05-15221. Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2006

AGENCY:

Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION:

Final rule.

SUMMARY:

In this final rule we update the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs), for fiscal year (FY) 2006. Annual updates to the PPS rates are required by section 1888(e) of the Social Security Act (the Act), as amended by the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (BBRA), the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA), and the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), relating to Medicare payments and consolidated billing for SNFs. This final rule also responds to public comments submitted on the proposed rule published on May 19, 2005 (70 FR 29070), and promulgates provisions set forth in that proposed rule, along with several additional technical revisions to the regulations.

DATES:

Effective Date: This final rule becomes effective on October 1, 2005.

FOR FURTHER INFORMATION CONTACT:

Ellen Gay, [phone] (for information related to the case-mix classification methodology, and for information related to swing-bed providers).

Jeanette Kranacs, [phone] (for information related to the development of the payment rates, and for information related to the wage index).

Bill Ullman, [phone] (for information related to coverage requirements, level of care determinations, consolidated billing, and general information).

SUPPLEMENTARY INFORMATION:

To assist readers in referencing sections contained in this document, we are providing the following Table of Contents.

Table of Contents

I. Background

A. Current System for Payment of SNF Services Under Part A of the Medicare Program

B. Requirements of the Balanced Budget Act of 1997 (BBA) for Updating the SNF PPS

C. The Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (BBRA)

D. The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA)

E. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA)

F. General Overview of the SNF PPS

1. Payment Provisions—Federal Rates

2. Payment Provisions—Initial Transition Period

G. Use of the SNF Market Basket Index

II. Summary of the Provisions of the FY 2006 Proposed Rule

III. Analysis of and Response to Public Comments on the FY 2006 Proposed Rule

A. General Comments on the FY 2006 Proposed Rule

1. Public Comment Schedule for the FY 2006 Proposed Rule

B. Update of Federal Payment Rates Under the SNF PPS

1. Costs and Services Covered by the Federal Rates

2. Methodology Used for the Calculation of the Federal Rates

C. Case-Mix Adjustment and Other Clinical Issues

1. Proposed Refinements to the RUG-III Case-Mix Classification System

2. Proposed Increases to the RUG-III Case-Mix Weight Values

3. Implementation Issues

4. Additional Clinical and Related Issues

a. Proposed Changes to the MDS Coding Requirements (“Look-Back” Period, 5-day Grace Periods for PPS MDS Assessments, and Projection of Anticipated Therapy Services during the 5-day PPS Assessment (Section T))

b. Long-Term Payment and Quality Incentive Proposals

c. Proposal to Clarify “Direct” and “Indirect” Employment Relationships for Nurse Practitioners and Clinical Nurse Specialists

d. Completion of Other Medicare Required Assessments (OMRAs)

e. Concurrent Therapy

5. Case-Mix Adjusted Federal Rates and Associated Indexes

D. Wage Index Adjustment to Federal Rates

1. Proposal to Incorporate the Revised OMB Definitions for Metropolitan Statistical Areas and Combined Statistical Areas

2. Determining the Labor-Related Portion of the SNF PPS Rate

3. Calculating the Budget Neutrality Factor

E. Updates to the Federal Rates

F. Relationship of Case-Mix Classification System to Existing SNF Level-of-Care Criteria

1. Proposals on the 9 New Rehabilitation Plus Extensive Services Groups

G. Example of Computation of Adjusted PPS Rates and SNF Payment

H. SNF Market Basket Index

1. Background

2. Use of the SNF Market Basket Percentage

3. Market Basket Forecast Error Adjustment

4. Federal Rate Update Factor

I. Consolidated Billing

J. Application of the SNF PPS to SNF Services Furnished by Swing-Bed Hospitals

K. Qualifying Three-Day Inpatient Hospital Stay Requirement

IV. Provisions of the Final Rule

V. Waiver of Proposed Rulemaking

VI. Collection of Information Requirements

VII. Regulatory Impact Analysis

A. Overall Impact

B. Anticipated Effects

C. Accounting Statement

D. Alternatives Considered Regulation Text

VIII. Addendum

In addition, because of the many terms to which we refer by abbreviation in this final rule, we are listing these abbreviations and their corresponding terms in alphabetical order below:

ADL Activity of Daily Living

ARD Assessment Reference Date

BBA Balanced Budget Act of 1997, Pub. L. 105-33

BBRA Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999, Pub. L. 106-113

BEA (U.S. Department of Commerce) Bureau of Economic Analysis

BIPA Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000, Pub. L. 106-554

CAH Critical Access Hospital

CBSA Core-Based Statistical Area

CFR Code of Federal Regulations

CMS Centers for Medicare & Medicaid Services

CMSA Consolidated Metropolitan Statistical Area

CPT (Physicians') Current Procedural Terminology

DRG Diagnosis Related Group

FI Fiscal Intermediary

FR Federal Register

FY Fiscal Year

GAO Government Accountability Office

HCPCS Healthcare Common Procedure Coding System

ICD-9-CM International Classification of Diseases, Ninth Edition, Clinical Modification

IFC Interim Final Rule With Comment Period

MDS Minimum Data Set

MEDPAR Medicare Provider Analysis and Review File

MMA Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Pub. L. 108-173

MSA Metropolitan Statistical Area

NECMA New England County Metropolitan Area

OIG Office of Inspector General

OMRA  Other Medicare Required Assessment

PMSA Primary Metropolitan Statistical Area

PPI Producer Price Index

PPS Prospective Payment System

PRM Provider Reimbursement Manual

RAI Resident Assessment Instrument

RAP Resident Assessment Protocol

RAVEN Resident Assessment Validation Entry

RFA Regulatory Flexibility Act, Pub. L. 96-354

RIA Regulatory Impact Analysis

RUG Resource Utilization Group

SCHIP  State Children's Health Insurance Program

SNF Skilled Nursing Facility

STM Staff Time Measurement

UMRA Unfunded Mandates Reform Act, Pub. L. 104-4

I. Background

On May 19, 2005, we published a proposed rule in the Federal Register (70 FR 29070, hereafter referred to as the FY 2006 SNF PPS proposed rule), setting forth the proposed updates to the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs), for FY 2006. Annual updates to the PPS rates are required by section 1888(e) of the Social Security Act (the Act), as amended by the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (BBRA, Pub. L. 106-113), the Medicare, Medicaid, and SCHIP Benefits Improvement and rotection Act of 2000 (BIPA, Pub. L. 106-554), and the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA, Pub. L. 100-173), relating to Medicare payments and consolidated billing for SNFs. In the FY 2006 SNF PPS proposed rule, we invited public comments on a number of proposed revisions and technical corrections to the regulations.

A. Current System for Payment of SNF Services Under Part A of the Medicare Program

Section 4432 of the Balanced Budget Act of 1997 (BBA, Pub. L. 105-33) amended section 1888 of the Act to provide for the implementation of a per diem PPS for SNFs, covering all costs (routine, ancillary, and capital-related) of covered SNF services furnished to beneficiaries under Part A of the Medicare program, effective for cost reporting periods beginning on or after July 1, 1998. We are updating the per diem payment rates for SNFs for FY 2006. Major elements of the SNF PPS include:

• Rates. Per diem Federal rates were established for urban and rural areas using allowable costs from FY 1995 cost reports. These rates also included an estimate of the cost of services that, before July 1, 1998, were paid under Part B but furnished to Medicare beneficiaries in a SNF during a Part A covered stay. The rates were adjusted annually using a SNF market basket index. Rates were case-mix adjusted using a classification system (Resource Utilization Groups, version III (RUG-III)) based on beneficiary assessments (using the Minimum Data Set (MDS) version 2.0) (In section III.C of this final rule, we discuss refinements to the case-mix classification system). The rates were also adjusted by the hospital wage index to account for geographic variation in wages. (In section III.D of this final rule, we discuss the wage index adjustment in detail.) Correction notices were published in the Federal Register on October 7, 2004 (69 FR 60158) and on December 30, 2004 (69 FR 78445) that announced corrections to several of the wage factors. Additionally, as noted in the July 30, 2004 update notice (69 FR 45775), section 101 of BBRA and certain sections of BIPA also affect the payment rate.
• Transition. The SNF PPS included an initial 3-year, phased transition that blended a facility-specific payment rate with the Federal case-mix adjusted rate. For each cost reporting period after a facility migrated to the new system, the facility-specific portion of the blend decreased and the Federal portion increased in 25 percentage point increments. For most facilities, the facility-specific rate was based on allowable costs from FY 1995; however, since the last year of the transition was FY 2001, all facilities were paid at the full Federal rate by the following fiscal year (FY 2002). Therefore, as discussed in section I.F.2 of this final rule, we are no longer including adjustment factors related to facility-specific rates for the coming fiscal year.
• Coverage. The establishment of the SNF PPS did not change Medicare's fundamental requirements for SNF coverage. However, because the RUG-III classification is based, in part, on the beneficiary's need for skilled nursing care and therapy, we have attempted, where possible, to coordinate claims review procedures involving level of care determinations with the outputs of beneficiary assessment and RUG-III classifying activities. We discuss this coordination in greater detail in section III.F of this final rule. Moreover, the Part A SNF benefit has not only level of care requirements, but also a set of technical, or “posthospital” requirements as well. In section III.K of this final rule, we discuss one aspect of the technical requirement for a qualifying prior inpatient hospital stay of at least 3 consecutive days, on which we invited public comment in the FY 2006 SNF PPS proposed rule.
• Consolidated Billing. The SNF PPS includes a consolidated billing provision that requires a SNF to submit consolidated Medicare claims for almost all of the services that the resident receives during the course of a covered Part A stay. (In addition, this provision places with the SNF the Medicare billing responsibility for physical and occupational therapy, and speech-language pathology services that the resident receives during a noncovered stay.) The statute excludes from the consolidated billing provision a few services—primarily those of physicians and certain other types of practitioners—which remain separately billable to Part B by the outside entity that furnishes them. We discuss this provision in greater detail in section III.I of this final rule.
• Application of the SNF PPS to SNF services furnished by swing-bed hospitals. Section 1883 of the Act permits certain small, rural hospitals to enter into a Medicare swing-bed agreement, under which the hospital can use its beds to provide either acute or SNF care, as needed. For critical access hospitals (CAHs), Part A pays on a reasonable cost basis for SNF services furnished under a swing-bed agreement. However, in accordance with section 1888(e)(7) of the Act, these services furnished by non-CAH rural hospitals are paid under the SNF PPS, effective with cost reporting periods beginning on or after July 1, 2002. A more detailed discussion of this provision appears in section III.J of this final rule.
• Technical corrections. We are also taking this opportunity to make certain technical corrections in the text of the regulations, as discussed in greater detail in section IV. of this final rule.

B. Requirements of the Balanced Budget Act of 1997 (BBA) for Updating the SNF PPS

Section 1888(e)(4)(H) of the Act requires that we publish in the Federal Register:

1. The unadjusted Federal per diem rates to be applied to days of covered SNF services furnished during the FY.

2. The case-mix classification system to be applied with respect to these services during the FY.

3. The factors to be applied in making the area wage adjustment with respect to these services.

In the July 30, 1999 final rule (64 FR 41670), we indicated that we would announce any changes to the guidelines for Medicare level of care determinations related to modifications in the RUG-III classification structure (see section III.F of this final rule).

Along with a number of other revisions discussed later in this preamble, this final rule provides the annual updates to the Federal rates as mandated by the Act.

C. The Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (BBRA)

There were several provisions in the BBRA that resulted in adjustments to the SNF PPS. These provisions were described in detail in the final rule that we published in the Federal Register on July 31, 2000 (65 FR 46770). In particular, sections 101(a) and (b) of the BBRA provided for a temporary 20 percent increase in the per diem adjusted payment rates for 15 specified RUG-III groups (SE3, SE2, SE1, SSC, SSB, SSA, CC2, CC1, CB2, CB1, CA2, CA1, RHC, RMC, and RMB). Under section 101(c) of the BBRA, this temporary increase remains in effect until the later of October 1, 2000, or the implementation of case-mix refinements in the PPS. (We discuss refinements to the case-mix classification system in section III.C of this final rule.) In addition, section 101(d) of the BBRA included a 4 percent across-the-board increase in the adjusted Federal per diem payment rates each year for FYs 2001 and 2002, exclusive of the 20 percent increase.

We included further information on all of the provisions of the BBRA that affect the SNF PPS in Program Memoranda A-99-53 and A-99-61 (December 1999), and Program Memorandus AB-00-18 (March 2000). In addition, for swing-bed hospitals with more than 49 (but less than 100) beds, section 408 of the BBRA provided for the repeal of certain statutory restrictions on length of stay and aggregate payment for patient days, effective with the end of the SNF PPS transition period described in section 1888(e)(2)(E) of the Act. In the July 31, 2001 final rule (66 FR 39562), we made conforming changes to the regulations in § 413.114(d), effective for services furnished in cost reporting periods beginning on or after July 1, 2002, to reflect section 408 of the BBRA.

D. The Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA)

The BIPA included several provisions that resulted in adjustments to the PPS for SNFs. These provisions were described in detail in the final rule that we published in the Federal Register on July 31, 2001 (66 FR 39562), as follows:

• Section 203 of the BIPA exempted critical access hospital (CAH) swing-beds from the SNF PPS; we included further information on this provision in Program Memorandum A-01-09 (January 16, 2001).
• Section 311 of the BIPA eliminated the 1 percent reduction in the SNF market basket that the statutory update formula had previously specified for FY 2001, and changed the 1 percent reduction specified for FYs 2002 and 2003 to a 0.5 percent reduction. This section also required us to conduct a study of alternative case-mix classification systems for the SNF PPS, and to submit a report to the Congress on the results of the study.
• Section 312 of the BIPA provided for a temporary 16.66 percent increase in the nursing component of the case-mix adjusted Federal rate for services furnished on or after April 1, 2001, and before October 1, 2002. This section also required the Government Accountability Office (GAO) to conduct an audit of SNF nursing staff ratios and submit a report to the Congress on whether the temporary increase in the nursing component should be continued. GAO issued this report (GAO-03-176) in November 2002.
• Section 313 of the BIPA repealed the consolidated billing requirement for services (other than physical and occupational therapy, and speech-language pathology services) furnished to SNF residents during noncovered stays, effective January 1, 2001.
• Section 314 of the BIPA adjusted the payment rates for all of the 14 rehabilitation RUGs (RUC, RUB, RUA, RVC, RVB, RVA, RHC, RHB, RHA, RMC, RMB, RMA, RLB, and RLA), in order to correct an anomaly under which the existing payment rates for three particular rehabilitation RUGs—RHC, RMC, and RMB—were higher than the rates for some other, more intensive rehabilitation RUGs. Under the BIPA adjustment, the temporary increase that sections 101(a) and (b) of the BBRA had applied to the RHC, RMC, and RMB rehabilitation RUGs was revised from 20 percent to 6.7 percent, and the BIPA adjustment also applied this temporary 6.7 percent increase to each of the other 11 rehabilitation RUGs. Under this provision, the temporary increase remained at 20 percent for each of the 12 non-rehabilitation RUGs specified in section 101(b) of the BBRA (SE3, SE2, SE1, SSC, SSB, SSA, CC2, CC1, CB2, CB1, CA2, and CA1).
• Section 315 of the BIPA authorized us to establish a geographic reclassification procedure that is specific to SNFs, but only after collecting the data necessary to establish a SNF wage index that is based on wage data from nursing homes.

We included further information on several of these provisions in Program Memorandum A-01-08 (January 16, 2001).

E. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA)

A provision of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) resulted in a further adjustment to the PPS for SNFs. Specifically, section 511 of the MMA amended paragraph (12) of section 1888(e) of the Act to provide for a temporary 128 percent increase in the PPS per diem payment for any SNF resident with Acquired Immune Deficiency Syndrome (AIDS), effective with services furnished on or after October 1, 2004. As discussed in Transmittal No. 160 (Change Request No. 3291, April 30, 2004, available online at http://www.cms.hhs.gov/​manuals/​transmittals/​comm_​date_​dsc.asp), this add-on applies to claims with diagnosis code 042. Like the temporary add-on payments created by section 101(a) of the BBRA (as amended by section 314 of the BIPA), this special AIDS add-on was not intended to remain in effect indefinitely. As amended by section 511 of the MMA, section 1888(e)(12)(B) of the Act specifies that this temporary increase for patients with AIDS is to remain in effect only until “* * * such date as the Secretary certifies that there is an appropriate adjustment in the case mix * * * to compensate for the increased costs associated with [such] residents * * *.” As discussed in the FY 2006 SNF PPS proposed rule (70 FR 29080), we are not addressing the issue of such certification at this time and, accordingly, the temporary add-on payments created by section 511 of the MMA will remain in effect during FY 2006.

The law further provided that the 128 percent increase in payment under the AIDS add-on is to be “* * * determined without regard to any increase” under section 101 of the BBRA (as amended by section 314 of the BIPA). As explained in the MMA Conference report, this means that if a resident qualifies for the temporary 128 percent increase in payment under the special AIDS add-on, “the BBRA temporary RUG add-on does not apply in this case * * *.” (H.R. Conf. Rep. No. 108-391 at 662).

In addition, section 410 of the MMA contained a provision that affects the SNF consolidated billing requirement's treatment of certain services furnished as of January 1, 2005, by rural health clinics (RHCs) and Federally qualified health centers (FQHCs). This provision was discussed in Transmittal No. 390 (Change Request No. 3575), issued on December 10, 2004, which is available online at http://www.cms.hhs.gov/​manuals/​transmittals/​comm_​date_​dsc.asp.

F. General Overview of the SNF PPS

We implemented the Medicare SNF PPS for cost reporting periods beginning on or after July 1, 1998. Under the PPS, we pay SNFs through prospective, case-mix adjusted per diem payment rates applicable to all covered SNF services. These payment rates cover all the costs of furnishing covered skilled nursing services (routine, ancillary, and capital-related costs) other than costs associated with approved educational activities. Covered SNF services include post-hospital services for which benefits are provided under Part A and all items and services that, before July 1, 1998, had been paid under Part B (other than physician and certain other services specifically excluded under the BBA) but furnished to Medicare beneficiaries in a SNF during a covered Part A stay. A complete discussion of these provisions appears in the May 12, 1998 interim final rule (63 FR 26252).

1. Payment Provisions—Federal Rate

The PPS uses per diem Federal payment rates based on mean SNF costs in a base year updated for inflation to the first effective period of the PPS. We developed the Federal payment rates using allowable costs from hospital-based and freestanding SNF cost reports for reporting periods beginning in FY 1995. The data used in developing the Federal rates also incorporated an estimate of the amounts that would be payable under Part B for covered SNF services furnished to individuals during the course of a covered Part A stay in a SNF.

In developing the rates for the initial period, we updated costs to the first effective year of PPS (the 15-month period beginning July 1, 1998) using a SNF market basket, and then standardized for the costs of facility differences in case-mix and for geographic variations in wages. The database used to compute the Federal payment rates excluded providers that received new provider exemptions from the routine cost limits, as well as costs related to payments for exceptions to the routine cost limits. In accordance with the formula prescribed in the BBA, we set the Federal rates at a level equal to the weighted mean of freestanding costs plus 50 percent of the difference between the freestanding mean and weighted mean of all SNF costs (hospital-based and freestanding) combined. We computed and applied separately the payment rates for facilities located in urban and rural areas. In addition, we adjusted the portion of the Federal rate attributable to wage-related costs by a wage index.

The Federal rate also incorporates adjustments to account for facility case-mix, using a classification system that accounts for the relative resource utilization of different patient types. This classification system, Resource Utilization Groups, version III (RUG-III), uses beneficiary assessment data from the Minimum Data Set (MDS) completed by SNFs to assign beneficiaries to one of 44 RUG-III groups. The May 12, 1998 interim final rule (63 FR 26252) included a complete and detailed description of the RUG-III classification system. A further discussion of the case-mix classification system, including the issue of case-mix refinements, appears in section III.C of this final rule.

The Federal rates in this final rule reflect an update to the rates that we published for FY 2005 equal to the full change in the SNF market basket index. According to section 1888(e)(4)(E)(ii)(IV) of the Act, for FY 2006, we have adjusted the current rates by the full SNF market basket index.

2. Payment Provisions—Initial Transition Period

The SNF PPS included an initial, phased transition from a facility-specific rate (which reflected the individual facility's historical cost experience) to the Federal case-mix adjusted rate. The transition extended through the facility's first three cost reporting periods under the PPS, up to, and potentially including, the one that began in FY 2001. (Further, once section 102 of the BBRA took effect, a facility could elect to bypass the remainder of its transition period and go directly to being paid entirely under the Federal rates.) Accordingly, starting with cost reporting periods beginning in FY 2002, we base payments entirely on the Federal rates and, as mentioned previously in this final rule, we no longer include adjustment factors related to facility-specific rates for the coming fiscal year.

G. Use of the SNF Market Basket Index

Section 1888(e)(5) of the Act requires us to establish a SNF market basket index that reflects changes over time in the prices of an appropriate mix of goods and services included in the covered SNF services. The SNF market basket index is used to update the Federal rates on an annual basis. The final rule published on July 31, 2001 (66 FR 39562) revised and rebased the market basket to reflect 1997 total cost data. The SNF market basket index is discussed in greater detail in section III.H of this final rule.

In addition, as explained in the FY 2004 final rule (68 FR 46058, August 4, 2003) and in section III.H of this final rule, the annual update of the payment rates includes, as appropriate, an adjustment to account for market basket forecast error. This adjustment takes into account the forecast error from the most recently available fiscal year for which there are final data, and is applied whenever the difference between the forecasted and actual change in the market basket exceeds a 0.25 percentage point threshold. For FY 2004 (the most recently available fiscal year for which there are final data), the estimated increase in the market basket index was 3.0 percentage points, while the actual increase also was 3.0 percentage points. Therefore, the payment rates for FY 2006 do not include a forecast error adjustment, as there is no difference between the estimated and actual amounts of change. Table 1 below shows the forecasted and actual market basket amounts for FY 2004.

Table 1.—FY 2004 Forecast Error Correction for CMS SNF Market Basket

Index	Forecasted FY 2004 increase*	Actual FY 2004 increase**	FY 2004 forecast error correction***
SNF	3.0	3.0	0.0
* Published in August 4, 2003 Federal Register; based on second quarter 2003 Global Insight/DRI-WEFA forecast.
** Based on the second quarter 2005 Global Insight/DRI-WEFA forecast.
*** The FY 2004 forecast error correction will be applied to the FY 2006 PPS update. Any forecast error less than 0.25 percentage points is not reflected in the update.

II. Summary of the Provisions of the FY 2006 Proposed Rule

The FY 2006 SNF PPS proposed rule included proposed updates to the FY 2006 Federal payment rates used under the SNF PPS. In accordance with section 1888(e)(4)(E)(ii)(IV) of the Act, the updates reflect the full SNF market basket percentage change for the fiscal year. We also proposed to introduce, as of January 1, 2006, a refined case-mix classification system that would add nine new Rehabilitation plus Extensive Services groups at the top of the existing RUG hierarchy. The FY 2006 SNF PPS proposed rule discussed and invited public comment on a number of other clinical issues as well, involving alternative ways to improve quality and efficiency and ensure accurate payments under the SNF PPS.

We also proposed to incorporate OMB's revised definitions for Metropolitan Statistical Areas and its new definitions of Micropolitan Statistical Areas and Combined Statistical Areas, and we invited comments on the appropriateness of implementing this change through a transition period similar to that adopted under the inpatient hospital PPS (IPPS). Further, we invited public comments on additional HCPCS codes that could represent the type of “high-cost, low probability” services within certain designated service categories (that is, chemotherapy and its administration, radioisotope services, and customized prosthetic devices) that section 103 of the BBRA has authorized us to exclude from the SNF consolidated billing provision. We also invited comments on the apparent hospital practice of having patients spend time in observation status prior to a formal inpatient admission, and on the potential implications of this practice for the SNF benefit's qualifying 3-day hospital stay requirement.

In addition to discussing these general issues in the FY 2006 SNF PPS proposed rule, we also proposed making the following specific revisions to the existing text of the regulations:

• In § 424.3, we would make a technical correction to the definition of “HCPCS”.
• In § 424.20, we would revise paragraph (e)(2) to clarify the distinction between “direct” and “indirect” employment relationships in terms of the ability of nurse practitioners and clinical nurse specialists to perform SNF certifications and recertifications.

More detailed information on each of these issues, to the extent that we received public comments on them, appears in the discussion contained in the following sections of this preamble.

III. Analysis of and Responses to Public Comments on the FY 2006 Proposed Rule

In response to the publication of the FY 2006 SNF PPS proposed rule, we received 149 timely items of correspondence from the public. We received numerous comments from various trade associations and major organizations. Comments also originated from nursing homes, hospitals, and other providers, suppliers, and practitioners, nursing home resident advocacy groups, health care consulting firms, and private citizens. The following discussion, arranged by subject area, includes a summary of the public comments that we received, and our responses to the comments appear under the appropriate heading.

A. General Comments on the FY 2006 SNF PPS Proposed Rule

1. Public Comment Schedule for the FY 2006 SNF PPS Proposed Rule

Comment: A few commenters noted that the July 12, 2005, closing date for the public comment period fell less than 60 days after the proposed rule's May 19, 2005, publication date in the Federal Register, and expressed concern about abbreviating the comment period available for the proposed rule. They asserted that a timeframe of less than 60 days was burdensome, and affected their ability to furnish comprehensive responses. They asked us to provide the full 60-day comment period in the future.

Response: We note that in accordance with the requirements of section 1871(b)(1) of the Act, “notice of the proposed regulation in the Federal Register” was provided as of May 13, 2005. At that same time, the document was also posted on the CMS website. Accordingly, the contents of the proposed rule were, in fact, available to the public for the full 60-day comment period.

B. Update of Federal Payment Rates Under the SNF PPS

This final rule sets forth a schedule of Federal prospective payment rates applicable to Medicare Part A SNF services beginning October 1, 2005. The schedule incorporates per diem Federal rates that provide Part A payment for all costs of services furnished to a beneficiary in a SNF during a Medicare-covered stay. In the proposed rule, we proposed case-mix refinements, including the introduction of 9 new RUGs. As part of this process, we proposed to update and recalibrate the therapy and nursing case-mix indexes associated with all RUGs. We also proposed to increase both the nursing and therapy case-mix indexes and provide additional funding to the system in order to account for the variation in non-therapy ancillary costs.

Comment: Several commenters expressed concern regarding the overall fiscal impact of the proposed changes and recommended that the aggregate expenditure levels be increased, either by further increasing the case-mix weights or by increasing the baseline expenditure levels. Other commenters stated that they had been unable to reconcile their independent analyses with the information contained in the proposed rule, and were concerned that the impact of the proposed rate structure would exceed the CMS projections. In other cases, commenters submitted technical questions on the accuracy of the methodology used in developing our proposals, and urged that these methodological issues be addressed for the final rule.

Response: Throughout the comment period, we examined the data presented in the proposed rule, updated the analyses to reflect the most recent available data, and corrected minor technical errors. We received information from industry representatives and others, which helped us to verify the accuracy of the data used in the rate calculations, and then to ensure that the resulting rates correctly reflected the policies specified in the proposed rule. To accomplish these objectives, we made several adjustments to our models to better reflect the methodologies described in the proposed rule.

For example, for our modeling in the proposed rule, we used a therapy case-mix index that originally had been created for use in our FY 2001 refinements proposal, and utilized the same therapy case-mix weights for the new groups as for the original rehabilitation groups; that is, the therapy case-mix weight for the ultra high rehabilitation and combined ultra high rehabilitation/extensive care RUG groups were the same. As part of our ongoing review, we also tested several adjustments to our model, including recalibration of the therapy case-mix weights, using different sets of decision rules, to create separate therapy weights for the nine new groups. The purpose of this exercise was to test whether the adjusted model(s) better reflected the policy outlined in the proposed rule.

Using the adjusted therapy case-mix weights, we repeated the payment simulation described in the proposed rule. We then recalculated the payment adjustment needed to ensure parity when comparing the aggregate expenditure levels of the 44-group and 53-group RUG models. We found that, in recalibrating both the nursing and therapy case-mix weights, applying the payment adjustment solely to the nursing case-mix weights was no longer appropriate. Thus, we tested a second adjustment to the model that modified the payment simulation provision to apply the payment adjustment to both the nursing and therapy case-mix weights. We posted the analyses on our CMS web site.

Industry representatives and others used these data to replicate these analyses, to suggest alternative methodologies, and to develop their formal comments on the proposed rule. Thus, the information exchange through the CMS website was productive, and was beneficial in terms of finalizing our analysis.

Comment: A commenter questioned the methodology used to recalibrate the therapy case-mix weights, and also expressed concerns about the small staff time measurement (STM) sample size used to create separate therapy weights for each of the RUG-III groups.

Response: As part of the ongoing analysis described above, we reviewed the methodology used to create the case-mix weights for the initial introduction of the SNF PPS in 1998, and the ABT recalibration that was published in our FY 2001 proposed rule. We found that, as mentioned by a commenter, we were relying on extremely small sample sizes for several of the combined rehabilitation and extensive care groups. In addition, we found several variations in the decision rules used in the two sets of analyses. We were able to adjust for these methodological differences by recreating the therapy case-mix indexes using the original decision rules.

Once these methodological changes were made, we examined the model to determine the potential impact of using small sample sizes to establish therapy case-mix weights for all 23 rehabilitation groups; that is, 14 existing rehabilitation groups and 9 combined rehabilitation and extensive care groups. We concluded that we could not fully adjust for these small sample sizes when recalibrating the therapy case-mix weights, either as proposed or as noted on our website. Therefore, we have determined that retaining the same therapy case-mix weights that are being used in the 44-group RUG model would best reflect our policy objectives as stated in the proposed rule. These weights will be applied to the RUG groups based on the rehabilitation level. For example, a therapy case-mix weight of 2.25 will be used for the RUC, RUB, RUA, RUX, and RUL groups.

Once the case-mix weight structure was determined, we developed the final rates in accordance with the procedures outlined in the proposed rule. As we updated the nursing case-mix index only, we then applied the payment simulation to the nursing case-mix weights by adding 8.65 percent to maintain parity between the 44-group and 53-group models. Then, a final adjustment of 8.51 percent was made to the nursing weights to reflect the variability in non-therapy ancillary utilization.

In conducting these analyses, it was clear that relying on data collected before the introduction of the SNF PPS is not a permanent solution. We intend to revisit the structural development of the case-mix weights as part of our upcoming STM study, in which we will survey SNFs and collect data to better reflect current practice patterns and resource use in the SNF PPS. In addition, we intend to investigate alternative methods of updating the payment system as part of our ongoing program monitoring and evaluation activities.

1. Costs and Services Covered by the Federal Rates

The Federal rates apply to all costs (routine, ancillary, and capital-related costs) of covered SNF services other than costs associated with approved educational activities as defined in § 413.85. Under section 1888(e)(2) of the Act, covered SNF services include post-hospital SNF services for which benefits are provided under Part A (the hospital insurance program), as well as all items and services (other than those services excluded by statute) that, before July 1, 1998, were paid under Part B (the supplementary medical insurance program) but furnished to Medicare beneficiaries in a SNF during a Part A covered stay. (These excluded service categories are discussed in greater detail in section V.B.2 of the May 12, 1998 interim final rule (63 FR 26295 through 26297)).

2. Methodology Used for the Calculation of the Federal Rates

The FY 2006 rates reflect an update using the full amount of the latest market basket index. The FY 2006 market basket increase factor is 3.1 percent. A complete description of the multi-step process was initially delineated in the May 12, 1998 interim final rule (63 FR 26252), and was further revised in subsequent rules. We note that in accordance with section 101(a) of the BBRA and section 314 of the BIPA, the existing, temporary increase in the per diem adjusted payment rates of 20 percent for certain specified clinically complex RUGs (and 6.7 percent for rehabilitation RUGs) remains in effect until January 1, 2006, when the refined RUG-53 classification system is implemented.

We used the SNF market basket to adjust each per diem component of the Federal rates forward to reflect price increases occurring between the midpoint of the Federal fiscal year beginning October 1, 2004, and ending September 30, 2005, and the midpoint of the Federal fiscal year beginning October 1, 2005, and ending September 30, 2006, to which the payment rates apply. In accordance with section 1888(e)(4)(E)(ii)(IV) of the Act, the payment rates for FY 2005 are updated by a factor equal to the full market basket index percentage increase to determine the payment rates for FY 2006. The rates are further adjusted by a wage index budget neutrality factor, described later in this section. The unadjusted rates are the same under both the 44-group RUG-III classification system and the refined RUG-53 classification system. Tables 2 and 3 below reflect the updated components of the unadjusted Federal rates for FY 2006.

Table 2.—FY 2006 Unadjusted Federal Rate Per Diem—Urban

Rate component	Nursing—case-mix	Therapy—case-mix	Therapy—non-case-mix	Non-case-mix
Per Diem Amount	$137.59	$103.64	$13.65	$70.22

Table 3.—FY 2006 Unadjusted Federal Rate Per Diem—Rural

Rate component	Nursing—case-mix	Therapy—case-mix	Therapy—non-case-mix	Non-case-mix
Per Diem Amount	$131.45	$119.51	$14.58	$71.52

C. Case-Mix Adjustment and Other Clinical Issues

1. Proposed Refinements to the RUG-III Case-Mix Classification System

Under the BBA, we must publish the SNF PPS case-mix classification methodology applicable for the next Federal fiscal year before August 1 of each year. In the FY 2006 SNF PPS proposed rule, we proposed to implement refinements in the existing 44-group RUG-III case-mix classification system that would add 9 new Rehabilitation plus Extensive Services groups at the top of the existing hierarchy. A full discussion of our proposal can be found in this year's proposed rule for FY 2006 (70 FR 29075-81). The following is a discussion of the comments that we received on this issue.

Comment: A number of commenters viewed the introduction of the proposed refinements in a positive light, both as a means to address the needs of a specific heavy-care population and as a way to remove the uncertainty over the past several years surrounding the pending expiration of the BBRA's temporary add-on payments, which had made it difficult for SNFs to predict with any certainty what their payments would be from one year to the next. Other commenters questioned why we introduced RUG refinements through the regulatory process before finalizing a long term research project and submitting a report to the Congress on the results of that research. Several commenters suggested that it would be more appropriate to wait until the upcoming STM study is completed, so that we could take advantage of more recent data on practice patterns and resource use. Still others were concerned that the proposed refinements do not go far enough to reimburse SNFs adequately for non-therapy ancillaries, and questioned why we proposed a series of incremental changes to the existing RUG-III system rather than developing a comprehensive replacement to the current SNF PPS.

Response: The RUG refinements and the SNF PPS report to the Congress on alternative systems have often been viewed as two components of a single project. However, while there is a definite relationship, the RUG refinements and the SNF PPS report to the Congress are, and should be viewed as, end products of two separate Congressional mandates.

The BBRA legislation authorized temporary payment adjustments that were intended to serve as short term, interim adjustments to the payment rates and RUG-III case-mix classification system as published in our July 30, 1999 final rule (64 FR 41644). In fact, while the legislation included a contingency plan to maintain the temporary payments until refinements to better account for “medically complex” patients were introduced, the Congress clearly envisioned that these temporary payments would expire on October 1, 2000. Given this short time frame, it seems clear that the “refinements” could be expected to be modest in scope. We believe the rulemaking process was the most appropriate vehicle for introducing any refinement policy changes, as it affords all stakeholders the opportunity to comment before any policy recommendations are finalized.

In contrast, section 311(e) of the BIPA directed us to conduct a study of the different systems for categorizing patients in Medicare SNFs, and to issue a report with any appropriate recommendations to the Congress. Based upon the broad language describing the purpose of this study, and the multi-year timeframe provided for conducting it, we believe that the Congress clearly intended for this study to address more comprehensive changes, by evaluating a number of different classification systems and considering the full range of patient types. The results of this broader research will be discussed in a report that will be released to the Congress once it has been completed.

However, we believe the need for ongoing evaluation and change should not preclude the more immediate introduction of incremental adjustments and improvements to the SNF PPS. We intend to use the report to Congress to outline a series of next steps, including the need for a new STM study, that support our ongoing efforts to enhance the accuracy and efficiency of the SNF PPS.

We note that many of the concerns advanced by the commenters are similar to the ones that some commenters expressed in response to the SNF PPS proposed rule for FY 2004 (68 FR 26758, May 16, 2003), when we last invited public comments on the issue of case-mix refinements. However, as we subsequently observed in the final rule for FY 2004, other commenters were at that same time urging us “* * * to move quickly to identify and implement short-term incremental improvements to provide more appropriate reimbursement for patients with heavy non-therapy ancillary needs” (68 FR 46041, August 4, 2003). As discussed in this year's FY 2006 proposed rule, we believe the refinements that we have developed offer an effective means of enabling the SNF PPS to make more accurate payments for non-therapy ancillary services (thus ensuring continued access to quality care for the very vulnerable heavy-care population), while at the same time avoiding the drawbacks in terms of added complexity that were inherent in previous proposals to address this issue (70 FR 29079). Accordingly, we are implementing the case-mix refinements as set forth in the proposed rule.

Comment: Commenters suggested we expand the proposed RUG-53 classification system by, for instance, creating an additional Rehabilitation RUG between Medium and High and the expansion of the Extensive Services category to include criteria such as cardiac respiratory conditions that require monitoring and the administration of aerosol medications.

Response: During future analysis, most notably our upcoming STM study, we will evaluate whether the RUG categories should be further modified.

In addition, we have discovered that in the FY 2006 SNF PPS proposed rule, we inadvertently misidentified some RUG classification categories corresponding to Rehab High, Rehab Medium, and Rehab Low in Table 3a (“Crosswalk Between Existing RUG-III Rehabilitation Groups and the Proposed Extensive Plus Rehabilitation Groups”). Accordingly, in this final rule, we are reprinting the retitled and corrected Table 3a, as set forth below.

Table 3a.—Crosswalk Between Existing RUG-III Rehabilitation Groups and the New Rehabilitation Plus Extensive Services Groups

	Current rehabilitation groups	New rehabilitation plus extensive services groups
Rehab Ultra	• RUC—ADL 16-18 • RUB—ADL 9-15 • RUA—ADL 4-8	• RUX—ADL 16-18. • RUL—ADL 7-15.
Rehab Very High	• RVC—ADL 16-18 • RVB—ADL 9-15 • RVA—ADL 4-8	• RVX—ADL 16-18. • RVL—ADL 7-15.
Rehab High	• RHC—ADL 13-18 • RHB—ADL 8-12 • RHA—ADL 4-7	• RHX—ADL 13-18. • RHL—ADL 7-12.
Rehab Medium	• RMC—ADL 15-18 • RMB—ADL 8-14 • RMA—ADL 4-7	• RMX—ADL 15-18. • RML—ADL 7-14.
Rehab Low	• RLB—ADL 14-18 • RLA—ADL 4-13	• RLX—ADL 7-18.

2. Proposed Increases to the RUG-III Case-Mix Weight Values

To help address the high degree of variability in the use of non-therapy ancillary services that we have identified both within and across groups, in the FY 2006 SNF PPS proposed rule, we proposed to increase the case-mix weights for all 53 RUGs (that is, the 44 existing RUG-III groups, as well as the proposed 9 new Rehabilitation plus Extensive Services groups). Specifically, we proposed to apply an increase of 8.4 percent to the component of the case-mix weights that includes both nursing and non-therapy ancillary costs (producing a 3 percent increase in aggregate spending), and to do so in a manner that would integrate the increase into base line spending levels and continue it in future years (70 FR 29079). (As noted previously in section III.B, the proposed 8.4 percent increase to the nursing component of the case-mix weights is now 8.51 percent in this final rule.) The following is a discussion of the comments that we received on this issue.

Comment: A number of commenters were concerned about the adequacy of payment for non-therapy ancillary services, and questioned whether the proposed increase in the nursing case-mix weights fully addresses the issue. Several commenters recommended that the case-mix weights should be adjusted by more than the 8.4 percent presented in the proposed rule. Others suggested that, rather than adjusting the case-mix weights by a factor comparable to outlier pools (that is, 3 percent of aggregate spending) established for other prospective payment systems, we implement a SNF outlier pool that could more specifically target high-cost cases. A few commenters also recommended that we adopt a payment adjustment for hospital-based SNFs, either as part of an outlier policy or as an adjustment to the base rates that would address not only the different levels of non-therapy ancillary utilization between hospital-based and freestanding facilities, but the overall cost structure differences related to differences in patient characteristics and care needs. In addition, several commenters recommended creating a variable per diem payment mechanism similar to the mechanism used for inpatient psychiatric hospitals, where higher payments could be made for the early (and presumably more costly) days of a SNF stay. Finally, a few commenters expressed concern that the effect of the refinements would be to redirect dollars away from beneficiaries needing complex medical services.

Response: As discussed here and in our proposed rule, the variability in non-therapy ancillary utilization increased the difficulty of any refinement to the RUG-III system without increasing the system complexity to such a degree that it would become both burdensome and confusing to the facility staff responsible for administering the system. In evaluating potential options, we recognized that this across-the-board increase in the nursing component is only an incremental improvement, but it is a change that did not give rise to the concerns about undue complexity noted above.

Moreover, while the introduction of these refinements fulfills our obligations under section 101 of the BBRA, we note it is just the first of an ongoing series of analyses aimed at enhancing the SNF PPS payment structure. For example, we are already examining the potential for an outlier program to further enhance program accuracy and beneficiary access to care.

The introduction of this incremental change is part of this ongoing process that will also include update activities such as the upcoming STM study and investigation of potential alternatives to the RUG system itself. However, the commitment to long term analysis and refinement should not preclude the introduction of more immediate methodological and policy updates.

While most commenters viewed the adoption of the nine new groups as beneficial, a few commenters were concerned that money was being redirected away from the complex medical RUGs. We are confident that the introduction of these refinements benefits heavy-care beneficiaries. However, as shown in Table 12 of this final rule, changes in the FY 2006 rate structure reflect an interrelationship between many factors, including the elimination of the BBRA add-ons, changes in the wage index, and the introduction of the refinements.

Comment: Some commenters suggested that the underfunding in the Medicaid system should be addressed at the same time as the Medicare RUGs refinement, and expressed concern about the impact that Medicare payment rate reductions would have in combination with changes in State Medicaid payments.

Response: While Medicare and Medicaid are independent programs that are subject to different ratesetting and budgetary mechanisms, we recognize their interrelationship, particularly for those States that utilize variations of Medicare's RUG case-mix classification system. We further recognize that Medicaid needs to establish rates that accurately reflect the cost of Medicaid services. In order to assist in realizing that objective, we plan to use our upcoming STM study to look at the entire RUG payment system, including facilities that are predominately Medicaid-based. Additionally, the Pay for Performance quality initiatives discussed in the FY 2006 proposed rule could apply to both covered Part A and noncovered (Part B) stays of dual-eligibles.

3. Implementation Issues

In order to enable nursing homes and Medicare contractors to have sufficient lead time to prepare for the changes associated with implementing the RUG-III case-mix refinements, in the FY 2006 SNF PPS proposed rule we proposed an effective date for the refinements of January 1, 2006, rather than the start of the fiscal year on October 1, 2005. (Under the terms of section 101(c) of the BBRA, the temporary add-on payments enacted by sections 101(a) and (b) of the BBRA for certain designated RUG-III groups would expire on the date that these refinements take effect.) The following is a discussion of the comments that we received on this issue.

Comment: Generally, commenters were supportive of the delay in implementing the case-mix refinements. However, some commenters were concerned that the January 2006 date does not provide adequate preparation time, especially for the software vendors and facilities that will need to update their MDS data systems. They pointed out the need for adequate lead time to ensure a smooth transition. In addition, a few commenters wanted to know which date would determine when the new RUG classification would need to be reported on the claim (for example the Assessment Reference Date (ARD, item A3a), the Minimum Data Set (MDS) completion date (item R2b), the service date, or the admission date), as well as whether the MDS edits will provide a 44-group RUG for corrected MDSs. Finally, a few commenters noted that the RAVEN software would need to be updated prior to any changes to the existing RUG-III classification system.

Response: We agree that software vendors and SNFs must have enough time to design, test, and implement the system changes needed to support these refinements. For this reason, we have scheduled a software vendor conference call on August 4, 2005 to review the data specifications, and respond to questions on the changes. Further information on this vendor teleconference is posted on our Quality Improvement Evaluation System (QIES) website at the following address: http://www.qtso.com/​vendor.html. We will also make available the new software specifications at http://www.cms.hhs.gov/​medicaid/​mds20/​mdssoftw.asp and vendors should implement the appropriate software by November 22, 2005. This timeline provides the vendors over 3 months to update their programs for SNFs. We also plan to release training materials and billing instructions in sufficient time so that SNFs will be able to transition to the refined RUG model.

As stated in the proposed rule, we will begin to apply the RUG case-mix refinement on January 1, 2006. Even though payments are determined by the MDS, the CMS claims processing systems operate on a date of service basis. Thus, the new rates need to go into effect as of January 1, 2006, rather than by the ARD date. This procedure is consistent with the billing procedures used at the start of each rate year. Providers are always instructed to prepare separate bills for services prior to and on or after October 1. This ensures that the claim is paid using the correct rate.

We believe that by scheduling implementation for January 1, 2006, rather than October 1, 2005 (the beginning of FY 2006), we are allowing ample time for providers to adjust to the refined RUG case-mix classification system and to train and educate their staff. This date also allows vendors sufficient time to update their programs to meet our requirements. Finally, by providing a date certain, all systems (State, CMS, FI, providers) can be configured uniformly, thus limiting potential billing errors.

The provider shall bill the appropriate RUG category based on the calendar date of service. For days of service before January 1, 2006, the provider shall record the 44-group RUG on the claim. For days of service beginning on January 1, 2006, the provider shall record the 53-group RUG on the claim.

If for some unforeseen reason, a software vendor is not able to update its program by mid-November, the State system “Final Validation Report” to the provider will list both the 44-group RUG and the 53-group RUG for SNF PPS assessments with ARDs of 11/22/2005 through 1/13/2006. These are the potential transition assessments that could be used for days of service both before January 1, 2006 and for days of service in 2006. For example, a 60-day SNF PPS MDS can be completed as early as day 50 of the beneficiary's SNF Part A stay. If the resident's 50th day of the stay is November 22, 2005 and the provider chooses this date as the ARD for the 60-day PPS MDS, the 44-group RUG would be billed from day 61 (December 3, 2005) to day 89 (December 31, 2005) and the 53-group RUG would be billed for day 90 (January 1, 2006).

For assessments with ARDs before November 22, 2005, only the 44-group RUG is appropriate for billing and the “Final Validation Report” will only report the 44-group RUG when the facility submits an incorrect 44-group RUG on the assessment. For assessments with ARDs after January 13, 2006, only the 53-group RUG is appropriate for billing and the “Final Validation Report” will only report the 53-group RUG when the facility submits an incorrect 53-group RUG on the assessment. For assessments with ARDs from November 22, 2005 through January 13, 2006, the MDS may be submitted with either the 44-group RUG or the 53-group RUG.

Correction assessments (Modifications or Significant Correction Assessments) will be processed in the same manner as other assessments. The RUG grouper (44-group vs. 53-group RUG) that will be calculated and accepted will be determined by the ARD of the Modification or Significant Correction Assessment.

We believe that these steps provide adequate support, and will proceed with the implementation of the refinements effective January 1, 2006.

4. Additional Clinical and Related Issues

In addition to the proposed case-mix refinements, the FY 2006 SNF PPS proposed rule discussed and invited public comment on a number of other clinical and related issues involving alternative ways to improve quality and efficiency and continue to ensure accurate payments under the SNF PPS.

a. Proposed Changes to the MDS Coding Requirements (“Look Back” Period, 5-Day Grace Periods for PPS MDS Assessments, and Projection of Anticipated Therapy Services During the 5-Day PPS Assessment (Section T))

In the FY 2006 SNF PPS proposed rule, we invited public comment on possible changes in MDS coding requirements, such as decreasing the length of the “look-back” period (to restrict coding of certain high intensity services to those actually received in the SNF), decreasing or eliminating the grace periods associated with PPS MDS assessments (specifically with reference to the 5-day PPS MDS assessment), and possibly eliminating the projection of anticipated therapy services during the 5-day PPS assessment (70 FR 29080).

Comment: We received numerous comments on several potential changes to the MDS and the case-mix classification system that we proposed. The overwhelming majority of commenters opposed the elimination of two current policies: The availability of grace days when completing the MDS, and the method of estimating therapy services during the first 15 days of a SNF admission. However, a few commenters supported eliminating the method of estimating therapy services, mentioning findings by the GAO and the Data Assessment and Verification Project (DAVE) that demonstrated a mismatch between the estimated and actual amount of therapy provided, and expressing concern that there may be some abuse of this policy. In addition, a few commenters suggested limiting the use of grace days to the 5-day and 14-day assessments. We also received numerous comments on the change in the MDS assessment “look back” period to restrict MDS reporting to services furnished in the SNF rather than during the preceding hospital stay. While some commenters supported the change in terms of SNF reimbursement policy, most commenters believed there were strong care planning reasons for retaining the current policy. Specifically, the commenters were concerned that facility staff would be unable to perform an accurate assessment of the resident, and that the elimination of the data would result in an underestimate of resource needs and negatively affect the development of an individualized care plan. A number of commenters also recommended that the type of changes discussed in the proposed rule needed to be coordinated with other CMS initiatives, including the development of MDS 3.0 and the upcoming STM study.

Response: After reviewing the comments, we agree that the changes discussed above should be addressed as part of a comprehensive examination of both the MDS 3.0 design initiative and the case-mix classification system. Therefore, we will not implement changes at this time, but will continue to study these and other issues during the upcoming STM study and MDS 3.0 design initiative.

b. Long-Term Payment and Quality Incentive Proposals

In the FY 2006 SNF PPS proposed rule, we discussed and invited comment on various long-term payment and quality incentives (70 FR 29080-29081). The following is a discussion of the comments that we received on these issues.

Comment: Commenters generally responded positively to our discussion of these issues. Regarding Pay for Performance initiatives, the overwhelming majority of commenters believed that its design should be a collaborative process between CMS, industry representatives, and other stakeholders to ensure development of a fair and equitable program. In some cases, the comments we received contained detailed suggestions on the design, validation, and use of quality measures in such a program. A few commenters also suggested specific funding structures. Other commenters suggested that additional work is needed to evaluate the interaction between performance measures used for payment and the design structure of an MDS 3.0 assessment tool. Commenters also expressed interest in the integrated post acute payment system, and were supportive of the idea that reimbursement under such a system could be more closely linked to actual patient need. Similarly, the majority of commenters believed that the development of electronic health records has a real potential for improving the accuracy and efficiency of the system. Commenters were also very supportive of enhanced discharge planning, and saw it as a way of achieving improved outcomes in terms of quality of care as well as quality of life for facility residents.

Response: We agree with the commenters that the most effective way of designing any of these initiatives would be through a collaborative process. To that end, we have begun work on a SNF Pay for Performance model, and have already had informal discussions with stakeholders, where we asked them for their input and comments on specific design issues. These issues included the type of measures that would be most appropriate, and the importance of ensuring that they reflect the needs of the entire population, from post acute patients to chronic, long-term care patients. We also informed the stakeholders that we have contracted with Abt Associates to design a demonstration model, and we asked for their feedback on the type of model that would be most effective in fostering quality of care. We plan to follow up with a general meeting early this fall, where we will discuss design issues and potential quality measures in greater detail. We expect to follow similar procedures as we undertake development of the various other initiatives discussed here and in the proposed rule.

c. Proposal To Clarify “Direct” and “Indirect” Employment Relationships for Nurse Practitioners and Clinical Nurse Specialists

The Medicare statute specifies that a nurse practitioner (NP) or a clinical nurse specialist (CNS) can perform the required level of care certifications and recertifications in a SNF only if the NP or CNS “ * * * does not have a direct or indirect employment relationship with the facility * * *” (section 1814(a)(2) of the Act). In the FY 2006 SNF PPS proposed rule, we proposed revising our policies at § 424.20(e)(2) of the regulations to distinguish more clearly between “direct” and “indirect” employment relationships in terms of the ability of NPs and CNSs to perform SNF certifications and recertifications. We noted that NPs and CNSs who are employed by SNFs not only perform the types of delegated physician tasks that are permitted under the long-term care facility requirements for participation at 42 CFR 483.40(e), but typically perform general nursing services as well. In those situations where no direct employment relationship exists between an NP or CNS and the SNF, we proposed that an indirect employment relationship exists for any NP or CNS who performs these general nursing services for the SNF under the regulations at 42 CFR 409.21 (70 FR 29082).

Comment: Many commenters expressed concern that our proposal to define “indirect” employment in terms of the provision of general nursing services was overly restrictive. They argued that adopting this approach would inhibit NPs and CNSs from engaging in their full scope of practice, and would limit SNF residents' access to their services. It was also asserted that our proposed definition actually goes well beyond the intent of the Congressional restriction on indirect employment relationships, as it could encompass even those NPs and CNSs who operate in independent practice and have no employment relationship whatsoever with the SNF, either directly or through another entity. In addition, some commenters suggested that our proposed approach represents a double standard, in that it would not subject physicians to similar restrictions.

Response: Regarding the concerns about unduly impeding the scope of practice for NPs and CNSs and limiting resident access to their services, we note that under section 1814(a)(2) of the Act, the statutory prohibition against an NP or CNS having a direct or indirect employment relationship with the SNF applies solely in terms of performing the required certification and recertifications of the beneficiary's need for Part A SNF services, and does not carry over to any other context. This means that while the presence of such an employment relationship would serve to preclude an NP or CNS from performing the required SNF certification and recertifications, it would not additionally prevent the NP or CNS from furnishing the full range of direct patient care to the SNF's residents. Further, regarding the issue of the differential treatment of physicians (who are not subject to this restriction), we note that the statute itself specifically applies the restriction to NPs and CNSs, but not to physicians.

In essence, we believe that a direct employment relationship is one in which the SNF itself exercises the right of direction and control over the NP or CNS that characterizes an employment relationship under the common law test (see the regulations at 20 CFR 404.1005, 404.1007, and 404.1009), while an indirect employment relationship is one in which another entity exercises this right on the SNF's behalf. However, we agree that an indirect employment relationship should not be defined so broadly as to encompass an NP or CNS who is operating in independent practice and, thus, has no employer-employee relationship whatsoever, either with the SNF or with any other entity. Moreover, we believe this term should not encompass situations where an entity other than the SNF, although employing the NP or CNS, does not do so on the SNF's behalf. For example, it is common for an NP or CNS who is employed by a group practice to see SNF residents on behalf of one of the group practice's physicians. There may be instances where the group practice enters into an agreement with the SNF that includes having the group practice's NP or CNS employee furnish general nursing services to the SNF's residents. As these general nursing services would fall within the package of bundled services for which the SNF is financially and professionally responsible, the group practice under such an agreement essentially would be exercising its authority as the NP's or CNS's employer on the SNF's behalf, so that an indirect employment relationship would exist between the SNF and the NP or CNS.

By contrast, if the group practice's agreement with the SNF does not involve the provision of bundled nursing services (for example, it is solely for the purpose of gaining admitting privileges for the group practice's physicians, or for providing excluded NP or CNS services to the SNF's residents), then the group practice's exercise of its authority as the NP's or CNS's employer would not be done on the SNF's behalf. Consequently, an indirect employment relationship would not arise under such an agreement, and the NP or CNS would not be precluded from either furnishing the separately billable NP or CNS services to the SNF's residents, or from completing the required certifications and recertifications. Similarly, an indirect employment relationship would not arise in those instances where the only services that the NP or CNS furnishes to the SNF's residents under the agreement are delegated physician tasks under 42 CFR 483.40(e).

Accordingly, in response to comments, we are modifying this aspect of the proposed rule in the regulations at § 424.20 to specify that in contrast to a direct employment relationship with a SNF (in which the SNF itself exercises the right of direction and control over the NP or CNS that characterizes an employment relationship under the common law test), an indirect employment relationship exists in situations where an NP or CNS meets both of the following conditions: (1) The NP or CNS has a direct employment relationship with an entity other than the SNF itself; and (2) The NP's or CNS's employer enters into an agreement with the SNF for the provision of bundled general nursing services to the SNF's residents. Under this definition, an NP or CNS who is employed by an entity other than the SNF can still perform SNF certifications and recertifications, as long as his or her employer has not entered into such an agreement with the SNF.

d. Completion of Other Medicare Required Assessments (OMRAs)

In the FY 2006 SNF PPS proposed rule, we noted that one of the requirements governing the completion of Other Medicare Required Assessments (OMRAs) specifies that an OMRA “is due” 8 to 10 days after the cessation of all therapy (occupational and physical therapies and speech-language pathology services) in all situations where the beneficiary was assigned a rehabilitation RUG on the previous assessment. We then went on to clarify how the last day of therapy is determined in this context.

Comment: Most commenters supported introduction of the clarification, while a small number of commenters expressed concern about the wording. Others expressed concerns on issues that are not directly related to the OMRA language, including comments expressing concern about the limited ability to capture the “short-stay patients discharged before the five-day assessment,” and suggesting that we introduce either an at-admission or an at-discharge assessment, or that we eliminate the 5-day assessment.

Response: After reviewing the comments, we agree that we can further clarify our discussion of OMRA assessments in the proposed rule. Therefore, we wish to clarify that in our previous statements that the OMRA “is due” 8 to 10 days after the cessation of all therapy, and that therapeutic leave days are counted in determining the OMRA “due date,” the due date to which we refer is, in fact, the Assessment Reference Date (ARD). Thus, it is the ARD of the OMRA that must be set 8 to 10 days after the cessation of all therapy, and therapeutic leave days are counted when setting the OMRA ARD. Further, we note that we will keep the commenters' additional suggestions in this area in mind as we pursue our ongoing efforts to improve the accuracy and efficiency of the SNF PPS and the MDS processing system.

e. Concurrent Therapy

In the FY 2006 SNF PPS proposed rule, we solicited public comment on whether additional guidance might be warranted to help prevent the inappropriate provision of concurrent therapy in situations where it is not clinically justified (70 FR 29082-29083). The following is a discussion of the comments that we received on this issue.

Comment: A majority of commenters support the continuation of concurrent therapy as a delivery mode for rehabilitation services when properly furnished by the therapist. Many commenters suggested that CMS establish guidelines or develop examples that would provide guidance on the appropriate use of concurrent therapy, while a few commenters pointed out that CMS already has authority to conduct medical reviews and opposed further regulation. We also received some comments that suggested ways to decrease confusion among therapists, including educational outreach with the assistance of the professional associations, and establishing a single set of guidelines for Medicare Part A and Medicare Part B. Several commenters reported abuse and some reported that staff are being coerced to maximize minutes and reimbursement. One commenter expressed concern that, in the absence of concurrent therapy, some patients might not receive any services. However, another commenter suggested that the overuse of concurrent therapy could mean that a beneficiary might never receive necessary individualized care.

Response: We addressed the practice of concurrent therapy in the FY 2006 SNF PPS proposed rule in order to reiterate Medicare policy and to solicit public comment. Our concern was two-fold: That therapists' professional judgment was being overridden by pressures to be more productive by treating multiple beneficiaries concurrently; and that the Medicare policy that allows for the treatment of multiple beneficiaries was being used inappropriately and could lead to diminished quality of care. We wished to convey that the therapist's professional judgment should not be compromised and concurrent therapy should be performed only when it is clinically appropriate to render care to more than one individual (other than group therapy) at the same time. We agree that, at times, such care can be provided concurrently with another therapy patient, as long as the decision to do so is driven by valid clinical considerations. As requested by several commenters and based on the reports of overuse and/or abuse of concurrent therapy, we will continue to monitor these issues. We intend to work with professional organizations to determine the type of guidelines and educational materials that would be most helpful to therapists and other stakeholders. In addition, we also intend to address concurrent and group therapy utilization patterns during our STM study scheduled to start later this calendar year.

5. Case-Mix Adjusted Federal Rates and Associated Indexes

We have established January 1, 2006, as the beginning date for the use of the case-mix refinements. Accordingly, from October 1, 2005, through December 31, 2005, we will make payment based entirely on the existing 44-group RUG-III classification system. Tables 4, 5, 6, and 7 reflect the corresponding rate information for the existing 44-group RUG-III classification system to be used during this time.

Beginning on January 1, 2006, we will make payment based entirely on the refined RUG-53 classification system (and, thus, would not include the add-on payments). Tables 4a, 5a, 6a, and 7a reflect the corresponding rate information for the RUG-53 classification system.

As part of our ongoing analysis of the 53-group model, we updated the nursing case-mix weights presented in the proposed rule using 2001 data, the most current data available. In addition, based on comments, we adjusted the 53-group model to retain the existing therapy case-mix weights for the 23 Rehabilitation and combined Rehabilitation/Extensive Care groups. We then used the updated case-mix data to repeat the payment simulation described in the proposed rule. The payment simulation showed that adjustments were needed to maintain parity between the 44-group and 53-group models. Thus, we modified the payment simulation model to apply the payment adjustment to both the nursing and therapy case-mix weights proportionally by the aggregate number of days in therapy RUGs versus non-therapy RUGs. This parity was achieved by increasing the nursing case-mix weight by 8.65 percent. Finally, using the methodology described in the proposed rule, we calculated an 8.51 percent nursing case-mix weight adjustment factor to use to address variability in non-therapy ancillary costs. The steps taken to calculate the 53-group model nursing case-mix weights are shown on the SNF PPS website, at www.cms.hhs.gov/​providers/​snfpps.

Tables 4 and 5 reflect the updated SNF Federal rates for FY 2006 for the existing 44-group RUG-III classification system. Tables 4a and 5a reflect the updated SNF Federal rates for FY 2006 for the RUG-53 classification system. The first nine groups listed in Tables 4a and 5a are for the new Rehabilitation plus Extensive Services groups.

Table 4.—RUG-44 Case-Mix Adjusted Federal Rates and Associated Indexes—Urban

RUG III category	Nursing index	Therapy index	Nursing component	Therapy component	Non-case mix therapy component	Non-case mix component	Total rate
RUC	1.30	2.25	178.87	233.19		70.22	482.28
RUB	0.95	2.25	130.71	233.19		70.22	434.12
RUA	0.78	2.25	107.32	233.19		70.22	410.73
RVC	1.13	1.41	155.48	146.13		70.22	371.83
RVB	1.04	1.41	143.09	146.13		70.22	359.44
RVA	0.81	1.41	111.45	146.13		70.22	327.80
RHC	1.26	0.94	173.36	97.42		70.22	341.00
RHB	1.06	0.94	145.85	97.42		70.22	313.49
RHA	0.87	0.94	119.70	97.42		70.22	287.34
RMC	1.35	0.77	185.75	79.80		70.22	335.77
RMB	1.09	0.77	149.97	79.80		70.22	299.99
RMA	0.96	0.77	132.09	79.80		70.22	282.11
RLB	1.11	0.43	152.72	44.57		70.22	267.51
RLA	0.80	0.43	110.07	44.57		70.22	224.86
SE3	1.70		233.90		13.65	70.22	317.77
SE2	1.39		191.25		13.65	70.22	275.12
SE1	1.17		160.98		13.65	70.22	244.85
SSC	1.13		155.48		13.65	70.22	239.35
SSB	1.05		144.47		13.65	70.22	228.34
SSA	1.01		138.97		13.65	70.22	222.84
CC2	1.12		154.10		13.65	70.22	237.97
CC1	0.99		136.21		13.65	70.22	220.08
CB2	0.91		125.21		13.65	70.22	209.08
CB1	0.84		115.58		13.65	70.22	199.45
CA2	0.83		114.20		13.65	70.22	198.07
CA1	0.75		103.19		13.65	70.22	187.06
IB2	0.69		94.94		13.65	70.22	178.81
IB1	0.67		92.19		13.65	70.22	176.06
IA2	0.57		78.43		13.65	70.22	162.30
IA1	0.53		72.92		13.65	70.22	156.79
BB2	0.68		93.56		13.65	70.22	177.43
BB1	0.65		89.43		13.65	70.22	173.30
BA2	0.56		77.05		13.65	70.22	160.92
BA1	0.48		66.04		13.65	70.22	149.91
PE2	0.79		108.70		13.65	70.22	192.57
PE1	0.77		105.94		13.65	70.22	189.81
PD2	0.72		99.06		13.65	70.22	182.93
PD1	0.70		96.31		13.65	70.22	180.18
PC2	0.65		89.43		13.65	70.22	173.30
PC1	0.64		88.06		13.65	70.22	171.93
PB2	0.51		70.17		13.65	70.22	154.04
PB1	0.50		68.80		13.65	70.22	152.67
PA2	0.49		67.42		13.65	70.22	151.29
PA1	0.46		63.29		13.65	70.22	147.16

Table 4a.—RUG-53 Case-Mix Adjusted Federal Rates and Associated Indexes—Urban

RUG-53 category	Nursing index	Therapy index	Nursing component	Therapy component	Non-case mix therapy component	Non-case mix component	Total rate
RUX	1.90	2.25	261.42	233.19		70.22	564.83
RUL	1.40	2.25	192.63	233.19		70.22	496.04
RVX	1.54	1.41	211.89	146.13		70.22	428.24
RVL	1.33	1.41	182.99	146.13		70.22	399.34
RHX	1.42	0.94	195.38	97.42		70.22	363.02
RHL	1.37	0.94	188.50	97.42		70.22	356.14
RMX	1.93	0.77	265.55	79.80		70.22	415.57
RML	1.68	0.77	231.15	79.80		70.22	381.17
RLX	1.31	0.43	180.24	44.57		70.22	295.03
RUC	1.28	2.25	176.12	233.19		70.22	479.53
RUB	0.99	2.25	136.21	233.19		70.22	439.62
RUA	0.84	2.25	115.58	233.19		70.22	418.99
RVC	1.23	1.41	169.24	146.13		70.22	385.59
RVB	1.09	1.41	149.97	146.13		70.22	366.32
RVA	0.82	1.41	112.82	146.13		70.22	329.17
RHC	1.22	0.94	167.86	97.42		70.22	335.50
RHB	1.11	0.94	152.72	97.42		70.22	320.36
RHA	0.94	0.94	129.33	97.42		70.22	296.97
RMC	1.15	0.77	158.23	79.80		70.22	308.25
RMB	1.09	0.77	149.97	79.80		70.22	299.99
RMA	1.04	0.77	143.09	79.80		70.22	293.11
RLB	1.14	0.43	156.85	44.57		70.22	271.64
RLA	0.85	0.43	116.95	44.57		70.22	231.74
SE3	1.86		255.92		13.65	70.22	339.79
SE2	1.49		205.01		13.65	70.22	288.88
SE1	1.26		173.36		13.65	70.22	257.23
SSC	1.23		169.24		13.65	70.22	253.11
SSB	1.13		155.48		13.65	70.22	239.35
SSA	1.10		151.35		13.65	70.22	235.22
CC2	1.22		167.86		13.65	70.22	251.73
CC1	1.06		145.85		13.65	70.22	229.72
CB2	0.98		134.84		13.65	70.22	218.71
CB1	0.91		125.21		13.65	70.22	209.08
CA2	0.90		123.83		13.65	70.22	207.70
CA1	0.80		110.07		13.65	70.22	193.94
IB2	0.74		101.82		13.65	70.22	185.69
IB1	0.72		99.06		13.65	70.22	182.93
IA2	0.61		83.93		13.65	70.22	167.80
IA1	0.56		77.05		13.65	70.22	160.92
BB2	0.73		100.44		13.65	70.22	184.31
BB1	0.69		94.94		13.65	70.22	178.81
BA2	0.60		82.55		13.65	70.22	166.42
BA1	0.52		71.55		13.65	70.22	155.42
PE2	0.85		116.95		13.65	70.22	200.82
PE1	0.82		112.82		13.65	70.22	196.69
PD2	0.78		107.32		13.65	70.22	191.19
PD1	0.76		104.57		13.65	70.22	188.44
PC2	0.71		97.69		13.65	70.22	181.56
PC1	0.69		94.94		13.65	70.22	178.81
PB2	0.55		75.67		13.65	70.22	159.54
PB1	0.54		74.30		13.65	70.22	158.17
PA2	0.53		72.92		13.65	70.22	156.79
PA1	0.50		68.80		13.65	70.22	152.67

Table 5.—RUG-44 Case-Mix Adjusted Federal Rates and Associated Indexes—Rural

RUG III category	Nursing index	Therapy index	Nursing component	Therapy component	Non-case mix therapy component	Non-case mix component	Total rate
RUC	1.30	2.25	170.89	268.90		71.52	511.31
RUB	0.95	2.25	124.88	268.90		71.52	465.30
RUA	0.78	2.25	102.53	268.90		71.52	442.95
RVC	1.13	1.41	148.54	168.51		71.52	388.57
RVB	1.04	1.41	136.71	168.51		71.52	376.74
RVA	0.81	1.41	106.47	168.51		71.52	346.50
RHC	1.26	0.94	165.63	112.34		71.52	349.49
RHB	1.06	0.94	139.34	112.34		71.52	323.20
RHA	0.87	0.94	114.36	112.34		71.52	298.22
RMC	1.35	0.77	177.46	92.02		71.52	341.00
RMB	1.09	0.77	143.28	92.02		71.52	306.82
RMA	0.96	0.77	126.19	92.02		71.52	289.73
RLB	1.11	0.43	145.91	51.39		71.52	268.82
RLA	0.80	0.43	105.16	51.39		71.52	228.07
SE3	1.70		223.47		14.58	71.52	309.57
SE2	1.39		182.72		14.58	71.52	268.82
SE1	1.17		153.80		14.58	71.52	239.90
SSC	1.13		148.54		14.58	71.52	234.64
SSB	1.05		138.02		14.58	71.52	224.12
SSA	1.01		132.76		14.58	71.52	218.86
CC2	1.12		147.22		14.58	71.52	233.32
CC1	0.99		130.14		14.58	71.52	216.24
CB2	0.91		119.62		14.58	71.52	205.72
CB1	0.84		110.42		14.58	71.52	196.52
CA2	0.83		109.10		14.58	71.52	195.20
CA1	0.75		98.59		14.58	71.52	184.69
IB2	0.69		90.70		14.58	71.52	176.80
IB1	0.67		88.07		14.58	71.52	174.17
IA2	0.57		74.93		14.58	71.52	161.03
IA1	0.53		69.67		14.58	71.52	155.77
BB2	0.68		89.39		14.58	71.52	175.49
BB1	0.65		85.44		14.58	71.52	171.54
BA2	0.56		73.61		14.58	71.52	159.71
BA1	0.48		63.10		14.58	71.52	149.20
PE2	0.79		103.85		14.58	71.52	189.95
PE1	0.77		101.22		14.58	71.52	187.32
PD2	0.72		94.64		14.58	71.52	180.74
PD1	0.70		92.02		14.58	71.52	178.12
PC2	0.65		85.44		14.58	71.52	171.54
PC1	0.64		84.13		14.58	71.52	170.23
PB2	0.51		67.04		14.58	71.52	153.14
PB1	0.50		65.73		14.58	71.52	151.83
PA2	0.49		64.41		14.58	71.52	150.51
PA1	0.46		60.47		14.58	71.52	146.57

Table 5a.—RUG-53 Case-Mix Adjusted Federal Rates and Associated Indexes—Rural

RUG-53 category	Nursing index	Therapy index	Nursing component	Therapy component	Non-case mix therapy comp	Non-case mix component	Total rate
RUX	1.90	2.25	249.76	268.90		71.52	590.18
RUL	1.40	2.25	184.03	268.90		71.52	524.45
RVX	1.54	1.41	202.43	168.51		71.52	442.46
RVL	1.33	1.41	174.83	168.51		71.52	414.86
RHX	1.42	0.94	186.66	112.34		71.52	370.52
RHL	1.37	0.94	180.09	112.34		71.52	363.95
RMX	1.93	0.77	253.70	92.02		71.52	417.24
RML	1.68	0.77	220.84	92.02		71.52	384.38
RLX	1.31	0.43	172.20	51.39		71.52	295.11
RUC	1.28	2.25	168.26	268.90		71.52	508.68
RUB	0.99	2.25	130.14	268.90		71.52	470.56
RUA	0.84	2.25	110.42	268.90		71.52	450.84
RVC	1.23	1.41	161.68	168.51		71.52	401.71
RVB	1.09	1.41	143.28	168.51		71.52	383.31
RVA	0.82	1.41	107.79	168.51		71.52	347.82
RHC	1.22	0.94	160.37	112.34		71.52	344.23
RHB	1.11	0.94	145.91	112.34		71.52	329.77
RHA	0.94	0.94	123.56	112.34		71.52	307.42
RMC	1.15	0.77	151.17	92.02		71.52	314.71
RMB	1.09	0.77	143.28	92.02		71.52	306.82
RMA	1.04	0.77	136.71	92.02		71.52	300.25
RLB	1.14	0.43	149.85	51.39		71.52	272.76
RLA	0.85	0.43	111.73	51.39		71.52	234.64
SE3	1.86		244.50		14.58	71.52	330.60
SE2	1.49		195.86		14.58	71.52	281.96
SE1	1.26		165.63		14.58	71.52	251.73
SSC	1.23		161.68		14.58	71.52	247.78
SSB	1.13		148.54		14.58	71.52	234.64
SSA	1.10		144.60		14.58	71.52	230.70
CC2	1.22		160.37		14.58	71.52	246.47
CC1	1.06		139.34		14.58	71.52	225.44
CB2	0.98		128.82		14.58	71.52	214.92
CB1	0.91		119.62		14.58	71.52	205.72
CA2	0.90		118.31		14.58	71.52	204.41
CA1	0.80		105.16		14.58	71.52	191.26
IB2	0.74		97.27		14.58	71.52	183.37
IB1	0.72		94.64		14.58	71.52	180.74
IA2	0.61		80.18		14.58	71.52	166.28
IA1	0.56		73.61		14.58	71.52	159.71
BB2	0.73		95.96		14.58	71.52	182.06
BB1	0.69		90.70		14.58	71.52	176.80
BA2	0.60		78.87		14.58	71.52	164.97
BA1	0.52		68.35		14.58	71.52	154.45
PE2	0.85		111.73		14.58	71.52	197.83
PE1	0.82		107.79		14.58	71.52	193.89
PD2	0.78		102.53		14.58	71.52	188.63
PD1	0.76		99.90		14.58	71.52	186.00
PC2	0.71		93.33		14.58	71.52	179.43
PC1	0.69		90.70		14.58	71.52	176.80
PB2	0.55		72.30		14.58	71.52	158.40
PB1	0.54		70.98		14.58	71.52	157.08
PA2	0.53		69.67		14.58	71.52	155.77
PA1	0.50		65.73		14.58	71.52	151.83

D. Wage Index Adjustment to Federal Rates

Section 1888(e)(4)(G)(ii) of the Act requires that we adjust the Federal rates to account for differences in area wage levels, using a wage index that we find appropriate. Since the inception of a PPS for SNFs, we have used hospital wage data in developing a wage index to be applied to SNFs. We are continuing that practice for FY 2006.

1. Proposal To Incorporate the Revised OMB Definitions for Metropolitan Statistical Areas and Combined Statistical Areas

In the FY 2006 SNF PPS proposed rule, we proposed to incorporate into the SNF PPS the revised OMB definitions for Metropolitan Statistical Areas, as well as the new definitions of Micropolitan Statistical Areas and Combined Statistical Areas. For a full discussion of this proposal, see our FY 2006 proposed rule (70 FR 29090-94). We also invited comments on the appropriateness of implementing this change through a transition period similar to that adopted under the inpatient hospital PPS (IPPS)(70 FR 29095). The following is a discussion of the comments that we received on this issue.

Comment: A number of commenters questioned the continued use of the hospital wage index, and suggested that, rather than using the hospital wage index to implement the OMB designations, CMS postpone action until a SNF-specific wage index can be created. Commenters also recommended adopting policies included in the IPPS, such as the creation of a geographic reclassification policy for SNFs and the introduction of a “rural floor” (ensuring that no urban wage index value is lower than the State-wide rural wage index.

Response: As part of our ongoing program analysis, we periodically reevaluate the suitability of establishing a SNF-specific wage index and a provider reclassification methodology. However, as we noted in the FY 2004 SNF PPS final rule when this issue was raised previously (68 FR 46046, August 4, 2003), in view of the volatility of existing SNF wage data and the significant amount of resources that would be required to improve the quality of that data, we do not expect to propose a SNF-specific wage index until we can demonstrate that it would significantly improve our ability to determine payment for facilities and justify the resources required to collect the data, as well as the increased burden on providers.

In addition, we note that the development of the hospital wage data can also be scrutinized and evaluated by the SNF industry when commenting on the hospital proposed rule that is published each spring. Therefore, because of the problems associated with the current SNF-specific data, and our inability to demonstrate that a SNF-specific wage index would be more reflective of the wages and salaries paid in a specific area, we continue to believe that hospital wage data are the most appropriate data for adjusting payments made to SNFs.

We also noted in the FY 2004 final rule that while section 315 of the BIPA does authorize the SNF PPS to use a reclassification methodology that would allow providers to seek geographic reclassification, it specifically provides that such reclassification cannot be implemented until we have collected the data necessary to establish a SNF-specific wage index. At that time, we also invited input from the industry that could demonstrate that the adoption of a “rural floor” would provide a more accurate wage index. To date, however, we have not received evidence that such an approach would, in fact, accomplish this result. Accordingly, we are not adopting these suggested changes at this time.

Comment: Several commenters recommended that we withdraw or postpone implementation of this provision because the fiscal impact of the wage index changes have a disproportionate effect on different facilities or in different localities. One commenter also questioned whether CMS has the legislative authority to implement the OMB designations, as the SNF PPS structure distinguishes between urban and rural providers, but doesn't include a category for micropolitan areas.

Response: The statute provides the Secretary with broad authority to select an appropriate wage index, and we believe that the adoption of these OMB designations is consistent with and in compliance with the statutory authority. We further understand that impact on providers based on the wage index adjustments (which, by statute, must be accomplished in a budget neutral manner) will always vary as an inherent aspect of such adjustments, and would occur regardless of whether we continue to use the current MSA designations or use the more accurate CBSA designations established by OMB in June 2003. Therefore, we continue to believe that an appropriate wage index includes the CBSA designations described in the proposed rule.

Comment: A large number of commenters urged CMS to develop a transition policy to minimize the fiscal impact of the transition to the OMB designations. Many commenters urged CMS to adopt broad protections for facilities against changes in the wage index due to the adoption of the new OMB designations. Commenters offered various recommendations about how to provide such protection. Some advocated transition mechanisms such as blending wage index factors specifically for those facilities that would experience a wage index decrease (similar to the approach adopted under the IPPS), with a one to four year phase-in period to allow SNFs to make appropriate adjustments in their operations. In addition, many commenters recommended caps on gains and losses or a hold harmless provision for SNFs facing significant wage index reductions under the proposal.

Response: In the FY 2006 SNF PPS proposed rule, while we did not view it as appropriate or necessary to propose a transition period, we provided various transition options and specifically invited comments on our proposed approaches. We continue to recognize that some SNFs will experience decreases in their applicable wage index as a result of the conversion from the MSA to the CBSA structure. We also agree that it is appropriate to assist providers in adapting to these changes in a manner that provides the most benefit to the largest number of providers. Therefore, based in part upon the comments, we now agree that a transition period for SNFs would be appropriate and beneficial.

In evaluating transition options, we looked for approaches that would provide relief to the largest percentage of adversely affected SNFs with the least impact to the rest of the facilities, who either received small increases or remained the same. One possible approach that we considered would involve creating a floor (for example, at a 2 percent decrease), to be funded by also imposing a ceiling (for example, at a 5 percent gain). Instead, we have decided to use a 1-year transition with a blended wage index for all providers. The wage index for each provider will consist of a blend of 50 percent of the FY 2006 MSA-based wage index and 50 percent of the FY 2006 CBSA-based wage index (both using FY 2002 hospital wage data). We refer to this blended wage index as the FY 2006 SNF PPS transition wage index and these values can be found in the Addendum in Table A. This option achieves our objective of creating a transition policy that provides relief to the largest percentage of adversely affected SNFs with the least impact to the rest of the facilities. In addition, the 50/50 blend option allows us to achieve a high degree of stability in the unadjusted base rates. The adoption of this option results in only minimal change to the budget neutrality factor, from 1.0011 to 1.0012. In fact, the unadjusted base rates applicable to all SNFs actually show a slight increase.

Accordingly, as noted above, after consideration of these comments, we have modified the wage index proposal to include the transition policy discussed above. This transition policy is for a one-year period. It goes into effect October 1, 2005, and remains in effect through September 30, 2006. Thus, the transition will end at the start of FY 2007.

In addition, we solicited comments on approaches to calculating the wage index values for areas without hospitals for FY 2006 and subsequent years. We received no comments on our approach and we will implement the methodology described in the FY 2006 SNF PPS proposed rule (70 FR 29096).

2. Determining the Labor-Related Portion of the SNF PPS Rate

The wage index adjustment is applied to the labor-related portion of the Federal rate, which is 75.922 percent of the total rate, as explained in section III.H.1 of this final rule. This percentage reflects the labor-related relative importance for FY 2006. The labor-related relative importance is calculated from the SNF market basket, and approximates the labor-related portion of the total costs after taking into account historical and projected price changes between the base year and FY 2006. The price proxies that move the different cost categories in the market basket do not necessarily change at the same rate, and the relative importance captures these changes. Accordingly, the relative importance figure more closely reflects the cost share weights for FY 2006 than the base year weights from the SNF market basket.

We calculate the labor-related relative importance for FY 2006 in four steps. First, we compute the FY 2006 price index level for the total market basket and each cost category of the market basket. Second, we calculate a ratio for each cost category by dividing the FY 2006 price index level for that cost category by the total market basket price index level. Third, we determine the FY 2006 relative importance for each cost category by multiplying this ratio by the base year (FY 1997) weight. Finally, we sum the FY 2006 relative importance for each of the labor-related cost categories (wages and salaries, employee benefits, nonmedical professional fees, labor-intensive services, and capital-related expenses) to produce the FY 2006 labor-related relative importance. Tables 6 and 7 show the Federal rates by labor-related and non-labor-related components for the existing 44-group RUG-III classification system. Tables 6a and 7a show the Federal rates by labor-related and non-labor-related components for the refined 53-group RUG classification system.

Table 6.—RUG-44 Case-Mix Adjusted Federal Rates for Urban SNFs by Labor and Non-Labor Component

RUG III category	Total rate	Labor portion	Non-labor portion
RUC	482.28	366.16	116.12
RUB	434.12	329.59	104.53
RUA	410.73	311.83	98.90
RVC	371.83	282.30	89.53
RVB	359.44	272.89	86.55
RVA	327.80	248.87	78.93
RHC	341.00	258.89	82.11
RHB	313.49	238.01	75.48
RHA	287.34	218.15	69.19
RMC	335.77	254.92	80.85
RMB	299.99	227.76	72.23
RMA	282.11	214.18	67.93
RLB	267.51	203.10	64.41
RLA	224.86	170.72	54.14
SE3	317.77	241.26	76.51
SE2	275.12	208.88	66.24
SE1	244.85	185.90	58.95
SSC	239.35	181.72	57.63
SSB	228.34	173.36	54.98
SSA	222.84	169.18	53.66
CC2	237.97	180.67	57.30
CC1	220.08	167.09	52.99
CB2	209.08	158.74	50.34
CB1	199.45	151.43	48.02
CA2	198.07	150.38	47.69
CA1	187.06	142.02	45.04
IB2	178.81	135.76	43.05
IB1	176.06	133.67	42.39
IA2	162.30	123.22	39.08
IA1	156.79	119.04	37.75
BB2	177.43	134.71	42.72
BB1	173.30	131.57	41.73
BA2	160.92	122.17	38.75
BA1	149.91	113.81	36.10
PE2	192.57	146.20	46.37
PE1	189.81	144.11	45.70
PD2	182.93	138.88	44.05
PD1	180.18	136.80	43.38
PC2	173.30	131.57	41.73
PC1	171.93	130.53	41.40
PB2	154.04	116.95	37.09
PB1	152.67	115.91	36.76
PA2	151.29	114.86	36.43
PA1	147.16	111.73	35.43

Table 6a.—RUG-53 Case-Mix Adjusted Federal Rates for Urban SNFs by Labor and Non-Labor Component

RUG-53 category	Total rate	Labor portion	Non-labor portion
RUX	564.83	428.83	136.00
RUL	496.04	376.60	119.44
RVX	428.24	325.13	103.11
RVL	399.34	303.19	96.15
RHX	363.02	275.61	87.41
RHL	356.14	270.39	85.75
RMX	415.57	315.51	100.06
RML	381.17	289.39	91.78
RLX	295.03	223.99	71.04
RUC	479.53	364.07	115.46
RUB	439.62	333.77	105.85
RUA	418.99	318.11	100.88
RVC	385.59	292.75	92.84
RVB	366.32	278.12	88.20
RVA	329.17	249.91	79.26
RHC	335.50	254.72	80.78
RHB	320.36	243.22	77.14
RHA	296.97	225.47	71.50
RMC	308.25	234.03	74.22
RMB	299.99	227.76	72.23
RMA	293.11	222.53	70.58
RLB	271.64	206.23	65.41
RLA	231.74	175.94	55.80
SE3	339.79	257.98	81.81
SE2	288.88	219.32	69.56
SE1	257.23	195.29	61.94
SSC	253.11	192.17	60.94
SSB	239.35	181.72	57.63
SSA	235.22	178.58	56.64
CC2	251.73	191.12	60.61
CC1	229.72	174.41	55.31
CB2	218.71	166.05	52.66
CB1	209.08	158.74	50.34
CA2	207.70	157.69	50.01
CA1	193.94	147.24	46.70
IB2	185.69	140.98	44.71
IB1	182.93	138.88	44.05
IA2	167.80	127.40	40.40
IA1	160.92	122.17	38.75
BB2	184.31	139.93	44.38
BB1	178.81	135.76	43.05
BA2	166.42	126.35	40.07
BA1	155.42	118.00	37.42
PE2	200.82	152.47	48.35
PE1	196.69	149.33	47.36
PD2	191.19	145.16	46.03
PD1	188.44	143.07	45.37
PC2	181.56	137.84	43.72
PC1	178.81	135.76	43.05
PB2	159.54	121.13	38.41
PB1	158.17	120.09	38.08
PA2	156.79	119.04	37.75
PA1	152.67	115.91	36.76

Table 7.—RUG-44 Case-Mix Adjusted Federal Rates for Rural SNFs by Labor and Non-Labor Component

RUG III category	Total rate	Labor portion	Non-labor portion
RUC	511.31	388.20	123.11
RUB	465.30	353.27	112.03
RUA	442.95	336.30	106.65
RVC	388.57	295.01	93.56
RVB	376.74	286.03	90.71
RVA	346.50	263.07	83.43
RHC	349.49	265.34	84.15
RHB	323.20	245.38	77.82
RHA	298.22	226.41	71.81
RMC	341.00	258.89	82.11
RMB	306.82	232.94	73.88
RMA	289.73	219.97	69.76
RLB	268.82	204.09	64.73
RLA	228.07	173.16	54.91
SE3	309.57	235.03	74.54
SE2	268.82	204.09	64.73
SE1	239.90	182.14	57.76
SSC	234.64	178.14	56.50
SSB	224.12	170.16	53.96
SSA	218.86	166.16	52.70
CC2	233.32	177.14	56.18
CC1	216.24	164.17	52.07
CB2	205.72	156.19	49.53
CB1	196.52	149.20	47.32
CA2	195.20	148.20	47.00
CA1	184.69	140.22	44.47
IB2	176.80	134.23	42.57
IB1	174.17	132.23	41.94
IA2	161.03	122.26	38.77
IA1	155.77	118.26	37.51
BB2	175.49	133.24	42.25
BB1	171.54	130.24	41.30
BA2	159.71	121.26	38.45
BA1	149.20	113.28	35.92
PE2	189.95	144.21	45.74
PE1	187.32	142.22	45.10
PD2	180.74	137.22	43.52
PD1	178.12	135.23	42.89
PC2	171.54	130.24	41.30
PC1	170.23	129.24	40.99
PB2	153.14	116.27	36.87
PB1	151.83	115.27	36.56
PA2	150.51	114.27	36.24
PA1	146.57	111.28	35.29

Table 7a.—RUG-53 Case-Mix Adjusted Federal Rates for Rural SNFs by Labor and Non-Labor Component

RUG-53 category	Total rate	Labor portion	Non-labor portion
RUX	590.18	448.08	142.10
RUL	524.45	398.17	126.28
RVX	442.46	335.92	106.54
RVL	414.86	314.97	99.89
RHX	370.52	281.31	89.21
RHL	363.95	276.32	87.63
RMX	417.24	316.78	100.46
RML	384.38	291.83	92.55
RLX	295.11	224.05	71.06
RUC	508.68	386.20	122.48
RUB	470.56	357.26	113.30
RUA	450.84	342.29	108.55
RVC	401.71	304.99	96.72
RVB	383.31	291.02	92.29
RVA	347.82	264.07	83.75
RHC	344.23	261.35	82.88
RHB	329.77	250.37	79.40
RHA	307.42	233.40	74.02
RMC	314.71	238.93	75.78
RMB	306.82	232.94	73.88
RMA	300.25	227.96	72.29
RLB	272.76	207.08	65.68
RLA	234.64	178.14	56.50
SE3	330.60	251.00	79.60
SE2	281.96	214.07	67.89
SE1	251.73	191.12	60.61
SSC	247.78	188.12	59.66
SSB	234.64	178.14	56.50
SSA	230.70	175.15	55.55
CC2	246.47	187.12	59.35
CC1	225.44	171.16	54.28
CB2	214.92	163.17	51.75
CB1	205.72	156.19	49.53
CA2	204.41	155.19	49.22
CA1	191.26	145.21	46.05
IB2	183.37	139.22	44.15
IB1	180.74	137.22	43.52
IA2	166.28	126.24	40.04
IA1	159.71	121.26	38.45
BB2	182.06	138.22	43.84
BB1	176.80	134.23	42.57
BA2	164.97	125.25	39.72
BA1	154.45	117.26	37.19
PE2	197.83	150.20	47.63
PE1	193.89	147.21	46.68
PD2	188.63	143.21	45.42
PD1	186.00	141.21	44.79
PC2	179.43	136.23	43.20
PC1	176.80	134.23	42.57
PB2	158.40	120.26	38.14
PB1	157.08	119.26	37.82
PA2	155.77	118.26	37.51
PA1	151.83	115.27	36.56

3. Calculating the Budget Neutrality Factor

Section 1888(e)(4)(G)(ii) of the Act also requires that we apply this wage index in a manner that does not result in aggregate payments that are greater or lesser than would otherwise be made in the absence of the wage adjustment. For FY 2006 (Federal rates effective October 1, 2005), we are applying the wage index applicable to SNF payments using the most recent hospital wage data applicable to FY 2006 payments (as discussed previously in section III.D.1 of this final rule), and applying an adjustment to fulfill the budget neutrality requirement. This requirement is met by multiplying each of the components of the unadjusted Federal rates by a factor equal to the ratio of the volume weighted mean wage adjustment factor (using the wage index from the previous year) to the volume weighted mean wage adjustment factor, using the wage index for the fiscal year beginning October 1, 2005. The same volume weights are used in both the numerator and denominator and were derived from 1997 Medicare Provider Analysis and Review File (MEDPAR) data. The wage adjustment factor used in this calculation is defined as the labor share of the rate component multiplied by the wage index plus the non-labor share. The budget neutrality factor has been recalculated to reflect the addition of a transition policy. Effective October 1, 2005, we will adopt a budget neutrality factor of 1.0012. In order to give the public a sense of the magnitude of this adjustment, last year's factor was 1.0011.

E. Updates to the Federal Rates

In accordance with section 1888(e)(4)(E) of the Act, the final payment rates listed here reflect an update equal to the full SNF market basket, which equals 3.1 percent.

We will continue to disseminate the rates, wage index, and case-mix classification methodology in the Federal Register before August 1 preceding the start of each succeeding fiscal year. Along with a number of other revisions discussed elsewhere in this preamble, this final rule provides the annual updates to the Federal rates as required by statute.

F. Relationship of Case-Mix Classification System to Existing SNF Level-of-Care Criteria

As discussed in § 413.345, we include in each update of the Federal payment rates in the Federal Register the designation of those specific RUGs under the classification system that represent the required SNF level of care, as provided in § 409.30. This designation reflects an administrative presumption that we initially adopted under the original 44-group RUG-III classification system. Under the presumption, any beneficiary correctly assigned to one of the upper 26 of the 44 RUG-III groups in the initial 5-day, Medicare-required assessment is automatically classified as meeting the SNF level of care definition up to the assessment reference date (ARD) for that assessment.

A beneficiary assigned to any of the lower 18 of the 44 RUG-III groups is not automatically classified as either meeting or not meeting the definition, but instead receives an individual level of care determination using the existing administrative criteria. This presumption recognizes the strong likelihood that beneficiaries assigned to one of the upper 26 groups during the immediate post-hospital period require a covered level of care, which would be significantly less likely for those beneficiaries assigned to one of the lower 18 groups.

1. Proposals on the 9 New Rehabilitation Plus Extensive Services Groups

In the FY 2006 SNF PPS proposed rule, we noted that the 9 new Rehabilitation plus Extensive Services groups that we proposed to add at the top of the existing RUG-III hierarchy would effectively encompass care “* * * that is at least as intensive as that identified by any of the upper 26 RUG-III groups under the original, 44-group RUG-III classification system.” Accordingly, with the adoption of those 9 new groups as discussed elsewhere in this final rule (and as proposed), we hereby designate as representing a covered level of care under the administrative presumption the upper 35 groups of the refined case-mix classification system (including the upper 26 groups that were previously so designated under the original 44-group system, plus the additional 9 Rehabilitation plus Extensive Services groups that we are now adopting), consisting of the following RUG classifications:

• All groups within the new Rehabilitation plus Extensive Services category;
• All groups within the Ultra High Rehabilitation category;
• All groups within the Very High Rehabilitation category;
• All groups within the High Rehabilitation category;
• All groups within the Medium Rehabilitation category;
• All groups within the Low Rehabilitation category;
• All groups within the Extensive Services category;
• All groups within the Special Care category; and
• All groups within the Clinically Complex category.

Comment: Commenters consistently supported the extension of the administrative presumption to the nine new RUG groups.

Response: We appreciate the commenters' support, and will implement this provision as proposed without modification.

G. Example of Computation of Adjusted PPS Rates and SNF Payment

As explained in section II., from October 1, 2005, through December 31, 2005, we will make payment based entirely on the existing 44-group RUG-III classification system (including any associated add-on payments). Using the model SNF (XYZ) described in Table 10, the following shows the adjustments made to the Federal per diem rate to compute the provider's actual per diem PPS for the time period mentioned above using the existing 44-group RUG-III classification system.

Beginning January 1, 2006, we will make payment based on the refined RUG-53 classification system (and, thus, would not include the add-on payments). Table 10a shows an example of the actual per diem PPS payments under the RUG-53 classification system.

The Labor and Non-labor columns are derived from Tables 6 or 6a. In addition, the adjustment for residents with AIDS enacted in section 511 of the MMA is reflected in Tables 10 and 10a.

Table 10.—RUG-44, SNF XYZ: Located in Benton County, IA (Urban CBSA Designation), Wage Index: 0.8710 (See Transition Wage Index in Table A)

RUG group	Labor	Wage index	Adjusted labor	Non-labor	Adjusted rate	Percent adjustment	Medicare days	Payment
RVC	$282.30	0.8710	$245.88	$89.53	$335.41	*$357.88	14	$5,010
RHA	218.15	0.8710	190.01	69.19	259.20	*276.57	16	4,425
CC2	180.67	0.8710	157.36	57.30	214.66	**489.42	10	4,894
SSC	181.72	0.8710	158.28	57.63	215.91	***259.09	30	7,773
IA2	123.22	0.8710	107.32	39.08	146.40	146.40	30	4,392
Total							100	26,494
*Reflects a 6.7 percent adjustment from section 314 of the BIPA.
**Reflects a 128 percent adjustment from section 511 of the MMA. Section 101(a) of the BBRA no longer applies because of the MMA section 511 adjustment.
***Reflects a 20 percent adjustment from section 101(a) of the BBRA.

Table 10a.—RUG-53, SNF XYZ: Located in Benton County, IA (Urban CBSA Designation) Wage Index: 0.8710 (See Transition Wage Index in Table A)

RUG group	Labor	Wage index	Adjusted labor	Non-labor	Adjusted rate	Percent adjustment	Medicare days	Payment
RVX	$325.13	0.871	$283.19	$103.11	$386.30	$386.30	14	$5,408
RHA	225.47	0.871	196.38	71.50	267.88	267.88	16	4,286
CC2	191.12	0.871	166.47	60.61	227.08	517.73	10	5,177
RLX	223.99	0.871	195.10	71.04	266.14	266.14	30	7,984
IA2	127.40	0.871	110.97	40.40	151.37	151.37	30	4,541
Total							100	27,396
* Reflects a 128 percent adjustment from section 511 of the MMA.

H. SNF Market Basket Index

1. Background

Section 1888(e)(5)(A) of the Act requires us to establish a SNF market basket index (input price index) that reflects changes over time in the prices of an appropriate mix of goods and services included in the SNF PPS. This final rule incorporates the latest available projections of the SNF market basket index. Accordingly, we have developed a SNF market basket index that encompasses the most commonly used cost categories for SNF routine services, ancillary services, and capital-related expenses. In the July 31, 2001 Federal Register (66 FR 39562), we included a complete discussion on the rebasing of the SNF market basket to FY 1997. There are 21 separate cost categories and respective price proxies. These cost categories were illustrated in Table 10.A, Table 10.B, and Appendix A, along with other relevant information, in the July 31, 2001 Federal Register.

Each year, we calculate a revised labor-related share based on the relative importance of labor-related cost categories in the input price index. Table 11 summarizes the updated labor-related share for FY 2006.

Table 11.—Labor-related Relative Importance, FY2005 and FY2006

	Relative importance, labor-related, FY 2005 (97 index)	Relative importance, labor-related, FY 2006 (97 index)
Wages and salaries	54.356	54.391
Employee benefits	11.506	11.648
Nonmedical professional fees	2.708	2.739
Labor-intensive services	4.114	4.128
Capital-related	3.092	3.016
Total	75.776	75.922
Source: Global Insights, Inc., formerly DRI-WEFA, 2nd Quarter, 2005.

2. Use of the SNF Market Basket Percentage

Section 1888(e)(5)(B) of the Act defines the SNF market basket percentage as the percentage change in the SNF market basket index, as described in the previous section, from the average index level of the prior fiscal year to the average index level of the current fiscal year. For the Federal rates established in this final rule, this percentage increase in the SNF market basket index is used to compute the update factor occurring between FY 2005 and FY 2006. We used the Global Insights, Inc. (formerly DRI-WEFA), 2nd quarter 2005 forecasted percentage increase in the FY 1997-based SNF market basket index for routine, ancillary, and capital-related expenses, described in the previous section, to compute the update factor.

Comment: The current SNF market basket is based on FY 1997 Medicare cost report data. Several commenters requested that CMS utilize more up-to-date cost reports in the SNF market basket in order to produce more accurate and representative weights for the various cost categories, such as compensation and pharmaceuticals. They also requested that CMS review the price proxies used in the market basket, specifically the Employment Cost Index (ECI) for wages and salaries for Private Nursing Homes. This price proxy includes wage price data for SNFs as well as for other nursing and long-term care facilities. One commenter claimed the staffing mix in a SNF is much different than in these other types of facilities. Finally, a few commenters suggested that CMS collect SNF-specific labor data provided by the SNF industry.

Response: CMS is considering revising and rebasing the SNF market basket in the near future. We would expect to use the most recent and complete SNF Medicare cost reports available. Moreover, we would use the SNF Medicare cost reports to develop as many viable cost category weights (such as wages and salaries, benefits, contract labor, and pharmaceuticals) as possible. We also plan to review alternative price proxies based on our criteria of relevance, reliability, timeliness, and public availability. We will include a detailed discussion of our analysis when we propose a revised and rebased SNF market basket, and will also provide an opportunity for public comment.

Comment: Several commenters requested that the SNF rebasing follow the same frequency planned for IPPS hospital rebasing, currently set at every four years.

Response: As noted above, we intend to revise and rebase the SNF market basket in the near future, and we would use the most recent and complete SNF Medicare cost reports available to do this. We will keep the commenters' suggestions in mind in considering whether to establish a schedule for rebasing the SNF market basket.

Comment: Several commenters requested that the SNF market basket be revised to reflect industry data and CMS's own data, which show that prescription drugs represent more than 10 percent of SNF costs. They cite the CMS Health Care Financing Review, which shows that Medicare SNF facility charges for pharmaceuticals from 1997 to 2001 represent over 10 percent of total Medicare SNF facility charges. Also, one commenter stated the pharmaceutical cost weight was derived using a combination of nursing facility and hospital cost reports.

Response: The market basket is intended to reflect the average change in the price of a basket of goods and services that SNFs purchase in order to furnish patient care. The current market basket is based on the purchasing behavior of SNFs in 1997. Preliminary analysis shows that both the FY 2002 and FY 2003 pharmaceutical cost weights (the cost of pharmaceuticals as a percent of total costs), based on freestanding SNF Medicare cost reports, are slightly below 3 percent, compared to 3 percent in the 1997-based SNF market basket. It would be inappropriate for the market basket weight to reflect trends in charges, which have little relationship to the actual costs incurred.

The pharmaceutical cost weight in the 1997-based SNF market basket is based on Medicare cost reports of freestanding SNF facilities. As discussed in the SNF PPS proposed rule for FY 2002, hospital cost report data were not used to derive this cost weight (66 FR 24013, May 10, 2001).

Comment: In view of the concern regarding the adequacy of the pharmaceutical cost weight included in the SNF market basket, we received a comment recommending that we identify discrepancies between the forecasted and actual cost of pharmaceuticals, and develop an adjustment mechanism similar to the forecast error correction policy described previously in section I.G of this final rule.

Response: As part of the forecast error correction, the difference between the projected and actual pharmaceutical price increases is incorporated. Therefore, it would be inappropriate to develop a separate mechanism.

Comment: One commenter suggested that CMS should study the effect of adding a separate weight for professional liability insurance (PLI), and should work with the SNF industry to determine how the weight should be calculated and how to develop an appropriate price index.

Response: We intend to review both SNF cost reports and other industry data to determine the feasibility of developing a weight and price proxy for PLI for SNFs. We look forward to working with the SNF industry on this effort, and have already received feedback about the nature of PLI for SNFs.

3. Market Basket Forecast Error Adjustment

As discussed in the June 10, 2003, supplemental proposed rule (68 FR 34768) and finalized in the August 4, 2003, final rule (68 FR 46067), the regulations at 42 CFR 413.337(d)(2) provide for an adjustment to account for market basket forecast error. The initial adjustment applied to the update of the FY 2003 rate that occurred in FY 2004, and took into account the cumulative forecast error for the period from FY 2000 through FY 2002. Subsequent adjustments in succeeding FYs take into account the forecast error from the most recently available fiscal year for which there is final data, and are applied whenever the difference between the forecasted and actual change in the market basket exceeds a 0.25 percentage point threshold. As discussed previously in section I.G of this final rule, as the difference between the estimated and actual amounts of increase in the market basket index for FY 2004 (the most recently available fiscal year for which there is final data) did not exceed the 0.25 percentage point threshold, the payment rates for FY 2006 do not include a forecast error adjustment.

4. Federal Rate Update Factor

Section 1888(e)(4)(E)(ii)(IV) of the Act requires that the update factor used to establish the FY 2006 Federal rates be at a level equal to the full market basket percentage change. Accordingly, to establish the update factor, we determined the total growth from the average market basket level for the period of October 1, 2004 through September 30, 2005 to the average market basket level for the period of October 1, 2005 through September 30, 2006. Using this process, the market basket update factor for FY 2006 SNF Federal rates is 3.1 percent. We used this revised update factor to compute the Federal portion of the SNF PPS rate shown in Tables 2 and 3.

I. Consolidated Billing

As established by section 4432(b) of the BBA, the consolidated billing requirement places with the SNF the Medicare billing responsibility for virtually all of the services that the SNF's residents receive, except for a small number of services that the statute specifically identifies as being excluded from this provision. Section 103 of the BBRA amended this provision by further excluding a number of high-cost, low probability services (identified by Healthcare Common Procedure Coding System (HCPCS) codes) within several broader categories that otherwise remained subject to the provision. Section 313 of the BIPA further amended this provision by repealing its Part B aspect, that is, its applicability to services furnished to a resident during a SNF stay that Medicare does not cover. (However, physical and occupational therapy, and speech-language pathology services remain subject to consolidated billing, regardless of whether the resident who receives these services is in a covered Part A stay.) In addition, section 313 of the BIPA specified that consolidated billing applies only to services furnished to those individuals residing in an institution (or portion of an institution) that is actually certified by Medicare as a SNF. Further, as noted in section I.E. of this final rule, section 410 of the MMA revised the SNF consolidated billing requirement as to certain services furnished on or after January 1, 2005, by rural health clinics (RHCs) and Federally qualified health centers (FQHCs).

To date, the Congress has enacted no further legislation affecting the consolidated billing provision. However, as we noted in the April 10, 2000 proposed rule (65 FR 19232), section 1888(e)(2)(A)(iii) of the Act, as added by section 103 of the BBRA, not only identified for exclusion from this provision a number of particular service codes within four specified categories (that is, chemotherapy items, chemotherapy administration services, radioisotope services, and customized prosthetic devices), but “ * * * also gives the Secretary the authority to designate additional, individual services for exclusion within each of the specified service categories.” In the FY 2001 proposed rule, we also noted that the BBRA Conference Report (H.R. Conf. Rep. No. 106-479 at 854) characterizes the individual services that this legislation targets for exclusion as “* * * high-cost, low probability events that could have devastating financial impacts because their costs far exceed the payment [SNFs] receive under the prospective payment system * * *.” According to the conferees, section 103(a) “is an attempt to exclude from the PPS certain services and costly items that are provided infrequently in SNFs * * *.” By contrast, we noted that the Congress declined to designate for exclusion any of the remaining services within those four categories (thus leaving all of those services subject to SNF consolidated billing), because they are relatively inexpensive and are furnished routinely in SNFs.

As we further explained in the July 31, 2000 final rule (65 FR 46790), any additional service codes that we might designate for exclusion under our discretionary authority must meet the same criteria that the Congress used in identifying the original codes excluded from consolidated billing under section 103(a) of the BBRA: They must fall within one of the four service categories specified in the BBRA, and they also must meet the same standards of high cost and low probability in the SNF setting. Accordingly, we characterized this statutory authority to identify additional service codes for exclusion “* * * as essentially affording the flexibility to revise the list of excluded codes in response to changes of major significance that may occur over time (for example, the development of new medical technologies or other advances in the state of medical practice)” (65 FR 46791). In view of the amount of time that has elapsed since we last invited comments on this issue, we invited public comments in the FY 2006 SNF PPS proposed rule on codes in any of these four service categories which represent recent medical advances that might meet the BBRA criteria for exclusion from SNF consolidated billing (70 FR 29098).

Comment: Commenters proposed for exclusion particular services that fell within the four specified categories specified by section 103 of the BBRA (chemotherapy items, chemotherapy administration services, radioisotope services, and customized prosthetic devices).

Response: We will further examine whether these particular services should be excluded as we complete work on the 2006 annual updated list of the specific HCPCS codes that are excluded from consolidated billing, which we plan to issue this fall.

Comment: Noting that some chemotherapy drugs have two HCPCS codes assigned—both a C code and a J code—two commenters pointed out that a number of the chemotherapy medications that we exclude by J code also have C codes assigned to them. They asserted that hospital outpatient departments are mandated to use C codes when billing Medicare for some chemotherapy medications under the hospital outpatient prospective payment system and asked that we add the corresponding C codes for the following codes: J9040, J9060, J9065, J9070, J9093, J9100, J9130, J9150, J9181, J9200, J9208, J9211, J9265, and J9280.

Response: It is our understanding that hospital outpatient departments can, in fact, use J codes when billing Medicare for chemotherapy medications. Accordingly, at this time we see no need to add the corresponding C codes when the J code chemotherapy medications are already excluded.

Comment: Although the FY 2006 SNF PPS proposed rule specifically invited comments on possible exclusions within the specific service categories identified in the BBRA legislation, a number of commenters took this opportunity to reiterate concerns about other aspects of consolidated billing. For example, we received a number of comments concerning the possible exclusion of additional categories of services from SNF consolidated billing, beyond those specified in the BBRA. The commenters identified services such as barium swallows, video fluoroscopies, hyperbaric oxygen therapy, sterile larvae therapy, ultrasonic procedures and duplex scans, PET scans, and nuclear medicine as appropriate candidates for exclusion. In addition, a number of commenters recommended a further set of services for exclusion. These additional services are durable medical equipment (including, but not limited to, wound care devices and diabetic shoes), total parenteral nutrition (TPN), and specialized bariatric equipment.

Response: As we noted previously in the final rule of August 4, 2003 (68 FR 46060), the original set of consolidated billing exclusions at section 1888(e)(2)(A)(ii) of the Act (as enacted by section 4432(b) of the BBA) broadly excluded entire categories of services from consolidated billing (primarily, those of physicians and certain other types of medical practitioners). By contrast, the set of statutory exclusions at section 1888(e)(2)(A)(iii) of the Act, as subsequently enacted by section 103 of the BBRA, was more specifically targeted within a number of broader service categories. In the FY 2006 SNF PPS proposed rule, we noted that the original BBRA legislation (as well as the implementing regulations) provides the Secretary the authority to designate additional, individual services for exclusion within each of the BBRA-specified service categories. However, the statute does not provide the Secretary the authority to create additional categories of excluded services beyond those specified in the law. Therefore, based on the statute, we cannot exclude services and items from consolidated billing unless they fall into the categories of services provided in the statute.

Comment: Some commenters cited the existing list of exclusions (in § 411.15(p)(3)(iii)) for certain high-intensity outpatient hospital services, and expressed the view that these exclusions should not be limited to only those services that actually require the intensity of a hospital setting, but rather, should also encompass services furnished in other, nonhospital settings as well. As examples, they cited services such as magnetic resonance imaging (MRIs) and computerized axial tomography (CT) scans furnished in freestanding imaging centers, and radiation therapy furnished in physician's clinics or ambulatory care centers, all of which may be cheaper and more accessible in certain particular localities (such as rural settings) than those furnished by hospitals.

Response: As we noted in the May 12, 1998 interim final rule (63 FR 26298), in the July 31, 2000 final rule (65 FR 46790 through 46791), and again in the August 4, 2003 final rule (68 FR 46061), the exclusion of certain outpatient hospital services (in § 411.15(p)(3)(iii)) is targeted specifically at those services “* * * that, under commonly accepted standards of medical practice, lie exclusively within the purview of hospitals * * *” (emphasis added); that is, services which generally require the intensity of the hospital setting in order to be furnished safely and effectively. We have determined that this high level of outpatient hospital care is beyond the scope of SNF comprehensive care plans and should be excluded from consolidated billing. However, this exclusion does not encompass services furnished in any other health care setting. Thus, to the extent that advances in medical practice over time may make it feasible to perform such a service more widely in a less intensive, nonhospital setting, this would not argue in favor of excluding the nonhospital performance of the service from consolidated billing under these regulations, but rather, would call into question whether the service should continue to be excluded from consolidated billing at all, even when performed in the hospital setting. In addition, we note that unlike the outpatient hospital exclusions in § 411.15(p)(3)(iii), the statutory exclusions enacted by the BBRA for certain chemotherapy and other services apply regardless of the setting (hospital versus freestanding) in which the services are furnished. However, we do not have the authority to add services such as MRIs, CT scans, or radiation therapy to the existing statutory list administratively.

Comment: Several commenters also proposed expanding the list of excluded services by redefining categories of service that are currently excluded from consolidated billing. For example, while the BBRA excludes specific chemotherapy services by HCPCS codes, these commenters recommended not only adding to the list of excluded chemotherapy pharmaceuticals, but expanding the exclusion to encompass all related services associated with a chemotherapy treatment, such as supplies and other pharmaceuticals used to treat side effects. In addition, several commenters recommended exclusion of oral chemotherapy agents that are not separately billable to Medicare Part B for any beneficiary, and are currently covered only as part of the overall package of services furnished under the Part A inpatient hospital or SNF benefits.

Response: In the FY 2006 SNF PPS proposed rule, we noted that the BBRA's list of services excluded by HCPCS code is a targeted list, narrowly carving out only certain individual “high-cost, low probability” services within a number of broader service categories—such as chemotherapy services—that otherwise remained subject to consolidated billing. As we noted in the FY 2006 SNF PPS proposed rule, the BBRA provides the Secretary the authority to designate additional, individual services for exclusion within each of the service categories that it specifies. However, the statute does not provide authority to exclude other services that, while related, fall outside of the specified service categories themselves. For example, although anti-nausea drugs are commonly used in conjunction with chemotherapy, they are not in themselves chemotherapeutic agents and, consequently, do not fall within one of the excluded categories designated in the BBRA. Further, we believe that the Congress was clear in its intent regarding the particular items and services to be excluded from consolidated billing, by use of the HCPCS codes specified in the Act. Regarding the suggestion to exclude from consolidated billing those oral chemotherapy agents that are not separately billable to Part B (and are currently covered only under the Part A inpatient hospital and SNF benefits), we note that expanding the existing statutory drug coverage available under Part B to include those drugs is not within our authority.

We note that some chemotherapy pharmaceuticals that commenters proposed for exclusion have already been added to the list of HCPCS codes excluded from the consolidated billing provisions. The most recent annual update regarding HCPCS exclusions from consolidated billing can be found in Transmittal No. 360 (Change Request (CR) No. 3542), issued on November 5, 2004, which is available online at http://www.cms.hhs.gov/​manuals/​transmittals/​comm_​date_​dsc.asp.

Comment: A few commenters requested an expansion of the existing Part B dialysis exclusion to encompass dialysis services furnished directly by the SNF. In addition, several commenters noted that erythropoietin (EPO or Aranesp) currently is excluded from consolidated billing only when furnished in conjunction with the Part B dialysis benefit, and they recommended expanding this exclusion to encompass its use in connection with other, non-dialysis forms of treatment (such as chemotherapy).

Response: As we noted previously in the final rule published on August 4, 2003 (68 FR 46062), under section 1888(e)(2)(A)(ii) of the Act, the exclusion of dialysis services from consolidated billing applies only to those services that meet the requirements for coverage under the separate Part B dialysis benefit at section 1861(s)(2)(F) of the Act. The Part B benefit allows for home dialysis and dialysis performed on the premises of a certified dialysis facility. By contrast, if the SNF itself elects to furnish dialysis services to a resident during a covered Part A stay (either directly with its own resources, or under an “arrangement” with a certified dialysis facility in which the SNF itself does the billing), the services are no longer considered Part B dialysis services, but instead are Part A SNF services. Accordingly, they would no longer be subject to the statutory exclusion of Part B dialysis services from consolidated billing, and would instead be bundled into the comprehensive PPS per diem payment that the SNF receives for the package of services that it furnishes during the resident's covered Part A stay.

Similarly, under section 1888(e)(2)(A)(ii) of the Act, the exclusion of EPO from consolidated billing applies only to those services that meet the requirements for coverage under the separate Part B EPO benefit at section 1861(s)(2)(O) of the Act. Section 1861(s)(2)(O) of the Act permits coverage of EPO and items related to its administration for those dialysis patients who can self-administer the drug, subject to methods and standards established by the Secretary for its safe and effective use (as described in § 405.2163(g) and (h)). Since EPO that is used for non-dialysis patients does not fall within the scope of section 1861(s)(2)(O) of the Act, that usage does not fall within the scope of the EPO exclusion from consolidated billing.

Comment: One commenter requested that we amend 42 CFR § 409.20(a)(3) and 409.23 to add recreational therapy to the current list of rehabilitation services (i.e., physical and occupational therapy and speech-language pathology services).

Response: The purpose of the two above-cited sections of the regulations is to implement section 1861(h)(3) of the Act, which currently specifies that “* * * ‘extended care services’ means the following items and services furnished to an inpatient of a skilled nursing facility * * * (3) physical or occupational therapy or speech-language pathology services furnished by the skilled nursing facility or by others under arrangements with them made by the facility * * *.” Notably, recreational therapy is not included in this statutory definition and we cannot adopt the commenter's request to revise the regulations.

J. Application of the SNF PPS to SNF Services Furnished by Swing-Bed Hospitals

In accordance with section 1888(e)(7) of the Act (as amended by section 203 of the BIPA), Part A pays critical access hospitals (CAHs) on a reasonable cost basis for SNF services furnished under a swing-bed agreement. However, as noted previously in section I.A. of this final rule, the services furnished by non-CAH rural hospitals are paid under the SNF PPS. In the July 31, 2001 final rule (66 FR 39562), we announced the conversion of swing-bed rural hospitals to the SNF PPS, effective with the start of the provider's first cost reporting period beginning on or after July 1, 2002. We selected this date consistent with the statutory provision to integrate swing-bed rural hospitals into the SNF PPS by the end of the SNF transition period, June 30, 2002.

As of June 30, 2003, all swing-bed rural hospitals have come under the SNF PPS. Therefore, the SNF PPS rates and wage indexes outlined in earlier sections of this final rule for SNFs also apply to all swing-bed rural hospitals. A complete discussion of assessment schedules, the MDS and the transmission software, Raven-SB for Swing Beds can be found in the July 31, 2001 final rule (66 FR 39562). The latest changes in the MDS for swing-bed rural hospitals are listed on our SNF PPS web site, http://www.cms.hhs.gov/​providers/​snfpps/​default.asp.

K. Qualifying Three-Day Inpatient Hospital Stay Requirement

In the FY 2006 SNF PPS proposed rule, we noted that one of the prerequisites for Part A coverage under the Medicare SNF benefit is a qualifying hospital stay of at least 3 consecutive days, and that under current policy, only time following the formal inpatient admission to the hospital counts toward meeting this requirement. We invited comments on having patients spend time in observation status prior to a formal inpatient admission, and on the potential implications of this practice for the SNF benefit's qualifying 3-day hospital stay requirement.

Comment: Of the comments that we received on this issue, most expressed support for the idea that hospital time spent in observation status immediately preceding a formal inpatient admission should count toward satisfying the SNF benefit's statutory qualifying three-day hospital stay requirement, while some advocated eliminating the statutory requirement altogether. Still others recommended counting all time spent in the hospital (not only in observation status, but also in the emergency room as well), while some others supported counting the observation time but were opposed to counting time spent in the emergency room. Other commenters raised related issues regarding the availability of information in this area, such as the inability of existing CMS operating systems (including the claims and cost reporting systems) to accommodate the counting of observation time for this purpose without further modification, and the inability of SNFs to distinguish between observation and emergency room time spent in the hospital. Some of these commenters also suggested taking certain additional measures, such as requiring the hospital to certify that a beneficiary has met the SNF benefit's qualifying 3-day stay requirement (and to assume the financial liability for any related coverage denials), and examining ways in which SNFs can obtain better information from hospitals about the specific nature and duration of a patient's hospital stay.

Response: Regarding the comments that expressed support for repealing the statutory 3-day qualifying hospital stay requirement altogether, we note that such an action would require legislation by the Congress to amend the law itself and, thus, is beyond the scope of this final rule. Further, we do not share the belief expressed by some commenters that time spent in the emergency room is essentially comparable to observation time in this context. As we noted in the FY 2006 SNF PPS proposed rule, except for scheduled admissions, the emergency room generally serves as the overall point of entry into the hospital for most patients; thus, the mere presence of time spent in the emergency room prior to formal admission would not, in itself, serve to identify the degree of severity of a particular patient's condition during that time.

With regard to the comments that suggested other possible modifications to the 3-day inpatient hospital stay requirement, we note that we are continuing to review this issue, but are not yet ready to make a final determination at this time. As we observed in the FY 2006 SNF PPS proposed rule, the SNF benefit was never intended to cover long-term, relatively low-level “custodial” care; rather, the Congress envisioned this benefit more narrowly, in terms of serving as a less expensive alternative to what would otherwise be the final, convalescent portion of an acute care stay of several days as an inpatient at a hospital. Thus, any potential changes in the SNF benefit's qualifying hospital stay requirement would need to be carefully evaluated, in order to ensure that they accurately reflect Congressional intent in establishing the qualifying hospital stay requirement, and would not result in altering the unique nature of the SNF benefit in a manner that is inconsistent with that intent.

IV. Provisions of the Final Rule

In section III. above, “Analysis of and Responses to Public Comments on the FY 2006 SNF PPS Proposed Rule,” we have added a statement at the end of each issue indicating our final decision either to adopt the provisions as set forth in the FY 2006 SNF PPS proposed rule or to make modifications based on public comments. However, all other changes, including clarifying and technical changes that are not issue-specific will be addressed in this section below.

Specifically, we are making the following technical correction in the regulations text, as discussed in the FY 2006 SNF PPS proposed rule: we are correcting the definition of “HCPCS” that appears in § 424.3, by removing the acronym “CMS” and adding the word “Healthcare” in its place.

Further, we note that we are taking this opportunity to make two additional technical corrections in Part 409 of the regulations. The first involves updating an obsolete citation that appears in several places in § 409.60(c). This section of the regulations sets forth several administrative presumptions that serve to help determine the end of a benefit period in a SNF, and it makes repeated references to an obsolete citation (§ 405.330) for the provision dealing with limitation of liability for care that is custodial or not reasonable and necessary. Accordingly, we are hereby updating that obsolete citation by replacing it with the current citation, § 411.400.

The other correction to Part 409 involves the regulations at 42 CFR 409.31(b)(2), which describe one aspect of the SNF level of care requirements. In a final rule published on August 22, 2003 (68 FR 50855), we added § 409.31(b)(2)(iii) regarding Medicare+Choice (M+C) enrollees. However, in republishing § 409.31(b)(2)(ii), we inadvertently omitted several words that previously had appeared in the text. Accordingly, we are now taking this opportunity to restore the missing language, so that § 409.31(b)(2)(ii) is revised to reflect its original complete and accurate language.

Finally, we note that in the FY 2004 final rule (68 FR 46060, 46070, August 4, 2003), we added two radiopharmaceuticals, Zevalin and Bexxar, to the list of chemotherapy drugs that are excluded from consolidated billing (and, thus, are separately billable to Part B when furnished to a SNF resident during a covered Part A stay). The final rule specified that regulation text at 42 CFR 411.15(p)(2)(xii) and 42 CFR 489.20(s)(12) list the Healthcare Common Procedure Coding System (HCPCS) codes for Zevalin (A9522 and A9523) “as of January 1, 2004.” At the time the FY 2004 final rule was published, the codes for Bexxar were not yet available (see 68 FR 46060) but were about to be issued. Accordingly, we are now adding the initial Bexxar HCPCS codes to 42 CFR 411.15(p)(2)(xii) and 42 CFR 489.20(s)(12) effective “as of January 1, 2004.” These codes for Bexxar are A9533 and A9534. As we clarified in the September 29, 2003 Federal Register (68 FR 55883), the HCPCS codes to be utilized in connection with Bexxar and Zevalin include any successor codes that may replace (or supplement) the codes currently listed in the regulation. Such successor codes are disseminated through program instructions.

V. Waiver of Proposed Rulemaking

Regarding the technical corrections to Parts 409, 411, and 489 of the regulations that we discuss in the preceding section, we note that we would ordinarily publish a notice of proposed rulemaking in the Federal Register to provide a period for public comment before revisions in the regulations text would take effect; however, we can waive this procedure if we find good cause that a notice and comment procedure is impracticable, unnecessary, or contrary to the public interest and incorporate a statement of the finding and its reasons in the notice issued. We find it unnecessary to undertake notice and comment rulemaking in connection with these particular revisions, as they merely provide technical corrections to the regulations, without making any substantive changes. Therefore, for good cause, we waive notice and comment procedures for the revisions that we are making to the regulations text in Parts 409, 411, and 489.

VI. Collection of Information Requirements

This document does not impose information collection and recordkeeping requirements. Consequently, it need not be reviewed by the Office of Management and Budget under the authority of the Paperwork Reduction Act of 1995 (44 U.S.C. 3501 et seq.).

VII. Regulatory Impact Analysis

A. Overall Impact

We have examined the impacts of this final rule as required by Executive Order 12866 (September 1993, Regulatory Planning and Review), the Regulatory Flexibility Act (RFA, September 16, 1980, Pub. L. 96-354), section 1102(b) of the Social Security Act, the Unfunded Mandates Reform Act of 1995 (Pub. L. 104-4), and Executive Order 13132.

Executive Order 12866 (as amended by Executive Order 13258, which merely reassigns responsibility of duties) directs agencies to assess all costs and benefits of available regulatory alternatives and, if regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health and safety effects, distributive impacts, and equity). A regulatory impact analysis (RIA) must be prepared for major rules with economically significant effects ($100 million or more in any 1 year). This final rule is a major rule, as defined in Title 5, United States Code, section 804(2), because we estimate the impact to the Medicare program, and the annual effects to the overall economy, would be more than $100 million.

The RFA requires agencies to analyze options for regulatory relief of small businesses. For purposes of the RFA, small entities include small businesses, nonprofit organizations, and government agencies. Most SNFs and most other providers and suppliers are small entities, either by their nonprofit status or by having revenues of $11.5 million or less in any 1 year. For purposes of the RFA, approximately 53 percent of SNFs are considered small businesses according to the Small Business Administration's latest size standards, with total revenues of $11.5 million or less in any 1 year (for further information, see 65 FR 69432, November 17, 2000). Individuals and States are not included in the definition of a small entity. In addition, approximately 29 percent of SNFs are nonprofit organizations.

This final rule updates the SNF PPS rates published in the FY 2005 update notice on July 30, 2004 (69 FR 45775) and the associated correction notices published on October 7, 2004 (69 FR 60158), and December 30, 2004 (69 FR 78445).

In addition, section 1102(b) of the Act requires us to prepare a regulatory impact analysis if a rule may have a significant impact on the operations of a substantial number of small rural hospitals. This analysis must conform to the provisions of section 603 of the RFA. For purposes of section 1102(b) of the Act, we define a small rural hospital as a hospital that is located outside of a Metropolitan Statistical Area and has fewer than 100 beds. We anticipate that the impact on swing-bed facilities will be similar to the impact on rural hospital-based facilities, which benefit from the case-mix refinement (see Table 12 below).

Section 202 of the Unfunded Mandates Reform Act of 1995 also requires that agencies assess anticipated costs and benefits before issuing any rule that may result in expenditure in any 1 year by State, local, or tribal governments, in the aggregate, or by the private sector, of $110 million or more. This final rule will not have a substantial effect on the governments mentioned, or on private sector costs.

Executive Order 13132 establishes certain requirements that an agency must meet when it promulgates a proposed rule (and subsequent final rule) that imposes substantial direct requirement costs on State and local governments, preempts State law, or otherwise has Federalism implications. As stated above, this final rule will not have a substantial effect on State and local governments.

B. Anticipated Effects

This final rule sets forth updates of the SNF PPS rates contained in the FY 2005 update notice (69 FR 45775) and the associated correction notices (69 FR 60158 and 69 FR 78445), and implements a refinement to the RUG-III case-mix classification system to be incorporated into the Medicare SNF PPS effective January 1, 2006.

As described in Section III., providers will continue to be paid under the current 44-group RUG-III system from October 1, 2005 through December 31, 2005. Beginning January 1, 2006, providers will be paid under the refined RUG-53 system.

Based on the above, we estimate the FY 2006 impact will be a net increase of $20 million in payments to SNF providers (this reflects a $1.02 billion reduction from the expiration of temporary payment increases, offset by a $510 million increase from the refined case-mix classification system and a $530 million increase from the update to the payment rates, as explained in greater detail later in this section). The impact analysis in Table 12 of this final rule represents the projected effects of the policy changes in the SNF PPS from FY 2005 to FY 2006. We estimate the effects by estimating payments while holding all other payment variables constant. We use the best data available, but we do not attempt to predict behavioral responses to these changes, and we do not make adjustments for future changes in such variables as days or case-mix.

We note that certain events may combine to limit the scope or accuracy of our impact analysis, because such an analysis is future-oriented and, thus, susceptible to forecasting errors due to other changes in the forecasted impact time period. Some examples are newly-legislated general Medicare program funding changes by the Congress, or changes specifically related to SNFs. In addition, changes to the Medicare program may continue to be made as a result of the BBA, the BBRA, the BIPA, the MMA, or new statutory provisions. Although these changes may not be specific to the SNF PPS, the nature of the Medicare program is such that the changes may interact, and the complexity of the interaction of these changes could make it difficult to predict accurately the full scope of the impact upon SNFs.

In accordance with section 1888(e)(4)(E) of the Act, we are updating the payment rates for FY 2006. The BBRA, BIPA, and MMA provided for several temporary adjustments to the SNF PPS payment rates that together, using the most recent data available, accounted for an estimated impact of $1.4 billion per year.

We note that in accordance with section 101(a) of the BBRA and section 314 of the BIPA, the existing, temporary increase in the per diem adjusted payment rates of 20 percent for certain specified clinically complex RUGs (and 6.7 percent for other, rehabilitation RUGs) would expire with the implementation of the case-mix refinements in the SNF PPS. As explained in section II. of this final rule, section 511 of the MMA, which provides for a 128 percent increase in the PPS per diem payment for any SNF resident with Acquired Immune Deficiency Syndrome (AIDS), remains in effect. However, we have not provided a separate impact analysis for the MMA provision. Our latest estimates indicate that there are less than 2,000 beneficiaries who qualify for the AIDS add-on payment. The impact to Medicare is included in the “total” column of Table 12.

In updating the rates for FY 2006, we made a number of standard annual revisions and clarifications mentioned elsewhere in this final rule (for example, the update to the wage and market basket indexes used for adjusting the Federal rates). These revisions would increase payments to SNFs by approximately $530 million.

The aggregate change in payments associated with this final rule is estimated to be an increase in payments to SNFs of $20 million for FY 2006. The decrease of $1.02 billion due to the elimination of the temporary add-ons, together with the additional payment due to the refined case-mix classification system of $510 million and the market basket increase of $530 million, results in a net change in payments of $20 million. There are two areas of change that produce this impact on SNFs:

1. The implementation of a refined case-mix classification system under section 1888(e)(4)(G)(i) of the Act and, consequently, the expiration of the temporary 20 percent/6.7 percent add-ons to the Federal rates for the specified RUG groups.

2. The total change in payments from FY 2005 levels to FY 2006 levels. This includes all of the previously noted changes in addition to the effect of the update to the rates.

The impacts are shown in Table 12. The breakdown of the various categories of data in the table follows.

The first column shows the breakdown of all SNFs by urban or rural status, hospital-based or freestanding status, and census region.

The first row of figures in the first column describes the estimated effects of the various changes on all facilities. The next 6 rows show the effects on facilities split by hospital-based, freestanding, urban, and rural categories. The urban and rural designations are based on the location of the facility under the CBSA designations. The next 20 rows show the effects on urban versus rural status by census region.

The second column in the table shows the number of facilities in the impact database.

The third column of the table shows the effect of the annual update to the wage index. This represents the effect of using the most recent wage data available. The total impact of this change is zero percent; however, there are distributional effects of the change.

The fourth column of the table shows the effect of using the new OMB geographic designations based on CBSAs. During the FY 2006 transition to CBSAs, SNFs will receive a transition-based wage index value consisting of a blend of 50 percent of the FY 2006 MSA-based wage index and 50 percent of the FY 2006 CBSA-based wage index (see Table A in the Addendum), as described in Section III.D.1 of this final rule.

The fifth column of the table shows the effect of the elimination of the add-on for specified RUG groups. As expected, this results in a decrease in payments for all providers.

The sixth column of the table shows the effect of the refinements to the case-mix classification system. Table 12 shows that there is a positive 3 percent overall impact from the case-mix refinements. Distributional effects are noted for specific providers. For example, hospital-based facilities are expected to receive greater than an 7.7 percent increase in payment, compared with freestanding facilities that show an increase in payments of between 2.2 percent and 2.6 percent. Additionally, rural Census regions show increases in payments of 3.4 percent.

The seventh column of the table shows the effect of all of the changes on the FY 2006 payments. As the market basket increase of 3.1 percentage points is constant for all providers, it is not shown individually; however, we note that the “Total FY 2006 change” column does incorporate this increase. It is projected that aggregate payments will increase by $20 million, assuming facilities do not change their care delivery and billing practices in response.

As can be seen from this table, the combined effects of all of the changes would vary by specific types of providers and by location. For example, though facilities in the urban New England and rural South Atlantic regions experience payment decreases of 0.4 percent and 0.4 percent, respectively, some providers (such as those in the rural Pacific and rural New England regions) show increases of 4.1 percent and 2.4 percent, respectively. Payment increases for facilities in the Rural Pacific area of the country are the highest for any provider category.

Table 12.—Projected Impact to the SNF PPS for FY 2006

	Number of facilities	Update wage data (percent)	MSA to CBSA (percent)	Eliminate add-on to certain RUGs (percent)	Case-mix refinements (percent)	Total FY 2006 change (percent)
Total	15,675	0.0	0.0	−6.0	3.0	0.1
Urban	10,599	0.0	0.0	−6.0	2.9	0.0
Rural	5,076	0.1	0.1	−6.0	3.4	0.7
Hospital based urban	1,097	0.0	0.0	−6.3	7.8	4.6
Freestanding urban	8,693	0.0	0.0	−5.9	2.2	−0.6
Hospital based rural	1,160	0.0	0.1	−6.8	7.7	4.1
Freestanding rural	3,372	0.1	0.1	−5.9	2.6	0.1
Urban by Region
New England	917	−0.2	−0.1	−6.4	3.2	−0.4
Middle Atlantic	1,499	0.2	0.0	−6.1	3.0	0.2
South Atlantic	1,739	−0.3	0.0	−5.9	2.9	−0.3
East North Central	2,009	−0.4	0.0	−5.7	2.9	−0.2
East South Central	531	0.3	0.0	−6.0	2.6	0.0
West North Central	836	−0.6	0.0	−5.9	3.6	0.3
West South Central	1,093	−0.1	0.1	−5.8	2.6	0.0
Mountain	467	−0.3	0.1	−5.6	2.9	0.2
Pacific	1,501	1.2	0.0	−6.2	2.9	1.0
Rural by Region
New England	139	2.0	0.0	−5.7	3.0	2.4
Middle Atlantic	283	−0.1	0.1	−6.0	3.6	0.7
South Atlantic	612	−0.3	0.0	−6.2	3.0	−0.4
East North Central	947	0.3	0.0	−5.9	3.8	1.4
East South Central	571	0.1	0.1	−6.3	2.6	−0.4
West North Central	1,219	−0.5	0.1	−6.2	4.1	0.7
West South Central	823	0.2	0.0	−6.2	2.7	−0.2
Mountain	298	0.6	−0.2	−5.9	3.8	1.4
Pacific	182	1.6	0.0	−4.2	3.6	4.1
Ownership
Government	693	0.0	0.2	−6.5	4.8	1.6
Proprietary	9,317	0.0	0.0	−5.9	2.3	−0.6
Voluntary	3,493	−0.1	0.0	−6.0	4.9	1.9

Comment: Several commenters asked that we provide additional data and files to help them model the impact on providers.

Response: CMS worked to make additional data and updated analyses readily available throughout the comment period, and posted these additional data and analyses to the CMS website as soon as they became available.

Comment: A few commenters expressed concern that the proposed FY 2006 market basket update was included in our impact analysis. They contended that the market basket update reflects changes in price levels that have already taken place and, in their view, reimburses them for expenses they have already incurred. By including the market basket update in the impact analysis, these commenters argue that we have understated the actual impact of the FY 2006 changes.

Response: The impact analyses presented here and in the proposed rule utilize the same methodology that has been in effect since the introduction of the SNF PPS. Specifically, we determine the impact analysis by estimating aggregate payments attributable to each major component of the rate, including the market basket adjustment, while holding all other payment variables constant. By including the FY 2006 market basket variable in the analysis, and then comparing the expenditures to the FY 2005 levels (which also include a market basket update factor), we obtain a more accurate picture of aggregate spending changes.

Comment: Several commenters expressed concern regarding the overall fiscal impact of the proposed changes and recommended that the aggregate expenditure levels be increased. Other commenters stated that they had been unable to reconcile their independent analyses with the information contained in the proposed rule, and were concerned that the impact of the proposed rate structure would exceed the CMS projections.

Response: As mentioned in Section III., throughout the comment period, we reexamined the data presented in the proposed rule, updated the analyses to reflect the most recent available data, and corrected minor technical errors. We also received information from industry representatives and others, which helped us to verify the accuracy of the data used in the rate calculations, and then to ensure that the resulting rates correctly reflected the policies specified in the proposed rule. We then repeated the payment simulation described in the proposed rule. Next we recalculated the payment adjustment needed to ensure parity when comparing the aggregate expenditure levels of the 44-group and 53-group RUG models. As a final step, we applied an 8.51 percent increase to the nursing weights to reflect variation in non-therapy ancillary costs.

The impact analyses presented here and in the proposed rule utilize the same methodology that has been in effect since the introduction of the SNF PPS. The numbers presented in the impact analysis section represent the impact to the Federal Government which is calculated as total payments net of coinsurance. However, when considering total payments (not total impact), such as determining any adjustment to the nursing weights to reflect the variation in non-therapy ancillary costs, we use total payments including the coinsurance amounts.

We further note that, while the market basket increases are mandated in the statute, the Congress established an oversight mechanism to adjust or eliminate the updates based on MedPAC's annual analysis and recommendations. For FY 2006, MedPAC recommended a zero update. Had the Congress accepted that recommendation and enacted a change, the market basket adjustment would have been zero, and we would have included that factor in our impact analyses.

C. Accounting Statement

As required by OMB Circular A-4 (available at http://www.whitehouse.gov/​omb/​circulars/​a004/​a-4.pdf), in Table 13 below, we have prepared an accounting statement showing the classification of the expenditures associated with the provisions of this final rule. This table provides our best estimate of the change in Medicare payments under the SNF PPS as a result of the policies in this final rule based on the data for 15,675 SNFs in our database. All expenditures are classified as transfers to Medicare providers (that is, SNFs).

Table 13.—Accounting Statement: Classification of Estimated Expenditures, From the 2005 SNF PPS Rate Year to the 2006 SNF PPS Rate Year (in Millions)

Category	Transfers
Annualized Monetized Transfers	$20 million.
From Whom To Whom?	Federal Government to SNF Medicare Providers.

D. Alternatives Considered

Section 1888(e) of the Act establishes the SNF PPS for the payment of Medicare SNF services for cost reporting periods beginning on or after July 1, 1998. This section of the statute prescribes a detailed formula for calculating payment rates under the SNF PPS, and does not provide for the use of any alternative methodology. It specifies that the base year cost data to be used for computing the payment rates must be from FY 1995 (October 1, 1994, through September 30, 1995.) In accordance with the statute, we also incorporated a number of elements into the SNF PPS, such as a case-mix classification methodology, the MDS assessment schedule, a market basket index, a wage index, and the urban and rural distinction used in the development or adjustment of the Federal rates. Further, section 1888(e)(4)(H) of the Act specifically requires us to disseminate the payment rates for each new fiscal year through the Federal Register, and to do so before the August 1 that precedes the start of the new fiscal year.

Because we have determined that this final rule will have a significant economic impact on SNFs, we will discuss the alternatives we considered. We reviewed the options considered in the proposed rule and took into consideration comments received during the public comment period as discussed in the preamble.

As discussed previously in section II. of this final rule, we will implement refinements to the RUG-III case-mix classification system under section 1888(e)(4)(G)(i) of the Act. At the same time, we continue to evaluate longer-range, more comprehensive changes in the case-mix classification system. One alternative that we considered was to defer refinements at this time until our evaluation of longer-range, more comprehensive changes is complete. However, we believe that these refinements will serve to improve the distribution of payments under the PPS in a manner that more accurately accounts for the care needs of the most medically complex patients. While our additional research may identify more comprehensive modifications, it is not currently known when the results of this research would become available. Therefore, we have decided to implement the refinements discussed elsewhere in this final rule.

As discussed in section III.D, we considered several budget neutral options that would most effectively implement the adoption of the CBSA designation. Among the alternatives that we considered were the options discussed in the proposed rule and new options that took into consideration comments received during the public comment period, as discussed elsewhere in this final rule.

In accordance with the provisions of Executive Order 12866, this regulation was reviewed by the Office of Management and Budget.

List of Subjects

42 CFR Part 409

• Health facilities
• Medicare

42 CFR Part 411

• Kidney diseases
• Medicare
• Reporting and recordkeeping requirements

42 CFR Part 424

• Emergency medical services
• Health facilities
• Health professions
• Medicare

42 CFR Part 489

• Health facilities
• Medicare
• Reporting and recordkeeping requirements

For the reasons set forth in the preamble, the Centers for Medicare & Medicaid Services amends 42 CFR chapter IV as follows:

PART 409—HOSPITAL INSURANCE BENEFITS

1. The authority citation for part 409 continues to read as follows:

Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh).

Subpart D—Requirements for Coverage of Posthospital SNF Care

2. Amend § 409.31 by—

A. Republishing paragraph (b)(2) introductory text.

B. Revising paragraph (b)(2)(ii) to read as follows:

§ 409.31

Level of care requirement.

* * * * *

(b) * * *

(2) Those services must be furnished for a condition—

(i) * * *

(ii) Which arose while the beneficiary was receiving care in a SNF or swing-bed hospital for a condition for which he or she received inpatient hospital or inpatient CAH services; or

* * * * *

Subpart F—Scope of Hospital Insurance Benefits

3. Amend § 409.60(c) by removing the references to “§ 405.330” and adding “§ 411.400” in its place.

PART 411—EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT

1. The authority citation for part 411 continues to read as follows:

Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh).

Subpart A—General Exclusions and Exclusion of Particular Services

2. Amend § 411.15 by—

A. Republishing paragraph (p)(2) introductory text.

B. Revising paragraph (p)(2)(xii) to read as follows:

§ 411.15

Particular services excluded from coverage.

* * * * *

(p) * * *

(2) Exceptions. The following services are not excluded from coverage, provided that the claim for payment includes the SNF's Medicare provider number in accordance with § 424.32(a)(5) of this chapter:

* * * * *

(xii) Those chemotherapy items identified, as of July 1, 1999, by HCPCS codes J9000-J9020; J9040-J9151; J9170-J9185; J9200-J9201; J9206-J9208; J9211; J9230-J9245; and J9265-J9600; and, as of January 1, 2004, by HCPCS codes A9522, A9523, A9533, and A9534.

* * * * *

PART 424—CONDITIONS FOR MEDICARE PAYMENT

1. The authority citation for part 424 continues to read as follows:

Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh).

Subpart B—Certification and Plan of Treatment Requirements

§ 424.3

Definitions.

2. In § 424.3, in the definition of “HCPCS” remove the word “CMS” and add the word “Healthcare” in its place.

3. In § 424.20, paragraph (e)(2) is revised to read as follows:

§ 424.20

Requirements for posthospital SNF care.

* * * * *

(e) * * *

(2) A nurse practitioner or clinical nurse specialist, neither of whom has a direct or indirect employment relationship with the facility but who is working in collaboration with a physician. For purposes of this section—

(i) Collaboration means a process whereby a nurse practitioner or clinical nurse specialist works with a doctor of medicine or osteopathy to deliver health care services. The services are delivered within the scope of the nurse's professional expertise, with medical direction and appropriate supervision as provided for in guidelines jointly developed by the nurse and the physician or other mechanisms defined by Federal regulations and the law of the State in which the services are performed.

(ii) A direct employment relationship with the facility is one in which the nurse practitioner or clinical nurse specialist meets the common law definition of the facility's “employee,” as specified in § 404.1005, § 404.1007, and § 404.1009 of title 20 of the regulations. When a nurse practitioner or clinical nurse specialist meets this definition with respect to an entity other than the facility itself, and that entity has an agreement with the facility for the provision of nursing services under § 409.21 of this subchapter, the facility is considered to have an indirect employment relationship with the nurse practitioner or clinical nurse specialist. An indirect employment relationship does not exist if the agreement between the entity and the facility involves only the performance of delegated physician tasks under § 483.40(e) of this chapter.

* * * * *

PART 489—PROVIDER AGREEMENTS AND SUPPLIER APPROVAL

1. The authority citation for part 489 continues to read as follows:

Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh).

Subpart B—Essentials of Provider Agreements

2. Section 489.20 is amended by:

A. Republishing the introductory text and the paragraph (s) introductory text.

B. Revising paragraph (s)(12).

§ 489.20

Basic commitments.

The provider agrees to the following:

* * * * *

(s) In the case of an SNF, either to furnish directly or make arrangements (as defined in § 409.3 of this chapter) for all Medicare-covered services furnished to a resident (as defined in § 411.15(p)(3) of this chapter) of the SNF, except the following:

* * * * *

(12) Those chemotherapy items identified, as of July 1, 1999, by HCPCS codes J9000-J9020; J9040-J9151; J9170-J9185; J9200-J9201; J9206-J9208; J9211; J9230-J9245; and J9265-J9600; and, as of January 1, 2004, by HCPCS codes A9522, A9523, A9533, and A9534.

* * * * *

(Catalog of Federal Domestic Assistance Program No. 93.773, Medicare—Hospital Insurance Program; and No. 93.774, Medicare—Supplementary Medical Insurance Program)

Dated: July 19, 2005.

Mark B. McClellan,

Administrator, Centers for Medicare & Medicaid Services.

Approved: July 27, 2005.

Michael O. Leavitt,

Secretary.

Addendum—FY 2006 Transition Wage Index and CBSA Tables

In this addendum, we provide the tables referred to in the preamble to this final rule. Tables 8 and 9 provide the CBSA-based wage index values for urban and rural providers. Though we will use the transition-based wage index values presented in Table A for FY 2006, CBSA-based wage index values will be used for FY 2007 when the transition will expire. Tables 8 and 9 serve the purpose of showing a possible format of how the CBSA-based wage index values will be presented for FY 2007.

Table A provides the following information: Social Security Administration (SSA) State and County Code; State and County name; existing MSA-based labor market area designation; MSA-based urban/rural geographic designation; FY 2006 MSA-based wage index; FY 2006 CBSA-based wage index; CBSA-based labor market area; CBSA-based urban/rural geographic designation (which will be used for the FY 2006 transition); and the FY 2006 transition wage index (based on 50 percent of the FY 2006 MSA-based wage index and 50 percent of the FY 2006 CBSA-based wage index).

Table 8.—FY 2006 Wage Index For Urban Areas Based On CBSA Labor Market Areas

CBSA code	Urban area (constituent counties)	Wage index
10180	Abilene, TX	0.7896
	Callahan County, TX
	Jones County, TX
	Taylor County, TX
10380	Aguadilla-Isabela-San Sebastian, PR	0.4738
	Aguada Municipio, PR
	Aguadilla Municipio, PR
	Anasco Municipio, PR
	Isabela Municipio, PR
	Lares Municipio, PR
	Moca Municipio, PR
	Rincon Municipio, PR
	San Sebastian Municipio, PR
10420	Akron, OH	0.8982
	Portage County, OH
	Summit County, OH
10500	Albany, GA	0.8628
	Baker County, GA
	Dougherty County, GA
	Lee County, GA
	Terrell County, GA
	Worth County, GA
10580	Albany-Schenectady-Troy, NY	0.8589
	Albany County, NY
	Rensselaer County, NY
	Saratoga County, NY
	Schenectady County, NY
	Schoharie County, NY
10740	Albuquerque, NM	0.9684
	Bernalillo County, NM
	Sandoval County, NM
	Torrance County, NM
	Valencia County, NM
10780	Alexandria, LA	0.8033
	Grant Parish, LA
	Rapides Parish, LA
10900	Allentown-Bethlehem-Easton, PA-NJ	0.9818
	Warren County, NJ
	Carbon County, PA
	Lehigh County, PA
	Northampton County, PA
11020	Altoona, PA	0.8944
	Blair County, PA
11100	Amarillo, TX	0.9156
	Armstrong County, TX
	Carson County, TX
	Potter County, TX
	Randall County, TX
11180	Ames, IA	0.9536
	Story County, IA
11260	Anchorage, AK	1.1895
	Anchorage Municipality, AK
	Matanuska-Susitna Borough, AK
11300	Anderson, IN	0.8586
	Madison County, IN
11340	Anderson, SC	0.8997
	Anderson County, SC
11460	Ann Arbor, MI	1.0859
	Washtenaw County, MI
11500	Anniston-Oxford, AL	0.7682
	Calhoun County, AL
11540	Appleton, WI	0.9288
	Calumet County, WI
	Outagamie County, WI
11700	Asheville, NC	0.9285
	Buncombe County, NC
	Haywood County, NC
	Henderson County, NC
	Madison County, NC
12020	Athens-Clarke County, GA	0.9855
	Clarke County, GA
	Madison County, GA
	Oconee County, GA
	Oglethorpe County, GA
12060	Atlanta-Sandy Springs-Marietta, GA	0.9793
	Barrow County, GA
	Bartow County, GA
	Butts County, GA
	Carroll County, GA
	Cherokee County, GA
	Clayton County, GA
	Cobb County, GA
	Coweta County, GA
	Dawson County, GA
	DeKalb County, GA
	Douglas County, GA
	Fayette County, GA
	Forsyth County, GA
	Fulton County, GA
	Gwinnett County, GA
	Haralson County, GA
	Heard County, GA
	Henry County, GA
	Jasper County, GA
	Lamar County, GA
	Meriwether County, GA
	Newton County, GA
	Paulding County, GA
	Pickens County, GA
	Pike County, GA
	Rockdale County, GA
	Spalding County, GA
	Walton County, GA
12100	Atlantic City, NJ	1.1615
	Atlantic County, NJ
12220	Auburn-Opelika, AL	0.8100
	Lee County, AL
12260	Augusta-Richmond County, GA-SC	0.9748
	Burke County, GA
	Columbia County, GA
	McDuffie County, GA
	Richmond County, GA
	Aiken County, SC
	Edgefield County, SC
12420	Austin-Round Rock, TX	0.9437
	Bastrop County, TX
	Caldwell County, TX
	Hays County, TX
	Travis County, TX
	Williamson County, TX
12540	Bakersfield, CA	1.0470
	Kern County, CA
12580	Baltimore-Towson, MD	0.9897
	Anne Arundel County, MD
	Baltimore County, MD
	Carroll County, MD
	Harford County, MD
	Howard County, MD
	Queen Anne's County, MD
	Baltimore City, MD
12620	Bangor, ME	0.9993
	Penobscot County, ME
12700	Barnstable Town, MA	1.2600
	Barnstable County, MA
12940	Baton Rouge, LA	0.8593
	Ascension Parish, LA
	East Baton Rouge Parish, LA
	East Feliciana Parish, LA
	Iberville Parish, LA
	Livingston Parish, LA
	Pointe Coupee Parish, LA
	St. Helena Parish, LA
	West Baton Rouge Parish, LA
	West Feliciana Parish, LA
12980	Battle Creek, MI	0.9508
	Calhoun County, MI
13020	Bay City, MI	0.9343
	Bay County, MI
13140	Beaumont-Port Arthur, TX	0.8412
	Hardin County, TX
	Jefferson County, TX
	Orange County, TX
13380	Bellingham, WA	1.1731
	Whatcom County, WA
13460	Bend, OR	1.0786
	Deschutes County, OR
13644	Bethesda-Frederick-Gaithersburg, MD	1.1483
	Frederick County, MD
	Montgomery County, MD
13740	Billings, MT	0.8834
	Carbon County, MT
	Yellowstone County, MT
13780	Binghamton, NY	0.8562
	Broome County, NY
	Tioga County, NY
13820	Birmingham-Hoover, AL	0.8959
	Bibb County, AL
	Blount County, AL
	Chilton County, AL
	Jefferson County, AL
	St. Clair County, AL
	Shelby County, AL
	Walker County, AL
13900	Bismarck, ND	0.7574
	Burleigh County, ND
	Morton County, ND
13980	Blacksburg-Christiansburg-Radford, VA	0.7954
	Giles County, VA
	Montgomery County, VA
	Pulaski County, VA
	Radford City, VA
14020	Bloomington, IN	0.8447
	Greene County, IN
	Monroe County, IN
	Owen County, IN
14060	Bloomington-Normal, IL	0.9075
	McLean County, IL
14260	Boise City-Nampa, ID	0.9052
	Ada County, ID
	Boise County, ID
	Canyon County, ID
	Gem County, ID
	Owyhee County, ID
14484	Boston-Quincy, MA	1.1558
	Norfolk County, MA
	Plymouth County, MA
	Suffolk County, MA
14500	Boulder, CO	0.9734
	Boulder County, CO
14540	Bowling Green, KY	0.8211
	Edmonson County, KY
	Warren County, KY
14740	Bremerton-Silverdale, WA	1.0675
	Kitsap County, WA
14860	Bridgeport-Stamford-Norwalk, CT	1.2592
	Fairfield County, CT
15180	Brownsville-Harlingen, TX	0.9804
	Cameron County, TX
15260	Brunswick, GA	0.9311
	Brantley County, GA
	Glynn County, GA
	McIntosh County, GA
15380	Buffalo-Niagara Falls, NY	0.9511
	Erie County, NY
	Niagara County, NY
15500	Burlington, NC	0.8905
	Alamance County, NC
15540	Burlington-South Burlington, VT	0.9410
	Chittenden County, VT
	Franklin County, VT
	Grand Isle County, VT
15764	Cambridge-Newton-Framingham, MA	1.1172
	Middlesex County, MA
15804	Camden, NJ	1.0517
	Burlington County, NJ
	Camden County, NJ
	Gloucester County, NJ
15940	Canton-Massillon, OH	0.8935
	Carroll County, OH
	Stark County, OH
15980	Cape Coral-Fort Myers, FL	0.9356
	Lee County, FL
16180	Carson City, NV	1.0234
	Carson City, NV
16220	Casper, WY	0.9026
	Natrona County, WY
16300	Cedar Rapids, IA	0.8825
	Benton County, IA
	Jones County, IA
	Linn County, IA
16580	Champaign-Urbana, IL	0.9594
	Champaign County, IL
	Ford County, IL
	Piatt County, IL
16620	Charleston, WV	0.8445
	Boone County, WV
	Clay County, WV
	Kanawha County, WV
	Lincoln County, WV
	Putnam County, WV
16700	Charleston-North Charleston, SC	0.9245
	Berkeley County, SC
	Charleston County, SC
	Dorchester County, SC
16740	Charlotte-Gastonia-Concord, NC-SC	0.9750
	Anson County, NC
	Cabarrus County, NC
	Gaston County, NC
	Mecklenburg County, NC
	Union County, NC
	York County, SC
16820	Charlottesville, VA	1.0187
	Albemarle County, VA
	Fluvanna County, VA
	Greene County, VA
	Nelson County, VA
	Charlottesville City, VA
16860	Chattanooga, TN-GA	0.9088
	Catoosa County, GA
	Dade County, GA
	Walker County, GA
	Hamilton County, TN
	Marion County, TN
	Sequatchie County, TN
16940	Cheyenne, WY	0.8775
	Laramie County, WY
16974	Chicago-Naperville-Joliet, IL	1.0790
	Cook County, IL
	DeKalb County, IL
	DuPage County, IL
	Grundy County, IL
	Kane County, IL
	Kendall County, IL
	McHenry County, IL
	Will County, IL
17020	Chico, CA	1.0511
	Butte County, CA
17140	Cincinnati-Middletown, OH-KY-IN	0.9615
	Dearborn County, IN
	Franklin County, IN
	Ohio County, IN
	Boone County, KY
	Bracken County, KY
	Campbell County, KY
	Gallatin County, KY
	Grant County, KY
	Kenton County, KY
	Pendleton County, KY
	Brown County, OH
	Butler County, OH
	Clermont County, OH
	Hamilton County, OH
	Warren County, OH
17300	Clarksville, TN-KY	0.8284
	Christian County, KY
	Trigg County, KY
	Montgomery County, TN
	Stewart County, TN
17420	Cleveland, TN	0.8139
	Bradley County, TN
	Polk County, TN
17460	Cleveland-Elyria-Mentor, OH	0.9213
	Cuyahoga County, OH
	Geauga County, OH
	Lake County, OH
	Lorain County, OH
	Medina County, OH
17660	Coeur d'Alene, ID	0.9647
	Kootenai County, ID
17780	College Station-Bryan, TX	0.8900
	Brazos County, TX
	Burleson County, TX
	Robertson County, TX
17820	Colorado Springs, CO	0.9468
	El Paso County, CO
	Teller County, CO
17860	Columbia, MO	0.8345
	Boone County, MO
	Howard County, MO
17900	Columbia, SC	0.9057
	Calhoun County, SC
	Fairfield County, SC
	Kershaw County, SC
	Lexington County, SC
	Richland County, SC
	Saluda County, SC
17980	Columbus, GA-AL	0.8560
	Russell County, AL
	Chattahoochee County, GA
	Harris County, GA
	Marion County, GA
	Muscogee County, GA
18020	Columbus, IN	0.9588
	Bartholomew County, IN
18140	Columbus, OH	0.9860
	Delaware County, OH
	Fairfield County, OH
	Franklin County, OH
	Licking County, OH
	Madison County, OH
	Morrow County, OH
	Pickaway County, OH
	Union County, OH
18580	Corpus Christi, TX	0.8550
	Aransas County, TX
	Nueces County, TX
	San Patricio County, TX
18700	Corvallis, OR	1.0729
	Benton County, OR
19060	Cumberland, MD-WV	0.9317
	Allegany County, MD
	Mineral County, WV
19124	Dallas-Plano-Irving, TX	1.0228
	Collin County, TX
	Dallas County, TX
	Delta County, TX
	Denton County, TX
	Ellis County, TX
	Hunt County, TX
	Kaufman County, TX
	Rockwall County, TX
19140	Dalton, GA	0.9079
	Murray County, GA
	Whitfield County, GA
19180	Danville, IL	0.9028
	Vermilion County, IL
19260	Danville, VA	0.8489
	Pittsylvania County, VA
	Danville City, VA
19340	Davenport-Moline-Rock Island, IA-IL	0.8724
	Henry County, IL
	Mercer County, IL
	Rock Island County, IL
	Scott County, IA
19380	Dayton, OH	0.9064
	Greene County, OH
	Miami County, OH
	Montgomery County, OH
	Preble County, OH
19460	Decatur, AL	0.8469
	Lawrence County, AL
	Morgan County, AL
19500	Decatur, IL	0.8067
	Macon County, IL
19660	Deltona-Daytona Beach-Ormond Beach, FL	0.9299
	Volusia County, FL
19740	Denver-Aurora, CO	1.0723
	Adams County, CO
	Arapahoe County, CO
	Broomfield County, CO
	Clear Creek County, CO
	Denver County, CO
	Douglas County, CO
	Elbert County, CO
	Gilpin County, CO
	Jefferson County, CO
	Park County, CO
19780	Des Moines, IA	0.9669
	Dallas County, IA
	Guthrie County, IA
	Madison County, IA
	Polk County, IA
	Warren County, IA
19804	Detroit-Livonia-Dearborn, MI	1.0424
	Wayne County, MI
20020	Dothan, AL	0.7721
	Geneva County, AL
	Henry County, AL
	Houston County, AL
20100	Dover, DE	0.9776
	Kent County, DE
20220	Dubuque, IA	0.9024
	Dubuque County, IA
20260	Duluth, MN-WI	1.0213
	Carlton County, MN
	St. Louis County, MN
	Douglas County, WI
20500	Durham, NC	1.0244
	Chatham County, NC
	Durham County, NC
	Orange County, NC
	Person County, NC
20740	Eau Claire, WI	0.9201
	Chippewa County, WI
	Eau Claire County, WI
20764	Edison, NJ	1.1249
	Middlesex County, NJ
	Monmouth County, NJ
	Ocean County, NJ
	Somerset County, NJ
20940	El Centro, CA	0.8906
	Imperial County, CA
21060	Elizabethtown, KY	0.8802
	Hardin County, KY
	Larue County, KY
21140	Elkhart-Goshen, IN	0.9627
	Elkhart County, IN
21300	Elmira, NY	0.8250
	Chemung County, NY
21340	El Paso, TX	0.8977
	El Paso County, TX
21500	Erie, PA	0.8737
	Erie County, PA
21604	Essex County, MA	1.0538
	Essex County, MA
21660	Eugene-Springfield, OR	1.0818
	Lane County, OR
21780	Evansville, IN-KY	0.8713
	Gibson County, IN
	Posey County, IN
	Vanderburgh County, IN
	Warrick County, IN
	Henderson County, KY
	Webster County, KY
21820	Fairbanks, AK	1.1408
	Fairbanks North Star Borough, AK
21940	Fajardo, PR	0.4153
	Ceiba Municipio, PR
	Fajardo Municipio, PR
	Luquillo Municipio, PR
22020	Fargo, ND-MN	0.8486
	Cass County, ND
	Clay County, MN
22140	Farmington, NM	0.8509
	San Juan County, NM
22180	Fayetteville, NC	0.9416
	Cumberland County, NC
	Hoke County, NC
22220	Fayetteville-Springdale-Rogers, AR-MO	0.8661
	Benton County, AR
	Madison County, AR
	Washington County, AR
	McDonald County, MO
22380	Flagstaff, AZ	1.2092
	Coconino County, AZ
22420	Flint, MI	1.0655
	Genesee County, MI
22500	Florence, SC	0.8947
	Darlington County, SC
	Florence County, SC
22520	Florence-Muscle Shoals, AL	0.8272
	Colbert County, AL
	Lauderdale County, AL
22540	Fond du Lac, WI	0.9640
	Fond du Lac County, WI
22660	Fort Collins-Loveland, CO	1.0122
	Larimer County, CO
22744	Fort Lauderdale-Pompano Beach-Deerfield Beach, FL	1.0432
	Broward County, FL
22900	Fort Smith, AR-OK	0.8230
	Crawford County, AR
	Franklin County, AR
	Sebastian County, AR
	Le Flore County, OK
	Sequoyah County, OK
23020	Fort Walton Beach-Crestview-Destin, FL	0.8872
	Okaloosa County, FL
23060	Fort Wayne, IN	0.9793
	Allen County, IN
	Wells County, IN
	Whitley County, IN
23104	Fort Worth-Arlington, TX	0.9486
	Johnson County, TX
	Parker County, TX
	Tarrant County, TX
	Wise County, TX
23420	Fresno, CA	1.0538
	Fresno County, CA
23460	Gadsden, AL	0.7938
	Etowah County, AL
23540	Gainesville, FL	0.9388
	Alachua County, FL
	Gilchrist County, FL
23580	Gainesville, GA	0.8874
	Hall County, GA
23844	Gary, IN	0.9395
	Jasper County, IN
	Lake County, IN
	Newton County, IN
	Porter County, IN
24020	Glens Falls, NY	0.8559
	Warren County, NY
	Washington County, NY
24140	Goldsboro, NC	0.8775
	Wayne County, NC
24220	Grand Forks, ND-MN	0.7901
	Polk County, MN
	Grand Forks County, ND
24300	Grand Junction, CO	0.9550
	Mesa County, CO
24340	Grand Rapids-Wyoming, MI	0.9390
	Barry County, MI
	Ionia County, MI
	Kent County, MI
	Newaygo County, MI
24500	Great Falls, MT	0.9052
	Cascade County, MT
24540	Greeley, CO	0.9570
	Weld County, CO
24580	Green Bay, WI	0.9483
	Brown County, WI
	Kewaunee County, WI
	Oconto County, WI
24660	Greensboro-High Point, NC	0.9104
	Guilford County, NC
	Randolph County, NC
	Rockingham County, NC
24780	Greenville, NC	0.9425
	Greene County, NC
	Pitt County, NC
24860	Greenville, SC	1.0027
	Greenville County, SC
	Laurens County, SC
	Pickens County, SC
25020	Guayama, PR	0.3181
	Arroyo Municipio, PR
	Guayama Municipio, PR
	Patillas Municipio, PR
25060	Gulfport-Biloxi, MS	0.8929
	Hancock County, MS
	Harrison County, MS
	Stone County, MS
25180	Hagerstown-Martinsburg, MD-WV	0.9489
	Washington County, MD
	Berkeley County, WV
	Morgan County, WV
25260	Hanford-Corcoran, CA	1.0036
	Kings County, CA
25420	Harrisburg-Carlisle, PA	0.9313
	Cumberland County, PA
	Dauphin County, PA
	Perry County, PA
25500	Harrisonburg, VA	0.9088
	Rockingham County, VA
	Harrisonburg City, VA
25540	Hartford-West Hartford-East Hartford, CT	1.1073
	Hartford County, CT
	Litchfield County, CT
	Middlesex County, CT
	Tolland County, CT
25620	Hattiesburg, MS	0.7601
	Forrest County, MS
	Lamar County, MS
	Perry County, MS
25860	Hickory-Lenoir-Morganton, NC	0.8921
	Alexander County, NC
	Burke County, NC
	Caldwell County, NC
	Catawba County, NC
25980	Hinesville-Fort Stewart, GA1
	Liberty County, GA
	Long County, GA
26100	Holland-Grand Haven, MI	0.9055
	Ottawa County, MI
26180	Honolulu, HI	1.1214
	Honolulu County, HI
26300	Hot Springs, AR	0.9005
	Garland County, AR
26380	Houma-Bayou Cane-Thibodaux, LA	0.7894
	Lafourche Parish, LA
	Terrebonne Parish, LA
26420	Houston-Baytown-Sugar Land, TX	0.9992
	Austin County, TX
	Brazoria County, TX
	Chambers County, TX
	Fort Bend County, TX
	Galveston County, TX
	Harris County, TX
	Liberty County, TX
	Montgomery County, TX
	San Jacinto County, TX
	Waller County, TX
26580	Huntington-Ashland, WV-KY-OH	0.9477
	Boyd County, KY
	Greenup County, KY
	Lawrence County, OH
	Cabell County, WV
	Wayne County, WV
26620	Huntsville, AL	0.9146
	Limestone County, AL
	Madison County, AL
26820	Idaho Falls, ID	0.9420
	Bonneville County, ID
	Jefferson County, ID
26900	Indianapolis, IN	0.9920
	Boone County, IN
	Brown County, IN
	Hamilton County, IN
	Hancock County, IN
	Hendricks County, IN
	Johnson County, IN
	Marion County, IN
	Morgan County, IN
	Putnam County, IN
	Shelby County, IN
26980	Iowa City, IA	0.9747
	Johnson County, IA
	Washington County, IA
27060	Ithaca, NY	0.9793
	Tompkins County, NY
27100	Jackson, MI	0.9304
	Jackson County, MI
27140	Jackson, MS	0.8311
	Copiah County, MS
	Hinds County, MS
	Madison County, MS
	Rankin County, MS
	Simpson County, MS
27180	Jackson, TN	0.8964
	Chester County, TN
	Madison County, TN
27260	Jacksonville, FL	0.9290
	Baker County, FL
	Clay County, FL
	Duval County, FL
	Nassau County, FL
	St. Johns County, FL
27340	Jacksonville, NC	0.8236
	Onslow County, NC
27500	Janesville, WI	0.9538
	Rock County, WI
27620	Jefferson City, MO	0.8387
	Callaway County, MO
	Cole County, MO
	Moniteau County, MO
	Osage County, MO
27740	Johnson City, TN	0.7937
	Carter County, TN
	Unicoi County, TN
	Washington County, TN
27780	Johnstown, PA	0.8354
	Cambria County, PA
27860	Jonesboro, AR	0.7911
	Craighead County, AR
	Poinsett County, AR
27900	Joplin, MO	0.8582
	Jasper County, MO
	Newton County, MO
28020	Kalamazoo-Portage, MI	1.0381
	Kalamazoo County, MI
	Van Buren County, MI
28100	Kankakee-Bradley, IL	1.0721
	Kankakee County, IL
28140	Kansas City, MO-KS	0.9476
	Franklin County, KS
	Johnson County, KS
	Leavenworth County, KS
	Linn County, KS
	Miami County, KS
	Wyandotte County, KS
	Bates County, MO
	Caldwell County, MO
	Cass County, MO
	Clay County, MO
	Clinton County, MO
	Jackson County, MO
	Lafayette County, MO
	Platte County, MO
	Ray County, MO
28420	Kennewick-Richland-Pasco, WA	1.0619
	Benton County, WA
	Franklin County, WA
28660	Killeen-Temple-Fort Hood, TX	0.8526
	Bell County, TX
	Coryell County, TX
	Lampasas County, TX
28700	Kingsport-Bristol-Bristol, TN-VA	0.8054
	Hawkins County, TN
	Sullivan County, TN
	Bristol City, VA
	Scott County, VA
	Washington County, VA
28740	Kingston, NY	0.9255
	Ulster County, NY
28940	Knoxville, TN	0.8441
	Anderson County, TN
	Blount County, TN
	Knox County, TN
	Loudon County, TN
	Union County, TN
29020	Kokomo, IN	0.9508
	Howard County, IN
	Tipton County, IN
29100	La Crosse, WI-MN	0.9564
	Houston County, MN
	La Crosse County, WI
29140	Lafayette, IN	0.8736
	Benton County, IN
	Carroll County, IN
	Tippecanoe County, IN
29180	Lafayette, LA	0.8428
	Lafayette Parish, LA
	St. Martin Parish, LA
29340	Lake Charles, LA	0.7833
	Calcasieu Parish, LA
	Cameron Parish, LA
29404	Lake County-Kenosha County, IL-WI	1.0429
	Lake County, IL
	Kenosha County, WI
29460	Lakeland, FL	0.8912
	Polk County, FL
29540	Lancaster, PA	0.9694
	Lancaster County, PA
29620	Lansing-East Lansing, MI	0.9794
	Clinton County, MI
	Eaton County, MI
	Ingham County, MI
29700	Laredo, TX	0.8068
	Webb County, TX
29740	Las Cruces, NM	0.8467
	Dona Ana County, NM
29820	Las Vegas-Paradise, NV	1.1437
	Clark County, NV
29940	Lawrence, KS	0.8537
	Douglas County, KS
30020	Lawton, OK	0.7872
	Comanche County, OK
30140	Lebanon, PA	0.8459
	Lebanon County, PA
30300	Lewiston, ID-WA	0.9886
	Nez Perce County, ID
	Asotin County, WA
30340	Lewiston-Auburn, ME	0.9331
	Androscoggin County, ME
30460	Lexington-Fayette, KY	0.9075
	Bourbon County, KY
	Clark County, KY
	Fayette County, KY
	Jessamine County, KY
	Scott County, KY
	Woodford County, KY
30620	Lima, OH	0.9225
	Allen County, OH
30700	Lincoln, NE	1.0214
	Lancaster County, NE
	Seward County, NE
30780	Little Rock-North Little Rock, AR	0.8747
	Faulkner County, AR
	Grant County, AR
	Lonoke County, AR
	Perry County, AR
	Pulaski County, AR
	Saline County, AR
30860	Logan, UT-ID	0.9164
	Franklin County, ID
	Cache County, UT
30980	Longview, TX	0.8730
	Gregg County, TX
	Rusk County, TX
	Upshur County, TX
31020	Longview, WA	0.9579
	Cowlitz County, WA
31084	Los Angeles-Long Beach-Glendale, CA	1.1783
	Los Angeles County, CA
31140	Louisville, KY-IN	0.9251
	Clark County, IN
	Floyd County, IN
	Harrison County, IN
	Washington County, IN
	Bullitt County, KY
	Henry County, KY
	Jefferson County, KY
	Meade County, KY
	Nelson County, KY
	Oldham County, KY
	Shelby County, KY
	Spencer County, KY
	Trimble County, KY
31180	Lubbock, TX	0.8783
	Crosby County, TX
	Lubbock County, TX
31340	Lynchburg, VA	0.8691
	Amherst County, VA
	Appomattox County, VA
	Bedford County, VA
	Campbell County, VA
	Bedford City, VA
	Lynchburg City, VA
31420	Macon, GA	0.9443
	Bibb County, GA
	Crawford County, GA
	Jones County, GA
	Monroe County, GA
	Twiggs County, GA
31460	Madera, CA	0.8713
	Madera County, CA
31540	Madison, WI	1.0659
	Columbia County, WI
	Dane County, WI
	Iowa County, WI
31700	Manchester-Nashua, NH	1.0354
	Hillsborough County, NH
	Merrimack County, NH
31900	Mansfield, OH 1
	Richland County, OH
32420	Mayaguez, PR	0.4020
	Hormigueros Municipio, PR
	Mayaguez Municipio, PR
32580	McAllen-Edinburg-Pharr, TX	0.8934
	Hidalgo County, TX
32780	Medford, OR	1.0225
	Jackson County, OR
32820	Memphis, TN-MS-AR	0.9397
	Crittenden County, AR
	DeSoto County, MS
	Marshall County, MS
	Tate County, MS
	Tunica County, MS
	Fayette County, TN
	Shelby County, TN
	Tipton County, TN
32900	Merced, CA	1.1109
	Merced County, CA
33124	Miami-Miami Beach-Kendall, FL	0.9750
	Miami-Dade County, FL
33140	Michigan City-La Porte, IN	0.9399
	LaPorte County, IN
33260	Midland, TX	0.9514
	Midland County, TX
33340	Milwaukee-Waukesha-West Allis, WI	1.0146
	Milwaukee County, WI
	Ozaukee County, WI
	Washington County, WI
	Waukesha County, WI
33460	Minneapolis-St. Paul-Bloomington, MN-WI	1.1075
	Anoka County, MN
	Carver County, MN
	Chisago County, MN
	Dakota County, MN
	Hennepin County, MN
	Isanti County, MN
	Ramsey County, MN
	Scott County, MN
	Sherburne County, MN
	Washington County, MN
	Wright County, MN
	Pierce County, WI
	St. Croix County, WI
33540	Missoula, MT	0.9473
	Missoula County, MT
33660	Mobile, AL	0.7891
	Mobile County, AL
33700	Modesto, CA	1.1885
	Stanislaus County, CA
33740	Monroe, LA	0.8031
	Ouachita Parish, LA
	Union Parish, LA
33780	Monroe, MI	0.9468
	Monroe County, MI
33860	Montgomery, AL	0.8618
	Autauga County, AL
	Elmore County, AL
	Lowndes County, AL
	Montgomery County, AL
34060	Morgantown, WV	0.8420
	Monongalia County, WV
	Preston County, WV
34100	Morristown, TN	0.7961
	Grainger County, TN
	Hamblen County, TN
	Jefferson County, TN
34580	Mount Vernon-Anacortes, WA	1.0454
	Skagit County, WA
34620	Muncie, IN	0.8930
	Delaware County, IN
34740	Muskegon-Norton Shores, MI	0.9664
	Muskegon County, MI
34820	Myrtle Beach-Conway-North Myrtle Beach, SC	0.8934
	Horry County, SC
34900	Napa, CA	1.2643
	Napa County, CA
34940	Naples-Marco Island, FL	1.0139
	Collier County, FL
34980	Nashville-Davidson--Murfreesboro, TN	0.9741
	Cannon County, TN
	Cheatham County, TN
	Davidson County, TN
	Dickson County, TN
	Hickman County, TN
	Macon County, TN
	Robertson County, TN
	Rutherford County, TN
	Smith County, TN
	Sumner County, TN
	Trousdale County, TN
	Williamson County, TN
	Wilson County, TN
35004	Nassau-Suffolk, NY	1.2719
	Nassau County, NY
	Suffolk County, NY
35084	Newark-Union, NJ-PA	1.1883
	Essex County, NJ
	Hunterdon County, NJ
	Morris County, NJ
	Sussex County, NJ
	Union County, NJ
	Pike County, PA
35300	New Haven-Milford, CT	1.1887
	New Haven County, CT
35380	New Orleans-Metairie-Kenner, LA	0.8995
	Jefferson Parish, LA
	Orleans Parish, LA
	Plaquemines Parish, LA
	St. Bernard Parish, LA
	St. Charles Parish, LA
	St. John the Baptist Parish, LA
	St. Tammany Parish, LA
35644	New York-Wayne-White Plains, NY-NJ	1.3188
	Bergen County, NJ
	Hudson County, NJ
	Passaic County, NJ
	Bronx County, NY
	Kings County, NY
	New York County, NY
	Putnam County, NY
	Queens County, NY
	Richmond County, NY
	Rockland County, NY
	Westchester County, NY
35660	Niles-Benton Harbor, MI	0.8879
	Berrien County, MI
35980	Norwich-New London, CT	1.1345
	New London County, CT
36084	Oakland-Fremont-Hayward, CA	1.5346
	Alameda County, CA
	Contra Costa County, CA
36100	Ocala, FL	0.8925
	Marion County, FL
36140	Ocean City, NJ	1.1011
	Cape May County, NJ
36220	Odessa, TX	0.9884
	Ector County, TX
36260	Ogden-Clearfield, UT	0.9029
	Davis County, UT
	Morgan County, UT
	Weber County, UT
36420	Oklahoma City, OK	0.9031
	Canadian County, OK
	Cleveland County, OK
	Grady County, OK
	Lincoln County, OK
	Logan County, OK
	McClain County, OK
	Oklahoma County, OK
36500	Olympia, WA	1.0927
	Thurston County, WA
36540	Omaha-Council Bluffs, NE-IA	0.9560
	Harrison County, IA
	Mills County, IA
	Pottawattamie County, IA
	Cass County, NE
	Douglas County, NE
	Sarpy County, NE
	Saunders County, NE
	Washington County, NE
36740	Orlando, FL	0.9464
	Lake County, FL
	Orange County, FL
	Osceola County, FL
	Seminole County, FL
36780	Oshkosh-Neenah, WI	0.9183
	Winnebago County, WI
36980	Owensboro, KY	0.8780
	Daviess County, KY
	Hancock County, KY
	McLean County, KY
37100	Oxnard-Thousand Oaks-Ventura, CA	1.1622
	Ventura County, CA
37340	Palm Bay-Melbourne-Titusville, FL	0.9839
	Brevard County, FL
37460	Panama City-Lynn Haven, FL	0.8005
	Bay County, FL
37620	Parkersburg-Marietta, WV-OH	0.8270
	Washington County, OH
	Pleasants County, WV
	Wirt County, WV
	Wood County, WV
37700	Pascagoula, MS	0.8156
	George County, MS
	Jackson County, MS
37860	Pensacola-Ferry Pass-Brent, FL	0.8096
	Escambia County, FL
	Santa Rosa County, FL
37900	Peoria, IL	0.8870
	Marshall County, IL
	Peoria County, IL
	Stark County, IL
	Tazewell County, IL
	Woodford County, IL
37964	Philadelphia, PA	1.1038
	Bucks County, PA
	Chester County, PA
	Delaware County, PA
	Montgomery County, PA
	Philadelphia County, PA
38060	Phoenix-Mesa-Scottsdale, AZ	1.0127
	Maricopa County, AZ
	Pinal County, AZ
38220	Pine Bluff, AR	0.8680
	Cleveland County, AR
	Jefferson County, AR
	Lincoln County, AR
38300	Pittsburgh, PA	0.8845
	Allegheny County, PA
	Armstrong County, PA
	Beaver County, PA
	Butler County, PA
	Fayette County, PA
	Washington County, PA
	Westmoreland County, PA
38340	Pittsfield, MA	1.0181
	Berkshire County, MA
38540	Pocatello, ID	0.9351
	Bannock County, ID
	Power County, ID
38660	Ponce, PR	0.4939
	Juana Diaz Municipio, PR
	Ponce Municipio, PR
	Villalba Municipio, PR
38860	Portland-South Portland-Biddeford, ME	1.0382
	Cumberland County, ME
	Sagadahoc County, ME
	York County, ME
38900	Portland-Vancouver-Beaverton, OR-WA	1.1266
	Clackamas County, OR
	Columbia County, OR
	Multnomah County, OR
	Washington County, OR
	Yamhill County, OR
	Clark County, WA
	Skamania County, WA
38940	Port St. Lucie-Fort Pierce, FL	1.0123
	Martin County, FL
	St. Lucie County, FL
39100	Poughkeepsie-Newburgh-Middletown, NY	1.0891
	Dutchess County, NY
	Orange County, NY
39140	Prescott, AZ	0.9869
	Yavapai County, AZ
39300	Providence-New Bedford-Fall River, RI-MA	1.0966
	Bristol County, MA
	Bristol County, RI
	Kent County, RI
	Newport County, RI
	Providence County, RI
	Washington County, RI
39340	Provo-Orem, UT	0.9500
	Juab County, UT
	Utah County, UT
39380	Pueblo, CO	0.8623
	Pueblo County, CO
39460	Punta Gorda, FL	0.9255
	Charlotte County, FL
39540	Racine, WI	0.8997
	Racine County, WI
39580	Raleigh-Cary, NC	0.9691
	Franklin County, NC
	Johnston County, NC
	Wake County, NC
39660	Rapid City, SD	0.8987
	Meade County, SD
	Pennington County, SD
39740	Reading, PA	0.9686
	Berks County, PA
39820	Redding, CA	1.2203
	Shasta County, CA
39900	Reno-Sparks, NV	1.0982
	Storey County, NV
	Washoe County, NV
40060	Richmond, VA	0.9328
	Amelia County, VA
	Caroline County, VA
	Charles City County, VA
	Chesterfield County, VA
	Cumberland County, VA
	Dinwiddie County, VA
	Goochland County, VA
	Hanover County, VA
	Henrico County, VA
	King and Queen County, VA
	King William County, VA
	Louisa County, VA
	New Kent County, VA
	Powhatan County, VA
	Prince George County, VA
	Sussex County, VA
	Colonial Heights City, VA
	Hopewell City, VA
	Petersburg City, VA
	Richmond City, VA
40140	Riverside-San Bernardino-Ontario, CA	1.1027
	Riverside County, CA
	San Bernardino County, CA
40220	Roanoke, VA	0.8374
	Botetourt County, VA
	Craig County, VA
	Franklin County, VA
	Roanoke County, VA
	Roanoke City, VA
	Salem City, VA
40340	Rochester, MN	1.1131
	Dodge County, MN
	Olmsted County, MN
	Wabasha County, MN
40380	Rochester, NY	0.9121
	Livingston County, NY
	Monroe County, NY
	Ontario County, NY
	Orleans County, NY
	Wayne County, NY
40420	Rockford, IL	0.9984
	Boone County, IL
	Winnebago County, IL
40484	Rockingham County-Strafford County, NH	1.0374
	Rockingham County, NH
	Strafford County, NH
40580	Rocky Mount, NC	0.8915
	Edgecombe County, NC
	Nash County, NC
40660	Rome, GA	0.9414
	Floyd County, GA
40900	Sacramento--Arden-Arcade--Roseville, CA	1.2969
	El Dorado County, CA
	Placer County, CA
	Sacramento County, CA
	Yolo County, CA
40980	Saginaw-Saginaw Township North, MI	0.9088
	Saginaw County, MI
41060	St. Cloud, MN	0.9965
	Benton County, MN
	Stearns County, MN
41100	St. George, UT	0.9392
	Washington County, UT
41140	St. Joseph, MO-KS	0.9519
	Doniphan County, KS
	Andrew County, MO
	Buchanan County, MO
	DeKalb County, MO
41180	St. Louis, MO-IL	0.8954
	Bond County, IL
	Calhoun County, IL
	Clinton County, IL
	Jersey County, IL
	Macoupin County, IL
	Madison County, IL
	Monroe County, IL
	St. Clair County, IL
	Crawford County, MO
	Franklin County, MO
	Jefferson County, MO
	Lincoln County, MO
	St. Charles County, MO
	St. Louis County, MO
	Warren County, MO
	Washington County, MO
	St. Louis City, MO
41420	Salem, OR	1.0442
	Marion County, OR
	Polk County, OR
41500	Salinas, CA	1.4128
	Monterey County, CA
41540	Salisbury, MD	0.9064
	Somerset County, MD
	Wicomico County, MD
41620	Salt Lake City, UT	0.9421
	Salt Lake County, UT
	Summit County, UT
	Tooele County, UT
41660	San Angelo, TX	0.8271
	Irion County, TX
	Tom Green County, TX
41700	San Antonio, TX	0.8980
	Atascosa County, TX
	Bandera County, TX
	Bexar County, TX
	Comal County, TX
	Guadalupe County, TX
	Kendall County, TX
	Medina County, TX
	Wilson County, TX
41740	San Diego-Carlsbad-San Marcos, CA	1.1413
	San Diego County, CA
41780	Sandusky, OH	0.9019
	Erie County, OH
41884	San Francisco-San Mateo-Redwood City, CA	1.4994
	Marin County, CA
	San Francisco County, CA
	San Mateo County, CA
41900	San German-Cabo Rojo, PR	0.4650
	Cabo Rojo Municipio, PR
	Lajas Municipio, PR
	Sabana Grande Municipio, PR
	San German Municipio, PR
41940	San Jose-Sunnyvale-Santa Clara, CA	1.5099
	San Benito County, CA
	Santa Clara County, CA
41980	San Juan-Caguas-Guaynabo, PR	0.4621
	Aguas Buenas Municipio, PR
	Aibonito Municipio, PR
	Arecibo Municipio, PR
	Barceloneta Municipio, PR
	Barranquitas Municipio, PR
	Bayamon Municipio, PR
	Caguas Municipio, PR
	Camuy Municipio, PR
	Canovanas Municipio, PR
	Carolina Municipio, PR
	Catano Municipio, PR
	Cayey Municipio, PR
	Ciales Municipio, PR
	Cidra Municipio, PR
	Comerio Municipio, PR
	Corozal Municipio, PR
	Dorado Municipio, PR
	Florida Municipio, PR
	Guaynabo Municipio, PR
	Gurabo Municipio, PR
	Hatillo Municipio, PR
	Humacao Municipio, PR
	Juncos Municipio, PR
	Las Piedras Municipio, PR
	Loiza Municipio, PR
	Manati Municipio, PR
	Maunabo Municipio, PR
	Morovis Municipio, PR
	Naguabo Municipio, PR
	Naranjito Municipio, PR
	Orocovis Municipio, PR
	Quebradillas Municipio, PR
	Rio Grande Municipio, PR
	San Juan Municipio, PR
	San Lorenzo Municipio, PR
	Toa Alta Municipio, PR
	Toa Baja Municipio, PR
	Trujillo Alto Municipio, PR
	Vega Alta Municipio, PR
	Vega Baja Municipio, PR
	Yabucoa Municipio, PR
42020	San Luis Obispo-Paso Robles, CA	1.1349
	San Luis Obispo County, CA
42044	Santa Ana-Anaheim-Irvine, CA	1.1559
	Orange County, CA
42060	Santa Barbara-Santa Maria-Goleta, CA	1.1694
	Santa Barbara County, CA
42100	Santa Cruz-Watsonville, CA	1.5166
	Santa Cruz County, CA
42140	Santa Fe, NM	1.0920
	Santa Fe County, NM
42220	Santa Rosa-Petaluma, CA	1.3493
	Sonoma County, CA
42260	Sarasota-Bradenton-Venice, FL	0.9639
	Manatee County, FL
	Sarasota County, FL
42340	Savannah, GA	0.9461
	Bryan County, GA
	Chatham County, GA
	Effingham County, GA
42540	Scranton--Wilkes-Barre, PA	0.8540
	Lackawanna County, PA
	Luzerne County, PA
	Wyoming County, PA
42644	Seattle-Bellevue-Everett, WA	1.1577
	King County, WA
	Snohomish County, WA
43100	Sheboygan, WI	0.8911
	Sheboygan County, WI
43300	Sherman-Denison, TX	0.9507
	Grayson County, TX
43340	Shreveport-Bossier City, LA	0.8760
	Bossier Parish, LA
	Caddo Parish, LA
	De Soto Parish, LA
43580	Sioux City, IA-NE-SD	0.9381
	Woodbury County, IA
	Dakota County, NE
	Dixon County, NE
	Union County, SD
43620	Sioux Falls, SD	0.9635
	Lincoln County, SD
	McCook County, SD
	Minnehaha County, SD
	Turner County, SD
43780	South Bend-Mishawaka, IN-MI	0.9788
	St. Joseph County, IN
	Cass County, MI
43900	Spartanburg, SC	0.9172
	Spartanburg County, SC
44060	Spokane, WA	1.0905
	Spokane County, WA
44100	Springfield, IL	0.8792
	Menard County, IL
	Sangamon County, IL
44140	Springfield, MA	1.0248
	Franklin County, MA
	Hampden County, MA
	Hampshire County, MA
44180	Springfield, MO	0.8237
	Christian County, MO
	Dallas County, MO
	Greene County, MO
	Polk County, MO
	Webster County, MO
44220	Springfield, OH	0.8396
	Clark County, OH
44300	State College, PA	0.8356
	Centre County, PA
44700	Stockton, CA	1.1307
	San Joaquin County, CA
44940	Sumter, SC	0.8377
	Sumter County, SC
45060	Syracuse, NY	0.9574
	Madison County, NY
	Onondaga County, NY
	Oswego County, NY
45104	Tacoma, WA	1.0742
	Pierce County, WA
45220	Tallahassee, FL	0.8688
	Gadsden County, FL
	Jefferson County, FL
	Leon County, FL
	Wakulla County, FL
45300	Tampa-St. Petersburg-Clearwater, FL	0.9233
	Hernando County, FL
	Hillsborough County, FL
	Pasco County, FL
	Pinellas County, FL
45460	Terre Haute, IN	0.8304
	Clay County, IN
	Sullivan County, IN
	Vermillion County, IN
	Vigo County, IN
45500	Texarkana, TX-Texarkana, AR	0.8283
	Miller County, AR
	Bowie County, TX
45780	Toledo, OH	0.9574
	Fulton County, OH
	Lucas County, OH
	Ottawa County, OH
	Wood County, OH
45820	Topeka, KS	0.8920
	Jackson County, KS
	Jefferson County, KS
	Osage County, KS
	Shawnee County, KS
	Wabaunsee County, KS
45940	Trenton-Ewing, NJ	1.0834
	Mercer County, NJ
46060	Tucson, AZ	0.9007
	Pima County, AZ
46140	Tulsa, OK	0.8543
	Creek County, OK
	Okmulgee County, OK
	Osage County, OK
	Pawnee County, OK
	Rogers County, OK
	Tulsa County, OK
	Wagoner County, OK
46220	Tuscaloosa, AL	0.8645
	Greene County, AL
	Hale County, AL
	Tuscaloosa County, AL
46340	Tyler, TX	0.9168
	Smith County, TX
46540	Utica-Rome, NY	0.8358
	Herkimer County, NY
	Oneida County, NY
46660	Valdosta, GA	0.8866
	Brooks County, GA
	Echols County, GA
	Lanier County, GA
	Lowndes County, GA
46700	Vallejo-Fairfield, CA	1.4936
	Solano County, CA
46940	Vero Beach, FL	0.9434
	Indian River County, FL
47020	Victoria, TX	0.8160
	Calhoun County, TX
	Goliad County, TX
	Victoria County, TX
47220	Vineland-Millville-Bridgeton, NJ	0.9827
	Cumberland County, NJ
47260	Virginia Beach-Norfolk-Newport News, VA-NC	0.8799
	Currituck County, NC
	Gloucester County, VA
	Isle of Wight County, VA
	James City County, VA
	Mathews County, VA
	Surry County, VA
	York County, VA
	Chesapeake City, VA
	Hampton City, VA
	Newport News City, VA
	Norfolk City, VA
	Poquoson City, VA
	Portsmouth City, VA
	Suffolk City, VA
	Virginia Beach City, VA
	Williamsburg City, VA
47300	Visalia-Porterville, CA	1.0123
	Tulare County, CA
47380	Waco, TX	0.8518
	McLennan County, TX
47580	Warner Robins, GA	0.8645
	Houston County, GA
47644	Warren-Farmington Hills-Troy, MI	0.9871
	Lapeer County, MI
	Livingston County, MI
	Macomb County, MI
	Oakland County, MI
	St. Clair County, MI
47894	Washington-Arlington-Alexandria, DC-VA-MD-WV	1.0926
	District of Columbia, DC
	Calvert County, MD
	Charles County, MD
	Prince George's County, MD
	Arlington County, VA
	Clarke County, VA
	Fairfax County, VA
	Fauquier County, VA
	Loudoun County, VA
	Prince William County, VA
	Spotsylvania County, VA
	Stafford County, VA
	Warren County, VA
	Alexandria City, VA
	Fairfax City, VA
	Falls Church City, VA
	Fredericksburg City, VA
	Manassas City, VA
	Manassas Park City, VA
	Jefferson County, WV
47940	Waterloo-Cedar Falls, IA	0.8557
	Black Hawk County, IA
	Bremer County, IA
	Grundy County, IA
48140	Wausau, WI	0.9590
	Marathon County, WI
48260	Weirton-Steubenville, WV-OH	0.7819
	Jefferson County, OH
	Brooke County, WV
	Hancock County, WV
48300	Wenatchee, WA	1.0070
	Chelan County, WA
	Douglas County, WA
48424	West Palm Beach-Boca Raton-Boynton Beach, FL	1.0067
	Palm Beach County, FL
48540	Wheeling, WV-OH	0.7161
	Belmont County, OH
	Marshall County, WV
	Ohio County, WV
48620	Wichita, KS	0.9153
	Butler County, KS
	Harvey County, KS
	Sedgwick County, KS
	Sumner County, KS
48660	Wichita Falls, TX	0.8285
	Archer County, TX
	Clay County, TX
	Wichita County, TX
48700	Williamsport, PA	0.8364
	Lycoming County, PA
48864	Wilmington, DE-MD-NJ	1.0471
	New Castle County, DE
	Cecil County, MD
	Salem County, NJ
48900	Wilmington, NC	0.9582
	Brunswick County, NC
	New Hanover County, NC
	Pender County, NC
49020	Winchester, VA-WV	1.0214
	Frederick County, VA
	Winchester City, VA
	Hampshire County, WV
49180	Winston-Salem, NC	0.8944
	Davie County, NC
	Forsyth County, NC
	Stokes County, NC
	Yadkin County, NC
49340	Worcester, MA	1.1028
	Worcester County, MA
49420	Yakima, WA	1.0155
	Yakima County, WA
49500	Yauco, PR	0.4408
	Guanica Municipio, PR
	Guayanilla Municipio, PR
	Penuelas Municipio, PR
	Yauco Municipio, PR
49620	York-Hanover, PA	0.9347
	York County, PA
49660	Youngstown-Warren-Boardman, OH-PA	0.8603
	Mahoning County, OH
	Trumbull County, OH
	Mercer County, PA
49700	Yuba City, CA	1.0921
	Sutter County, CA
	Yuba County, CA
49740	Yuma, AZ	0.9126
	Yuma County, AZ
1 At this time, there are no hospitals located in these urban areas on which to base a wage index.

Table 9.—FY 2006 Wage Index Based on CBSA Labor Market Areas for Rural Areas

CBSA code	Nonurban area	Wage index
1	Alabama	0.7446
2	Alaska	1.1977
3	Arizona	0.8768
4	Arkansas	0.7466
5	California	1.1054
6	Colorado	0.9380
7	Connecticut	1.1730
8	Delaware	0.9579
10	Florida	0.8568
11	Georgia	0.7662
12	Hawaii	1.0551
13	Idaho	0.8037
14	Illinois	0.8271
15	Indiana	0.8624
16	Iowa	0.8509
17	Kansas	0.8035
18	Kentucky	0.7766
19	Louisiana	0.7411
20	Maine	0.8843
21	Maryland	0.9353
22	Massachusetts 1	1.2016
23	Michigan	0.8895
24	Minnesota	0.9132
25	Mississippi	0.7674
26	Missouri	0.7900
27	Montana	0.8762
28	Nebraska	0.8657
29	Nevada	0.9065
30	New Hampshire	1.0817
31	New Jersey 1
32	New Mexico	0.8635
33	New York	0.8154
34	North Carolina	0.8540
35	North Dakota	0.7261
36	Ohio	0.8826
37	Oklahoma	0.7581
38	Oregon	0.9826
39	Pennsylvania	0.8291
40	Puerto Rico1	0.4047
41	Rhode Island 1
42	South Carolina	0.8638
43	South Dakota	0.8560
44	Tennessee	0.7895
45	Texas	0.8003
46	Utah	0.8118
47	Vermont	0.9830
48	Virgin Islands	0.7615
49	Virginia	0.8013
50	Washington	1.0510
51	West Virginia	0.7717
52	Wisconsin	0.9509
53	Wyoming	0.9257
65	Guam	0.9611
1 All counties within the State are classified as urban, with the exception of Massachusetts and Puerto Rico. Massachusetts and Puerto Rico have areas designated as rural; however, no short-term, acute care hospitals are located in the area(s) for FY 2006. Because more recent data is not available for those areas, we are using last year's wage index value.

Table A.—FY 2006 SNF PPS Transition Wage Index Table

SSA state/county code	County name	MSA No.	MSA urban/rural	2006 MSA-based WI	2006 CBSA-based WI	CBSA No.	CBSA urban/rural	Transition wage index *
01000	Autauga County, Alabama	5240	Urban	0.8618	0.8618	33860	Urban	0.8618
01010	Baldwin County, Alabama	5160	Urban	0.7861	0.7446	99901	Rural	0.7654
01020	Barbour County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01030	Bibb County, Alabama	01	Rural	0.7432	0.8959	13820	Urban	0.8196
01040	Blount County, Alabama	1000	Urban	0.9000	0.8959	13820	Urban	0.8980
01050	Bullock County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01060	Butler County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01070	Calhoun County, Alabama	0450	Urban	0.7682	0.7682	11500	Urban	0.7682
01080	Chambers County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01090	Cherokee County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01100	Chilton County, Alabama	01	Rural	0.7432	0.8959	13820	Urban	0.8196
01110	Choctaw County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01120	Clarke County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01130	Clay County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01140	Cleburne County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01150	Coffee County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01160	Colbert County, Alabama	2650	Urban	0.8272	0.8272	22520	Urban	0.8272
01170	Conecuh County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01180	Coosa County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01190	Covington County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01200	Crenshaw County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01210	Cullman County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01220	Dale County, Alabama	2180	Urban	0.7701	0.7446	99901	Rural	0.7574
01230	Dallas County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01240	De Kalb County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01250	Elmore County, Alabama	5240	Urban	0.8618	0.8618	33860	Urban	0.8618
01260	Escambia County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01270	Etowah County, Alabama	2880	Urban	0.7938	0.7938	23460	Urban	0.7938
01280	Fayette County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01290	Franklin County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01300	Geneva County, Alabama	01	Rural	0.7432	0.7721	20020	Urban	0.7577
01310	Greene County, Alabama	01	Rural	0.7432	0.8645	46220	Urban	0.8039
01320	Hale County, Alabama	01	Rural	0.7432	0.8645	46220	Urban	0.8039
01330	Henry County, Alabama	01	Rural	0.7432	.7721	20020	Urban	0.7577
01340	Houston County, Alabama	2180	Urban	0.7701	0.7721	20020	Urban	0.7711
01350	Jackson County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01360	Jefferson County, Alabama	1000	Urban	0.9000	0.8959	13820	Urban	0.8980
01370	Lamar County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01380	Lauderdale County, Alabama	2650	Urban	0.8272	0.8272	22520	Urban	0.8272
01390	Lawrence County, Alabama	2030	Urban	0.8469	0.8469	19460	Urban	0.8469
01400	Lee County, Alabama	0580	Urban	0.8100	0.8100	12220	Urban	0.8100
01410	Limestone County, Alabama	3440	Urban	0.9146	0.9146	26620	Urban	0.9146
01420	Lowndes County, Alabama	01	Rural	0.7432	0.8618	33860	Urban	0.8025
01430	Macon County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01440	Madison County, Alabama	3440	Urban	0.9146	0.9146	26620	Urban	0.9146
01450	Marengo County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01460	Marion County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01470	Marshall County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01480	Mobile County, Alabama	5160	Urban	0.7861	0.7891	33660	Urban	0.7876
01490	Monroe County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01500	Montgomery County, Alabama	5240	Urban	0.8618	0.8618	33860	Urban	0.8618
01510	Morgan County, Alabama	2030	Urban	0.8469	0.8469	19460	Urban	0.8469
01520	Perry County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01530	Pickens County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01540	Pike County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01550	Randolph County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01560	Russell County, Alabama	1800	Urban	0.8560	0.8560	17980	Urban	0.8560
01570	St Clair County, Alabama	1000	Urban	0.9000	0.8959	13820	Urban	0.8980
01580	Shelby County, Alabama	1000	Urban	0.9000	0.8959	13820	Urban	0.8980
01590	Sumter County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01600	Talladega County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01610	Tallapoosa County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01620	Tuscaloosa County, Alabama	8600	Urban	0.8764	0.8645	46220	Urban	0.8705
01630	Walker County, Alabama	01	Rural	0.7432	0.8959	13820	Urban	0.8196
01640	Washington County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01650	Wilcox County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
01660	Winston County, Alabama	01	Rural	0.7432	0.7446	99901	Rural	0.7439
02013	Aleutians County East, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02016	Aleutians County West, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02020	Anchorage County, Alaska	0380	Urban	1.1784	1.1895	11260	Urban	1.1840
02030	Angoon County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02040	Barrow-North Slope County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02050	Bethel County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02060	Bristol Bay Borough County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02068	Denali County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02070	Bristol Bay County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02080	Cordova-Mc Carthy County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02090	Fairbanks County, Alaska	02	Rural	1.1888	1.1408	21820	Urban	1.1648
02100	Haines County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02110	Juneau County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02120	Kenai-Cook Inlet County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02122	Kenai Peninsula Borough, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02130	Ketchikan County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02140	Kobuk County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02150	Kodiak County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02160	Kuskokwin County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02164	Lake and Peninsula Borough, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02170	Matanuska County, Alaska	02	Rural	1.1888	1.1895	11260	Urban	1.1892
02180	Nome County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02185	North Slope Borough, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02188	Northwest Arctic Borough, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02190	Outer Ketchikan County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02200	Prince Of Wales County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02201	Prince of Wales-Outer Ketchikan Census Area, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02210	Seward County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02220	Sitka County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02230	Skagway-Yakutat County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02231	Skagway-Yakutat-Angoon Census Area, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02232	Skagway-Hoonah-Angoon Census Area, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02240	Southeast Fairbanks County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02250	Upper Yukon County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02260	Valdz-Chitna-Whitier County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02261	Valdex-Cordove Census Area, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02270	Wade Hampton County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02280	Wrangell-Petersburg County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02282	Yakutat Borough, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
02290	Yukon-Koyukuk County, Alaska	02	Rural	1.1888	1.1977	99902	Rural	1.1933
03000	Apache County, Arizona	03	Rural	0.9045	0.8768	99903	Rural	0.8907
03010	Cochise County, Arizona	03	Rural	0.9045	0.8768	99903	Rural	0.8907
03020	Coconino County, Arizona	2620	Urban	1.1845	1.2092	22380	Urban	1.1969
03030	Gila County, Arizona	03	Rural	0.9045	0.8768	99903	Rural	0.8907
03040	Graham County, Arizona	03	Rural	0.9045	0.8768	99903	Rural	0.8907
03050	Greenlee County, Arizona	03	Rural	0.9045	0.8768	99903	Rural	0.8907
03055	La Paz County, Arizona	03	Rural	0.9045	0.8768	99903	Rural	0.8907
03060	Maricopa County, Arizona	6200	Urban	1.0127	1.0127	38060	Urban	1.0127
03070	Mohave County, Arizona	4120	Urban	1.1155	0.8768	99903	Rural	0.9962
03080	Navajo County, Arizona	03	Rural	0.9045	0.8768	99903	Rural	0.8907
03090	Pima County, Arizona	8520	Urban	0.9007	0.9007	46060	Urban	0.9007
03100	Pinal County, Arizona	6200	Urban	1.0127	1.0127	38060	Urban	1.0127
03110	Santa Cruz County, Arizona	03	Rural	0.9045	0.8768	99903	Rural	0.8907
03120	Yavapai County, Arizona	03	Rural	0.9045	0.9869	39140	Urban	0.9457
03130	Yuma County, Arizona	9360	Urban	0.9126	0.9126	49740	Urban	0.9126
04000	Arkansas County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04010	Ashley County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04020	Baxter County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04030	Benton County, Arkansas	2580	Urban	0.8661	0.8661	22220	Urban	0.8661
04040	Boone County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04050	Bradley County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04060	Calhoun County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04070	Carroll County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04080	Chicot County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04090	Clark County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04100	Clay County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04110	Cleburne County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04120	Cleveland County, Arkansas	04	Rural	0.7744	0.8680	38220	Urban	0.8212
04130	Columbia County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04140	Conway County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04150	Craighead County, Arkansas	3700	Urban	0.7911	0.7911	27860	Urban	0.7911
04160	Crawford County, Arkansas	2720	Urban	0.8246	0.8230	22900	Urban	0.8238
04170	Crittenden County, Arkansas	4920	Urban	0.9416	0.9397	32820	Urban	0.9407
04180	Cross County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04190	Dallas County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04200	Desha County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04210	Drew County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04220	Faulkner County, Arkansas	4400	Urban	0.8747	0.8747	30780	Urban	0.8747
04230	Franklin County, Arkansas	04	Rural	0.7744	0.8230	22900	Urban	0.7987
04240	Fulton County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04250	Garland County, Arkansas	04	Rural	0.7744	0.9005	26300	Urban	0.8375
04260	Grant County, Arkansas	04	Rural	0.7744	0.8747	30780	Urban	0.8246
04270	Greene County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
4280	Hempstead County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04290	Hot Spring County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04300	Howard County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04310	Independence County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04320	Izard County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04330	Jackson County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04340	Jefferson County, Arkansas	6240	Urban	0.8680	0.8680	38220	Urban	0.8680
04350	Johnson County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04360	Lafayette County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04370	Lawrence County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04380	Lee County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04390	Lincoln County, Arkansas	04	Rural	0.7744	0.8680	38220	Urban	0.8212
04400	Little River County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04410	Logan County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04420	Lonoke County, Arkansas	4400	Urban	0.8747	0.8747	30780	Urban	0.8747
04430	Madison County, Arkansas	04	Rural	0.7744	0.8661	22220	Urban	0.8203
04440	Marion County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04450	Miller County, Arkansas	8360	Urban	0.8283	0.8283	45500	Urban	0.8283
04460	Mississippi County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04470	Monroe County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04480	Montgomery County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04490	Nevada County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04500	Newton County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04510	Ouachita County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04520	Perry County, Arkansas	04	Rural	0.7744	0.8747	30780	Urban	0.8246
04530	Phillips County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04540	Pike County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04550	Poinsett County, Arkansas	04	Rural	0.7744	0.7911	27860	Urban	0.7828
04560	Polk County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04570	Pope County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04580	Prairie County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04590	Pulaski County, Arkansas	4400	Urban	0.8747	0.8747	30780	Urban	0.8747
04600	Randolph County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04610	St Francis County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04620	Saline County, Arkansas	4400	Urban	0.8747	0.8747	30780	Urban	0.8747
04630	Scott County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04640	Searcy County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04650	Sebastian County, Arkansas	2720	Urban	0.8246	0.8230	22900	Urban	0.8238
04660	Sevier County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04670	Sharp County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04680	Stone County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04690	Union County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04700	Van Buren County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04710	Washington County, Arkansas	2580	Urban	0.8661	0.8661	22220	Urban	0.8661
04720	White County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04730	Woodruff County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
04740	Yell County, Arkansas	04	Rural	0.7744	0.7466	99904	Rural	0.7605
05000	Alameda County, California	5775	Urban	1.5346	1.5346	36084	Urban	1.5346
05010	Alpine County, California	05	Rural	1.0775	1.1054	99905	Rural	1.0915
05020	Amador County, California	05	Rural	1.0775	1.1054	99905	Rural	1.0915
05030	Butte County, California	1620	Urban	1.0511	1.0511	17020	Urban	1.0511
05040	Calaveras County, California	05	Rural	1.0775	1.1054	99905	Rural	1.0915
05050	Colusa County, California	05	Rural	1.0775	1.1054	99905	Rural	1.0915
05060	Contra Costa County, California	5775	Urban	1.5346	1.5346	36084	Urban	1.5346
05070	Del Norte County, California	05	Rural	1.0775	1.1054	99905	Rural	1.0915
05080	Eldorado County, California	6920	Urban	1.3143	1.2969	40900	Urban	1.3056
05090	Fresno County, California	2840	Urban	1.0428	1.0538	23420	Urban	1.0483
05100	Glenn County, California	05	Rural	1.0775	1.1054	99905	Rural	1.0915
05110	Humboldt County, California	05	Rural	1.0775	1.1054	99905	Rural	1.0915
05120	Imperial County, California	05	Rural	1.0775	0.8906	20940	Urban	0.9841
05130	Inyo County, California	05	Rural	1.0775	1.1054	99905	Rural	1.0915
05140	Kern County, California	0680	Urban	1.0470	1.0470	12540	Urban	1.0470
05150	Kings County, California	05	Rural	1.0775	1.0036	25260	Urban	1.0406
05160	Lake County, California	05	Rural	1.0775	1.1054	99905	Rural	1.0915
05170	Lassen County, California	05	Rural	1.0775	1.1054	99905	Rural	1.0915
05200	Los Angeles County, California	4480	Urban	1.1783	1.1783	31084	Urban	1.1783
05210	Los Angeles County, California	4480	Urban	1.1783	1.1783	31084	Urban	1.1783
05300	Madera County, California	2840	Urban	1.0428	0.8713	31460	Urban	0.9571
05310	Marin County, California	7360	Urban	1.4994	1.4994	41884	Urban	1.4994
05320	Mariposa County, California	05	Rural	1.0775	1.1054	99905	Rural	1.0915
05330	Mendocino County, California	05	Rural	1.0775	1.1054	99905	Rural	1.0915
05340	Merced County, California	4940	Urban	1.1109	1.1109	32900	Urban	1.1109
05350	Modoc County, California	05	Rural	1.0775	1.1054	99905	Rural	1.0915
05360	Mono County, California	05	Rural	1.0775	1.1054	99905	Rural	1.0915
05370	Monterey County, California	7120	Urban	1.4128	1.4128	41500	Urban	1.4128
05380	Napa County, California	8720	Urban	1.3983	1.2643	34900	Urban	1.3313
05390	Nevada County, California	05	Rural	1.0775	1.1054	99905	Rural	1.0915
05400	Orange County, California	5945	Urban	1.1559	1.1559	42044	Urban	1.1559
05410	Placer County, California	6920	Urban	1.3143	1.2969	40900	Urban	1.3056
05420	Plumas County, California	05	Rural	1.0775	1.1054	99905	Rural	1.0915
05430	Riverside County, California	6780	Urban	1.1027	1.1027	40140	Urban	1.1027
05440	Sacramento County, California	6920	Urban	1.3143	1.2969	40900	Urban	1.3056
05450	San Benito County, California	05	Rural	1.0775	1.5099	41940	Urban	1.2937
05460	San Bernardino County, California	6780	Urban	1.1027	1.1027	40140	Urban	1.1027
05470	San Diego County, California	7320	Urban	1.1413	1.1413	41740	Urban	1.1413
05480	San Francisco County, California	7360	Urban	1.4994	1.4994	41884	Urban	1.4994
05490	San Joaquin County, California	8120	Urban	1.1307	1.1307	44700	Urban	1.1307
05500	San Luis Obispo County, California	7460	Urban	1.1349	1.1349	42020	Urban	1.1349
05510	San Mateo County, California	7360	Urban	1.4994	1.4994	41884	Urban	1.4994
05520	Santa Barbara County, California	7480	Urban	1.1694	1.1694	42060	Urban	1.1694
05530	Santa Clara County, California	7400	Urban	1.5118	1.5099	41940	Urban	1.5109
05540	Santa Cruz County, California	7485	Urban	1.5166	1.5166	42100	Urban	1.5166
05550	Shasta County, California	6690	Urban	1.2203	1.2203	39820	Urban	1.2203
05560	Sierra County, California	05	Rural	1.0775	1.1054	99905	Rural	1.0915
05570	Siskiyou County, California	05	Rural	1.0775	1.1054	99905	Rural	1.0915
05580	Solano County, California	8720	Urban	1.3983	1.4936	46700	Urban	1.4460
05590	Sonoma County, California	7500	Urban	1.3493	1.3493	42220	Urban	1.3493
05600	Stanislaus County, California	5170	Urban	1.1885	1.1885	33700	Urban	1.1885
05610	Sutter County, California	9340	Urban	1.0921	1.0921	49700	Urban	1.0921
05620	Tehama County, California	05	Rural	1.0775	1.1054	99905	Rural	1.0915
05630	Trinity County, California	05	Rural	1.0775	1.1054	99905	Rural	1.0915
05640	Tulare County, California	8780	Urban	1.0123	1.0123	47300	Urban	1.0123
05650	Tuolumne County, California	05	Rural	1.0775	1.1054	99905	Rural	1.0915
05660	Ventura County, California	8735	Urban	1.1622	1.1622	37100	Urban	1.1622
05670	Yolo County, California	9270	Urban	0.9950	1.2969	40900	Urban	1.1460
05680	Yuba County, California	9340	Urban	1.0921	1.0921	49700	Urban	1.0921
06000	Adams County, Colorado	2080	Urban	1.0723	1.0723	19740	Urban	1.0723
06010	Alamosa County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06020	Arapahoe County, Colorado	2080	Urban	1.0723	1.0723	19740	Urban	1.0723
06030	Archuleta County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06040	Baca County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06050	Bent County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06060	Boulder County, Colorado	1125	Urban	0.9734	0.9734	14500	Urban	0.9734
06070	Chaffee County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06080	Cheyenne County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06090	Clear Creek County, Colorado	06	Rural	0.9380	1.0723	19740	Urban	1.0052
06100	Conejos County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06110	Costilla County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06120	Crowley County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06130	Custer County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06140	Delta County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06150	Denver County, Colorado	2080	Urban	1.0723	1.0723	19740	Urban	1.0723
06160	Dolores County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06170	Douglas County, Colorado	2080	Urban	1.0723	1.0723	19740	Urban	1.0723
06180	Eagle County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06190	Elbert County, Colorado	06	Rural	0.9380	1.0723	19740	Urban	1.0052
06200	El Paso County, Colorado	1720	Urban	0.9468	0.9468	17820	Urban	0.9468
06210	Fremont County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06220	Garfield County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06230	Gilpin County, Colorado	06	Rural	0.9380	1.0723	19740	Urban	1.0052
06240	Grand County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06250	Gunnison County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06260	Hinsdale County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06270	Huerfano County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06280	Jackson County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06290	Jefferson County, Colorado	2080	Urban	1.0723	1.0723	19740	Urban	1.0723
06300	Kiowa County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06310	Kit Carson County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06320	Lake County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06330	La Plata County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06340	Larimer County, Colorado	2670	Urban	1.0122	1.0122	22660	Urban	1.0122
06350	Las Animas County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06360	Lincoln County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06370	Logan County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06380	Mesa County, Colorado	2995	Urban	0.9550	0.9550	24300	Urban	0.9550
06390	Mineral County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06400	Moffat County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06410	Montezuma County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06420	Montrose County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06430	Morgan County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06440	Otero County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06450	Ouray County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06460	Park County, Colorado	06	Rural	0.9380	1.0723	19740	Urban	1.0052
06470	Phillips County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06480	Pitkin County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06490	Prowers County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06500	Pueblo County, Colorado	6560	Urban	0.8623	0.8623	39380	Urban	0.8623
06510	Rio Blanco County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06520	Rio Grande County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06530	Routt County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06540	Saguache County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06550	San Juan County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06560	San Miguel County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06570	Sedgwick County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06580	Summit County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06590	Teller County, Colorado	06	Rural	0.9380	0.9468	17820	Urban	0.9424
06600	Washington County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06610	Weld County, Colorado	3060	Urban	0.9570	0.9570	24540	Urban	0.9570
06620	Yuma County, Colorado	06	Rural	0.9380	0.9380	99906	Rural	0.9380
06630	Broomfield County, Colorado	2080	Urban	1.0723	1.0723	19740	Urban	1.0723
07000	Fairfield County, Connecticut	5483	Urban	1.2196	1.2592	14860	Urban	1.2394
07010	Hartford County, Connecticut	3283	Urban	1.1073	1.1073	25540	Urban	1.1073
07020	Litchfield County, Connecticut	3283	Urban	1.1073	1.1073	25540	Urban	1.1073
07030	Middlesex County, Connecticut	3283	Urban	1.1073	1.1073	25540	Urban	1.1073
07040	New Haven County, Connecticut	5483	Urban	1.2196	1.1887	35300	Urban	1.2042
07050	New London County, Connecticut	5523	Urban	1.1345	1.1345	35980	Urban	1.1345
07060	Tolland County, Connecticut	3283	Urban	1.1073	1.1073	25540	Urban	1.1073
07070	Windham County, Connecticut	07	Rural	1.1730	1.1730	99907	Rural	1.1730
08000	Kent County, Delaware	2190	Urban	0.9776	0.9776	20100	Urban	0.9776
08010	New Castle County, Delaware	9160	Urban	1.0527	1.0471	48864	Urban	1.0499
08020	Sussex County, Delaware	08	Rural	0.9579	0.9579	99908	Rural	0.9579
09000	Washington Dc County, Dist Of Col	8840	Urban	1.0976	1.0926	47894	Urban	1.0951
10000	Alachua County, Florida	2900	Urban	0.9388	0.9388	23540	Urban	0.9388
10010	Baker County, Florida	10	Rural	0.8677	0.9290	27260	Urban	0.8984
10020	Bay County, Florida	6015	Urban	0.8005	0.8005	37460	Urban	0.8005
10030	Bradford County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10040	Brevard County, Florida	4900	Urban	0.9839	0.9839	37340	Urban	0.9839
10050	Broward County, Florida	2680	Urban	1.0432	1.0432	22744	Urban	1.0432
10060	Calhoun County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10070	Charlotte County, Florida	6580	Urban	0.9255	0.9255	39460	Urban	0.9255
10080	Citrus County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10090	Clay County, Florida	3600	Urban	0.9299	0.9290	27260	Urban	0.9295
10100	Collier County, Florida	5345	Urban	1.0139	1.0139	34940	Urban	1.0139
10110	Columbia County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10120	Dade County, Florida	5000	Urban	0.9750	0.9750	33124	Urban	0.9750
10130	De Soto County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10140	Dixie County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10150	Duval County, Florida	3600	Urban	0.9299	0.9290	27260	Urban	0.9295
10160	Escambia County, Florida	6080	Urban	0.8096	0.8096	37860	Urban	0.8096
10170	Flagler County, Florida	2020	Urban	0.9325	0.8568	99910	Rural	0.8947
10180	Franklin County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10190	Gadsden County, Florida	8240	Urban	0.8688	0.8688	45220	Urban	0.8688
10200	Gilchrist County, Florida	10	Rural	0.8677	0.9388	23540	Urban	0.9033
10210	Glades County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10220	Gulf County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10230	Hamilton County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10240	Hardee County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10250	Hendry County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10260	Hernando County, Florida	8280	Urban	0.9233	0.9233	45300	Urban	0.9233
10270	Highlands County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10280	Hillsborough County, Florida	8280	Urban	0.9233	0.9233	45300	Urban	0.9233
10290	Holmes County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10300	Indian River County, Florida	10	Rural	0.8677	0.9434	46940	Urban	0.9056
10310	Jackson County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10320	Jefferson County, Florida	10	Rural	0.8677	0.8688	45220	Urban	0.8683
10330	Lafayette County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10340	Lake County, Florida	5960	Urban	0.9464	0.9464	36740	Urban	0.9464
10350	Lee County, Florida	2700	Urban	0.9356	0.9356	15980	Urban	0.9356
10360	Leon County, Florida	8240	Urban	0.8688	0.8688	45220	Urban	0.8688
10370	Levy County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10380	Liberty County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10390	Madison County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10400	Manatee County, Florida	7510	Urban	0.9639	0.9639	42260	Urban	0.9639
10410	Marion County, Florida	5790	Urban	0.8925	0.8925	36100	Urban	0.8925
10420	Martin County, Florida	2710	Urban	1.0123	1.0123	38940	Urban	1.0123
10430	Monroe County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10440	Nassau County, Florida	3600	Urban	0.9299	0.9290	27260	Urban	0.9295
10450	Okaloosa County, Florida	2750	Urban	0.8872	0.8872	23020	Urban	0.8872
10460	Okeechobee County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10470	Orange County, Florida	5960	Urban	0.9464	0.9464	36740	Urban	0.9464
10480	Osceola County, Florida	5960	Urban	0.9464	0.9464	36740	Urban	0.9464
10490	Palm Beach County, Florida	8960	Urban	1.0067	1.0067	48424	Urban	1.0067
10500	Pasco County, Florida	8280	Urban	0.9233	0.9233	45300	Urban	0.9233
10510	Pinellas County, Florida	8280	Urban	0.9233	0.9233	45300	Urban	0.9233
10520	Polk County, Florida	3980	Urban	0.8912	0.8912	29460	Urban	0.8912
10530	Putnam County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10540	Johns County, Florida	3600	Urban	0.9299	0.9290	27260	Urban	0.9295
10550	St Lucie County, Florida	2710	Urban	1.0123	1.0123	38940	Urban	1.0123
10560	Santa Rosa County, Florida	6080	Urban	0.8096	0.8096	37860	Urban	0.8096
10570	Sarasota County, Florida	7510	Urban	0.9639	0.9639	42260	Urban	0.9639
10580	Seminole County, Florida	5960	Urban	0.9464	0.9464	36740	Urban	0.9464
10590	Sumter County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10600	Suwannee County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10610	Taylor County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10620	Union County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10630	Volusia County, Florida	2020	Urban	0.9325	0.9299	19660	Urban	0.9312
10640	Wakulla County, Florida	10	Rural	0.8677	0.8688	45220	Urban	0.8683
10650	Walton County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
10660	Washington County, Florida	10	Rural	0.8677	0.8568	99910	Rural	0.8623
11000	Appling County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11010	Atkinson County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11011	Bacon County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11020	Baker County, Georgia	11	Rural	0.8166	0.8628	10500	Urban	0.8397
11030	Baldwin County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11040	Banks County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11050	Barrow County, Georgia	0520	Urban	0.9793	0.9793	12060	Urban	0.9793
11060	Bartow County, Georgia	0520	Urban	0.9793	0.9793	12060	Urban	0.9793
11070	Ben Hill County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11080	Berrien County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11090	Bibb County, Georgia	4680	Urban	0.9277	0.9443	31420	Urban	0.9360
11100	Bleckley County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11110	Brantley County, Georgia	11	Rural	0.8166	0.9311	15260	Urban	0.8739
11120	Brooks County, Georgia	11	Rural	0.8166	0.8866	46660	Urban	0.8516
11130	Bryan County, Georgia	7520	Urban	0.9461	0.9461	42340	Urban	0.9461
11140	Bulloch County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11150	Burke County, Georgia	11	Rural	0.8166	0.9748	12260	Urban	0.8957
11160	Butts County, Georgia	11	Rural	0.8166	0.9793	12060	Urban	0.8980
11161	Calhoun County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11170	Camden County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11180	Candler County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11190	Carroll County, Georgia	0520	Urban	0.9793	0.9793	12060	Urban	0.9793
11200	Catoosa County, Georgia	1560	Urban	0.9088	0.9088	16860	Urban	0.9088
11210	Charlton County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11220	Chatham County, Georgia	7520	Urban	0.9461	0.9461	42340	Urban	0.9461
11230	Chattahoochee County, Georgia	1800	Urban	0.8560	0.8560	17980	Urban	0.8560
11240	Chattooga County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11250	Cherokee County, Georgia	0520	Urban	0.9793	0.9793	12060	Urban	0.9793
11260	Clarke County, Georgia	0500	Urban	0.9855	0.9855	12020	Urban	0.9855
11270	Clay County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11280	Clayton County, Georgia	0520	Urban	0.9793	0.9793	12060	Urban	0.9793
11281	Clinch County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11290	Cobb County, Georgia	0520	Urban	0.9793	0.9793	12060	Urban	0.9793
11291	Coffee County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11300	Colquitt County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11310	Columbia County, Georgia	0600	Urban	0.9808	0.9748	12260	Urban	0.9778
11311	Cook County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11320	Coweta County, Georgia	0520	Urban	0.9793	0.9793	12060	Urban	0.9793
11330	Crawford County, Georgia	11	Rural	0.8166	0.9443	31420	Urban	0.8805
11340	Crisp County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11341	Dade County, Georgia	1560	Urban	0.9088	0.9088	16860	Urban	0.9088
11350	Dawson County, Georgia	11	Rural	0.8166	0.9793	12060	Urban	0.8980
11360	Decatur County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11370	De Kalb County, Georgia	0520	Urban	0.9793	0.9793	12060	Urban	0.9793
11380	Dodge County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11381	Dooly County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11390	Dougherty County, Georgia	0120	Urban	0.8628	0.8628	10500	Urban	0.8628
11400	Douglas County, Georgia	0520	Urban	0.9793	0.9793	12060	Urban	0.9793
11410	Early County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11420	Echols County, Georgia	11	Rural	0.8166	0.8866	46660	Urban	0.8516
11421	Effingham County, Georgia	7520	Urban	0.9461	0.9461	42340	Urban	0.9461
11430	Elbert County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11440	Emanuel County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11441	Evans County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11450	Fannin County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11451	Fayette County, Georgia	0520	Urban	9793	0.9793	12060	Urban	0.9793
11460	Floyd County, Georgia	11	Rural	0.8166	0.9414	40660	Urban	0.8790
11461	Forsyth County, Georgia	0520	Urban	0.9793	0.9793	12060	Urban	0.9793
11462	Franklin County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11470	Fulton County, Georgia	0520	Urban	0.9793	0.9793	12060	Urban	0.9793
11471	Gilmer County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11480	Glascock County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11490	Glynn County, Georgia	11	Rural	0.8166	0.9311	15260	Urban	0.8739
11500	Gordon County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11510	Grady County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11520	Greene County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11530	Gwinnett County, Georgia	0520	Urban	0.9793	0.9793	12060	Urban	0.9793
11540	Habersham County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11550	Hall County, Georgia	11	Rural	0.8166	0.8874	23580	Urban	0.8520
11560	Hancock County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11570	Haralson County, Georgia	11	Rural	0.8166	0.9793	12060	Urban	0.8980
11580	Harris County, Georgia	1800	Urban	0.8560	0.8560	17980	Urban	0.8560
11581	Hart County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11590	Heard County, Georgia	11	Rural	0.8166	0.9793	12060	Urban	0.8980
11591	Henry County, Georgia	0520	Urban	0.9793	0.9793	12060	Urban	0.9793
11600	Houston County, Georgia	4680	Urban	0.9277	0.8645	47580	Urban	0.8961
11601	Irwin County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11610	Jackson County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11611	Jasper County, Georgia	11	Rural	0.8166	0.9793	12060	Urban	0.8980
11612	Jeff Davis County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11620	Jefferson County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11630	Jenkins County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11640	Johnson County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11650	Jones County, Georgia	4680	Urban	0.9277	0.9443	31420	Urban	0.9360
11651	Lamar County, Georgia	11	Rural	0.8166	0.9793	12060	Urban	0.8980
11652	Lanier County, Georgia	11	Rural	0.8166	0.8866	46660	Urban	0.8516
11660	Laurens County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11670	Lee County, Georgia	0120	Urban	0.8628	0.8628	10500	Urban	0.8628
11680	Liberty County, Georgia	11	Rural	0.8166	(1)	25980	Urban	0.8973
11690	Lincoln County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11691	Long County, Georgia	11	Rural	0.8166	(1)	25980	Urban	0.8973
11700	Lowndes County, Georgia	11	Rural	0.8166	0.8866	46660	Urban	0.8516
11701	Lumpkin County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11702	Mc Duffie County, Georgia	0600	Urban	0.9808	0.9748	12260	Urban	0.9778
11703	Mc Intosh County, Georgia	11	Rural	0.8166	0.9311	15260	Urban	0.8739
11710	Macon County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11720	Madison County, Georgia	0500	Urban	0.9855	0.9855	12020	Urban	0.9855
11730	Marion County, Georgia	11	Rural	0.8166	0.8560	17980	Urban	0.8363
11740	Meriwether County, Georgia	11	Rural	0.8166	0.9793	12060	Urban	0.8980
11741	Miller County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11750	Mitchell County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11760	Monroe County, Georgia	11	Rural	0.8166	0.9443	31420	Urban	0.8805
11770	Montgomery County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11771	Morgan County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11772	Murray County, Georgia	11	Rural	0.8166	0.9079	19140	Urban	0.8623
11780	Muscogee County, Georgia	1800	Urban	0.8560	0.8560	17980	Urban	0.8560
11790	Newton County, Georgia	0520	Urban	0.9793	0.9793	12060	Urban	0.9793
11800	Oconee County, Georgia	0500	Urban	0.9855	0.9855	12020	Urban	0.9855
11801	Oglethorpe County, Georgia	11	Rural	0.8166	0.9855	12020	Urban	0.9011
11810	Paulding County, Georgia	0520	Urban	0.9793	0.9793	12060	Urban	0.9793
11811	Peach County, Georgia	4680	Urban	0.9277	0.7662	99911	Rural	0.8470
11812	Pickens County, Georgia	0520	Urban	0.9793	0.9793	12060	Urban	0.9793
11820	Pierce County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11821	Pike County, Georgia	11	Rural	0.8166	0.9793	12060	Urban	0.8980
11830	Polk County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11831	Pulaski County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11832	Putnam County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11833	Quitman County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11834	Rabun County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11835	Randolph County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11840	Richmond County, Georgia	0600	Urban	0.9808	0.9748	12260	Urban	10.9778
11841	Rockdale County, Georgia	0520	Urban	0.9793	0.9793	12060	Urban	0.9793
11842	Schley County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11850	Screven County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11851	Seminole County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11860	Spalding County, Georgia	0520	Urban	0.9793	0.9793	12060	Urban	0.9793
11861	Stephens County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11862	Stewart County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11870	Sumter County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11880	Talbot County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11881	Taliaferro County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11882	Tattnall County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11883	Taylor County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11884	Telfair County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11885	Terrell County, Georgia	11	Rural	0.8166	0.8628	10500	Urban	0.8397
11890	Thomas County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11900	Tift County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11901	Toombs County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11902	Towns County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11903	Treutlen County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11910	Troup County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11911	Turner County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11912	Twiggs County, Georgia	4680	Urban	0.9277	0.9443	31420	Urban	0.9360
11913	Union County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11920	Upson County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11921	Walker County, Georgia	1560	Urban	0.9088	0.9088	16860	Urban	0.9088
11930	Walton County, Georgia	0520	Urban	0.9793	0.9793	12060	Urban	0.9793
11940	Ware County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11941	Warren County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11950	Washington County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11960	Wayne County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11961	Webster County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11962	Wheeler County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11963	White County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11970	Whitfield County, Georgia	11	Rural	0.8166	0.9079	19140	Urban	0.8623
11971	Wilcox County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11972	Wilkes County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11973	Wilkinson County, Georgia	11	Rural	0.8166	0.7662	99911	Rural	0.7914
11980	Worth County, Georgia	11	Rural	0.8166	0.8628	10500	Urban	0.8397
12005	Kalawao County, Hawaii	12	Rural	1.0551	1.0551	99912	Rural	1.0551
12010	Hawaii County, Hawaii	12	Rural	1.0551	1.0551	99912	Rural	1.0551
12020	Honolulu County, Hawaii	3320	Urban	1.1214	1.1214	26180	Urban	1.1214
12040	Kauai County, Hawaii	12	Rural	1.0551	1.0551	99912	Rural	1.0551
12050	Maui County, Hawaii	12	Rural	1.0551	1.0551	99912	Rural	1.0551
13000	Ada County, Idaho	1080	Urban	0.9052	0.9052	14260	Urban	0.9052
13010	Adams County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13020	Bannock County, Idaho	6340	Urban	0.9351	0.9351	38540	Urban	0.9351
13030	Bear Lake County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13040	Benewah County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13050	Bingham County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13060	Blaine County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13070	Boise County, Idaho	13	Rural	0.9097	0.9052	14260	Urban	0.9075
13080	Bonner County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13090	Bonneville County, Idaho	13	Rural	0.9097	0.9420	26820	Urban	0.9259
13100	Boundary County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13110	Butte County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13120	Camas County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13130	Canyon County, Idaho	1080	Urban	0.9052	0.9052	14260	Urban	0.9052
13140	Caribou County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13150	Cassia County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13160	Clark County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13170	Clearwater County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13180	Custer County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13190	Elmore County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13200	Franklin County, Idaho	13	Rural	0.9097	0.9164	30860	Urban	0.9131
13210	Fremont County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13220	Gem County, Idaho	13	Rural	0.9097	0.9052	14260	Urban	0.9075
13230	Gooding County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13240	Idaho County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13250	Jefferson County, Idaho	13	Rural	0.9097	0.9420	26820	Urban	0.9259
13260	Jerome County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13270	Kootenai County, Idaho	13	Rural	0.9097	0.9647	17660	Urban	0.9372
13280	Latah County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13290	Lemhi County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13300	Lewis County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13310	Lincoln County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13320	Madison County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13330	Minidoka County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13340	Nez Perce County, Idaho	13	Rural	0.9097	0.9886	30300	Urban	0.9492
13350	Oneida County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13360	Owyhee County, Idaho	13	Rural	0.9097	0.9052	14260	Urban	0.9075
13370	Payette County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13380	Power County, Idaho	13	Rural	0.9097	0.9351	38540	Urban	0.9224
13390	Shoshone County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13400	Teton County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13410	Twin Falls County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13420	Valley County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
13430	Washington County, Idaho	13	Rural	0.9097	0.8037	99913	Rural	0.8567
14000	Adams County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14010	Alexander County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14020	Bond County, Illinois	14	Rural	0.8301	0.8954	41180	Urban	0.8628
14030	Boone County, Illinois	6880	Urban	0.9984	0.9984	40420	Urban	0.9984
14040	Brown County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14050	Bureau County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14060	Calhoun County, Illinois	14	Rural	0.8301	0.8954	41180	Urban	0.8628
14070	Carroll County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14080	Cass County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14090	Champaign County, Illinois	1400	Urban	0.9594	0.9594	16580	Urban	0.9594
14100	Christian County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14110	Clark County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14120	Clay County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14130	Clinton County, Illinois	7040	Urban	0.8962	0.8954	41180	Urban	0.8958
14140	Coles County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14141	Cook County, Illinois	1600	Urban	1.0783	1.0790	16974	Urban	1.0787
14150	Crawford County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14160	Cumberland County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14170	De Kalb County, Illinois	1600	Urban	1.0783	1.0790	16974	Urban	1.0787
14180	De Witt County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14190	Douglas County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14250	Du Page County, Illinois	1600	Urban	1.0783	1.0790	16974	Urban	1.0787
14310	Edgar County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14320	Edwards County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14330	Effingham County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14340	Fayette County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14350	Ford County, Illinois	14	Rural	0.8301	0.9594	16580	Urban	0.8948
14360	Franklin County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14370	Fulton County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14380	Gallatin County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14390	Greene County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14400	Grundy County, Illinois	1600	Urban	1.0783	1.0790	16974	Urban	1.0787
14410	Hamilton County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14420	Hancock County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14421	Hardin County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14440	Henderson County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14450	Henry County, Illinois	1960	Urban	0.8724	0.8724	19340	Urban	0.8724
14460	Iroquois County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14470	Jackson County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14480	Jasper County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14490	Jefferson County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14500	Jersey County, Illinois	7040	Urban	0.8962	0.8954	41180	Urban	0.8958
14510	Jo Daviess County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14520	Johnson County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14530	Kane County, Illinois	1600	Urban	1.0783	1.0790	16974	Urban	1.0787
14540	Kankakee County, Illinois	3740	Urban	1.0721	1.0721	28100	Urban	1.0721
14550	Kendall County, Illinois	1600	Urban	1.0783	1.0790	16974	Urban	1.0787
14560	Knox County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14570	Lake County, Illinois	1600	Urban	1.0783	1.0429	29404	Urban	1.0606
14580	La Salle County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14590	Lawrence County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14600	Lee County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14610	Livingston County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14620	Logan County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14630	Mc Donough County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14640	Mc Henry County, Illinois	1600	Urban	1.0783	1.0790	16974	Urban	1.0787
14650	Mclean County, Illinois	1040	Urban	0.9075	0.9075	14060	Urban	0.9075
14660	Macon County, Illinois	2040	Urban	0.8067	0.8067	19500	Urban	0.8067
14670	Macoupin County, Illinois	14	Rural	0.8301	0.8954	41180	Urban	0.8628
14680	Madison County, Illinois	7040	Urban	0.8962	0.8954	41180	Urban	0.8958
14690	Marion County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14700	Marshall County, Illinois	14	Rural	0.8301	0.8870	37900	Urban	0.8586
14710	Mason County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14720	Massac County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14730	Menard County, Illinois	7880	Urban	0.8792	0.8792	44100	Urban	0.8792
14740	Mercer County, Illinois	14	Rural	0.8301	0.8724	19340	Urban	0.8513
14750	Monroe County, Illinois	7040	Urban	0.8962	0.8954	41180	Urban	0.8958
14760	Montgomery County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14770	Morgan County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14780	Moultrie County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14790	Ogle County, Illinois	6880	Urban	0.9984	0.8271	99914	Rural	0.9128
14800	Peoria County, Illinois	6120	Urban	0.8870	0.8870	37900	Urban	0.8870
14810	Perry County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14820	Piatt County, Illinois	14	Rural	0.8301	0.9594	16580	Urban	0.8948
14830	Pike County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14831	Pope County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14850	Pulaski County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14860	Putnam County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14870	Randolph County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14880	Richland County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14890	Rock Island County, Illinois	1960	Urban	0.8724	0.8724	19340	Urban	0.8724
14900	St Clair County, Illinois	7040	Urban	0.8962	0.8954	41180	Urban	0.8958
14910	Saline County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14920	Sangamon County, Illinois	7880	Urban	0.8792	0.8792	44100	Urban	0.8792
14921	Schuyler County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14940	Scott County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14950	Shelby County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14960	Stark County, Illinois	14	Rural	0.8301	0.8870	37900	Urban	0.8586
14970	Stephenson County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14980	Tazewell County, Illinois	6120	Urban	0.8870	0.8870	37900	Urban	0.8870
14981	Union County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14982	Vermilion County, Illinois	14	Rural	0.8301	0.9028	19180	Urban	0.8665
14983	Wabash County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14984	Warren County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14985	Washington County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14986	Wayne County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14987	White County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14988	Whiteside County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14989	Will County, Illinois	1600	Urban	1.0783	1.0790	16974	Urban	1.0787
14990	Williamson County, Illinois	14	Rural	0.8301	0.8271	99914	Rural	0.8286
14991	Winnebago County, Illinois	6880	Urban	0.9984	0.9984	40420	Urban	0.9984
14992	Woodford County, Illinois	6120	Urban	0.8870	0.8870	37900	Urban	0.8870
15000	Adams County, Indiana	2760	Urban	0.9706	0.8624	99915	Rural	0.9165
15010	Allen County, Indiana	2760	Urban	0.9706	0.9793	23060	Urban	0.9750
15020	Bartholomew County, Indiana	15	Rural	0.8739	0.9588	18020	Urban	0.9164
15030	Benton County, Indiana	15	Rural	0.8739	0.8736	29140	Urban	0.8738
15040	Blackford County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15050	Boone County, Indiana	3480	Urban	0.9865	0.9920	26900	Urban	0.9893
15060	Brown County, Indiana	15	Rural	0.8739	0.9920	26900	Urban	0.9330
15070	Carroll County, Indiana	15	Rural	0.8739	0.8736	29140	Urban	0.8738
15080	Cass County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15090	Clark County, Indiana	4520	Urban	0.9293	0.9251	31140	Urban	0.9272
15100	Clay County, Indiana	8320	Urban	0.8337	0.8304	45460	Urban	0.8321
15110	Clinton County, Indiana	3920	Urban	0.8736	0.8624	99915	Rural	0.8680
15120	Crawford County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15130	Daviess County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15140	Dearborn County, Indiana	1640	Urban	0.9734	0.9615	17140	Urban	0.9675
15150	Decatur County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15160	De Kalb County, Indiana	2760	Urban	0.9706	0.8624	99915	Rural	0.9165
15170	Delaware County, Indiana	5280	Urban	0.8930	0.8930	34620	Urban	0.8930
15180	Dubois County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15190	Elkhart County, Indiana	2330	Urban	0.9627	0.9627	21140	Urban	0.9627
15200	Fayette County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15210	Floyd County, Indiana	4520	Urban	0.9293	0.9251	31140	Urban	0.9272
15220	Fountain County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15230	Franklin County, Indiana	15	Rural	0.8739	0.9615	17140	Urban	0.9177
15240	Fulton County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15250	Gibson County, Indiana	15	Rural	0.8739	0.8713	21780	Urban	0.8726
15260	Grant County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15270	Greene County, Indiana	15	Rural	0.8739	0.8447	14020	Urban	0.8593
15280	Hamilton County, Indiana	3480	Urban	0.9865	0.9920	26900	Urban	0.9893
15290	Hancock County, Indiana	3480	Urban	0.9865	0.9920	26900	Urban	0.9893
15300	Harrison County, Indiana	4520	Urban	0.9293	0.9251	31140	Urban	0.9272
15310	Hendricks County, Indiana	3480	Urban	0.9865	0.9920	26900	Urban	0.9893
15320	Henry County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15330	Howard County, Indiana	3850	Urban	0.9508	0.9508	29020	Urban	0.9508
15340	Huntington County, Indiana	2760	Urban	0.9706	0.8624	99915	Rural	0.9165
15350	Jackson County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15360	Jasper County, Indiana	15	Rural	0.8739	0.9395	23844	Urban	0.9067
15370	Jay County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15380	Jefferson County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15390	Jennings County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15400	Johnson County, Indiana	3480	Urban	0.9865	0.9920	26900	Urban	0.9893
15410	Knox County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15420	Kosciusko County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15430	Lagrange County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15440	Lake County, Indiana	2960	Urban	0.9395	0.9395	23844	Urban	0.9395
15450	La Porte County, Indiana	15	Rural	0.8739	0.9399	33140	Urban	0.9069
15460	Lawrence County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15470	Madison County, Indiana	3480	Urban	0.9865	0.8586	11300	Urban	0.9226
15480	Marion County, Indiana	3480	Urban	0.9865	0.9920	26900	Urban	0.9893
15490	Marshall County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15500	Martin County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15510	Miami County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15520	Monroe County, Indiana	1020	Urban	0.8447	0.8447	14020	Urban	0.8447
15530	Montgomery County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15540	Morgan County, Indiana	3480	Urban	0.9865	0.9920	26900	Urban	0.9893
15550	Newton County, Indiana	15	Rural	0.8739	0.9395	23844	Urban	0.9067
15560	Noble County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15570	Ohio County, Indiana	1640	Urban	0.9734	0.9615	17140	Urban	0.9675
15580	Orange County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15590	Owen County, Indiana	15	Rural	0.8739	0.8447	14020	Urban	0.8593
15600	Parke County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15610	Perry County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15620	Pike County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15630	Porter County, Indiana	2960	Urban	0.9395	0.9395	23844	Urban	0.9395
15640	Posey County, Indiana	2440	Urban	0.8713	0.8713	21780	Urban	0.8713
15650	Pulaski County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15660	Putnam County, Indiana	15	Rural	0.8739	0.9920	26900	Urban	0.9330
15670	Randolph County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15680	Ripley County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15690	Rush County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15700	St Joseph County, Indiana	7800	Urban	0.9788	0.9788	43780	Urban	0.9788
15710	Scott County, Indiana	4520	Urban	0.9293	0.8624	99915	Rural	0.8959
15720	Shelby County, Indiana	3480	Urban	0.9865	0.9920	26900	Urban	0.9893
15730	Spencer County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15740	Starke County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15750	Steuben County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15760	Sullivan County, Indiana	15	Rural	0.8739	0.8304	45460	Urban	0.8522
15770	Switzerland County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15780	Tippecanoe County, Indiana	3920	Urban	0.8736	0.8736	29140	Urban	0.8736
15790	Tipton County, Indiana	3850	Urban	0.9508	0.9508	29020	Urban	0.9508
15800	Union County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15810	Vanderburgh County, Indiana	2440	Urban	0.8713	0.8713	21780	Urban	0.8713
15820	Vermillion County, Indiana	8320	Urban	0.8337	0.8304	45460	Urban	0.8321
15830	Vigo County, Indiana	8320	Urban	0.8337	0.8304	45460	Urban	0.8321
15840	Wabash County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15850	Warren County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15860	Warrick County, Indiana	2440	Urban	0.8713	0.8713	21780	Urban	0.8713
15870	Washington County, Indiana	15	Rural	0.8739	0.9251	31140	Urban	0.8995
15880	Wayne County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15890	Wells County, Indiana	2760	Urban	0.9706	0.9793	23060	Urban	0.9750
15900	White County, Indiana	15	Rural	0.8739	0.8624	99915	Rural	0.8682
15910	Whitley County, Indiana	2760	Urban	0.9706	0.9793	23060	Urban	0.9750
16000	Adair County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16010	Adams County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16020	Allamakee County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16030	Appanoose County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16040	Audubon County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16050	Benton County, Iowa	16	Rural	0.8594	0.8825	16300	Urban	0.8710
16060	Black Hawk County, Iowa	8920	Urban	0.8557	0.8557	47940	Urban	0.8557
16070	Boone County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16080	Bremer County, Iowa	16	Rural	0.8594	0.8557	47940	Urban	0.8576
16090	Buchanan County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16100	Buena Vista County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16110	Butler County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16120	Calhoun County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16130	Carroll County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16140	Cass County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16150	Cedar County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16160	Cerro Gordo County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16170	Cherokee County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16180	Chickasaw County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16190	Clarke County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16200	Clay County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16210	Clayton County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16220	Clinton County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16230	Crawford County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16240	Dallas County, Iowa	2120	Urban	0.9669	0.9669	19780	Urban	0.9669
16250	Davis County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16260	Decatur County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16270	Delaware County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16280	Des Moines County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16290	Dickinson County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16300	Dubuque County, Iowa	2200	Urban	0.9024	0.9024	20220	Urban	0.9024
16310	Emmet County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16320	Fayette County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16330	Floyd County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16340	Franklin County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16350	Fremont County, Iowa	6	Rural	0.8594	0.8509	99916	Rural	0.8552
16360	Greene County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16370	Grundy County, Iowa	16	Rural	0.8594	0.8557	47940	Urban	0.8576
16380	Guthrie County, Iowa	16	Rural	0.8594	0.9669	19780	Urban	0.9132
16390	Hamilton County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16400	Hancock County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16410	Hardin County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16420	Harrison County, Iowa	16	Rural	0.8594	0.9560	36540	Urban	0.9077
16430	Henry County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16440	Howard County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16450	Humboldt County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16460	Ida County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16470	Iowa County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16480	Jackson County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16490	Jasper County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16500	Jefferson County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16510	Johnson County, Iowa	3500	Urban	0.9747	0.9747	26980	Urban	0.9747
16520	Jones County, Iowa	16	Rural	0.8594	0.8825	16300	Urban	0.8710
16530	Keokuk County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16540	Kossuth County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16550	Lee County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16560	Linn County, owa	1360	Urban	0.8825	0.8825	16300	Urban	0.8825
16570	Louisa County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16580	Lucas County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16590	Lyon County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16600	Madison County, Iowa	16	Rural	0.8594	0.9669	19780	Urban	0.9132
16610	Mahaska County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16620	Marion County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16630	Marshall County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16640	Mills County, Iowa	16	Rural	0.8594	0.9560	36540	Urban	0.9077
16650	Mitchell County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16660	Monona County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16670	Monroe County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16680	Montgomery County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16690	Muscatine County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16700	O Brien County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16710	Osceola County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16720	Page County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16730	Palo Alto County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16740	Plymouth County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16750	Pocahontas County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16760	Polk County, Iowa	2120	Urban	0.9669	0.9669	19780	Urban	0.9669
16770	Pottawattamie County, Iowa	5920	Urban	0.9560	0.9560	36540	Urban	0.9560
16780	Poweshiek County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16790	Ringgold County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16800	Sac County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16810	Scott County, Iowa	1960	Urban	0.8724	0.8724	19340	Urban	0.8724
16820	Shelby County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16830	Sioux County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16840	Story County, Iowa	16	Rural	0.8594	0.9536	11180	Urban	0.9065
16850	Tama County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16860	Taylor County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16870	Union County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16880	Van Buren County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16890	Wapello County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16900	Warren County, Iowa	2120	Urban	0.9669	0.9669	19780	Urban	0.9669
16910	Washington County, Iowa	16	Rural	0.8594	0.9747	26980	Urban	0.9171
16920	Wayne County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16930	Webster County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16940	Winnebago County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16950	Winneshiek County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16960	Woodbury County, Iowa	7720	Urban	0.9416	0.9381	43580	Urban	0.9399
16970	Worth County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
16980	Wright County, Iowa	16	Rural	0.8594	0.8509	99916	Rural	0.8552
17000	Allen County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17010	Anderson County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17020	Atchison County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17030	Barber County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17040	Barton County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17050	Bourbon County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17060	Brown County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17070	Butler County, Kansas	9040	Urban	0.9175	0.9153	48620	Urban	0.9164
17080	Chase County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17090	Chautauqua County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17100	Cherokee County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17110	Cheyenne County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17120	Clark County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17130	Clay County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17140	Cloud County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17150	Coffey County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17160	Comanche County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17170	Cowley County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17180	Crawford County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17190	Decatur County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17200	Dickinson County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17210	Doniphan County, Kansas	17	Rural	0.8040	0.9519	41140	Urban	0.8780
17220	Douglas County, Kansas	4150	Urban	0.8537	0.8537	29940	Urban	0.8537
17230	Edwards County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17240	Elk County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17250	Ellis County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17260	Ellsworth County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17270	Finney County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17280	Ford County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17290	Franklin County, Kansas	17	Rural	0.8040	0.9476	28140	Urban	0.8758
17300	Geary County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17310	Gove County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17320	Graham County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17330	Grant County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17340	Gray County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17350	Greeley County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17360	Greenwood County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17370	Hamilton County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17380	Harper County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17390	Harvey County, Kansas	9040	Urban	0.9175	0.9153	48620	Urban	0.9164
17391	Haskell County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17410	Hodgeman County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17420	Jackson County, Kansas	17	Rural	0.8040	0.8920	45820	Urban	0.8480
17430	Jefferson County, Kansas	17	Rural	0.8040	0.8920	45820	Urban	0.8480
17440	Jewell County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17450	Johnson County, Kansas	3760	Urban	0.9490	0.9476	28140	Urban	0.9483
17451	Kearny County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17470	Kingman County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17480	Kiowa County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17490	Labette County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17500	Lane County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17510	Leavenworth County, Kansas	3760	Urban	0.9490	0.9476	28140	Urban	0.9483
17520	Lincoln County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17530	Linn County, Kansas	17	Rural	0.8040	0.9476	28140	Urban	0.8758
17540	Logan County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17550	Lyon County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17560	Mc Pherson County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17570	Marion County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17580	Marshall County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17590	Meade County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17600	Miami County, Kansas	3760	Urban	0.9490	0.9476	28140	Urban	0.9483
17610	Mitchell County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17620	Montgomery County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17630	Morris County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17640	Morton County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17650	Nemaha County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17660	Neosho County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17670	Ness County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17680	Norton County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17690	Osage County, Kansas	17	Rural	0.8040	0.8920	45820	Urban	0.8480
17700	Osborne County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17710	Ottawa County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17720	Pawnee County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17730	Phillips County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17740	Pottawatomie County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17750	Pratt County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17760	Rawlins County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17770	Reno County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17780	Republic County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17790	Rice County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17800	Riley County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17810	Rooks County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17820	Rush County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17830	Russell County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17840	Saline County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17841	Scott County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17860	Sedgwick County, Kansas	9040	Urban	0.9175	0.9153	48620	Urban	0.9164
17870	Seward County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17880	Shawnee County, Kansas	8440	Urban	0.8920	0.8920	45820	Urban	0.8920
17890	Sheridan County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17900	Sherman County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17910	Smith County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17920	Stafford County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17921	Stanton County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17940	Stevens County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17950	Sumner County, Kansas	17	Rural	0.8040	0.9153	48620	Urban	0.8597
17960	Thomas County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17970	Trego County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17980	Wabaunsee County, Kansas	17	Rural	0.8040	0.8920	45820	Urban	0.8480
17981	Wallace County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17982	Washington County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17983	Wichita County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17984	Wilson County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17985	Woodson County, Kansas	17	Rural	0.8040	0.8035	99917	Rural	0.8038
17986	Wyandotte County, Kansas	3760	Urban	0.9490	0.9476	28140	Urban	0.9483
18000	Adair County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18010	Allen County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18020	Anderson County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18030	Ballard County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18040	Barren County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18050	Bath County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18060	Bell County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18070	Boone County, Kentucky	1640	Urban	0.9734	0.9615	17140	Urban	0.9675
18080	Bourbon County, Kentucky	4280	Urban	0.8988	0.9075	30460	Urban	0.9032
18090	Boyd County, Kentucky	3400	Urban	0.9477	0.9477	26580	Urban	0.9477
18100	Boyle County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18110	Bracken County, Kentucky	18	Rural	0.7858	0.9615	17140	Urban	0.8737
18120	Breathitt County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18130	Breckinridge County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18140	Bullitt County, Kentucky	4520	Urban	0.9293	0.9251	31140	Urban	0.9272
18150	Butler County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18160	Caldwell County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18170	Calloway County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18180	Campbell County, Kentucky	1640	Urban	0.9734	0.9615	17140	Urban	0.9675
18190	Carlisle County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18191	Carroll County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18210	Carter County, Kentucky	3400	Urban	0.9477	0.7766	99918	Rural	0.8622
18220	Casey County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18230	Christian County, Kentucky	1660	Urban	0.8284	0.8284	17300	Urban	0.8284
18240	Clark County, Kentucky	4280	Urban	0.8988	0.9075	30460	Urban	0.9032
18250	Clay County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18260	Clinton County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18270	Crittenden County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18271	Cumberland County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18290	Daviess County, Kentucky	5990	Urban	0.8780	0.8780	36980	Urban	0.8780
18291	Edmonson County, Kentucky	18	Rural	0.7858	0.8211	14540	Urban	0.8035
18310	Elliott County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18320	Estill County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18330	Fayette County, Kentucky	4280	Urban	0.8988	0.9075	30460	Urban	0.9032
18340	Fleming County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18350	Floyd County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18360	Franklin County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18361	Fulton County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18362	Gallatin County, Kentucky	1640	Urban	0.9734	0.9615	17140	Urban	0.9675
18390	Garrard County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18400	Grant County, Kentucky	1640	Urban	0.9734	0.9615	17140	Urban	0.9675
18410	Graves County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18420	Grayson County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18421	Green County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18440	Greenup County, Kentucky	3400	Urban	0.9477	0.9477	26580	Urban	0.9477
18450	Hancock County, Kentucky	18	Rural	0.7858	0.8780	36980	Urban	0.8319
18460	Hardin County, Kentucky	18	Rural	0.7858	0.8802	21060	Urban	0.8330
18470	Harlan County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18480	Harrison County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18490	Hart County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18500	Henderson County, Kentucky	2440	Urban	0.8713	0.8713	21780	Urban	0.8713
18510	Henry County, Kentucky	18	Rural	0.7858	0.9251	31140	Urban	0.8555
18511	Hickman County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18530	Hopkins County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18540	Jackson County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18550	Jefferson County, Kentucky	4520	Urban	0.9293	0.9251	31140	Urban	0.9272
18560	Jessamine County, Kentucky	4280	Urban	0.8988	0.9075	30460	Urban	0.9032
18570	Johnson County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18580	Kenton County, Kentucky	1640	Urban	0.9734	0.9615	17140	Urban	0.9675
18590	Knott County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18600	Knox County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18610	Larue County, Kentucky	18	Rural	0.7858	0.8802	21060	Urban	0.8330
18620	Laurel County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18630	Lawrence County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18640	Lee County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18650	Leslie County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18660	Letcher County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18670	Lewis County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18680	Lincoln County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18690	Livingston County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18700	Logan County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18710	Lyon County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18720	Mc Cracken County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18730	Mc Creary County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18740	Mc Lean County, Kentucky	18	Rural	0.7858	0.8780	36980	Urban	0.8319
18750	Madison County, Kentucky	4280	Urban	0.8988	0.7766	99918	Rural	0.8377
18760	Magoffin County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18770	Marion County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18780	Marshall County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18790	Martin County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18800	Mason County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18801	Meade County, Kentucky	18	Rural	0.7858	0.9251	31140	Urban	0.8555
18802	Menifee County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18830	Mercer County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18831	Metcalfe County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18850	Monroe County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18860	Montgomery County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18861	Morgan County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18880	Muhlenberg County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18890	Nelson County, Kentucky	18	Rural	0.7858	0.9251	31140	Urban	0.8555
18900	Nicholas County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18910	Ohio County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18920	Oldham County, Kentucky	4520	Urban	0.9293	0.9251	31140	Urban	0.9272
18930	Owen County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18931	Owsley County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18932	Pendleton County, Kentucky	1640	Urban	0.9734	0.9615	17140	Urban	0.9675
18960	Perry County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18970	Pike County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18971	Powell County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18972	Pulaski County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18973	Robertson County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18974	Rockcastle County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18975	Rowan County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18976	Russell County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18977	Scott County, Kentucky	4280	Urban	0.8988	0.9075	30460	Urban	0.9032
18978	Shelby County, Kentucky	18	Rural	0.7858	0.9251	31140	Urban	0.8555
18979	Simpson County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18980	Spencer County, Kentucky	18	Rural	0.7858	0.9251	31140	Urban	0.8555
18981	Taylor County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18982	Todd County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18983	Trigg County, Kentucky	18	Rural	0.7858	0.8284	17300	Urban	0.8071
18984	Trimble County, Kentucky	18	Rural	0.7858	0.9251	31140	Urban	0.8555
18985	Union County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18986	Warren County, Kentucky	18	Rural	0.7858	0.8211	14540	Urban	0.8035
18987	Washington County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18988	Wayne County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18989	Webster County, Kentucky	18	Rural	0.7858	0.8713	21780	Urban	0.8286
18990	Whitley County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18991	Wolfe County, Kentucky	18	Rural	0.7858	0.7766	99918	Rural	0.7812
18992	Woodford County, Kentucky	4280	Urban	0.8988	0.9075	30460	Urban	0.9032
19000	Acadia County, Louisiana	3880	Urban	0.8251	0.7411	99919	Rural	0.7831
19010	Allen County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19020	Ascension County, Louisiana	0760	Urban	0.8643	0.8593	12940	Urban	0.8618
19030	Assumption County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19040	Avoyelles County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19050	Beauregard County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19060	Bienville County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19070	Bossier County, Louisiana	7680	Urban	0.8737	0.8760	43340	Urban	0.8749
19080	Caddo County, Louisiana	7680	Urban	0.8737	0.8760	43340	Urban	0.8749
19090	Calcasieu County, Louisiana	3960	Urban	0.7858	0.7833	29340	Urban	0.7846
19100	Caldwell County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19110	Cameron County, Louisiana	19	Rural	0.7340	0.7833	29340	Urban	0.7587
19120	Catahoula County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19130	Claiborne County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19140	Concordia County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19150	De Soto County, Louisiana	19	Rural	0.7340	0.8760	43340	Urban	0.8050
19160	East Baton Rouge County, Louisiana	0760	Urban	0.8643	0.8593	12940	Urban	0.8618
19170	East Carroll County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19180	East Feliciana County, Louisiana	19	Rural	0.7340	0.8593	12940	Urban	0.7967
19190	Evangeline County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19200	Franklin County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19210	Grant County, Louisiana	19	Rural	0.7340	0.8033	10780	Urban	0.7687
19220	Iberia County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19230	Iberville County, Louisiana	19	Rural	0.7340	0.8593	12940	Urban	0.7967
19240	Jackson County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19250	Jefferson County, Louisiana	5560	Urban	0.8995	0.8995	35380	Urban	0.8995
19260	Jefferson Davis County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19270	Lafayette County, Louisiana	3880	Urban	0.8251	0.8428	29180	Urban	0.8340
19280	Lafourche County, Louisiana	3350	Urban	0.7894	0.7894	26380	Urban	0.7894
19290	La Salle County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19300	Lincoln County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19310	Livingston County, Louisiana	0760	Urban	0.8643	0.8593	12940	Urban	0.8618
19320	Madison County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19330	Morehouse County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19340	Natchitoches County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19350	Orleans County, Louisiana	5560	Urban	0.8995	0.8995	35380	Urban	0.8995
19360	Ouachita County, Louisiana	5200	Urban	0.8044	0.8031	33740	Urban	0.8038
19370	Plaquemines County, Louisiana	5560	Urban	0.8995	0.8995	35380	Urban	0.8995
19380	Pointe Coupee County, Louisiana	19	Rural	0.7340	0.8593	12940	Urban	0.7967
19390	Rapides County, Louisiana	0220	Urban	0.8033	0.8033	10780	Urban	0.8033
19400	Red River County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19410	Richland County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19420	Sabine County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19430	St Bernard County, Louisiana	5560	Urban	0.8995	0.8995	35380	Urban	0.8995
19440	St Charles County, Louisiana	5560	Urban	0.8995	0.8995	35380	Urban	0.8995
19450	St Helena County, Louisiana	19	Rural	0.7340	0.8593	12940	Urban	0.7967
19460	St James County, Louisiana	5560	Urban	0.8995	0.7411	99919	Rural	0.8203
19470	St John Baptist County, Louisiana	5560	Urban	0.8995	0.8995	35380	Urban	0.8995
19480	St Landry County, Louisiana	3880	Urban	0.8251	0.7411	99919	Rural	0.7831
19490	St Martin County, Louisiana	3880	Urban	0.8251	0.8428	29180	Urban	0.8340
19500	St Mary County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19510	St Tammany County, Louisiana	5560	Urban	0.8995	0.8995	35380	Urban	0.8995
19520	Tangipahoa County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19530	Tensas County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19540	Terrebonne County, Louisiana	3350	Urban	0.7894	0.7894	26380	Urban	0.7894
19550	Union County, Louisiana	19	Rural	0.7340	0.8031	33740	Urban	0.7686
19560	Vermilion County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19570	Vernon County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19580	Washington County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19590	Webster County, Louisiana	7680	Urban	0.8737	0.7411	99919	Rural	0.8074
19600	West Baton Rouge County, Louisiana	0760	Urban	0.8643	0.8593	12940	Urban	0.8618
19610	West Carroll County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
19620	West Feliciana County, Louisiana	19	Rural	0.7340	0.8593	12940	Urban	0.7967
19630	Winn County, Louisiana	19	Rural	0.7340	0.7411	99919	Rural	0.7376
20000	Androscoggin County, Maine	4243	Urban	0.9331	0.9331	30340	Urban	0.9331
20010	Aroostook County, Maine	20	Rural	0.8843	0.8843	99920	Rural	0.8843
20020	Cumberland County, Maine	6403	Urban	1.0382	1.0382	38860	Urban	1.0382
20030	Franklin County, Maine	20	Rural	0.8843	0.8843	99920	Rural	0.8843
20040	Hancock County, Maine	20	Rural	0.8843	0.8843	99920	Rural	0.8843
20050	Kennebec County, Maine	20	Rural	0.8843	0.8843	99920	Rural	0.8843
20060	Knox County, Maine	20	Rural	0.8843	0.8843	99920	Rural	0.8843
20070	Lincoln County, Maine	20	Rural	0.8843	0.8843	99920	Rural	0.8843
20080	Oxford County, Maine	20	Rural	0.8843	0.8843	99920	Rural	0.8843
20090	Penobscot County, Maine	0733	Urban	0.9993	0.9993	12620	Urban	0.9993
20100	Piscataquis County, Maine	20	Rural	0.8843	0.8843	99920	Rural	0.8843
20110	Sagadahoc County, Maine	6403	Urban	1.0382	1.0382	38860	Urban	1.0382
20120	Somerset County, Maine	20	Rural	0.8843	0.8843	99920	Rural	0.8843
20130	Waldo County, Maine	20	Rural	0.8843	0.8843	99920	Rural	0.8843
20140	Washington County, Maine	20	Rural	0.8843	0.8843	99920	Rural	0.8843
20150	York County, Maine	6403	Urban	1.0382	1.0382	38860	Urban	1.0382
21000	Allegany County, Maryland	1900	Urban	0.9317	0.9317	19060	Urban	0.9317
21010	Anne Arundel County, Maryland	0720	Urban	0.9897	0.9897	12580	Urban	0.9897
21020	Baltimore County, Maryland	0720	Urban	0.9897	0.9897	12580	Urban	0.9897
21030	Baltimore City County, Maryland	0720	Urban	0.9897	0.9897	12580	Urban	0.9897
21040	Calvert County, Maryland	8840	Urban	1.0976	1.0926	47894	Urban	1.0951
21050	Caroline County, Maryland	21	Rural	0.9230	0.9353	99921	Rural	0.9292
21060	Carroll County, Maryland	0720	Urban	0.9897	0.9897	12580	Urban	0.9897
21070	Cecil County, Maryland	9160	Urban	1.0527	1.0471	48864	Urban	1.0499
21080	Charles County, Maryland	8840	Urban	1.0976	1.0926	47894	Urban	1.0951
21090	Dorchester County, Maryland	21	Rural	0.9230	0.9353	99921	Rural	0.9292
21100	Frederick County, Maryland	8840	Urban	1.0976	1.1483	13644	Urban	1.1230
21110	Garrett County, Maryland	21	Rural	0.9230	0.9353	99921	Rural	0.9292
21120	Harford County, Maryland	0720	Urban	0.9897	0.9897	12580	Urban	0.9897
21130	Howard County, Maryland	0720	Urban	0.9897	0.9897	12580	Urban	0.9897
21140	Kent County, Maryland	21	Rural	0.9230	0.9353	99921	Rural	0.9292
21150	Montgomery County, Maryland	8840	Urban	1.0976	1.1483	13644	Urban	1.1230
21160	Prince Georges County, Maryland	8840	Urban	1.0976	1.0926	47894	Urban	1.0951
21170	Queen Annes County, Maryland	0720	Urban	0.9897	0.9897	12580	Urban	0.9897
21180	St Marys County, Maryland	21	Rural	0.9230	0.9353	99921	Rural	0.9292
21190	Somerset County, Maryland	21	Rural	0.9230	0.9064	41540	Urban	0.9147
21200	Talbot County, Maryland	21	Rural	0.9230	0.9353	99921	Rural	0.9292
21210	Washington County, Maryland	3180	Urban	0.9869	0.9489	25180	Urban	0.9679
21220	Wicomico County, Maryland	21	Rural	0.9230	0.9064	41540	Urban	0.9147
21230	Worcester County, Maryland	21	Rural	0.9230	0.9353	99921	Rural	0.9292
22000	Barnstable County, Massachusetts	0743	Urban	1.2600	1.2600	12700	Urban	1.2600
22010	Berkshire County, Massachusetts	6323	Urban	1.0181	1.0181	38340	Urban	1.0181
22020	Bristol County, Massachusetts	1123	Urban	1.1178	1.0966	39300	Urban	1.1072
22030	Dukes County, Massachusetts	22	Rural	1.0216	1.0216	99922	Rural	1.0216
22040	Essex County, Massachusetts	1123	Urban	1.1178	1.0538	21604	Urban	1.0858
22060	Franklin County, Massachusetts	22	Rural	1.0216	1.0248	44140	Urban	1.0232
22070	Hampden County, Massachusetts	8003	Urban	1.0263	1.0248	44140	Urban	1.0256
22080	Hampshire County, Massachusetts	8003	Urban	1.0263	1.0248	44140	Urban	1.0256
22090	Middlesex County, Massachusetts	1123	Urban	1.1178	1.1172	15764	Urban	1.1175
22120	Nantucket County, Massachusetts	22	Rural	1.0216	1.0216	99922	Rural	1.0216
22130	Norfolk County, Massachusetts	1123	Urban	1.1178	1.1558	14484	Urban	1.1368
22150	Plymouth County, Massachusetts	1123	Urban	1.1178	1.1558	14484	Urban	1.1368
22160	Suffolk County, Massachusetts	1123	Urban	1.1178	1.1558	14484	Urban	1.1368
22170	Worcester County, Massachusetts	1123	Urban	1.1178	1.1028	49340	Urban	1.1103
23000	Alcona County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23010	Alger County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23020	Allegan County, Michigan	3000	Urban	0.9445	0.8895	99923	Rural	0.9170
23030	Alpena County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23040	Antrim County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23050	Arenac County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23060	Baraga County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23070	Barry County, Michigan	23	Rural	0.8824	0.9390	24340	Urban	0.9107
23080	Bay County, Michigan	6960	Urban	0.9241	0.9343	13020	Urban	0.9292
23090	Benzie County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23100	Berrien County, Michigan	0870	Urban	0.8879	0.8879	35660	Urban	0.8879
23110	Branch County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23120	Calhoun County, Michigan	3720	Urban	1.0143	0.9508	12980	Urban	0.9826
23130	Cass County, Michigan	23	Rural	0.8824	0.9788	43780	Urban	0.9306
23140	Charlevoix County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23150	Cheboygan County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23160	Chippewa County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23170	Clare County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23180	Clinton County, Michigan	4040	Urban	0.9794	0.9794	29620	Urban	0.9794
23190	Crawford County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23200	Delta County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23210	Dickinson County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23220	Eaton County, Michigan	4040	Urban	0.9794	0.9794	29620	Urban	0.9794
23230	Emmet County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23240	Genesee County, Michigan	2640	Urban	1.0655	1.0655	22420	Urban	1.0655
23250	Gladwin County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23260	Gogebic County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23270	Grand Traverse County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23280	Gratiot County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23290	Hillsdale County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23300	Houghton County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23310	Huron County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23320	Ingham County, Michigan	4040	Urban	0.9794	0.9794	29620	Urban	0.9794
23330	Ionia County, Michigan	23	Rural	0.8824	0.9390	24340	Urban	0.9107
23340	Iosco County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23350	Iron County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23360	Isabella County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23370	Jackson County, Michigan	3520	Urban	0.9304	0.9304	27100	Urban	0.9304
23380	Kalamazoo County, Michigan	3720	Urban	1.0143	1.0381	28020	Urban	1.0262
23390	Kalkaska County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23400	Kent County, Michigan	3000	Urban	0.9445	0.9390	24340	Urban	0.9418
23410	Keweenaw County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23420	Lake County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23430	Lapeer County, Michigan	2160	Urban	1.0147	0.9871	47644	Urban	1.0009
23440	Leelanau County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23450	Lenawee County, Michigan	0440	Urban	1.0707	0.8895	99923	Rural	0.9801
23460	Livingston County, Michigan	0440	Urban	1.0707	0.9871	47644	Urban	1.0289
23470	Luce County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23480	Mackinac County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23490	Macomb County, Michigan	2160	Urban	1.0147	0.9871	47644	Urban	1.0009
23500	Manistee County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23510	Marquette County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23520	Mason County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23530	Mecosta County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23540	Menominee County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23550	Midland County, Michigan	6960	Urban	0.9241	0.8895	99923	Rural	0.9068
23560	Missaukee County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23570	Monroe County, Michigan	2160	Urban	1.0147	0.9468	33780	Urban	0.9808
23580	Montcalm County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23590	Montmorency County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23600	Muskegon County, Michigan	3000	Urban	0.9445	0.9664	34740	Urban	0.9555
23610	Newaygo County, Michigan	23	Rural	0.8824	0.9390	24340	Urban	0.9107
23620	Oakland County, Michigan	2160	Urban	1.0147	0.9871	47644	Urban	1.0009
23630	Oceana County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23640	Ogemaw County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23650	Ontonagon County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23660	Osceola County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23670	Oscoda County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23680	Otsego County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23690	Ottawa County, Michigan	3000	Urban	0.9445	0.9055	26100	Urban	0.9250
23700	Presque Isle County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23710	Roscommon County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23720	Saginaw County, Michigan	6960	Urban	0.9241	0.9088	40980	Urban	0.9165
23730	St Clair County, Michigan	2160	Urban	1.0147	0.9871	47644	Urban	1.0009
23740	St Joseph County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23750	Sanilac County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23760	Schoolcraft County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23770	Shiawassee County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23780	Tuscola County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
23790	Van Buren County, Michigan	3720	Urban	1.0143	1.0381	28020	Urban	1.0262
23800	Washtenaw County, Michigan	0440	Urban	1.0707	1.0859	11460	Urban	1.0783
23810	Wayne County, Michigan	2160	Urban	1.0147	1.0424	19804	Urban	1.0286
23830	Wexford County, Michigan	23	Rural	0.8824	0.8895	99923	Rural	0.8860
24000	Aitkin County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24010	Anoka County, Minnesota	5120	Urban	1.1075	1.1075	33460	Urban	1.1075
24020	Becker County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24030	Beltrami County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24040	Benton County, Minnesota	6980	Urban	0.9965	0.9965	41060	Urban	0.9965
24050	Big Stone County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24060	Blue Earth County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24070	Brown County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24080	Carlton County, Minnesota	24	Rural	0.9132	1.0213	20260	Urban	0.9673
24090	Carver County, Minnesota	5120	Urban	1.1075	1.1075	33460	Urban	1.1075
24100	Cass County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24110	Chippewa County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24120	Chisago County, Minnesota	5120	Urban	1.1075	1.1075	33460	Urban	1.1075
24130	Clay County, Minnesota	2520	Urban	0.8486	0.8486	22020	Urban	0.8486
24140	Clearwater County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24150	Cook County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24160	Cottonwood County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24170	Crow Wing County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24180	Dakota County, Minnesota	5120	Urban	1.1075	1.1075	33460	Urban	1.1075
24190	Dodge County, Minnesota	24	Rural	0.9132	1.1131	40340	Urban	1.0132
24200	Douglas County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24210	Faribault County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24220	Fillmore County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24230	Freeborn County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24240	Goodhue County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24250	Grant County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24260	Hennepin County, Minnesota	5120	Urban	1.1075	1.1075	33460	Urban	1.1075
24270	Houston County, Minnesota	3870	Urban	0.9564	0.9564	29100	Urban	0.9564
24280	Hubbard County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24290	Isanti County, Minnesota	5120	Urban	1.1075	1.1075	33460	Urban	1.1075
24300	Itasca County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24310	Jackson County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24320	Kanabec County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24330	Kandiyohi County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24340	Kittson County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24350	Koochiching County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24360	Lac Qui Parle County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24370	Lake County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24380	Lake Of Woods County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24390	Le Sueur County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24400	Lincoln County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24410	Lyon County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24420	Mc Leod County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24430	Mahnomen County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24440	Marshall County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24450	Martin County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24460	Meeker County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24470	Mille Lacs County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24480	Morrison County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24490	Mower County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24500	Murray County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24510	Nicollet County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24520	Nobles County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24530	Norman County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24540	Olmsted County, Minnesota	6820	Urban	1.1131	1.1131	40340	Urban	1.1131
24550	Otter Tail County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24560	Pennington County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24570	Pine County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24580	Pipestone County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24590	Polk County, Minnesota	2985	Urban	0.7901	0.7901	24220	Urban	0.7901
24600	Pope County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24610	Ramsey County, Minnesota	5120	Urban	1.1075	1.1075	33460	Urban	1.1075
24620	Red Lake County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24630	Redwood County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24640	Renville County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24650	Rice County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24660	Rock County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24670	Roseau County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24680	St Louis County, Minnesota	2240	Urban	1.0213	1.0213	20260	Urban	1.0213
24690	Scott County, Minnesota	5120	Urban	1.1075	1.1075	33460	Urban	1.1075
24700	Sherburne County, Minnesota	5120	Urban	1.1075	1.1075	33460	Urban	1.1075
24710	Sibley County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24720	Stearns County, Minnesota	6980	Urban	0.9965	0.9965	41060	Urban	0.9965
24730	Steele County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24740	Stevens County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24750	Swift County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24760	Todd County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24770	Traverse County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24780	Wabasha County, Minnesota	24	Rural	0.9132	1.1131	40340	Urban	1.0132
24790	Wadena County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24800	Waseca County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24810	Washington County, Minnesota	5120	Urban	1.1075	1.1075	33460	Urban	1.1075
24820	Watonwan County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24830	Wilkin County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24840	Winona County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
24850	Wright County, Minnesota	5120	Urban	1.1075	1.1075	33460	Urban	1.1075
24860	Yellow Medicine County, Minnesota	24	Rural	0.9132	0.9132	99924	Rural	0.9132
25000	Adams County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25010	Alcorn County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25020	Amite County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25030	Attala County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25040	Benton County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25050	Bolivar County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25060	Calhoun County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25070	Carroll County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25080	Chickasaw County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25090	Choctaw County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25100	Claiborne County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25110	Clarke County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25120	Clay County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25130	Coahoma County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25140	Copiah County, Mississippi	25	Rural	0.7634	0.8311	27140	Urban	0.7973
25150	Covington County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25160	Desoto County, Mississippi	4920	Urban	0.9416	0.9397	32820	Urban	0.9407
25170	Forrest County, Mississippi	3285	Urban	0.7601	0.7601	25620	Urban	0.7601
25180	Franklin County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25190	George County, Mississippi	25	Rural	0.7634	0.8156	37700	Urban	0.7895
25200	Greene County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25210	Grenada County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25220	Hancock County, Mississippi	0920	Urban	0.8706	0.8929	25060	Urban	0.8818
25230	Harrison County, Mississippi	0920	Urban	0.8706	0.8929	25060	Urban	0.8818
25240	Hinds County, Mississippi	3560	Urban	0.8382	0.8311	27140	Urban	0.8347
25250	Holmes County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25260	Humphreys County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25270	Issaquena County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25280	Itawamba County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25290	Jackson County, Mississippi	0920	Urban	0.8706	0.8156	37700	Urban	0.8431
25300	Jasper County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25310	Jefferson County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25320	Jefferson Davis County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25330	Jones County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25340	Kemper County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25350	Lafayette County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25360	Lamar County, Mississippi	3285	Urban	0.7601	0.7601	25620	Urban	0.7601
25370	Lauderdale County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25380	Lawrence County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25390	Leake County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25400	Lee County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25410	Leflore County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25420	Lincoln County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25430	Lowndes County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25440	Madison County, Mississippi	3560	Urban	0.8382	0.8311	27140	Urban	0.8347
25450	Marion County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25460	Marshall County, Mississippi	25	Rural	0.7634	0.9397	32820	Urban	0.8516
25470	Monroe County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25480	Montgomery County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25490	Neshoba County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25500	Newton County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25510	Noxubee County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25520	Oktibbeha County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25530	Panola County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25540	Pearl River County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25550	Perry County, Mississippi	25	Rural	0.7634	0.7601	25620	Urban	0.7618
25560	Pike County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25570	Pontotoc County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25580	Prentiss County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25590	Quitman County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25600	Rankin County, Mississippi	3560	Urban	0.8382	0.8311	27140	Urban	0.8347
25610	Scott County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25620	Sharkey County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25630	Simpson County, Mississippi	25	Rural	0.7634	0.8311	27140	Urban	0.7973
25640	Smith County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25650	Stone County, Mississippi	25	Rural	0.7634	0.8929	25060	Urban	0.8282
25660	Sunflower County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25670	Tallahatchie County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25680	Tate County, Mississippi	25	Rural	0.7634	0.9397	32820	Urban	0.8516
25690	Tippah County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25700	Tishomingo County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25710	Tunica County, Mississippi	25	Rural	0.7634	0.9397	32820	Urban	0.8516
25720	Union County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25730	Walthall County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25740	Warren County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25750	Washington County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25760	Wayne County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25770	Webster County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25780	Wilkinson County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25790	Winston County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25800	Yalobusha County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
25810	Yazoo County, Mississippi	25	Rural	0.7634	0.7674	99925	Rural	0.7654
26000	Adair County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26010	Andrew County, Missouri	7000	Urban	0.9519	0.9519	41140	Urban	0.9519
26020	Atchison County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26030	Audrain County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26040	Barry County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26050	Barton County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26060	Bates County, Missouri	26	Rural	0.7959	0.9476	28140	Urban	0.8718
26070	Benton County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26080	Bollinger County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26090	Boone County, Missouri	1740	Urban	0.8345	0.8345	17860	Urban	0.8345
26100	Buchanan County, Missouri	7000	Urban	0.9519	0.9519	41140	Urban	0.9519
26110	Butler County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26120	Caldwell County, Missouri	26	Rural	0.7959	0.9476	28140	Urban	0.8718
26130	Callaway County, Missouri	26	Rural	0.7959	0.8387	27620	Urban	0.8173
26140	Camden County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26150	Cape Girardeau County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26160	Carroll County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26170	Carter County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26180	Cass County, Missouri	3760	Urban	0.9490	0.9476	28140	Urban	0.9483
26190	Cedar County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26200	Chariton County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26210	Christian County, Missouri	7920	Urban	0.8250	0.8237	44180	Urban	0.8244
26220	Clark County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26230	Clay County, Missouri	3760	Urban	0.9490	0.9476	28140	Urban	0.9483
26240	Clinton County, Missouri	3760	Urban	0.9490	0.9476	28140	Urban	0.9483
26250	Cole County, Missouri	26	Rural	0.7959	0.8387	27620	Urban	0.8173
26260	Cooper County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26270	Crawford County, Missouri	26	Rural	0.7959	0.8954	41180	Urban	0.8457
26280	Dade County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26290	Dallas County, Missouri	26	Rural	0.7959	0.8237	44180	Urban	0.8098
26300	Daviess County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26310	De Kalb County, Missouri	26	Rural	0.7959	0.9519	41140	Urban	0.8739
26320	Dent County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26330	Douglas County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26340	Dunklin County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26350	Franklin County, Missouri	7040	Urban	0.8962	0.8954	41180	Urban	0.8958
26360	Gasconade County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26370	Gentry County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26380	Greene County, Missouri	7920	Urban	0.8250	0.8237	44180	Urban	0.8244
26390	Grundy County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26400	Harrison County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26410	Henry County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26411	Hickory County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26412	Holt County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26440	Howard County, Missouri	26	Rural	0.7959	0.8345	17860	Urban	0.8152
26450	Howell County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26460	Iron County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26470	Jackson County, Missouri	3760	Urban	0.9490	0.9476	28140	Urban	0.9483
26480	Jasper County, Missouri	3710	Urban	0.8582	0.8582	27900	Urban	0.8582
26490	Jefferson County, Missouri	7040	Urban	0.8962	0.8954	41180	Urban	0.8958
26500	Johnson County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26510	Knox County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26520	Laclede County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26530	Lafayette County, Missouri	3760	Urban	0.9490	0.9476	28140	Urban	0.9483
26540	Lawrence County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26541	Lewis County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26560	Lincoln County, Missouri	7040	Urban	0.8962	0.8954	41180	Urban	0.8958
26570	Linn County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26580	Livingston County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26590	Mc Donald County, Missouri	26	Rural	0.7959	0.8661	22220	Urban	0.8310
26600	Macon County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26601	Madison County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26620	Maries County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26630	Marion County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26631	Mercer County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26650	Miller County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26660	Mississippi County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26670	Moniteau County, Missouri	26	Rural	0.7959	0.8387	27620	Urban	0.8173
26680	Monroe County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26690	Montgomery County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26700	Morgan County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26710	New Madrid County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26720	Newton County, Missouri	3710	Urban	0.8582	0.8582	27900	Urban	0.8582
26730	Nodaway County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26740	Oregon County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26750	Osage County, Missouri	26	Rural	0.7959	0.8387	27620	Urban	0.8173
26751	Ozark County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26770	Pemiscot County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26780	Perry County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26790	Pettis County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26800	Phelps County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26810	Pike County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26820	Platte County, Missouri	3760	Urban	0.9490	0.9476	28140	Urban	0.9483
26821	Polk County, Missouri	26	Rural	0.7959	0.8237	44180	Urban	0.8098
26840	Pulaski County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26850	Putnam County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26860	Ralls County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26870	Randolph County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26880	Ray County, Missouri	3760	Urban	0.9490	0.9476	28140	Urban	0.9483
26881	Reynolds County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26900	Ripley County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26910	St Charles County, Missouri	7040	Urban	0.8962	0.8954	41180	Urban	0.8958
26911	St Clair County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26930	St Francois County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26940	St Louis County, Missouri	7040	Urban	0.8962	0.8954	41180	Urban	0.8958
26950	St Louis City County, Missouri	7040	Urban	0.8962	0.8954	41180	Urban	0.8958
26960	Ste Genevieve County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26970	Saline County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26980	Schuyler County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26981	Scotland County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26982	Scott County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26983	Shannon County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26984	Shelby County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26985	Stoddard County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26986	Stone County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26987	Sullivan County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26988	Taney County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26989	Texas County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26990	Vernon County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26991	Warren County, Missouri	7040	Urban	0.8962	0.8954	41180	Urban	0.8958
26992	Washington County, Missouri	26	Rural	0.7959	0.8954	41180	Urban	0.8457
26993	Wayne County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26994	Webster County, Missouri	7920	Urban	0.8250	0.8237	44180	Urban	0.8244
26995	Worth County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
26996	Wright County, Missouri	26	Rural	0.7959	0.7900	99926	Rural	0.7930
27000	Beaverhead County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27010	Big Horn County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27020	Blaine County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27030	Broadwater County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27040	Carbon County, Montana	27	Rural	0.8762	0.8834	13740	Urban	0.8798
27050	Carter County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27060	Cascade County, Montana	3040	Urban	0.9052	0.9052	24500	Urban	0.9052
27070	Chouteau County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27080	Custer County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27090	Daniels County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27100	Dawson County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27110	Deer Lodge County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27113	Yellowstone National Park, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27120	Fallon County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
D27130	Fergus County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27140	Flathead County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27150	Gallatin County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27160	Garfield County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27170	Glacier County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27180	Golden Valley County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27190	Granite County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27200	Hill County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27210	Jefferson County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27220	Judith Basin County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27230	Lake County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27240	Lewis And Clark County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27250	Liberty County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27260	Lincoln County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27270	Mc Cone County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27280	Madison County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27290	Meagher County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27300	Mineral County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27310	Missoula County, Montana	5140	Urban	0.9473	0.9473	33540	Urban	0.9473
27320	Musselshell County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27330	Park County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27340	Petroleum County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27350	Phillips County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27360	Pondera County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27370	Powder River County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27380	Powell County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27390	Prairie County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27400	Ravalli County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27410	Richland County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27420	Roosevelt County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27430	Rosebud County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27440	Sanders County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27450	Sheridan County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27460	Silver Bow County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27470	Stillwater County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27480	Sweet Grass County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27490	Teton County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27500	Toole County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27510	Treasure County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27520	Valley County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27530	Wheatland County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27540	Wibaux County, Montana	27	Rural	0.8762	0.8762	99927	Rural	0.8762
27550	Yellowstone County, Montana	0880	Urban	0.8834	0.8834	13740	Urban	0.8834
28000	Adams County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28010	Antelope County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28020	Arthur County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28030	Banner County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28040	Blaine County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28050	Boone County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28060	Box Butte County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28070	Boyd County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28080	Brown County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28090	Buffalo County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28100	Burt County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28110	Butler County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28120	Cass County, Nebraska	5920	Urban	0.9560	0.9560	36540	Urban	0.9560
28130	Cedar County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28140	Chase County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28150	Cherry County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28160	Cheyenne County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28170	Clay County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28180	Colfax County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28190	Cuming County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28200	Custer County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28210	Dakota County, Nebraska	7720	Urban	0.9416	0.9381	43580	Urban	0.9399
28220	Dawes County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28230	Dawson County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28240	Deuel County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28250	Dixon County, Nebraska	28	Rural	0.8657	0.9381	43580	Urban	0.9019
28260	Dodge County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28270	Douglas County, Nebraska	5920	Urban	0.9560	0.9560	36540	Urban	0.9560
28280	Dundy County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28290	Fillmore County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28300	Franklin County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28310	Frontier County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28320	Furnas County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28330	Gage County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28340	Garden County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28350	Garfield County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28360	Gosper County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28370	Grant County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28380	Greeley County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28390	Hall County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28400	Hamilton County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28410	Harlan County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28420	Hayes County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28430	Hitchcock County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28440	Holt County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28450	Hooker County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28460	Howard County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28470	Jefferson County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28480	Johnson County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28490	Kearney County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28500	Keith County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28510	Keya Paha County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28520	Kimball County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28530	Knox County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28540	Lancaster County, Nebraska	4360	Urban	1.0214	1.0214	30700	Urban	1.0214
28550	Lincoln County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28560	Logan County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28570	Loup County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28580	Mc Pherson County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28590	Madison County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28600	Merrick County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28610	Morrill County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28620	Nance County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28630	Nemaha County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28640	Nuckolls County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28650	Otoe County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28660	Pawnee County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28670	Perkins County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28680	Phelps County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28690	Pierce County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28700	Platte County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28710	Polk County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28720	Redwillow County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28730	Richardson County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28740	Rock County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28750	Saline County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28760	Sarpy County, Nebraska	5920	Urban	0.9560	0.9560	36540	Urban	0.9560
28770	Saunders County, Nebraska	28	Rural	0.8657	0.9560	36540	Urban	0.9109
28780	Scotts Bluff County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28790	Seward County, Nebraska	28	Rural	0.8657	1.0214	30700	Urban	0.9436
28800	Sheridan County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28810	Sherman County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28820	Sioux County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28830	Stanton County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28840	Thayer County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28850	Thomas County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28860	Thurston County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28870	Valley County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28880	Washington County, Nebraska	5920	Urban	0.9560	0.9560	36540	Urban	0.9560
28890	Wayne County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28900	Webster County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28910	Wheeler County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
28920	York County, Nebraska	28	Rural	0.8657	0.8657	99928	Rural	0.8657
29000	Churchill County, Nevada	29	Rural	0.9687	0.9065	99929	Rural	0.9376
29010	Clark County, Nevada	4120	Urban	1.1155	1.1437	29820	Urban	1.1296
29020	Douglas County, Nevada	29	Rural	0.9687	0.9065	99929	Rural	0.9376
29030	Elko County, Nevada	29	Rural	0.9687	0.9065	99929	Rural	0.9376
29040	Esmeralda County, Nevada	29	Rural	0.9687	0.9065	99929	Rural	0.9376
29050	Eureka County, Nevada	29	Rural	0.9687	0.9065	99929	Rural	0.9376
29060	Humboldt County, Nevada	29	Rural	0.9687	0.9065	99929	Rural	0.9376
29070	Lander County, Nevada	29	Rural	0.9687	0.9065	99929	Rural	0.9376
29080	Lincoln County, Nevada	29	Rural	0.9687	0.9065	99929	Rural	0.9376
29090	Lyon County, Nevada	29	Rural	0.9687	0.9065	99929	Rural	0.9376
29100	Mineral County, Nevada	29	Rural	0.9687	0.9065	99929	Rural	0.9376
29110	Nye County, Nevada	4120	Urban	1.1155	0.9065	99929	Rural	1.0110
29120	Carson City County, Nevada	29	Rural	0.9687	1.0234	16180	Urban	0.9961
29130	Pershing County, Nevada	29	Rural	0.9687	0.9065	99929	Rural	0.9376
29140	Storey County, Nevada	29	Rural	0.9687	1.0982	39900	Urban	1.0335
29150	Washoe County, Nevada	6720	Urban	1.0982	1.0982	39900	Urban	1.0982
29160	White Pine County, Nevada	29	Rural	0.9687	0.9065	99929	Rural	0.9376
30000	Belknap County, New Hampshire	30	Rural	1.0817	1.0817	99930	Rural	1.0817
30010	Carroll County, New Hampshire	30	Rural	1.0817	1.0817	99930	Rural	1.0817
30020	Cheshire County, New Hampshire	30	Rural	1.0817	1.0817	99930	Rural	1.0817
30030	Coos County, New Hampshire	30	Rural	1.0817	1.0817	99930	Rural	1.0817
30040	Grafton County, New Hampshire	30	Rural	1.0817	1.0817	99930	Rural	1.0817
30050	Hillsboro County, New Hampshire	1123	Urban	1.1178	1.0354	31700	Urban	1.0766
30060	Merrimack County, New Hampshire	1123	Urban	1.1178	1.0354	31700	Urban	1.0766
30070	Rockingham County, New Hampshire	1123	Urban	1.1178	1.0374	40484	Urban	1.0776
30080	Strafford County, New Hampshire	1123	Urban	1.1178	1.0374	40484	Urban	1.0776
30090	Sullivan County, New Hampshire	30	Rural	1.0817	1.0817	99930	Rural	1.0817
31000	Atlantic County, New Jersey	0560	Urban	1.1496	1.1615	12100	Urban	1.1556
31100	Bergen County, New Jersey	0875	Urban	1.1651	1.3188	35644	Urban	1.2420
31150	Burlington County, New Jersey	6160	Urban	1.0922	1.0517	15804	Urban	1.0720
31160	Camden County, New Jersey	6160	Urban	1.0922	1.0517	15804	Urban	1.0720
31180	Cape May County, New Jersey	0560	Urban	1.1496	1.1011	36140	Urban	1.1254
31190	Cumberland County, New Jersey	8760	Urban	0.9827	0.9827	47220	Urban	0.9827
31200	Essex County, New Jersey	5640	Urban	1.1834	1.1883	35084	Urban	1.1859
31220	Gloucester County, New Jersey	6160	Urban	1.0922	1.0517	15804	Urban	1.0720
31230	Hudson County, New Jersey	3640	Urban	1.1338	1.3188	35644	Urban	1.2263
31250	Hunterdon County, New Jersey	5015	Urban	1.1167	1.1883	35084	Urban	1.1525
31260	Mercer County, New Jersey	8480	Urban	1.0834	1.0834	45940	Urban	1.0834
31270	Middlesex County, New Jersey	5015	Urban	1.1167	1.1249	20764	Urban	1.1208
31290	Monmouth County, New Jersey	5190	Urban	1.1260	1.1249	20764	Urban	1.1255
31300	Morris County, New Jersey	5640	Urban	1.1834	1.1883	35084	Urban	1.1859
31310	Ocean County, New Jersey	5190	Urban	1.1260	1.1249	20764	Urban	1.1255
31320	Passaic County, New Jersey	0875	Urban	1.1651	1.3188	35644	Urban	1.2420
31340	Salem County, New Jersey	6160	Urban	1.0922	1.0471	48864	Urban	1.0697
31350	Somerset County, New Jersey	5015	Urban	1.1167	1.1249	20764	Urban	1.1208
31360	Sussex County, New Jersey	5640	Urban	1.1834	1.1883	35084	Urban	1.1859
31370	Union County, New Jersey	5640	Urban	1.1834	1.1883	35084	Urban	1.1859
31390	Warren County, New Jersey	5640	Urban	1.1834	0.9818	10900	Urban	1.0826
32000	Bernalillo County, New Mexico	0200	Urban	0.9684	0.9684	10740	Urban	0.9684
32010	Catron County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32020	Chaves County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32025	Cibola County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32030	Colfax County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32040	Curry County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32050	De Baca County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32060	Dona Ana County, New Mexico	4100	Urban	0.8467	0.8467	29740	Urban	0.8467
32070	Eddy County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32080	Grant County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32090	Guadalupe County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32100	Harding County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32110	Hidalgo County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32120	Lea County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32130	Lincoln County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32131	Los Alamos County, New Mexico	7490	Urban	1.0748	0.8635	99932	Rural	0.9692
32140	Luna County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32150	Mc Kinley County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32160	Mora County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32170	Otero County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32180	Quay County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32190	Rio Arriba County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32200	Roosevelt County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32210	Sandoval County, New Mexico	0200	Urban	0.9684	0.9684	10740	Urban	0.9684
32220	San Juan County, New Mexico	32	Rural	0.8563	0.8509	22140	Urban	0.8536
32230	San Miguel County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32240	Santa Fe County, New Mexico	7490	Urban	1.0748	1.0920	42140	Urban	1.0834
32250	Sierra County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32260	Socorro County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32270	Taos County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32280	Torrance County, New Mexico	32	Rural	0.8563	0.9684	10740	Urban	0.9124
32290	Union County, New Mexico	32	Rural	0.8563	0.8635	99932	Rural	0.8599
32300	Valencia County, New Mexico	0200	Urban	0.9684	0.9684	10740	Urban	0.9684
33000	Albany County, New York	0160	Urban	0.8559	0.8589	10580	Urban	0.8574
33010	Allegany County, New York	33	Rural	0.8395	0.8154	99933	Rural	0.8275
33020	Bronx County, New York	5600	Urban	1.3464	1.3188	35644	Urban	1.3326
33030	Broome County, New York	0960	Urban	0.8562	0.8562	13780	Urban	0.8562
33040	Cattaraugus County, New York	33	Rural	0.8395	0.8154	99933	Rural	0.8275
33050	Cayuga County, New York	8160	Urban	0.9492	0.8154	99933	Rural	0.8823
33060	Chautauqua County, New York	3610	Urban	0.7544	0.8154	99933	Rural	0.7849
33070	Chemung County, New York	2335	Urban	0.8250	0.8250	21300	Urban	0.8250
33080	Chenango County, New York	33	Rural	0.8395	0.8154	99933	Rural	0.8275
33090	Clinton County, New York	33	Rural	0.8395	0.8154	99933	Rural	0.8275
33200	Columbia County, New York	33	Rural	0.8395	0.8154	99933	Rural	0.8275
33210	Cortland County, New York	33	Rural	0.8395	0.8154	99933	Rural	0.8275
33220	Delaware County, New York	33	Rural	0.8395	0.8154	99933	Rural	0.8275
33230	Dutchess County, New York	2281	Urban	1.0475	1.0891	39100	Urban	1.0683
33240	Erie County, New York	1280	Urban	0.9511	0.9511	15380	Urban	0.9511
33260	Essex County, New York	33	Rural	0.8395	0.8154	99933	Rural	0.8275
33270	Franklin County, New York	33	Rural	0.8395	0.8154	99933	Rural	0.8275
33280	Fulton County, New York	33	Rural	0.8395	0.8154	99933	Rural	0.8275
33290	Genesee County, New York	6840	Urban	0.9049	0.8154	99933	Rural	0.8602
33300	Greene County, New York	33	Rural	0.8395	0.8154	99933	Rural	0.8275
33310	Hamilton County, New York	33	Rural	0.8395	0.8154	99933	Rural	0.8275
33320	Herkimer County, New York	8680	Urban	0.8358	0.8358	46540	Urban	0.8358
33330	Jefferson County, New York	33	Rural	0.8395	0.8154	99933	Rural	0.8275
33331	Kings County, New York	5600	Urban	1.3464	1.3188	35644	Urban	1.3326
33340	Lewis County, New York	33	Rural	0.8395	0.8154	99933	Rural	0.8275
33350	Livingston County, New York	6840	Urban	0.9049	0.9121	40380	Urban	0.9085
33360	Madison County, New York	8160	Urban	0.9492	0.9574	45060	Urban	0.9533
33370	Monroe County, New York	6840	Urban	0.9049	0.9121	40380	Urban	0.9085
33380	Montgomery County, New York	0160	Urban	0.8559	0.8154	99933	Rural	0.8357
33400	Nassau County, New York	5380	Urban	1.2719	1.2719	35004	Urban	1.2719
33420	New York County, New York	5600	Urban	1.3464	1.3188	35644	Urban	1.3326
33500	Niagara County, New York	1280	Urban	0.9511	0.9511	15380	Urban	0.9511
33510	Oneida County, New York	8680	Urban	0.8358	0.8358	46540	Urban	0.8358
33520	Onondaga County, New York	8160	Urban	0.9492	0.9574	45060	Urban	0.9533
33530	Ontario County, New York	6840	Urban	0.9049	0.9121	40380	Urban	0.9085
33540	Orange County, New York	5660	Urban	1.1207	1.0891	39100	Urban	1.1049
33550	Orleans County, New York	6840	Urban	0.9049	0.9121	40380	Urban	0.9085
33560	Oswego County, New York	8160	Urban	0.9492	0.9574	45060	Urban	0.9533
33570	Otsego County, New York	33	Rural	0.8395	0.8154	99933	Rural	0.8275
33580	Putnam County, New York	5600	Urban	1.3464	1.3188	35644	Urban	1.3326
33590	Queens County, New York	5600	Urban	1.3464	1.3188	35644	Urban	1.3326
33600	Rensselaer County, New York	0160	Urban	0.8559	0.8589	10580	Urban	0.8574
33610	Richmond County, New York	5600	Urban	1.3464	1.3188	35644	Urban	1.3326
33620	Rockland County, New York	5600	Urban	1.3464	1.3188	35644	Urban	1.3326
33630	St Lawrence County, New York	33	Rural	0.8395	0.8154	99933	Rural	0.8275
33640	Saratoga County, New York	0160	Urban	0.8559	0.8589	10580	Urban	0.8574
33650	Schenectady County, New York	0160	Urban	0.8559	0.8589	10580	Urban	0.8574
33660	Schoharie County, New York	0160	Urban	0.8559	0.8589	10580	Urban	0.8574
33670	Schuyler County, New York	33	Rural	0.8395	0.8154	99933	Rural	0.8275
33680	Seneca County, New York	33	Rural	0.8395	0.8154	99933	Rural	0.8275
33690	Steuben County, New York	33	Rural	0.8395	0.8154	99933	Rural	0.8275
33700	Suffolk County, New York	5380	Urban	1.2719	1.2719	35004	Urban	1.2719
33710	Sullivan County, New York	33	Rural	0.8395	0.8154	99933	Rural	0.8275
33720	Tioga County, New York	0960	Urban	0.8562	0.8562	13780	Urban	0.8562
33730	Tompkins County, New York	33	Rural	0.8395	0.9793	27060	Urban	0.9094
33740	Ulster County, New York	33	Rural	0.8395	0.9255	28740	Urban	0.8825
33750	Warren County, New York	2975	Urban	0.8559	0.8559	24020	Urban	0.8559
33760	Washington County, New York	2975	Urban	0.8559	0.8559	24020	Urban	0.8559
33770	Wayne County, New York	6840	Urban	0.9049	0.9121	40380	Urban	0.9085
33800	Westchester County, New York	5600	Urban	1.3464	1.3188	35644	Urban	1.3326
33900	Wyoming County, New York	33	Rural	0.8395	0.8154	99933	Rural	0.8275
33910	Yates County, New York	33	Rural	0.8395	0.8154	99933	Rural	0.8275
34000	Alamance County, N Carolina	3120	Urban	0.9018	0.8905	15500	Urban	0.8962
34010	Alexander County, N Carolina	3290	Urban	0.8921	0.8921	25860	Urban	0.8921
34020	Alleghany County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34030	Anson County, N Carolina	34	Rural	0.8462	0.9750	16740	Urban	0.9106
34040	Ashe County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34050	Avery County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34060	Beaufort County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34070	Bertie County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34080	Bladen County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34090	Brunswick County, N Carolina	9200	Urban	0.9582	0.9582	48900	Urban	0.9582
34100	Buncombe County, N Carolina	0480	Urban	0.9737	0.9285	11700	Urban	0.9511
34110	Burke County, N Carolina	3290	Urban	0.8921	0.8921	25860	Urban	0.8921
34120	Cabarrus County, N Carolina	1520	Urban	0.9715	0.9750	16740	Urban	0.9733
34130	Caldwell County, N Carolina	3290	Urban	0.8921	0.8921	25860	Urban	0.8921
34140	Camden County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34150	Carteret County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34160	Caswell County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34170	Catawba County, N Carolina	3290	Urban	0.8921	0.8921	25860	Urban	0.8921
34180	Chatham County, N Carolina	6640	Urban	1.0034	1.0244	20500	Urban	1.0139
34190	Cherokee County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34200	Chowan County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34210	Clay County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34220	Cleveland County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34230	Columbus County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34240	Craven County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34250	Cumberland County, N Carolina	2560	Urban	0.9416	0.9416	22180	Urban	0.9416
34251	Currituck County, N Carolina	5720	Urban	0.8799	0.8799	47260	Urban	0.8799
34270	are County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34280	Davidson County, N Carolina	3120	Urban	0.9018	0.8540	99934	Rural	0.8779
34290	Davie County, N Carolina	3120	Urban	0.9018	0.8944	49180	Urban	0.8981
34300	Duplin County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34310	Durham County, N Carolina	6640	Urban	1.0034	1.0244	20500	Urban	1.0139
34320	Edgecombe County, N Carolina	6895	Urban	0.8915	0.8915	40580	Urban	0.8915
34330	Forsyth County, N Carolina	3120	Urban	0.9018	0.8944	49180	Urban	0.8981
34340	Franklin County, N Carolina	6640	Urban	1.0034	0.9691	39580	Urban	0.9863
34350	Gaston County, N Carolina	1520	Urban	0.9715	0.9750	16740	Urban	0.9733
34360	Gates County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34370	Graham County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34380	Granville County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34390	Greene County, N Carolina	34	Rural	0.8462	0.9425	24780	Urban	0.8944
34400	Guilford County, N Carolina	3120	Urban	0.9018	0.9104	24660	Urban	0.9061
34410	Halifax County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34420	Harnett County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34430	Haywood County, N Carolina	34	Rural	0.8462	0.9285	11700	Urban	0.8874
34440	Henderson County, N Carolina	34	Rural	0.8462	0.9285	11700	Urban	0.8874
34450	Hertford County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34460	Hoke County, N Carolina	34	Rural	0.8462	0.9416	22180	Urban	0.8939
34470	Hyde County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34480	Iredell County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34490	Jackson County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34500	Johnston County, N Carolina	6640	Urban	1.0034	0.9691	39580	Urban	0.9863
34510	Jones County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34520	Lee County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34530	Lenoir County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34540	Lincoln County, N Carolina	1520	Urban	0.9715	0.8540	99934	Rural	0.9128
34550	Mc Dowell County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34560	Macon County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34570	Madison County, N Carolina	0480	Urban	0.9737	0.9285	11700	Urban	0.9511
34580	Martin County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34590	Mecklenburg County, N Carolina	1520	Urban	0.9715	0.9750	16740	Urban	0.9733
34600	Mitchell County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34610	Montgomery County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34620	Moore County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34630	Nash County, N Carolina	6895	Urban	0.8915	0.8915	40580	Urban	0.8915
34640	New Hanover County, N Carolina	9200	Urban	0.9582	0.9582	48900	Urban	0.9582
34650	Northampton County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34660	Onslow County, N Carolina	3605	Urban	0.8236	0.8236	27340	Urban	0.8236
34670	Orange County, N Carolina	6640	Urban	1.0034	1.0244	20500	Urban	1.0139
34680	Pamlico County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34690	Pasquotank County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34700	Pender County, N Carolina	34	Rural	0.8462	0.9582	48900	Urban	0.9022
34710	Perquimans County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34720	Person County, N Carolina	34	Rural	0.8462	1.0244	20500	Urban	0.9353
34730	Pitt County, N Carolina	3150	Urban	0.9425	0.9425	24780	Urban	0.9425
34740	Polk County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34750	Randolph County, N Carolina	3120	Urban	0.9018	0.9104	24660	Urban	0.9061
34760	Richmond County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34770	Robeson County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34780	Rockingham County, N Carolina	34	Rural	0.8462	0.9104	24660	Urban	0.8783
34790	Rowan County, N Carolina	1520	Urban	0.9715	0.8540	99934	Rural	0.9128
34800	Rutherford County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34810	Sampson County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34820	Scotland County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34830	Stanly County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34840	Stokes County, N Carolina	3120	Urban	0.9018	0.8944	49180	Urban	0.8981
34850	Surry County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34860	Swain County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34870	Transylvania County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34880	Tyrrell County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34890	Union County, N Carolina	1520	Urban	0.9715	0.9750	16740	Urban	0.9733
34900	Vance County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34910	Wake County, N Carolina	6640	Urban	1.0034	0.9691	39580	Urban	0.9863
34920	Warren County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34930	Washington County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34940	Watauga County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34950	Wayne County, N Carolina	2980	Urban	0.8775	0.8775	24140	Urban	0.8775
34960	Wilkes County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34970	Wilson County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
34980	Yadkin County, N Carolina	3120	Urban	0.9018	0.8944	49180	Urban	0.8981
34981	Yancey County, N Carolina	34	Rural	0.8462	0.8540	99934	Rural	0.8501
35000	Adams County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35010	Barnes County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35020	Benson County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35030	Billings County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35040	Bottineau County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35050	Bowman County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35060	Burke County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35070	Burleigh County, N Dakota	1010	Urban	0.7574	0.7574	13900	Urban	0.7574
35080	Cass County, N Dakota	2520	Urban	0.8486	0.8486	22020	Urban	0.8486
35090	Cavalier County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35100	Dickey County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35110	Divide County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35120	Dunn County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35130	Eddy County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35140	Emmons County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35150	Foster County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35160	Golden Valley County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35170	Grand Forks County, N Dakota	2985	Urban	0.7901	0.7901	24220	Urban	0.7901
35180	Grant County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35190	Griggs County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35200	Hettinger County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35210	Kidder County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35220	La Moure County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35230	Logan County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35240	Mc Henry County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35250	Mc Intosh County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35260	Mc Kenzie County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35270	Mc Lean County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35280	Mercer County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35290	Morton County, N Dakota	1010	Urban	0.7574	0.7574	13900	Urban	0.7574
35300	Mountrail County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35310	Nelson County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35320	Oliver County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35330	Pembina County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35340	Pierce County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35350	Ramsey County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35360	Ransom County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35370	Renville County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35380	Richland County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35390	Rolette County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35400	Sargent County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35410	Sheridan County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35420	Sioux County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35430	Slope County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35440	Stark County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35450	Steele County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35460	Stutsman County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35470	Towner County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35480	Traill County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35490	Walsh County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35500	Ward County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35510	Wells County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
35520	Williams County, N Dakota	35	Rural	0.7261	0.7261	99935	Rural	0.7261
36000	Adams County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36010	Allen County, Ohio	4320	Urban	0.9119	0.9225	30620	Urban	0.9172
36020	Ashland County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36030	Ashtabula County, Ohio	1680	Urban	0.9183	0.8826	99936	Rural	0.9005
36040	Athens County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36050	Auglaize County, Ohio	4320	Urban	0.9119	0.8826	99936	Rural	0.8973
36060	Belmont County, Ohio	9000	Urban	0.7161	0.7161	48540	Urban	0.7161
36070	Brown County, Ohio	1640	Urban	0.9734	0.9615	17140	Urban	0.9675
36080	Butler County, Ohio	3200	Urban	0.8951	0.9615	17140	Urban	0.9283
36090	Carroll County, Ohio	1320	Urban	0.8935	0.8935	15940	Urban	0.8935
36100	Champaign County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36110	Clark County, Ohio	2000	Urban	0.8980	0.8396	44220	Urban	0.8688
36120	Clermont County, Ohio	1640	Urban	0.9734	0.9615	17140	Urban	0.9675
36130	Clinton County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36140	Columbiana County, Ohio	9320	Urban	0.8848	0.8826	99936	Rural	0.8837
36150	Coshocton County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36160	Crawford County, Ohio	4800	Urban	0.9891	0.8826	99936	Rural	0.9359
36170	Cuyahoga County, Ohio	1680	Urban	0.9183	0.9213	17460	Urban	0.9198
36190	Darke County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36200	Defiance County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36210	Delaware County, Ohio	1840	Urban	0.9874	0.9860	18140	Urban	0.9867
36220	Erie County, Ohio	36	Rural	0.8921	0.9019	41780	Urban	0.8970
36230	Fairfield County, Ohio	1840	Urban	0.9874	0.9860	18140	Urban	0.9867
36240	Fayette County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36250	Franklin County, Ohio	1840	Urban	0.9874	0.9860	18140	Urban	0.9867
36260	Fulton County, Ohio	8400	Urban	0.9574	0.9574	45780	Urban	0.9574
36270	Gallia County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36280	Geauga County, Ohio	1680	Urban	0.9183	0.9213	17460	Urban	0.9198
36290	Greene County, Ohio	2000	Urban	0.8980	0.9064	19380	Urban	0.9022
36300	Guernsey County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36310	Hamilton County, Ohio	1640	Urban	0.9734	0.9615	17140	Urban	0.9675
36330	Hancock County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36340	Hardin County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36350	Harrison County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36360	Henry County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36370	Highland County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36380	Hocking County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36390	Holmes County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36400	Huron County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36410	Jackson County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36420	Jefferson County, Ohio	8080	Urban	0.7819	0.7819	48260	Urban	0.7819
36430	Knox County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36440	Lake County, Ohio	1680	Urban	0.9183	0.9213	17460	Urban	0.9198
36450	Lawrence County, Ohio	3400	Urban	0.9477	0.9477	26580	Urban	0.9477
36460	Licking County, Ohio	1840	Urban	0.9874	0.9860	18140	Urban	0.9867
36470	Logan County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36480	Lorain County, Ohio	1680	Urban	0.9183	0.9213	17460	Urban	0.9198
36490	Lucas County, Ohio	8400	Urban	0.9574	0.9574	45780	Urban	0.9574
36500	Madison County, Ohio	1840	Urban	0.9874	0.9860	18140	Urban	0.9867
36510	Mahoning County, Ohio	9320	Urban	0.8848	0.8603	49660	Urban	0.8726
36520	Marion County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36530	Medina County, Ohio	1680	Urban	0.9183	0.9213	17460	Urban	0.9198
36540	Meigs County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36550	Mercer County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36560	Miami County, Ohio	2000	Urban	0.8980	0.9064	19380	Urban	0.9022
36570	Monroe County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36580	Montgomery County, Ohio	2000	Urban	0.8980	0.9064	19380	Urban	0.9022
36590	Morgan County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36600	Morrow County, Ohio	36	Rural	0.8921	0.9860	18140	Urban	0.9391
36610	Muskingum County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36620	Noble County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36630	Ottawa County, Ohio	36	Rural	0.8921	0.9574	45780	Urban	0.9248
36640	Paulding County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36650	Perry County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36660	Pickaway County, Ohio	1840	Urban	0.9874	0.9860	18140	Urban	0.9867
36670	Pike County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36680	Portage County, Ohio	0080	Urban	0.8982	0.8982	10420	Urban	0.8982
36690	Preble County, Ohio	36	Rural	0.8921	0.9064	19380	Urban	0.8993
36700	Putnam County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36710	Richland County, Ohio	4800	Urban	0.9891	------1	31900	Urban	0.8902
36720	Ross County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36730	Sandusky County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36740	Scioto County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36750	Seneca County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36760	Shelby County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36770	Stark County, Ohio	1320	Urban	0.8935	0.8935	15940	Urban	0.8935
36780	Summit County, Ohio	0080	Urban	0.8982	0.8982	10420	Urban	0.8982
36790	Trumbull County, Ohio	9320	Urban	0.8848	0.8603	49660	Urban	0.8726
36800	Tuscarawas County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36810	Union County, Ohio	36	Rural	0.8921	0.9860	18140	Urban	0.9391
36820	Van Wert County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36830	Vinton County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36840	Warren County, Ohio	1640	Urban	0.9734	0.9615	17140	Urban	0.9675
36850	Washington County, Ohio	6020	Urban	0.8270	0.8270	37620	Urban	0.8270
36860	Wayne County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36870	Williams County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
36880	Wood County, Ohio	8400	Urban	0.9574	0.9574	45780	Urban	0.9574
36890	Wyandot County, Ohio	36	Rural	0.8921	0.8826	99936	Rural	0.8874
37000	Adair County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37010	Alfalfa County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37020	Atoka County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37030	Beaver County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37040	Beckham County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37050	Blaine County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37060	Bryan County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37070	Caddo County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37080	Canadian County, Oklahoma	5880	Urban	0.9025	0.9031	36420	Urban	0.9028
37090	Carter County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37100	Cherokee County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37110	Choctaw County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37120	Cimarron County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37130	Cleveland County, Oklahoma	5880	Urban	0.9025	0.9031	36420	Urban	0.9028
37140	Coal County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37150	Comanche County, Oklahoma	4200	Urban	0.7872	0.7872	30020	Urban	0.7872
37160	Cotton County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37170	Craig County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37180	Creek County, Oklahoma	8560	Urban	0.8587	0.8543	46140	Urban	0.8565
37190	Custer County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37200	Delaware County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37210	Dewey County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37220	Ellis County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37230	Garfield County, Oklahoma	2340	Urban	0.8666	0.7581	99937	Rural	0.8124
37240	Garvin County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37250	Grady County, Oklahoma	37	Rural	0.7442	0.9031	36420	Urban	0.8237
37260	Grant County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37270	Greer County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37280	Harmon County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37290	Harper County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37300	Haskell County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37310	Hughes County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37320	Jackson County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37330	Jefferson County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37340	Johnston County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37350	Kay County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37360	Kingfisher County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37370	Kiowa County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37380	Latimer County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37390	Le Flore County, Oklahoma	37	Rural	0.7442	0.8230	22900	Urban	0.7836
37400	Lincoln County, Oklahoma	37	Rural	0.7442	0.9031	36420	Urban	0.8237
37410	Logan County, Oklahoma	5880	Urban	0.9025	0.9031	36420	Urban	0.9028
37420	Love County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37430	Mc Clain County, Oklahoma	5880	Urban	0.9025	0.9031	36420	Urban	0.9028
37440	Mc Curtain County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37450	Mc Intosh County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37460	Major County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37470	Marshall County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37480	Mayes County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37490	Murray County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37500	Muskogee County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37510	Noble County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37520	Nowata County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37530	Okfuskee County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37540	Oklahoma County, Oklahoma	5880	Urban	0.9025	0.9031	36420	Urban	0.9028
37550	Okmulgee County, Oklahoma	37	Rural	0.7442	0.8543	46140	Urban	0.7993
37560	Osage County, Oklahoma	8560	Urban	0.8587	0.8543	46140	Urban	0.8565
37570	Ottawa County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37580	Pawnee County, Oklahoma	37	Rural	0.7442	0.8543	46140	Urban	0.7993
37590	Payne County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37600	Pittsburg County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37610	Pontotoc County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37620	Pottawatomie County, Oklahoma	5880	Urban	0.9025	0.7581	99937	Rural	0.8303
37630	Pushmataha County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37640	Roger Mills County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37650	Rogers County, Oklahoma	8560	Urban	0.8587	0.8543	46140	Urban	0.8565
37660	Seminole County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37670	Sequoyah County, Oklahoma	2720	Urban	0.8246	0.8230	22900	Urban	0.8238
37680	Stephens County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37690	Texas County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37700	Tillman County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37710	Tulsa County, Oklahoma	8560	Urban	0.8587	0.8543	46140	Urban	0.8565
37720	Wagoner County, Oklahoma	8560	Urban	0.8587	0.8543	46140	Urban	0.8565
37730	Washington County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37740	Washita County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37750	Woods County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
37760	Woodward County, Oklahoma	37	Rural	0.7442	0.7581	99937	Rural	0.7512
38000	Baker County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38010	Benton County, Oregon	1890	Urban	1.0729	1.0729	18700	Urban	1.0729
38020	Clackamas County, Oregon	6440	Urban	1.1266	1.1266	38900	Urban	1.1266
38030	Clatsop County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38040	Columbia County, Oregon	6440	Urban	1.1266	1.1266	38900	Urban	1.1266
38050	Coos County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38060	Crook County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38070	Curry County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38080	Deschutes County, Oregon	38	Rural	1.0052	1.0786	13460	Urban	1.0419
38090	Douglas County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38100	Gilliam County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38110	Grant County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38120	Harney County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38130	Hood River County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38140	Jackson County, Oregon	4890	Urban	1.0225	1.0225	32780	Urban	1.0225
38150	Jefferson County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38160	Josephine County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38170	Klamath County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38180	Lake County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38190	Lane County, Oregon	2400	Urban	1.0818	1.0818	21660	Urban	1.0818
38200	Lincoln County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38210	Linn County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38220	Malheur County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38230	Marion County, Oregon	7080	Urban	1.0442	1.0442	41420	Urban	1.0442
38240	Morrow County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38250	Multnomah County, Oregon	6440	Urban	1.1266	1.1266	38900	Urban	1.1266
38260	Polk County, Oregon	7080	Urban	1.0442	1.0442	41420	Urban	1.0442
38270	Sherman County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38280	Tillamook County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38290	Umatilla County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38300	Union County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38310	Wallowa County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38320	Wasco County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38330	Washington County, Oregon	6440	Urban	1.1266	1.1266	38900	Urban	1.1266
38340	Wheeler County, Oregon	38	Rural	1.0052	0.9826	99938	Rural	0.9939
38350	Yamhill County, Oregon	6440	Urban	1.1266	1.1266	38900	Urban	1.1266
39000	Adams County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39010	Allegheny County, Pennsylvania	6280	Urban	0.8860	0.8845	38300	Urban	0.8853
39070	Armstrong County, Pennsylvania	39	Rural	0.8319	0.8845	38300	Urban	0.8582
39080	Beaver County, Pennsylvania	6280	Urban	0.8860	0.8845	38300	Urban	0.8853
39100	Bedford County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39110	Berks County, Pennsylvania	6680	Urban	0.9686	0.9686	39740	Urban	0.9686
39120	Blair County, Pennsylvania	0280	Urban	0.8944	0.8944	11020	Urban	0.8944
39130	Bradford County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39140	Bucks County, Pennsylvania	6160	Urban	1.0922	1.1038	37964	Urban	1.0980
39150	Butler County, Pennsylvania	6280	Urban	0.8860	0.8845	38300	Urban	0.8853
39160	Cambria County, Pennsylvania	3680	Urban	0.8086	0.8354	27780	Urban	0.8220
39180	Cameron County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39190	Carbon County, Pennsylvania	0240	Urban	0.9845	0.9818	10900	Urban	0.9832
39200	Centre County, Pennsylvania	8050	Urban	0.8356	0.8356	44300	Urban	0.8356
39210	Chester County, Pennsylvania	6160	Urban	1.0922	1.1038	37964	Urban	1.0980
39220	Clarion County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39230	Clearfield County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39240	Clinton County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39250	Columbia County, Pennsylvania	7560	Urban	0.8524	0.8291	99939	Rural	0.8408
39260	Crawford County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39270	Cumberland County, Pennsylvania	3240	Urban	0.9233	0.9313	25420	Urban	0.9273
39280	Dauphin County, Pennsylvania	3240	Urban	0.9233	0.9313	25420	Urban	0.9273
39290	Delaware County, Pennsylvania	6160	Urban	1.0922	1.1038	37964	Urban	1.0980
39310	Elk County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39320	Erie County, Pennsylvania	2360	Urban	0.8737	0.8737	21500	Urban	0.8737
39330	Fayette County, Pennsylvania	6280	Urban	0.8860	0.8845	38300	Urban	0.8853
39340	Forest County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39350	Franklin County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39360	Fulton County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39370	Greene County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39380	Huntingdon County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39390	Indiana County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39400	Jefferson County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39410	Juniata County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39420	Lackawanna County, Pennsylvania	7560	Urban	0.8524	0.8540	42540	Urban	0.8532
39440	Lancaster County, Pennsylvania	4000	Urban	0.9694	0.9694	29540	Urban	0.9694
39450	Lawrence County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39460	Lebanon County, Pennsylvania	3240	Urban	0.9233	0.8459	30140	Urban	0.8846
39470	Lehigh County, Pennsylvania	0240	Urban	0.9845	0.9818	10900	Urban	0.9832
39480	Luzerne County, Pennsylvania	7560	Urban	0.8524	0.8540	42540	Urban	0.8532
39510	Lycoming County, Pennsylvania	9140	Urban	0.8364	0.8364	48700	Urban	0.8364
39520	Mc Kean County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39530	Mercer County, Pennsylvania	7610	Urban	0.7793	0.8603	49660	Urban	0.8198
39540	Mifflin County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39550	Monroe County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39560	Montgomery County, Pennsylvania	6160	Urban	1.0922	1.1038	37964	Urban	1.0980
39580	Montour County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39590	Northampton County, Pennsylvania	0240	Urban	0.9845	0.9818	10900	Urban	0.9832
39600	Northumberland County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39610	Perry County, Pennsylvania	3240	Urban	0.9233	0.9313	25420	Urban	0.9273
39620	Philadelphia County, Pennsylvania	6160	Urban	1.0922	1.1038	37964	Urban	1.0980
39630	Pike County, Pennsylvania	5660	Urban	1.1207	1.1883	35084	Urban	1.1545
39640	Potter County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39650	Schuylkill County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39670	Snyder County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39680	Somerset County, Pennsylvania	3680	Urban	0.8086	0.8291	99939	Rural	0.8189
39690	Sullivan County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39700	Susquehanna County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39710	Tioga County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39720	Union County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39730	Venango County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39740	Warren County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39750	Washington County, Pennsylvania	6280	Urban	0.8860	0.8845	38300	Urban	0.8853
39760	Wayne County, Pennsylvania	39	Rural	0.8319	0.8291	99939	Rural	0.8305
39770	Westmoreland County, Pennsylvania	6280	Urban	0.8860	0.8845	38300	Urban	0.8853
39790	Wyoming County, Pennsylvania	7560	Urban	0.8524	0.8540	42540	Urban	0.8532
39800	York County, Pennsylvania	9280	Urban	0.9347	0.9347	49620	Urban	0.9347
40010	Adjuntas County, Puerto Rico	40	Rural	0.3604	0.4047	99940	Rural	0.3826
40020	Aguada County, Puerto Rico	0060	Urban	0.4876	0.4738	10380	Urban	0.4807
40030	Aguadilla County, Puerto Rico	0060	Urban	0.4876	0.4738	10380	Urban	0.4807
40040	Aguas Buenas County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40050	Aibonito County, Puerto Rico	40	Rural	0.3604	0.4621	41980	Urban	0.4113
40060	Anasco County, Puerto Rico	4840	Urban	0.4243	0.4738	10380	Urban	0.4491
40070	Arecibo County, Puerto Rico	0470	Urban	0.4112	0.4621	41980	Urban	0.4367
40080	Arroyo County, Puerto Rico	40	Rural	0.3604	0.3181	25020	Urban	0.3393
40090	Barceloneta County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40100	Barranquitas County, Puerto Rico	40	Rural	0.3604	0.4621	41980	Urban	0.4113
40110	Bayamon County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40120	Cabo Rojo County, Puerto Rico	4840	Urban	0.4243	0.4650	41900	Urban	0.4447
40130	Caguas County, Puerto Rico	1310	Urban	0.4120	0.4621	41980	Urban	0.4371
40140	Camuy County, Puerto Rico	0470	Urban	0.4112	0.4621	41980	Urban	0.4367
40145	Canovanas County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40150	Carolina County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40160	Catano County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40170	Cayey County, Puerto Rico	1310	Urban	0.4120	0.4621	41980	Urban	0.4371
40180	Ceiba County, Puerto Rico	7440	Urban	0.4752	0.4153	21940	Urban	0.4453
40190	Ciales County, Puerto Rico	40	Rural	0.3604	0.4621	41980	Urban	0.4113
40200	Cidra County, Puerto Rico	1310	Urban	0.4120	0.4621	41980	Urban	0.4371
40210	Coamo County, Puerto Rico	40	Rural	0.3604	0.4047	99940	Rural	0.3826
40220	Comerio County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40230	Corozal County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40240	Culebra County, Puerto Rico	40	Rural	0.3604	0.4047	99940	Rural	0.3826
40250	Dorado County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40260	Fajardo County, Puerto Rico	7440	Urban	0.4752	0.4153	21940	Urban	0.4453
40265	Florida County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40270	Guanica County, Puerto Rico	40	Rural	0.3604	0.4408	49500	Urban	0.4006
40280	Guayama County, Puerto Rico	40	Rural	0.3604	0.3181	25020	Urban	0.3393
40290	Guayanilla County, Puerto Rico	6360	Urban	0.4881	0.4408	49500	Urban	0.4645
40300	Guaynabo County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40310	Gurabo County, Puerto Rico	1310	Urban	0.4120	0.4621	41980	Urban	0.4371
40320	Hatillo County, Puerto Rico	0470	Urban	0.4112	0.4621	41980	Urban	0.4367
40330	Hormigueros County, Puerto Rico	4840	Urban	0.4243	0.4020	32420	Urban	0.4132
40340	Humacao County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40350	Isabela County, Puerto Rico	40	Rural	0.3604	0.4738	10380	Urban	0.4171
40360	Jayuya County, Puerto Rico	40	Rural	0.3604	0.4047	99940	Rural	0.3826
40370	Juana Diaz County, Puerto Rico	6360	Urban	0.4881	0.4939	38660	Urban	0.4910
40380	Juncos County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40390	Lajas County, Puerto Rico	40	Rural	0.3604	0.4650	41900	Urban	0.4127
40400	Lares County, Puerto Rico	40	Rural	0.3604	0.4738	10380	Urban	0.4171
40410	Las Marias County, Puerto Rico	40	Rural	0.3604	0.4047	99940	Rural	0.3826
40420	Las Piedras County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40430	Loiza County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40440	Luquillo County, Puerto Rico	7440	Urban	0.4752	0.4153	21940	Urban	0.4453
40450	Manati County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40460	Maricao County, Puerto Rico	40	Rural	0.3604	0.4047	99940	Rural	0.3826
40470	Maunabo County, Puerto Rico	40	Rural	0.3604	0.4621	41980	Urban	0.4113
40480	Mayaguez County, Puerto Rico	4840	Urban	0.4243	0.4020	32420	Urban	0.4132
40490	Moca County, Puerto Rico	0060	Urban	0.4876	0.4738	10380	Urban	0.4807
40500	Morovis County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40510	Naguabo County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40520	Naranjito County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40530	Orocovis County, Puerto Rico	40	Rural	0.3604	0.4621	41980	Urban	0.4113
40540	Patillas County, Puerto Rico	40	Rural	0.3604	0.3181	25020	Urban	0.3393
40550	Penuelas County, Puerto Rico	6360	Urban	0.4881	0.4408	49500	Urban	0.4645
40560	Ponce County, Puerto Rico	6360	Urban	0.4881	0.4939	38660	Urban	0.4910
40570	Quebradillas County, Puerto Rico	40	Rural	0.3604	0.4621	41980	Urban	0.4113
40580	Rincon County, Puerto Rico	40	Rural	0.3604	0.4738	10380	Urban	0.4171
40590	Rio Grande County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40610	Sabana Grande County, Puerto Rico	4840	Urban	0.4243	0.4650	41900	Urban	0.4447
40620	Salinas County, Puerto Rico	40	Rural	0.3604	0.4047	99940	Rural	0.3826
40630	San German County, Puerto Rico	4840	Urban	0.4243	0.4650	41900	Urban	0.4447
40640	San Juan County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40650	San Lorenzo County, Puerto Rico	1310	Urban	0.4120	0.4621	41980	Urban	0.4371
40660	San Sebastian County, Puerto Rico	40	Rural	0.3604	0.4738	10380	Urban	0.4171
40670	Santa Isabel County, Puerto Rico	40	Rural	0.3604	0.4047	99940	Rural	0.3826
40680	Toa Alta County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40690	Toa Baja County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40700	Trujillo Alto County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40710	Utuado County, Puerto Rico	40	Rural	0.3604	0.4047	99940	Rural	0.3826
40720	Vega Alta County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40730	Vega Baja County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40740	Vieques County, Puerto Rico	40	Rural	0.3604	0.4047	99940	Rural	0.3826
40750	Villalba County, Puerto Rico	6360	Urban	0.4881	0.4939	38660	Urban	0.4910
40760	Yabucoa County, Puerto Rico	7440	Urban	0.4752	0.4621	41980	Urban	0.4687
40770	Yauco County, Puerto Rico	6360	Urban	0.4881	0.4408	49500	Urban	0.4645
41000	Bristol County, Rhode Island	6483	Urban	1.1058	1.0966	39300	Urban	1.1012
41010	Kent County, Rhode Island	6483	Urban	1.1058	1.0966	39300	Urban	1.1012
41020	Newport County, Rhode Island	6483	Urban	1.1058	1.0966	39300	Urban	1.1012
41030	Providence County, Rhode Island	6483	Urban	1.1058	1.0966	39300	Urban	1.1012
41050	Washington County, Rhode Island	6483	Urban	1.1058	1.0966	39300	Urban	1.1012
42000	Abbeville County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42010	Aiken County, S Carolina	0600	Urban	0.9808	0.9748	12260	Urban	0.9778
42020	Allendale County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42030	Anderson County, S Carolina	3160	Urban	0.9615	0.8997	11340	Urban	0.9306
42040	Bamberg County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42050	Barnwell County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42060	Beaufort County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42070	Berkeley County, S Carolina	1440	Urban	0.9245	0.9245	16700	Urban	0.9245
42080	Calhoun County, S Carolina	42	Rural	0.8631	0.9057	17900	Urban	0.8844
42090	Charleston County, S Carolina	1440	Urban	0.9245	0.9245	16700	Urban	0.9245
42100	Cherokee County, S Carolina	3160	Urban	0.9615	0.8638	99942	Rural	0.9127
42110	Chester County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42120	Chesterfield County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42130	Clarendon County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42140	Colleton County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42150	Darlington County, S Carolina	42	Rural	0.8631	0.8947	22500	Urban	0.8789
42160	Dillon County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42170	Dorchester County, S Carolina	1440	Urban	0.9245	0.9245	16700	Urban	0.9245
42180	Edgefield County, S Carolina	0600	Urban	0.9808	0.9748	12260	Urban	0.9778
42190	Fairfield County, S Carolina	42	Rural	0.8631	0.9057	17900	Urban	0.8844
42200	Florence County, S Carolina	2655	Urban	0.9042	0.8947	22500	Urban	0.8995
42210	Georgetown County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42220	Greenville County, S Carolina	3160	Urban	0.9615	1.0027	24860	Urban	0.9821
42230	Greenwood County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42240	Hampton County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42250	Horry County, S Carolina	5330	Urban	0.8934	0.8934	34820	Urban	0.8934
42260	Jasper County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42270	Kershaw County, S Carolina	42	Rural	0.8631	0.9057	17900	Urban	0.8844
42280	Lancaster County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42290	Laurens County, S Carolina	42	Rural	0.8631	1.0027	24860	Urban	0.9329
42300	Lee County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42310	Lexington County, S Carolina	1760	Urban	0.9082	0.9057	17900	Urban	0.9070
42320	Mc Cormick County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42330	Marion County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42340	Marlboro County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42350	Newberry County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42360	Oconee County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42370	Orangeburg County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42380	Pickens County, S Carolina	3160	Urban	0.9615	1.0027	24860	Urban	0.9821
42390	Richland County, S Carolina	1760	Urban	0.9082	0.9057	17900	Urban	0.9070
42400	Saluda County, S Carolina	42	Rural	0.8631	0.9057	17900	Urban	0.8844
42410	Spartanburg County, S Carolina	3160	Urban	0.9615	0.9172	43900	Urban	0.9394
42420	Sumter County, S Carolina	8140	Urban	0.8377	0.8377	44940	Urban	0.8377
42430	Union County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42440	Williamsburg County, S Carolina	42	Rural	0.8631	0.8638	99942	Rural	0.8635
42450	York County, S Carolina	1520	Urban	0.9715	0.9750	16740	Urban	0.9733
43010	Aurora County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43020	Beadle County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43030	Bennett County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43040	Bon Homme County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43050	Brookings County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43060	Brown County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43070	Brule County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43080	Buffalo County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43090	Butte County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43100	Campbell County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43110	Charles Mix County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43120	Clark County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43130	Clay County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43140	Codington County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43150	Corson County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43160	Custer County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43170	Davison County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43180	Day County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43190	Deuel County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43200	Dewey County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43210	Douglas County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43220	Edmunds County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43230	Fall River County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43240	Faulk County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43250	Grant County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43260	Gregory County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43270	Haakon County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43280	Hamlin County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43290	Hand County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43300	Hanson County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43310	Harding County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43320	Hughes County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43330	Hutchinson County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43340	Hyde County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43350	Jackson County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43360	Jerauld County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43370	Jones County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43380	Kingsbury County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43390	Lake County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43400	Lawrence County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43410	Lincoln County, S Dakota	7760	Urban	0.9635	0.9635	43620	Urban	0.9635
43420	Lyman County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43430	Mc Cook County, S Dakota	43	Rural	0.8551	0.9635	43620	Urban	0.9093
43440	Mc Pherson County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43450	Marshall County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43460	Meade County, S Dakota	43	Rural	0.8551	0.8987	39660	Urban	0.8769
43470	Mellette County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43480	Miner County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43490	Minnehaha County, S Dakota	7760	Urban	0.9635	0.9635	43620	Urban	0.9635
43500	Moody County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43510	Pennington County, S Dakota	6660	Urban	0.8987	0.8987	39660	Urban	0.8987
43520	Perkins County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43530	Potter County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43540	Roberts County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43550	Sanborn County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43560	Shannon County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43570	Spink County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43580	Stanley County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43590	Sully County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43600	Todd County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43610	Tripp County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43620	Turner County, S Dakota	43	Rural	0.8551	0.9635	43620	Urban	0.9093
43630	Union County, S Dakota	43	Rural	0.8551	0.9381	43580	Urban	0.8966
43640	Walworth County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43650	Washabaugh County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43670	Yankton County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
43680	Ziebach County, S Dakota	43	Rural	0.8551	0.8560	99943	Rural	0.8556
44000	Anderson County, Tennessee	3840	Urban	0.8397	0.8441	28940	Urban	0.8419
44010	Bedford County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44020	Benton County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44030	Bledsoe County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44040	Blount County, Tennessee	3840	Urban	0.8397	0.8441	28940	Urban	0.8419
44050	Bradley County, Tennessee	44	Rural	0.7935	0.8139	17420	Urban	0.8037
44060	Campbell County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44070	Cannon County, Tennessee	44	Rural	0.7935	0.9741	34980	Urban	0.8838
44080	Carroll County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44090	Carter County, Tennessee	3660	Urban	0.8007	0.7937	27740	Urban	0.7972
44100	Cheatham County, Tennessee	5360	Urban	0.9760	0.9741	34980	Urban	0.9751
44110	Chester County, Tennessee	3580	Urban	0.8964	0.8964	27180	Urban	0.8964
44120	Claiborne County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44130	Clay County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44140	Cocke County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44150	Coffee County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44160	Crockett County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44170	Cumberland County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44180	Davidson County, Tennessee	5360	Urban	0.9760	0.9741	34980	Urban	0.9751
44190	Decatur County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44200	De Kalb County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44210	Dickson County, Tennessee	5360	Urban	0.9760	0.9741	34980	Urban	0.9751
44220	Dyer County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44230	Fayette County, Tennessee	4920	Urban	0.9416	0.9397	32820	Urban	0.9407
44240	Fentress County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44250	Franklin County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44260	Gibson County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44270	Giles County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44280	Grainger County, Tennessee	44	Rural	0.7935	0.7961	34100	Urban	0.7948
44290	Greene County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44300	Grundy County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44310	Hamblen County, Tennessee	44	Rural	0.7935	0.7961	34100	Urban	0.7948
44320	Hamilton County, Tennessee	1560	Urban	0.9088	0.9088	16860	Urban	0.9088
44330	Hancock County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44340	Hardeman County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44350	Hardin County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44360	Hawkins County, Tennessee	3660	Urban	0.8007	0.8054	28700	Urban	0.8031
44370	Haywood County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44380	Henderson County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44390	Henry County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44400	Hickman County, Tennessee	44	Rural	0.7935	0.9741	34980	Urban	0.8838
44410	Houston County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44420	Humphreys County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44430	Jackson County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44440	Jefferson County, Tennessee	44	Rural	0.7935	0.7961	34100	Urban	0.7948
44450	Johnson County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44460	Knox County, Tennessee	3840	Urban	0.8397	0.8441	28940	Urban	0.8419
44470	Lake County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44480	Lauderdale County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44490	Lawrence County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44500	Lewis County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44510	Lincoln County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44520	Loudon County, Tennessee	3840	Urban	0.8397	0.8441	28940	Urban	0.8419
44530	Mc Minn County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44540	Mc Nairy County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44550	Macon County, Tennessee	44	Rural	0.7935	0.9741	34980	Urban	0.8838
44560	Madison County, Tennessee	3580	Urban	0.8964	0.8964	27180	Urban	0.8964
44570	Marion County, Tennessee	1560	Urban	0.9088	0.9088	16860	Urban	0.9088
44580	Marshall County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44590	Maury County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44600	Meigs County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44610	Monroe County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44620	Montgomery County, Tennessee	1660	Urban	0.8284	0.8284	17300	Urban	0.8284
44630	Moore County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44640	Morgan County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44650	Obion County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44660	Overton County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44670	Perry County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44680	Pickett County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44690	Polk County, Tennessee	44	Rural	0.7935	0.8139	17420	Urban	0.8037
44700	Putnam County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44710	Rhea County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44720	Roane County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44730	Robertson County, Tennessee	5360	Urban	0.9760	0.9741	34980	Urban	0.9751
44740	Rutherford County, Tennessee	5360	Urban	0.9760	0.9741	34980	Urban	0.9751
44750	Scott County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44760	Sequatchie County, Tennessee	44	Rural	0.7935	0.9088	16860	Urban	0.8512
44770	Sevier County, Tennessee	3840	Urban	0.8397	0.7895	99944	Rural	0.8146
44780	Shelby County, Tennessee	4920	Urban	0.9416	0.9397	32820	Urban	0.9407
44790	Smith County, Tennessee	44	Rural	0.7935	0.9741	34980	Urban	0.8838
44800	Stewart County, Tennessee	44	Rural	0.7935	0.8284	17300	Urban	0.8110
44810	Sullivan County, Tennessee	3660	Urban	0.8007	0.8054	28700	Urban	0.8031
44820	Sumner County, Tennessee	5360	Urban	0.9760	0.9741	34980	Urban	0.9751
44830	Tipton County, Tennessee	4920	Urban	0.9416	0.9397	32820	Urban	0.9407
44840	Trousdale County, Tennessee	44	Rural	0.7935	0.9741	34980	Urban	0.8838
44850	Unicoi County, Tennessee	3660	Urban	0.8007	0.7937	27740	Urban	0.7972
44860	Union County, Tennessee	3840	Urban	0.8397	0.8441	28940	Urban	0.8419
44870	Van Buren County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44880	Warren County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44890	Washington County, Tennessee	3660	Urban	0.8007	0.7937	27740	Urban	0.7972
44900	Wayne County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44910	Weakley County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44920	White County, Tennessee	44	Rural	0.7935	0.7895	99944	Rural	0.7915
44930	Williamson County, Tennessee	5360	Urban	0.9760	0.9741	34980	Urban	0.9751
44940	Wilson County, Tennessee	5360	Urban	0.9760	0.9741	34980	Urban	0.9751
45000	Anderson County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45010	Andrews County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45020	Angelina County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45030	Aransas County, Texas	45	Rural	0.7931	0.8550	18580	Urban	0.8241
45040	Archer County, Texas	9080	Urban	0.8365	0.8285	48660	Urban	0.8325
45050	Armstrong County, Texas	45	Rural	0.7931	0.9156	11100	Urban	0.8544
45060	Atascosa County, Texas	45	Rural	0.7931	0.8980	41700	Urban	0.8456
45070	Austin County, Texas	45	Rural	0.7931	0.9992	26420	Urban	0.8962
45080	Bailey County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45090	Bandera County, Texas	45	Rural	0.7931	0.8980	41700	Urban	0.8456
45100	Bastrop County, Texas	0640	Urban	0.9437	0.9437	12420	Urban	0.9437
45110	Baylor County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45113	Bee County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45120	Bell County, Texas	3810	Urban	0.8526	0.8526	28660	Urban	0.8526
45130	Bexar County, Texas	7240	Urban	0.8984	0.8980	41700	Urban	0.8982
45140	Blanco County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45150	Borden County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45160	Bosque County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45170	Bowie County, Texas	8360	Urban	0.8283	0.8283	45500	Urban	0.8283
45180	Brazoria County, Texas	1145	Urban	0.8563	0.9992	26420	Urban	0.9278
45190	Brazos County, Texas	1260	Urban	0.8900	0.8900	17780	Urban	0.8900
45200	Brewster County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45201	Briscoe County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45210	Brooks County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45220	Brown County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45221	Burleson County, Texas	45	Rural	0.7931	0.8900	17780	Urban	0.8416
45222	Burnet County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45223	Caldwell County, Texas	0640	Urban	0.9437	0.9437	12420	Urban	0.9437
45224	Calhoun County, Texas	45	Rural	0.7931	0.8160	47020	Urban	0.8046
45230	Callahan County, Texas	45	Rural	0.7931	0.7896	10180	Urban	0.7914
45240	Cameron County, Texas	1240	Urban	0.9804	0.9804	15180	Urban	0.9804
45250	Camp County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45251	Carson County, Texas	45	Rural	0.7931	0.9156	11100	Urban	0.8544
45260	Cass County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45270	Castro County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45280	Chambers County, Texas	3360	Urban	1.0088	0.9992	26420	Urban	1.0040
45281	Cherokee County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45290	Childress County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45291	Clay County, Texas	45	Rural	0.7931	0.8285	48660	Urban	0.8108
45292	Cochran County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45300	Coke County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45301	Coleman County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45310	Collin County, Texas	1920	Urban	1.0205	1.0228	19124	Urban	1.0217
45311	Collingsworth County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45312	Colorado County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45320	Comal County, Texas	7240	Urban	0.8984	0.8980	41700	Urban	0.8982
45321	Comanche County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45330	Concho County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45340	Cooke County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45341	Coryell County, Texas	3810	Urban	0.8526	0.8526	660	Urban	0.8526
45350	Cottle County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45360	Crane County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45361	Crockett County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45362	Crosby County, Texas	45	Rural	0.7931	0.8783	31180	Urban	0.8357
45370	Culberson County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45380	Dallam County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45390	Dallas County, Texas	1920	Urban	1.0205	1.0228	19124	Urban	1.0217
45391	Dawson County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45392	Deaf Smith County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45400	Delta County, Texas	45	Rural	0.7931	1.0228	19124	Urban	0.9080
45410	Denton County, Texas	1920	Urban	1.0205	1.0228	19124	Urban	1.0217
45420	De Witt County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45421	Dickens County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45430	Dimmit County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45431	Donley County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45440	Duval County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45450	Eastland County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45451	Ector County, Texas	5800	Urban	0.9741	0.9884	36220	Urban	0.9813
45460	Edwards County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45470	Ellis County, Texas	1920	Urban	1.0205	1.0228	19124	Urban	1.0217
45480	El Paso County, Texas	2320	Urban	0.8977	0.8977	21340	Urban	0.8977
45490	Erath County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45500	Falls County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45510	Fannin County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45511	Fayette County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45520	Fisher County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45521	Floyd County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45522	Foard County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45530	Fort Bend County, Texas	3360	Urban	1.0088	0.9992	26420	Urban	1.0040
45531	Franklin County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45540	Freestone County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45541	Frio County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45542	Gaines County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45550	Galveston County, Texas	2920	Urban	0.9635	0.9992	26420	Urban	0.9814
45551	Garza County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45552	Gillespie County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45560	Glasscock County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45561	Goliad County, Texas	45	Rural	0.7931	0.8160	47020	Urban	0.8046
45562	Gonzales County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45563	Gray County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45564	Grayson County, Texas	7640	Urban	0.9507	0.9507	43300	Urban	0.9507
45570	Gregg County, Texas	4420	Urban	0.8888	0.8730	30980	Urban	0.8809
45580	Grimes County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45581	Guadaloupe County, Texas	7240	Urban	0.8984	0.8980	41700	Urban	0.8982
45582	Hale County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45583	Hall County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45590	Hamilton County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45591	Hansford County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45592	Hardeman County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45600	Hardin County, Texas	0840	Urban	0.8412	0.8412	13140	Urban	0.8412
45610	Harris County, Texas	3360	Urban	1.0088	0.9992	26420	Urban	1.0040
45620	Harrison County, Texas	4420	Urban	0.8888	0.8003	99945	Rural	0.8446
45621	Hartley County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45630	Haskell County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45631	Hays County, Texas	0640	Urban	0.9437	0.9437	12420	Urban	0.9437
45632	Hemphill County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45640	Henderson County, Texas	1920	Urban	1.0205	0.8003	99945	Rural	0.9104
45650	Hidalgo County, Texas	4880	Urban	0.8934	0.8934	32580	Urban	0.8934
45651	Hill County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45652	Hockley County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45653	Hood County, Texas	2800	Urban	0.9522	0.8003	99945	Rural	0.8763
45654	Hopkins County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45660	Houston County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45661	Howard County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45662	Hudspeth County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45670	Hunt County, Texas	1920	Urban	1.0205	1.0228	19124	Urban	1.0217
45671	Hutchinson County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45672	Irion County, Texas	45	Rural	0.7931	0.8271	41660	Urban	0.8101
45680	Jack County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45681	Jackson County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45690	Jasper County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45691	Jeff Davis County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45700	Jefferson County, Texas	0840	Urban	0.8412	0.8412	13140	Urban	0.8412
45710	Jim Hogg County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45711	Jim Wells County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45720	Johnson County, Texas	2800	Urban	0.9522	0.9486	23104	Urban	0.9504
45721	Jones County, Texas	45	Rural	0.7931	0.7896	10180	Urban	0.7914
45722	Karnes County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45730	Kaufman County, Texas	1920	Urban	1.0205	1.0228	19124	Urban	1.0217
45731	Kendall County, Texas	45	Rural	0.7931	0.8980	41700	Urban	0.8456
45732	Kenedy County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45733	Kent County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45734	Kerr County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45740	Kimble County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45741	King County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45742	Kinney County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45743	Kleberg County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45744	Knox County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45750	Lamar County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45751	Lamb County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45752	Lampasas County, Texas	45	Rural	0.7931	0.8526	28660	Urban	0.8229
45753	La Salle County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45754	Lavaca County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45755	Lee County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45756	Leon County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45757	Liberty County, Texas	3360	Urban	1.0088	0.9992	26420	Urban	1.0040
45758	Limestone County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45759	Lipscomb County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45760	Live Oak County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45761	Llano County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45762	Loving County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45770	Lubbock County, Texas	4600	Urban	0.8783	0.8783	31180	Urban	0.8783
45771	Lynn County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45772	Mc Culloch County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45780	Mc Lennan County, Texas	8800	Urban	0.8518	0.8518	47380	Urban	0.8518
45781	Mc Mullen County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45782	Madison County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45783	Marion County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45784	Martin County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45785	Mason County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45790	Matagorda County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45791	Maverick County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45792	Medina County, Texas	45	Rural	0.7931	0.8980	41700	Urban	0.8456
45793	Menard County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45794	Midland County, Texas	5800	Urban	0.9741	0.9514	33260	Urban	0.9628
45795	Milam County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45796	Mills County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45797	Mitchell County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45800	Montague County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45801	Montgomery County, Texas	3360	Urban	1.0088	0.9992	26420	Urban	1.0040
45802	Moore County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45803	Morris County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45804	Motley County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45810	Nacogdoches County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45820	Navarro County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45821	Newton County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45822	Nolan County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45830	Nueces County, Texas	1880	Urban	0.8550	0.8550	18580	Urban	0.8550
45831	Ochiltree County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45832	Oldham County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45840	Orange County, Texas	0840	Urban	0.8412	0.8412	13140	Urban	0.8412
45841	Palo Pinto County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45842	Panola County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45843	Parker County, Texas	2800	Urban	0.9522	0.9486	23104	Urban	0.9504
45844	Parmer County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45845	Pecos County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45850	Polk County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45860	Potter County, Texas	0320	Urban	0.9156	0.9156	11100	Urban	0.9156
45861	Presidio County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45870	Rains County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45871	Randall County, Texas	0320	Urban	0.9156	0.9156	11100	Urban	0.9156
45872	Reagan County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45873	Real County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45874	Red River County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45875	Reeves County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45876	Refugio County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45877	Roberts County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45878	Robertson County, Texas	45	Rural	0.7931	0.8900	17780	Urban	0.8416
45879	Rockwall County, Texas	1920	Urban	1.0205	1.0228	19124	Urban	1.0217
45880	Runnels County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45881	Rusk County, Texas	45	Rural	0.7931	0.8730	30980	Urban	0.8331
45882	Sabine County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45883	San Augustine County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45884	San Jacinto County, Texas	45	Rural	0.7931	0.9992	26420	Urban	0.8962
45885	San Patricio County, Texas	1880	Urban	0.8550	0.8550	18580	Urban	0.8550
45886	San Saba County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45887	Schleicher County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45888	Scurry County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45889	Shackelford County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45890	Shelby County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45891	Sherman County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45892	Smith County, Texas	8640	Urban	0.9168	0.9168	46340	Urban	0.9168
45893	Somervell County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45900	Starr County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45901	Stephens County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45902	Sterling County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45903	Stonewall County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45904	Sutton County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45905	Swisher County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45910	Tarrant County, Texas	2800	Urban	0.9522	0.9486	23104	Urban	0.9504
45911	Taylor County, Texas	0040	Urban	0.8054	0.7896	10180	Urban	0.7975
45912	Terrell County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45913	Terry County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45920	Throckmorton County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45921	Titus County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45930	Tom Green County, Texas	7200	Urban	0.8271	0.8271	41660	Urban	0.8271
45940	Travis County, Texas	0640	Urban	0.9437	0.9437	12420	Urban	0.9437
45941	Trinity County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45942	Tyler County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45943	Upshur County, Texas	4420	Urban	0.8888	0.8730	30980	Urban	0.8809
45944	Upton County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45945	Uvalde County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45946	Val Verde County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45947	Van Zandt County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45948	Victoria County, Texas	8750	Urban	0.8160	0.8160	47020	Urban	0.8160
45949	Walker County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45950	Waller County, Texas	3360	Urban	1.0088	0.9992	26420	Urban	1.0040
45951	Ward County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45952	Washington County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45953	Webb County, Texas	4080	Urban	0.8068	0.8068	29700	Urban	0.8068
45954	Wharton County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45955	Wheeler County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45960	Wichita County, Texas	9080	Urban	0.8365	0.8285	48660	Urban	0.8325
45961	Wilbarger County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45962	Willacy County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45970	Williamson County, Texas	0640	Urban	0.9437	0.9437	12420	Urban	0.9437
45971	Wilson County, Texas	7240	Urban	0.8984	0.8980	41700	Urban	0.8982
45972	Winkler County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45973	Wise County, Texas	45	Rural	0.7931	0.9486	23104	Urban	0.8709
45974	Wood County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45980	Yoakum County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45981	Young County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45982	Zapata County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
45983	Zavala County, Texas	45	Rural	0.7931	0.8003	99945	Rural	0.7967
46000	Beaver County, Utah	46	Rural	0.8762	0.8118	99946	Rural	0.8440
46010	Box Elder County, Utah	46	Rural	0.8762	0.8118	99946	Rural	0.8440
46020	Cache County, Utah	46	Rural	0.8762	0.9164	30860	Urban	0.8963
46030	Carbon County, Utah	46	Rural	0.8762	0.8118	99946	Rural	0.8440
46040	Daggett County, Utah	46	Rural	0.8762	0.8118	99946	Rural	0.8440
46050	Davis County, Utah	7160	Urban	0.9340	0.9029	36260	Urban	0.9185
46060	Duchesne County, Utah	46	Rural	0.8762	0.8118	99946	Rural	0.8440
46070	Emery County, Utah	46	Rural	0.8762	0.8118	99946	Rural	0.8440
46080	Garfield County, Utah	46	Rural	0.8762	0.8118	99946	Rural	0.8440
46090	Grand County, Utah	46	Rural	0.8762	0.8118	99946	Rural	0.8440
46100	Iron County, Utah	46	Rural	0.8762	0.8118	99946	Rural	0.8440
46110	Juab County, Utah	46	Rural	0.8762	0.9500	39340	Urban	0.9131
46120	Kane County, Utah	2620	Urban	1.1845	0.8118	99946	Rural	0.9982
46130	Millard County, Utah	46	Rural	0.8762	0.8118	99946	Rural	0.8440
46140	Morgan County, Utah	46	Rural	0.8762	0.9029	36260	Urban	0.8896
46150	Piute County, Utah	46	Rural	0.8762	0.8118	99946	Rural	0.8440
46160	Rich County, Utah	46	Rural	0.8762	0.8118	99946	Rural	0.8440
46170	Salt Lake County, Utah	7160	Urban	0.9340	0.9421	41620	Urban	0.9381
46180	San Juan County, Utah	46	Rural	0.8762	0.8118	99946	Rural	0.8440
46190	Sanpete County, Utah	46	Rural	0.8762	0.8118	99946	Rural	0.8440
46200	Sevier County, Utah	46	Rural	0.8762	0.8118	99946	Rural	0.8440
46210	Summit County, Utah	46	Rural	0.8762	0.9421	41620	Urban	0.9092
46220	Tooele County, Utah	46	Rural	0.8762	0.9421	41620	Urban	0.9092
46230	Uintah County, Utah	46	Rural	0.8762	0.8118	99946	Rural	0.8440
46240	Utah County, Utah	6520	Urban	0.9500	0.9500	39340	Urban	0.9500
46250	Wasatch County, Utah	46	Rural	0.8762	0.8118	99946	Rural	0.8440
46260	Washington County, Utah	46	Rural	0.8762	0.9392	41100	Urban	0.9077
46270	Wayne County, Utah	46	Rural	0.8762	0.8118	99946	Rural	0.8440
46280	Weber County, Utah	7160	Urban	0.9340	0.9029	36260	Urban	0.9185
47000	Addison County, Vermont	47	Rural	0.9830	0.9830	99947	Rural	0.9830
47010	Bennington County, Vermont	47	Rural	0.9830	0.9830	99947	Rural	0.9830
47020	Caledonia County, Vermont	47	Rural	0.9830	0.9830	99947	Rural	0.9830
47030	Chittenden County, Vermont	1303	Urban	0.9410	0.9410	15540	Urban	0.9410
47040	Essex County, Vermont	47	Rural	0.9830	0.9830	99947	Rural	0.9830
47050	Franklin County, Vermont	1303	Urban	0.9410	0.9410	15540	Urban	0.9410
47060	Grand Isle County, Vermont	1303	Urban	0.9410	0.9410	15540	Urban	0.9410
47070	Lamoille County, Vermont	47	Rural	0.9830	0.9830	99947	Rural	0.9830
47080	Orange County, Vermont	47	Rural	0.9830	0.9830	99947	Rural	0.9830
47090	Orleans County, Vermont	47	Rural	0.9830	0.9830	99947	Rural	0.9830
47100	Rutland County, Vermont	47	Rural	0.9830	0.9830	99947	Rural	0.9830
47110	Washington County, Vermont	47	Rural	0.9830	0.9830	99947	Rural	0.9830
47120	Windham County, Vermont	47	Rural	0.9830	0.9830	99947	Rural	0.9830
47130	Windsor County, Vermont	47	Rural	0.9830	0.9830	99947	Rural	0.9830
48010	St Croix County, Virgin Islands	48	Rural	0.7615	0.7615	99948	Rural	0.7615
48020	St Thomas-John County, Virgin Islands	48	Rural	0.7615	0.7615	99948	Rural	0.7615
49000	Accomack County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49010	Albemarle County, Virginia	1540	Urban	1.0187	1.0187	16820	Urban	1.0187
49011	Alexandria City County, Virginia	8840	Urban	1.0976	1.0926	47894	Urban	1.0951
49020	Alleghany County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49030	Amelia County, Virginia	49	Rural	0.8417	0.9328	40060	Urban	0.8873
49040	Amherst County, Virginia	4640	Urban	0.8691	0.8691	31340	Urban	0.8691
49050	Appomattox County, Virginia	49	Rural	0.8417	0.8691	31340	Urban	0.8554
49060	Arlington County, Virginia	8840	Urban	1.0976	1.0926	47894	Urban	1.0951
49070	Augusta County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49080	Bath County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49088	Bedford City County, Virginia	4640	Urban	0.8691	0.8691	31340	Urban	0.8691
49090	Bedford County, Virginia	4640	Urban	0.8691	0.8691	31340	Urban	0.8691
49100	Bland County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49110	Botetourt County, Virginia	6800	Urban	0.8387	0.8374	40220	Urban	0.8381
49111	Bristol City County, Virginia	3660	Urban	0.8007	0.8054	28700	Urban	0.8031
49120	Brunswick County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49130	Buchanan County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49140	Buckingham County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49141	Buena Vista City County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49150	Campbell County, Virginia	4640	Urban	0.8691	0.8691	31340	Urban	0.8691
49160	Caroline County, Virginia	49	Rural	0.8417	0.9328	40060	Urban	0.8873
49170	Carroll County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49180	Charles City County, Virginia	6760	Urban	0.9328	0.9328	40060	Urban	0.9328
49190	Charlotte County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49191	Charlottesville City County, Virginia	1540	Urban	1.0187	1.0187	16820	Urban	1.0187
49194	Chesapeake County, Virginia	5720	Urban	0.8799	0.8799	47260	Urban	0.8799
49200	Chesterfield County, Virginia	6760	Urban	0.9328	0.9328	40060	Urban	0.9328
49210	Clarke County, Virginia	8840	Urban	1.0976	1.0926	47894	Urban	1.0951
49211	Clifton Forge City County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49212	Colonial Heights County, Virginia	6760	Urban	0.9328	0.9328	40060	Urban	0.9328
49213	Covington City County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49220	Craig County, Virginia	49	Rural	0.8417	0.8374	40220	Urban	0.8396
49230	Culpeper County, Virginia	8840	Urban	1.0976	0.8013	99949	Rural	0.9495
49240	Cumberland County, Virginia	49	Rural	0.8417	0.9328	40060	Urban	0.8873
49241	Danville City County, Virginia	1950	Urban	0.8489	0.8489	19260	Urban	0.8489
49250	Dickenson County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49260	Dinniddie County, Virginia	6760	Urban	0.9328	0.9328	40060	Urban	0.9328
49270	Emporia County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49280	Essex County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49288	Fairfax City County, Virginia	8840	Urban	1.0976	1.0926	47894	Urban	1.0951
49290	Fairfax County, Virginia	8840	Urban	1.0976	1.0926	47894	Urban	1.0951
49291	Falls Church City County, Virginia	8840	Urban	1.0976	1.0926	47894	Urban	1.0951
49300	Fauquier County, Virginia	8840	Urban	1.0976	1.0926	47894	Urban	1.0951
49310	Floyd County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49320	Fluvanna County, Virginia	1540	Urban	1.0187	1.0187	16820	Urban	1.0187
49328	Franklin City County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49330	Franklin County, Virginia	49	Rural	0.8417	0.8374	40220	Urban	0.8396
49340	Frederick County, Virginia	49	Rural	0.8417	1.0214	49020	Urban	0.9316
49342	Fredericksburg City County, Virginia	8840	Urban	1.0976	1.0926	47894	Urban	1.0951
49343	Galax City County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49350	Giles County, Virginia	49	Rural	0.8417	0.7954	13980	Urban	0.8186
49360	Gloucester County, Virginia	5720	Urban	0.8799	0.8799	47260	Urban	0.8799
49370	Goochland County, Virginia	6760	Urban	0.9328	0.9328	40060	Urban	0.9328
49380	Grayson County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49390	Greene County, Virginia	1540	Urban	1.0187	1.0187	16820	Urban	1.0187
49400	Greensville County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49410	Halifax County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49411	Hampton City County, Virginia	5720	Urban	0.8799	0.8799	47260	Urban	0.8799
49420	Hanover County, Virginia	6760	Urban	0.9328	0.9328	40060	Urban	0.9328
49421	Harrisonburg City County, Virginia	49	Rural	0.8417	0.9088	25500	Urban	0.8753
49430	Henrico County, Virginia	6760	Urban	0.9328	0.9328	40060	Urban	0.9328
49440	Henry County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49450	Highland County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49451	Hopewell City County, Virginia	6760	Urban	0.9328	0.9328	40060	Urban	0.9328
49460	Isle Of Wight County, Virginia	5720	Urban	0.8799	0.8799	47260	Urban	0.8799
49470	James City Co County, Virginia	5720	Urban	0.8799	0.8799	47260	Urban	0.8799
49480	King And Queen County, Virginia	49	Rural	0.8417	0.9328	40060	Urban	0.8873
49490	King George County, Virginia	8840	Urban	1.0976	0.8013	99949	Rural	0.9495
49500	King William County, Virginia	49	Rural	0.8417	0.9328	40060	Urban	0.8873
49510	Lancaster County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49520	Lee County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49522	Lexington County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49530	Loudoun County, Virginia	8840	Urban	1.0976	1.0926	47894	Urban	1.0951
49540	Louisa County, Virginia	49	Rural	0.8417	0.9328	40060	Urban	0.8873
49550	Lunenburg County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49551	Lynchburg City County, Virginia	4640	Urban	0.8691	0.8691	31340	Urban	0.8691
49560	Madison County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49561	Martinsville City County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49563	Manassas City County, Virginia	8840	Urban	1.0976	1.0926	47894	Urban	1.0951
49565	Manassas Park City County, Virginia	8840	Urban	1.0976	1.0926	47894	Urban	1.0951
49570	Mathews County, Virginia	5720	Urban	0.8799	0.8799	47260	Urban	0.8799
49580	Mecklenburg County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49590	Middlesex County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49600	Montgomery County, Virginia	49	Rural	0.8417	0.7954	13980	Urban	0.8186
49610	Nansemond County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49620	Nelson County, Virginia	49	Rural	0.8417	1.0187	16820	Urban	0.9302
49621	New Kent County, Virginia	6760	Urban	0.9328	0.9328	40060	Urban	0.9328
49622	Newport News City County, Virginia	5720	Urban	0.8799	0.8799	47260	Urban	0.8799
49641	Norfolk City County, Virginia	5720	Urban	0.8799	0.8799	47260	Urban	0.8799
49650	Northampton County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49660	Northumberland County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49661	Norton City County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49670	Nottoway County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49680	Orange County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49690	Page County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49700	Patrick County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49701	Petersburg City County, Virginia	6760	Urban	0.9328	0.9328	40060	Urban	0.9328
49710	Pittsylvania County, Virginia	1950	Urban	0.8489	0.8489	19260	Urban	0.8489
49711	Portsmouth City County, Virginia	5720	Urban	0.8799	0.8799	47260	Urban	0.8799
49712	Poquoson City County, Virginia	5720	Urban	0.8799	0.8799	47260	Urban	0.8799
49720	Powhatan County, Virginia	6760	Urban	0.9328	0.9328	40060	Urban	0.9328
49730	Prince Edward County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49740	Prince George County, Virginia	6760	Urban	0.9328	0.9328	40060	Urban	0.9328
49750	Prince William County, Virginia	8840	Urban	1.0976	1.0926	47894	Urban	1.0951
49770	Pulaski County, Virginia	49	Rural	0.8417	0.7954	13980	Urban	0.8186
49771	Radford City County, Virginia	49	Rural	0.8417	0.7954	13980	Urban	0.8186
49780	Rappahannock County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49790	Richmond County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49791	Richmond City County, Virginia	6760	Urban	0.9328	0.9328	40060	Urban	0.9328
49800	Roanoke County, Virginia	6800	Urban	0.8387	0.8374	40220	Urban	0.8381
49801	Roanoke City County, Virginia	6800	Urban	0.8387	0.8374	40220	Urban	0.8381
49810	Rockbridge County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49820	Rockingham County, Virginia	49	Rural	0.8417	0.9088	25500	Urban	0.8753
49830	Russell County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49838	Salem County, Virginia	6800	Urban	0.8387	0.8374	40220	Urban	0.8381
49840	Scott County, Virginia	3660	Urban	0.8007	0.8054	28700	Urban	0.8031
49850	Shenandoah County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49860	Smyth County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49867	South Boston City County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49870	Southampton County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49880	Spotsylvania County, Virginia	8840	Urban	1.0976	1.0926	47894	Urban	1.0951
49890	Stafford County, Virginia	8840	Urban	1.0976	1.0926	47894	Urban	1.0951
49891	Staunton City County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49892	Suffolk City County, Virginia	5720	Urban	0.8799	0.8799	47260	Urban	0.8799
49900	Surry County, Virginia	49	Rural	0.8417	0.8799	47260	Urban	0.8608
49910	Sussex County, Virginia	49	Rural	0.8417	0.9328	40060	Urban	0.8873
49920	Tazewell County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49921	Virginia Beach City County, Virginia	5720	Urban	0.8799	0.8799	47260	Urban	0.8799
49930	Warren County, Virginia	8840	Urban	1.0976	1.0926	47894	Urban	1.0951
49950	Washington County, Virginia	3660	Urban	0.8007	0.8054	28700	Urban	0.8031
49951	Waynesboro City County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49960	Westmoreland County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49961	Williamsburg City County, Virginia	5720	Urban	0.8799	0.8799	47260	Urban	0.8799
49962	Winchester City County, Virginia	49	Rural	0.8417	1.0214	49020	Urban	0.9316
49970	Wise County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49980	Wythe County, Virginia	49	Rural	0.8417	0.8013	99949	Rural	0.8215
49981	York County, Virginia	5720	Urban	0.8799	0.8799	47260	Urban	0.8799
50000	Adams County, Washington	50	Rural	1.0217	1.0510	99950	Rural	1.0364
50010	Asotin County, Washington	50	Rural	1.0217	0.9886	30300	Urban	1.0052
50020	Benton County, Washington	6740	Urban	1.0619	1.0619	28420	Urban	1.0619
50030	Chelan County, Washington	50	Rural	1.0217	1.0070	48300	Urban	1.0144
50040	Clallam County, Washington	50	Rural	1.0217	1.0510	99950	Rural	1.0364
50050	Clark County, Washington	6440	Urban	1.1266	1.1266	38900	Urban	1.1266
50060	Columbia County, Washington	50	Rural	1.0217	1.0510	99950	Rural	1.0364
50070	Cowlitz County, Washington	50	Rural	1.0217	0.9579	31020	Urban	0.9898
50080	Douglas County, Washington	50	Rural	1.0217	1.0070	48300	Urban	1.0144
50090	Ferry County, Washington	50	Rural	1.0217	1.0510	99950	Rural	1.0364
50100	Franklin County, Washington	6740	Urban	1.0619	1.0619	28420	Urban	1.0619
50110	Garfield County, Washington	50	Rural	1.0217	1.0510	99950	Rural	1.0364
50120	Grant County, Washington	50	Rural	1.0217	1.0510	99950	Rural	1.0364
50130	Grays Harbor County, Washington	50	Rural	1.0217	1.0510	99950	Rural	1.0364
50140	Island County, Washington	7600	Urban	1.1567	1.0510	99950	Rural	1.1039
50150	Jefferson County, Washington	50	Rural	1.0217	1.0510	99950	Rural	1.0364
50160	King County, Washington	7600	Urban	1.1567	1.1577	42644	Urban	1.1572
50170	Kitsap County, Washington	1150	Urban	1.0675	1.0675	14740	Urban	1.0675
50180	Kittitas County, Washington	50	Rural	1.0217	1.0510	99950	Rural	1.0364
50190	Klickitat County, Washington	50	Rural	1.0217	1.0510	99950	Rural	1.0364
50200	Lewis County, Washington	50	Rural	1.0217	1.0510	99950	Rural	1.0364
50210	Lincoln County, Washington	50	Rural	1.0217	1.0510	99950	Rural	1.0364
50220	Mason County, Washington	50	Rural	1.0217	1.0510	99950	Rural	1.0364
50230	Okanogan County, Washington	50	Rural	1.0217	1.0510	99950	Rural	1.0364
50240	Pacific County, Washington	50	Rural	1.0217	1.0510	99950	Rural	1.0364
50250	Pend Oreille County, Washington	50	Rural	1.0217	1.0510	99950	Rural	1.0364
50260	Pierce County, Washington	8200	Urban	1.0742	1.0742	45104	Urban	1.0742
50270	San Juan County, Washington	50	Rural	1.0217	1.0510	99950	Rural	1.0364
50280	Skagit County, Washington	50	Rural	1.0217	1.0454	34580	Urban	1.0336
50290	Skamania County, Washington	50	Rural	1.0217	1.1266	38900	Urban	1.0742
50300	Snohomish County, Washington	7600	Urban	1.1567	1.1577	42644	Urban	1.1572
50310	Spokane County, Washington	7840	Urban	1.0905	1.0905	44060	Urban	1.0905
50320	Stevens County, Washington	50	Rural	1.0217	1.0510	99950	Rural	1.0364
50330	Thurston County, Washington	5910	Urban	1.0927	1.0927	36500	Urban	1.0927
50340	Wahkiakum County, Washington	50	Rural	1.0217	1.0510	99950	Rural	1.0364
50350	Walla Walla County, Washington	50	Rural	1.0217	1.0510	99950	Rural	1.0364
50360	Whatcom County, Washington	0860	Urban	1.1731	1.1731	13380	Urban	1.1731
50370	Whitman County, Washington	50	Rural	1.0217	1.0510	99950	Rural	1.0364
50380	Yakima County, Washington	9260	Urban	1.0155	1.0155	49420	Urban	1.0155
51000	Barbour County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51010	Berkeley County, W Virginia	8840	Urban	1.0976	0.9489	25180	Urban	1.0233
51020	Boone County, W Virginia	51	Rural	0.7900	0.8445	16620	Urban	0.8173
51030	Braxton County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51040	Brooke County, W Virginia	8080	Urban	0.7819	0.7819	48260	Urban	0.7819
51050	Cabell County, W Virginia	3400	Urban	0.9477	0.9477	26580	Urban	0.9477
51060	Calhoun County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51070	Clay County, W Virginia	51	Rural	0.7900	0.8445	16620	Urban	0.8173
51080	Doddridge County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51090	Fayette County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51100	Gilmer County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51110	Grant County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51120	Greenbrier County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51130	Hampshire County, W Virginia	51	Rural	0.7900	1.0214	49020	Urban	0.9057
51140	Hancock County, W Virginia	8080	Urban	0.7819	0.7819	48260	Urban	0.7819
51150	Hardy County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51160	Harrison County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51170	Jackson County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51180	Jefferson County, W Virginia	8840	Urban	1.0976	1.0926	47894	Urban	1.0951
51190	Kanawha County, W Virginia	1480	Urban	0.8445	0.8445	16620	Urban	0.8445
51200	Lewis County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51210	Lincoln County, W Virginia	51	Rural	0.7900	0.8445	16620	Urban	0.8173
51220	Logan County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51230	Mc Dowell County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51240	Marion County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51250	Marshall County, W Virginia	9000	Urban	0.7161	0.7161	48540	Urban	0.7161
51260	Mason County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51270	Mercer County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51280	Mineral County, W Virginia	1900	Urban	0.9317	0.9317	19060	Urban	0.9317
51290	Mingo County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51300	Monongalia County, W Virginia	51	Rural	0.7900	0.8420	34060	Urban	0.8160
51310	Monroe County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51320	Morgan County, W Virginia	51	Rural	0.7900	0.9489	25180	Urban	0.8695
51330	Nicholas County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51340	Ohio County, W Virginia	9000	Urban	0.7161	0.7161	48540	Urban	0.7161
51350	Pendleton County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51360	Pleasants County, W Virginia	51	Rural	0.7900	0.8270	37620	Urban	0.8085
51370	Pocahontas County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51380	Preston County, W Virginia	51	Rural	0.7900	0.8420	34060	Urban	0.8160
51390	Putnam County, W Virginia	1480	Urban	0.8445	0.8445	16620	Urban	0.8445
51400	Raleigh County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51410	Randolph County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51420	Ritchie County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51430	Roane County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51440	Summers County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51450	Taylor County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51460	Tucker County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51470	Tyler County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51480	Upshur County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51490	Wayne County, W Virginia	3400	Urban	0.9477	0.9477	26580	Urban	0.9477
51500	Webster County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51510	Wetzel County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
51520	Wirt County, W Virginia	51	Rural	0.7900	0.8270	37620	Urban	0.8085
51530	Wood County, W Virginia	6020	Urban	0.8270	0.8270	37620	Urban	0.8270
51540	Wyoming County, W Virginia	51	Rural	0.7900	0.7717	99951	Rural	0.7809
52000	Adams County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52010	Ashland County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52020	Barron County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52030	Bayfield County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52040	Brown County, Wisconsin	3080	Urban	0.9483	0.9483	24580	Urban	0.9483
52050	Buffalo County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52060	Burnett County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52070	Calumet County, Wisconsin	0460	Urban	0.9239	0.9288	11540	Urban	0.9264
52080	Chippewa County, Wisconsin	2290	Urban	0.9201	0.9201	20740	Urban	0.9201
52090	Clark County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52100	Columbia County, Wisconsin	52	Rural	0.9478	1.0659	31540	Urban	1.0069
52110	Crawford County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52120	Dane County, Wisconsin	4720	Urban	1.0754	1.0659	31540	Urban	1.0707
52130	Dodge County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52140	Door County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52150	Douglas County, Wisconsin	2240	Urban	1.0213	1.0213	20260	Urban	1.0213
52160	Dunn County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52170	Eau Claire County, Wisconsin	2290	Urban	0.9201	0.9201	20740	Urban	0.9201
52180	Florence County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52190	Fond Du Lac County, Wisconsin	52	Rural	0.9478	0.9640	22540	Urban	0.9559
52200	Forest County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52210	Grant County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52220	Green County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52230	Green Lake County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52240	Iowa County, Wisconsin	52	Rural	0.9478	1.0659	31540	Urban	1.0069
52250	Iron County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52260	Jackson County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52270	Jefferson County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52280	Juneau County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52290	Kenosha County, Wisconsin	3800	Urban	0.9760	1.0429	29404	Urban	1.0095
52300	Kewaunee County, Wisconsin	52	Rural	0.9478	0.9483	24580	Urban	0.9481
52310	La Crosse County, Wisconsin	3870	Urban	0.9564	0.9564	29100	Urban	0.9564
52320	Lafayette County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52330	Langlade County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52340	Lincoln County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52350	Manitowoc County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52360	Marathon County, Wisconsin	8940	Urban	0.9590	0.9590	48140	Urban	0.9590
52370	Marinette County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52380	Marquette County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52381	Menominee County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52390	Milwaukee County, Wisconsin	5080	Urban	1.0146	1.0146	33340	Urban	1.0146
52400	Monroe County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52410	Oconto County, Wisconsin	52	Rural	0.9478	0.9483	24580	Urban	0.9481
52420	Oneida County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52430	Outagamie County, Wisconsin	0460	Urban	0.9239	0.9288	11540	Urban	0.9264
52440	Ozaukee County, Wisconsin	5080	Urban	1.0146	1.0146	33340	Urban	1.0146
52450	Pepin County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52460	Pierce County, Wisconsin	5120	Urban	1.1075	1.1075	33460	Urban	1.1075
52470	Polk County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52480	Portage County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52490	Price County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52500	Racine County, Wisconsin	6600	Urban	0.8997	0.8997	39540	Urban	0.8997
52510	Richland County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52520	Rock County, Wisconsin	3620	Urban	0.9538	0.9538	27500	Urban	0.9538
52530	Rusk County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52540	St Croix County, Wisconsin	5120	Urban	1.1075	1.1075	33460	Urban	1.1075
52550	Sauk County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52560	Sawyer County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52570	Shawano County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52580	Sheboygan County, Wisconsin	7620	Urban	0.8911	0.8911	43100	Urban	0.8911
52590	Taylor County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52600	Trempealeau County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52610	Vernon County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52620	Vilas County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52630	Walworth County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52640	Washburn County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52650	Washington County, Wisconsin	5080	Urban	1.0146	1.0146	33340	Urban	1.0146
52660	Waukesha County, Wisconsin	5080	Urban	1.0146	1.0146	33340	Urban	1.0146
52670	Waupaca County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52680	Waushara County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
52690	Winnebago County, Wisconsin	0460	Urban	0.9239	0.9183	36780	Urban	0.9211
52700	Wood County, Wisconsin	52	Rural	0.9478	0.9509	99952	Rural	0.9494
53000	Albany County, Wyoming	53	Rural	0.9257	0.9257	99953	Rural	0.9257
53010	Big Horn County, Wyoming	53	Rural	0.9257	0.9257	99953	Rural	0.9257
53020	Campbell County, Wyoming	53	Rural	0.9257	0.9257	99953	Rural	0.9257
53030	Carbon County, Wyoming	53	Rural	0.9257	0.9257	99953	Rural	0.9257
53040	Converse County, Wyoming	53	Rural	0.9257	0.9257	99953	Rural	0.9257
53050	Crook County, Wyoming	53	Rural	0.9257	0.9257	99953	Rural	0.9257
53060	Fremont County, Wyoming	53	Rural	0.9257	0.9257	99953	Rural	0.9257
53070	Goshen County, Wyoming	53	Rural	0.9257	0.9257	99953	Rural	0.9257
53080	Hot Springs County, Wyoming	53	Rural	0.9257	0.9257	99953	Rural	0.9257
53090	Johnson County, Wyoming	53	Rural	0.9257	0.9257	99953	Rural	0.9257
53100	Laramie County, Wyoming	1580	Urban	0.8775	0.8775	16940	Urban	0.8775
53110	Lincoln County, Wyoming	53	Rural	0.9257	0.9257	99953	Rural	0.9257
53120	Natrona County, Wyoming	1350	Urban	0.9026	0.9026	16220	Urban	0.9026
53130	Niobrara County, Wyoming	53	Rural	0.9257	0.9257	99953	Rural	0.9257
53140	Park County, Wyoming	53	Rural	0.9257	0.9257	99953	Rural	0.9257
53150	Platte County, Wyoming	53	Rural	0.9257	0.9257	99953	Rural	0.9257
53160	Sheridan County, Wyoming	53	Rural	0.9257	0.9257	99953	Rural	0.9257
53170	Sublette County, Wyoming	53	Rural	0.9257	0.9257	99953	Rural	0.9257
53180	Sweetwater County, Wyoming	53	Rural	0.9257	0.9257	99953	Rural	0.9257
53190	Teton County, Wyoming	53	Rural	0.9257	0.9257	99953	Rural	0.9257
53200	Uinta County, Wyoming	53	Rural	0.9257	0.9257	99953	Rural	0.9257
53210	Washakie County, Wyoming	53	Rural	0.9257	0.9257	99953	Rural	0.9257
53220	Weston County, Wyoming	53	Rural	0.9257	0.9257	99953	Rural	0.9257
65010	Agana County, Guam	65	Rural	0.9611	0.9611	99965	Rural	0.9611
65020	Agana Heights County, Guam	65	Rural	0.9611	0.9611	99965	Rural	0.9611
65030	Agat County, Guam	65	Rural	0.9611	0.9611	99965	Rural	0.9611
65040	Asan County, Guam	65	Rural	0.9611	0.9611	99965	Rural	0.9611
65050	Barrigada County, Guam	65	Rural	0.9611	0.9611	99965	Rural	0.9611
65060	Chalan Pago County, Guam	65	Rural	0.9611	0.9611	99965	Rural	0.9611
65070	Dededo County, Guam	65	Rural	0.9611	0.9611	99965	Rural	0.9611
65080	Inarajan County, Guam	65	Rural	0.9611	0.9611	99965	Rural	0.9611
65090	Maite County, Guam	65	Rural	0.9611	0.9611	99965	Rural	0.9611
65100	Mangilao County, Guam	65	Rural	0.9611	0.9611	99965	Rural	0.9611
65110	Merizo County, Guam	65	Rural	0.9611	0.9611	99965	Rural	0.9611
65120	Mongmong County, Guam	65	Rural	0.9611	0.9611	99965	Rural	0.9611
65130	Ordot County, Guam	65	Rural	0.9611	0.9611	99965	Rural	0.9611
65140	Piti County, Guam	65	Rural	0.9611	0.9611	99965	Rural	0.9611
65150	Santa Rita County, Guam	65	Rural	0.9611	0.9611	99965	Rural	0.9611
65160	Sinajana County, Guam	65	Rural	0.9611	0.9611	99965	Rural	0.9611
65170	Talofofo County, Guam	65	Rural	0.9611	0.9611	99965	Rural	0.9611
65180	Tamuning County, Guam	65	Rural	0.9611	0.9611	99965	Rural	0.9611
65190	Toto County, Guam	65	Rural	0.9611	0.9611	99965	Rural	0.9611
65200	Umatac County, Guam	65	Rural	0.9611	0.9611	99965	Rural	0.9611
65210	Yigo County, Guam	65	Rural	0.9611	0.9611	99965	Rural	0.9611
65220	Yona County, Guam	65	Rural	0.9611	0.9611	99965	Rural	0.9611
* Transition wage index value should be used with the CBSA urban/rural designation for rate calculation purposes.
1 At this time, there are no hospitals located in these CBSA-based urban areas on which to base a wage index. Therefore, the transition wage index value is based on the average transition wage index for all urban areas within the state.