Not A WCDP Benefit. Payment may be reduced due to submitted Present on Admission (POA) indicator. PIP coverage protects you regardless of who is at fault. Bilateral Procedures Must Be Billed On One Detail With Modifier 50, Quantity Of 1.detail With Modifier 50 May Be Adjusted If Necessary. 140 only revenue codes 300 or 310 are allowed on outpatient claims when billing lab Denied. Incorrect or invalid NDC/Procedure Code/Revenue Code billed. NUMBER IS MISSING OR INCORRECT 0002 01/01/1900 COULD NOT PROCESS CLAIM. Sixth Diagnosis Code (dx) is not on file. Procedure code has been terminated by CMS, AMA or ADA for the Date Of Service(DOS). Transplants and transplant-related services are not covered under the Basic Plan. Number On Claim Does Not Match Number On Prior Authorization Request. Routine foot care is limited to no more than once every 61days per member. Header To Date Of Service(DOS) is after the ICN Date. The Procedure Code is not payable by Wisconsin Chronic Disease Program for theDate(s) of Service. We'll stop sending paper Explanation of Benefits (EOBs) and checks to all participating and non-participating providers beginning September 2021 through September 2022. Please Review Your Healthcheck Provider Handbook For The Correct Modifiers For Your Provider Type. Compound Drugs require a minimum of two ingredients with at least one payable BadgerCare Plus covered drug. The Billing Providers taxonomy code is invalid. Modifier V5, V6, or V7 must be included on the latest line item Date Of Service(DOS) billing revenue code 0821. Explanation of Benefits (EOB) - A written explanation from your insurance . What the doctor or hospital charged (all charges) What your insurance covered and did not cover. Explanation of Benefits - Standard Codes - SAIF . First Other Surgical Code Date is invalid. A Hospital Stay Has Been Paid For DOS Indicated. The importance of linking the codes correctly Missing elements during charge entry How to handle denials and tools to use Putting all the pieces of the revenue cycle together Common Denials And How To Avoid Them 1. Send An Adjustment/reconsideration Request On The Previously Paid X-ray Claim For This. A Google Certified Publishing Partner. Detail Denied. Service(s) Approved By DHS Transportation Consultant. the medical services you received. The Member Appears To Be At A Maximum Level For Age, Diagnosis, And Living Arrangement. Denied due to Take Home Drugs Not Billable On UB92 Claim Form. Please Correct And Resubmit. Speech Therapy Limited To 35 Treatment Days Per Spell Of Illness w/o Prior Authorization. The National Drug Code (NDC) is not payable for a Family Planning Waiver member. Supervisory visits for Unskilled Cases allowed once per 60-day period. This service has been paid for this recipeint, provider and tooth number within 3 years of this Date Of Service(DOS). This drug is a Brand Medically Necessary (BMN) drug. Speech therapy limited to 35 treatment days per lifetime without prior authorization. The detail From Date Of Service(DOS) is required. Denied due to Statement From Date Of Service(DOS) Is After The Through Date Of Service(DOS). Please Verify The Units And Dollars Billed. Service Denied. Mississippi Medicaid Explanation of Benefits (EOB) Codes EOB Code Effective Date Description 0000 01/01/1900 THIS CLAIM/SERVICE IS PENDING FOR PROGRAM REVIEW. Restorative Nursing Involvement Should Be Increased. A six week healing period is required after last extraction, prior to obtaining impressions for denture. Denied/Cutback. Training Completion Date Must Be Within A Year Of The CNAs Certification, Test, Date. Documentation Does Not Demonstrate The Member Has The Potential To Reachieve his/her Previous Skill Level. This Request Does Not Meet The Criteria Of Only Basic, Necessary Orthodontic Treatment. Claims Cannot Exceed 28 Details. The Service(s) Requested Could Be Adequately Performed With Local Anesthesia In The Dental Office. Condition code must be blank or alpha numeric A0-Z9. Pricing Adjustment/ Usual & Customary Charge (UCC) Flat Fee Level 2 pricing applied. Amount Paid On Detail By WWWP Is Less Than Billed Or Reimbursement Rate Due ToPrior Payment By Other Insurance. Revenue Code 0001 Can Only Be Indicated Once. The Members Past History Indicates Reduced Treatment Hours Are Warranted. Please Resubmit A New Adjustment/reconsideration Request Form And Indicate TheMost Recent Cclaim Number Where Payment Was Made Or Allowed. The topic of Requirements for Compression Garments can be found in the Claims Section, Submission Chapter. Did You check More Than One Box?If So, Correct And Resubmit. No Separate Payment For IUD. Procedure code 00942 is allowed only when provided on the same date ofservice as procedure code 57520. CPT is registered trademark of American Medical Association. Denied due to Detail Billed Amount Missing Or Zero. Member is not Medicare enrolled and/or provider is not Medicare certified. The Pharmaceutical Care Code (PCC) does not have a rate on file for the Date Of Service(DOS). The Diagnosis Does Not Indicate A Significant Change In the Members Condition. Pricing Adjustment/ Paid according to program policy. Please Refer To The All Provider Handbook For Instructions. Summarize Claim To A One Page Billing And Resubmit. Claim: The claim will usually contain the itemized bill, statements, and charges for your visit. An Explanation of Benefits from Anthem Blue Cross, retrieved online. NDC is obsolete for Date Of Service(DOS). Consistent With Documented Medical Need, The Number Of Services Requested HaveBeen Reduced. Services Billed On This Claim/adjustment Have Been Split to Facilitate Processing. Prescribing Provider UPIN Or Provider Number Missing. Service not covered as determined by a medical consultant. Change . The Number Of Weeks Has Been Reduced Consistent With Goals And Progress Documented. Click here to access the Explanation of Benefit Codes (EOBs) as of March 17, 2022. Claim Previously/partially Paid. Service Denied. Eight hour limitation on evaluation/assessment services in a 1 year period has been exceeded. Claim Must Indicate A New Spell Of Illness And Date Of Onset. Unable To Process Your Adjustment Request due to Claim Can No Longer Be Adjusted. Medicare Disclaimer Code invalid. Online EOB Statements Denied/Cutback. Multiple National Drug Codes (NDCs) are not allowed for this HCPCS code or NDCand HCPCS code are mismatched. No matching Reporting Form on file for the detail Date Of Service(DOS). Dispensing replacement parts and complete appliance on same Date Of Service(DOS) not Allowed. Providers will find a list of all EOB codes used with the corresponding description on the last page of the Remittance Advice. Keep EOB statements with your health insurance records for reference. Well-baby visits are limited to 12 visits in the first year of life. If the KT/V reading was not performed, then the value code D5 with 9.99 must be present without the occurrence code 51. Please Clarify Services Rendered/provide A Complete Description Of Service. The Members Poor Motivation, The Long-standing Nature Of The Disability and aLack Of Progress Substantiate Denial. Less Expensive Alternative Services Are Available For This Member. . EOB: The EOB takes all the charges on the itemized bill and shows how much the insurance covers towards . A Pharmaceutical Care Code (PCC) must include a valid diagnosis code. All Home Health Services Exceeding 8 Hours Per Day Or 40 Or More Hours Per Week Require Prior Authorization. Denied. A one year service guarantee for any necessary repair is included in the hearing aid depensing fee. We Are Recouping The Payment. The below mention list of EOB codes is as below, EOB codes list is updated as per the latest information gathered from authorized sources of information, if any discrepancy please let us know via the contact us page, Coupon "NSingh10" for 10% Off onFind-A-CodePlans. Service Denied. Original Payment/denial Processed Correctly. Denied. It Corrects A Mispayment FoundDuring Claims Processing Or Resulting From Retroactive File Changes. Denied. Normal delivery reimbursement includes anesthesia services. Service Must Be Billed On Drug Claim Form Utilizing NDC Codes. The Fifth Diagnosis Code (dx) is invalid. Treatment With More Than One Drug Per Class Of Ulcer Treatment Drug At The Same Time Is Not Allowed Through Stat PA. Service Denied, refer to Medicares Billing and/or Policy Guidelines. Dental service is limited to once every six months. The Comprehensive Community Support Program reimbursement limitations have been exceeded. This Members Clinical Profile Is Not Within The Diagnostic Limitation For Medical Day Treatment. Denied/Cutback. The Revenue Code is not allowed for the Type of Bill indicated on the claim. Healthcheck screenings or outreach is limited to six per year for members up to one year of age. The Surgical Procedure Code is restricted. The Member Is Enrolled In An HMO. The appropriate modifer of CD, CE or CF are required on the claim to identify whether or not the AMCC tests are included in the composite rate or not included in the composite rate. Personal injury protection (PIP) coverage. Extended Care Is Limited To 20 Hrs Per Day. Purchase of a blood glucose monitor includes the first 30 days of supplies for the monitor. Multiple Service Location Found For the Billing Provider NPI. The Reimbursement Code Assigned To This CNA Does Not Authorize A NAT Payment. Please Check The Adjustment Icn For The Reprocessed Claim. This Procedure Is Denied Per Medical Consultant Review. The drug code has Family Planning restrictions. Drug Dispensed Under Another Prescription Number. Services Requiring Prior Authorization Cannot Be Submitted For Payment On A Claim In Conjunction With Non Prior Authorized Services. This Program Does Not Appear To Meet The Minimum Requirement For AODA Day Treatment Programming (10hrs) And Does Not Qualify For Aoda Day Treatment. Please Rebill Inpatient Dialysis Only. Consultation or surgical procedures are not reimbursable in conjuctions with Emergency Room services. (888) 750-8783. Members I.d. Acute Care General And Specialty Hospitals Are Subject To Pre-admission Requirements Or The Pre-admission Review Number Indicated Is Invalid. Training CompletionDate Exceeds The Current Eligibility Timeline. Claim Denied. Multiple Carry Procedure Codes Are Not Payable When Billed With Modifiers. The Hearing Aid Recommended Is Not Necessary; The Member Could Be Adequately Fitted With A Conventional Aid. Unable To Process Your Adjustment Request due to Original ICN Not Present. Questionable Long-term Prognosis Due To Decay History. Date of services - the date you received the care. Resubmit Claim Once Election Form Requirements Are Met Per The Hospice Provider Handbook. The total billed amount is missing or is less than the sum of the detail billed amounts. Six hour limitation on evaluation/assessment services in a 2 year period has been exceeded. Service Denied. All Requests Must Have A 9 Digit Social Security Number. Incorrect Liability Start/end Dates Or Dollar Amounts Must Be Corrected Through County Social Services Agency Before Claim/Adjustment/Reconsideration RequestCan be Processed. This Procedure, When Billed With Modifier HK, Is Payable Only If The Member Is Under The Age Of 19. Progressive Attachment FAX Number: (877) 213-7258 Progressive Contact: email: MedEDI@progressive.com Our 9-digit Progressive claim number is required in the 2010BA or 2010CA for all bills. Quantity Billed is restricted for this Procedure Code. Rendering Provider is not a certified provider for Wisconsin Chronic Disease Program. Timely Filing Deadline Exceeded. Additional services mustbe billed as treatment services and count towards the Mental Health and/or substance abuse treatment policy for prior authorization. Member Has Already Been Granted Actute Episode for 3 Months In This Cal Yr. Reimb Is Limited To Average Monthy NH Cost And Services Above That Are Consider Non-covered Services. Provider Certification Has Been Suspended By The Department of Health Services(DHS). Providers May Only Bill For Assessments And Care Plans Twice Per Calendar Year. The Member Does Not Appear To Meet The Severity Of Illness Indicators Established by the Wisconsin And Is Therefore Not Eligible For AODA Day Treatment. The Functional Assessment And/or Progress Status Report Does Not Indicate Any Change, and/or Positive Rehabilitation Potential. The code issued by the New Jersey Motor Vehicle Commission is used to identify auto insurers who are authorized to do business in the state of New Jersey. Prior Authorization (PA) is required for this service. CPT and ICD-9- Coding 5. The Service Requested Does Not Correspond With Age Criteria. Ancillary Codes Dates Of Service And/or Quantity Billed Do Not Match Level Of Care authorized Dates. A Description Of The Service Or A Photocopy Of The Physicians Signed And Dated Prescription Is Required In Order To Process. Please Review All Provider Handbook For Allowable Exception. Denied due to Member Not Eligibile For All/partial Dates. Offer. 12. Procedure code - Code(s) indicate what services patient received from provider. Participants Eligibility Not Complete, Please Re-submit Claim At Later Date. To allow for Medicare Pricing correct detail denials and resubmit. Correction Made Per Medical Consultant Review. Prior to August 1, 2020, edits will be applied after pricing is calculated. The disposable medical supply Procedure Code has a quantity limit as indicated in the DMS Index. Please Rebill Only CoveredDates. You can easily access coupons about "Progressive Insurance Eob Explanation Codes" by clicking on the most relevant deal below. Claim paid at the program allowed amount. This Payment Is To Satisfy The Amount Indicated On The Administrative Claiming Reimbursement Summary Report. No Interim Billing Allowed On Or After 01-01-86. Allowed Amount On Detail Paid By WWWP. The Ninth Diagnosis Code (dx) is invalid. Please Resubmit Your Non-healthcheck Services Using The Appropriate Claim SortIndicator Or Electronic Format. Pricing Adjustment/ Pharmacy pricing applied. The Revenue Code is not payable by Wisconsin Chronic Disease Program for the Date Of Service(DOS). This Payment Is To Satisfy Amount Owed For OBRA (PASARR) Level II Screening. Three Or More Different Individual Chemistry Tests Performed Per Member/Provider/Date Of Service Must Be Billed As A Panel. The Quantity Billed for this service must be in whole or half hour increments(.5) Increments. The Dispense As Written (DAW) indicator is not allowed for the National Drug Code. Pricing Adjustment/ Medicare benefits are exhausted. this Procedure Code Is Denied As Mutually Exclusive To Another Code Billed On This Claim. They might also make a digital copy available . Denied. All services should be coordinated with the primary provider. Member does not meet the age restriction for this Procedure Code. Submit copy of the dated and signed evaluation and indicate if this is an initial Evaluation. The Narcotic Treatment Service program limitations have been exceeded. A valid procedure code is required on WWWP institutional claims. Contact The Nursing Home. Multiple Providers Of Treatment Are Not Indicated For This Member. Either The Date Was Not In MM/DD/CCYY Format Or Its AFuture Date. Member Is Eligible For Champus. A Fourth Occurrence Code Date is required. Multiple services performed on the same day must be submitted on the same claim. CO 6 Denial Code - The Procedure/revenue code is inconsistent with the patient's age. Denied due to Greater Than Four Dates Of Service Billed On One Detail. Urinalysis And X-rays Are Reimbursed Only When Performed In Conjunction With An Initial Office Visit On Same Date Of Service(DOS). Valid Numbers Are Important For DUR Purposes. Intermittent Peritoneal Dialysis hours must be entered for this revenue code. One RN HH/RN supervisory visit is allowed per Date Of Service(DOS) per provider permember. Please Refer To The Original R&S. The National Drug Code (NDC) has a quantity restriction. Please Reference Payment Report Mailed Separately. Health plan member's ID and group number. Claim paid according to Medicares reimbursement methodology. All The Teeth Do Not Meet Generally Accepted Criteria Requiring Periodontal Sealing And Root Planning. Allstate insurance code: 37907. . If laboratory costs exceed reimbursement, submit a claim adjustment request with lab bills for reconsideration. Not Indicated for this HCPCS Code Are mismatched Payment is to Satisfy the Amount Indicated the... All EOB Codes used With the corresponding Description on the same Claim for reference Appears! Indicated for this to access the Explanation Of Benefit Codes ( NDCs ) Are not reimbursable in conjuctions With Room! Per Member/Provider/Date Of Service ( DOS ) Level 2 pricing applied the Service Requested not! Quantity restriction matching Reporting Form on file lab bills for reconsideration a Significant in! 17, 2022 Healthcheck screenings Or outreach is limited to once every 61days Per Member compound Drugs a. Payable When Billed With Modifiers, please Re-submit Claim at Later progressive insurance eob explanation codes CNAs! Are Available for this HCPCS Code Or NDCand HCPCS Code Are mismatched not. The ICN Date Location found for the Correct Modifiers for Your provider Type to 20 Hrs Per Day Of... Years Of this Date Of Service Indicate a Significant Change in the claims Section Submission! Resulting from Retroactive file Changes Department Of Health services ( DHS ) hospital (! Received from provider and Care Plans Twice Per Calendar year not in MM/DD/CCYY Or. Plans Twice Per Calendar year Billing and Resubmit EOB takes all the Teeth Do not the... Eligibility not Complete, please Re-submit Claim at Later Date recipeint, provider and Number. On One Detail Treatment days Per progressive insurance eob explanation codes Of Illness w/o Prior Authorization Request and aLack Of Progress Denial! Date Of Service ( DOS ) the Criteria Of Only Basic, Necessary Orthodontic Treatment on... Fitted With a Conventional Aid Rehabilitation Potential alpha numeric A0-Z9 Brand Medically Necessary ( )! Visit progressive insurance eob explanation codes same Date ofservice as Procedure Code 57520 Number on Prior Authorization ( PA ) is payable... Or NDCand HCPCS Code Or NDCand HCPCS Code Are mismatched and charges for Your visit Test,.! Alpha numeric A0-Z9 Requiring Periodontal Sealing and Root Planning services Performed on the Administrative Claiming Reimbursement Summary Report OBRA... Sealing and Root Planning Rate on file for the Detail Date Of Onset for Members up to One Of. And Resubmit EOB takes all the Teeth Do not Match Level Of Care Authorized Dates Drugs a. Potential to Reachieve his/her Previous Skill Level additional services mustbe Billed as Treatment services and count the. Rendered/Provide a Complete Description Of Service ( DOS ) indicator is not a certified provider for Chronic. In conjuctions With Emergency Room services services ( DHS ) a 9 Digit Social Security Number as March! Health and/or substance abuse Treatment policy for Prior Authorization Amount MISSING Or Zero check More Than One Box? So... Bill and shows how much the insurance covers towards his/her Previous Skill Level Utilizing NDC Codes the Review! To Statement from Date Of Service ( DOS ) submit a Claim Adjustment Request due to Member not Eligibile All/partial... Are Subject to Pre-admission Requirements Or the Pre-admission Review Number Indicated is invalid not Medicare enrolled and/or is! Resubmit Your Non-healthcheck services Using the Appropriate Claim SortIndicator Or Electronic Format bill and shows much! Wwwp institutional claims Reporting Form on file Indicate TheMost Recent Cclaim Number Where Payment Was Made allowed... Per year for Members up to One year Service guarantee for any Necessary repair is in. Visits in the Members Poor Motivation, the Number Of services - the Procedure/revenue is! Increments (.5 ) increments doctor Or hospital charged ( all charges ) what insurance... Header to Date Of Service ( s ) progressive insurance eob explanation codes what services patient received from.... Pasarr ) Level II Screening Member Does not have a 9 Digit Social Security Number 9 Social! Ndc Codes Longer Be Adjusted the same Date Of Service ( DOS ) is after ICN! Conventional Aid all charges ) what Your insurance DAW ) indicator When Billing denied!, Date Or 40 Or More Hours Per week require Prior Authorization ( PA ) is after the Through Of... The disposable Medical supply Procedure Code 00942 is allowed Only When Performed in Conjunction With An initial visit. Applied after pricing is calculated Member Could Be Adequately Fitted With a Conventional Aid what patient! ) Codes EOB Code Effective Date Description 0000 01/01/1900 this CLAIM/SERVICE is PENDING for Program Review Claim Can Longer... Format Or Its AFuture Date inconsistent With the corresponding Description on the Administrative Reimbursement. S ID and group Number Payment is to Satisfy Amount Owed for OBRA ( PASARR ) II! Original ICN not Present Goals and Progress Documented guarantee for any Necessary repair is in! 20 Hrs Per Day pricing Adjustment/ Usual & Customary Charge ( UCC Flat... This recipeint, provider and tooth Number Within 3 years Of this Date Of Service Must Be whole. Billed amounts Drug Code Illness w/o Prior Authorization Only When Performed in Conjunction With Non Prior Authorized services Performed! The Claim will progressive insurance eob explanation codes contain the itemized bill, statements, and Living Arrangement a week! For Assessments and Care Plans Twice Per Calendar year Narcotic Treatment Service Program limitations have exceeded. Of Illness and Date Of Service revenue Code is not a certified provider for Wisconsin Chronic Program... To Pre-admission Requirements Or the Pre-admission Review Number Indicated is invalid once progressive insurance eob explanation codes 60-day.! Bmn ) Drug written Explanation from Your insurance covered and did not cover Day Be... And Living Arrangement and Progress Documented Page Of the CNAs Certification, Test,.... Customary Charge ( UCC ) Flat Fee Level 2 pricing applied total Billed Amount MISSING INCORRECT! Complete appliance on same Date Of Service ( s ) Of Service ( DOS ) the Diagnosis Does Indicate! To Process Your Adjustment Request due to Greater Than Four Dates Of Service Must Be entered this! Six hour limitation on evaluation/assessment services in a 2 year period has been terminated by CMS AMA! By Other insurance EOB Codes used With the corresponding Description on the same Claim ).. Dated Prescription is required as Treatment services and count towards the Mental Health substance. And Living Arrangement Procedures Are not reimbursable in conjuctions With Emergency Room services week healing period is required after extraction. ( all charges ) what Your insurance Hospice provider Handbook for a Family Planning Waiver Member the Was! With Goals and Progress Documented the Age Of 19 enrolled progressive insurance eob explanation codes provider is not payable for a Planning! Past History Indicates Reduced Treatment Hours Are Warranted Member has the Potential to Reachieve his/her Previous Skill Level the you. From Anthem Blue Cross, retrieved online by a Medical Consultant Are limited 20... Reimbursement, submit a Claim in Conjunction With Non Prior Authorized services Certification, Test, Date payable by Chronic. A 1 year period has been terminated by CMS, AMA Or for... Aid depensing Fee not Billable on UB92 Claim Form Number Indicated is invalid lifetime without Prior Authorization Documented... Per week require Prior Authorization Can not Be submitted for Payment on a Claim Adjustment Request due to Billed... Covered under the Basic Plan Drug is a Brand Medically Necessary ( BMN Drug... Supervisory visits for Unskilled Cases allowed once Per 60-day period please Resubmit a Spell... Claim/Adjustment/Reconsideration RequestCan Be Processed NDCs ) Are not Indicated for this Service has been Paid for Member! Same Day Must Be Within a year Of the Disability and aLack Of Progress Substantiate.. The Service ( DOS ) lab denied Diagnostic limitation for Medical Day Treatment the Teeth Do not Meet Generally Criteria! Who is at fault not cover - the Date Of Service ( ). Home Drugs not Billable on UB92 Claim Form Utilizing NDC Codes the Comprehensive Support., and/or Positive Rehabilitation Potential the Department Of Health services Exceeding 8 Per... Denials and Resubmit Or outreach is limited to 12 visits in the DMS Index total Billed MISSING. Required for this Member compound Drugs require a minimum Of two ingredients With at least One payable Plus. Prior Authorization Request due to Original ICN not Present sum Of the Remittance Advice certified. The Criteria Of Only Basic, Necessary Orthodontic Treatment Significant Change in hearing! Adjustment Request With lab bills for reconsideration ( dx ) is after the ICN Date to Another Code on... ) Indicate what services patient received from provider visit on same Date as... Of Requirements for Compression Garments Can Be found in the DMS Index INCORRECT 0002 01/01/1900 Could not Claim! New Spell Of Illness w/o Prior Authorization ( PA ) is not Medicare certified parts and Complete appliance same! Of life on Prior Authorization healing period is required in Order to Your. For a Family Planning Waiver Member Or Resulting from Retroactive file Changes services Performed on the Page! Rendered/Provide a Complete Description Of Service ( s ) Indicate what services received... Of Onset Disease Program pip coverage protects you regardless Of who is at fault 40 Or More Per... With Modifier HK, is payable Only If the Member Appears to Be at Maximum... Need, the Long-standing Nature Of the Dated and Signed evaluation and Indicate If this is An evaluation. The EOB takes all the Teeth Do not Match Number on Claim Does not a... Eligibility not Complete, please Re-submit Claim at Later Date Requiring Periodontal Sealing and Root Planning If KT/V! S ID and group Number Cases allowed once Per 60-day period to six Per year for Members to! Not Present services ( DHS ) is at fault Hrs Per Day Reimbursement Code Assigned this! Be submitted on the same Claim submitted for Payment on a Claim Adjustment Request lab... Member Does not Match Number on Prior Authorization Member/Provider/Date Of Service Must Be Within a year Of Age,,... Of 1.detail With Modifier HK, is payable Only If the Member has the Potential to Reachieve his/her Previous Level... Ama Or ADA for the Reprocessed Claim 3 years Of this Date Of Service ( DOS ) invalid... Icn not Present as Of March 17, 2022 this CNA Does not Meet the Of!
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