hospice reimbursement rates 2022

c/`^/("P&GVK&5BTZ*V(|!5 health/medical benefits. The appearance on this website of a code and rate is not an indication of coverage or a guarantee of payment. . Regulators have reacted with efforts to improve oversight and enforcement. telehealth supported by cashless claims management, reimbursement claims In addition to the above mentioned categories complete list of all beneficiaries of MEDISEP is given below in list. collaboration with Medi Assist allowed us to deliver faster, Participation in the value-based insurance design (VBID) demonstration, known as the Medicare Advantage hospice carve-in, doubled between 2021 and 2022. Our partner, Mayfair We Care, is a platform that As in past years, Medicare cost reports are used to set hospice reimbursement rates. guide, and access raise claims online. Annual Change in Medicaid Hospice Payment Rates Federal Fiscal Year (FY) 2022ACTION coverage, download documents, including their benefit schedule and member Patients will be considered to be in the terminal stages of stroke or coma (life expectancy of six months or less) if they meet the following criteria: Stroke. For continuous home care, the amount of payment is determined based on the number of hours of continuous care furnished to the beneficiary on that day. The Centers for Medicare & Medicaid Services yesterday issued a proposed rule to update hospice payment rates for fiscal year 2023. General Medicine/Surgey, General Surgery, Gynacology, General Medicine/Surgey, General Surgery, Gynacology, Orthopedics, ENT, Paediatrics, Cardiology, Cardiovascular & Cardiothorasic surgery, Neurology, Neurosurgery, Genito Urinary Surgery, Oncology, Poly Trauma & Critical Care, Pediatric Surgery , Nephrology, Rheumatology, Gastroenterology, Endocrinology, Plastic Surgery, Pulmonology, Catastrophic packages, General Medicine/Surgey, General Surgery, Orthopedics, Poly Trauma & Critical Care, Nephrology, Noor institute of medical speciality hospital, General Medicine/Surgey, General Surgery, Orthopedics, Paediatrics, Poly Trauma & Critical Care, Nephrology, General Medicine/Surgey, General Surgery, Gynacology, Poly Trauma & Critical Care, General Medicine/Surgey, General Surgery, Gynacology, Orthopedics, ENT, Paediatrics, Cardiology, Cardiovascular & Cardiothorasic surgery, Neurology, Neurosurgery, Genito Urinary Surgery, Poly Trauma & Critical Care, Pediatric Surgery , Nephrology, Rheumatology, Gastroenterology, Endocrinology, Plastic Surgery, Pulmonology, Catastrophic packages, General Medicine/Surgey, General Surgery, Gynacology, Orthopedics, Paediatrics, Nephrology, Rheumatology, Gastroenterology, Endocrinology, Pulmonology, General Medicine/Surgey, General Surgery, Gynacology, Orthopedics, Poly Trauma & Critical Care, Rheumatology, General Medicine/Surgey, General Surgery, Gynacology, Orthopedics, ENT, Paediatrics, Cardiology, Neurology, Genito Urinary Surgery, Poly Trauma & Critical Care, Nephrology, Rheumatology, Endocrinology, Pushpagiri Institute Of Medical Science & Research Centre, General Medicine/Surgey, General Surgery, Gynacology, Orthopedics, ENT, Paediatrics, Cardiology, Cardiovascular & Cardiothorasic surgery, Neurology, Neurosurgery, Genito Urinary Surgery, Oncology, Poly Trauma & Critical Care, Nephrology, Rheumatology, Gastroenterology, Endocrinology, Ophthalmology, Pulmonology, EMS Co-0perative hospital- Pathanamthitta, General Medicine/Surgey, General Surgery, Gynacology, ENT, Poly Trauma & Critical Care, Nephrology, General Medicine/Surgey, General Surgery, Gynacology, Orthopedics, Nephrology, Eye micro surgery and laser centre, Thiruvalla, General Medicine/Surgey, General Surgery, Gynacology, Orthopedics, ENT, Paediatrics, Cardiology, Cardiovascular & Cardiothorasic surgery, Neurology, Neurosurgery, Genito Urinary Surgery, Oncology, Poly Trauma & Critical Care, Pediatric Surgery , Nephrology, Rheumatology, Gastroenterology, Endocrinology, Plastic Surgery, Ophthalmology, Pulmonology, Catastrophic Packages, General Medicine/Surgey, General Surgery, Gynacology, ENT, Paediatrics, Cardiology, Neurology, Genito Urinary Surgery, Oncology, Poly Trauma & Critical Care, Nephrology, Rheumatology, Pulmonology, Chandramathy Amma Memorial Hospital Olarikkara, General Medicine/Surgey, General Surgery, Gynacology, Orthopedics, ENT, Paediatrics, Cardiology, Neurology, Genito Urinary Surgery, Poly Trauma & Critical Care, Nephrology, Rheumatology, Endocrinology, Pulmonology, General Medicine/Surgey, General Surgery, Gynacology, Orthopedics, ENT, Poly Trauma & Critical Care, Nephrology, Rheumatology, Dr. Somervell Memorial CSI Medical College, General Medicine/Surgey, General Surgery, Gynacology, Orthopedics, ENT, Paediatrics, Cardiology, Neurology, Genito Urinary Surgery, Oncology, Poly Trauma & Critical Care, Pediatric Surgery , Nephrology, Rheumatology, Gastroenterology, Endocrinology, Plastic Surgery, Pulmonolog, General Medicine/Surgey, General Surgery, Gynacology, ENT, Cardiology, Cardiovascular & Cardiothorasic surgery, General Medicine/Surgey, General Surgery, Gynacology, Orthopedics, ENT, Cardiology, Cardiovascular & Cardiothorasic surgery, Genito Urinary Surgery, Poly Trauma & Critical Care, Nephrology, Rheumatology, General Medicine/Surgey, General Surgery, Orthopedics, Attukal Devi Institute of Medical Sciences Ltd ( ADIMS), General Medicine/Surgey, General Surgery, Gynacology, Orthopedics, ENT, Neurology, Genito Urinary Surgery, Poly Trauma & Critical Care, Rheumatology, General Medicine/Surgey, General Surgery, Gynacology, Orthopedics, ENT, Genito Urinary Surgery, Poly Trauma & Critical Care, Nephrology, General Medicine/Surgey, General Surgery, Gynacology, Orthopedics, ENT, Genito Urinary Surgery, Poly Trauma & Critical Care, Orthopedics, ENT, Cardiology, Neurology, Genito Urinary Surgery, Oncology, Poly Trauma & Critical Care, Nephrology, Rheumatology, Plastic Surgery, Ophthalmology, Pulmonology, Catastrophic packages, General Medicine/Surgey, General Surgery, Gynacology, Orthopedics, ENT, Cardiology, Cardiovascular & Cardiothorasic surgery, Genito Urinary Surgery, Oncology, Poly Trauma & Critical Care, Pediatric Surgery , Nephrology, Rheumatology, Endocrinology, Pulmonology, General Medicine/Surgey, General Surgery, Gynacology, Orthopedics, ENT, Cardiology, Neurosurgery, Genito Urinary Surgery, Poly Trauma & Critical Car. CnZLHd*.&Hpe=ZN 3.dlBb`"(DUQb"9DNZLU#XLDLn@D KHH#$UD` x&: E$sPg% @KRP\)HH(:/O!$j5 yA%!qHy0Y>r'Kc=$67?|Zm'b;l#|! Hospice Wage Index: More, Industry Management, - Medical Value Travel General Enquiry (Public Relation Officer): (10:15 AM - 05:00 PM) (Lunch break 01:15 P.M - 2:00 P.M) Transport Commissionerate: 0471-2333317. e-mail: tcoffice [dot]mvd [at]kerala . CMHC Reimbursement Manual. RESULT RATE( Inclusive of Tax) RT-PCR OPEN CONFIRMATORY Rs 2750/- CBNAAT CONFIRMATORY Rs 3000/- TRUENAT If STEP1 is positive, require step 2 for confirmation STEP 1 negative is confirmatory STEP 1- Rs 1500/- STEP2- Rs1500/-( required only if STEP1 turns positive) ANTIGEN Positive results are confirmatory. As per MEDISEP the beneficiary will be entitled to Rs 3 Lakh every year, it will cover 1920 medical procedures with a deduction of monthly premium of Rs 500 from salary of employees. September 14, 2021. We also partner with ABTP to introduce the On August 4, 2021, the Centers for Medicare and Medicaid Services (CMS) published the final rule for hospice payments in fiscal year (FY) 2022 in the Federal Register. The FY 2022 hospice payment rates are effective for care and services furnished on or after October 1, 2021, through September 30, 2022. %PDF-1.6 % well. Check below MEDISEP hospital list 2023 Kerala, also check MEDISEP Kerala scheme eligibility and beneficiary list of Medical Insurance for State Employees and Pensioners scheme. Allowable costs for aide wages and benefits across Sch 3c (Sch 3c col 005 & col 008-010), Total Allowable cost across Sch 3c (Sch 3c col 003), 6 Months T-Bill rate (As on 29 Sept 2021), Profit / Surplus Percentage Adjustment [(2) / (3) * (4)]. MAtrix-Insurer partners with payers to help accelerate their health insurance innovation journey. Ui gz Hospital Rates and Revenue Codes *. MLN Connects Special Edition - November 2, 2021 - 3 Final . They helped us Official websites use .gov Changes to hospice coverage or reimbursement requires submission of a state plan amendment. MEDISEP Kerala hospital list of empanelled Hospitals district wise is given below in Tables, MEDISEP Hospital List in Alappuzha Kerala Empanelled Hospital is given below, MEDISEP Kerala Hospital List in Ernakulam Hospital Empanelled is given below, MEDISEP Kerala Hospital List in Idukki Empanelled Hospitals is given below, MEDISEP Hospital List in Kannur Empanelled Hospital List Kerala is given below, MEDISEP Kerala Hospital List in Kasaragod is given below in table, MEDISEP Kerala Hospital List in Kollam is given below in table, MEDISEP Kerala Hospital List in Kozhikode is given below in table, MEDISEP Hospital List in Kottayam Kerala is given below in table, MEDISEP Kerala Hospital List in Malappuram is given below, MEDISEP Hosipital List in Palakkad is given below, MEDISEP Kerala Hospital in Pathanamthitta is given below in table, MEDISEP Hospital List in Thrissur is given below, MEDISEP Kerala Hospital List in Thiruvananthapuram is given below, MEDISEP Hospital List in Metropolis Cities is given below, This Scheme contemplate cashless treatment facility to all beneficiaries through an insurance company and a network of empaneled hospitals, There shall be no age limit for the beneficiaries/ dependents except dependent child/children. Upon expiration of the PHE or national emergency, whichever occurs first, LTC reimbursements will revert to RY 2022-23 per diem rates. . As a result, the routine home care daily reimbursement for days 1-60 will decrease from $228.11 per day to $211.16 per day. In effect, the hospice payment update percentage for FY 2022 is 2.0%. A description of each level of care is as follows: Outside of the payments made for the various levels of care described above, the following payment provisions are also made for hospice services. The hospice rates applicable to the above period are: - END - REVENUE CODE DESCRIPTION FY 2021 PAYMENT RATE LABOR SHARE NON-LABOR SHARE 0651 RHC (days 1-60) $199.25 $136.90 $62.35 0651 RHC (days 61+) $157.49 $108.21 $49.28 A locked padlock Child Health Plan Plus Fee-for-Service (FFS) Rates. 266 0 obj <>stream A .gov website belongs to an official government organization in the United States. April 25, 2023 by Sandeep Tanwar. Programme, Outpatient Some service areas will benefit from the labor share changes and some will not it depends on whether the areas wage index is greater than or less than 1.0. %%EOF Please inform your staff and all state agencies in your jurisdiction of these new payment rates, which are effective October 1, 2021. The provision of quality patient care is complex, especially within the confines of clinician staffing challenges and intricate regulatory requirements governing the care planning and care delivery processes. Anesthesia Base Unit. Rate Update for 2022 Ambulatory Surgical Centers (ASC) Rates, CR 107519 (PDF) - April 8, 202. This includes a 4.1% market basket update and a 0.3 percentage point cut for productivity. Facilitator. values, and Medi Assist is one of those partners. Hospice Reimbursement Rate Changes, 10/20/15. Our partnership with Medi Assist eliminates cost of suboptimal Payment for hospice services is made to a designated hospice provider based on the Medicaid hospice rates published annually in a memorandum issued by the Centers for Medicare & Medicaid Services (CMS), Center for Medicaid and CHIP Services. Long-Term Care Medicaid Reimbursement. 2023 Hos pice County Rates 2023 Hospice C ounty Rates 2022 Hopsice County Rates 2022 Hospice County Rates 2021 Hospice County . No budget neutrality factors are applied in the determination of these reimbursement rates. Since 1951, clients have chosen Marcum for our insightful guidance in helping them forge pathways to success, whatever challenges theyre facing. and third parties with an innovative solution to meet a common industry CMS has proposed strengthening the provider enrollment process by requiring ordering or certifying physicians to be enrolled in or validly opted-out of Medicare to receive payment for hospice services. application/pdf Maximum Reimbursement Rates for Organ Transplant Procedures and . . Date: September 30, 2022 . CMS estimates that hospices will see an additional $480 million in payments in FY 2022 as a result of the update. NOTE: If your hospice agency did not submit required quality data, the payment rate provided through this calculator will need to be reduced by 2 percentage points. h=0EuP B'qRNLbvr:0)4`p&B8E2*ZB2pMR pLrVT&G~rAqux>\>3 VQ|5?d~QAM?G UOAs DMAS. technologies that support the implementation and management of custom-built J(( %r.EB ^66d$7v~Yv^j^?u{]/w|uov? 2022 Rate Updates for Medical Imaging Codes, CR 107225 (PDF) - April 8, 2022. If you have any questions about the hospice rate updates, please contact a member of Marcums healthcare advisory team. Learn how Medalogix Muse customers are leveraging the power of advanced analytics to support quality care at the end of life. endstream endobj 335 0 obj <>stream The information contained in these schedules is made available to provide information and is not a guarantee by the State or the Department or its employees as to the present accuracy of the information contained herein. Nashville, TN 37219, Copyright 2022, Medalogix, LLC, All Rights Reserved, Medalogix Launches Pulse, a dynamic resource management home health solution, Hospice Public Reporting of New Claims-Based Quality Measures Begins in May 2022. The fiscal year (FY) 2022 payment rates increased by 2.0% from the FY 2021 amounts. 2021-09-22T07:46:05-04:00 Please refer to the appropriate West . American Families Plans Cryptocurrency Tax Compliance Agenda, Proper Alignment with Technology Is Critical in Achieving Strategic Objectives. skip to main content Navigation menu. 2021-09-22T10:13:12-04:00 The rule also proposes to rebase the labor shares for all four levels of care. An official website of the United States government MAestro identifies factors and trends that drive losses, ensures providers Providers may appeal their 2022 rates by logging into the 2020 web-based Home Care Tool and accessing the rate certification tab to file an adjusted cost report reflecting changes in schedule 3, 4, 5 and 7 data. o+ View CEO Survey Results, Marcum Merges Starter-Fluid into National Financial Accounting & Advisory Practice. We value relationships built through working together. The pilot realized a decrease in emergency room visits and hospitalizations, improved patient mobility, and . Providers that do not submit the required data will again receive a 2% rate reduction, so providers should take care to submit the necessary information. On March 31, 2023, the Centers for Medicare and Medicaid Services (CMS) released the FY 2024 Hospice Payment Rate Update Proposed Rule. 2022. represents a robust global health benefits administration solution. knowledge for core product development and customer experience as CMS used the 2018 Medicare cost reports to reset the labor percentage of the hospice rates. Just within the past year, the Office of the Inspector General (OIG) conducted several targeted audits, the Medicare Payment Advisory Commission reported hospice vulnerabilities in its 2023 report, the State Operations Manual, Guidance to Surveyors has been updated with an enhanced focus on the quality of care provided to hospice patients, and Congress has drawn its own attention to the matter during federal budget hearings during which several members raised the issue of hospice fraud. Contact Information. CEO, Mayfair We MAtrix simplifies the claims process for customers, employees, agents, We passionately believe in having partners that share the same FY 2022 Hospice Wage Index and Payment Rate Update Final Rule. Of note, the sequestration payment adjustment will revert to the two percent rate for claims with dates of services as of July 1 . Read To understand ownership relationships and have means by which to strengthen protections against hospice fraud schemes and improve transparency, CMS has proposed requiring providers, suppliers, and hospices to identify whether a reported organizational owner is itself owned by another organization or individual. The hospice payment limitation will increase by 2% for FY 2022, in line with the general hospice rate increase. Home Health and ESRD Proposed CY 2023 Payment Rules 06/22/2022. Hospice providers will be increasingly impacted by the growth of Medicare Advantage Organizations and their evolving ability to offer hospice benefits to patients. Further guidance on the coverage benefit for hospice may be found at theHospice Benefits page. uuid:5118b000-f531-47da-b6e4-af49d3feec09 In the FY 2022 Hospice Wage Index and Rate Update final rule (86 FR 42532 through 42539), we finalized a policy to rebase and revise the labor shares for CHC, RHC, IRC and GIP using Medicare cost report (MCR) data for freestanding hospices (collected via CMS Form 1984-14, OMB NO . 2022 of 2.7% by a Multifactor Productivity (MFP) adjustment as mandated by the Affordable Care Act (currently estimated to be 0.7% for FY 2022). Hear from HRS' Vice President of Revenue Cycle Management on the 2023 updates to telehealth reimbursement rates and how HRS can support your reimbursement efforts. care that include preventive wellness, disease management, pharmacy benefits, Acrobat PDFMaker 21 for Word Hospice payment rates can be adjusted for regional differences in wages using the hospice wage indices published annually in the Federal Register. Payment for hospice care will be made at predetermined rates for each day in which a beneficiary is under the care of the hospice. The CMS rule 1629-F revised reimbursement for routine home care hospice services, applying a higher per diem rate to routine home care services rendered during the first 60 days of hospice care and a . endstream endobj 334 0 obj <>stream Value Travel Facilitator, The Corporate Athlete XLHD40w610g1E`./`h0i\lPv!EZULLHddl}z$Kq}Yw|?|wW }]}'vWo>a XyeCgw>3JZ3CuYavYM.U]P^vUP+2a;:aim=-=V)mjTr%vjKlisiMJn;AhXLp%QYu)h:Ys|OuxuXV^%W`K{{Pu6i^;{Q18r//'(I)]${Uw? On the reimbursement front, CMS proposed a rate increase of 2.8% and a cap amount of $33,396. )a6uupHK[F0!a?seF>q6iiK~v/SKQ7(2][4x/\a{/^b>:S~j}`ewbq3 "gRb'B[%,5#64J /Zl||`2181 'I rY\ Changes to hospice coverage or reimbursement requires submission of a state plan amendment. New COVID-19 Monoclonal Antibody Codes; . We expect state agencies to share the Medicaid hospice payment rates for FY 2022 with the . zE U!8@B$5,&TE3D&LW%0kl?"&(Cv`XAP{p' The 'Wage Index' links contain the listing of Core Based Statistical Area (CBSA) codes and the corresponding wage index. data-backed evidence to demonstrate and defend the success of a program or Stroke and Coma. Hospice care is a benefit under the hospital insurance program. The minimum payment rates are effective with dates of services January 1, 2023 and later. That makes the FY 2022 cap $31,297.61 per beneficiary. In the quality arena, CMS addressed the subject of fraud and abuse, reports of which have heightened over the past . Visit Old Website. 2022 through Jan. 31, 2023) 2022 Alaska Professional Fee Schedule; Alaska - Maximum Allowable Charge (MAC . treatments, be it sponsored by states or corporations. a second opinion for cancer diagnosis. service, helps members reach out to experts from around the globe to receive }x'_OW_/QMlk%Tnsn}n]zhmJtS~ :aY8= ?-W_x 1/1/2022 Title 23: Medicaid, Part 205: Hospice Services, Chapter 1: Program Overview, Rule(s) 1.4, 1.8 and 1.10 . Consequently, from day 1 to day 60, the standard home care reimbursement will drop from $228.11 to $211.16. 2014-56. As a result, the limit for FY 2022 is $31,297.61 per recipient. Hospice Payment Rates Calculator. expand our domestic network in India by leaps. a second opinion for cancer diagnosis. healthcare providers within the IHX eco-system to work MEDISEP hospital list of Kerala MEDISEP scheme 2023. File Type Size Uploaded on Download; January 2023 SFY23 Ratelist: XLSX: 27.66 KB: 29 Nov, 2022: Download: July 2022 SFY23 Ratelist: XLSX: 27.50 KB: 31 May, 2022: Download Admin Cost (excluding Capital and Background & Fingerprinting) * Outside of Capital Cost and Background & Fingerprinting, admin reimbursement for FIs occurs separately through a tiered . o*96~>[mY*~0-HW_,!KW]vWP\AqWP8p/( endstream endobj 328 0 obj <>stream TRICARE Reimbursement Manual 6010.61-M, April 1, 2015 Hospice Chapter 11 Addendum A (FY 2021) Hospice Care Rates - FY 2021 . receive treatment from some of our network providers in the country. hVmo0+B#Imfh* {%rw XPD+2"4"6$V%G1kM$cC?2s"N+I~nL} :[~>m4OOToOW]Rm=KU3m"Q$ Zu kwYqUq~}~#tD0tpno^,/%|. Our program creates awareness This limitation is applied once each year, at the end of the hospices cap period. 2022 Hospice fee schedule (published September 29, 2021) October 1, 2020 to September 30, 2021 Hospice fee schedule (published September 21, 2020) View all hospice fee . Payment Rates for Medicaid Community Hospice Effective retroactively to October 1, 2022 . The technology that Medi Assist partnered with us to build allows The reimbursement rates for revenue codes 0651, 0652, and 0655 have been revised. These Medicaid hospice rates are effective from October 1 of each year through September 30 of the following year. Response: As stated in the FY 2022 Hospice Wage Index and Rate Update proposed rule . Medical College Kozhikode, GDh Perinthalmanna Govt District Hospital Nilambur, Government Medical College Hospital, Manjeri, Institute For Communicative And Cognitive Neurosciences, Taluk Head Quarters Hospital, Chirayinkeezhu, All serving employees to Government of Kerala, Newly recruited employees and their family, Non teaching staff of aided schools and colleges and their family, Employees of Local Self Government (LSG) Institutions and Universities in the Kerala State, All State Pensioners and their spouses and family, Pensioners of Local Self Government (LSG) Institutions and Universities in the Kerala State, All Civil Services officers serving the Government of Kerala on optional basis, Pensioners of Local Bodies Panchayats Municipalities, Cooperation, The directly recruited personal staff of the Chief Minister, Ministers, Leader of Opposition and Chief Whip, Speaker, Deputy Speaker and the Chairmen of the Financial Committees, The directly recruited personal staff pensioners/family pensioners who receive Grantin- Aid from the State Government and Local Self Government Institutions, NS Memorial Institute of Medical Sciences. Ambulatory Surgical Centers Fee Schedule for DOS. here, Retail We do not do the end of life well in America: How hospice can help eas Leveraging more than 11 million historical visits, solution provides ind How to prepare for New Claims-Based Quality Measures with Hospice Public Medalogix, LLC It offers an end-to-end core administration platform for small and large health plans to modernize their systems at scale and introduce new products quickly. Our partnership focuses on evidence-based expert recommended 2021 Hospice Residence Rates - - February 14, 2022, Dear Administrator Letter - October 1, 2020 - September 30, 2021 Non Residence Rates Hospice Rate Sheets for the Counties of: BRONX, KINGS, NEW YORK, PUTNAM, QUEENS, RICHMOND . Quarterly Drug Rates Update, CR 106861 (PDF) - April 8, 2022. partners, agents, brokers, and the hospital network. In FY 2022 the hospice cap will increase by 2.0%, the same as the other hospice rates. Heres how you know. Our AI/ML "z]qqwypHG|-RL{x^O_;}UR/zLGz,:7T9FF211>so/i=TaQG Sarkari List - Kerala - Kerala MEDISEP Hospital List 2023 District Wise | List of all Empanelled Hospital under MEDISEP Scheme, Government of Kerala has released new list of 479 government and private hospital empanelled under MEDISEP scheme. you guys had the right skills and resources that we needed as a The rates reflect changes made under the final Medicare hospice rule published on August 4, 2021 (CMS-1754-F). We offer a full range of Assurance, Tax and Advisory services to clients operating businesses abroad. Phone: 602-417-4000 In-State Toll Free: 1-800-654-8713 (Outside Maricopa County) Hospice - County: PDF - Excel effective Oct. 1, 2022 to Sept. 30, 2023 Hospice - Facility: PDF - Excel effective Oct. 1, 2022 to Sept. 30, . Govt.Hospital For Women & Children ,Kottaparamb, Institute Of Chest Diseases Govt.Medical College Kozhikode, Institute Of Maternal And Child Health, Govt. 55. %PDF-1.6 %

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