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{
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    "body": "<!DOCTYPE html><html><head><meta charset=\"UTF-8\"><style></style></head><body><div class=\"ck\"><div class=\"ck-content\"><div class=\"docx-wrapper\"><section class=\"docx\" style=\"min-height:792pt;padding:18pt;width:612pt;\"><article><p style=\"margin-top:-10pt;\"><span>Teva</span><strong> Shared Solutions</strong><span> for </span><span style=\"color:rgb(0,0,0);\">TRUXIMA<sup>®</sup> (rituximab-abbs) Injection</span><span>    </span></p><p>&nbsp;</p><p><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:12pt;min-height:12pt;\">PH: </span>888-857-3263</span></p><p><span style=\"color:rgb(0,0,0);\">FX: 866-676-4073</span></p><p>&nbsp;</p><p><span style=\"color:rgb(0,0,0);\">{{current_date}}</span></p><p style=\"margin-right:45.5pt;text-align:center;\">&nbsp;</p><p style=\"margin-bottom:8pt!important;margin-right:45.5pt;text-align:center;\"><strong>SUMMARY OF </strong><span style=\"color:rgb(0,0,0);\"><strong>BENEFITS FOR TRUXIMA</strong></span></p><figure class=\"table\"><table class=\"first-row first-col no-vband docx_tablegrid\" style=\"width:571.25pt;\"><tbody><tr style=\"height:10.3pt;\"><td style=\"background-color:rgb(59, 56, 56);border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:571.25pt;\" colspan=\"11\"><p style=\"line-height:1.15;\"><span style=\"color:#ffffff;\"><span style=\"font-size:10pt;min-height:10pt;\"><strong>PRESCRIBER INFORMATION</strong></span></span></p></td></tr><tr style=\"height:10.3pt;\"><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:272.1pt;\" colspan=\"4\"><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">Prescriber Name: {{case.c_provider.first_name}} {{case.c_provider.last_name}}</span></span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:163.1pt;\" colspan=\"5\"><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">Office Phone: </span><span class=\"col-wrap\" style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.facility_phone_number}}</span></span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:136.05pt;\" colspan=\"2\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">Office </span><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">Fax: </span><span class=\"col-wrap\" style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.facility_fax_number}}</span></span></p></td></tr><tr style=\"height:10.3pt;\"><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:272.1pt;\" colspan=\"4\"><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">Facility Name: {{case.bv_summary_view.facility_name}}</span></span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:299.15pt;\" colspan=\"7\"><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">Site of Care Name (if applicable): {{case.site_of_care.name}}</span></span></p></td></tr><tr style=\"height:10.3pt;\"><td style=\"background-color:rgb(59, 56, 56);border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:571.25pt;\" colspan=\"11\"><p style=\"line-height:1.15;\"><span style=\"color:#ffffff;\"><span style=\"font-size:10pt;min-height:10pt;\"><strong>PATIENT INFORMATION</strong></span></span></p></td></tr><tr style=\"height:12.05pt;\"><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:272.1pt;\" colspan=\"4\"><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">Patient Name: {{case.patient.first_name}} {{case.patient.last_name}}</span></span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:129.45pt;\" colspan=\"3\"><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">Patient DOB: {{case.patient.date_of_birth}}</span></span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:169.7pt;\" colspan=\"4\"><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">Shared Solutions ID: {{case.patient.patient_key}}</span></span></p></td></tr><tr style=\"height:10.3pt;\"><td style=\"background-color:rgb(59, 56, 56);border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:571.25pt;\" colspan=\"11\"><p style=\"line-height:1.15;\"><span style=\"color:#ffffff;\"><span style=\"font-size:10pt;min-height:10pt;\"><strong>INSURANCE INFORMATION</strong></span></span></p></td></tr><tr style=\"height:10.3pt;\"><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:193.25pt;\" colspan=\"2\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">Payer Name: </span><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.primary_payer_name}}</span></span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:238.5pt;\" colspan=\"6\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">Plan Type: </span><span style=\"color:rgb(0,0,0);\"><span class=\"col-wrap\" style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.primary_plan_name}}</span></span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:139.5pt;\" colspan=\"3\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">Effective Date: </span><span style=\"color:rgb(0,0,0);\"><span class=\"col-wrap\" style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.primary_effective_start_date}}</span></span></p></td></tr><tr style=\"height:10.3pt;\"><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:218.5pt;\" colspan=\"3\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">Policy ID: </span><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.primary_policy_number}}</span></span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:183.05pt;\" colspan=\"4\"><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">Payer Rank: </span><span class=\"col-wrap\" style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.primary_payer_rannk}}</span></span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:169.7pt;\" colspan=\"4\"><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">Phone Number: {{case.bv_summary_view.primary_payer_contact}}</span></span></p></td></tr><tr style=\"height:10.3pt;\"><td style=\"background-color:rgb(59, 56, 56);border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:571.25pt;\" colspan=\"11\"><p style=\"line-height:1.15;\"><span style=\"color:#ffffff;\"><span style=\"font-size:10pt;min-height:10pt;\"><strong>BENEFIT RESULTS</strong></span></span></p></td></tr><tr style=\"height:10.3pt;\"><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:571.25pt;\" colspan=\"11\"><p style=\"line-height:1.15;text-align:center;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\"><strong>TRUXIMA Single-dose Vial for Intravenous Use</strong></span></span></p></td></tr><tr style=\"height:10.3pt;\"><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:292.25pt;\" colspan=\"5\"><p style=\"line-height:1.15;text-align:center;\"><span style=\"font-size:9pt;min-height:9pt;\"><strong>Coverage Details</strong></span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:279pt;\" colspan=\"6\"><p style=\"line-height:1.15;text-align:center;\"><span style=\"font-size:9pt;min-height:9pt;\"><strong>Benefit Details</strong></span></p></td></tr><tr style=\"height:10.3pt;\"><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:103.25pt;\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">Formulation</span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:189pt;\" colspan=\"4\"><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.primary_formulation }}</span></span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:108pt;\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">Coverage</span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:171pt;\" colspan=\"5\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.primary_coverage}}</span></p></td></tr><tr style=\"height:10.3pt;\"><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:103.25pt;\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">Strength</span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:189pt;\" colspan=\"4\"><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.primary_strength}}</span></span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:108pt;\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">Coverage Reason</span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:171pt;\" colspan=\"5\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.primary_coverage_reason}}</span></p></td></tr><tr style=\"height:10.3pt;\"><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:103.25pt;\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">Benefit Type</span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:189pt;\" colspan=\"4\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.primary_benefit_type}}</span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:108pt;\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">Co-Pay/Coinsurance</span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:171pt;\" colspan=\"5\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.primary_copay_coinsurance}}</span></p></td></tr><tr style=\"height:10.3pt;\"><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:103.25pt;\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">Drug Code</span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:189pt;\" colspan=\"4\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.primary_drug_code}}</span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:108pt;\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">Deductible</span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:171pt;\" colspan=\"5\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.primary_deductible}}</span></p></td></tr><tr style=\"height:10.3pt;\"><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:103.25pt;\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">Setting of Care</span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:189pt;\" colspan=\"4\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.primary_setting_of_care}}</span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:108pt;\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">Out of Pocket Maximum</span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:171pt;\" colspan=\"5\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.primary_oop_max}}</span></p></td></tr><tr style=\"height:10.3pt;\"><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:103.25pt;\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">Network Status</span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:189pt;\" colspan=\"4\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.network_status}}</span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:108pt;\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">Annual Maximum</span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:171pt;\" colspan=\"5\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.annual_maximum}}</span></p></td></tr><tr style=\"height:10.3pt;\"><td style=\"background-color:rgb(59, 56, 56);border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:571.25pt;\" colspan=\"11\"><p style=\"line-height:1.15;\"><span style=\"color:#ffffff;\"><span style=\"font-size:10pt;min-height:10pt;\"><strong>PREFERRED SPECIALTY PHARMACY (SP)</strong></span></span></p></td></tr><tr style=\"height:11.6pt;\"><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:292.25pt;\" colspan=\"5\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">Specialty Pharmacy Name:{{case.bv_summary_view.preferred_specialty_pharmacy_name}}</span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:146.4pt;\" colspan=\"5\"><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">Phone:</span></span></p><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.preferred_specialty_phone_number}}</span></span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:132.6pt;\"><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">Fax:</span></span></p><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.preferred_specialty_fax_number}}</span></span></p></td></tr><tr style=\"height:10.3pt;\"><td style=\"background-color:rgb(59, 56, 56);border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:571.25pt;\" colspan=\"11\"><p style=\"line-height:1.15;\"><span style=\"color:#ffffff;\"><span style=\"font-size:10pt;min-height:10pt;\"><strong>PRIOR AUTHORIZATION (PA)</strong></span></span></p></td></tr><tr style=\"height:10.3pt;\"><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:571.25pt;\" colspan=\"11\"><p style=\"line-height:1.15;text-align:center;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\"><strong>TRUXIMA Single-dose Vial for Intravenous Use</strong></span></span></p></td></tr><tr style=\"height:10.3pt;\"><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:103.25pt;\"><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">PA Required</span></span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:189pt;\" colspan=\"4\"><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.pa_required}}</span></span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:108pt;\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">Submission Options</span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:171pt;\" colspan=\"5\"><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.primary_authorization_submission_method}}</span></span></p></td></tr><tr style=\"height:10.3pt;\"><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:103.25pt;\"><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">PA Dept. Phone</span></span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:189pt;\" colspan=\"4\"><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.primary_authorization_phone_number}}</span></span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:108pt;\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">PA Dept. Fax</span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:171pt;\" colspan=\"5\"><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.primary_authorization_fax_number}}</span></span></p></td></tr><tr style=\"height:10.3pt;\"><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:103.25pt;\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">Approval Number</span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:189pt;\" colspan=\"4\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.primary_authorization_number}}</span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:108pt;\"><p style=\"line-height:1.15;\"><span style=\"font-size:9pt;min-height:9pt;\">Approval Dates</span></p></td><td style=\"border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:171pt;\" colspan=\"5\"><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:9pt;min-height:9pt;\">{{case.bv_summary_view.primary_authorization_effective_start_date}} - {{case.bv_summary_view.primary_authorization_end_date}}</span></span></p></td></tr><tr style=\"height:10.3pt;\"><td style=\"background-color:rgb(59, 56, 56);border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:571.25pt;\" colspan=\"11\"><p style=\"line-height:1.15;\">&nbsp;</p></td></tr><tr style=\"height:64.75pt;\"><td style=\"background-color:inherit;border-color:rgb(165, 165, 165);border-style:solid;border-width:0.5pt;vertical-align:middle;width:571.25pt;\" colspan=\"11\"><p style=\"line-height:1.15;\"><span style=\"color:rgb(0,0,0);\"><span style=\"font-size:10pt;min-height:10pt;\">[notes]</span></span></p><p style=\"line-height:1.15;\">&nbsp;</p><p style=\"line-height:1.15;\">&nbsp;</p><p style=\"line-height:1.15;\">&nbsp;</p><p style=\"line-height:1.15;\">&nbsp;</p></td></tr></tbody></table></figure><p>&nbsp;</p></article></section></div></div></div></body></html>",
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