Medicare: Skilled nursing facilities; prospective payment system and consolidating billing,

[Federal Register: August 4, 2005 (Volume 70, Number 149)]

[Rules and Regulations]

[Page 45025-45127]

From the Federal Register Online via GPO Access [wais.access.gpo.gov]

[DOCID:fr04au05-8]

[[Page 45025]]

Part III

Department of Health and Human Services

Centers for Medicare & Medicaid Services

42 CFR Parts 409, 411, 424, and 489

Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2006; Final Rule

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 409, 411, 424, and 489

[CMS-1282-F]

RIN 0938-AN65

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, (410) 786-4528 (for information related to the case-mix classification methodology, and for information related to swing-bed providers).

Jeanette Kranacs, (410) 786-9385 (for information related to the development of the payment rates, and for information related to the wage index).

Bill Ullman, (410) 786-5667 (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

  1. Background

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

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

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

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

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

    6. General Overview of the SNF PPS

      1. Payment Provisions--Federal Rates

      2. Payment Provisions--Initial Transition Period

    7. 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

    8. General Comments on the FY 2006 Proposed Rule

      1. Public Comment Schedule for the FY 2006 Proposed Rule

    9. 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

    10. 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

      1. 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))

      2. Long-Term Payment and Quality Incentive Proposals

      3. Proposal to Clarify ``Direct'' and ``Indirect'' Employment Relationships for Nurse Practitioners and Clinical Nurse Specialists

      4. Completion of Other Medicare Required Assessments (OMRAs)

      5. Concurrent Therapy

      5. Case-Mix Adjusted Federal Rates and Associated Indexes

    11. 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

    12. Updates to the Federal Rates

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

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

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

    15. 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

  2. Consolidated Billing

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

    2. 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

    3. Overall Impact

    4. Anticipated Effects

    5. Accounting Statement

    6. 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

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    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

  3. 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.

    1. 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.

    2. 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

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      annual updates to the Federal rates as mandated by the Act.

    3. 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 Sec. 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.

    4. 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).

    5. 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/

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      manuals/ transmittals/comm--date--dsc.asp.

    6. 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.

    7. 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

      FY 2004 Forecasted Actual FY forecast Index

      FY 2004

      2004

      error increase* increase** 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.

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  4. 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 Sec. 424.3, we would make a technical correction to the definition of ``HCPCS''.

    In Sec. 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.

  5. 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.

    1. 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.

    2. 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

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      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 Sec. 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

      Nursing--case- Therapy--case- Therapy--non- Rate component

      mix

      mix

      case-mix Non-case-mix

      Per Diem Amount.................................... $137.59

      $103.64

      $13.65

      $70.22

      [[Page 45032]]

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

      Nursing--case- Therapy--case- Therapy--non- Rate component

      mix

      mix

      case-mix Non-case-mix

      Per Diem Amount.................................... $131.45

      $119.51

      $14.58

      $71.52

    3. 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.

      [[Page 45033]]

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

      New rehabilitation plus extensive Current rehabilitation groups

      services groups

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

      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

      [[Page 45034]]

      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

      [[Page 45035]]

      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 Sec. 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

      [[Page 45036]]

      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 Sec. 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

      [[Page 45037]]

      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 http://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

      Non-case Non-case RUG III category

      Nursing Therapy Nursing Therapy mix therapy mix Total rate index

      index component component component component

      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

      [[Page 45038]]

      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

      Non-case Non-case RUG-53 category

      Nursing Therapy Nursing Therapy mix therapy mix Total rate index

      index component component component component

      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

      [[Page 45039]]

      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

      Non-case Non-case RUG III category

      Nursing Therapy Nursing Therapy mix therapy mix Total rate index

      index component component component component

      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

      Non-case Non-case RUG-53 category

      Nursing Therapy Nursing Therapy mix therapy mix Total rate index

      index component component comp component

      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

      [[Page 45040]]

      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

    4. 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

      [[Page 45041]]

      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.

      [[Page 45042]]

      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

      Labor Non-labor RUG III category

      Total rate portion 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

      Labor Non-labor RUG-53 category

      Total rate portion 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

      [[Page 45043]]

      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

      Labor Non-labor RUG III category

      Total rate portion 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

      [[Page 45044]]

      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

      Labor Non-labor RUG-53 category

      Total rate portion 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

      [[Page 45045]]

      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.

    5. 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.

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

      As discussed in Sec. 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 Sec. 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

      [[Page 45046]]

      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.

    7. 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)

      Adjusted

      Adjusted Percent Medicare RUG group

      Labor Wage index labor Non-labor rate adjustment 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)

      Adjusted

      Adjusted Percent Medicare RUG group

      Labor Wage index labor Non-labor rate adjustment 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.

    8. 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

      Relative importance, importance, labor-related, labor-related, FY 2005 (97 FY 2006 (97 index)

      index)

      Wages and salaries..................

      54.356

      54.391 Employee benefits...................

      11.506

      11.648 Nonmedical professional fees........

      2.708

      2.739

      [[Page 45047]]

      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

      [[Page 45048]]

      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.

  6. 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.

    [[Page 45049]]

    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 Sec. 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 Sec. 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 Sec. 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

    [[Page 45050]]

    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 Sec. 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 Sec. 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.

    1. 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.

    2. 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;

      [[Page 45051]]

      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.

  7. 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 Sec. 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 Sec. 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 (Sec. 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, Sec. 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 Sec. 409.31(b)(2)(iii) regarding Medicare+Choice (M+C) enrollees. However, in republishing Sec. 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 Sec. 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.

  8. 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.

  9. 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.).

  10. Regulatory Impact Analysis

    1. 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

      [[Page 45052]]

      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.

    2. 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

      [[Page 45053]]

      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

      Eliminate add- Number of Update wage MSA to CBSA on to certain Case-mix Total FY 2006 facilities

      data

      (percent)

      RUGs

      refinements change (percent)

      (percent) (percent) (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

      [[Page 45054]]

      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.

    3. 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.

    4. 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.

      [[Page 45055]]

      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.

      0 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

      0 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

      0 2. Amend Sec. 409.31 by-- 0 A. Republishing paragraph (b)(2) introductory text. 0 B. Revising paragraph (b)(2)(ii) to read as follows:

      Sec. 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

      0 3. Amend Sec. 409.60(c) by removing the references to ``Sec. 405.330'' and adding ``Sec. 411.400'' in its place.

      PART 411--EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT

      0 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

      0 2. Amend Sec. 411.15 by-- 0 A. Republishing paragraph (p)(2) introductory text. 0 B. Revising paragraph (p)(2)(xii) to read as follows:

      Sec. 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 Sec. 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

      0 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

      Sec. 424.3 Definitions.

      0 2. In Sec. 424.3, in the definition of ``HCPCS'' remove the word ``CMS'' and add the word ``Healthcare'' in its place. 0 3. In Sec. 424.20, paragraph (e)(2) is revised to read as follows:

      Sec. 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 Sec. 404.1005, Sec. 404.1007, and Sec. 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 Sec. 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 Sec. 483.40(e) of this chapter. * * * * *

      PART 489--PROVIDER AGREEMENTS AND SUPPLIER APPROVAL

      0 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

      0 2. Section 489.20 is amended by: 0 A. Republishing the introductory text and the paragraph (s) introductory text. 0 B. Revising paragraph (s)(12).

      Sec. 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 Sec. 409.3 of this chapter) for all Medicare-covered services furnished to a resident (as defined in Sec. 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

      [[Page 45056]]

      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.

      [[Page 45057]]

      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

      Wage CBSA code

      Urban area (constituent counties)

      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

      [[Page 45058]]

      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

      [[Page 45059]]

      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

      [[Page 45060]]

      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

      [[Page 45061]]

      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

      [[Page 45062]]

      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

      [[Page 45063]]

      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

      [[Page 45064]]

      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

      [[Page 45065]]

      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, GA\1\.......................... ....... 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

      [[Page 45066]]

      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

      [[Page 45067]]

      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

      [[Page 45068]]

      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

      [[Page 45069]]

      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

      [[Page 45070]]

      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

      [[Page 45071]]

      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

      [[Page 45072]]

      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

      [[Page 45073]]

      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

      [[Page 45074]]

      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

      [[Continued on page 45075]]

      From the Federal Register Online via GPO Access [wais.access.gpo.gov] ]

      [[pp. 45075-45124]] Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2006

      [[Continued from page 45074]]

      [[Page 45075]]

      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

      [[Page 45076]]

      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

      [[Page 45077]]

      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

      [[Page 45078]]

      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

      [[Page 45079]]

      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

      Wage CBSA code

      Nonurban area

      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

      2006 2006 SSA state/county

      MSA urban/ MSA- CBSA- CBSA CBSA urban/ Transition code

      County name MSA No. rural based based No. rural wage index WI WI

      *

      01000............ Autauga County,

      5240 Urban

      0.8618 0.8618 33860 Urban

      0.8618 Alabama. 01010............ Baldwin County,

      5160 Urban

      0.7861 0.7446 99901 Rural

      0.7654 Alabama. 01020............ Barbour County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01030............ Bibb County, Alabama. 01 Rural

      0.7432 0.8959 13820 Urban

      0.8196 01040............ Blount County,

      1000 Urban

      0.9000 0.8959 13820 Urban

      0.8980 Alabama. 01050............ Bullock County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01060............ Butler County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01070............ Calhoun County,

      0450 Urban

      0.7682 0.7682 11500 Urban

      0.7682 Alabama. 01080............ Chambers County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01090............ Cherokee County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01100............ Chilton County,

      01 Rural

      0.7432 0.8959 13820 Urban

      0.8196 Alabama. 01110............ Choctaw County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01120............ Clarke County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01130............ Clay County, Alabama. 01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 01140............ Cleburne County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01150............ Coffee County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01160............ Colbert County,

      2650 Urban

      0.8272 0.8272 22520 Urban

      0.8272 Alabama. 01170............ Conecuh County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01180............ Coosa County, Alabama 01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 01190............ Covington County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01200............ Crenshaw County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01210............ Cullman County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01220............ Dale County, Alabama. 2180 Urban

      0.7701 0.7446 99901 Rural

      0.7574 01230............ Dallas County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01240............ De Kalb County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01250............ Elmore County,

      5240 Urban

      0.8618 0.8618 33860 Urban

      0.8618 Alabama. 01260............ Escambia County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01270............ Etowah County,

      2880 Urban

      0.7938 0.7938 23460 Urban

      0.7938 Alabama. 01280............ Fayette County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01290............ Franklin County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama.

      [[Page 45080]]

      01300............ Geneva County,

      01 Rural

      0.7432 0.7721 20020 Urban

      0.7577 Alabama. 01310............ Greene County,

      01 Rural

      0.7432 0.8645 46220 Urban

      0.8039 Alabama. 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,

      2180 Urban

      0.7701 0.7721 20020 Urban

      0.7711 Alabama. 01350............ Jackson County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01360............ Jefferson County,

      1000 Urban

      0.9000 0.8959 13820 Urban

      0.8980 Alabama. 01370............ Lamar County, Alabama 01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 01380............ Lauderdale County,

      2650 Urban

      0.8272 0.8272 22520 Urban

      0.8272 Alabama. 01390............ Lawrence County,

      2030 Urban

      0.8469 0.8469 19460 Urban

      0.8469 Alabama. 01400............ Lee County, Alabama.. 0580 Urban

      0.8100 0.8100 12220 Urban

      0.8100 01410............ Limestone County,

      3440 Urban

      0.9146 0.9146 26620 Urban

      0.9146 Alabama. 01420............ Lowndes County,

      01 Rural

      0.7432 0.8618 33860 Urban

      0.8025 Alabama. 01430............ Macon County, Alabama 01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 01440............ Madison County,

      3440 Urban

      0.9146 0.9146 26620 Urban

      0.9146 Alabama. 01450............ Marengo County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01460............ Marion County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01470............ Marshall County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01480............ Mobile County,

      5160 Urban

      0.7861 0.7891 33660 Urban

      0.7876 Alabama. 01490............ Monroe County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01500............ Montgomery County,

      5240 Urban

      0.8618 0.8618 33860 Urban

      0.8618 Alabama. 01510............ Morgan County,

      2030 Urban

      0.8469 0.8469 19460 Urban

      0.8469 Alabama. 01520............ Perry County, Alabama 01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 01530............ Pickens County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01540............ Pike County, Alabama. 01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 01550............ Randolph County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01560............ Russell County,

      1800 Urban

      0.8560 0.8560 17980 Urban

      0.8560 Alabama. 01570............ St Clair County,

      1000 Urban

      0.9000 0.8959 13820 Urban

      0.8980 Alabama. 01580............ Shelby County,

      1000 Urban

      0.9000 0.8959 13820 Urban

      0.8980 Alabama. 01590............ Sumter County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01600............ Talladega County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01610............ Tallapoosa County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01620............ Tuscaloosa County,

      8600 Urban

      0.8764 0.8645 46220 Urban

      0.8705 Alabama. 01630............ Walker County,

      01 Rural

      0.7432 0.8959 13820 Urban

      0.8196 Alabama. 01640............ Washington County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01650............ Wilcox County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 01660............ Winston County,

      01 Rural

      0.7432 0.7446 99901 Rural

      0.7439 Alabama. 02013............ Aleutians County

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 East, Alaska. 02016............ Aleutians County

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 West, Alaska. 02020............ Anchorage County,

      0380 Urban

      1.1784 1.1895 11260 Urban

      1.1840 Alaska. 02030............ Angoon County, Alaska 02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 02040............ Barrow-North Slope

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 County, Alaska. 02050............ Bethel County, Alaska 02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 02060............ Bristol Bay Borough

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 County, Alaska. 02068............ Denali County, Alaska 02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 02070............ Bristol Bay County,

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 Alaska. 02080............ Cordova-Mc Carthy

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 County, Alaska. 02090............ Fairbanks County,

      02 Rural

      1.1888 1.1408 21820 Urban

      1.1648 Alaska. 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

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 County, Alaska. 02122............ Kenai Peninsula

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 Borough, Alaska. 02130............ Ketchikan County,

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 Alaska. 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,

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 Alaska. 02164............ Lake and Peninsula

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 Borough, Alaska. 02170............ Matanuska County,

      02 Rural

      1.1888 1.1895 11260 Urban

      1.1892 Alaska. 02180............ Nome County, Alaska.. 02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 02185............ North Slope Borough,

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 Alaska. 02188............ Northwest Arctic

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 Borough, Alaska. 02190............ Outer Ketchikan

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 County, Alaska. 02200............ Prince Of Wales

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 County, Alaska. 02201............ Prince of Wales-Outer 02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 Ketchikan Census Area, Alaska. 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

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 County, Alaska. 02231............ Skagway-Yakutat-

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 Angoon Census Area, Alaska.

      [[Page 45081]]

      02232............ Skagway-Hoonah-Angoon 02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 Census Area, Alaska. 02240............ Southeast Fairbanks

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 County, Alaska. 02250............ Upper Yukon County,

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 Alaska. 02260............ Valdz-Chitna-Whitier

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 County, Alaska. 02261............ Valdex-Cordove Census 02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 Area, Alaska. 02270............ Wade Hampton County,

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 Alaska. 02280............ Wrangell-Petersburg

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 County, Alaska. 02282............ Yakutat Borough,

      02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 Alaska. 02290............ Yukon-Koyukuk County, 02 Rural

      1.1888 1.1977 99902 Rural

      1.1933 Alaska. 03000............ Apache County,

      03 Rural

      0.9045 0.8768 99903 Rural

      0.8907 Arizona. 03010............ Cochise County,

      03 Rural

      0.9045 0.8768 99903 Rural

      0.8907 Arizona. 03020............ Coconino County,

      2620 Urban

      1.1845 1.2092 22380 Urban

      1.1969 Arizona. 03030............ Gila County, Arizona. 03 Rural

      0.9045 0.8768 99903 Rural

      0.8907 03040............ Graham County,

      03 Rural

      0.9045 0.8768 99903 Rural

      0.8907 Arizona. 03050............ Greenlee County,

      03 Rural

      0.9045 0.8768 99903 Rural

      0.8907 Arizona. 03055............ La Paz County,

      03 Rural

      0.9045 0.8768 99903 Rural

      0.8907 Arizona. 03060............ Maricopa County,

      6200 Urban

      1.0127 1.0127 38060 Urban

      1.0127 Arizona. 03070............ Mohave County,

      4120 Urban

      1.1155 0.8768 99903 Rural

      0.9962 Arizona. 03080............ Navajo County,

      03 Rural

      0.9045 0.8768 99903 Rural

      0.8907 Arizona. 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,

      03 Rural

      0.9045 0.8768 99903 Rural

      0.8907 Arizona. 03120............ Yavapai County,

      03 Rural

      0.9045 0.9869 39140 Urban

      0.9457 Arizona. 03130............ Yuma County, Arizona. 9360 Urban

      0.9126 0.9126 49740 Urban

      0.9126 04000............ Arkansas County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04010............ Ashley County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04020............ Baxter County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04030............ Benton County,

      2580 Urban

      0.8661 0.8661 22220 Urban

      0.8661 Arkansas. 04040............ Boone County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04050............ Bradley County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04060............ Calhoun County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04070............ Carroll County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04080............ Chicot County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04090............ Clark County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04100............ Clay County, Arkansas 04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 04110............ Cleburne County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04120............ Cleveland County,

      04 Rural

      0.7744 0.8680 38220 Urban

      0.8212 Arkansas. 04130............ Columbia County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04140............ Conway County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04150............ Craighead County,

      3700 Urban

      0.7911 0.7911 27860 Urban

      0.7911 Arkansas. 04160............ Crawford County,

      2720 Urban

      0.8246 0.8230 22900 Urban

      0.8238 Arkansas. 04170............ Crittenden County,

      4920 Urban

      0.9416 0.9397 32820 Urban

      0.9407 Arkansas. 04180............ Cross County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04190............ Dallas County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04200............ Desha County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04210............ Drew County, Arkansas 04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 04220............ Faulkner County,

      4400 Urban

      0.8747 0.8747 30780 Urban

      0.8747 Arkansas. 04230............ Franklin County,

      04 Rural

      0.7744 0.8230 22900 Urban

      0.7987 Arkansas. 04240............ Fulton County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04250............ Garland County,

      04 Rural

      0.7744 0.9005 26300 Urban

      0.8375 Arkansas. 04260............ Grant County,

      04 Rural

      0.7744 0.8747 30780 Urban

      0.8246 Arkansas. 04270............ Greene County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 4280............. Hempstead County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04290............ Hot Spring County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04300............ Howard County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04310............ Independence County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04320............ Izard County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04330............ Jackson County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04340............ Jefferson County,

      6240 Urban

      0.8680 0.8680 38220 Urban

      0.8680 Arkansas. 04350............ Johnson County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04360............ Lafayette County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04370............ Lawrence County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04380............ Lee County, Arkansas. 04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 04390............ Lincoln County,

      04 Rural

      0.7744 0.8680 38220 Urban

      0.8212 Arkansas. 04400............ Little River County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04410............ Logan County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04420............ Lonoke County,

      4400 Urban

      0.8747 0.8747 30780 Urban

      0.8747 Arkansas. 04430............ Madison County,

      04 Rural

      0.7744 0.8661 22220 Urban

      0.8203 Arkansas.

      [[Page 45082]]

      04440............ Marion County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04450............ Miller County,

      8360 Urban

      0.8283 0.8283 45500 Urban

      0.8283 Arkansas. 04460............ Mississippi County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04470............ Monroe County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04480............ Montgomery County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04490............ Nevada County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04500............ Newton County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04510............ Ouachita County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04520............ Perry County,

      04 Rural

      0.7744 0.8747 30780 Urban

      0.8246 Arkansas. 04530............ Phillips County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04540............ Pike County, Arkansas 04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 04550............ Poinsett County,

      04 Rural

      0.7744 0.7911 27860 Urban

      0.7828 Arkansas. 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,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04590............ Pulaski County,

      4400 Urban

      0.8747 0.8747 30780 Urban

      0.8747 Arkansas. 04600............ Randolph County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04610............ St Francis County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04620............ Saline County,

      4400 Urban

      0.8747 0.8747 30780 Urban

      0.8747 Arkansas. 04630............ Scott County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04640............ Searcy County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04650............ Sebastian County,

      2720 Urban

      0.8246 0.8230 22900 Urban

      0.8238 Arkansas. 04660............ Sevier County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04670............ Sharp County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04680............ Stone County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04690............ Union County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04700............ Van Buren County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04710............ Washington County,

      2580 Urban

      0.8661 0.8661 22220 Urban

      0.8661 Arkansas. 04720............ White County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04730............ Woodruff County,

      04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 Arkansas. 04740............ Yell County, Arkansas 04 Rural

      0.7744 0.7466 99904 Rural

      0.7605 05000............ Alameda County,

      5775 Urban

      1.5346 1.5346 36084 Urban

      1.5346 California. 05010............ Alpine County,

      05 Rural

      1.0775 1.1054 99905 Rural

      1.0915 California. 05020............ Amador County,

      05 Rural

      1.0775 1.1054 99905 Rural

      1.0915 California. 05030............ Butte County,

      1620 Urban

      1.0511 1.0511 17020 Urban

      1.0511 California. 05040............ Calaveras County,

      05 Rural

      1.0775 1.1054 99905 Rural

      1.0915 California. 05050............ Colusa County,

      05 Rural

      1.0775 1.1054 99905 Rural

      1.0915 California. 05060............ Contra Costa County, 5775 Urban

      1.5346 1.5346 36084 Urban

      1.5346 California. 05070............ Del Norte County,

      05 Rural

      1.0775 1.1054 99905 Rural

      1.0915 California. 05080............ Eldorado County,

      6920 Urban

      1.3143 1.2969 40900 Urban

      1.3056 California. 05090............ Fresno County,

      2840 Urban

      1.0428 1.0538 23420 Urban

      1.0483 California. 05100............ Glenn County,

      05 Rural

      1.0775 1.1054 99905 Rural

      1.0915 California. 05110............ Humboldt County,

      05 Rural

      1.0775 1.1054 99905 Rural

      1.0915 California. 05120............ Imperial County,

      05 Rural

      1.0775 0.8906 20940 Urban

      0.9841 California. 05130............ Inyo County,

      05 Rural

      1.0775 1.1054 99905 Rural

      1.0915 California. 05140............ Kern County,

      0680 Urban

      1.0470 1.0470 12540 Urban

      1.0470 California. 05150............ Kings County,

      05 Rural

      1.0775 1.0036 25260 Urban

      1.0406 California. 05160............ Lake County,

      05 Rural

      1.0775 1.1054 99905 Rural

      1.0915 California. 05170............ Lassen County,

      05 Rural

      1.0775 1.1054 99905 Rural

      1.0915 California. 05200............ Los Angeles County, 4480 Urban

      1.1783 1.1783 31084 Urban

      1.1783 California. 05210............ Los Angeles County, 4480 Urban

      1.1783 1.1783 31084 Urban

      1.1783 California. 05300............ Madera County,

      2840 Urban

      1.0428 0.8713 31460 Urban

      0.9571 California. 05310............ Marin County,

      7360 Urban

      1.4994 1.4994 41884 Urban

      1.4994 California. 05320............ Mariposa County,

      05 Rural

      1.0775 1.1054 99905 Rural

      1.0915 California. 05330............ Mendocino County,

      05 Rural

      1.0775 1.1054 99905 Rural

      1.0915 California. 05340............ Merced County,

      4940 Urban

      1.1109 1.1109 32900 Urban

      1.1109 California. 05350............ Modoc County,

      05 Rural

      1.0775 1.1054 99905 Rural

      1.0915 California. 05360............ Mono County,

      05 Rural

      1.0775 1.1054 99905 Rural

      1.0915 California. 05370............ Monterey County,

      7120 Urban

      1.4128 1.4128 41500 Urban

      1.4128 California. 05380............ Napa County,

      8720 Urban

      1.3983 1.2643 34900 Urban

      1.3313 California. 05390............ Nevada County,

      05 Rural

      1.0775 1.1054 99905 Rural

      1.0915 California. 05400............ Orange County,

      5945 Urban

      1.1559 1.1559 42044 Urban

      1.1559 California. 05410............ Placer County,

      6920 Urban

      1.3143 1.2969 40900 Urban

      1.3056 California. 05420............ Plumas County,

      05 Rural

      1.0775 1.1054 99905 Rural

      1.0915 California. 05430............ Riverside County,

      6780 Urban

      1.1027 1.1027 40140 Urban

      1.1027 California. 05440............ Sacramento County,

      6920 Urban

      1.3143 1.2969 40900 Urban

      1.3056 California. 05450............ San Benito County,

      05 Rural

      1.0775 1.5099 41940 Urban

      1.2937 California. 05460............ San Bernardino

      6780 Urban

      1.1027 1.1027 40140 Urban

      1.1027 County, California.

      [[Page 45083]]

      05470............ San Diego County,

      7320 Urban

      1.1413 1.1413 41740 Urban

      1.1413 California. 05480............ San Francisco County, 7360 Urban

      1.4994 1.4994 41884 Urban

      1.4994 California. 05490............ San Joaquin County, 8120 Urban

      1.1307 1.1307 44700 Urban

      1.1307 California. 05500............ San Luis Obispo

      7460 Urban

      1.1349 1.1349 42020 Urban

      1.1349 County, California. 05510............ San Mateo County,

      7360 Urban

      1.4994 1.4994 41884 Urban

      1.4994 California. 05520............ Santa Barbara County, 7480 Urban

      1.1694 1.1694 42060 Urban

      1.1694 California. 05530............ Santa Clara County, 7400 Urban

      1.5118 1.5099 41940 Urban

      1.5109 California. 05540............ Santa Cruz County,

      7485 Urban

      1.5166 1.5166 42100 Urban

      1.5166 California. 05550............ Shasta County,

      6690 Urban

      1.2203 1.2203 39820 Urban

      1.2203 California. 05560............ Sierra County,

      05 Rural

      1.0775 1.1054 99905 Rural

      1.0915 California. 05570............ Siskiyou County,

      05 Rural

      1.0775 1.1054 99905 Rural

      1.0915 California. 05580............ Solano County,

      8720 Urban

      1.3983 1.4936 46700 Urban

      1.4460 California. 05590............ Sonoma County,

      7500 Urban

      1.3493 1.3493 42220 Urban

      1.3493 California. 05600............ Stanislaus County,

      5170 Urban

      1.1885 1.1885 33700 Urban

      1.1885 California. 05610............ Sutter County,

      9340 Urban

      1.0921 1.0921 49700 Urban

      1.0921 California. 05620............ Tehama County,

      05 Rural

      1.0775 1.1054 99905 Rural

      1.0915 California. 05630............ Trinity County,

      05 Rural

      1.0775 1.1054 99905 Rural

      1.0915 California. 05640............ Tulare County,

      8780 Urban

      1.0123 1.0123 47300 Urban

      1.0123 California. 05650............ Tuolumne County,

      05 Rural

      1.0775 1.1054 99905 Rural

      1.0915 California. 05660............ Ventura County,

      8735 Urban

      1.1622 1.1622 37100 Urban

      1.1622 California. 05670............ Yolo County,

      9270 Urban

      0.9950 1.2969 40900 Urban

      1.1460 California. 05680............ Yuba County,

      9340 Urban

      1.0921 1.0921 49700 Urban

      1.0921 California. 06000............ Adams County,

      2080 Urban

      1.0723 1.0723 19740 Urban

      1.0723 Colorado. 06010............ Alamosa County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06020............ Arapahoe County,

      2080 Urban

      1.0723 1.0723 19740 Urban

      1.0723 Colorado. 06030............ Archuleta County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 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,

      1125 Urban

      0.9734 0.9734 14500 Urban

      0.9734 Colorado. 06070............ Chaffee County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06080............ Cheyenne County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06090............ Clear Creek County,

      06 Rural

      0.9380 1.0723 19740 Urban

      1.0052 Colorado. 06100............ Conejos County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06110............ Costilla County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06120............ Crowley County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06130............ Custer County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06140............ Delta County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06150............ Denver County,

      2080 Urban

      1.0723 1.0723 19740 Urban

      1.0723 Colorado. 06160............ Dolores County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06170............ Douglas County,

      2080 Urban

      1.0723 1.0723 19740 Urban

      1.0723 Colorado. 06180............ Eagle County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06190............ Elbert County,

      06 Rural

      0.9380 1.0723 19740 Urban

      1.0052 Colorado. 06200............ El Paso County,

      1720 Urban

      0.9468 0.9468 17820 Urban

      0.9468 Colorado. 06210............ Fremont County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06220............ Garfield County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06230............ Gilpin County,

      06 Rural

      0.9380 1.0723 19740 Urban

      1.0052 Colorado. 06240............ Grand County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06250............ Gunnison County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06260............ Hinsdale County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06270............ Huerfano County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06280............ Jackson County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06290............ Jefferson County,

      2080 Urban

      1.0723 1.0723 19740 Urban

      1.0723 Colorado. 06300............ Kiowa County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06310............ Kit Carson County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06320............ Lake County, Colorado 06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 06330............ La Plata County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06340............ Larimer County,

      2670 Urban

      1.0122 1.0122 22660 Urban

      1.0122 Colorado. 06350............ Las Animas County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06360............ Lincoln County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06370............ Logan County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06380............ Mesa County, Colorado 2995 Urban

      0.9550 0.9550 24300 Urban

      0.9550 06390............ Mineral County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06400............ Moffat County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06410............ Montezuma County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06420............ Montrose County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06430............ Morgan County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06440............ Otero County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06450............ Ouray County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado.

      [[Page 45084]]

      06460............ Park County, Colorado 06 Rural

      0.9380 1.0723 19740 Urban

      1.0052 06470............ Phillips County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06480............ Pitkin County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06490............ Prowers County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06500............ Pueblo County,

      6560 Urban

      0.8623 0.8623 39380 Urban

      0.8623 Colorado. 06510............ Rio Blanco County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06520............ Rio Grande County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06530............ Routt County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06540............ Saguache County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06550............ San Juan County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06560............ San Miguel County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06570............ Sedgwick County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06580............ Summit County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 06590............ Teller County,

      06 Rural

      0.9380 0.9468 17820 Urban

      0.9424 Colorado. 06600............ Washington County,

      06 Rural

      0.9380 0.9380 99906 Rural

      0.9380 Colorado. 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,

      2080 Urban

      1.0723 1.0723 19740 Urban

      1.0723 Colorado. 07000............ Fairfield County,

      5483 Urban

      1.2196 1.2592 14860 Urban

      1.2394 Connecticut. 07010............ Hartford County,

      3283 Urban

      1.1073 1.1073 25540 Urban

      1.1073 Connecticut. 07020............ Litchfield County,

      3283 Urban

      1.1073 1.1073 25540 Urban

      1.1073 Connecticut. 07030............ Middlesex County,

      3283 Urban

      1.1073 1.1073 25540 Urban

      1.1073 Connecticut. 07040............ New Haven County,

      5483 Urban

      1.2196 1.1887 35300 Urban

      1.2042 Connecticut. 07050............ New London County,

      5523 Urban

      1.1345 1.1345 35980 Urban

      1.1345 Connecticut. 07060............ Tolland County,

      3283 Urban

      1.1073 1.1073 25540 Urban

      1.1073 Connecticut. 07070............ Windham County,

      07 Rural

      1.1730 1.1730 99907 Rural

      1.1730 Connecticut. 08000............ Kent County, Delaware 2190 Urban

      0.9776 0.9776 20100 Urban

      0.9776 08010............ New Castle County,

      9160 Urban

      1.0527 1.0471 48864 Urban

      1.0499 Delaware. 08020............ Sussex County,

      08 Rural

      0.9579 0.9579 99908 Rural

      0.9579 Delaware. 09000............ Washington Dc County, 8840 Urban

      1.0976 1.0926 47894 Urban

      1.0951 Dist Of Col. 10000............ Alachua County,

      2900 Urban

      0.9388 0.9388 23540 Urban

      0.9388 Florida. 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,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 10040............ Brevard County,

      4900 Urban

      0.9839 0.9839 37340 Urban

      0.9839 Florida. 10050............ Broward County,

      2680 Urban

      1.0432 1.0432 22744 Urban

      1.0432 Florida. 10060............ Calhoun County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 10070............ Charlotte County,

      6580 Urban

      0.9255 0.9255 39460 Urban

      0.9255 Florida. 10080............ Citrus County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 10090............ Clay County, Florida. 3600 Urban

      0.9299 0.9290 27260 Urban

      0.9295 10100............ Collier County,

      5345 Urban

      1.0139 1.0139 34940 Urban

      1.0139 Florida. 10110............ Columbia County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 10120............ Dade County, Florida. 5000 Urban

      0.9750 0.9750 33124 Urban

      0.9750 10130............ De Soto County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 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,

      6080 Urban

      0.8096 0.8096 37860 Urban

      0.8096 Florida. 10170............ Flagler County,

      2020 Urban

      0.9325 0.8568 99910 Rural

      0.8947 Florida. 10180............ Franklin County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 10190............ Gadsden County,

      8240 Urban

      0.8688 0.8688 45220 Urban

      0.8688 Florida. 10200............ Gilchrist County,

      10 Rural

      0.8677 0.9388 23540 Urban

      0.9033 Florida. 10210............ Glades County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 10220............ Gulf County, Florida. 10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 10230............ Hamilton County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 10240............ Hardee County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 10250............ Hendry County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 10260............ Hernando County,

      8280 Urban

      0.9233 0.9233 45300 Urban

      0.9233 Florida. 10270............ Highlands County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 10280............ Hillsborough County, 8280 Urban

      0.9233 0.9233 45300 Urban

      0.9233 Florida. 10290............ Holmes County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 10300............ Indian River County,

      10 Rural

      0.8677 0.9434 46940 Urban

      0.9056 Florida. 10310............ Jackson County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 10320............ Jefferson County,

      10 Rural

      0.8677 0.8688 45220 Urban

      0.8683 Florida. 10330............ Lafayette County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 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

      [[Page 45085]]

      10380............ Liberty County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 10390............ Madison County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 10400............ Manatee County,

      7510 Urban

      0.9639 0.9639 42260 Urban

      0.9639 Florida. 10410............ Marion County,

      5790 Urban

      0.8925 0.8925 36100 Urban

      0.8925 Florida. 10420............ Martin County,

      2710 Urban

      1.0123 1.0123 38940 Urban

      1.0123 Florida. 10430............ Monroe County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 10440............ Nassau County,

      3600 Urban

      0.9299 0.9290 27260 Urban

      0.9295 Florida. 10450............ Okaloosa County,

      2750 Urban

      0.8872 0.8872 23020 Urban

      0.8872 Florida. 10460............ Okeechobee County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 10470............ Orange County,

      5960 Urban

      0.9464 0.9464 36740 Urban

      0.9464 Florida. 10480............ Osceola County,

      5960 Urban

      0.9464 0.9464 36740 Urban

      0.9464 Florida. 10490............ Palm Beach County,

      8960 Urban

      1.0067 1.0067 48424 Urban

      1.0067 Florida. 10500............ Pasco County, Florida 8280 Urban

      0.9233 0.9233 45300 Urban

      0.9233 10510............ Pinellas County,

      8280 Urban

      0.9233 0.9233 45300 Urban

      0.9233 Florida. 10520............ Polk County, Florida. 3980 Urban

      0.8912 0.8912 29460 Urban

      0.8912 10530............ Putnam County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 10540............ Johns County, Florida 3600 Urban

      0.9299 0.9290 27260 Urban

      0.9295 10550............ St Lucie County,

      2710 Urban

      1.0123 1.0123 38940 Urban

      1.0123 Florida. 10560............ Santa Rosa County,

      6080 Urban

      0.8096 0.8096 37860 Urban

      0.8096 Florida. 10570............ Sarasota County,

      7510 Urban

      0.9639 0.9639 42260 Urban

      0.9639 Florida. 10580............ Seminole County,

      5960 Urban

      0.9464 0.9464 36740 Urban

      0.9464 Florida. 10590............ Sumter County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 10600............ Suwannee County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 10610............ Taylor County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 10620............ Union County, Florida 10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 10630............ Volusia County,

      2020 Urban

      0.9325 0.9299 19660 Urban

      0.9312 Florida. 10640............ Wakulla County,

      10 Rural

      0.8677 0.8688 45220 Urban

      0.8683 Florida. 10650............ Walton County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 10660............ Washington County,

      10 Rural

      0.8677 0.8568 99910 Rural

      0.8623 Florida. 11000............ Appling County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11010............ Atkinson County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 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,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11040............ Banks County, Georgia 11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 11050............ Barrow County,

      0520 Urban

      0.9793 0.9793 12060 Urban

      0.9793 Georgia. 11060............ Bartow County,

      0520 Urban

      0.9793 0.9793 12060 Urban

      0.9793 Georgia. 11070............ Ben Hill County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11080............ Berrien County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11090............ Bibb County, Georgia. 4680 Urban

      0.9277 0.9443 31420 Urban

      0.9360 11100............ Bleckley County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11110............ Brantley County,

      11 Rural

      0.8166 0.9311 15260 Urban

      0.8739 Georgia. 11120............ Brooks County,

      11 Rural

      0.8166 0.8866 46660 Urban

      0.8516 Georgia. 11130............ Bryan County, Georgia 7520 Urban

      0.9461 0.9461 42340 Urban

      0.9461 11140............ Bulloch County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 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,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11170............ Camden County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11180............ Candler County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11190............ Carroll County,

      0520 Urban

      0.9793 0.9793 12060 Urban

      0.9793 Georgia. 11200............ Catoosa County,

      1560 Urban

      0.9088 0.9088 16860 Urban

      0.9088 Georgia. 11210............ Charlton County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11220............ Chatham County,

      7520 Urban

      0.9461 0.9461 42340 Urban

      0.9461 Georgia. 11230............ Chattahoochee County, 1800 Urban

      0.8560 0.8560 17980 Urban

      0.8560 Georgia. 11240............ Chattooga County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11250............ Cherokee County,

      0520 Urban

      0.9793 0.9793 12060 Urban

      0.9793 Georgia. 11260............ Clarke County,

      0500 Urban

      0.9855 0.9855 12020 Urban

      0.9855 Georgia. 11270............ Clay County, Georgia. 11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 11280............ Clayton County,

      0520 Urban

      0.9793 0.9793 12060 Urban

      0.9793 Georgia. 11281............ Clinch County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11290............ Cobb County, Georgia. 0520 Urban

      0.9793 0.9793 12060 Urban

      0.9793 11291............ Coffee County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11300............ Colquitt County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11310............ Columbia County,

      0600 Urban

      0.9808 0.9748 12260 Urban

      0.9778 Georgia. 11311............ Cook County, Georgia. 11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 11320............ Coweta County,

      0520 Urban

      0.9793 0.9793 12060 Urban

      0.9793 Georgia. 11330............ Crawford County,

      11 Rural

      0.8166 0.9443 31420 Urban

      0.8805 Georgia.

      [[Page 45086]]

      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,

      11 Rural

      0.8166 0.9793 12060 Urban

      0.8980 Georgia. 11360............ Decatur County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11370............ De Kalb County,

      0520 Urban

      0.9793 0.9793 12060 Urban

      0.9793 Georgia. 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,

      0120 Urban

      0.8628 0.8628 10500 Urban

      0.8628 Georgia. 11400............ Douglas County,

      0520 Urban

      0.9793 0.9793 12060 Urban

      0.9793 Georgia. 11410............ Early County, Georgia 11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 11420............ Echols County,

      11 Rural

      0.8166 0.8866 46660 Urban

      0.8516 Georgia. 11421............ Effingham County,

      7520 Urban

      0.9461 0.9461 42340 Urban

      0.9461 Georgia. 11430............ Elbert County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11440............ Emanuel County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11441............ Evans County, Georgia 11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 11450............ Fannin County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11451............ Fayette County,

      0520 Urban

      9793 0.9793 12060 Urban

      0.9793 Georgia. 11460............ Floyd County, Georgia 11 Rural

      0.8166 0.9414 40660 Urban

      0.8790 11461............ Forsyth County,

      0520 Urban

      0.9793 0.9793 12060 Urban

      0.9793 Georgia. 11462............ Franklin County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11470............ Fulton County,

      0520 Urban

      0.9793 0.9793 12060 Urban

      0.9793 Georgia. 11471............ Gilmer County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11480............ Glascock County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11490............ Glynn County, Georgia 11 Rural

      0.8166 0.9311 15260 Urban

      0.8739 11500............ Gordon County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11510............ Grady County, Georgia 11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 11520............ Greene County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11530............ Gwinnett County,

      0520 Urban

      0.9793 0.9793 12060 Urban

      0.9793 Georgia. 11540............ Habersham County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11550............ Hall County, Georgia. 11 Rural

      0.8166 0.8874 23580 Urban

      0.8520 11560............ Hancock County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11570............ Haralson County,

      11 Rural

      0.8166 0.9793 12060 Urban

      0.8980 Georgia. 11580............ Harris County,

      1800 Urban

      0.8560 0.8560 17980 Urban

      0.8560 Georgia. 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,

      4680 Urban

      0.9277 0.8645 47580 Urban

      0.8961 Georgia. 11601............ Irwin County, Georgia 11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 11610............ Jackson County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11611............ Jasper County,

      11 Rural

      0.8166 0.9793 12060 Urban

      0.8980 Georgia. 11612............ Jeff Davis County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11620............ Jefferson County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11630............ Jenkins County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11640............ Johnson County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 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,

      11 Rural

      0.8166 0.8866 46660 Urban

      0.8516 Georgia. 11660............ Laurens County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11670............ Lee County, Georgia.. 0120 Urban

      0.8628 0.8628 10500 Urban

      0.8628 11680............ Liberty County,

      11 Rural

      0.8166 (\1\) 25980 Urban

      0.8973 Georgia. 11690............ Lincoln County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11691............ Long County, Georgia. 11 Rural

      0.8166 (\1\) 25980 Urban

      0.8973 11700............ Lowndes County,

      11 Rural

      0.8166 0.8866 46660 Urban

      0.8516 Georgia. 11701............ Lumpkin County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11702............ Mc Duffie County,

      0600 Urban

      0.9808 0.9748 12260 Urban

      0.9778 Georgia. 11703............ Mc Intosh County,

      11 Rural

      0.8166 0.9311 15260 Urban

      0.8739 Georgia. 11710............ Macon County, Georgia 11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 11720............ Madison County,

      0500 Urban

      0.9855 0.9855 12020 Urban

      0.9855 Georgia. 11730............ Marion County,

      11 Rural

      0.8166 0.8560 17980 Urban

      0.8363 Georgia. 11740............ Meriwether County,

      11 Rural

      0.8166 0.9793 12060 Urban

      0.8980 Georgia. 11741............ Miller County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11750............ Mitchell County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11760............ Monroe County,

      11 Rural

      0.8166 0.9443 31420 Urban

      0.8805 Georgia. 11770............ Montgomery County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11771............ Morgan County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11772............ Murray County,

      11 Rural

      0.8166 0.9079 19140 Urban

      0.8623 Georgia. 11780............ Muscogee County,

      1800 Urban

      0.8560 0.8560 17980 Urban

      0.8560 Georgia. 11790............ Newton County,

      0520 Urban

      0.9793 0.9793 12060 Urban

      0.9793 Georgia.

      [[Page 45087]]

      11800............ Oconee County,

      0500 Urban

      0.9855 0.9855 12020 Urban

      0.9855 Georgia. 11801............ Oglethorpe County,

      11 Rural

      0.8166 0.9855 12020 Urban

      0.9011 Georgia. 11810............ Paulding County,

      0520 Urban

      0.9793 0.9793 12060 Urban

      0.9793 Georgia. 11811............ Peach County, Georgia 4680 Urban

      0.9277 0.7662 99911 Rural

      0.8470 11812............ Pickens County,

      0520 Urban

      0.9793 0.9793 12060 Urban

      0.9793 Georgia. 11820............ Pierce County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 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,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11832............ Putnam County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11833............ Quitman County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11834............ Rabun County, Georgia 11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 11835............ Randolph County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11840............ Richmond County,

      0600 Urban

      0.9808 0.9748 12260 Urban

      10.9778 Georgia. 11841............ Rockdale County,

      0520 Urban

      0.9793 0.9793 12060 Urban

      0.9793 Georgia. 11842............ Schley County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11850............ Screven County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11851............ Seminole County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11860............ Spalding County,

      0520 Urban

      0.9793 0.9793 12060 Urban

      0.9793 Georgia. 11861............ Stephens County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11862............ Stewart County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11870............ Sumter County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11880............ Talbot County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11881............ Taliaferro County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11882............ Tattnall County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11883............ Taylor County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11884............ Telfair County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11885............ Terrell County,

      11 Rural

      0.8166 0.8628 10500 Urban

      0.8397 Georgia. 11890............ Thomas County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11900............ Tift County, Georgia. 11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 11901............ Toombs County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11902............ Towns County, Georgia 11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 11903............ Treutlen County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11910............ Troup County, Georgia 11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 11911............ Turner County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11912............ Twiggs County,

      4680 Urban

      0.9277 0.9443 31420 Urban

      0.9360 Georgia. 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,

      1560 Urban

      0.9088 0.9088 16860 Urban

      0.9088 Georgia. 11930............ Walton County,

      0520 Urban

      0.9793 0.9793 12060 Urban

      0.9793 Georgia. 11940............ Ware County, Georgia. 11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 11941............ Warren County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11950............ Washington County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11960............ Wayne County, Georgia 11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 11961............ Webster County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11962............ Wheeler County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11963............ White County, Georgia 11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 11970............ Whitfield County,

      11 Rural

      0.8166 0.9079 19140 Urban

      0.8623 Georgia. 11971............ Wilcox County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11972............ Wilkes County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11973............ Wilkinson County,

      11 Rural

      0.8166 0.7662 99911 Rural

      0.7914 Georgia. 11980............ Worth County, Georgia 11 Rural

      0.8166 0.8628 10500 Urban

      0.8397 12005............ Kalawao County,

      12 Rural

      1.0551 1.0551 99912 Rural

      1.0551 Hawaii. 12010............ Hawaii County, Hawaii 12 Rural

      1.0551 1.0551 99912 Rural

      1.0551 12020............ Honolulu County,

      3320 Urban

      1.1214 1.1214 26180 Urban

      1.1214 Hawaii. 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,

      13 Rural

      0.9097 0.8037 99913 Rural

      0.8567 Idaho. 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,

      13 Rural

      0.9097 0.9420 26820 Urban

      0.9259 Idaho. 13100............ Boundary County,

      13 Rural

      0.9097 0.8037 99913 Rural

      0.8567 Idaho.

      [[Page 45088]]

      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,

      13 Rural

      0.9097 0.8037 99913 Rural

      0.8567 Idaho. 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,

      13 Rural

      0.9097 0.9164 30860 Urban

      0.9131 Idaho. 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,

      13 Rural

      0.9097 0.9420 26820 Urban

      0.9259 Idaho. 13260............ Jerome County, Idaho. 13 Rural

      0.9097 0.8037 99913 Rural

      0.8567 13270............ Kootenai County,

      13 Rural

      0.9097 0.9647 17660 Urban

      0.9372 Idaho. 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,

      13 Rural

      0.9097 0.8037 99913 Rural

      0.8567 Idaho. 13340............ Nez Perce County,

      13 Rural

      0.9097 0.9886 30300 Urban

      0.9492 Idaho. 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,

      13 Rural

      0.9097 0.8037 99913 Rural

      0.8567 Idaho. 13400............ Teton County, Idaho.. 13 Rural

      0.9097 0.8037 99913 Rural

      0.8567 13410............ Twin Falls County,

      13 Rural

      0.9097 0.8037 99913 Rural

      0.8567 Idaho. 13420............ Valley County, Idaho. 13 Rural

      0.9097 0.8037 99913 Rural

      0.8567 13430............ Washington County,

      13 Rural

      0.9097 0.8037 99913 Rural

      0.8567 Idaho. 14000............ Adams County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14010............ Alexander County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14020............ Bond County, Illinois 14 Rural

      0.8301 0.8954 41180 Urban

      0.8628 14030............ Boone County,

      6880 Urban

      0.9984 0.9984 40420 Urban

      0.9984 Illinois. 14040............ Brown County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14050............ Bureau County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14060............ Calhoun County,

      14 Rural

      0.8301 0.8954 41180 Urban

      0.8628 Illinois. 14070............ Carroll County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14080............ Cass County, Illinois 14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 14090............ Champaign County,

      1400 Urban

      0.9594 0.9594 16580 Urban

      0.9594 Illinois. 14100............ Christian County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14110............ Clark County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14120............ Clay County, Illinois 14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 14130............ Clinton County,

      7040 Urban

      0.8962 0.8954 41180 Urban

      0.8958 Illinois. 14140............ Coles County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14141............ Cook County, Illinois 1600 Urban

      1.0783 1.0790 16974 Urban

      1.0787 14150............ Crawford County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14160............ Cumberland County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14170............ De Kalb County,

      1600 Urban

      1.0783 1.0790 16974 Urban

      1.0787 Illinois. 14180............ De Witt County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14190............ Douglas County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14250............ Du Page County,

      1600 Urban

      1.0783 1.0790 16974 Urban

      1.0787 Illinois. 14310............ Edgar County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14320............ Edwards County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14330............ Effingham County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14340............ Fayette County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14350............ Ford County, Illinois 14 Rural

      0.8301 0.9594 16580 Urban

      0.8948 14360............ Franklin County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14370............ Fulton County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14380............ Gallatin County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14390............ Greene County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14400............ Grundy County,

      1600 Urban

      1.0783 1.0790 16974 Urban

      1.0787 Illinois. 14410............ Hamilton County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14420............ Hancock County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14421............ Hardin County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois.

      [[Page 45089]]

      14440............ Henderson County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14450............ Henry County,

      1960 Urban

      0.8724 0.8724 19340 Urban

      0.8724 Illinois. 14460............ Iroquois County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14470............ Jackson County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14480............ Jasper County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14490............ Jefferson County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14500............ Jersey County,

      7040 Urban

      0.8962 0.8954 41180 Urban

      0.8958 Illinois. 14510............ Jo Daviess County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14520............ Johnson County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14530............ Kane County, Illinois 1600 Urban

      1.0783 1.0790 16974 Urban

      1.0787 14540............ Kankakee County,

      3740 Urban

      1.0721 1.0721 28100 Urban

      1.0721 Illinois. 14550............ Kendall County,

      1600 Urban

      1.0783 1.0790 16974 Urban

      1.0787 Illinois. 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,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14590............ Lawrence County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14600............ Lee County, Illinois. 14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 14610............ Livingston County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14620............ Logan County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14630............ Mc Donough County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14640............ Mc Henry County,

      1600 Urban

      1.0783 1.0790 16974 Urban

      1.0787 Illinois. 14650............ Mclean County,

      1040 Urban

      0.9075 0.9075 14060 Urban

      0.9075 Illinois. 14660............ Macon County,

      2040 Urban

      0.8067 0.8067 19500 Urban

      0.8067 Illinois. 14670............ Macoupin County,

      14 Rural

      0.8301 0.8954 41180 Urban

      0.8628 Illinois. 14680............ Madison County,

      7040 Urban

      0.8962 0.8954 41180 Urban

      0.8958 Illinois. 14690............ Marion County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14700............ Marshall County,

      14 Rural

      0.8301 0.8870 37900 Urban

      0.8586 Illinois. 14710............ Mason County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14720............ Massac County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14730............ Menard County,

      7880 Urban

      0.8792 0.8792 44100 Urban

      0.8792 Illinois. 14740............ Mercer County,

      14 Rural

      0.8301 0.8724 19340 Urban

      0.8513 Illinois. 14750............ Monroe County,

      7040 Urban

      0.8962 0.8954 41180 Urban

      0.8958 Illinois. 14760............ Montgomery County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14770............ Morgan County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14780............ Moultrie County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14790............ Ogle County, Illinois 6880 Urban

      0.9984 0.8271 99914 Rural

      0.9128 14800............ Peoria County,

      6120 Urban

      0.8870 0.8870 37900 Urban

      0.8870 Illinois. 14810............ Perry County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14820............ Piatt County,

      14 Rural

      0.8301 0.9594 16580 Urban

      0.8948 Illinois. 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,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14860............ Putnam County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14870............ Randolph County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14880............ Richland County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14890............ Rock Island County, 1960 Urban

      0.8724 0.8724 19340 Urban

      0.8724 Illinois. 14900............ St Clair County,

      7040 Urban

      0.8962 0.8954 41180 Urban

      0.8958 Illinois. 14910............ Saline County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14920............ Sangamon County,

      7880 Urban

      0.8792 0.8792 44100 Urban

      0.8792 Illinois. 14921............ Schuyler County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14940............ Scott County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14950............ Shelby County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14960............ Stark County,

      14 Rural

      0.8301 0.8870 37900 Urban

      0.8586 Illinois. 14970............ Stephenson County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14980............ Tazewell County,

      6120 Urban

      0.8870 0.8870 37900 Urban

      0.8870 Illinois. 14981............ Union County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14982............ Vermilion County,

      14 Rural

      0.8301 0.9028 19180 Urban

      0.8665 Illinois. 14983............ Wabash County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14984............ Warren County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14985............ Washington County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14986............ Wayne County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14987............ White County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14988............ Whiteside County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14989............ Will County, Illinois 1600 Urban

      1.0783 1.0790 16974 Urban

      1.0787 14990............ Williamson County,

      14 Rural

      0.8301 0.8271 99914 Rural

      0.8286 Illinois. 14991............ Winnebago County,

      6880 Urban

      0.9984 0.9984 40420 Urban

      0.9984 Illinois. 14992............ Woodford County,

      6120 Urban

      0.8870 0.8870 37900 Urban

      0.8870 Illinois. 15000............ Adams County, Indiana 2760 Urban

      0.9706 0.8624 99915 Rural

      0.9165

      [[Page 45090]]

      15010............ Allen County, Indiana 2760 Urban

      0.9706 0.9793 23060 Urban

      0.9750 15020............ Bartholomew County,

      15 Rural

      0.8739 0.9588 18020 Urban

      0.9164 Indiana. 15030............ Benton County,

      15 Rural

      0.8739 0.8736 29140 Urban

      0.8738 Indiana. 15040............ Blackford County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 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,

      15 Rural

      0.8739 0.8736 29140 Urban

      0.8738 Indiana. 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,

      3920 Urban

      0.8736 0.8624 99915 Rural

      0.8680 Indiana. 15120............ Crawford County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15130............ Daviess County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15140............ Dearborn County,

      1640 Urban

      0.9734 0.9615 17140 Urban

      0.9675 Indiana. 15150............ Decatur County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15160............ De Kalb County,

      2760 Urban

      0.9706 0.8624 99915 Rural

      0.9165 Indiana. 15170............ Delaware County,

      5280 Urban

      0.8930 0.8930 34620 Urban

      0.8930 Indiana. 15180............ Dubois County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15190............ Elkhart County,

      2330 Urban

      0.9627 0.9627 21140 Urban

      0.9627 Indiana. 15200............ Fayette County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15210............ Floyd County, Indiana 4520 Urban

      0.9293 0.9251 31140 Urban

      0.9272 15220............ Fountain County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15230............ Franklin County,

      15 Rural

      0.8739 0.9615 17140 Urban

      0.9177 Indiana. 15240............ Fulton County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15250............ Gibson County,

      15 Rural

      0.8739 0.8713 21780 Urban

      0.8726 Indiana. 15260............ Grant County, Indiana 15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 15270............ Greene County,

      15 Rural

      0.8739 0.8447 14020 Urban

      0.8593 Indiana. 15280............ Hamilton County,

      3480 Urban

      0.9865 0.9920 26900 Urban

      0.9893 Indiana. 15290............ Hancock County,

      3480 Urban

      0.9865 0.9920 26900 Urban

      0.9893 Indiana. 15300............ Harrison County,

      4520 Urban

      0.9293 0.9251 31140 Urban

      0.9272 Indiana. 15310............ Hendricks County,

      3480 Urban

      0.9865 0.9920 26900 Urban

      0.9893 Indiana. 15320............ Henry County, Indiana 15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 15330............ Howard County,

      3850 Urban

      0.9508 0.9508 29020 Urban

      0.9508 Indiana. 15340............ Huntington County,

      2760 Urban

      0.9706 0.8624 99915 Rural

      0.9165 Indiana. 15350............ Jackson County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15360............ Jasper County,

      15 Rural

      0.8739 0.9395 23844 Urban

      0.9067 Indiana. 15370............ Jay County, Indiana.. 15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 15380............ Jefferson County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15390............ Jennings County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15400............ Johnson County,

      3480 Urban

      0.9865 0.9920 26900 Urban

      0.9893 Indiana. 15410............ Knox County, Indiana. 15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 15420............ Kosciusko County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15430............ Lagrange County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15440............ Lake County, Indiana. 2960 Urban

      0.9395 0.9395 23844 Urban

      0.9395 15450............ La Porte County,

      15 Rural

      0.8739 0.9399 33140 Urban

      0.9069 Indiana. 15460............ Lawrence County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15470............ Madison County,

      3480 Urban

      0.9865 0.8586 11300 Urban

      0.9226 Indiana. 15480............ Marion County,

      3480 Urban

      0.9865 0.9920 26900 Urban

      0.9893 Indiana. 15490............ Marshall County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15500............ Martin County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15510............ Miami County, Indiana 15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 15520............ Monroe County,

      1020 Urban

      0.8447 0.8447 14020 Urban

      0.8447 Indiana. 15530............ Montgomery County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15540............ Morgan County,

      3480 Urban

      0.9865 0.9920 26900 Urban

      0.9893 Indiana. 15550............ Newton County,

      15 Rural

      0.8739 0.9395 23844 Urban

      0.9067 Indiana. 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,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 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,

      2960 Urban

      0.9395 0.9395 23844 Urban

      0.9395 Indiana. 15640............ Posey County, Indiana 2440 Urban

      0.8713 0.8713 21780 Urban

      0.8713 15650............ Pulaski County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15660............ Putnam County,

      15 Rural

      0.8739 0.9920 26900 Urban

      0.9330 Indiana. 15670............ Randolph County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15680............ Ripley County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana.

      [[Page 45091]]

      15690............ Rush County, Indiana. 15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 15700............ St Joseph County,

      7800 Urban

      0.9788 0.9788 43780 Urban

      0.9788 Indiana. 15710............ Scott County, Indiana 4520 Urban

      0.9293 0.8624 99915 Rural

      0.8959 15720............ Shelby County,

      3480 Urban

      0.9865 0.9920 26900 Urban

      0.9893 Indiana. 15730............ Spencer County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15740............ Starke County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15750............ Steuben County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15760............ Sullivan County,

      15 Rural

      0.8739 0.8304 45460 Urban

      0.8522 Indiana. 15770............ Switzerland County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15780............ Tippecanoe County,

      3920 Urban

      0.8736 0.8736 29140 Urban

      0.8736 Indiana. 15790............ Tipton County,

      3850 Urban

      0.9508 0.9508 29020 Urban

      0.9508 Indiana. 15800............ Union County, Indiana 15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 15810............ Vanderburgh County, 2440 Urban

      0.8713 0.8713 21780 Urban

      0.8713 Indiana. 15820............ Vermillion County,

      8320 Urban

      0.8337 0.8304 45460 Urban

      0.8321 Indiana. 15830............ Vigo County, Indiana. 8320 Urban

      0.8337 0.8304 45460 Urban

      0.8321 15840............ Wabash County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15850............ Warren County,

      15 Rural

      0.8739 0.8624 99915 Rural

      0.8682 Indiana. 15860............ Warrick County,

      2440 Urban

      0.8713 0.8713 21780 Urban

      0.8713 Indiana. 15870............ Washington County,

      15 Rural

      0.8739 0.9251 31140 Urban

      0.8995 Indiana. 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,

      2760 Urban

      0.9706 0.9793 23060 Urban

      0.9750 Indiana. 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,

      16 Rural

      0.8594 0.8509 99916 Rural

      0.8552 Iowa. 16030............ Appanoose County,

      16 Rural

      0.8594 0.8509 99916 Rural

      0.8552 Iowa. 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,

      8920 Urban

      0.8557 0.8557 47940 Urban

      0.8557 Iowa. 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,

      16 Rural

      0.8594 0.8509 99916 Rural

      0.8552 Iowa. 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,

      16 Rural

      0.8594 0.8509 99916 Rural

      0.8552 Iowa. 16170............ Cherokee County, Iowa 16 Rural

      0.8594 0.8509 99916 Rural

      0.8552 16180............ Chickasaw County,

      16 Rural

      0.8594 0.8509 99916 Rural

      0.8552 Iowa. 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,

      16 Rural

      0.8594 0.8509 99916 Rural

      0.8552 Iowa. 16290............ Dickinson County,

      16 Rural

      0.8594 0.8509 99916 Rural

      0.8552 Iowa. 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

      [[Page 45092]]

      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,

      16 Rural

      0.8594 0.8509 99916 Rural

      0.8552 Iowa. 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,

      16 Rural

      0.8594 0.8509 99916 Rural

      0.8552 Iowa. 16690............ Muscatine County,

      16 Rural

      0.8594 0.8509 99916 Rural

      0.8552 Iowa. 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,

      16 Rural

      0.8594 0.8509 99916 Rural

      0.8552 Iowa. 16740............ Plymouth County, Iowa 16 Rural

      0.8594 0.8509 99916 Rural

      0.8552 16750............ Pocahontas County,

      16 Rural

      0.8594 0.8509 99916 Rural

      0.8552 Iowa. 16760............ Polk County, Iowa.... 2120 Urban

      0.9669 0.9669 19780 Urban

      0.9669 16770............ Pottawattamie County, 5920 Urban

      0.9560 0.9560 36540 Urban

      0.9560 Iowa. 16780............ Poweshiek County,

      16 Rural

      0.8594 0.8509 99916 Rural

      0.8552 Iowa. 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,

      16 Rural

      0.8594 0.8509 99916 Rural

      0.8552 Iowa. 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,

      16 Rural

      0.8594 0.9747 26980 Urban

      0.9171 Iowa. 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,

      16 Rural

      0.8594 0.8509 99916 Rural

      0.8552 Iowa. 16950............ Winneshiek County,

      16 Rural

      0.8594 0.8509 99916 Rural

      0.8552 Iowa. 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,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17020............ Atchison County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 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,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 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,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17100............ Cherokee County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17110............ Cheyenne County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 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

      [[Page 45093]]

      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,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17170............ Cowley County, Kansas 17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 17180............ Crawford County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17190............ Decatur County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17200............ Dickinson County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17210............ Doniphan County,

      17 Rural

      0.8040 0.9519 41140 Urban

      0.8780 Kansas. 17220............ Douglas County,

      4150 Urban

      0.8537 0.8537 29940 Urban

      0.8537 Kansas. 17230............ Edwards County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 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,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 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,

      17 Rural

      0.8040 0.9476 28140 Urban

      0.8758 Kansas. 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,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17360............ Greenwood County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17370............ Hamilton County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 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,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17410............ Hodgeman County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17420............ Jackson County,

      17 Rural

      0.8040 0.8920 45820 Urban

      0.8480 Kansas. 17430............ Jefferson County,

      17 Rural

      0.8040 0.8920 45820 Urban

      0.8480 Kansas. 17440............ Jewell County, Kansas 17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 17450............ Johnson County,

      3760 Urban

      0.9490 0.9476 28140 Urban

      0.9483 Kansas. 17451............ Kearny County, Kansas 17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 17470............ Kingman County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17480............ Kiowa County, Kansas. 17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 17490............ Labette County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17500............ Lane County, Kansas.. 17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 17510............ Leavenworth County, 3760 Urban

      0.9490 0.9476 28140 Urban

      0.9483 Kansas. 17520............ Lincoln County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 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,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17570............ Marion County, Kansas 17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 17580............ Marshall County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 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,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17620............ Montgomery County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 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,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 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,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17740............ Pottawatomie County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17750............ Pratt County, Kansas. 17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 17760............ Rawlins County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17770............ Reno County, Kansas.. 17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 17780............ Republic County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 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

      [[Page 45094]]

      17820............ Rush County, Kansas.. 17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 17830............ Russell County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 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,

      9040 Urban

      0.9175 0.9153 48620 Urban

      0.9164 Kansas. 17870............ Seward County, Kansas 17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 17880............ Shawnee County,

      8440 Urban

      0.8920 0.8920 45820 Urban

      0.8920 Kansas. 17890............ Sheridan County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17900............ Sherman County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17910............ Smith County, Kansas. 17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 17920............ Stafford County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17921............ Stanton County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17940............ Stevens County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 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,

      17 Rural

      0.8040 0.8920 45820 Urban

      0.8480 Kansas. 17981............ Wallace County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17982............ Washington County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17983............ Wichita County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17984............ Wilson County, Kansas 17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 17985............ Woodson County,

      17 Rural

      0.8040 0.8035 99917 Rural

      0.8038 Kansas. 17986............ Wyandotte County,

      3760 Urban

      0.9490 0.9476 28140 Urban

      0.9483 Kansas. 18000............ Adair County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18010............ Allen County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18020............ Anderson County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18030............ Ballard County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18040............ Barren County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 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,

      1640 Urban

      0.9734 0.9615 17140 Urban

      0.9675 Kentucky. 18080............ Bourbon County,

      4280 Urban

      0.8988 0.9075 30460 Urban

      0.9032 Kentucky. 18090............ Boyd County, Kentucky 3400 Urban

      0.9477 0.9477 26580 Urban

      0.9477 18100............ Boyle County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18110............ Bracken County,

      18 Rural

      0.7858 0.9615 17140 Urban

      0.8737 Kentucky. 18120............ Breathitt County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18130............ Breckinridge County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18140............ Bullitt County,

      4520 Urban

      0.9293 0.9251 31140 Urban

      0.9272 Kentucky. 18150............ Butler County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18160............ Caldwell County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18170............ Calloway County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18180............ Campbell County,

      1640 Urban

      0.9734 0.9615 17140 Urban

      0.9675 Kentucky. 18190............ Carlisle County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18191............ Carroll County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18210............ Carter County,

      3400 Urban

      0.9477 0.7766 99918 Rural

      0.8622 Kentucky. 18220............ Casey County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18230............ Christian County,

      1660 Urban

      0.8284 0.8284 17300 Urban

      0.8284 Kentucky. 18240............ Clark County,

      4280 Urban

      0.8988 0.9075 30460 Urban

      0.9032 Kentucky. 18250............ Clay County, Kentucky 18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 18260............ Clinton County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18270............ Crittenden County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18271............ Cumberland County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18290............ Daviess County,

      5990 Urban

      0.8780 0.8780 36980 Urban

      0.8780 Kentucky. 18291............ Edmonson County,

      18 Rural

      0.7858 0.8211 14540 Urban

      0.8035 Kentucky. 18310............ Elliott County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18320............ Estill County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18330............ Fayette County,

      4280 Urban

      0.8988 0.9075 30460 Urban

      0.9032 Kentucky. 18340............ Fleming County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18350............ Floyd County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18360............ Franklin County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18361............ Fulton County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18362............ Gallatin County,

      1640 Urban

      0.9734 0.9615 17140 Urban

      0.9675 Kentucky. 18390............ Garrard County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18400............ Grant County,

      1640 Urban

      0.9734 0.9615 17140 Urban

      0.9675 Kentucky. 18410............ Graves County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18420............ Grayson County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18421............ Green County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18440............ Greenup County,

      3400 Urban

      0.9477 0.9477 26580 Urban

      0.9477 Kentucky.

      [[Page 45095]]

      18450............ Hancock County,

      18 Rural

      0.7858 0.8780 36980 Urban

      0.8319 Kentucky. 18460............ Hardin County,

      18 Rural

      0.7858 0.8802 21060 Urban

      0.8330 Kentucky. 18470............ Harlan County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18480............ Harrison County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18490............ Hart County, Kentucky 18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 18500............ Henderson County,

      2440 Urban

      0.8713 0.8713 21780 Urban

      0.8713 Kentucky. 18510............ Henry County,

      18 Rural

      0.7858 0.9251 31140 Urban

      0.8555 Kentucky. 18511............ Hickman County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18530............ Hopkins County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18540............ Jackson County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18550............ Jefferson County,

      4520 Urban

      0.9293 0.9251 31140 Urban

      0.9272 Kentucky. 18560............ Jessamine County,

      4280 Urban

      0.8988 0.9075 30460 Urban

      0.9032 Kentucky. 18570............ Johnson County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18580............ Kenton County,

      1640 Urban

      0.9734 0.9615 17140 Urban

      0.9675 Kentucky. 18590............ Knott County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18600............ Knox County, Kentucky 18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 18610............ Larue County,

      18 Rural

      0.7858 0.8802 21060 Urban

      0.8330 Kentucky. 18620............ Laurel County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18630............ Lawrence County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18640............ Lee County, Kentucky. 18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 18650............ Leslie County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18660............ Letcher County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18670............ Lewis County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18680............ Lincoln County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18690............ Livingston County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18700............ Logan County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18710............ Lyon County, Kentucky 18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 18720............ Mc Cracken County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18730............ Mc Creary County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18740............ Mc Lean County,

      18 Rural

      0.7858 0.8780 36980 Urban

      0.8319 Kentucky. 18750............ Madison County,

      4280 Urban

      0.8988 0.7766 99918 Rural

      0.8377 Kentucky. 18760............ Magoffin County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18770............ Marion County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18780............ Marshall County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18790............ Martin County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18800............ Mason County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18801............ Meade County,

      18 Rural

      0.7858 0.9251 31140 Urban

      0.8555 Kentucky. 18802............ Menifee County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18830............ Mercer County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18831............ Metcalfe County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18850............ Monroe County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18860............ Montgomery County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18861............ Morgan County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18880............ Muhlenberg County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18890............ Nelson County,

      18 Rural

      0.7858 0.9251 31140 Urban

      0.8555 Kentucky. 18900............ Nicholas County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18910............ Ohio County, Kentucky 18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 18920............ Oldham County,

      4520 Urban

      0.9293 0.9251 31140 Urban

      0.9272 Kentucky. 18930............ Owen County, Kentucky 18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 18931............ Owsley County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18932............ Pendleton County,

      1640 Urban

      0.9734 0.9615 17140 Urban

      0.9675 Kentucky. 18960............ Perry County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18970............ Pike County, Kentucky 18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 18971............ Powell County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18972............ Pulaski County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18973............ Robertson County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18974............ Rockcastle County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18975............ Rowan County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18976............ Russell County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18977............ Scott County,

      4280 Urban

      0.8988 0.9075 30460 Urban

      0.9032 Kentucky. 18978............ Shelby County,

      18 Rural

      0.7858 0.9251 31140 Urban

      0.8555 Kentucky. 18979............ Simpson County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18980............ Spencer County,

      18 Rural

      0.7858 0.9251 31140 Urban

      0.8555 Kentucky. 18981............ Taylor County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18982............ Todd County, Kentucky 18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 18983............ Trigg County,

      18 Rural

      0.7858 0.8284 17300 Urban

      0.8071 Kentucky. 18984............ Trimble County,

      18 Rural

      0.7858 0.9251 31140 Urban

      0.8555 Kentucky. 18985............ Union County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky.

      [[Page 45096]]

      18986............ Warren County,

      18 Rural

      0.7858 0.8211 14540 Urban

      0.8035 Kentucky. 18987............ Washington County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18988............ Wayne County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18989............ Webster County,

      18 Rural

      0.7858 0.8713 21780 Urban

      0.8286 Kentucky. 18990............ Whitley County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18991............ Wolfe County,

      18 Rural

      0.7858 0.7766 99918 Rural

      0.7812 Kentucky. 18992............ Woodford County,

      4280 Urban

      0.8988 0.9075 30460 Urban

      0.9032 Kentucky. 19000............ Acadia County,

      3880 Urban

      0.8251 0.7411 99919 Rural

      0.7831 Louisiana. 19010............ Allen County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19020............ Ascension County,

      0760 Urban

      0.8643 0.8593 12940 Urban

      0.8618 Louisiana. 19030............ Assumption County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19040............ Avoyelles County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19050............ Beauregard County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19060............ Bienville County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19070............ Bossier County,

      7680 Urban

      0.8737 0.8760 43340 Urban

      0.8749 Louisiana. 19080............ Caddo County,

      7680 Urban

      0.8737 0.8760 43340 Urban

      0.8749 Louisiana. 19090............ Calcasieu County,

      3960 Urban

      0.7858 0.7833 29340 Urban

      0.7846 Louisiana. 19100............ Caldwell County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19110............ Cameron County,

      19 Rural

      0.7340 0.7833 29340 Urban

      0.7587 Louisiana. 19120............ Catahoula County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19130............ Claiborne County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19140............ Concordia County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19150............ De Soto County,

      19 Rural

      0.7340 0.8760 43340 Urban

      0.8050 Louisiana. 19160............ East Baton Rouge

      0760 Urban

      0.8643 0.8593 12940 Urban

      0.8618 County, Louisiana. 19170............ East Carroll County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19180............ East Feliciana

      19 Rural

      0.7340 0.8593 12940 Urban

      0.7967 County, Louisiana. 19190............ Evangeline County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19200............ Franklin County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19210............ Grant County,

      19 Rural

      0.7340 0.8033 10780 Urban

      0.7687 Louisiana. 19220............ Iberia County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19230............ Iberville County,

      19 Rural

      0.7340 0.8593 12940 Urban

      0.7967 Louisiana. 19240............ Jackson County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19250............ Jefferson County,

      5560 Urban

      0.8995 0.8995 35380 Urban

      0.8995 Louisiana. 19260............ Jefferson Davis

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 County, Louisiana. 19270............ Lafayette County,

      3880 Urban

      0.8251 0.8428 29180 Urban

      0.8340 Louisiana. 19280............ Lafourche County,

      3350 Urban

      0.7894 0.7894 26380 Urban

      0.7894 Louisiana. 19290............ La Salle County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19300............ Lincoln County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19310............ Livingston County,

      0760 Urban

      0.8643 0.8593 12940 Urban

      0.8618 Louisiana. 19320............ Madison County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19330............ Morehouse County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19340............ Natchitoches County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19350............ Orleans County,

      5560 Urban

      0.8995 0.8995 35380 Urban

      0.8995 Louisiana. 19360............ Ouachita County,

      5200 Urban

      0.8044 0.8031 33740 Urban

      0.8038 Louisiana. 19370............ Plaquemines County, 5560 Urban

      0.8995 0.8995 35380 Urban

      0.8995 Louisiana. 19380............ Pointe Coupee County, 19 Rural

      0.7340 0.8593 12940 Urban

      0.7967 Louisiana. 19390............ Rapides County,

      0220 Urban

      0.8033 0.8033 10780 Urban

      0.8033 Louisiana. 19400............ Red River County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19410............ Richland County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19420............ Sabine County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19430............ St Bernard County,

      5560 Urban

      0.8995 0.8995 35380 Urban

      0.8995 Louisiana. 19440............ St Charles County,

      5560 Urban

      0.8995 0.8995 35380 Urban

      0.8995 Louisiana. 19450............ St Helena County,

      19 Rural

      0.7340 0.8593 12940 Urban

      0.7967 Louisiana. 19460............ St James County,

      5560 Urban

      0.8995 0.7411 99919 Rural

      0.8203 Louisiana. 19470............ St John Baptist

      5560 Urban

      0.8995 0.8995 35380 Urban

      0.8995 County, Louisiana. 19480............ St Landry County,

      3880 Urban

      0.8251 0.7411 99919 Rural

      0.7831 Louisiana. 19490............ St Martin County,

      3880 Urban

      0.8251 0.8428 29180 Urban

      0.8340 Louisiana. 19500............ St Mary County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19510............ St Tammany County,

      5560 Urban

      0.8995 0.8995 35380 Urban

      0.8995 Louisiana. 19520............ Tangipahoa County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19530............ Tensas County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19540............ Terrebonne County,

      3350 Urban

      0.7894 0.7894 26380 Urban

      0.7894 Louisiana. 19550............ Union County,

      19 Rural

      0.7340 0.8031 33740 Urban

      0.7686 Louisiana. 19560............ Vermilion County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19570............ Vernon County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19580............ Washington County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19590............ Webster County,

      7680 Urban

      0.8737 0.7411 99919 Rural

      0.8074 Louisiana. 19600............ West Baton Rouge

      0760 Urban

      0.8643 0.8593 12940 Urban

      0.8618 County, Louisiana.

      [[Page 45097]]

      19610............ West Carroll County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 19620............ West Feliciana

      19 Rural

      0.7340 0.8593 12940 Urban

      0.7967 County, Louisiana. 19630............ Winn County,

      19 Rural

      0.7340 0.7411 99919 Rural

      0.7376 Louisiana. 20000............ Androscoggin County, 4243 Urban

      0.9331 0.9331 30340 Urban

      0.9331 Maine. 20010............ Aroostook County,

      20 Rural

      0.8843 0.8843 99920 Rural

      0.8843 Maine. 20020............ Cumberland County,

      6403 Urban

      1.0382 1.0382 38860 Urban

      1.0382 Maine. 20030............ Franklin County,

      20 Rural

      0.8843 0.8843 99920 Rural

      0.8843 Maine. 20040............ Hancock County, Maine 20 Rural

      0.8843 0.8843 99920 Rural

      0.8843 20050............ Kennebec County,

      20 Rural

      0.8843 0.8843 99920 Rural

      0.8843 Maine. 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,

      0733 Urban

      0.9993 0.9993 12620 Urban

      0.9993 Maine. 20100............ Piscataquis County,

      20 Rural

      0.8843 0.8843 99920 Rural

      0.8843 Maine. 20110............ Sagadahoc County,

      6403 Urban

      1.0382 1.0382 38860 Urban

      1.0382 Maine. 20120............ Somerset County,

      20 Rural

      0.8843 0.8843 99920 Rural

      0.8843 Maine. 20130............ Waldo County, Maine.. 20 Rural

      0.8843 0.8843 99920 Rural

      0.8843 20140............ Washington County,

      20 Rural

      0.8843 0.8843 99920 Rural

      0.8843 Maine. 20150............ York County, Maine... 6403 Urban

      1.0382 1.0382 38860 Urban

      1.0382 21000............ Allegany County,

      1900 Urban

      0.9317 0.9317 19060 Urban

      0.9317 Maryland. 21010............ Anne Arundel County, 0720 Urban

      0.9897 0.9897 12580 Urban

      0.9897 Maryland. 21020............ Baltimore County,

      0720 Urban

      0.9897 0.9897 12580 Urban

      0.9897 Maryland. 21030............ Baltimore City

      0720 Urban

      0.9897 0.9897 12580 Urban

      0.9897 County, Maryland. 21040............ Calvert County,

      8840 Urban

      1.0976 1.0926 47894 Urban

      1.0951 Maryland. 21050............ Caroline County,

      21 Rural

      0.9230 0.9353 99921 Rural

      0.9292 Maryland. 21060............ Carroll County,

      0720 Urban

      0.9897 0.9897 12580 Urban

      0.9897 Maryland. 21070............ Cecil County,

      9160 Urban

      1.0527 1.0471 48864 Urban

      1.0499 Maryland. 21080............ Charles County,

      8840 Urban

      1.0976 1.0926 47894 Urban

      1.0951 Maryland. 21090............ Dorchester County,

      21 Rural

      0.9230 0.9353 99921 Rural

      0.9292 Maryland. 21100............ Frederick County,

      8840 Urban

      1.0976 1.1483 13644 Urban

      1.1230 Maryland. 21110............ Garrett County,

      21 Rural

      0.9230 0.9353 99921 Rural

      0.9292 Maryland. 21120............ Harford County,

      0720 Urban

      0.9897 0.9897 12580 Urban

      0.9897 Maryland. 21130............ Howard County,

      0720 Urban

      0.9897 0.9897 12580 Urban

      0.9897 Maryland. 21140............ Kent County, Maryland 21 Rural

      0.9230 0.9353 99921 Rural

      0.9292 21150............ Montgomery County,

      8840 Urban

      1.0976 1.1483 13644 Urban

      1.1230 Maryland. 21160............ Prince Georges

      8840 Urban

      1.0976 1.0926 47894 Urban

      1.0951 County, Maryland. 21170............ Queen Annes County, 0720 Urban

      0.9897 0.9897 12580 Urban

      0.9897 Maryland. 21180............ St Marys County,

      21 Rural

      0.9230 0.9353 99921 Rural

      0.9292 Maryland. 21190............ Somerset County,

      21 Rural

      0.9230 0.9064 41540 Urban

      0.9147 Maryland. 21200............ Talbot County,

      21 Rural

      0.9230 0.9353 99921 Rural

      0.9292 Maryland. 21210............ Washington County,

      3180 Urban

      0.9869 0.9489 25180 Urban

      0.9679 Maryland. 21220............ Wicomico County,

      21 Rural

      0.9230 0.9064 41540 Urban

      0.9147 Maryland. 21230............ Worcester County,

      21 Rural

      0.9230 0.9353 99921 Rural

      0.9292 Maryland. 22000............ Barnstable County,

      0743 Urban

      1.2600 1.2600 12700 Urban

      1.2600 Massachusetts. 22010............ Berkshire County,

      6323 Urban

      1.0181 1.0181 38340 Urban

      1.0181 Massachusetts. 22020............ Bristol County,

      1123 Urban

      1.1178 1.0966 39300 Urban

      1.1072 Massachusetts. 22030............ Dukes County,

      22 Rural

      1.0216 1.0216 99922 Rural

      1.0216 Massachusetts. 22040............ Essex County,

      1123 Urban

      1.1178 1.0538 21604 Urban

      1.0858 Massachusetts. 22060............ Franklin County,

      22 Rural

      1.0216 1.0248 44140 Urban

      1.0232 Massachusetts. 22070............ Hampden County,

      8003 Urban

      1.0263 1.0248 44140 Urban

      1.0256 Massachusetts. 22080............ Hampshire County,

      8003 Urban

      1.0263 1.0248 44140 Urban

      1.0256 Massachusetts. 22090............ Middlesex County,

      1123 Urban

      1.1178 1.1172 15764 Urban

      1.1175 Massachusetts. 22120............ Nantucket County,

      22 Rural

      1.0216 1.0216 99922 Rural

      1.0216 Massachusetts. 22130............ Norfolk County,

      1123 Urban

      1.1178 1.1558 14484 Urban

      1.1368 Massachusetts. 22150............ Plymouth County,

      1123 Urban

      1.1178 1.1558 14484 Urban

      1.1368 Massachusetts. 22160............ Suffolk County,

      1123 Urban

      1.1178 1.1558 14484 Urban

      1.1368 Massachusetts. 22170............ Worcester County,

      1123 Urban

      1.1178 1.1028 49340 Urban

      1.1103 Massachusetts. 23000............ Alcona County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23010............ Alger County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23020............ Allegan County,

      3000 Urban

      0.9445 0.8895 99923 Rural

      0.9170 Michigan. 23030............ Alpena County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23040............ Antrim County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23050............ Arenac County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23060............ Baraga County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23070............ Barry County,

      23 Rural

      0.8824 0.9390 24340 Urban

      0.9107 Michigan. 23080............ Bay County, Michigan. 6960 Urban

      0.9241 0.9343 13020 Urban

      0.9292 23090............ Benzie County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23100............ Berrien County,

      0870 Urban

      0.8879 0.8879 35660 Urban

      0.8879 Michigan.

      [[Page 45098]]

      23110............ Branch County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23120............ Calhoun County,

      3720 Urban

      1.0143 0.9508 12980 Urban

      0.9826 Michigan. 23130............ Cass County, Michigan 23 Rural

      0.8824 0.9788 43780 Urban

      0.9306 23140............ Charlevoix County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23150............ Cheboygan County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23160............ Chippewa County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23170............ Clare County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23180............ Clinton County,

      4040 Urban

      0.9794 0.9794 29620 Urban

      0.9794 Michigan. 23190............ Crawford County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23200............ Delta County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23210............ Dickinson County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23220............ Eaton County,

      4040 Urban

      0.9794 0.9794 29620 Urban

      0.9794 Michigan. 23230............ Emmet County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23240............ Genesee County,

      2640 Urban

      1.0655 1.0655 22420 Urban

      1.0655 Michigan. 23250............ Gladwin County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23260............ Gogebic County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23270............ Grand Traverse

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 County, Michigan. 23280............ Gratiot County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23290............ Hillsdale County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23300............ Houghton County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23310............ Huron County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23320............ Ingham County,

      4040 Urban

      0.9794 0.9794 29620 Urban

      0.9794 Michigan. 23330............ Ionia County,

      23 Rural

      0.8824 0.9390 24340 Urban

      0.9107 Michigan. 23340............ Iosco County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23350............ Iron County, Michigan 23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 23360............ Isabella County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23370............ Jackson County,

      3520 Urban

      0.9304 0.9304 27100 Urban

      0.9304 Michigan. 23380............ Kalamazoo County,

      3720 Urban

      1.0143 1.0381 28020 Urban

      1.0262 Michigan. 23390............ Kalkaska County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23400............ Kent County, Michigan 3000 Urban

      0.9445 0.9390 24340 Urban

      0.9418 23410............ Keweenaw County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23420............ Lake County, Michigan 23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 23430............ Lapeer County,

      2160 Urban

      1.0147 0.9871 47644 Urban

      1.0009 Michigan. 23440............ Leelanau County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23450............ Lenawee County,

      0440 Urban

      1.0707 0.8895 99923 Rural

      0.9801 Michigan. 23460............ Livingston County,

      0440 Urban

      1.0707 0.9871 47644 Urban

      1.0289 Michigan. 23470............ Luce County, Michigan 23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 23480............ Mackinac County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23490............ Macomb County,

      2160 Urban

      1.0147 0.9871 47644 Urban

      1.0009 Michigan. 23500............ Manistee County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23510............ Marquette County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23520............ Mason County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23530............ Mecosta County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23540............ Menominee County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23550............ Midland County,

      6960 Urban

      0.9241 0.8895 99923 Rural

      0.9068 Michigan. 23560............ Missaukee County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23570............ Monroe County,

      2160 Urban

      1.0147 0.9468 33780 Urban

      0.9808 Michigan. 23580............ Montcalm County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23590............ Montmorency County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23600............ Muskegon County,

      3000 Urban

      0.9445 0.9664 34740 Urban

      0.9555 Michigan. 23610............ Newaygo County,

      23 Rural

      0.8824 0.9390 24340 Urban

      0.9107 Michigan. 23620............ Oakland County,

      2160 Urban

      1.0147 0.9871 47644 Urban

      1.0009 Michigan. 23630............ Oceana County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23640............ Ogemaw County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23650............ Ontonagon County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23660............ Osceola County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23670............ Oscoda County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23680............ Otsego County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23690............ Ottawa County,

      3000 Urban

      0.9445 0.9055 26100 Urban

      0.9250 Michigan. 23700............ Presque Isle County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23710............ Roscommon County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23720............ Saginaw County,

      6960 Urban

      0.9241 0.9088 40980 Urban

      0.9165 Michigan. 23730............ St Clair County,

      2160 Urban

      1.0147 0.9871 47644 Urban

      1.0009 Michigan. 23740............ St Joseph County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23750............ Sanilac County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23760............ Schoolcraft County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23770............ Shiawassee County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 23780............ Tuscola County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan.

      [[Page 45099]]

      23790............ Van Buren County,

      3720 Urban

      1.0143 1.0381 28020 Urban

      1.0262 Michigan. 23800............ Washtenaw County,

      0440 Urban

      1.0707 1.0859 11460 Urban

      1.0783 Michigan. 23810............ Wayne County,

      2160 Urban

      1.0147 1.0424 19804 Urban

      1.0286 Michigan. 23830............ Wexford County,

      23 Rural

      0.8824 0.8895 99923 Rural

      0.8860 Michigan. 24000............ Aitkin County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24010............ Anoka County,

      5120 Urban

      1.1075 1.1075 33460 Urban

      1.1075 Minnesota. 24020............ Becker County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24030............ Beltrami County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24040............ Benton County,

      6980 Urban

      0.9965 0.9965 41060 Urban

      0.9965 Minnesota. 24050............ Big Stone County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24060............ Blue Earth County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24070............ Brown County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24080............ Carlton County,

      24 Rural

      0.9132 1.0213 20260 Urban

      0.9673 Minnesota. 24090............ Carver County,

      5120 Urban

      1.1075 1.1075 33460 Urban

      1.1075 Minnesota. 24100............ Cass County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24110............ Chippewa County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24120............ Chisago County,

      5120 Urban

      1.1075 1.1075 33460 Urban

      1.1075 Minnesota. 24130............ Clay County,

      2520 Urban

      0.8486 0.8486 22020 Urban

      0.8486 Minnesota. 24140............ Clearwater County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24150............ Cook County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24160............ Cottonwood County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24170............ Crow Wing County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24180............ Dakota County,

      5120 Urban

      1.1075 1.1075 33460 Urban

      1.1075 Minnesota. 24190............ Dodge County,

      24 Rural

      0.9132 1.1131 40340 Urban

      1.0132 Minnesota. 24200............ Douglas County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24210............ Faribault County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24220............ Fillmore County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24230............ Freeborn County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24240............ Goodhue County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24250............ Grant County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24260............ Hennepin County,

      5120 Urban

      1.1075 1.1075 33460 Urban

      1.1075 Minnesota. 24270............ Houston County,

      3870 Urban

      0.9564 0.9564 29100 Urban

      0.9564 Minnesota. 24280............ Hubbard County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24290............ Isanti County,

      5120 Urban

      1.1075 1.1075 33460 Urban

      1.1075 Minnesota. 24300............ Itasca County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24310............ Jackson County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24320............ Kanabec County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24330............ Kandiyohi County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24340............ Kittson County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24350............ Koochiching County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24360............ Lac Qui Parle County, 24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24370............ Lake County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24380............ Lake Of Woods County, 24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24390............ Le Sueur County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24400............ Lincoln County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24410............ Lyon County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24420............ Mc Leod County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24430............ Mahnomen County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24440............ Marshall County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24450............ Martin County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24460............ Meeker County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24470............ Mille Lacs County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24480............ Morrison County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24490............ Mower County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24500............ Murray County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24510............ Nicollet County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24520............ Nobles County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24530............ Norman County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24540............ Olmsted County,

      6820 Urban

      1.1131 1.1131 40340 Urban

      1.1131 Minnesota. 24550............ Otter Tail County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24560............ Pennington County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24570............ Pine County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24580............ Pipestone County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24590............ Polk County,

      2985 Urban

      0.7901 0.7901 24220 Urban

      0.7901 Minnesota. 24600............ Pope County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24610............ Ramsey County,

      5120 Urban

      1.1075 1.1075 33460 Urban

      1.1075 Minnesota. 24620............ Red Lake County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24630............ Redwood County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota.

      [[Page 45100]]

      24640............ Renville County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24650............ Rice County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24660............ Rock County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24670............ Roseau County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24680............ St Louis County,

      2240 Urban

      1.0213 1.0213 20260 Urban

      1.0213 Minnesota. 24690............ Scott County,

      5120 Urban

      1.1075 1.1075 33460 Urban

      1.1075 Minnesota. 24700............ Sherburne County,

      5120 Urban

      1.1075 1.1075 33460 Urban

      1.1075 Minnesota. 24710............ Sibley County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24720............ Stearns County,

      6980 Urban

      0.9965 0.9965 41060 Urban

      0.9965 Minnesota. 24730............ Steele County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24740............ Stevens County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24750............ Swift County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24760............ Todd County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24770............ Traverse County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24780............ Wabasha County,

      24 Rural

      0.9132 1.1131 40340 Urban

      1.0132 Minnesota. 24790............ Wadena County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24800............ Waseca County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24810............ Washington County,

      5120 Urban

      1.1075 1.1075 33460 Urban

      1.1075 Minnesota. 24820............ Watonwan County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24830............ Wilkin County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24840............ Winona County,

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 Minnesota. 24850............ Wright County,

      5120 Urban

      1.1075 1.1075 33460 Urban

      1.1075 Minnesota. 24860............ Yellow Medicine

      24 Rural

      0.9132 0.9132 99924 Rural

      0.9132 County, Minnesota. 25000............ Adams County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25010............ Alcorn County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25020............ Amite County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25030............ Attala County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25040............ Benton County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25050............ Bolivar County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25060............ Calhoun County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25070............ Carroll County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25080............ Chickasaw County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25090............ Choctaw County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25100............ Claiborne County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25110............ Clarke County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25120............ Clay County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25130............ Coahoma County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25140............ Copiah County,

      25 Rural

      0.7634 0.8311 27140 Urban

      0.7973 Mississippi. 25150............ Covington County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25160............ Desoto County,

      4920 Urban

      0.9416 0.9397 32820 Urban

      0.9407 Mississippi. 25170............ Forrest County,

      3285 Urban

      0.7601 0.7601 25620 Urban

      0.7601 Mississippi. 25180............ Franklin County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25190............ George County,

      25 Rural

      0.7634 0.8156 37700 Urban

      0.7895 Mississippi. 25200............ Greene County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25210............ Grenada County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25220............ Hancock County,

      0920 Urban

      0.8706 0.8929 25060 Urban

      0.8818 Mississippi. 25230............ Harrison County,

      0920 Urban

      0.8706 0.8929 25060 Urban

      0.8818 Mississippi. 25240............ Hinds County,

      3560 Urban

      0.8382 0.8311 27140 Urban

      0.8347 Mississippi. 25250............ Holmes County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25260............ Humphreys County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25270............ Issaquena County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25280............ Itawamba County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25290............ Jackson County,

      0920 Urban

      0.8706 0.8156 37700 Urban

      0.8431 Mississippi. 25300............ Jasper County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25310............ Jefferson County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25320............ Jefferson Davis

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 County, Mississippi. 25330............ Jones County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25340............ Kemper County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25350............ Lafayette County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25360............ Lamar County,

      3285 Urban

      0.7601 0.7601 25620 Urban

      0.7601 Mississippi. 25370............ Lauderdale County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25380............ Lawrence County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25390............ Leake County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25400............ Lee County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25410............ Leflore County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25420............ Lincoln County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25430............ Lowndes County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25440............ Madison County,

      3560 Urban

      0.8382 0.8311 27140 Urban

      0.8347 Mississippi.

      [[Page 45101]]

      25450............ Marion County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25460............ Marshall County,

      25 Rural

      0.7634 0.9397 32820 Urban

      0.8516 Mississippi. 25470............ Monroe County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25480............ Montgomery County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25490............ Neshoba County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25500............ Newton County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25510............ Noxubee County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25520............ Oktibbeha County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25530............ Panola County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25540............ Pearl River County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25550............ Perry County,

      25 Rural

      0.7634 0.7601 25620 Urban

      0.7618 Mississippi. 25560............ Pike County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25570............ Pontotoc County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25580............ Prentiss County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25590............ Quitman County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25600............ Rankin County,

      3560 Urban

      0.8382 0.8311 27140 Urban

      0.8347 Mississippi. 25610............ Scott County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25620............ Sharkey County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25630............ Simpson County,

      25 Rural

      0.7634 0.8311 27140 Urban

      0.7973 Mississippi. 25640............ Smith County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25650............ Stone County,

      25 Rural

      0.7634 0.8929 25060 Urban

      0.8282 Mississippi. 25660............ Sunflower County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25670............ Tallahatchie County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25680............ Tate County,

      25 Rural

      0.7634 0.9397 32820 Urban

      0.8516 Mississippi. 25690............ Tippah County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25700............ Tishomingo County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25710............ Tunica County,

      25 Rural

      0.7634 0.9397 32820 Urban

      0.8516 Mississippi. 25720............ Union County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25730............ Walthall County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25740............ Warren County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25750............ Washington County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25760............ Wayne County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25770............ Webster County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25780............ Wilkinson County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25790............ Winston County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25800............ Yalobusha County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 25810............ Yazoo County,

      25 Rural

      0.7634 0.7674 99925 Rural

      0.7654 Mississippi. 26000............ Adair County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26010............ Andrew County,

      7000 Urban

      0.9519 0.9519 41140 Urban

      0.9519 Missouri. 26020............ Atchison County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26030............ Audrain County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26040............ Barry County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26050............ Barton County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26060............ Bates County,

      26 Rural

      0.7959 0.9476 28140 Urban

      0.8718 Missouri. 26070............ Benton County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26080............ Bollinger County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26090............ Boone County,

      1740 Urban

      0.8345 0.8345 17860 Urban

      0.8345 Missouri. 26100............ Buchanan County,

      7000 Urban

      0.9519 0.9519 41140 Urban

      0.9519 Missouri. 26110............ Butler County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26120............ Caldwell County,

      26 Rural

      0.7959 0.9476 28140 Urban

      0.8718 Missouri. 26130............ Callaway County,

      26 Rural

      0.7959 0.8387 27620 Urban

      0.8173 Missouri. 26140............ Camden County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26150............ Cape Girardeau

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 County, Missouri. 26160............ Carroll County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26170............ Carter County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26180............ Cass County, Missouri 3760 Urban

      0.9490 0.9476 28140 Urban

      0.9483 26190............ Cedar County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26200............ Chariton County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26210............ Christian County,

      7920 Urban

      0.8250 0.8237 44180 Urban

      0.8244 Missouri. 26220............ Clark County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26230............ Clay County, Missouri 3760 Urban

      0.9490 0.9476 28140 Urban

      0.9483 26240............ Clinton County,

      3760 Urban

      0.9490 0.9476 28140 Urban

      0.9483 Missouri. 26250............ Cole County, Missouri 26 Rural

      0.7959 0.8387 27620 Urban

      0.8173 26260............ Cooper County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26270............ Crawford County,

      26 Rural

      0.7959 0.8954 41180 Urban

      0.8457 Missouri. 26280............ Dade County, Missouri 26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 26290............ Dallas County,

      26 Rural

      0.7959 0.8237 44180 Urban

      0.8098 Missouri. 26300............ Daviess County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri.

      [[Page 45102]]

      26310............ De Kalb County,

      26 Rural

      0.7959 0.9519 41140 Urban

      0.8739 Missouri. 26320............ Dent County, Missouri 26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 26330............ Douglas County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26340............ Dunklin County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26350............ Franklin County,

      7040 Urban

      0.8962 0.8954 41180 Urban

      0.8958 Missouri. 26360............ Gasconade County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26370............ Gentry County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26380............ Greene County,

      7920 Urban

      0.8250 0.8237 44180 Urban

      0.8244 Missouri. 26390............ Grundy County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26400............ Harrison County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26410............ Henry County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26411............ Hickory County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26412............ Holt County, Missouri 26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 26440............ Howard County,

      26 Rural

      0.7959 0.8345 17860 Urban

      0.8152 Missouri. 26450............ Howell County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26460............ Iron County, Missouri 26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 26470............ Jackson County,

      3760 Urban

      0.9490 0.9476 28140 Urban

      0.9483 Missouri. 26480............ Jasper County,

      3710 Urban

      0.8582 0.8582 27900 Urban

      0.8582 Missouri. 26490............ Jefferson County,

      7040 Urban

      0.8962 0.8954 41180 Urban

      0.8958 Missouri. 26500............ Johnson County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26510............ Knox County, Missouri 26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 26520............ Laclede County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26530............ Lafayette County,

      3760 Urban

      0.9490 0.9476 28140 Urban

      0.9483 Missouri. 26540............ Lawrence County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26541............ Lewis County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26560............ Lincoln County,

      7040 Urban

      0.8962 0.8954 41180 Urban

      0.8958 Missouri. 26570............ Linn County, Missouri 26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 26580............ Livingston County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26590............ Mc Donald County,

      26 Rural

      0.7959 0.8661 22220 Urban

      0.8310 Missouri. 26600............ Macon County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26601............ Madison County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26620............ Maries County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26630............ Marion County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26631............ Mercer County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26650............ Miller County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26660............ Mississippi County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26670............ Moniteau County,

      26 Rural

      0.7959 0.8387 27620 Urban

      0.8173 Missouri. 26680............ Monroe County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26690............ Montgomery County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26700............ Morgan County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26710............ New Madrid County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26720............ Newton County,

      3710 Urban

      0.8582 0.8582 27900 Urban

      0.8582 Missouri. 26730............ Nodaway County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26740............ Oregon County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26750............ Osage County,

      26 Rural

      0.7959 0.8387 27620 Urban

      0.8173 Missouri. 26751............ Ozark County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26770............ Pemiscot County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26780............ Perry County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26790............ Pettis County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26800............ Phelps County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26810............ Pike County, Missouri 26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 26820............ Platte County,

      3760 Urban

      0.9490 0.9476 28140 Urban

      0.9483 Missouri. 26821............ Polk County, Missouri 26 Rural

      0.7959 0.8237 44180 Urban

      0.8098 26840............ Pulaski County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26850............ Putnam County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26860............ Ralls County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26870............ Randolph County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26880............ Ray County, Missouri. 3760 Urban

      0.9490 0.9476 28140 Urban

      0.9483 26881............ Reynolds County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26900............ Ripley County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26910............ St Charles County,

      7040 Urban

      0.8962 0.8954 41180 Urban

      0.8958 Missouri. 26911............ St Clair County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26930............ St Francois County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26940............ St Louis County,

      7040 Urban

      0.8962 0.8954 41180 Urban

      0.8958 Missouri. 26950............ St Louis City County, 7040 Urban

      0.8962 0.8954 41180 Urban

      0.8958 Missouri. 26960............ Ste Genevieve County, 26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26970............ Saline County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26980............ Schuyler County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri.

      [[Page 45103]]

      26981............ Scotland County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26982............ Scott County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26983............ Shannon County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26984............ Shelby County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26985............ Stoddard County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26986............ Stone County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26987............ Sullivan County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26988............ Taney County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26989............ Texas County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26990............ Vernon County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26991............ Warren County,

      7040 Urban

      0.8962 0.8954 41180 Urban

      0.8958 Missouri. 26992............ Washington County,

      26 Rural

      0.7959 0.8954 41180 Urban

      0.8457 Missouri. 26993............ Wayne County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26994............ Webster County,

      7920 Urban

      0.8250 0.8237 44180 Urban

      0.8244 Missouri. 26995............ Worth County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 26996............ Wright County,

      26 Rural

      0.7959 0.7900 99926 Rural

      0.7930 Missouri. 27000............ Beaverhead County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27010............ Big Horn County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27020............ Blaine County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27030............ Broadwater County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27040............ Carbon County,

      27 Rural

      0.8762 0.8834 13740 Urban

      0.8798 Montana. 27050............ Carter County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27060............ Cascade County,

      3040 Urban

      0.9052 0.9052 24500 Urban

      0.9052 Montana. 27070............ Chouteau County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27080............ Custer County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27090............ Daniels County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27100............ Dawson County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27110............ Deer Lodge County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27113............ Yellowstone National

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Park, Montana. 27120............ Fallon County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. D27130........... Fergus County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27140............ Flathead County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27150............ Gallatin County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27160............ Garfield County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27170............ Glacier County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27180............ Golden Valley County, 27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27190............ Granite County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27200............ Hill County, Montana. 27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 27210............ Jefferson County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27220............ Judith Basin County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27230............ Lake County, Montana. 27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 27240............ Lewis And Clark

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 County, Montana. 27250............ Liberty County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27260............ Lincoln County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27270............ Mc Cone County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27280............ Madison County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27290............ Meagher County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27300............ Mineral County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27310............ Missoula County,

      5140 Urban

      0.9473 0.9473 33540 Urban

      0.9473 Montana. 27320............ Musselshell County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27330............ Park County, Montana. 27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 27340............ Petroleum County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27350............ Phillips County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27360............ Pondera County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27370............ Powder River County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27380............ Powell County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27390............ Prairie County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27400............ Ravalli County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27410............ Richland County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27420............ Roosevelt County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27430............ Rosebud County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27440............ Sanders County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27450............ Sheridan County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27460............ Silver Bow County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27470............ Stillwater County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27480............ Sweet Grass County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 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

      [[Page 45104]]

      27510............ Treasure County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27520............ Valley County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27530............ Wheatland County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27540............ Wibaux County,

      27 Rural

      0.8762 0.8762 99927 Rural

      0.8762 Montana. 27550............ Yellowstone County, 0880 Urban

      0.8834 0.8834 13740 Urban

      0.8834 Montana. 28000............ Adams County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28010............ Antelope County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28020............ Arthur County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28030............ Banner County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28040............ Blaine County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28050............ Boone County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28060............ Box Butte County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28070............ Boyd County, Nebraska 28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 28080............ Brown County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28090............ Buffalo County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28100............ Burt County, Nebraska 28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 28110............ Butler County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28120............ Cass County, Nebraska 5920 Urban

      0.9560 0.9560 36540 Urban

      0.9560 28130............ Cedar County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28140............ Chase County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28150............ Cherry County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28160............ Cheyenne County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28170............ Clay County, Nebraska 28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 28180............ Colfax County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28190............ Cuming County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28200............ Custer County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28210............ Dakota County,

      7720 Urban

      0.9416 0.9381 43580 Urban

      0.9399 Nebraska. 28220............ Dawes County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28230............ Dawson County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28240............ Deuel County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28250............ Dixon County,

      28 Rural

      0.8657 0.9381 43580 Urban

      0.9019 Nebraska. 28260............ Dodge County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28270............ Douglas County,

      5920 Urban

      0.9560 0.9560 36540 Urban

      0.9560 Nebraska. 28280............ Dundy County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28290............ Fillmore County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28300............ Franklin County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28310............ Frontier County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28320............ Furnas County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28330............ Gage County, Nebraska 28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 28340............ Garden County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28350............ Garfield County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28360............ Gosper County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28370............ Grant County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28380............ Greeley County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28390............ Hall County, Nebraska 28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 28400............ Hamilton County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28410............ Harlan County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28420............ Hayes County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28430............ Hitchcock County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28440............ Holt County, Nebraska 28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 28450............ Hooker County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28460............ Howard County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28470............ Jefferson County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28480............ Johnson County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28490............ Kearney County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28500............ Keith County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28510............ Keya Paha County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28520............ Kimball County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28530............ Knox County, Nebraska 28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 28540............ Lancaster County,

      4360 Urban

      1.0214 1.0214 30700 Urban

      1.0214 Nebraska. 28550............ Lincoln County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28560............ Logan County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28570............ Loup County, Nebraska 28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 28580............ Mc Pherson County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28590............ Madison County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28600............ Merrick County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28610............ Morrill County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28620............ Nance County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska.

      [[Page 45105]]

      28630............ Nemaha County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28640............ Nuckolls County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28650............ Otoe County, Nebraska 28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 28660............ Pawnee County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28670............ Perkins County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28680............ Phelps County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28690............ Pierce County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28700............ Platte County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28710............ Polk County, Nebraska 28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 28720............ Redwillow County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28730............ Richardson County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28740............ Rock County, Nebraska 28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 28750............ Saline County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28760............ Sarpy County,

      5920 Urban

      0.9560 0.9560 36540 Urban

      0.9560 Nebraska. 28770............ Saunders County,

      28 Rural

      0.8657 0.9560 36540 Urban

      0.9109 Nebraska. 28780............ Scotts Bluff County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28790............ Seward County,

      28 Rural

      0.8657 1.0214 30700 Urban

      0.9436 Nebraska. 28800............ Sheridan County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28810............ Sherman County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28820............ Sioux County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28830............ Stanton County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28840............ Thayer County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28850............ Thomas County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28860............ Thurston County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28870............ Valley County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28880............ Washington County,

      5920 Urban

      0.9560 0.9560 36540 Urban

      0.9560 Nebraska. 28890............ Wayne County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28900............ Webster County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28910............ Wheeler County,

      28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 Nebraska. 28920............ York County, Nebraska 28 Rural

      0.8657 0.8657 99928 Rural

      0.8657 29000............ Churchill County,

      29 Rural

      0.9687 0.9065 99929 Rural

      0.9376 Nevada. 29010............ Clark County, Nevada. 4120 Urban

      1.1155 1.1437 29820 Urban

      1.1296 29020............ Douglas County,

      29 Rural

      0.9687 0.9065 99929 Rural

      0.9376 Nevada. 29030............ Elko County, Nevada.. 29 Rural

      0.9687 0.9065 99929 Rural

      0.9376 29040............ Esmeralda County,

      29 Rural

      0.9687 0.9065 99929 Rural

      0.9376 Nevada. 29050............ Eureka County, Nevada 29 Rural

      0.9687 0.9065 99929 Rural

      0.9376 29060............ Humboldt County,

      29 Rural

      0.9687 0.9065 99929 Rural

      0.9376 Nevada. 29070............ Lander County, Nevada 29 Rural

      0.9687 0.9065 99929 Rural

      0.9376 29080............ Lincoln County,

      29 Rural

      0.9687 0.9065 99929 Rural

      0.9376 Nevada. 29090............ Lyon County, Nevada.. 29 Rural

      0.9687 0.9065 99929 Rural

      0.9376 29100............ Mineral County,

      29 Rural

      0.9687 0.9065 99929 Rural

      0.9376 Nevada. 29110............ Nye County, Nevada... 4120 Urban

      1.1155 0.9065 99929 Rural

      1.0110 29120............ Carson City County,

      29 Rural

      0.9687 1.0234 16180 Urban

      0.9961 Nevada. 29130............ Pershing County,

      29 Rural

      0.9687 0.9065 99929 Rural

      0.9376 Nevada. 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,

      29 Rural

      0.9687 0.9065 99929 Rural

      0.9376 Nevada. 30000............ Belknap County, New

      30 Rural

      1.0817 1.0817 99930 Rural

      1.0817 Hampshire. 30010............ Carroll County, New

      30 Rural

      1.0817 1.0817 99930 Rural

      1.0817 Hampshire. 30020............ Cheshire County, New

      30 Rural

      1.0817 1.0817 99930 Rural

      1.0817 Hampshire. 30030............ Coos County, New

      30 Rural

      1.0817 1.0817 99930 Rural

      1.0817 Hampshire. 30040............ Grafton County, New

      30 Rural

      1.0817 1.0817 99930 Rural

      1.0817 Hampshire. 30050............ Hillsboro County, New 1123 Urban

      1.1178 1.0354 31700 Urban

      1.0766 Hampshire. 30060............ Merrimack County, New 1123 Urban

      1.1178 1.0354 31700 Urban

      1.0766 Hampshire. 30070............ Rockingham County,

      1123 Urban

      1.1178 1.0374 40484 Urban

      1.0776 New Hampshire. 30080............ Strafford County, New 1123 Urban

      1.1178 1.0374 40484 Urban

      1.0776 Hampshire. 30090............ Sullivan County, New

      30 Rural

      1.0817 1.0817 99930 Rural

      1.0817 Hampshire. 31000............ Atlantic County, New 0560 Urban

      1.1496 1.1615 12100 Urban

      1.1556 Jersey. 31100............ Bergen County, New

      0875 Urban

      1.1651 1.3188 35644 Urban

      1.2420 Jersey. 31150............ Burlington County,

      6160 Urban

      1.0922 1.0517 15804 Urban

      1.0720 New Jersey. 31160............ Camden County, New

      6160 Urban

      1.0922 1.0517 15804 Urban

      1.0720 Jersey. 31180............ Cape May County, New 0560 Urban

      1.1496 1.1011 36140 Urban

      1.1254 Jersey. 31190............ Cumberland County,

      8760 Urban

      0.9827 0.9827 47220 Urban

      0.9827 New Jersey. 31200............ Essex County, New

      5640 Urban

      1.1834 1.1883 35084 Urban

      1.1859 Jersey. 31220............ Gloucester County,

      6160 Urban

      1.0922 1.0517 15804 Urban

      1.0720 New Jersey. 31230............ Hudson County, New

      3640 Urban

      1.1338 1.3188 35644 Urban

      1.2263 Jersey. 31250............ Hunterdon County, New 5015 Urban

      1.1167 1.1883 35084 Urban

      1.1525 Jersey. 31260............ Mercer County, New

      8480 Urban

      1.0834 1.0834 45940 Urban

      1.0834 Jersey.

      [[Page 45106]]

      31270............ Middlesex County, New 5015 Urban

      1.1167 1.1249 20764 Urban

      1.1208 Jersey. 31290............ Monmouth County, New 5190 Urban

      1.1260 1.1249 20764 Urban

      1.1255 Jersey. 31300............ Morris County, New

      5640 Urban

      1.1834 1.1883 35084 Urban

      1.1859 Jersey. 31310............ Ocean County, New

      5190 Urban

      1.1260 1.1249 20764 Urban

      1.1255 Jersey. 31320............ Passaic County, New 0875 Urban

      1.1651 1.3188 35644 Urban

      1.2420 Jersey. 31340............ Salem County, New

      6160 Urban

      1.0922 1.0471 48864 Urban

      1.0697 Jersey. 31350............ Somerset County, New 5015 Urban

      1.1167 1.1249 20764 Urban

      1.1208 Jersey. 31360............ Sussex County, New

      5640 Urban

      1.1834 1.1883 35084 Urban

      1.1859 Jersey. 31370............ Union County, New

      5640 Urban

      1.1834 1.1883 35084 Urban

      1.1859 Jersey. 31390............ Warren County, New

      5640 Urban

      1.1834 0.9818 10900 Urban

      1.0826 Jersey. 32000............ Bernalillo County,

      0200 Urban

      0.9684 0.9684 10740 Urban

      0.9684 New Mexico. 32010............ Catron County, New

      32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32020............ Chaves County, New

      32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32025............ Cibola County, New

      32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32030............ Colfax County, New

      32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32040............ Curry County, New

      32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32050............ De Baca County, New

      32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32060............ Dona Ana County, New 4100 Urban

      0.8467 0.8467 29740 Urban

      0.8467 Mexico. 32070............ Eddy County, New

      32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32080............ Grant County, New

      32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32090............ Guadalupe County, New 32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32100............ Harding County, New

      32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32110............ Hidalgo County, New

      32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32120............ Lea County, New

      32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32130............ Lincoln County, New

      32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32131............ Los Alamos County,

      7490 Urban

      1.0748 0.8635 99932 Rural

      0.9692 New Mexico. 32140............ Luna County, New

      32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32150............ Mc Kinley County, New 32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32160............ Mora County, New

      32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32170............ Otero County, New

      32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32180............ Quay County, New

      32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32190............ Rio Arriba County,

      32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 New Mexico. 32200............ Roosevelt County, New 32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32210............ Sandoval County, New 0200 Urban

      0.9684 0.9684 10740 Urban

      0.9684 Mexico. 32220............ San Juan County, New

      32 Rural

      0.8563 0.8509 22140 Urban

      0.8536 Mexico. 32230............ San Miguel County,

      32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 New Mexico. 32240............ Santa Fe County, New 7490 Urban

      1.0748 1.0920 42140 Urban

      1.0834 Mexico. 32250............ Sierra County, New

      32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32260............ Socorro County, New

      32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32270............ Taos County, New

      32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32280............ Torrance County, New

      32 Rural

      0.8563 0.9684 10740 Urban

      0.9124 Mexico. 32290............ Union County, New

      32 Rural

      0.8563 0.8635 99932 Rural

      0.8599 Mexico. 32300............ Valencia County, New 0200 Urban

      0.9684 0.9684 10740 Urban

      0.9684 Mexico. 33000............ Albany County, New

      0160 Urban

      0.8559 0.8589 10580 Urban

      0.8574 York. 33010............ Allegany County, New

      33 Rural

      0.8395 0.8154 99933 Rural

      0.8275 York. 33020............ Bronx County, New

      5600 Urban

      1.3464 1.3188 35644 Urban

      1.3326 York. 33030............ Broome County, New

      0960 Urban

      0.8562 0.8562 13780 Urban

      0.8562 York. 33040............ Cattaraugus County,

      33 Rural

      0.8395 0.8154 99933 Rural

      0.8275 New York. 33050............ Cayuga County, New

      8160 Urban

      0.9492 0.8154 99933 Rural

      0.8823 York. 33060............ Chautauqua County,

      3610 Urban

      0.7544 0.8154 99933 Rural

      0.7849 New York. 33070............ Chemung County, New 2335 Urban

      0.8250 0.8250 21300 Urban

      0.8250 York. 33080............ Chenango County, New

      33 Rural

      0.8395 0.8154 99933 Rural

      0.8275 York. 33090............ Clinton County, New

      33 Rural

      0.8395 0.8154 99933 Rural

      0.8275 York. 33200............ Columbia County, New

      33 Rural

      0.8395 0.8154 99933 Rural

      0.8275 York. 33210............ Cortland County, New

      33 Rural

      0.8395 0.8154 99933 Rural

      0.8275 York. 33220............ Delaware County, New

      33 Rural

      0.8395 0.8154 99933 Rural

      0.8275 York. 33230............ Dutchess County, New 2281 Urban

      1.0475 1.0891 39100 Urban

      1.0683 York. 33240............ Erie County, New York 1280 Urban

      0.9511 0.9511 15380 Urban

      0.9511 33260............ Essex County, New

      33 Rural

      0.8395 0.8154 99933 Rural

      0.8275 York. 33270............ Franklin County, New

      33 Rural

      0.8395 0.8154 99933 Rural

      0.8275 York. 33280............ Fulton County, New

      33 Rural

      0.8395 0.8154 99933 Rural

      0.8275 York. 33290............ Genesee County, New 6840 Urban

      0.9049 0.8154 99933 Rural

      0.8602 York. 33300............ Greene County, New

      33 Rural

      0.8395 0.8154 99933 Rural

      0.8275 York. 33310............ Hamilton County, New

      33 Rural

      0.8395 0.8154 99933 Rural

      0.8275 York. 33320............ Herkimer County, New 8680 Urban

      0.8358 0.8358 46540 Urban

      0.8358 York. 33330............ Jefferson County, New 33 Rural

      0.8395 0.8154 99933 Rural

      0.8275 York. 33331............ Kings County, New

      5600 Urban

      1.3464 1.3188 35644 Urban

      1.3326 York. 33340............ Lewis County, New

      33 Rural

      0.8395 0.8154 99933 Rural

      0.8275 York.

      [[Page 45107]]

      33350............ Livingston County,

      6840 Urban

      0.9049 0.9121 40380 Urban

      0.9085 New York. 33360............ Madison County, New 8160 Urban

      0.9492 0.9574 45060 Urban

      0.9533 York. 33370............ Monroe County, New

      6840 Urban

      0.9049 0.9121 40380 Urban

      0.9085 York. 33380............ Montgomery County,

      0160 Urban

      0.8559 0.8154 99933 Rural

      0.8357 New York. 33400............ Nassau County, New

      5380 Urban

      1.2719 1.2719 35004 Urban

      1.2719 York. 33420............ New York County, New 5600 Urban

      1.3464 1.3188 35644 Urban

      1.3326 York. 33500............ Niagara County, New 1280 Urban

      0.9511 0.9511 15380 Urban

      0.9511 York. 33510............ Oneida County, New

      8680 Urban

      0.8358 0.8358 46540 Urban

      0.8358 York. 33520............ Onondaga County, New 8160 Urban

      0.9492 0.9574 45060 Urban

      0.9533 York. 33530............ Ontario County, New 6840 Urban

      0.9049 0.9121 40380 Urban

      0.9085 York. 33540............ Orange County, New

      5660 Urban

      1.1207 1.0891 39100 Urban

      1.1049 York. 33550............ Orleans County, New 6840 Urban

      0.9049 0.9121 40380 Urban

      0.9085 York. 33560............ Oswego County, New

      8160 Urban

      0.9492 0.9574 45060 Urban

      0.9533 York. 33570............ Otsego County, New

      33 Rural

      0.8395 0.8154 99933 Rural

      0.8275 York. 33580............ Putnam County, New

      5600 Urban

      1.3464 1.3188 35644 Urban

      1.3326 York. 33590............ Queens County, New

      5600 Urban

      1.3464 1.3188 35644 Urban

      1.3326 York. 33600............ Rensselaer County,

      0160 Urban

      0.8559 0.8589 10580 Urban

      0.8574 New York. 33610............ Richmond County, New 5600 Urban

      1.3464 1.3188 35644 Urban

      1.3326 York. 33620............ Rockland County, New 5600 Urban

      1.3464 1.3188 35644 Urban

      1.3326 York. 33630............ St Lawrence County,

      33 Rural

      0.8395 0.8154 99933 Rural

      0.8275 New York. 33640............ Saratoga County, New 0160 Urban

      0.8559 0.8589 10580 Urban

      0.8574 York. 33650............ Schenectady County, 0160 Urban

      0.8559 0.8589 10580 Urban

      0.8574 New York. 33660............ Schoharie County, New 0160 Urban

      0.8559 0.8589 10580 Urban

      0.8574 York. 33670............ Schuyler County, New

      33 Rural

      0.8395 0.8154 99933 Rural

      0.8275 York. 33680............ Seneca County, New

      33 Rural

      0.8395 0.8154 99933 Rural

      0.8275 York. 33690............ Steuben County, New

      33 Rural

      0.8395 0.8154 99933 Rural

      0.8275 York. 33700............ Suffolk County, New 5380 Urban

      1.2719 1.2719 35004 Urban

      1.2719 York. 33710............ Sullivan County, New

      33 Rural

      0.8395 0.8154 99933 Rural

      0.8275 York. 33720............ Tioga County, New

      0960 Urban

      0.8562 0.8562 13780 Urban

      0.8562 York. 33730............ Tompkins County, New

      33 Rural

      0.8395 0.9793 27060 Urban

      0.9094 York. 33740............ Ulster County, New

      33 Rural

      0.8395 0.9255 28740 Urban

      0.8825 York. 33750............ Warren County, New

      2975 Urban

      0.8559 0.8559 24020 Urban

      0.8559 York. 33760............ Washington County,

      2975 Urban

      0.8559 0.8559 24020 Urban

      0.8559 New York. 33770............ Wayne County, New

      6840 Urban

      0.9049 0.9121 40380 Urban

      0.9085 York. 33800............ Westchester County, 5600 Urban

      1.3464 1.3188 35644 Urban

      1.3326 New York. 33900............ Wyoming County, New

      33 Rural

      0.8395 0.8154 99933 Rural

      0.8275 York. 33910............ Yates County, New

      33 Rural

      0.8395 0.8154 99933 Rural

      0.8275 York. 34000............ Alamance County, N

      3120 Urban

      0.9018 0.8905 15500 Urban

      0.8962 Carolina. 34010............ Alexander County, N 3290 Urban

      0.8921 0.8921 25860 Urban

      0.8921 Carolina. 34020............ Alleghany County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34030............ Anson County, N

      34 Rural

      0.8462 0.9750 16740 Urban

      0.9106 Carolina. 34040............ Ashe County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34050............ Avery County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34060............ Beaufort County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34070............ Bertie County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34080............ Bladen County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34090............ Brunswick County, N 9200 Urban

      0.9582 0.9582 48900 Urban

      0.9582 Carolina. 34100............ Buncombe County, N

      0480 Urban

      0.9737 0.9285 11700 Urban

      0.9511 Carolina. 34110............ Burke County, N

      3290 Urban

      0.8921 0.8921 25860 Urban

      0.8921 Carolina. 34120............ Cabarrus County, N

      1520 Urban

      0.9715 0.9750 16740 Urban

      0.9733 Carolina. 34130............ Caldwell County, N

      3290 Urban

      0.8921 0.8921 25860 Urban

      0.8921 Carolina. 34140............ Camden County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34150............ Carteret County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34160............ Caswell County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34170............ Catawba County, N

      3290 Urban

      0.8921 0.8921 25860 Urban

      0.8921 Carolina. 34180............ Chatham County, N

      6640 Urban

      1.0034 1.0244 20500 Urban

      1.0139 Carolina. 34190............ Cherokee County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34200............ Chowan County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34210............ Clay County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34220............ Cleveland County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34230............ Columbus County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34240............ Craven County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34250............ Cumberland County, N 2560 Urban

      0.9416 0.9416 22180 Urban

      0.9416 Carolina. 34251............ Currituck County, N 5720 Urban

      0.8799 0.8799 47260 Urban

      0.8799 Carolina. 34270............ are County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34280............ Davidson County, N

      3120 Urban

      0.9018 0.8540 99934 Rural

      0.8779 Carolina. 34290............ Davie County, N

      3120 Urban

      0.9018 0.8944 49180 Urban

      0.8981 Carolina. 34300............ Duplin County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina.

      [[Page 45108]]

      34310............ Durham County, N

      6640 Urban

      1.0034 1.0244 20500 Urban

      1.0139 Carolina. 34320............ Edgecombe County, N 6895 Urban

      0.8915 0.8915 40580 Urban

      0.8915 Carolina. 34330............ Forsyth County, N

      3120 Urban

      0.9018 0.8944 49180 Urban

      0.8981 Carolina. 34340............ Franklin County, N

      6640 Urban

      1.0034 0.9691 39580 Urban

      0.9863 Carolina. 34350............ Gaston County, N

      1520 Urban

      0.9715 0.9750 16740 Urban

      0.9733 Carolina. 34360............ Gates County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34370............ Graham County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34380............ Granville County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34390............ Greene County, N

      34 Rural

      0.8462 0.9425 24780 Urban

      0.8944 Carolina. 34400............ Guilford County, N

      3120 Urban

      0.9018 0.9104 24660 Urban

      0.9061 Carolina. 34410............ Halifax County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34420............ Harnett County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34430............ Haywood County, N

      34 Rural

      0.8462 0.9285 11700 Urban

      0.8874 Carolina. 34440............ Henderson County, N

      34 Rural

      0.8462 0.9285 11700 Urban

      0.8874 Carolina. 34450............ Hertford County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34460............ Hoke County, N

      34 Rural

      0.8462 0.9416 22180 Urban

      0.8939 Carolina. 34470............ Hyde County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34480............ Iredell County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34490............ Jackson County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34500............ Johnston County, N

      6640 Urban

      1.0034 0.9691 39580 Urban

      0.9863 Carolina. 34510............ Jones County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34520............ Lee County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34530............ Lenoir County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34540............ Lincoln County, N

      1520 Urban

      0.9715 0.8540 99934 Rural

      0.9128 Carolina. 34550............ Mc Dowell County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34560............ Macon County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34570............ Madison County, N

      0480 Urban

      0.9737 0.9285 11700 Urban

      0.9511 Carolina. 34580............ Martin County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34590............ Mecklenburg County, N 1520 Urban

      0.9715 0.9750 16740 Urban

      0.9733 Carolina. 34600............ Mitchell County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34610............ Montgomery County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34620............ Moore County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34630............ Nash County, N

      6895 Urban

      0.8915 0.8915 40580 Urban

      0.8915 Carolina. 34640............ New Hanover County, N 9200 Urban

      0.9582 0.9582 48900 Urban

      0.9582 Carolina. 34650............ Northampton County, N 34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34660............ Onslow County, N

      3605 Urban

      0.8236 0.8236 27340 Urban

      0.8236 Carolina. 34670............ Orange County, N

      6640 Urban

      1.0034 1.0244 20500 Urban

      1.0139 Carolina. 34680............ Pamlico County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34690............ Pasquotank County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34700............ Pender County, N

      34 Rural

      0.8462 0.9582 48900 Urban

      0.9022 Carolina. 34710............ Perquimans County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34720............ Person County, N

      34 Rural

      0.8462 1.0244 20500 Urban

      0.9353 Carolina. 34730............ Pitt County, N

      3150 Urban

      0.9425 0.9425 24780 Urban

      0.9425 Carolina. 34740............ Polk County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34750............ Randolph County, N

      3120 Urban

      0.9018 0.9104 24660 Urban

      0.9061 Carolina. 34760............ Richmond County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34770............ Robeson County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34780............ Rockingham County, N

      34 Rural

      0.8462 0.9104 24660 Urban

      0.8783 Carolina. 34790............ Rowan County, N

      1520 Urban

      0.9715 0.8540 99934 Rural

      0.9128 Carolina. 34800............ Rutherford County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34810............ Sampson County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34820............ Scotland County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34830............ Stanly County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34840............ Stokes County, N

      3120 Urban

      0.9018 0.8944 49180 Urban

      0.8981 Carolina. 34850............ Surry County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34860............ Swain County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34870............ Transylvania County,

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 N Carolina. 34880............ Tyrrell County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34890............ Union County, N

      1520 Urban

      0.9715 0.9750 16740 Urban

      0.9733 Carolina. 34900............ Vance County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34910............ Wake County, N

      6640 Urban

      1.0034 0.9691 39580 Urban

      0.9863 Carolina. 34920............ Warren County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34930............ Washington County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34940............ Watauga County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34950............ Wayne County, N

      2980 Urban

      0.8775 0.8775 24140 Urban

      0.8775 Carolina. 34960............ Wilkes County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34970............ Wilson County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 34980............ Yadkin County, N

      3120 Urban

      0.9018 0.8944 49180 Urban

      0.8981 Carolina.

      [[Page 45109]]

      34981............ Yancey County, N

      34 Rural

      0.8462 0.8540 99934 Rural

      0.8501 Carolina. 35000............ Adams County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35010............ Barnes County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35020............ Benson County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35030............ Billings County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35040............ Bottineau County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35050............ Bowman County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35060............ Burke County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35070............ Burleigh County, N

      1010 Urban

      0.7574 0.7574 13900 Urban

      0.7574 Dakota. 35080............ Cass County, N Dakota 2520 Urban

      0.8486 0.8486 22020 Urban

      0.8486 35090............ Cavalier County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35100............ Dickey County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35110............ Divide County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 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

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35150............ Foster County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35160............ Golden Valley County, 35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 N Dakota. 35170............ Grand Forks County, N 2985 Urban

      0.7901 0.7901 24220 Urban

      0.7901 Dakota. 35180............ Grant County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35190............ Griggs County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35200............ Hettinger County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35210............ Kidder County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35220............ La Moure County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35230............ Logan County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35240............ Mc Henry County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35250............ Mc Intosh County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35260............ Mc Kenzie County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35270............ Mc Lean County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35280............ Mercer County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35290............ Morton County, N

      1010 Urban

      0.7574 0.7574 13900 Urban

      0.7574 Dakota. 35300............ Mountrail County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35310............ Nelson County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35320............ Oliver County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35330............ Pembina County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35340............ Pierce County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35350............ Ramsey County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35360............ Ransom County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35370............ Renville County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35380............ Richland County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35390............ Rolette County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35400............ Sargent County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35410............ Sheridan County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35420............ Sioux County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35430............ Slope County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35440............ Stark County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35450............ Steele County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35460............ Stutsman County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35470............ Towner County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35480............ Traill County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35490............ Walsh County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35500............ Ward County, N Dakota 35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 35510............ Wells County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 35520............ Williams County, N

      35 Rural

      0.7261 0.7261 99935 Rural

      0.7261 Dakota. 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,

      1680 Urban

      0.9183 0.8826 99936 Rural

      0.9005 Ohio. 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,

      36 Rural

      0.8921 0.8826 99936 Rural

      0.8874 Ohio. 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

      [[Page 45110]]

      36140............ Columbiana County,

      9320 Urban

      0.8848 0.8826 99936 Rural

      0.8837 Ohio. 36150............ Coshocton County,

      36 Rural

      0.8921 0.8826 99936 Rural

      0.8874 Ohio. 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,

      1840 Urban

      0.9874 0.9860 18140 Urban

      0.9867 Ohio. 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,

      8080 Urban

      0.7819 0.7819 48260 Urban

      0.7819 Ohio. 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,

      2000 Urban

      0.8980 0.9064 19380 Urban

      0.9022 Ohio. 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,

      36 Rural

      0.8921 0.8826 99936 Rural

      0.8874 Ohio. 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 ------ 31900 Urban

      0.8902 \1\ 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,

      36 Rural

      0.8921 0.8826 99936 Rural

      0.8874 Ohio. 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

      [[Page 45111]]

      36840............ Warren County, Ohio.. 1640 Urban

      0.9734 0.9615 17140 Urban

      0.9675 36850............ Washington County,

      6020 Urban

      0.8270 0.8270 37620 Urban

      0.8270 Ohio. 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,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37010............ Alfalfa County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37020............ Atoka County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37030............ Beaver County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37040............ Beckham County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37050............ Blaine County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37060............ Bryan County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37070............ Caddo County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37080............ Canadian County,

      5880 Urban

      0.9025 0.9031 36420 Urban

      0.9028 Oklahoma. 37090............ Carter County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37100............ Cherokee County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37110............ Choctaw County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37120............ Cimarron County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37130............ Cleveland County,

      5880 Urban

      0.9025 0.9031 36420 Urban

      0.9028 Oklahoma. 37140............ Coal County, Oklahoma 37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 37150............ Comanche County,

      4200 Urban

      0.7872 0.7872 30020 Urban

      0.7872 Oklahoma. 37160............ Cotton County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37170............ Craig County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37180............ Creek County,

      8560 Urban

      0.8587 0.8543 46140 Urban

      0.8565 Oklahoma. 37190............ Custer County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37200............ Delaware County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37210............ Dewey County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37220............ Ellis County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37230............ Garfield County,

      2340 Urban

      0.8666 0.7581 99937 Rural

      0.8124 Oklahoma. 37240............ Garvin County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37250............ Grady County,

      37 Rural

      0.7442 0.9031 36420 Urban

      0.8237 Oklahoma. 37260............ Grant County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37270............ Greer County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37280............ Harmon County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37290............ Harper County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37300............ Haskell County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37310............ Hughes County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37320............ Jackson County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37330............ Jefferson County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37340............ Johnston County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37350............ Kay County, Oklahoma. 37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 37360............ Kingfisher County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37370............ Kiowa County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37380............ Latimer County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37390............ Le Flore County,

      37 Rural

      0.7442 0.8230 22900 Urban

      0.7836 Oklahoma. 37400............ Lincoln County,

      37 Rural

      0.7442 0.9031 36420 Urban

      0.8237 Oklahoma. 37410............ Logan County,

      5880 Urban

      0.9025 0.9031 36420 Urban

      0.9028 Oklahoma. 37420............ Love County, Oklahoma 37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 37430............ Mc Clain County,

      5880 Urban

      0.9025 0.9031 36420 Urban

      0.9028 Oklahoma. 37440............ Mc Curtain County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37450............ Mc Intosh County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37460............ Major County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37470............ Marshall County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37480............ Mayes County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37490............ Murray County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37500............ Muskogee County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37510............ Noble County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37520............ Nowata County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37530............ Okfuskee County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37540............ Oklahoma County,

      5880 Urban

      0.9025 0.9031 36420 Urban

      0.9028 Oklahoma. 37550............ Okmulgee County,

      37 Rural

      0.7442 0.8543 46140 Urban

      0.7993 Oklahoma. 37560............ Osage County,

      8560 Urban

      0.8587 0.8543 46140 Urban

      0.8565 Oklahoma. 37570............ Ottawa County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37580............ Pawnee County,

      37 Rural

      0.7442 0.8543 46140 Urban

      0.7993 Oklahoma. 37590............ Payne County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37600............ Pittsburg County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37610............ Pontotoc County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma.

      [[Page 45112]]

      37620............ Pottawatomie County, 5880 Urban

      0.9025 0.7581 99937 Rural

      0.8303 Oklahoma. 37630............ Pushmataha County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37640............ Roger Mills County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37650............ Rogers County,

      8560 Urban

      0.8587 0.8543 46140 Urban

      0.8565 Oklahoma. 37660............ Seminole County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37670............ Sequoyah County,

      2720 Urban

      0.8246 0.8230 22900 Urban

      0.8238 Oklahoma. 37680............ Stephens County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37690............ Texas County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37700............ Tillman County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37710............ Tulsa County,

      8560 Urban

      0.8587 0.8543 46140 Urban

      0.8565 Oklahoma. 37720............ Wagoner County,

      8560 Urban

      0.8587 0.8543 46140 Urban

      0.8565 Oklahoma. 37730............ Washington County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37740............ Washita County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37750............ Woods County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 37760............ Woodward County,

      37 Rural

      0.7442 0.7581 99937 Rural

      0.7512 Oklahoma. 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,

      6440 Urban

      1.1266 1.1266 38900 Urban

      1.1266 Oregon. 38030............ Clatsop County,

      38 Rural

      1.0052 0.9826 99938 Rural

      0.9939 Oregon. 38040............ Columbia County,

      6440 Urban

      1.1266 1.1266 38900 Urban

      1.1266 Oregon. 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,

      38 Rural

      1.0052 1.0786 13460 Urban

      1.0419 Oregon. 38090............ Douglas County,

      38 Rural

      1.0052 0.9826 99938 Rural

      0.9939 Oregon. 38100............ Gilliam County,

      38 Rural

      1.0052 0.9826 99938 Rural

      0.9939 Oregon. 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,

      38 Rural

      1.0052 0.9826 99938 Rural

      0.9939 Oregon. 38140............ Jackson County,

      4890 Urban

      1.0225 1.0225 32780 Urban

      1.0225 Oregon. 38150............ Jefferson County,

      38 Rural

      1.0052 0.9826 99938 Rural

      0.9939 Oregon. 38160............ Josephine County,

      38 Rural

      1.0052 0.9826 99938 Rural

      0.9939 Oregon. 38170............ Klamath County,

      38 Rural

      1.0052 0.9826 99938 Rural

      0.9939 Oregon. 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,

      38 Rural

      1.0052 0.9826 99938 Rural

      0.9939 Oregon. 38210............ Linn County, Oregon.. 38 Rural

      1.0052 0.9826 99938 Rural

      0.9939 38220............ Malheur County,

      38 Rural

      1.0052 0.9826 99938 Rural

      0.9939 Oregon. 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,

      6440 Urban

      1.1266 1.1266 38900 Urban

      1.1266 Oregon. 38260............ Polk County, Oregon.. 7080 Urban

      1.0442 1.0442 41420 Urban

      1.0442 38270............ Sherman County,

      38 Rural

      1.0052 0.9826 99938 Rural

      0.9939 Oregon. 38280............ Tillamook County,

      38 Rural

      1.0052 0.9826 99938 Rural

      0.9939 Oregon. 38290............ Umatilla County,

      38 Rural

      1.0052 0.9826 99938 Rural

      0.9939 Oregon. 38300............ Union County, Oregon. 38 Rural

      1.0052 0.9826 99938 Rural

      0.9939 38310............ Wallowa County,

      38 Rural

      1.0052 0.9826 99938 Rural

      0.9939 Oregon. 38320............ Wasco County, Oregon. 38 Rural

      1.0052 0.9826 99938 Rural

      0.9939 38330............ Washington County,

      6440 Urban

      1.1266 1.1266 38900 Urban

      1.1266 Oregon. 38340............ Wheeler County,

      38 Rural

      1.0052 0.9826 99938 Rural

      0.9939 Oregon. 38350............ Yamhill County,

      6440 Urban

      1.1266 1.1266 38900 Urban

      1.1266 Oregon. 39000............ Adams County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39010............ Allegheny County,

      6280 Urban

      0.8860 0.8845 38300 Urban

      0.8853 Pennsylvania. 39070............ Armstrong County,

      39 Rural

      0.8319 0.8845 38300 Urban

      0.8582 Pennsylvania. 39080............ Beaver County,

      6280 Urban

      0.8860 0.8845 38300 Urban

      0.8853 Pennsylvania. 39100............ Bedford County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39110............ Berks County,

      6680 Urban

      0.9686 0.9686 39740 Urban

      0.9686 Pennsylvania. 39120............ Blair County,

      0280 Urban

      0.8944 0.8944 11020 Urban

      0.8944 Pennsylvania. 39130............ Bradford County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39140............ Bucks County,

      6160 Urban

      1.0922 1.1038 37964 Urban

      1.0980 Pennsylvania. 39150............ Butler County,

      6280 Urban

      0.8860 0.8845 38300 Urban

      0.8853 Pennsylvania. 39160............ Cambria County,

      3680 Urban

      0.8086 0.8354 27780 Urban

      0.8220 Pennsylvania. 39180............ Cameron County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39190............ Carbon County,

      0240 Urban

      0.9845 0.9818 10900 Urban

      0.9832 Pennsylvania. 39200............ Centre County,

      8050 Urban

      0.8356 0.8356 44300 Urban

      0.8356 Pennsylvania. 39210............ Chester County,

      6160 Urban

      1.0922 1.1038 37964 Urban

      1.0980 Pennsylvania. 39220............ Clarion County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39230............ Clearfield County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania.

      [[Page 45113]]

      39240............ Clinton County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39250............ Columbia County,

      7560 Urban

      0.8524 0.8291 99939 Rural

      0.8408 Pennsylvania. 39260............ Crawford County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39270............ Cumberland County,

      3240 Urban

      0.9233 0.9313 25420 Urban

      0.9273 Pennsylvania. 39280............ Dauphin County,

      3240 Urban

      0.9233 0.9313 25420 Urban

      0.9273 Pennsylvania. 39290............ Delaware County,

      6160 Urban

      1.0922 1.1038 37964 Urban

      1.0980 Pennsylvania. 39310............ Elk County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39320............ Erie County,

      2360 Urban

      0.8737 0.8737 21500 Urban

      0.8737 Pennsylvania. 39330............ Fayette County,

      6280 Urban

      0.8860 0.8845 38300 Urban

      0.8853 Pennsylvania. 39340............ Forest County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39350............ Franklin County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39360............ Fulton County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39370............ Greene County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39380............ Huntingdon County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39390............ Indiana County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39400............ Jefferson County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39410............ Juniata County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39420............ Lackawanna County,

      7560 Urban

      0.8524 0.8540 42540 Urban

      0.8532 Pennsylvania. 39440............ Lancaster County,

      4000 Urban

      0.9694 0.9694 29540 Urban

      0.9694 Pennsylvania. 39450............ Lawrence County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39460............ Lebanon County,

      3240 Urban

      0.9233 0.8459 30140 Urban

      0.8846 Pennsylvania. 39470............ Lehigh County,

      0240 Urban

      0.9845 0.9818 10900 Urban

      0.9832 Pennsylvania. 39480............ Luzerne County,

      7560 Urban

      0.8524 0.8540 42540 Urban

      0.8532 Pennsylvania. 39510............ Lycoming County,

      9140 Urban

      0.8364 0.8364 48700 Urban

      0.8364 Pennsylvania. 39520............ Mc Kean County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39530............ Mercer County,

      7610 Urban

      0.7793 0.8603 49660 Urban

      0.8198 Pennsylvania. 39540............ Mifflin County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39550............ Monroe County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39560............ Montgomery County,

      6160 Urban

      1.0922 1.1038 37964 Urban

      1.0980 Pennsylvania. 39580............ Montour County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39590............ Northampton County, 0240 Urban

      0.9845 0.9818 10900 Urban

      0.9832 Pennsylvania. 39600............ Northumberland

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 County, Pennsylvania. 39610............ Perry County,

      3240 Urban

      0.9233 0.9313 25420 Urban

      0.9273 Pennsylvania. 39620............ Philadelphia County, 6160 Urban

      1.0922 1.1038 37964 Urban

      1.0980 Pennsylvania. 39630............ Pike County,

      5660 Urban

      1.1207 1.1883 35084 Urban

      1.1545 Pennsylvania. 39640............ Potter County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39650............ Schuylkill County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39670............ Snyder County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39680............ Somerset County,

      3680 Urban

      0.8086 0.8291 99939 Rural

      0.8189 Pennsylvania. 39690............ Sullivan County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39700............ Susquehanna County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39710............ Tioga County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39720............ Union County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39730............ Venango County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39740............ Warren County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39750............ Washington County,

      6280 Urban

      0.8860 0.8845 38300 Urban

      0.8853 Pennsylvania. 39760............ Wayne County,

      39 Rural

      0.8319 0.8291 99939 Rural

      0.8305 Pennsylvania. 39770............ Westmoreland County, 6280 Urban

      0.8860 0.8845 38300 Urban

      0.8853 Pennsylvania. 39790............ Wyoming County,

      7560 Urban

      0.8524 0.8540 42540 Urban

      0.8532 Pennsylvania. 39800............ York County,

      9280 Urban

      0.9347 0.9347 49620 Urban

      0.9347 Pennsylvania. 40010............ Adjuntas County,

      40 Rural

      0.3604 0.4047 99940 Rural

      0.3826 Puerto Rico. 40020............ Aguada County, Puerto 0060 Urban

      0.4876 0.4738 10380 Urban

      0.4807 Rico. 40030............ Aguadilla County,

      0060 Urban

      0.4876 0.4738 10380 Urban

      0.4807 Puerto Rico. 40040............ Aguas Buenas County, 7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Puerto Rico. 40050............ Aibonito County,

      40 Rural

      0.3604 0.4621 41980 Urban

      0.4113 Puerto Rico. 40060............ Anasco County, Puerto 4840 Urban

      0.4243 0.4738 10380 Urban

      0.4491 Rico. 40070............ Arecibo County,

      0470 Urban

      0.4112 0.4621 41980 Urban

      0.4367 Puerto Rico. 40080............ Arroyo County, Puerto 40 Rural

      0.3604 0.3181 25020 Urban

      0.3393 Rico. 40090............ Barceloneta County, 7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Puerto Rico. 40100............ Barranquitas County,

      40 Rural

      0.3604 0.4621 41980 Urban

      0.4113 Puerto Rico. 40110............ Bayamon County,

      7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Puerto Rico. 40120............ Cabo Rojo County,

      4840 Urban

      0.4243 0.4650 41900 Urban

      0.4447 Puerto Rico. 40130............ Caguas County, Puerto 1310 Urban

      0.4120 0.4621 41980 Urban

      0.4371 Rico. 40140............ Camuy County, Puerto 0470 Urban

      0.4112 0.4621 41980 Urban

      0.4367 Rico. 40145............ Canovanas County,

      7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Puerto Rico. 40150............ Carolina County,

      7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Puerto Rico. 40160............ Catano County, Puerto 7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Rico. 40170............ Cayey County, Puerto 1310 Urban

      0.4120 0.4621 41980 Urban

      0.4371 Rico.

      [[Page 45114]]

      40180............ Ceiba County, Puerto 7440 Urban

      0.4752 0.4153 21940 Urban

      0.4453 Rico. 40190............ Ciales County, Puerto 40 Rural

      0.3604 0.4621 41980 Urban

      0.4113 Rico. 40200............ Cidra County, Puerto 1310 Urban

      0.4120 0.4621 41980 Urban

      0.4371 Rico. 40210............ Coamo County, Puerto

      40 Rural

      0.3604 0.4047 99940 Rural

      0.3826 Rico. 40220............ Comerio County,

      7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Puerto Rico. 40230............ Corozal County,

      7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Puerto Rico. 40240............ Culebra County,

      40 Rural

      0.3604 0.4047 99940 Rural

      0.3826 Puerto Rico. 40250............ Dorado County, Puerto 7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Rico. 40260............ Fajardo County,

      7440 Urban

      0.4752 0.4153 21940 Urban

      0.4453 Puerto Rico. 40265............ Florida County,

      7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Puerto Rico. 40270............ Guanica County,

      40 Rural

      0.3604 0.4408 49500 Urban

      0.4006 Puerto Rico. 40280............ Guayama County,

      40 Rural

      0.3604 0.3181 25020 Urban

      0.3393 Puerto Rico. 40290............ Guayanilla County,

      6360 Urban

      0.4881 0.4408 49500 Urban

      0.4645 Puerto Rico. 40300............ Guaynabo County,

      7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Puerto Rico. 40310............ Gurabo County, Puerto 1310 Urban

      0.4120 0.4621 41980 Urban

      0.4371 Rico. 40320............ Hatillo County,

      0470 Urban

      0.4112 0.4621 41980 Urban

      0.4367 Puerto Rico. 40330............ Hormigueros County, 4840 Urban

      0.4243 0.4020 32420 Urban

      0.4132 Puerto Rico. 40340............ Humacao County,

      7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Puerto Rico. 40350............ Isabela County,

      40 Rural

      0.3604 0.4738 10380 Urban

      0.4171 Puerto Rico. 40360............ Jayuya County, Puerto 40 Rural

      0.3604 0.4047 99940 Rural

      0.3826 Rico. 40370............ Juana Diaz County,

      6360 Urban

      0.4881 0.4939 38660 Urban

      0.4910 Puerto Rico. 40380............ Juncos County, Puerto 7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Rico. 40390............ Lajas County, Puerto

      40 Rural

      0.3604 0.4650 41900 Urban

      0.4127 Rico. 40400............ Lares County, Puerto

      40 Rural

      0.3604 0.4738 10380 Urban

      0.4171 Rico. 40410............ Las Marias County,

      40 Rural

      0.3604 0.4047 99940 Rural

      0.3826 Puerto Rico. 40420............ Las Piedras County, 7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Puerto Rico. 40430............ Loiza County, Puerto 7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Rico. 40440............ Luquillo County,

      7440 Urban

      0.4752 0.4153 21940 Urban

      0.4453 Puerto Rico. 40450............ Manati County, Puerto 7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Rico. 40460............ Maricao County,

      40 Rural

      0.3604 0.4047 99940 Rural

      0.3826 Puerto Rico. 40470............ Maunabo County,

      40 Rural

      0.3604 0.4621 41980 Urban

      0.4113 Puerto Rico. 40480............ Mayaguez County,

      4840 Urban

      0.4243 0.4020 32420 Urban

      0.4132 Puerto Rico. 40490............ Moca County, Puerto 0060 Urban

      0.4876 0.4738 10380 Urban

      0.4807 Rico. 40500............ Morovis County,

      7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Puerto Rico. 40510............ Naguabo County,

      7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Puerto Rico. 40520............ Naranjito County,

      7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Puerto Rico. 40530............ Orocovis County,

      40 Rural

      0.3604 0.4621 41980 Urban

      0.4113 Puerto Rico. 40540............ Patillas County,

      40 Rural

      0.3604 0.3181 25020 Urban

      0.3393 Puerto Rico. 40550............ Penuelas County,

      6360 Urban

      0.4881 0.4408 49500 Urban

      0.4645 Puerto Rico. 40560............ Ponce County, Puerto 6360 Urban

      0.4881 0.4939 38660 Urban

      0.4910 Rico. 40570............ Quebradillas County,

      40 Rural

      0.3604 0.4621 41980 Urban

      0.4113 Puerto Rico. 40580............ Rincon County, Puerto 40 Rural

      0.3604 0.4738 10380 Urban

      0.4171 Rico. 40590............ Rio Grande County,

      7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Puerto Rico. 40610............ Sabana Grande County, 4840 Urban

      0.4243 0.4650 41900 Urban

      0.4447 Puerto Rico. 40620............ Salinas County,

      40 Rural

      0.3604 0.4047 99940 Rural

      0.3826 Puerto Rico. 40630............ San German County,

      4840 Urban

      0.4243 0.4650 41900 Urban

      0.4447 Puerto Rico. 40640............ San Juan County,

      7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Puerto Rico. 40650............ San Lorenzo County, 1310 Urban

      0.4120 0.4621 41980 Urban

      0.4371 Puerto Rico. 40660............ San Sebastian County, 40 Rural

      0.3604 0.4738 10380 Urban

      0.4171 Puerto Rico. 40670............ Santa Isabel County,

      40 Rural

      0.3604 0.4047 99940 Rural

      0.3826 Puerto Rico. 40680............ Toa Alta County,

      7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Puerto Rico. 40690............ Toa Baja County,

      7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Puerto Rico. 40700............ Trujillo Alto County, 7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Puerto Rico. 40710............ Utuado County, Puerto 40 Rural

      0.3604 0.4047 99940 Rural

      0.3826 Rico. 40720............ Vega Alta County,

      7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Puerto Rico. 40730............ Vega Baja County,

      7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Puerto Rico. 40740............ Vieques County,

      40 Rural

      0.3604 0.4047 99940 Rural

      0.3826 Puerto Rico. 40750............ Villalba County,

      6360 Urban

      0.4881 0.4939 38660 Urban

      0.4910 Puerto Rico. 40760............ Yabucoa County,

      7440 Urban

      0.4752 0.4621 41980 Urban

      0.4687 Puerto Rico. 40770............ Yauco County, Puerto 6360 Urban

      0.4881 0.4408 49500 Urban

      0.4645 Rico. 41000............ Bristol County, Rhode 6483 Urban

      1.1058 1.0966 39300 Urban

      1.1012 Island. 41010............ Kent County, Rhode

      6483 Urban

      1.1058 1.0966 39300 Urban

      1.1012 Island. 41020............ Newport County, Rhode 6483 Urban

      1.1058 1.0966 39300 Urban

      1.1012 Island. 41030............ Providence County,

      6483 Urban

      1.1058 1.0966 39300 Urban

      1.1012 Rhode Island. 41050............ Washington County,

      6483 Urban

      1.1058 1.0966 39300 Urban

      1.1012 Rhode Island. 42000............ Abbeville County, S

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 Carolina. 42010............ Aiken County, S

      0600 Urban

      0.9808 0.9748 12260 Urban

      0.9778 Carolina. 42020............ Allendale County, S

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 Carolina.

      [[Page 45115]]

      42030............ Anderson County, S

      3160 Urban

      0.9615 0.8997 11340 Urban

      0.9306 Carolina. 42040............ Bamberg County, S

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 Carolina. 42050............ Barnwell County, S

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 Carolina. 42060............ Beaufort County, S

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 Carolina. 42070............ Berkeley County, S

      1440 Urban

      0.9245 0.9245 16700 Urban

      0.9245 Carolina. 42080............ Calhoun County, S

      42 Rural

      0.8631 0.9057 17900 Urban

      0.8844 Carolina. 42090............ Charleston County, S 1440 Urban

      0.9245 0.9245 16700 Urban

      0.9245 Carolina. 42100............ Cherokee County, S

      3160 Urban

      0.9615 0.8638 99942 Rural

      0.9127 Carolina. 42110............ Chester County, S

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 Carolina. 42120............ Chesterfield County,

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 S Carolina. 42130............ Clarendon County, S

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 Carolina. 42140............ Colleton County, S

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 Carolina. 42150............ Darlington County, S

      42 Rural

      0.8631 0.8947 22500 Urban

      0.8789 Carolina. 42160............ Dillon County, S

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 Carolina. 42170............ Dorchester County, S 1440 Urban

      0.9245 0.9245 16700 Urban

      0.9245 Carolina. 42180............ Edgefield County, S 0600 Urban

      0.9808 0.9748 12260 Urban

      0.9778 Carolina. 42190............ Fairfield County, S

      42 Rural

      0.8631 0.9057 17900 Urban

      0.8844 Carolina. 42200............ Florence County, S

      2655 Urban

      0.9042 0.8947 22500 Urban

      0.8995 Carolina. 42210............ Georgetown County, S

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 Carolina. 42220............ Greenville County, S 3160 Urban

      0.9615 1.0027 24860 Urban

      0.9821 Carolina. 42230............ Greenwood County, S

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 Carolina. 42240............ Hampton County, S

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 Carolina. 42250............ Horry County, S

      5330 Urban

      0.8934 0.8934 34820 Urban

      0.8934 Carolina. 42260............ Jasper County, S

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 Carolina. 42270............ Kershaw County, S

      42 Rural

      0.8631 0.9057 17900 Urban

      0.8844 Carolina. 42280............ Lancaster County, S

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 Carolina. 42290............ Laurens County, S

      42 Rural

      0.8631 1.0027 24860 Urban

      0.9329 Carolina. 42300............ Lee County, S

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 Carolina. 42310............ Lexington County, S 1760 Urban

      0.9082 0.9057 17900 Urban

      0.9070 Carolina. 42320............ Mc Cormick County, S

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 Carolina. 42330............ Marion County, S

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 Carolina. 42340............ Marlboro County, S

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 Carolina. 42350............ Newberry County, S

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 Carolina. 42360............ Oconee County, S

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 Carolina. 42370............ Orangeburg County, S

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 Carolina. 42380............ Pickens County, S

      3160 Urban

      0.9615 1.0027 24860 Urban

      0.9821 Carolina. 42390............ Richland County, S

      1760 Urban

      0.9082 0.9057 17900 Urban

      0.9070 Carolina. 42400............ Saluda County, S

      42 Rural

      0.8631 0.9057 17900 Urban

      0.8844 Carolina. 42410............ Spartanburg County, S 3160 Urban

      0.9615 0.9172 43900 Urban

      0.9394 Carolina. 42420............ Sumter County, S

      8140 Urban

      0.8377 0.8377 44940 Urban

      0.8377 Carolina. 42430............ Union County, S

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 Carolina. 42440............ Williamsburg County,

      42 Rural

      0.8631 0.8638 99942 Rural

      0.8635 S Carolina. 42450............ York County, S

      1520 Urban

      0.9715 0.9750 16740 Urban

      0.9733 Carolina. 43010............ Aurora County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43020............ Beadle County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43030............ Bennett County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43040............ Bon Homme County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43050............ Brookings County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43060............ Brown County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43070............ Brule County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43080............ Buffalo County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43090............ Butte County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43100............ Campbell County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43110............ Charles Mix County, S 43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43120............ Clark County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43130............ Clay County, S Dakota 43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 43140............ Codington County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43150............ Corson County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43160............ Custer County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43170............ Davison County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43180............ Day County, S Dakota. 43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 43190............ Deuel County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43200............ Dewey County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43210............ Douglas County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43220............ Edmunds County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43230............ Fall River County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43240............ Faulk County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43250............ Grant County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota.

      [[Page 45116]]

      43260............ Gregory County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43270............ Haakon County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43280............ Hamlin County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43290............ Hand County, S Dakota 43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 43300............ Hanson County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43310............ Harding County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43320............ Hughes County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43330............ Hutchinson County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43340............ Hyde County, S Dakota 43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 43350............ Jackson County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43360............ Jerauld County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43370............ Jones County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43380............ Kingsbury County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43390............ Lake County, S Dakota 43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 43400............ Lawrence County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43410............ Lincoln County, S

      7760 Urban

      0.9635 0.9635 43620 Urban

      0.9635 Dakota. 43420............ Lyman County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43430............ Mc Cook County, S

      43 Rural

      0.8551 0.9635 43620 Urban

      0.9093 Dakota. 43440............ Mc Pherson County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43450............ Marshall County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43460............ Meade County, S

      43 Rural

      0.8551 0.8987 39660 Urban

      0.8769 Dakota. 43470............ Mellette County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43480............ Miner County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43490............ Minnehaha County, S 7760 Urban

      0.9635 0.9635 43620 Urban

      0.9635 Dakota. 43500............ Moody County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43510............ Pennington County, S 6660 Urban

      0.8987 0.8987 39660 Urban

      0.8987 Dakota. 43520............ Perkins County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43530............ Potter County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43540............ Roberts County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43550............ Sanborn County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43560............ Shannon County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43570............ Spink County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43580............ Stanley County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43590............ Sully County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43600............ Todd County, S Dakota 43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 43610............ Tripp County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43620............ Turner County, S

      43 Rural

      0.8551 0.9635 43620 Urban

      0.9093 Dakota. 43630............ Union County, S

      43 Rural

      0.8551 0.9381 43580 Urban

      0.8966 Dakota. 43640............ Walworth County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43650............ Washabaugh County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43670............ Yankton County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 43680............ Ziebach County, S

      43 Rural

      0.8551 0.8560 99943 Rural

      0.8556 Dakota. 44000............ Anderson County,

      3840 Urban

      0.8397 0.8441 28940 Urban

      0.8419 Tennessee. 44010............ Bedford County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44020............ Benton County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44030............ Bledsoe County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44040............ Blount County,

      3840 Urban

      0.8397 0.8441 28940 Urban

      0.8419 Tennessee. 44050............ Bradley County,

      44 Rural

      0.7935 0.8139 17420 Urban

      0.8037 Tennessee. 44060............ Campbell County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44070............ Cannon County,

      44 Rural

      0.7935 0.9741 34980 Urban

      0.8838 Tennessee. 44080............ Carroll County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44090............ Carter County,

      3660 Urban

      0.8007 0.7937 27740 Urban

      0.7972 Tennessee. 44100............ Cheatham County,

      5360 Urban

      0.9760 0.9741 34980 Urban

      0.9751 Tennessee. 44110............ Chester County,

      3580 Urban

      0.8964 0.8964 27180 Urban

      0.8964 Tennessee. 44120............ Claiborne County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44130............ Clay County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44140............ Cocke County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44150............ Coffee County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44160............ Crockett County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44170............ Cumberland County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44180............ Davidson County,

      5360 Urban

      0.9760 0.9741 34980 Urban

      0.9751 Tennessee. 44190............ Decatur County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44200............ De Kalb County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44210............ Dickson County,

      5360 Urban

      0.9760 0.9741 34980 Urban

      0.9751 Tennessee. 44220............ Dyer County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44230............ Fayette County,

      4920 Urban

      0.9416 0.9397 32820 Urban

      0.9407 Tennessee. 44240............ Fentress County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44250............ Franklin County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee.

      [[Page 45117]]

      44260............ Gibson County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44270............ Giles County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44280............ Grainger County,

      44 Rural

      0.7935 0.7961 34100 Urban

      0.7948 Tennessee. 44290............ Greene County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44300............ Grundy County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44310............ Hamblen County,

      44 Rural

      0.7935 0.7961 34100 Urban

      0.7948 Tennessee. 44320............ Hamilton County,

      1560 Urban

      0.9088 0.9088 16860 Urban

      0.9088 Tennessee. 44330............ Hancock County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44340............ Hardeman County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44350............ Hardin County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44360............ Hawkins County,

      3660 Urban

      0.8007 0.8054 28700 Urban

      0.8031 Tennessee. 44370............ Haywood County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44380............ Henderson County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44390............ Henry County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44400............ Hickman County,

      44 Rural

      0.7935 0.9741 34980 Urban

      0.8838 Tennessee. 44410............ Houston County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44420............ Humphreys County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44430............ Jackson County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44440............ Jefferson County,

      44 Rural

      0.7935 0.7961 34100 Urban

      0.7948 Tennessee. 44450............ Johnson County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44460............ Knox County,

      3840 Urban

      0.8397 0.8441 28940 Urban

      0.8419 Tennessee. 44470............ Lake County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44480............ Lauderdale County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44490............ Lawrence County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44500............ Lewis County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44510............ Lincoln County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44520............ Loudon County,

      3840 Urban

      0.8397 0.8441 28940 Urban

      0.8419 Tennessee. 44530............ Mc Minn County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44540............ Mc Nairy County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44550............ Macon County,

      44 Rural

      0.7935 0.9741 34980 Urban

      0.8838 Tennessee. 44560............ Madison County,

      3580 Urban

      0.8964 0.8964 27180 Urban

      0.8964 Tennessee. 44570............ Marion County,

      1560 Urban

      0.9088 0.9088 16860 Urban

      0.9088 Tennessee. 44580............ Marshall County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44590............ Maury County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44600............ Meigs County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44610............ Monroe County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44620............ Montgomery County,

      1660 Urban

      0.8284 0.8284 17300 Urban

      0.8284 Tennessee. 44630............ Moore County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44640............ Morgan County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44650............ Obion County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44660............ Overton County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44670............ Perry County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44680............ Pickett County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44690............ Polk County,

      44 Rural

      0.7935 0.8139 17420 Urban

      0.8037 Tennessee. 44700............ Putnam County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44710............ Rhea County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44720............ Roane County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44730............ Robertson County,

      5360 Urban

      0.9760 0.9741 34980 Urban

      0.9751 Tennessee. 44740............ Rutherford County,

      5360 Urban

      0.9760 0.9741 34980 Urban

      0.9751 Tennessee. 44750............ Scott County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44760............ Sequatchie County,

      44 Rural

      0.7935 0.9088 16860 Urban

      0.8512 Tennessee. 44770............ Sevier County,

      3840 Urban

      0.8397 0.7895 99944 Rural

      0.8146 Tennessee. 44780............ Shelby County,

      4920 Urban

      0.9416 0.9397 32820 Urban

      0.9407 Tennessee. 44790............ Smith County,

      44 Rural

      0.7935 0.9741 34980 Urban

      0.8838 Tennessee. 44800............ Stewart County,

      44 Rural

      0.7935 0.8284 17300 Urban

      0.8110 Tennessee. 44810............ Sullivan County,

      3660 Urban

      0.8007 0.8054 28700 Urban

      0.8031 Tennessee. 44820............ Sumner County,

      5360 Urban

      0.9760 0.9741 34980 Urban

      0.9751 Tennessee. 44830............ Tipton County,

      4920 Urban

      0.9416 0.9397 32820 Urban

      0.9407 Tennessee. 44840............ Trousdale County,

      44 Rural

      0.7935 0.9741 34980 Urban

      0.8838 Tennessee. 44850............ Unicoi County,

      3660 Urban

      0.8007 0.7937 27740 Urban

      0.7972 Tennessee. 44860............ Union County,

      3840 Urban

      0.8397 0.8441 28940 Urban

      0.8419 Tennessee. 44870............ Van Buren County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44880............ Warren County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44890............ Washington County,

      3660 Urban

      0.8007 0.7937 27740 Urban

      0.7972 Tennessee. 44900............ Wayne County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44910............ Weakley County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44920............ White County,

      44 Rural

      0.7935 0.7895 99944 Rural

      0.7915 Tennessee. 44930............ Williamson County,

      5360 Urban

      0.9760 0.9741 34980 Urban

      0.9751 Tennessee.

      [[Page 45118]]

      44940............ Wilson County,

      5360 Urban

      0.9760 0.9741 34980 Urban

      0.9751 Tennessee. 45000............ Anderson County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45010............ Andrews County, Texas 45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 45020............ Angelina County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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,

      45 Rural

      0.7931 0.9156 11100 Urban

      0.8544 Texas. 45060............ Atascosa County,

      45 Rural

      0.7931 0.8980 41700 Urban

      0.8456 Texas. 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,

      1145 Urban

      0.8563 0.9992 26420 Urban

      0.9278 Texas. 45190............ Brazos County, Texas. 1260 Urban

      0.8900 0.8900 17780 Urban

      0.8900 45200............ Brewster County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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,

      45 Rural

      0.7931 0.8900 17780 Urban

      0.8416 Texas. 45222............ Burnet County, Texas. 45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 45223............ Caldwell County,

      0640 Urban

      0.9437 0.9437 12420 Urban

      0.9437 Texas. 45224............ Calhoun County, Texas 45 Rural

      0.7931 0.8160 47020 Urban

      0.8046 45230............ Callahan County,

      45 Rural

      0.7931 0.7896 10180 Urban

      0.7914 Texas. 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,

      3360 Urban

      1.0088 0.9992 26420 Urban

      1.0040 Texas. 45281............ Cherokee County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45290............ Childress County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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, 45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45312............ Colorado County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45320............ Comal County, Texas.. 7240 Urban

      0.8984 0.8980 41700 Urban

      0.8982 45321............ Comanche County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45362............ Crosby County, Texas. 45 Rural

      0.7931 0.8783 31180 Urban

      0.8357 45370............ Culberson County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas.

      [[Page 45119]]

      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,

      3360 Urban

      1.0088 0.9992 26420 Urban

      1.0040 Texas. 45531............ Franklin County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45540............ Freestone County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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,

      2920 Urban

      0.9635 0.9992 26420 Urban

      0.9814 Texas. 45551............ Garza County, Texas.. 45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 45552............ Gillespie County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45560............ Glasscock County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45561............ Goliad County, Texas. 45 Rural

      0.7931 0.8160 47020 Urban

      0.8046 45562............ Gonzales County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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,

      7240 Urban

      0.8984 0.8980 41700 Urban

      0.8982 Texas. 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,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45591............ Hansford County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45592............ Hardeman County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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,

      4420 Urban

      0.8888 0.8003 99945 Rural

      0.8446 Texas. 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,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45640............ Henderson County,

      1920 Urban

      1.0205 0.8003 99945 Rural

      0.9104 Texas. 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,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45670............ Hunt County, Texas... 1920 Urban

      1.0205 1.0228 19124 Urban

      1.0217 45671............ Hutchinson County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45700............ Jefferson County,

      0840 Urban

      0.8412 0.8412 13140 Urban

      0.8412 Texas. 45710............ Jim Hogg County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45711............ Jim Wells County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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

      [[Page 45120]]

      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,

      45 Rural

      0.7931 0.8526 28660 Urban

      0.8229 Texas. 45753............ La Salle County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45759............ Lipscomb County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45760............ Live Oak County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45780............ Mc Lennan County,

      8800 Urban

      0.8518 0.8518 47380 Urban

      0.8518 Texas. 45781............ Mc Mullen County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45791............ Maverick County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45800............ Montague County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45801............ Montgomery County,

      3360 Urban

      1.0088 0.9992 26420 Urban

      1.0040 Texas. 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,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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,

      45 Rural

      0.7931 0.8900 17780 Urban

      0.8416 Texas. 45879............ Rockwall County,

      1920 Urban

      1.0205 1.0228 19124 Urban

      1.0217 Texas. 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, 45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas.

      [[Page 45121]]

      45884............ San Jacinto County,

      45 Rural

      0.7931 0.9992 26420 Urban

      0.8962 Texas. 45885............ San Patricio County, 1880 Urban

      0.8550 0.8550 18580 Urban

      0.8550 Texas. 45886............ San Saba County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45887............ Schleicher County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45888............ Scurry County, Texas. 45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 45889............ Shackelford County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45900............ Starr County, Texas.. 45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 45901............ Stephens County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45902............ Sterling County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45903............ Stonewall County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45921............ Titus County, Texas.. 45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 45930............ Tom Green County,

      7200 Urban

      0.8271 0.8271 41660 Urban

      0.8271 Texas. 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,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45947............ Van Zandt County,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45948............ Victoria County,

      8750 Urban

      0.8160 0.8160 47020 Urban

      0.8160 Texas. 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,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 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,

      45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 Texas. 45962............ Willacy County, Texas 45 Rural

      0.7931 0.8003 99945 Rural

      0.7967 45970............ Williamson County,

      0640 Urban

      0.9437 0.9437 12420 Urban

      0.9437 Texas. 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,

      46 Rural

      0.8762 0.8118 99946 Rural

      0.8440 Utah. 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

      [[Page 45122]]

      46170............ Salt Lake County,

      7160 Urban

      0.9340 0.9421 41620 Urban

      0.9381 Utah. 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,

      46 Rural

      0.8762 0.9392 41100 Urban

      0.9077 Utah. 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,

      47 Rural

      0.9830 0.9830 99947 Rural

      0.9830 Vermont. 47010............ Bennington County,

      47 Rural

      0.9830 0.9830 99947 Rural

      0.9830 Vermont. 47020............ Caledonia County,

      47 Rural

      0.9830 0.9830 99947 Rural

      0.9830 Vermont. 47030............ Chittenden County,

      1303 Urban

      0.9410 0.9410 15540 Urban

      0.9410 Vermont. 47040............ Essex County, Vermont 47 Rural

      0.9830 0.9830 99947 Rural

      0.9830 47050............ Franklin County,

      1303 Urban

      0.9410 0.9410 15540 Urban

      0.9410 Vermont. 47060............ Grand Isle County,

      1303 Urban

      0.9410 0.9410 15540 Urban

      0.9410 Vermont. 47070............ Lamoille County,

      47 Rural

      0.9830 0.9830 99947 Rural

      0.9830 Vermont. 47080............ Orange County,

      47 Rural

      0.9830 0.9830 99947 Rural

      0.9830 Vermont. 47090............ Orleans County,

      47 Rural

      0.9830 0.9830 99947 Rural

      0.9830 Vermont. 47100............ Rutland County,

      47 Rural

      0.9830 0.9830 99947 Rural

      0.9830 Vermont. 47110............ Washington County,

      47 Rural

      0.9830 0.9830 99947 Rural

      0.9830 Vermont. 47120............ Windham County,

      47 Rural

      0.9830 0.9830 99947 Rural

      0.9830 Vermont. 47130............ Windsor County,

      47 Rural

      0.9830 0.9830 99947 Rural

      0.9830 Vermont. 48010............ St Croix County,

      48 Rural

      0.7615 0.7615 99948 Rural

      0.7615 Virgin Islands. 48020............ St Thomas-John

      48 Rural

      0.7615 0.7615 99948 Rural

      0.7615 County, Virgin Islands. 49000............ Accomack County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49010............ Albemarle County,

      1540 Urban

      1.0187 1.0187 16820 Urban

      1.0187 Virginia. 49011............ Alexandria City

      8840 Urban

      1.0976 1.0926 47894 Urban

      1.0951 County, Virginia. 49020............ Alleghany County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49030............ Amelia County,

      49 Rural

      0.8417 0.9328 40060 Urban

      0.8873 Virginia. 49040............ Amherst County,

      4640 Urban

      0.8691 0.8691 31340 Urban

      0.8691 Virginia. 49050............ Appomattox County,

      49 Rural

      0.8417 0.8691 31340 Urban

      0.8554 Virginia. 49060............ Arlington County,

      8840 Urban

      1.0976 1.0926 47894 Urban

      1.0951 Virginia. 49070............ Augusta County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49080............ Bath County, Virginia 49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 49088............ Bedford City County, 4640 Urban

      0.8691 0.8691 31340 Urban

      0.8691 Virginia. 49090............ Bedford County,

      4640 Urban

      0.8691 0.8691 31340 Urban

      0.8691 Virginia. 49100............ Bland County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49110............ Botetourt County,

      6800 Urban

      0.8387 0.8374 40220 Urban

      0.8381 Virginia. 49111............ Bristol City County, 3660 Urban

      0.8007 0.8054 28700 Urban

      0.8031 Virginia. 49120............ Brunswick County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49130............ Buchanan County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49140............ Buckingham County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49141............ Buena Vista City

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 County, Virginia. 49150............ Campbell County,

      4640 Urban

      0.8691 0.8691 31340 Urban

      0.8691 Virginia. 49160............ Caroline County,

      49 Rural

      0.8417 0.9328 40060 Urban

      0.8873 Virginia. 49170............ Carroll County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49180............ Charles City County, 6760 Urban

      0.9328 0.9328 40060 Urban

      0.9328 Virginia. 49190............ Charlotte County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49191............ Charlottesville City 1540 Urban

      1.0187 1.0187 16820 Urban

      1.0187 County, Virginia. 49194............ Chesapeake County,

      5720 Urban

      0.8799 0.8799 47260 Urban

      0.8799 Virginia. 49200............ Chesterfield County, 6760 Urban

      0.9328 0.9328 40060 Urban

      0.9328 Virginia. 49210............ Clarke County,

      8840 Urban

      1.0976 1.0926 47894 Urban

      1.0951 Virginia. 49211............ Clifton Forge City

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 County, Virginia. 49212............ Colonial Heights

      6760 Urban

      0.9328 0.9328 40060 Urban

      0.9328 County, Virginia. 49213............ Covington City

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 County, Virginia. 49220............ Craig County,

      49 Rural

      0.8417 0.8374 40220 Urban

      0.8396 Virginia. 49230............ Culpeper County,

      8840 Urban

      1.0976 0.8013 99949 Rural

      0.9495 Virginia. 49240............ Cumberland County,

      49 Rural

      0.8417 0.9328 40060 Urban

      0.8873 Virginia. 49241............ Danville City County, 1950 Urban

      0.8489 0.8489 19260 Urban

      0.8489 Virginia. 49250............ Dickenson County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49260............ Dinniddie County,

      6760 Urban

      0.9328 0.9328 40060 Urban

      0.9328 Virginia. 49270............ Emporia County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49280............ Essex County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49288............ Fairfax City County, 8840 Urban

      1.0976 1.0926 47894 Urban

      1.0951 Virginia.

      [[Page 45123]]

      49290............ Fairfax County,

      8840 Urban

      1.0976 1.0926 47894 Urban

      1.0951 Virginia. 49291............ Falls Church City

      8840 Urban

      1.0976 1.0926 47894 Urban

      1.0951 County, Virginia. 49300............ Fauquier County,

      8840 Urban

      1.0976 1.0926 47894 Urban

      1.0951 Virginia. 49310............ Floyd County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49320............ Fluvanna County,

      1540 Urban

      1.0187 1.0187 16820 Urban

      1.0187 Virginia. 49328............ Franklin City County, 49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49330............ Franklin County,

      49 Rural

      0.8417 0.8374 40220 Urban

      0.8396 Virginia. 49340............ Frederick County,

      49 Rural

      0.8417 1.0214 49020 Urban

      0.9316 Virginia. 49342............ Fredericksburg City 8840 Urban

      1.0976 1.0926 47894 Urban

      1.0951 County, Virginia. 49343............ Galax City County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49350............ Giles County,

      49 Rural

      0.8417 0.7954 13980 Urban

      0.8186 Virginia. 49360............ Gloucester County,

      5720 Urban

      0.8799 0.8799 47260 Urban

      0.8799 Virginia. 49370............ Goochland County,

      6760 Urban

      0.9328 0.9328 40060 Urban

      0.9328 Virginia. 49380............ Grayson County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49390............ Greene County,

      1540 Urban

      1.0187 1.0187 16820 Urban

      1.0187 Virginia. 49400............ Greensville County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49410............ Halifax County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49411............ Hampton City County, 5720 Urban

      0.8799 0.8799 47260 Urban

      0.8799 Virginia. 49420............ Hanover County,

      6760 Urban

      0.9328 0.9328 40060 Urban

      0.9328 Virginia. 49421............ Harrisonburg City

      49 Rural

      0.8417 0.9088 25500 Urban

      0.8753 County, Virginia. 49430............ Henrico County,

      6760 Urban

      0.9328 0.9328 40060 Urban

      0.9328 Virginia. 49440............ Henry County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49450............ Highland County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49451............ Hopewell City County, 6760 Urban

      0.9328 0.9328 40060 Urban

      0.9328 Virginia. 49460............ Isle Of Wight County, 5720 Urban

      0.8799 0.8799 47260 Urban

      0.8799 Virginia. 49470............ James City Co County, 5720 Urban

      0.8799 0.8799 47260 Urban

      0.8799 Virginia. 49480............ King And Queen

      49 Rural

      0.8417 0.9328 40060 Urban

      0.8873 County, Virginia. 49490............ King George County, 8840 Urban

      1.0976 0.8013 99949 Rural

      0.9495 Virginia. 49500............ King William County,

      49 Rural

      0.8417 0.9328 40060 Urban

      0.8873 Virginia. 49510............ Lancaster County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49520............ Lee County, Virginia. 49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 49522............ Lexington County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49530............ Loudoun County,

      8840 Urban

      1.0976 1.0926 47894 Urban

      1.0951 Virginia. 49540............ Louisa County,

      49 Rural

      0.8417 0.9328 40060 Urban

      0.8873 Virginia. 49550............ Lunenburg County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49551............ Lynchburg City

      4640 Urban

      0.8691 0.8691 31340 Urban

      0.8691 County, Virginia. 49560............ Madison County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49561............ Martinsville City

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 County, Virginia. 49563............ Manassas City County, 8840 Urban

      1.0976 1.0926 47894 Urban

      1.0951 Virginia. 49565............ Manassas Park City

      8840 Urban

      1.0976 1.0926 47894 Urban

      1.0951 County, Virginia. 49570............ Mathews County,

      5720 Urban

      0.8799 0.8799 47260 Urban

      0.8799 Virginia. 49580............ Mecklenburg County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49590............ Middlesex County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49600............ Montgomery County,

      49 Rural

      0.8417 0.7954 13980 Urban

      0.8186 Virginia. 49610............ Nansemond County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49620............ Nelson County,

      49 Rural

      0.8417 1.0187 16820 Urban

      0.9302 Virginia. 49621............ New Kent County,

      6760 Urban

      0.9328 0.9328 40060 Urban

      0.9328 Virginia. 49622............ Newport News City

      5720 Urban

      0.8799 0.8799 47260 Urban

      0.8799 County, Virginia. 49641............ Norfolk City County, 5720 Urban

      0.8799 0.8799 47260 Urban

      0.8799 Virginia. 49650............ Northampton County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49660............ Northumberland

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 County, Virginia. 49661............ Norton City County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49670............ Nottoway County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49680............ Orange County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49690............ Page County, Virginia 49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 49700............ Patrick County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49701............ Petersburg City

      6760 Urban

      0.9328 0.9328 40060 Urban

      0.9328 County, Virginia. 49710............ Pittsylvania County, 1950 Urban

      0.8489 0.8489 19260 Urban

      0.8489 Virginia. 49711............ Portsmouth City

      5720 Urban

      0.8799 0.8799 47260 Urban

      0.8799 County, Virginia. 49712............ Poquoson City County, 5720 Urban

      0.8799 0.8799 47260 Urban

      0.8799 Virginia. 49720............ Powhatan County,

      6760 Urban

      0.9328 0.9328 40060 Urban

      0.9328 Virginia. 49730............ Prince Edward County, 49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49740............ Prince George County, 6760 Urban

      0.9328 0.9328 40060 Urban

      0.9328 Virginia. 49750............ Prince William

      8840 Urban

      1.0976 1.0926 47894 Urban

      1.0951 County, Virginia. 49770............ Pulaski County,

      49 Rural

      0.8417 0.7954 13980 Urban

      0.8186 Virginia. 49771............ Radford City County,

      49 Rural

      0.8417 0.7954 13980 Urban

      0.8186 Virginia. 49780............ Rappahannock County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49790............ Richmond County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia.

      [[Page 45124]]

      49791............ Richmond City County, 6760 Urban

      0.9328 0.9328 40060 Urban

      0.9328 Virginia. 49800............ Roanoke County,

      6800 Urban

      0.8387 0.8374 40220 Urban

      0.8381 Virginia. 49801............ Roanoke City County, 6800 Urban

      0.8387 0.8374 40220 Urban

      0.8381 Virginia. 49810............ Rockbridge County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49820............ Rockingham County,

      49 Rural

      0.8417 0.9088 25500 Urban

      0.8753 Virginia. 49830............ Russell County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49838............ Salem County,

      6800 Urban

      0.8387 0.8374 40220 Urban

      0.8381 Virginia. 49840............ Scott County,

      3660 Urban

      0.8007 0.8054 28700 Urban

      0.8031 Virginia. 49850............ Shenandoah County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49860............ Smyth County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49867............ South Boston City

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 County, Virginia. 49870............ Southampton County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49880............ Spotsylvania County, 8840 Urban

      1.0976 1.0926 47894 Urban

      1.0951 Virginia. 49890............ Stafford County,

      8840 Urban

      1.0976 1.0926 47894 Urban

      1.0951 Virginia. 49891............ Staunton City County, 49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49892............ Suffolk City County, 5720 Urban

      0.8799 0.8799 47260 Urban

      0.8799 Virginia. 49900............ Surry County,

      49 Rural

      0.8417 0.8799 47260 Urban

      0.8608 Virginia. 49910............ Sussex County,

      49 Rural

      0.8417 0.9328 40060 Urban

      0.8873 Virginia. 49920............ Tazewell County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49921............ Virginia Beach City 5720 Urban

      0.8799 0.8799 47260 Urban

      0.8799 County, Virginia. 49930............ Warren County,

      8840 Urban

      1.0976 1.0926 47894 Urban

      1.0951 Virginia. 49950............ Washington County,

      3660 Urban

      0.8007 0.8054 28700 Urban

      0.8031 Virginia. 49951............ Waynesboro City

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 County, Virginia. 49960............ Westmoreland County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49961............ Williamsburg City

      5720 Urban

      0.8799 0.8799 47260 Urban

      0.8799 County, Virginia. 49962............ Winchester City

      49 Rural

      0.8417 1.0214 49020 Urban

      0.9316 County, Virginia. 49970............ Wise County, Virginia 49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 49980............ Wythe County,

      49 Rural

      0.8417 0.8013 99949 Rural

      0.8215 Virginia. 49981............ York County, Virginia 5720 Urban

      0.8799 0.8799 47260 Urban

      0.8799 50000............ Adams County,

      50 Rural

      1.0217 1.0510 99950 Rural

      1.0364 Washington. 50010............ Asotin County,

      50 Rural

      1.0217 0.9886 30300 Urban

      1.0052 Washington. 50020............ Benton County,

      6740 Urban

      1.0619 1.0619 28420 Urban

      1.0619 Washington. 50030............ Chelan County,

      50 Rural

      1.0217 1.0070 48300 Urban

      1.0144 Washington. 50040............ Clallam County,

      50 Rural

      1.0217 1.0510 99950 Rural

      1.0364 Washington. 50050............ Clark County,

      6440 Urban

      1.1266 1.1266 38900 Urban

      1.1266 Washington. 50060............ Columbia County,

      50 Rural

      1.0217 1.0510 99950 Rural

      1.0364 Washington. 50070............ Cowlitz County,

      50 Rural

      1.0217 0.9579 31020 Urban

      0.9898 Washington. 50080............ Douglas County,

      50 Rural

      1.0217 1.0070 48300 Urban

      1.0144 Washington. 50090............ Ferry County,

      50 Rural

      1.0217 1.0510 99950 Rural

      1.0364 Washington. 50100............ Franklin County,

      6740 Urban

      1.0619 1.0619 28420 Urban

      1.0619 Washington. 50110............ Garfield County,

      50 Rural

      1.0217 1.0510 99950 Rural

      1.0364 Washington. 50120............ Grant County,

      50 Rural

      1.0217 1.0510 99950 Rural

      1.0364 Washington. 50130............ Grays Harbor County,

      50 Rural

      1.0217 1.0510 99950 Rural

      1.0364 Washington. 50140............ Island County,

      7600 Urban

      1.1567 1.0510 99950 Rural

      1.1039 Washington. 50150............ Jefferson County,

      50 Rural

      1.0217 1.0510 99950 Rural

      1.0364 Washington. 50160............ King County,

      7600 Urban

      1.1567 1.1577 42644 Urban

      1.1572 Washington. 50170............ Kitsap County,

      1150 Urban

      1.0675 1.0675 14740 Urban

      1.0675 Washington. 50180............ Kittitas County,

      50 Rural

      1.0217 1.0510 99950 Rural

      1.0364 Washington. 50190............ Klickitat County,

      50 Rural

      1.0217 1.0510 99950 Rural

      1.0364 Washington. 50200............ Lewis County,

      50 Rural

      1.0217 1.0510 99950 Rural

      1.0364 Washington. 50210............ Lincoln County,

      50 Rural

      1.0217 1.0510 99950 Rural

      1.0364 Washington. 50220............ Mason County,

      50 Rural

      1.0217 1.0510 99950 Rural

      1.0364 Washington. 50230............ Okanogan County,

      50 Rural

      1.0217 1.0510 99950 Rural

      1.0364 Washington. 50240............ Pacific County,

      50 Rural

      1.0217 1.0510 99950 Rural

      1.0364 Washington. 50250............ Pend Oreille County,

      50 Rural

      1.0217 1.0510 99950 Rural

      1.0364 Washington. 50260............ Pierce County,

      8200 Urban

      1.0742 1.0742 45104 Urban

      1.0742 Washington. 50270............ San Juan County,

      50 Rural

      1.0217 1.0510 99950 Rural

      1.0364 Washington. 50280............ Skagit County,

      50 Rural

      1.0217 1.0454 34580 Urban

      1.0336 Washington. 50290............ Skamania County,

      50 Rural

      1.0217 1.1266 38900 Urban

      1.0742 Washington. 50300............ Snohomish County,

      7600 Urban

      1.1567 1.1577 42644 Urban

      1.1572 Washington. 50310............ Spokane County,

      7840 Urban

      1.0905 1.0905 44060 Urban

      1.0905 Washington. 50320............ Stevens County,

      50 Rural

      1.0217 1.0510 99950 Rural

      1.0364 Washington. 50330............ Thurston County,

      5910 Urban

      1.0927 1.0927 36500 Urban

      1.0927 Washington. 50340............ Wahkiakum County,

      50 Rural

      1.0217 1.0510 99950 Rural

      1.0364 Washington. 50350............ Walla Walla County,

      50 Rural

      1.0217 1.0510 99950 Rural

      1.0364 Washington. 50360............ Whatcom County,

      0860 Urban

      1.1731 1.1731 13380 Urban

      1.1731 Washington. 50370............ Whitman County,

      50 Rural

      1.0217 1.0510 99950 Rural

      1.0364 Washington. 50380............ Yakima County,

      9260 Urban

      1.0155 1.0155 49420 Urban

      1.0155 Washington.

      [[Continued on page 45125]]

      From the Federal Register Online via GPO Access [wais.access.gpo.gov] ]

      [[pp. 45125-45127]] Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2006

      [[Continued from page 45124]]

      [[Page 45125]]

      51000............ Barbour County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51010............ Berkeley County, W

      8840 Urban

      1.0976 0.9489 25180 Urban

      1.0233 Virginia. 51020............ Boone County, W

      51 Rural

      0.7900 0.8445 16620 Urban

      0.8173 Virginia. 51030............ Braxton County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51040............ Brooke County, W

      8080 Urban

      0.7819 0.7819 48260 Urban

      0.7819 Virginia. 51050............ Cabell County, W

      3400 Urban

      0.9477 0.9477 26580 Urban

      0.9477 Virginia. 51060............ Calhoun County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51070............ Clay County, W

      51 Rural

      0.7900 0.8445 16620 Urban

      0.8173 Virginia. 51080............ Doddridge County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51090............ Fayette County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51100............ Gilmer County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51110............ Grant County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51120............ Greenbrier County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51130............ Hampshire County, W

      51 Rural

      0.7900 1.0214 49020 Urban

      0.9057 Virginia. 51140............ Hancock County, W

      8080 Urban

      0.7819 0.7819 48260 Urban

      0.7819 Virginia. 51150............ Hardy County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51160............ Harrison County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51170............ Jackson County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51180............ Jefferson County, W 8840 Urban

      1.0976 1.0926 47894 Urban

      1.0951 Virginia. 51190............ Kanawha County, W

      1480 Urban

      0.8445 0.8445 16620 Urban

      0.8445 Virginia. 51200............ Lewis County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51210............ Lincoln County, W

      51 Rural

      0.7900 0.8445 16620 Urban

      0.8173 Virginia. 51220............ Logan County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51230............ Mc Dowell County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51240............ Marion County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51250............ Marshall County, W

      9000 Urban

      0.7161 0.7161 48540 Urban

      0.7161 Virginia. 51260............ Mason County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51270............ Mercer County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51280............ Mineral County, W

      1900 Urban

      0.9317 0.9317 19060 Urban

      0.9317 Virginia. 51290............ Mingo County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51300............ Monongalia County, W

      51 Rural

      0.7900 0.8420 34060 Urban

      0.8160 Virginia. 51310............ Monroe County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51320............ Morgan County, W

      51 Rural

      0.7900 0.9489 25180 Urban

      0.8695 Virginia. 51330............ Nicholas County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51340............ Ohio County, W

      9000 Urban

      0.7161 0.7161 48540 Urban

      0.7161 Virginia. 51350............ Pendleton County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51360............ Pleasants County, W

      51 Rural

      0.7900 0.8270 37620 Urban

      0.8085 Virginia. 51370............ Pocahontas County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51380............ Preston County, W

      51 Rural

      0.7900 0.8420 34060 Urban

      0.8160 Virginia. 51390............ Putnam County, W

      1480 Urban

      0.8445 0.8445 16620 Urban

      0.8445 Virginia. 51400............ Raleigh County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51410............ Randolph County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51420............ Ritchie County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51430............ Roane County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51440............ Summers County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51450............ Taylor County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51460............ Tucker County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51470............ Tyler County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51480............ Upshur County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51490............ Wayne County, W

      3400 Urban

      0.9477 0.9477 26580 Urban

      0.9477 Virginia. 51500............ Webster County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51510............ Wetzel County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 51520............ Wirt County, W

      51 Rural

      0.7900 0.8270 37620 Urban

      0.8085 Virginia. 51530............ Wood County, W

      6020 Urban

      0.8270 0.8270 37620 Urban

      0.8270 Virginia. 51540............ Wyoming County, W

      51 Rural

      0.7900 0.7717 99951 Rural

      0.7809 Virginia. 52000............ Adams County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52010............ Ashland County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52020............ Barron County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52030............ Bayfield County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52040............ Brown County,

      3080 Urban

      0.9483 0.9483 24580 Urban

      0.9483 Wisconsin. 52050............ Buffalo County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52060............ Burnett County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52070............ Calumet County,

      0460 Urban

      0.9239 0.9288 11540 Urban

      0.9264 Wisconsin. 52080............ Chippewa County,

      2290 Urban

      0.9201 0.9201 20740 Urban

      0.9201 Wisconsin. 52090............ Clark County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52100............ Columbia County,

      52 Rural

      0.9478 1.0659 31540 Urban

      1.0069 Wisconsin. 52110............ Crawford County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52120............ Dane County,

      4720 Urban

      1.0754 1.0659 31540 Urban

      1.0707 Wisconsin.

      [[Page 45126]]

      52130............ Dodge County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52140............ Door County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52150............ Douglas County,

      2240 Urban

      1.0213 1.0213 20260 Urban

      1.0213 Wisconsin. 52160............ Dunn County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52170............ Eau Claire County,

      2290 Urban

      0.9201 0.9201 20740 Urban

      0.9201 Wisconsin. 52180............ Florence County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52190............ Fond Du Lac County,

      52 Rural

      0.9478 0.9640 22540 Urban

      0.9559 Wisconsin. 52200............ Forest County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52210............ Grant County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52220............ Green County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52230............ Green Lake County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52240............ Iowa County,

      52 Rural

      0.9478 1.0659 31540 Urban

      1.0069 Wisconsin. 52250............ Iron County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52260............ Jackson County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52270............ Jefferson County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52280............ Juneau County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52290............ Kenosha County,

      3800 Urban

      0.9760 1.0429 29404 Urban

      1.0095 Wisconsin. 52300............ Kewaunee County,

      52 Rural

      0.9478 0.9483 24580 Urban

      0.9481 Wisconsin. 52310............ La Crosse County,

      3870 Urban

      0.9564 0.9564 29100 Urban

      0.9564 Wisconsin. 52320............ Lafayette County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52330............ Langlade County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52340............ Lincoln County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52350............ Manitowoc County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52360............ Marathon County,

      8940 Urban

      0.9590 0.9590 48140 Urban

      0.9590 Wisconsin. 52370............ Marinette County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52380............ Marquette County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52381............ Menominee County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52390............ Milwaukee County,

      5080 Urban

      1.0146 1.0146 33340 Urban

      1.0146 Wisconsin. 52400............ Monroe County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52410............ Oconto County,

      52 Rural

      0.9478 0.9483 24580 Urban

      0.9481 Wisconsin. 52420............ Oneida County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52430............ Outagamie County,

      0460 Urban

      0.9239 0.9288 11540 Urban

      0.9264 Wisconsin. 52440............ Ozaukee County,

      5080 Urban

      1.0146 1.0146 33340 Urban

      1.0146 Wisconsin. 52450............ Pepin County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52460............ Pierce County,

      5120 Urban

      1.1075 1.1075 33460 Urban

      1.1075 Wisconsin. 52470............ Polk County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52480............ Portage County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52490............ Price County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52500............ Racine County,

      6600 Urban

      0.8997 0.8997 39540 Urban

      0.8997 Wisconsin. 52510............ Richland County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52520............ Rock County,

      3620 Urban

      0.9538 0.9538 27500 Urban

      0.9538 Wisconsin. 52530............ Rusk County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52540............ St Croix County,

      5120 Urban

      1.1075 1.1075 33460 Urban

      1.1075 Wisconsin. 52550............ Sauk County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52560............ Sawyer County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52570............ Shawano County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52580............ Sheboygan County,

      7620 Urban

      0.8911 0.8911 43100 Urban

      0.8911 Wisconsin. 52590............ Taylor County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52600............ Trempealeau County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52610............ Vernon County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52620............ Vilas County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52630............ Walworth County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52640............ Washburn County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52650............ Washington County,

      5080 Urban

      1.0146 1.0146 33340 Urban

      1.0146 Wisconsin. 52660............ Waukesha County,

      5080 Urban

      1.0146 1.0146 33340 Urban

      1.0146 Wisconsin. 52670............ Waupaca County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52680............ Waushara County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 52690............ Winnebago County,

      0460 Urban

      0.9239 0.9183 36780 Urban

      0.9211 Wisconsin. 52700............ Wood County,

      52 Rural

      0.9478 0.9509 99952 Rural

      0.9494 Wisconsin. 53000............ Albany County,

      53 Rural

      0.9257 0.9257 99953 Rural

      0.9257 Wyoming. 53010............ Big Horn County,

      53 Rural

      0.9257 0.9257 99953 Rural

      0.9257 Wyoming. 53020............ Campbell County,

      53 Rural

      0.9257 0.9257 99953 Rural

      0.9257 Wyoming. 53030............ Carbon County,

      53 Rural

      0.9257 0.9257 99953 Rural

      0.9257 Wyoming. 53040............ Converse County,

      53 Rural

      0.9257 0.9257 99953 Rural

      0.9257 Wyoming. 53050............ Crook County, Wyoming 53 Rural

      0.9257 0.9257 99953 Rural

      0.9257 53060............ Fremont County,

      53 Rural

      0.9257 0.9257 99953 Rural

      0.9257 Wyoming. 53070............ Goshen County,

      53 Rural

      0.9257 0.9257 99953 Rural

      0.9257 Wyoming. 53080............ Hot Springs County,

      53 Rural

      0.9257 0.9257 99953 Rural

      0.9257 Wyoming.

      [[Page 45127]]

      53090............ Johnson County,

      53 Rural

      0.9257 0.9257 99953 Rural

      0.9257 Wyoming. 53100............ Laramie County,

      1580 Urban

      0.8775 0.8775 16940 Urban

      0.8775 Wyoming. 53110............ Lincoln County,

      53 Rural

      0.9257 0.9257 99953 Rural

      0.9257 Wyoming. 53120............ Natrona County,

      1350 Urban

      0.9026 0.9026 16220 Urban

      0.9026 Wyoming. 53130............ Niobrara County,

      53 Rural

      0.9257 0.9257 99953 Rural

      0.9257 Wyoming. 53140............ Park County, Wyoming. 53 Rural

      0.9257 0.9257 99953 Rural

      0.9257 53150............ Platte County,

      53 Rural

      0.9257 0.9257 99953 Rural

      0.9257 Wyoming. 53160............ Sheridan County,

      53 Rural

      0.9257 0.9257 99953 Rural

      0.9257 Wyoming. 53170............ Sublette County,

      53 Rural

      0.9257 0.9257 99953 Rural

      0.9257 Wyoming. 53180............ Sweetwater County,

      53 Rural

      0.9257 0.9257 99953 Rural

      0.9257 Wyoming. 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,

      53 Rural

      0.9257 0.9257 99953 Rural

      0.9257 Wyoming. 53220............ Weston County,

      53 Rural

      0.9257 0.9257 99953 Rural

      0.9257 Wyoming. 65010............ Agana County, Guam... 65 Rural

      0.9611 0.9611 99965 Rural

      0.9611 65020............ Agana Heights County, 65 Rural

      0.9611 0.9611 99965 Rural

      0.9611 Guam. 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,

      65 Rural

      0.9611 0.9611 99965 Rural

      0.9611 Guam. 65060............ Chalan Pago County,

      65 Rural

      0.9611 0.9611 99965 Rural

      0.9611 Guam. 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,

      65 Rural

      0.9611 0.9611 99965 Rural

      0.9611 Guam. 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.

      [FR Doc. 05-15221 Filed 7-28-05; 4:00 pm]

      BILLING CODE 4120-03-P

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