
[1,"2016-06-02",6,2,{"$f":"VLOOKUP(ServiceCode,FractureFeeSchedule,6,FALSE)","v":"Ground mileage, per statute mile"},{"$f":"VLOOKUP(ServiceCode,FractureFeeSchedule,5,FALSE)","v":"Ambulance"},{"$f":"VLOOKUP(BenefitCategory,BenefitDesignTable,COLUMN(BenefitCostSharing),FALSE)","v":"Not Covered"},{"$f":"VLOOKUP(D4,FractureFeeSchedule,7,FALSE)","v":{"v":161.71,"d":"$161.71"}},{"$f":"IF(G4=\"Not Covered\",H4,0)","v":{"v":161.71,"d":"$161.71"}},{"$f":"H4-I4","v":0},{"$f":"VLOOKUP(F4,nrCoverageTable,COLUMN(nrOOPLimitValid),FALSE)","v":false},{"$f":"IF(K4,VLOOKUP(F4,BenefitDesignTable,COLUMN(BenefitOOPLimitApplies),FALSE),\"No\")","v":"No"},{"$f":"VLOOKUP(F4,BenefitDesignTable,COLUMN(OPLimit),FALSE)","v":"."},{"$f":"IFERROR(IF(AND(L4=\"Yes\",ISNUMBER(M4)),MAX(0,M4-SUMIFS(BU$3:BU3,L$3:L3,\"Yes\")),IF(OR(L4=\"No\",M4=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},{"$f":"IF(F4=\"Professional Services: Primary Care\",TRUE, FALSE)","v":false},{"$f":"IF(O4,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P4=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},{"$f":"IF(O4,COUNTIFS(BenefitCategory,\"Professional Services: Primary Care\",ClaimNumber,\"<\"&A4),\"N/A\")","v":"N/A"},{"$f":"IF(P4=\"Yes\",IF(R4<Q4,MIN(J4,N4),0),0)","v":0},{"$f":"J4-S4","v":{"v":0,"d":"$0.00"}},{"$f":"IF(F4=\"Professional Services: Primary Care\",TRUE, FALSE)","v":false},{"$f":"IF(O4,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V4=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O4,COUNTIF(Z$3:Z3,\">0\"),\"N/A\")","v":"N/A"},{"$f":"IF(V4=\"Yes\",VLOOKUP(\"Professional Services: Primary Care\",BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(V4=\"Yes\",U4=TRUE,X4<W4), MIN(Y4,T4,N4),\"N/A\")","v":"N/A"},{"$f":"IF(Z4=\"N/A\",0,T4-Z4)","v":0},{"$f":"IF(L4=\"Yes\",IF(Z4=\"N/A\",N4,N4-Z4),\"N/A\")","v":"N/A"},{"$f":"IF(Z4=\"N/A\",T4,0)","v":{"v":0,"d":"$0.00"}},{"$f":"VLOOKUP(F4,nrCoverageTable,COLUMN(nrMonthlyLimitValid),FALSE)","v":false},{"$f":"IF(AD4,VLOOKUP(F4,BenefitDesignTable,COLUMN(BenefitLimithMonth),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D4,ClaimMonth,C4,ClaimNumber,\"<\"&A4)","v":0},{"$f":"IF(AD4,IF(OR(AE4=\"None\",ISNUMBER(AE4)),IF(AF4>=AE4,H4,0),\"ERR\"),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F4,nrCoverageTable,COLUMN(nrAnnualLimitValid),FALSE)","v":false},{"$f":"IF(AH4,VLOOKUP(F4,BenefitDesignTable,COLUMN(BenefitLimitAnnual),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D4,ClaimNumber,\"<\"&A4)","v":0},{"$f":"IF(AH4,IF(OR(AI4=\"None\",ISNUMBER(AI4)),IF(AJ4>=AI4,H4,0),\"ERR\"),\"N/A\")","v":"N/A"},{"$f":"IF(OR(AG4=\"ERR\",AK4=\"ERR\"),\"ERR\",MAX(AG4,AK4))","v":0},{"$f":"IFERROR(AC4-AL4,\"ERR\")","v":0},{"$f":"VLOOKUP(F4,nrCoverageTable,COLUMN(nrUsesPlanDeduct),FALSE)","v":false},{"$f":"IF(AN4,VLOOKUP(F4,BenefitDesignTable,COLUMN(PlanDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(ISNUMBER(AO4),AN4=TRUE),MAX(0,AO4-SUMIFS($AM$3:$AM3,AN$3:AN3,TRUE)),IF(AND(AN4=TRUE,ISNUMBER(AO4)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AP4),MIN($AM4,AP4),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F4,nrCoverageTable,COLUMN(nrUsesRxDeduct),FALSE)","v":false},{"$f":"IF(AR4,VLOOKUP(F4,BenefitDesignTable,COLUMN(RxDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AR4=TRUE,ISNUMBER(AS4)),MAX(0,AS4-SUMIFS($AM$3:$AM3,AR$3:AR3,TRUE)),IF(AND(AR4=TRUE,ISNUMBER(AS4)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AT4),MIN($AM4,AT4),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F4,nrCoverageTable,COLUMN(nrUsesDeductC),FALSE)","v":false},{"$f":"IF(AV4,VLOOKUP(F4,BenefitDesignTable,COLUMN(OptDeductibleC),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AV4=TRUE,ISNUMBER(AW4)),MAX(0,AW4-SUMIFS($AM$3:$AM3,AV$3:AV3,TRUE)),IF(AND(AV4=TRUE,ISNUMBER(AW4)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AX4),MIN($AM4,AX4),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F4,nrCoverageTable,COLUMN(nrUsesDeductD),FALSE)","v":false},{"$f":"IF(AZ4,VLOOKUP(F4,BenefitDesignTable,COLUMN(OptDeductibleD),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AZ4=TRUE,ISNUMBER(BA4)),MAX(0,BA4-SUMIFS($AM$3:$AM3,AZ$3:AZ3,TRUE)),IF(AND(AZ4=TRUE,ISNUMBER(BA4)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BB4),MIN($AM4,BB4),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F4,nrCoverageTable,COLUMN(nrUsesBenDeduct),FALSE)","v":false},{"$f":"IF(BD4,VLOOKUP(F4,BenefitDesignTable,COLUMN(BenefitDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(BD4=TRUE,ISNUMBER(BE4)=TRUE),MAX(0,BE4-SUMIFS(AM$3:AM3,BD$3:BD3,TRUE,F$3:F3,F4)),IF(AND(BD4=TRUE,ISNUMBER(BE4)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BF4),MIN($AM4,BF4),\"N/A\")","v":"N/A"},{"$f":"SUM(AQ4,AU4,AY4,BC4,BG4)","v":0},{"$f":"IF(OR(AB4=\"ERR\",BH4=\"ERR\"),\"ERR\",MIN(BH4,AB4))","v":0},{"$f":"IF(AND(L4=\"Yes\",ISNUMBER(M4)),IF(OR(BI4=\"ERR\",AB4=\"ERR\"),\"ERR\",MAX($AB4-BI4,0)),\"N/A\")","v":"N/A"},{"$f":"IF(OR(BI4=\"ERR\",AM4=\"ERR\"),\"ERR\",MAX(0,AM4-BI4))","v":0},{"$f":"VLOOKUP(F4,nrCoverageTable,COLUMN(nrUsesCopay),FALSE)","v":false},{"$f":"IF(BL4,VLOOKUP(F4,BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(BK4=\"ERR\",\"ERR\",IF(AND(BL4=TRUE,ISNUMBER(BM4)),MIN(BK4,BM4,BJ4),IF(AND(BL4=TRUE,ISNUMBER(BM4)=FALSE),\"ERR\",\"N/A\")))","v":"N/A"},{"$f":"VLOOKUP(F4,nrCoverageTable,COLUMN(nrUsesCoins),FALSE)","v":false},{"$f":"IF(BO4,VLOOKUP(F4,BenefitDesignTable,COLUMN(BenefitCoins),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(BK4=\"ERR\",\"ERR\",IF(AND(BO4=TRUE,ISNUMBER(BP4)=TRUE),MIN(BJ4,BK4*BP4),IF(AND(BO4=TRUE,ISNUMBER(BP4)=FALSE),\"ERR\",\"N/A\")))","v":"N/A"},{"$f":"IF(OR(BJ4=\"ERR\",BN4=\"ERR\",BQ4=\"ERR\"),\"ERR\",MIN(BJ4,SUM(BN4,BQ4)))","v":0},{"$f":"IF(AND(L4=\"Yes\",ISNUMBER(M4)),IF(OR(BJ4=\"ERR\",BR4=\"ERR\"),\"ERR\",MAX(BJ4-BR4,0)),\"N/A\")","v":"N/A"},{"$f":"IF(OR(BK4=\"ERR\",BR4=\"ERR\"),\"ERR\",MAX(BK4-BR4,0))","v":0},{"$f":"IF(OR(BI4=\"ERR\",BR4=\"ERR\"),\"ERR\",SUM(BI4,BR4,Z4))","v":0},{"$f":"IF(OR(AM4=\"ERR\",BU4=\"ERR\"),\"ERR\",MAX(S4+AA4+AM4-BI4-BR4,0))","v":0},{"$f":"I4","v":{"v":161.71,"d":"$161.71"}},{"$f":"IF(OR(AG4=\"ERR\",AK4=\"ERR\"),\"ERR\",SUM(AG4,AK4))","v":0},{"$f":"BI4","v":0},{"$f":"IF(V4=\"Yes\",IF(Z4=\"N/A\",0,Z4),0)+IF(BL4,BN4,0)","v":0},{"$f":"IF(BO4,BQ4,0)","v":0},{"$f":"SUM(BV4:CA4)=H4","v":true}]
[2,"2016-06-02",6,18,"Ambulance service, basic life support, emergency transport (bls-emergency)","Ambulance","Not Covered",{"$f":"VLOOKUP(D5,FractureFeeSchedule,7,FALSE)","v":{"v":782.16,"d":"$782.16"}},{"$f":"IF(G5=\"Not Covered\",H5,0)","v":{"v":782.16,"d":"$782.16"}},{"$f":"H5-I5","v":0},{"$f":"VLOOKUP(F5,nrCoverageTable,COLUMN(nrOOPLimitValid),FALSE)","v":false},{"$f":"IF(K5,VLOOKUP(F5,BenefitDesignTable,COLUMN(BenefitOOPLimitApplies),FALSE),\"No\")","v":"No"},{"$f":"VLOOKUP(F5,BenefitDesignTable,COLUMN(OPLimit),FALSE)","v":"."},{"$f":"IFERROR(IF(AND(L5=\"Yes\",ISNUMBER(M5)),MAX(0,M5-SUMIFS(BU$3:BU4,L$3:L4,\"Yes\")),IF(OR(L5=\"No\",M5=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},{"$f":"IF(F5=\"Professional Services: Primary Care\",TRUE, FALSE)","v":false},{"$f":"IF(O5,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P5=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",{"$f":"IF(P5=\"Yes\",IF(R5<Q5,MIN(J5,N5),0),0)","v":0},{"$f":"J5-S5","v":0},{"$f":"IF(F5=\"Professional Services: Primary Care\",TRUE, FALSE)","v":false},{"$f":"IF(O5,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V5=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O5,COUNTIF(Z$3:Z4,\">0\"),\"N/A\")","v":"N/A"},{"$f":"IF(V5=\"Yes\",VLOOKUP(\"Professional Services: Primary Care\",BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(V5=\"Yes\",U5=TRUE,X5<W5), MIN(Y5,T5,N5),\"N/A\")","v":"N/A"},{"$f":"IF(Z5=\"N/A\",0,T5-Z5)","v":0},{"$f":"IF(L5=\"Yes\",IF(Z5=\"N/A\",N5,N5-Z5),\"N/A\")","v":"N/A"},{"$f":"IF(Z5=\"N/A\",T5,0)","v":0},{"$f":"VLOOKUP(F5,nrCoverageTable,COLUMN(nrMonthlyLimitValid),FALSE)","v":false},{"$f":"IF(AD5,VLOOKUP(F5,BenefitDesignTable,COLUMN(BenefitLimithMonth),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D5,ClaimMonth,C5,ClaimNumber,\"<\"&A5)","v":0},{"$f":"IF(AD5,IF(OR(AE5=\"None\",ISNUMBER(AE5)),IF(AF5>=AE5,H5,0),\"ERR\"),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F5,nrCoverageTable,COLUMN(nrAnnualLimitValid),FALSE)","v":false},{"$f":"IF(AH5,VLOOKUP(F5,BenefitDesignTable,COLUMN(BenefitLimitAnnual),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D5,ClaimNumber,\"<\"&A5)","v":0},{"$f":"IF(AH5,IF(OR(AI5=\"None\",ISNUMBER(AI5)),IF(AJ5>=AI5,H5,0),\"ERR\"),\"N/A\")","v":"N/A"},{"$f":"IF(OR(AG5=\"ERR\",AK5=\"ERR\"),\"ERR\",MAX(AG5,AK5))","v":0},{"$f":"IFERROR(AC5-AL5,\"ERR\")","v":0},{"$f":"VLOOKUP(F5,nrCoverageTable,COLUMN(nrUsesPlanDeduct),FALSE)","v":false},{"$f":"IF(AN5,VLOOKUP(F5,BenefitDesignTable,COLUMN(PlanDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(ISNUMBER(AO5),AN5=TRUE),MAX(0,AO5-SUMIFS($AM$3:$AM4,AN$3:AN4,TRUE)),IF(AND(AN5=TRUE,ISNUMBER(AO5)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AP5),MIN($AM5,AP5),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F5,nrCoverageTable,COLUMN(nrUsesRxDeduct),FALSE)","v":false},{"$f":"IF(AR5,VLOOKUP(F5,BenefitDesignTable,COLUMN(RxDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AR5=TRUE,ISNUMBER(AS5)),MAX(0,AS5-SUMIFS($AM$3:$AM4,AR$3:AR4,TRUE)),IF(AND(AR5=TRUE,ISNUMBER(AS5)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AT5),MIN($AM5,AT5),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F5,nrCoverageTable,COLUMN(nrUsesDeductC),FALSE)","v":false},{"$f":"IF(AV5,VLOOKUP(F5,BenefitDesignTable,COLUMN(OptDeductibleC),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AV5=TRUE,ISNUMBER(AW5)),MAX(0,AW5-SUMIFS($AM$3:$AM4,AV$3:AV4,TRUE)),IF(AND(AV5=TRUE,ISNUMBER(AW5)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AX5),MIN($AM5,AX5),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F5,nrCoverageTable,COLUMN(nrUsesDeductD),FALSE)","v":false},{"$f":"IF(AZ5,VLOOKUP(F5,BenefitDesignTable,COLUMN(OptDeductibleD),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AZ5=TRUE,ISNUMBER(BA5)),MAX(0,BA5-SUMIFS($AM$3:$AM4,AZ$3:AZ4,TRUE)),IF(AND(AZ5=TRUE,ISNUMBER(BA5)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BB5),MIN($AM5,BB5),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F5,nrCoverageTable,COLUMN(nrUsesBenDeduct),FALSE)","v":false},{"$f":"IF(BD5,VLOOKUP(F5,BenefitDesignTable,COLUMN(BenefitDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(BD5=TRUE,ISNUMBER(BE5)=TRUE),MAX(0,BE5-SUMIFS(AM$3:AM4,BD$3:BD4,TRUE,F$3:F4,F5)),IF(AND(BD5=TRUE,ISNUMBER(BE5)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BF5),MIN($AM5,BF5),\"N/A\")","v":"N/A"},{"$f":"SUM(AQ5,AU5,AY5,BC5,BG5)","v":0},{"$f":"IF(OR(AB5=\"ERR\",BH5=\"ERR\"),\"ERR\",MIN(BH5,AB5))","v":0},{"$f":"IF(AND(L5=\"Yes\",ISNUMBER(M5)),IF(OR(BI5=\"ERR\",AB5=\"ERR\"),\"ERR\",MAX($AB5-BI5,0)),\"N/A\")","v":"N/A"},{"$f":"IF(OR(BI5=\"ERR\",AM5=\"ERR\"),\"ERR\",MAX(0,AM5-BI5))","v":0},{"$f":"VLOOKUP(F5,nrCoverageTable,COLUMN(nrUsesCopay),FALSE)","v":false},{"$f":"IF(BL5,VLOOKUP(F5,BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(BK5=\"ERR\",\"ERR\",IF(AND(BL5=TRUE,ISNUMBER(BM5)),MIN(BK5,BM5,BJ5),IF(AND(BL5=TRUE,ISNUMBER(BM5)=FALSE),\"ERR\",\"N/A\")))","v":"N/A"},{"$f":"VLOOKUP(F5,nrCoverageTable,COLUMN(nrUsesCoins),FALSE)","v":false},{"$f":"IF(BO5,VLOOKUP(F5,BenefitDesignTable,COLUMN(BenefitCoins),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(BK5=\"ERR\",\"ERR\",IF(AND(BO5=TRUE,ISNUMBER(BP5)=TRUE),MIN(BJ5,BK5*BP5),IF(AND(BO5=TRUE,ISNUMBER(BP5)=FALSE),\"ERR\",\"N/A\")))","v":"N/A"},{"$f":"IF(OR(BJ5=\"ERR\",BN5=\"ERR\",BQ5=\"ERR\"),\"ERR\",MIN(BJ5,SUM(BN5,BQ5)))","v":0},{"$f":"IF(AND(L5=\"Yes\",ISNUMBER(M5)),IF(OR(BJ5=\"ERR\",BR5=\"ERR\"),\"ERR\",MAX(BJ5-BR5,0)),\"N/A\")","v":"N/A"},{"$f":"IF(OR(BK5=\"ERR\",BR5=\"ERR\"),\"ERR\",MAX(BK5-BR5,0))","v":0},{"$f":"IF(OR(BI5=\"ERR\",BR5=\"ERR\"),\"ERR\",SUM(BI5,BR5,Z5))","v":0},{"$f":"IF(OR(AM5=\"ERR\",BU5=\"ERR\"),\"ERR\",MAX(S5+AA5+AM5-BI5-BR5,0))","v":0},{"$f":"I5","v":{"v":782.16,"d":"$782.16"}},{"$f":"IF(OR(AG5=\"ERR\",AK5=\"ERR\"),\"ERR\",SUM(AG5,AK5))","v":0},{"$f":"BI5","v":0},{"$f":"IF(V5=\"Yes\",IF(Z5=\"N/A\",0,Z5),0)+IF(BL5,BN5,0)","v":0},{"$f":"IF(BO5,BQ5,0)","v":0},{"$f":"SUM(BV5:CA5)=H5","v":true}]
[3,"2016-06-02",6,4,"Emergency department visit for evaluation and management of patient, which req 3 key components. Usually, presenting problem(s) are high severity, & require urgent physician evaluation but do not pose","Emergency Department (Facility)","Not Covered",{"v":357.31,"d":"$357.31"},{"v":357.31,"d":"$357.31"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L6=\"Yes\",ISNUMBER(M6)),MAX(0,M6-SUMIFS(BU$3:BU5,L$3:L5,\"Yes\")),IF(OR(L6=\"No\",M6=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O6,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P6=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O6,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V6=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O6,COUNTIF(Z$3:Z5,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO6),AN6=TRUE),MAX(0,AO6-SUMIFS($AM$3:$AM5,AN$3:AN5,TRUE)),IF(AND(AN6=TRUE,ISNUMBER(AO6)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR6=TRUE,ISNUMBER(AS6)),MAX(0,AS6-SUMIFS($AM$3:$AM5,AR$3:AR5,TRUE)),IF(AND(AR6=TRUE,ISNUMBER(AS6)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV6=TRUE,ISNUMBER(AW6)),MAX(0,AW6-SUMIFS($AM$3:$AM5,AV$3:AV5,TRUE)),IF(AND(AV6=TRUE,ISNUMBER(AW6)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ6=TRUE,ISNUMBER(BA6)),MAX(0,BA6-SUMIFS($AM$3:$AM5,AZ$3:AZ5,TRUE)),IF(AND(AZ6=TRUE,ISNUMBER(BA6)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD6=TRUE,ISNUMBER(BE6)=TRUE),MAX(0,BE6-SUMIFS(AM$3:AM5,BD$3:BD5,TRUE,F$3:F5,F6)),IF(AND(BD6=TRUE,ISNUMBER(BE6)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":357.31,"d":"$357.31"},0,0,0,0,true]
[4,"2016-06-02",6,5,"Radiologic examination, foot; complete, minimum of 3 views","Professional Services: Emergency Department","Not Covered",{"v":49.72,"d":"$49.72"},{"v":49.72,"d":"$49.72"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L7=\"Yes\",ISNUMBER(M7)),MAX(0,M7-SUMIFS(BU$3:BU6,L$3:L6,\"Yes\")),IF(OR(L7=\"No\",M7=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O7,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P7=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O7,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V7=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O7,COUNTIF(Z$3:Z6,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO7),AN7=TRUE),MAX(0,AO7-SUMIFS($AM$3:$AM6,AN$3:AN6,TRUE)),IF(AND(AN7=TRUE,ISNUMBER(AO7)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR7=TRUE,ISNUMBER(AS7)),MAX(0,AS7-SUMIFS($AM$3:$AM6,AR$3:AR6,TRUE)),IF(AND(AR7=TRUE,ISNUMBER(AS7)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV7=TRUE,ISNUMBER(AW7)),MAX(0,AW7-SUMIFS($AM$3:$AM6,AV$3:AV6,TRUE)),IF(AND(AV7=TRUE,ISNUMBER(AW7)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ7=TRUE,ISNUMBER(BA7)),MAX(0,BA7-SUMIFS($AM$3:$AM6,AZ$3:AZ6,TRUE)),IF(AND(AZ7=TRUE,ISNUMBER(BA7)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD7=TRUE,ISNUMBER(BE7)=TRUE),MAX(0,BE7-SUMIFS(AM$3:AM6,BD$3:BD6,TRUE,F$3:F6,F7)),IF(AND(BD7=TRUE,ISNUMBER(BE7)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":49.72,"d":"$49.72"},0,0,0,0,true]
[5,"2016-06-02",6,6,"Closed treatment of metatarsal fracture; without manipulation, each","Professional Services: Emergency Department","Not Covered",{"v":335.16,"d":"$335.16"},{"v":335.16,"d":"$335.16"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L8=\"Yes\",ISNUMBER(M8)),MAX(0,M8-SUMIFS(BU$3:BU7,L$3:L7,\"Yes\")),IF(OR(L8=\"No\",M8=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O8,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P8=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O8,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V8=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O8,COUNTIF(Z$3:Z7,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO8),AN8=TRUE),MAX(0,AO8-SUMIFS($AM$3:$AM7,AN$3:AN7,TRUE)),IF(AND(AN8=TRUE,ISNUMBER(AO8)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR8=TRUE,ISNUMBER(AS8)),MAX(0,AS8-SUMIFS($AM$3:$AM7,AR$3:AR7,TRUE)),IF(AND(AR8=TRUE,ISNUMBER(AS8)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV8=TRUE,ISNUMBER(AW8)),MAX(0,AW8-SUMIFS($AM$3:$AM7,AV$3:AV7,TRUE)),IF(AND(AV8=TRUE,ISNUMBER(AW8)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ8=TRUE,ISNUMBER(BA8)),MAX(0,BA8-SUMIFS($AM$3:$AM7,AZ$3:AZ7,TRUE)),IF(AND(AZ8=TRUE,ISNUMBER(BA8)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD8=TRUE,ISNUMBER(BE8)=TRUE),MAX(0,BE8-SUMIFS(AM$3:AM7,BD$3:BD7,TRUE,F$3:F7,F8)),IF(AND(BD8=TRUE,ISNUMBER(BE8)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":335.16,"d":"$335.16"},0,0,0,0,true]
[6,"2016-06-02",6,19,"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","Durable Medical Equipment","Not Covered",{"v":211.56,"d":"$211.56"},{"v":211.56,"d":"$211.56"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L9=\"Yes\",ISNUMBER(M9)),MAX(0,M9-SUMIFS(BU$3:BU8,L$3:L8,\"Yes\")),IF(OR(L9=\"No\",M9=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O9,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P9=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O9,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V9=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O9,COUNTIF(Z$3:Z8,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO9),AN9=TRUE),MAX(0,AO9-SUMIFS($AM$3:$AM8,AN$3:AN8,TRUE)),IF(AND(AN9=TRUE,ISNUMBER(AO9)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR9=TRUE,ISNUMBER(AS9)),MAX(0,AS9-SUMIFS($AM$3:$AM8,AR$3:AR8,TRUE)),IF(AND(AR9=TRUE,ISNUMBER(AS9)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV9=TRUE,ISNUMBER(AW9)),MAX(0,AW9-SUMIFS($AM$3:$AM8,AV$3:AV8,TRUE)),IF(AND(AV9=TRUE,ISNUMBER(AW9)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ9=TRUE,ISNUMBER(BA9)),MAX(0,BA9-SUMIFS($AM$3:$AM8,AZ$3:AZ8,TRUE)),IF(AND(AZ9=TRUE,ISNUMBER(BA9)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD9=TRUE,ISNUMBER(BE9)=TRUE),MAX(0,BE9-SUMIFS(AM$3:AM8,BD$3:BD8,TRUE,F$3:F8,F9)),IF(AND(BD9=TRUE,ISNUMBER(BE9)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":211.56,"d":"$211.56"},0,0,0,0,true]
[7,"2016-06-02",6,9,"Crutches, underarm, other than wood, adjustable or fixed, pair, with pads, tips, and handgrips","Durable Medical Equipment","Not Covered",{"v":35.97,"d":"$35.97"},{"v":35.97,"d":"$35.97"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L10=\"Yes\",ISNUMBER(M10)),MAX(0,M10-SUMIFS(BU$3:BU9,L$3:L9,\"Yes\")),IF(OR(L10=\"No\",M10=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O10,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P10=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O10,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V10=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O10,COUNTIF(Z$3:Z9,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO10),AN10=TRUE),MAX(0,AO10-SUMIFS($AM$3:$AM9,AN$3:AN9,TRUE)),IF(AND(AN10=TRUE,ISNUMBER(AO10)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR10=TRUE,ISNUMBER(AS10)),MAX(0,AS10-SUMIFS($AM$3:$AM9,AR$3:AR9,TRUE)),IF(AND(AR10=TRUE,ISNUMBER(AS10)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV10=TRUE,ISNUMBER(AW10)),MAX(0,AW10-SUMIFS($AM$3:$AM9,AV$3:AV9,TRUE)),IF(AND(AV10=TRUE,ISNUMBER(AW10)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ10=TRUE,ISNUMBER(BA10)),MAX(0,BA10-SUMIFS($AM$3:$AM9,AZ$3:AZ9,TRUE)),IF(AND(AZ10=TRUE,ISNUMBER(BA10)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD10=TRUE,ISNUMBER(BE10)=TRUE),MAX(0,BE10-SUMIFS(AM$3:AM9,BD$3:BD9,TRUE,F$3:F9,F10)),IF(AND(BD10=TRUE,ISNUMBER(BE10)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":35.97,"d":"$35.97"},0,0,0,0,true]
[8,"2016-06-02",6,8,"Week supply of Acetaminophen 300 MG / Codeine Phosphate 30 MG Oral Tablet","Prescription Drugs: Generic","Not Covered",{"$f":"VLOOKUP(D11,FractureFeeSchedule,7,FALSE)","v":{"v":5.24,"d":"$5.24"}},{"$f":"IF(G11=\"Not Covered\",H11,0)","v":{"v":5.24,"d":"$5.24"}},{"$f":"H11-I11","v":0},{"$f":"VLOOKUP(F11,nrCoverageTable,COLUMN(nrOOPLimitValid),FALSE)","v":false},{"$f":"IF(K11,VLOOKUP(F11,BenefitDesignTable,COLUMN(BenefitOOPLimitApplies),FALSE),\"No\")","v":"No"},{"$f":"VLOOKUP(F11,BenefitDesignTable,COLUMN(OPLimit),FALSE)","v":"."},{"$f":"IFERROR(IF(AND(L11=\"Yes\",ISNUMBER(M11)),MAX(0,M11-SUMIFS(BU$3:BU10,L$3:L10,\"Yes\")),IF(OR(L11=\"No\",M11=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},{"$f":"IF(F11=\"Professional Services: Primary Care\",TRUE, FALSE)","v":false},{"$f":"IF(O11,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P11=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},{"$f":"IF(O11,COUNTIFS(BenefitCategory,\"Professional Services: Primary Care\",ClaimNumber,\"<\"&A11),\"N/A\")","v":"N/A"},{"$f":"IF(P11=\"Yes\",IF(R11<Q11,MIN(J11,N11),0),0)","v":0},{"$f":"J11-S11","v":0},{"$f":"IF(F11=\"Professional Services: Primary Care\",TRUE, FALSE)","v":false},{"$f":"IF(O11,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V11=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O11,COUNTIF(Z$3:Z10,\">0\"),\"N/A\")","v":"N/A"},{"$f":"IF(V11=\"Yes\",VLOOKUP(\"Professional Services: Primary Care\",BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(V11=\"Yes\",U11=TRUE,X11<W11), MIN(Y11,T11,N11),\"N/A\")","v":"N/A"},{"$f":"IF(Z11=\"N/A\",0,T11-Z11)","v":0},{"$f":"IF(L11=\"Yes\",IF(Z11=\"N/A\",N11,N11-Z11),\"N/A\")","v":"N/A"},{"$f":"IF(Z11=\"N/A\",T11,0)","v":0},{"$f":"VLOOKUP(F11,nrCoverageTable,COLUMN(nrMonthlyLimitValid),FALSE)","v":false},{"$f":"IF(AD11,VLOOKUP(F11,BenefitDesignTable,COLUMN(BenefitLimithMonth),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D11,ClaimMonth,C11,ClaimNumber,\"<\"&A11)","v":0},{"$f":"IF(AD11,IF(OR(AE11=\"None\",ISNUMBER(AE11)),IF(AF11>=AE11,H11,0),\"ERR\"),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F11,nrCoverageTable,COLUMN(nrAnnualLimitValid),FALSE)","v":false},{"$f":"IF(AH11,VLOOKUP(F11,BenefitDesignTable,COLUMN(BenefitLimitAnnual),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D11,ClaimNumber,\"<\"&A11)","v":0},{"$f":"IF(AH11,IF(OR(AI11=\"None\",ISNUMBER(AI11)),IF(AJ11>=AI11,H11,0),\"ERR\"),\"N/A\")","v":"N/A"},{"$f":"IF(OR(AG11=\"ERR\",AK11=\"ERR\"),\"ERR\",MAX(AG11,AK11))","v":0},{"$f":"IFERROR(AC11-AL11,\"ERR\")","v":0},{"$f":"VLOOKUP(F11,nrCoverageTable,COLUMN(nrUsesPlanDeduct),FALSE)","v":false},{"$f":"IF(AN11,VLOOKUP(F11,BenefitDesignTable,COLUMN(PlanDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(ISNUMBER(AO11),AN11=TRUE),MAX(0,AO11-SUMIFS($AM$3:$AM10,AN$3:AN10,TRUE)),IF(AND(AN11=TRUE,ISNUMBER(AO11)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AP11),MIN($AM11,AP11),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F11,nrCoverageTable,COLUMN(nrUsesRxDeduct),FALSE)","v":false},{"$f":"IF(AR11,VLOOKUP(F11,BenefitDesignTable,COLUMN(RxDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AR11=TRUE,ISNUMBER(AS11)),MAX(0,AS11-SUMIFS($AM$3:$AM10,AR$3:AR10,TRUE)),IF(AND(AR11=TRUE,ISNUMBER(AS11)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AT11),MIN($AM11,AT11),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F11,nrCoverageTable,COLUMN(nrUsesDeductC),FALSE)","v":false},{"$f":"IF(AV11,VLOOKUP(F11,BenefitDesignTable,COLUMN(OptDeductibleC),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AV11=TRUE,ISNUMBER(AW11)),MAX(0,AW11-SUMIFS($AM$3:$AM10,AV$3:AV10,TRUE)),IF(AND(AV11=TRUE,ISNUMBER(AW11)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AX11),MIN($AM11,AX11),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F11,nrCoverageTable,COLUMN(nrUsesDeductD),FALSE)","v":false},{"$f":"IF(AZ11,VLOOKUP(F11,BenefitDesignTable,COLUMN(OptDeductibleD),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AZ11=TRUE,ISNUMBER(BA11)),MAX(0,BA11-SUMIFS($AM$3:$AM10,AZ$3:AZ10,TRUE)),IF(AND(AZ11=TRUE,ISNUMBER(BA11)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BB11),MIN($AM11,BB11),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F11,nrCoverageTable,COLUMN(nrUsesBenDeduct),FALSE)","v":false},{"$f":"IF(BD11,VLOOKUP(F11,BenefitDesignTable,COLUMN(BenefitDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(BD11=TRUE,ISNUMBER(BE11)=TRUE),MAX(0,BE11-SUMIFS(AM$3:AM10,BD$3:BD10,TRUE,F$3:F10,F11)),IF(AND(BD11=TRUE,ISNUMBER(BE11)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BF11),MIN($AM11,BF11),\"N/A\")","v":"N/A"},{"$f":"SUM(AQ11,AU11,AY11,BC11,BG11)","v":0},{"$f":"IF(OR(AB11=\"ERR\",BH11=\"ERR\"),\"ERR\",MIN(BH11,AB11))","v":0},{"$f":"IF(AND(L11=\"Yes\",ISNUMBER(M11)),IF(OR(BI11=\"ERR\",AB11=\"ERR\"),\"ERR\",MAX($AB11-BI11,0)),\"N/A\")","v":"N/A"},{"$f":"IF(OR(BI11=\"ERR\",AM11=\"ERR\"),\"ERR\",MAX(0,AM11-BI11))","v":0},{"$f":"VLOOKUP(F11,nrCoverageTable,COLUMN(nrUsesCopay),FALSE)","v":false},{"$f":"IF(BL11,VLOOKUP(F11,BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(BK11=\"ERR\",\"ERR\",IF(AND(BL11=TRUE,ISNUMBER(BM11)),MIN(BK11,BM11,BJ11),IF(AND(BL11=TRUE,ISNUMBER(BM11)=FALSE),\"ERR\",\"N/A\")))","v":"N/A"},{"$f":"VLOOKUP(F11,nrCoverageTable,COLUMN(nrUsesCoins),FALSE)","v":false},{"$f":"IF(BO11,VLOOKUP(F11,BenefitDesignTable,COLUMN(BenefitCoins),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(BK11=\"ERR\",\"ERR\",IF(AND(BO11=TRUE,ISNUMBER(BP11)=TRUE),MIN(BJ11,BK11*BP11),IF(AND(BO11=TRUE,ISNUMBER(BP11)=FALSE),\"ERR\",\"N/A\")))","v":"N/A"},{"$f":"IF(OR(BJ11=\"ERR\",BN11=\"ERR\",BQ11=\"ERR\"),\"ERR\",MIN(BJ11,SUM(BN11,BQ11)))","v":0},{"$f":"IF(AND(L11=\"Yes\",ISNUMBER(M11)),IF(OR(BJ11=\"ERR\",BR11=\"ERR\"),\"ERR\",MAX(BJ11-BR11,0)),\"N/A\")","v":"N/A"},{"$f":"IF(OR(BK11=\"ERR\",BR11=\"ERR\"),\"ERR\",MAX(BK11-BR11,0))","v":0},0,0,{"$f":"I11","v":{"v":5.24,"d":"$5.24"}},{"$f":"IF(OR(AG11=\"ERR\",AK11=\"ERR\"),\"ERR\",SUM(AG11,AK11))","v":0},{"$f":"BI11","v":0},{"$f":"IF(V11=\"Yes\",IF(Z11=\"N/A\",0,Z11),0)+IF(BL11,BN11,0)","v":0},{"$f":"IF(BO11,BQ11,0)","v":0},{"$f":"SUM(BV11:CA11)=H11","v":true}]
[9,"2016-06-09",6,11,"Office or other outpatient visit for the evaluation and management of a new patient, which requires at least 3 key components. Physicians typically spend 30 minutes face-to-face with the patient.","Professional Services: Specialist","Not Covered",{"v":127.51,"d":"$127.51"},{"v":127.51,"d":"$127.51"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L12=\"Yes\",ISNUMBER(M12)),MAX(0,M12-SUMIFS(BU$3:BU11,L$3:L11,\"Yes\")),IF(OR(L12=\"No\",M12=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O12,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P12=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O12,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V12=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O12,COUNTIF(Z$3:Z11,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO12),AN12=TRUE),MAX(0,AO12-SUMIFS($AM$3:$AM11,AN$3:AN11,TRUE)),IF(AND(AN12=TRUE,ISNUMBER(AO12)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR12=TRUE,ISNUMBER(AS12)),MAX(0,AS12-SUMIFS($AM$3:$AM11,AR$3:AR11,TRUE)),IF(AND(AR12=TRUE,ISNUMBER(AS12)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV12=TRUE,ISNUMBER(AW12)),MAX(0,AW12-SUMIFS($AM$3:$AM11,AV$3:AV11,TRUE)),IF(AND(AV12=TRUE,ISNUMBER(AW12)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ12=TRUE,ISNUMBER(BA12)),MAX(0,BA12-SUMIFS($AM$3:$AM11,AZ$3:AZ11,TRUE)),IF(AND(AZ12=TRUE,ISNUMBER(BA12)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD12=TRUE,ISNUMBER(BE12)=TRUE),MAX(0,BE12-SUMIFS(AM$3:AM11,BD$3:BD11,TRUE,F$3:F11,F12)),IF(AND(BD12=TRUE,ISNUMBER(BE12)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":127.51,"d":"$127.51"},0,0,0,0,true]
[10,"2016-06-09",6,7,"Radiologic examination, foot; complete, minimum of 3 views","Diagnostic Services: Radiology","Not Covered",{"v":49.72,"d":"$49.72"},{"v":49.72,"d":"$49.72"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L13=\"Yes\",ISNUMBER(M13)),MAX(0,M13-SUMIFS(BU$3:BU12,L$3:L12,\"Yes\")),IF(OR(L13=\"No\",M13=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O13,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P13=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O13,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V13=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O13,COUNTIF(Z$3:Z12,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO13),AN13=TRUE),MAX(0,AO13-SUMIFS($AM$3:$AM12,AN$3:AN12,TRUE)),IF(AND(AN13=TRUE,ISNUMBER(AO13)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR13=TRUE,ISNUMBER(AS13)),MAX(0,AS13-SUMIFS($AM$3:$AM12,AR$3:AR12,TRUE)),IF(AND(AR13=TRUE,ISNUMBER(AS13)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV13=TRUE,ISNUMBER(AW13)),MAX(0,AW13-SUMIFS($AM$3:$AM12,AV$3:AV12,TRUE)),IF(AND(AV13=TRUE,ISNUMBER(AW13)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ13=TRUE,ISNUMBER(BA13)),MAX(0,BA13-SUMIFS($AM$3:$AM12,AZ$3:AZ12,TRUE)),IF(AND(AZ13=TRUE,ISNUMBER(BA13)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD13=TRUE,ISNUMBER(BE13)=TRUE),MAX(0,BE13-SUMIFS(AM$3:AM12,BD$3:BD12,TRUE,F$3:F12,F13)),IF(AND(BD13=TRUE,ISNUMBER(BE13)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":49.72,"d":"$49.72"},0,0,0,0,true]
[11,"2016-06-09",6,12,"Application of short leg cast (below knee to toes);","Professional Services: Specialist","Not Covered",{"v":132.03,"d":"$132.03"},{"v":132.03,"d":"$132.03"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L14=\"Yes\",ISNUMBER(M14)),MAX(0,M14-SUMIFS(BU$3:BU13,L$3:L13,\"Yes\")),IF(OR(L14=\"No\",M14=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O14,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P14=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O14,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V14=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O14,COUNTIF(Z$3:Z13,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO14),AN14=TRUE),MAX(0,AO14-SUMIFS($AM$3:$AM13,AN$3:AN13,TRUE)),IF(AND(AN14=TRUE,ISNUMBER(AO14)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR14=TRUE,ISNUMBER(AS14)),MAX(0,AS14-SUMIFS($AM$3:$AM13,AR$3:AR13,TRUE)),IF(AND(AR14=TRUE,ISNUMBER(AS14)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV14=TRUE,ISNUMBER(AW14)),MAX(0,AW14-SUMIFS($AM$3:$AM13,AV$3:AV13,TRUE)),IF(AND(AV14=TRUE,ISNUMBER(AW14)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ14=TRUE,ISNUMBER(BA14)),MAX(0,BA14-SUMIFS($AM$3:$AM13,AZ$3:AZ13,TRUE)),IF(AND(AZ14=TRUE,ISNUMBER(BA14)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD14=TRUE,ISNUMBER(BE14)=TRUE),MAX(0,BE14-SUMIFS(AM$3:AM13,BD$3:BD13,TRUE,F$3:F13,F14)),IF(AND(BD14=TRUE,ISNUMBER(BE14)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":132.03,"d":"$132.03"},0,0,0,0,true]
[12,"2016-06-09",6,13,"Cast supplies, short leg cast, adult (11 years +), fiberglass","Other Facility Services","Not Covered",{"v":43.22,"d":"$43.22"},{"v":43.22,"d":"$43.22"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L15=\"Yes\",ISNUMBER(M15)),MAX(0,M15-SUMIFS(BU$3:BU14,L$3:L14,\"Yes\")),IF(OR(L15=\"No\",M15=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O15,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P15=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O15,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V15=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O15,COUNTIF(Z$3:Z14,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO15),AN15=TRUE),MAX(0,AO15-SUMIFS($AM$3:$AM14,AN$3:AN14,TRUE)),IF(AND(AN15=TRUE,ISNUMBER(AO15)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR15=TRUE,ISNUMBER(AS15)),MAX(0,AS15-SUMIFS($AM$3:$AM14,AR$3:AR14,TRUE)),IF(AND(AR15=TRUE,ISNUMBER(AS15)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV15=TRUE,ISNUMBER(AW15)),MAX(0,AW15-SUMIFS($AM$3:$AM14,AV$3:AV14,TRUE)),IF(AND(AV15=TRUE,ISNUMBER(AW15)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ15=TRUE,ISNUMBER(BA15)),MAX(0,BA15-SUMIFS($AM$3:$AM14,AZ$3:AZ14,TRUE)),IF(AND(AZ15=TRUE,ISNUMBER(BA15)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD15=TRUE,ISNUMBER(BE15)=TRUE),MAX(0,BE15-SUMIFS(AM$3:AM14,BD$3:BD14,TRUE,F$3:F14,F15)),IF(AND(BD15=TRUE,ISNUMBER(BE15)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":43.22,"d":"$43.22"},0,0,0,0,true]
[13,"2016-07-14",7,14,"X-ray of ankle, minimum of 3 views","Diagnostic Services: Radiology","Not Covered",{"v":63.18,"d":"$63.18"},{"v":63.18,"d":"$63.18"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L16=\"Yes\",ISNUMBER(M16)),MAX(0,M16-SUMIFS(BU$3:BU15,L$3:L15,\"Yes\")),IF(OR(L16=\"No\",M16=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O16,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P16=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O16,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V16=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O16,COUNTIF(Z$3:Z15,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO16),AN16=TRUE),MAX(0,AO16-SUMIFS($AM$3:$AM15,AN$3:AN15,TRUE)),IF(AND(AN16=TRUE,ISNUMBER(AO16)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR16=TRUE,ISNUMBER(AS16)),MAX(0,AS16-SUMIFS($AM$3:$AM15,AR$3:AR15,TRUE)),IF(AND(AR16=TRUE,ISNUMBER(AS16)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV16=TRUE,ISNUMBER(AW16)),MAX(0,AW16-SUMIFS($AM$3:$AM15,AV$3:AV15,TRUE)),IF(AND(AV16=TRUE,ISNUMBER(AW16)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ16=TRUE,ISNUMBER(BA16)),MAX(0,BA16-SUMIFS($AM$3:$AM15,AZ$3:AZ15,TRUE)),IF(AND(AZ16=TRUE,ISNUMBER(BA16)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD16=TRUE,ISNUMBER(BE16)=TRUE),MAX(0,BE16-SUMIFS(AM$3:AM15,BD$3:BD15,TRUE,F$3:F15,F16)),IF(AND(BD16=TRUE,ISNUMBER(BE16)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":63.18,"d":"$63.18"},0,0,0,0,true]
[14,"2016-07-14",7,15,"Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of 3 key components. Physicians typically spend 15 minutes face-to-face with the","Professional Services: Specialist","Not Covered",{"v":81.66,"d":"$81.66"},{"v":81.66,"d":"$81.66"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L17=\"Yes\",ISNUMBER(M17)),MAX(0,M17-SUMIFS(BU$3:BU16,L$3:L16,\"Yes\")),IF(OR(L17=\"No\",M17=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O17,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P17=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O17,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V17=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O17,COUNTIF(Z$3:Z16,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO17),AN17=TRUE),MAX(0,AO17-SUMIFS($AM$3:$AM16,AN$3:AN16,TRUE)),IF(AND(AN17=TRUE,ISNUMBER(AO17)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR17=TRUE,ISNUMBER(AS17)),MAX(0,AS17-SUMIFS($AM$3:$AM16,AR$3:AR16,TRUE)),IF(AND(AR17=TRUE,ISNUMBER(AS17)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV17=TRUE,ISNUMBER(AW17)),MAX(0,AW17-SUMIFS($AM$3:$AM16,AV$3:AV16,TRUE)),IF(AND(AV17=TRUE,ISNUMBER(AW17)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ17=TRUE,ISNUMBER(BA17)),MAX(0,BA17-SUMIFS($AM$3:$AM16,AZ$3:AZ16,TRUE)),IF(AND(AZ17=TRUE,ISNUMBER(BA17)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD17=TRUE,ISNUMBER(BE17)=TRUE),MAX(0,BE17-SUMIFS(AM$3:AM16,BD$3:BD16,TRUE,F$3:F16,F17)),IF(AND(BD17=TRUE,ISNUMBER(BE17)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":81.66,"d":"$81.66"},0,0,0,0,true]
[15,"2016-08-04",8,16,"Physical therapy evaluation","Professional Services: Physical Therapy","Not Covered",{"v":116.43,"d":"$116.43"},{"v":116.43,"d":"$116.43"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L18=\"Yes\",ISNUMBER(M18)),MAX(0,M18-SUMIFS(BU$3:BU17,L$3:L17,\"Yes\")),IF(OR(L18=\"No\",M18=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O18,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P18=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O18,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V18=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O18,COUNTIF(Z$3:Z17,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",0,"N/A",false,".",0,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO18),AN18=TRUE),MAX(0,AO18-SUMIFS($AM$3:$AM17,AN$3:AN17,TRUE)),IF(AND(AN18=TRUE,ISNUMBER(AO18)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR18=TRUE,ISNUMBER(AS18)),MAX(0,AS18-SUMIFS($AM$3:$AM17,AR$3:AR17,TRUE)),IF(AND(AR18=TRUE,ISNUMBER(AS18)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV18=TRUE,ISNUMBER(AW18)),MAX(0,AW18-SUMIFS($AM$3:$AM17,AV$3:AV17,TRUE)),IF(AND(AV18=TRUE,ISNUMBER(AW18)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ18=TRUE,ISNUMBER(BA18)),MAX(0,BA18-SUMIFS($AM$3:$AM17,AZ$3:AZ17,TRUE)),IF(AND(AZ18=TRUE,ISNUMBER(BA18)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD18=TRUE,ISNUMBER(BE18)=TRUE),MAX(0,BE18-SUMIFS(AM$3:AM17,BD$3:BD17,TRUE,F$3:F17,F18)),IF(AND(BD18=TRUE,ISNUMBER(BE18)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":116.43,"d":"$116.43"},0,0,0,0,true]
[16,"2016-08-11",8,17,"Therapeutic procedure, 1 or more areas, 2 sessions (15 minutes/session); therapeutic exercises to develop strength and endurance, range of motion and flexibility. ","Professional Services: Physical Therapy","Not Covered",{"$f":"VLOOKUP(D19,FractureFeeSchedule,7,FALSE)","v":{"v":82.53,"d":"$82.53"}},{"$f":"IF(G19=\"Not Covered\",H19,0)","v":{"v":82.53,"d":"$82.53"}},{"$f":"H19-I19","v":0},{"$f":"VLOOKUP(F19,nrCoverageTable,COLUMN(nrOOPLimitValid),FALSE)","v":false},{"$f":"IF(K19,VLOOKUP(F19,BenefitDesignTable,COLUMN(BenefitOOPLimitApplies),FALSE),\"No\")","v":"No"},{"$f":"VLOOKUP(F19,BenefitDesignTable,COLUMN(OPLimit),FALSE)","v":"."},{"$f":"IFERROR(IF(AND(L19=\"Yes\",ISNUMBER(M19)),MAX(0,M19-SUMIFS(BU$3:BU18,L$3:L18,\"Yes\")),IF(OR(L19=\"No\",M19=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},{"$f":"IF(F19=\"Professional Services: Primary Care\",TRUE, FALSE)","v":false},{"$f":"IF(O19,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P19=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},{"$f":"IF(O19,COUNTIFS(BenefitCategory,\"Professional Services: Primary Care\",ClaimNumber,\"<\"&A19),\"N/A\")","v":"N/A"},{"$f":"IF(P19=\"Yes\",IF(R19<Q19,MIN(J19,N19),0),0)","v":0},{"$f":"J19-S19","v":0},{"$f":"IF(F19=\"Professional Services: Primary Care\",TRUE, FALSE)","v":false},{"$f":"IF(O19,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V19=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O19,COUNTIF(Z$3:Z18,\">0\"),\"N/A\")","v":"N/A"},{"$f":"IF(V19=\"Yes\",VLOOKUP(\"Professional Services: Primary Care\",BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(V19=\"Yes\",U19=TRUE,X19<W19), MIN(Y19,T19,N19),\"N/A\")","v":"N/A"},{"$f":"IF(Z19=\"N/A\",0,T19-Z19)","v":0},{"$f":"IF(L19=\"Yes\",IF(Z19=\"N/A\",N19,N19-Z19),\"N/A\")","v":"N/A"},{"$f":"IF(Z19=\"N/A\",T19,0)","v":0},{"$f":"VLOOKUP(F19,nrCoverageTable,COLUMN(nrMonthlyLimitValid),FALSE)","v":false},{"$f":"IF(AD19,VLOOKUP(F19,BenefitDesignTable,COLUMN(BenefitLimithMonth),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D19,ClaimMonth,C19,ClaimNumber,\"<\"&A19)","v":0},{"$f":"IF(AD19,IF(OR(AE19=\"None\",ISNUMBER(AE19)),IF(AF19>=AE19,H19,0),\"ERR\"),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F19,nrCoverageTable,COLUMN(nrAnnualLimitValid),FALSE)","v":false},{"$f":"IF(AH19,VLOOKUP(F19,BenefitDesignTable,COLUMN(BenefitLimitAnnual),FALSE),\".\")","v":"."},{"$f":"COUNTIFS(ServiceCode,D19,ClaimNumber,\"<\"&A19)","v":0},{"$f":"IF(AH19,IF(OR(AI19=\"None\",ISNUMBER(AI19)),IF(AJ19>=AI19,H19,0),\"ERR\"),\"N/A\")","v":"N/A"},{"$f":"IF(OR(AG19=\"ERR\",AK19=\"ERR\"),\"ERR\",MAX(AG19,AK19))","v":0},{"$f":"IFERROR(AC19-AL19,\"ERR\")","v":0},{"$f":"VLOOKUP(F19,nrCoverageTable,COLUMN(nrUsesPlanDeduct),FALSE)","v":false},{"$f":"IF(AN19,VLOOKUP(F19,BenefitDesignTable,COLUMN(PlanDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(ISNUMBER(AO19),AN19=TRUE),MAX(0,AO19-SUMIFS($AM$3:$AM18,AN$3:AN18,TRUE)),IF(AND(AN19=TRUE,ISNUMBER(AO19)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AP19),MIN($AM19,AP19),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F19,nrCoverageTable,COLUMN(nrUsesRxDeduct),FALSE)","v":false},{"$f":"IF(AR19,VLOOKUP(F19,BenefitDesignTable,COLUMN(RxDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AR19=TRUE,ISNUMBER(AS19)),MAX(0,AS19-SUMIFS($AM$3:$AM18,AR$3:AR18,TRUE)),IF(AND(AR19=TRUE,ISNUMBER(AS19)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AT19),MIN($AM19,AT19),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F19,nrCoverageTable,COLUMN(nrUsesDeductC),FALSE)","v":false},{"$f":"IF(AV19,VLOOKUP(F19,BenefitDesignTable,COLUMN(OptDeductibleC),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AV19=TRUE,ISNUMBER(AW19)),MAX(0,AW19-SUMIFS($AM$3:$AM18,AV$3:AV18,TRUE)),IF(AND(AV19=TRUE,ISNUMBER(AW19)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(AX19),MIN($AM19,AX19),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F19,nrCoverageTable,COLUMN(nrUsesDeductD),FALSE)","v":false},{"$f":"IF(AZ19,VLOOKUP(F19,BenefitDesignTable,COLUMN(OptDeductibleD),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(AZ19=TRUE,ISNUMBER(BA19)),MAX(0,BA19-SUMIFS($AM$3:$AM18,AZ$3:AZ18,TRUE)),IF(AND(AZ19=TRUE,ISNUMBER(BA19)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BB19),MIN($AM19,BB19),\"N/A\")","v":"N/A"},{"$f":"VLOOKUP(F19,nrCoverageTable,COLUMN(nrUsesBenDeduct),FALSE)","v":false},{"$f":"IF(BD19,VLOOKUP(F19,BenefitDesignTable,COLUMN(BenefitDeductible),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(AND(BD19=TRUE,ISNUMBER(BE19)=TRUE),MAX(0,BE19-SUMIFS(AM$3:AM18,BD$3:BD18,TRUE,F$3:F18,F19)),IF(AND(BD19=TRUE,ISNUMBER(BE19)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},{"$f":"IF(ISNUMBER(BF19),MIN($AM19,BF19),\"N/A\")","v":"N/A"},{"$f":"SUM(AQ19,AU19,AY19,BC19,BG19)","v":0},{"$f":"IF(OR(AB19=\"ERR\",BH19=\"ERR\"),\"ERR\",MIN(BH19,AB19))","v":0},{"$f":"IF(AND(L19=\"Yes\",ISNUMBER(M19)),IF(OR(BI19=\"ERR\",AB19=\"ERR\"),\"ERR\",MAX($AB19-BI19,0)),\"N/A\")","v":"N/A"},{"$f":"IF(OR(BI19=\"ERR\",AM19=\"ERR\"),\"ERR\",MAX(0,AM19-BI19))","v":0},{"$f":"VLOOKUP(F19,nrCoverageTable,COLUMN(nrUsesCopay),FALSE)","v":false},{"$f":"IF(BL19,VLOOKUP(F19,BenefitDesignTable,COLUMN(BenefitCopay),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(BK19=\"ERR\",\"ERR\",IF(AND(BL19=TRUE,ISNUMBER(BM19)),MIN(BK19,BM19,BJ19),IF(AND(BL19=TRUE,ISNUMBER(BM19)=FALSE),\"ERR\",\"N/A\")))","v":"N/A"},{"$f":"VLOOKUP(F19,nrCoverageTable,COLUMN(nrUsesCoins),FALSE)","v":false},{"$f":"IF(BO19,VLOOKUP(F19,BenefitDesignTable,COLUMN(BenefitCoins),FALSE),\"N/A\")","v":"N/A"},{"$f":"IF(BK19=\"ERR\",\"ERR\",IF(AND(BO19=TRUE,ISNUMBER(BP19)=TRUE),MIN(BJ19,BK19*BP19),IF(AND(BO19=TRUE,ISNUMBER(BP19)=FALSE),\"ERR\",\"N/A\")))","v":"N/A"},{"$f":"IF(OR(BJ19=\"ERR\",BN19=\"ERR\",BQ19=\"ERR\"),\"ERR\",MIN(BJ19,SUM(BN19,BQ19)))","v":0},{"$f":"IF(AND(L19=\"Yes\",ISNUMBER(M19)),IF(OR(BJ19=\"ERR\",BR19=\"ERR\"),\"ERR\",MAX(BJ19-BR19,0)),\"N/A\")","v":"N/A"},{"$f":"IF(OR(BK19=\"ERR\",BR19=\"ERR\"),\"ERR\",MAX(BK19-BR19,0))","v":0},0,0,{"$f":"I19","v":{"v":82.53,"d":"$82.53"}},{"$f":"IF(OR(AG19=\"ERR\",AK19=\"ERR\"),\"ERR\",SUM(AG19,AK19))","v":0},{"$f":"BI19","v":0},{"$f":"IF(V19=\"Yes\",IF(Z19=\"N/A\",0,Z19),0)+IF(BL19,BN19,0)","v":0},{"$f":"IF(BO19,BQ19,0)","v":0},{"$f":"SUM(BV19:CA19)=H19","v":true}]
[17,"2016-08-11",8,17,"Therapeutic procedure, 1 or more areas, 2 sessions (15 minutes/session); therapeutic exercises to develop strength and endurance, range of motion and flexibility. ","Professional Services: Physical Therapy","Not Covered",{"v":82.53,"d":"$82.53"},{"v":82.53,"d":"$82.53"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L20=\"Yes\",ISNUMBER(M20)),MAX(0,M20-SUMIFS(BU$3:BU19,L$3:L19,\"Yes\")),IF(OR(L20=\"No\",M20=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O20,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P20=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O20,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V20=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O20,COUNTIF(Z$3:Z19,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",1,"N/A",false,".",1,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO20),AN20=TRUE),MAX(0,AO20-SUMIFS($AM$3:$AM19,AN$3:AN19,TRUE)),IF(AND(AN20=TRUE,ISNUMBER(AO20)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR20=TRUE,ISNUMBER(AS20)),MAX(0,AS20-SUMIFS($AM$3:$AM19,AR$3:AR19,TRUE)),IF(AND(AR20=TRUE,ISNUMBER(AS20)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV20=TRUE,ISNUMBER(AW20)),MAX(0,AW20-SUMIFS($AM$3:$AM19,AV$3:AV19,TRUE)),IF(AND(AV20=TRUE,ISNUMBER(AW20)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ20=TRUE,ISNUMBER(BA20)),MAX(0,BA20-SUMIFS($AM$3:$AM19,AZ$3:AZ19,TRUE)),IF(AND(AZ20=TRUE,ISNUMBER(BA20)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD20=TRUE,ISNUMBER(BE20)=TRUE),MAX(0,BE20-SUMIFS(AM$3:AM19,BD$3:BD19,TRUE,F$3:F19,F20)),IF(AND(BD20=TRUE,ISNUMBER(BE20)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":82.53,"d":"$82.53"},0,0,0,0,true]
[18,"2016-08-18",8,17,"Therapeutic procedure, 1 or more areas, 2 sessions (15 minutes/session); therapeutic exercises to develop strength and endurance, range of motion and flexibility. ","Professional Services: Physical Therapy","Not Covered",{"v":82.53,"d":"$82.53"},{"v":82.53,"d":"$82.53"},0,false,"No",".",{"$f":"IFERROR(IF(AND(L21=\"Yes\",ISNUMBER(M21)),MAX(0,M21-SUMIFS(BU$3:BU20,L$3:L20,\"Yes\")),IF(OR(L21=\"No\",M21=\"None\"),\"N/A\",\"ERR\")),\"ERR\")","v":"N/A"},false,{"$f":"IF(O21,BENEFIT_PARAMETERS!$C$76,\"N/A\")","v":"N/A"},{"$f":"IF(P21=\"Yes\", BENEFIT_PARAMETERS!$D$76,\"N/A\")","v":"N/A"},"N/A",0,0,false,{"$f":"IF(O21,BENEFIT_PARAMETERS!$C$77,\"N/A\")","v":"N/A"},{"$f":"IF(V21=\"Yes\", BENEFIT_PARAMETERS!$D$77,\"N/A\")","v":"N/A"},{"$f":"IF(O21,COUNTIF(Z$3:Z20,\">0\"),\"N/A\")","v":"N/A"},"N/A","N/A",0,"N/A",0,false,".",2,"N/A",false,".",2,"N/A",0,0,false,"N/A",{"$f":"IF(AND(ISNUMBER(AO21),AN21=TRUE),MAX(0,AO21-SUMIFS($AM$3:$AM20,AN$3:AN20,TRUE)),IF(AND(AN21=TRUE,ISNUMBER(AO21)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AR21=TRUE,ISNUMBER(AS21)),MAX(0,AS21-SUMIFS($AM$3:$AM20,AR$3:AR20,TRUE)),IF(AND(AR21=TRUE,ISNUMBER(AS21)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AV21=TRUE,ISNUMBER(AW21)),MAX(0,AW21-SUMIFS($AM$3:$AM20,AV$3:AV20,TRUE)),IF(AND(AV21=TRUE,ISNUMBER(AW21)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(AZ21=TRUE,ISNUMBER(BA21)),MAX(0,BA21-SUMIFS($AM$3:$AM20,AZ$3:AZ20,TRUE)),IF(AND(AZ21=TRUE,ISNUMBER(BA21)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",false,"N/A",{"$f":"IF(AND(BD21=TRUE,ISNUMBER(BE21)=TRUE),MAX(0,BE21-SUMIFS(AM$3:AM20,BD$3:BD20,TRUE,F$3:F20,F21)),IF(AND(BD21=TRUE,ISNUMBER(BE21)=FALSE),\"ERR\",\"N/A\"))","v":"N/A"},"N/A",0,0,"N/A",0,false,"N/A","N/A",false,"N/A","N/A",0,"N/A",0,0,0,{"v":82.53,"d":"$82.53"},0,0,0,0,true]

{"sheet":"FRACTURE_LINE_ITEM","index":17,"n_rows":17,"n_cols":10,"rows_kept":17,"hidden":true}
["Item or Service Code","Diagnosis Code \n(ICD-10)","CPT©, HCPCS, or\nOther Billing Code","Provider\nType","Benefit Category","Description","Allowed\nAmount","Notes","Valid Benefit Category","Timeline Count"]
[2,"S99929A","A0425","Ambulance (land)","Ambulance","Ground mileage, per statute mile",161.71,null,{"$f":"IF(ISERROR(VLOOKUP(E2,BenefitCategoryList,1,FALSE)),FALSE,TRUE)","v":true},{"$f":"COUNTIF(FRACTURE_TIMELINE!ServiceCode,A2)","v":1}]
[4,"S92353A",99283,"Outpatient Hospital","Emergency Department (Facility)","Emergency department visit for evaluation and management of patient, which req 3 key components. Usually, presenting problem(s) are high severity, & require urgent physician evaluation but do not pose",357.31,null,true,{"$f":"COUNTIF(FRACTURE_TIMELINE!ServiceCode,A3)","v":1}]
[5,"S92353A",73630,"Outpatient Hospital","Professional Services: Emergency Department","Radiologic examination, foot; complete, minimum of 3 views",49.72,null,true,{"$f":"COUNTIF(FRACTURE_TIMELINE!ServiceCode,A4)","v":1}]
[6,"S92353A",28470,"Outpatient Hospital","Professional Services: Emergency Department","Closed treatment of metatarsal fracture; without manipulation, each",335.16,null,true,{"$f":"COUNTIF(FRACTURE_TIMELINE!ServiceCode,A5)","v":1}]
[7,"S92353A",73630,"Outpatient Hospital","Diagnostic Services: Radiology","Radiologic examination, foot; complete, minimum of 3 views",49.72,null,{"$f":"IF(ISERROR(VLOOKUP(E6,BenefitCategoryList,1,FALSE)),FALSE,TRUE)","v":true},{"$f":"COUNTIF(FRACTURE_TIMELINE!ServiceCode,A6)","v":1}]
[8,"S92353A","00093015010","Pharmacy Retail","Prescription Drugs: Generic","Week supply of Acetaminophen 300 MG / Codeine Phosphate 30 MG Oral Tablet",5.24,null,{"$f":"IF(ISERROR(VLOOKUP(E7,BenefitCategoryList,1,FALSE)),FALSE,TRUE)","v":true},{"$f":"COUNTIF(FRACTURE_TIMELINE!ServiceCode,A7)","v":1}]
[9,null,"E0114","Pharmacy Retail","Durable Medical Equipment","Crutches, underarm, other than wood, adjustable or fixed, pair, with pads, tips, and handgrips",35.97,null,true,{"$f":"COUNTIF(FRACTURE_TIMELINE!ServiceCode,A8)","v":1}]
[11,"S92353A",99203,"Outpatient Hospital","Professional Services: Specialist","Office or other outpatient visit for the evaluation and management of a new patient, which requires at least 3 key components. Physicians typically spend 30 minutes face-to-face with the patient.",127.51,null,true,{"$f":"COUNTIF(FRACTURE_TIMELINE!ServiceCode,A9)","v":1}]
[12,"S92353A",29405,"Outpatient Hospital","Professional Services: Specialist","Application of short leg cast (below knee to toes);",132.03,null,true,{"$f":"COUNTIF(FRACTURE_TIMELINE!ServiceCode,A10)","v":1}]
[13,"S92353A","Q4038","Outpatient Hospital","Other Facility Services","Cast supplies, short leg cast, adult (11 years +), fiberglass",43.22,null,true,{"$f":"COUNTIF(FRACTURE_TIMELINE!ServiceCode,A11)","v":1}]
[14,"S92353A",73610,"Primary","Diagnostic Services: Radiology","X-ray of ankle, minimum of 3 views",63.18,null,true,{"$f":"COUNTIF(FRACTURE_TIMELINE!ServiceCode,A12)","v":1}]
[15,"S92353A",99213,"Primary","Professional Services: Specialist","Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of 3 key components. Physicians typically spend 15 minutes face-to-face with the",81.66,null,true,{"$f":"COUNTIF(FRACTURE_TIMELINE!ServiceCode,A13)","v":1}]
[16,"S92353A",97001,"Physical Therapy","Professional Services: Physical Therapy","Physical therapy evaluation",116.43,null,true,{"$f":"COUNTIF(FRACTURE_TIMELINE!ServiceCode,A14)","v":1}]
[17,"S92353A",97110,"Physical Therapy","Professional Services: Physical Therapy","Therapeutic procedure, 1 or more areas, 2 sessions (15 minutes/session); therapeutic exercises to develop strength and endurance, range of motion and flexibility. ",82.53,null,true,{"$f":"COUNTIF(FRACTURE_TIMELINE!ServiceCode,A15)","v":3}]
[18,null,"A0429","Ambulance (land)","Ambulance","Ambulance service, basic life support, emergency transport (bls-emergency)",782.16,null,true,{"$f":"COUNTIF(FRACTURE_TIMELINE!ServiceCode,A16)","v":1}]
[19,null,"L4361","Outpatient Hospital","Durable Medical Equipment","Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf",211.56,null,true,{"$f":"COUNTIF(FRACTURE_TIMELINE!ServiceCode,A17)","v":1}]