ࡱ> }z{|9 Gbjbj >ddFdd   8E$ !")")")"$$$OQQQQQQp&fQ$#"$$$Q)")"fu+u+u+$8)")"Ou+$Ou+u+\#)"@~$n;|0e(##4W&$$u+$$$$$QQ)$$$$$$$$$$$$$$$$d o: Sample Clinical Documentation Query Templates Table of Contents Template TopicsAcute Kidney InjuryAcute Tubular NecrosisAcute Blood Loss AnemiaBMI < 19BMI > 40Chest PainCKD StageDebridement, ExcisionalDemand Ischemia with Elevated Troponins (Type 2 MI)DepressionEncephalopathy Altered Mental StatusEncephalopathy v. DeliriumFunctional QuadriplegiaGI BleedingHeart Failure specify typeHeart Failure specify type and acuityHIV/AIDSHypertensive Urgency / EmergencyMalnutritionMalnutrition, SeverePancytopeniaPneumonia Specificity HCAP Pneumonia, AspirationPressure UlcerRespiratory Failure AcuteRespiratory Failure Chronic SchizophreniaSepsis-2Sepsis-3ShockShock - HemorrhagicSyncopeTIA CauseUrosepsisCause and effect UTI and catheterCause and effect Two diagnosesClarification of conflicting diagnosisClinical findings without a diagnosisClinical validation (with example for sepsis)Confirmation of a diagnosis from an interpreted reportProbable/suspected cause of symptomsGeneral query template These sample physician query documents are offered solely as examples of standardized physician queries to clarify clinical documentation within the medical record. These query documents were created based on our interpretation of guidelines and may be used by healthcare facilities at their own discretion. Pinson & Tang LLC makes no representation, guarantee or warranty with respect to these query documents, including with respect to their compliance with any relevant state, federal or other guidance. It is the sole responsibility of the healthcare facility to review and modify these examples as needed to ensure they meet their own compliance policies and standards, as well as the standards of any applicable state or federal regulatory entity. These templates are considered a copyrighted work under the United States and other copyright laws and is the property of Pinson & Tang LLC. Healthcare facilities may make archival copies and customize this template only for the limited use of their facility or organization and not for resale or public sharing. This template and any customized or modified version of this template may NOT be sold, distributed, published to an online gallery, hosted on a website, or placed on a public server. If any questions regarding this limited use license, contact Cynthia L. Tang for Pinson & Tang LLC:  HYPERLINK "mailto:info@Pinsonandtang.com" info@Pinsonandtang.com. Recommendations for use: These query templates are designed for use as Word documents or e-messages and the content is to be edited and customized for the specific findings in each record. Suggested indicators not present in a particular case and/or multiple choice response options not supported by indicators (e.g., acute heart failure with only chronic indicators) should be deleted prior to submission to the provider. Content within brackets should be completed and deleted. Titles of each template are for reference only and should not appear on queries submitted to providers. 2018 Pinson & Tang, LLC. All Rights Reserved. Acute Kidney Injury Documentation in the medical record indicates that this patient has been admitted with or diagnosed as having . The following lab is also documented in the medical record: [include criteria that apply] Creatinine on admission = Baseline Creatinine (if known): Correction of serum creatinine from ____ to _____ following rehydration Urine output : Based on your medical judgment, can you please clarify in the progress notes the diagnosis associated with these findings such as: Acute Kidney Injury Acute on Chronic Renal Failure Chronic Kidney Disease (Stage, if known) Other (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Acute Tubular Necrosis (ATN) Documentation in the medical record indicates that this patient has been admitted with or diagnosed as having ACUTE KIDNEY INJURY. The following is also documented in the medical record: Creatinine levels [list all and dates] FENa = Urine sodium concentration = Urine output of _________ over ___ hours IV contrast Medication [if potentially neurotoxic]: Other: Based on your medical judgment, can you further clarify in the progress notes confirmed or suspected underlying cause for this patients condition such as: Acute Tubular Necrosis Acute Cortical Necrosis Acute Glomerulonephritis Pre-Renal Acute Kidney Injury Other condition: (please specify) None of the above /Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Acute Blood Loss Anemia Documentation in the medical record indicates the following: Diagnosis of Anemia [include type] Drop in Hct/Hgb from to Blood transfusion of xxx units GI Bleeding [or other hemorrhage] Other: Based on your medical judgment, can you further clarify in the progress notes the diagnosis associated with these findings such as: Acute blood loss anemia Acute hemorrhagic anemia Chronic blood loss anemia Acute on chronic blood loss anemia Iron deficiency anemia Other anemia: (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! BMI < 19 Documentation in the medical record indicates that this patient has a: BMI = The following is also documented in the medical record [if pertinent to below diagnoses]: Based on your medical judgment, can you further clarify in the progress notes the diagnosis associated with these findings such as: Underweight Cachexia Emaciation Malnutrition Undernutrition Anorexia Other condition (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! BMI > 40 Documentation in the medical record indicates that this patient has: BMI = The following is also documented in the medical record [if pertinent to below diagnoses]: Based on your medical judgment, can you further clarify in the progress notes the diagnosis associated with these findings in the progress notes such as: Overweight Obesity Morbid obesity Other condition (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Chest Pain Based on the documentation in the medical record, this patient was admitted with CHEST PAIN. Other information in the medical records includes: Based on your medical judgment, can you further clarify in the progress notes the most likely or suspected underlying cause for this condition such as [include only those that may apply]: Coronary artery disease GERD/reflux Esophagitis or esophageal spasm Pleurisy Costochondritis Chest wall / musculoskeletal pain Gastritis Hiatal hernia Anxiety Hyperventilation syndrome Biliary colic Peptic Ulcer Other cause (please specify) None of the above / not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! CKD Stage Based on the clinical information documented in the medical record, this patient has been diagnosed with Chronic Kidney Disease / CKD. Documentation in the medical record also indicates: GFR = Based on your medical judgment, can you further clarify in the progress notes the appropriate stage of CKD? National Kidney Foundation stages of Chronic Kidney Disease (CKD): Stage 1: GFR > 90 Stage 2: GFR 60-89 Stage 3: GFR 30-59 Stage 4: GFR 15-29 Stage 5: GFR < 15 ESRD: Need for dialysis In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Debridement Excisional Based on the documentation in the medical record, this patient has undergone WOUND CARE and/or WOUND DEBRIDEMENT. Based on your medical judgment, can you further clarify in the progress notes the type of wound debridement: Excisional debridement (use of a scalpel/blade to cut away tissue) Non-excisional debridement (chemical, scrubbing, trimming with scissors) Other debridement (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Demand Ischemia with Elevated Troponins (Type 2 MI) Documentation in the medical record indicates that this patient has been admitted with or diagnosed as having ___________________________. The following is also documented in the medical record [include only those that apply]: Serial troponin levels [list all] = Associated conditions: [include potential causes, e.g., severe anemia, sepsis, hypotension or shock, rapid tachycardia, hypertensive crisis] Treatment: [any treatment or management of associated conditions] EKG showing: History of CAD or MI Based on your medical judgment, can you further clarify in the progress notes which, if any, of the following this condition is intended to indicate: Type 2 MI Type 1 MI (NSTEMI) Demand ischemia only Unstable angina Other, please specify: None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Depression Documentation in the medical record indicates that this patient has been admitted with or diagnosed as having DEPRESSION. The following is also documented in the medical record: Psychiatric consult Medication change from _____________ to ____________ Symptoms: Behavior: Other: Based on your medical judgment, can you further clarify in the progress notes the status of this patients DEPRESSION: Type and Severity: Major (MDD) Simple Situational Endogenous Bipolar Mild Moderate Severe Other (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Encephalopathy Altered Mental Status Documentation in the medical record indicates that this patient has been diagnosed as having the symptom of ALTERED MENTAL STATUS. Additional findings also documented in the medical record: [include all that apply] Fever of ____ Infection: [type] Dehydration Electrolyte Imbalance: Sepsis Hypoxemia Renal / Hepatic Failure Drug toxicity or adverse effect: Abnormal lab tests: Other findings: Based on your medical judgment, can you further clarify in the progress notes if these findings associated with altered mental status are due to a definite or suspected underlying neurologic cause such as: Metabolic Encephalopathy Toxic Encephalopathy Altered mental status without encephalopathy Other condition (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Encephalopathy vs. Delirium Documentation in the medical record indicates that this patient has been diagnosed as having the symptom of DELIRIUM. Additional findings also documented in the medical record: [include all that apply] Fever of _________ Infection: [type] Dehydration Electrolyte Imbalance: Sepsis Hypoxemia Renal / Hepatic Failure Drug toxicity or adverse effect: Abnormal lab tests: Other findings: Based on your medical judgment, can you further clarify in the progress notes if any of the follow are a definite or suspected cause of delirium: Metabolic Encephalopathy Toxic Encephalopathy An underlying psychiatric disorder (please specify) Another condition (please specify) Delirium without an underlying cause None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Functional Quadriplegia Documentation in the medical record indicates that this patient has been admitted with with or diagnosed as having ____________________________________ Additional findings also documented in the medical record [include all that apply]: Severe dementia Total care Feeding tube Activity Level: Bedfast Extreme/severe neurologic deficits Urinary/bowel incontinence Flexion contractures Mobility Level: Completely immobile, or very limited Other severe disability condition: Based on your medical judgment, can you please provide in the progress notes one or more diagnoses (if any) associated with the above findings: Functional Quadriplegia Coma Quadriparesis Dementia only Severe debility only Paralysis Other condition (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! GI Bleeding Documentation in the medical record indicates that this patient has been identified to have and/or is being treated for GI BLEEDING. Other information in the medical record includes: EGD report: Colonoscopy report: Other: Based on your medical judgment, can you please document in the progress notes the confirmed or suspected underlying cause of these findings such as [include only those that may apply]: Esophageal varices Esophageal ulcer or tear Esophagitis Gastritis Gastric ulcer or erosion Peptic ulcer disease Inflammatory bowel disease (ulcerative colitis or Crohns) Polyps (gastric, colon, duodenal, etc.) Diverticulosis w or w/o diverticulitis Hemorrhoids Arteriovenous malformations (AVM) Other condition (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you!   Heart Failure Specify Type Documentation in the medical record indicates that this patient is being treated for HEART FAILURE. Echocardiogram reports EF = Other documentation and findings include: Based on your medical judgment, can you further clarify in the progress notes the Type of the patients heart failure/dysfunction for this admission such as: Systolic Diastolic Combined systolic/diastolic Other (please specify) None of the above / Not Applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Heart Failure Specify Type & Acuity Documentation in the medical record indicates that this patient is being treated for HEART FAILURE. Echocardiogram reports EF = IV medications: CXR findings: BNP: Other documentation and findings include: Based on your medical judgment, can you further clarify in the progress notes both of the following: Type of heart failure: Systolic Diastolic Combined systolic/diastolic Other (please specify) None of the above / Not applicable - AND - Severity of heart failure Acute, exacerbation, or decompensation Chronic Acute on chronic Other (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. HIV / AIDS Documentation in the medical record indicates the patient has HIV or HIV+ The CDC case definition of AIDS (HIV disease) is an HIV positive patient with any one of the following: Current or prior diagnosis of an AIDS-defining condition, or Current or prior CD4+ lymphocyte count < 200 cells.cm Documentation in the medical record includes the following: Prior [or current] diagnosis of [any AIDS-defining conditions]. Dates and location: Prior [or current] CD4+ lymphocyte count = ___ Date and location [where <200]: Based on your medical judgment, can you further clarify in the progress notes whether this patient has: HIV positive status only / HIV infection without AIDS, or HIV disease (AIDS) Another condition (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Hypertensive Urgency / Emergency Documentation in the medical record indicates that this patient has been admitted with or diagnosed as having: The following is also documented in the medical record: SBP > 180 [indicate actual SBPs] DBP > 120 [indicate actual DBPs] End organ involvement: [indicate any associated cardiac, neurologic, renal involvement] Treatment: Based on your medical judgment, can you further clarify in the progress notes the diagnosis related to these findings such as: Hypertensive urgency Hypertensive emergency Hypertensive crisis Hypertension only Other (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Malnutrition The following information is documented in the medical record regarding this patients nutritional status [include only those that apply]: BMI < 19 (include actual BMI) Albumin and/or Prealbumin (if low and not explained by other circumstances) Risk Factors: [examples: cancer, chemotherapy, alcoholism, GI disorders, etc.] Weight < 90% of ideal body weight [indicate actual] Weight < 95% of usual body weight [indicate actual] Unintended weight loss of: Recent weight loss of _______ pounds over _______ months Nutrition Consult: Nutritional Supplementation: Based on your medical judgment, can you further clarify in the progress notes which, if any, of the following conditions may be causing these findings: Malnutrition (please specify severity, if known: mild, moderate, severe) Weight loss only Underweight only Nutritional deficiency (please specify) Another cause (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Malnutrition Severe The medical record indicates that this patient has been diagnosed as having MALNUTRITION with the following findings documented [include only those that apply]: BMI < 16 [include actual BMI] Risk factors: Weight < 70% of ideal body weight [include actual] Weight < 75% of usual body weight [include actual] Unintended weight loss of: Albumin and/or Prealbumin [if significantly low and not explained by other circumstances] Muscle wasting/atrophy Nutrition Consult: Nutritional Supplementation Based on your medical judgment, can you further clarify in the progress notes the SEVERITY OF MALNUTRITION: Mild Moderate Severe Other (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Pancytopenia Documentation in the medical record indicates that this patient has been diagnosed as having [examples: anemia, leukopenia, thrombocytopenia] Based on your medical judgment, can you please provide in the progress notes a more specific diagnosis for the clinical findings below: ANC = [or WBC = ______ with neutrophils + bands = ____ %] Platelets = Hgb = Treatment: (examples: transfusion, lab testing, monitoring etc.) transfusion Based on your medical judgment, can you further clarify in the progress notes the diagnosis related to these finding such as: Pancytopenia due to chemotherapy Pancytopenia due to another medication (please specify) Pancytopenia due to another disease process (please specify) Pancytopenia due to unknown cause Other (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Pneumonia Specificity HCAP Based on the documentation in the medical record, this patient has been diagnosed with HCAP (Healthcare Associated Pneumonia). Associated conditions include: [ESRD, chemotherapy, steroids, immune suppression, ventilator status, cancer, COPD] IV antibiotics: Based on your medical judgment, can you further clarify in the progress notes the most likely or suspected underlying cause of the pneumonia: Gram negative Staph Pseudomonas Pneumococcus Aspiration Other organism (please specify) Other cause (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Pneumonia - Aspiration Based on the documentation in the medical record, this patient has been diagnosed with PNEUMONIA / HCAP / CAP [include only one] Additional documentation in the medical record includes: [include only those that apply] RLL infiltrate Risk factors: NH patient, vomiting, debilitated, bed confined, difficulty swallowing, impaired gag reflex, abnormal swallowing study, GERD/Esophageal disorder, history of stroke Comorbid conditions: Antibiotics: Based on your medical judgment, can you further clarify in the progress notes whether the pneumonia is most likely or suspected to be related to any of the following: Aspiration Pseudomonas MRSA Pneumococcus Viral Gram negative Other specific organism Other cause (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Pressure Ulcer Documentation in the medical record indicates that this patient has been identified as having and/or is being treated for PRESSURE ULCER(s) of the following sites: Based on your medical judgment, can you please confirm the location/sites and the present on admission status of the ulcer(s) in the progress notes. In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Respiratory Failure Acute Documentation in the medical record indicates that this patient has been admitted with or diagnosed as having: The following is also documented in the medical record: Symptoms: Respiratory Rate: ABG: pO2 < 60 [indicate actual] on room air; or pO2 __ on __ liters oxygen pO2: if < 91% [indicate actual -- on room air] pCO2: if > 50 / pH < 7.35 [indicate actual: pCO2 = _____ / pH = _____] P/F Ratio = Treatment with: Based on your medical judgment, can you further clarify the diagnosis related to these findings in the progress notes such as: Acute Respiratory Failure Acute on Chronic Respiratory Failure Chronic Respiratory Failure without acute exacerbation Other cause (please specify) None of the above / Not applicable If any of the above diagnoses have resolved, you may specify as such. In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Respiratory Failure Chronic Documentation in the medical record indicates that this patient has been admitted with or diagnosed as having . The following is also documented in the medical record: Severe COPD Home oxygen therapy at _____ L/min ABG: pO2 = _____mmHg on oxygen at ______ % or _____ L/min SpO2 = ____ % on oxygen at ______ % or _____ L/min Elevated pCO2 (actual = _______) Elevated bicarbonate [ reported as CO2 on BNP] (actual = _______) Other: Based on your medical judgment, can you further clarify the diagnosis related to these findings in the progress notes such as: Chronic Respiratory Failure Hypoxia, hypercapnea and/or hyperbicarbonatemia only Another condition (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Schizophrenia Documentation in the medical record indicates that this patient has been admitted with or diagnosed as having SCHIZOPHRENIA. The following is also documented in the medical record: Based on your medical judgment, can you further clarify in the progress notes the type and/or acuity of schizophrenia such as (one or more): Acute Chronic undifferentiated Paranoid Residual Remission status (in remission or not in remission) Other: please specify None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Sepsis-2 Based on documentation in the medical record, this patient is being treated for: The following are also documented in the medical record [include the sepsis criteria that apply]: Temperature = WBC = Pulse = Respirations = Lactate = BP = Mental status alteration AKI Acute respiratory distress/failure Other: Based on your medical judgment, can you further clarify in the progress notes the cause of these systemic findings in the progress notes such as: Sepsis Sepsis with organ dysfunction (specify) A localized infection only Non-infectious SIRS Another condition (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Sepsis-3 Based on documentation in the medical record, this patient is being treated for: The following are also documented in the medical record [include the sepsis criteria that apply]: P/F ratio = Platelets = Bilirubin = Creatinine = Glasgow Coma Scale score = BP / MAP = Lactate = Vasopressor [if any and infusion rate]: Mental status alteration [if present] Respiratory rate [if > 22] Other: Based on your medical judgment, can you further clarify in the progress notes the cause of these findings such as: Sepsis Severe sepsis Septic shock A localized infection only Another condition (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Shock Documentation in the medical record indicates that this patient has been admitted with or diagnosed as having: HYPOTENSION. The following findings are also documented in the medical record [included only those that apply]: Systolic blood pressure range [if persistently < 90mmHg]: Mean arterial pressure range [if < 70mmHg]: Decrease in systolic blood pressure from _____mmHg to _____mmHg [if >40mmHg] Lactate [if > 4.0]: _____mmol/L Vasopressor support: [drug and infusion rate] Other clinical findings: Based on your medical judgment, can you further clarify in the progress notes the diagnosis related to these findings such as: Shock (please specify type) Hypotension without shock (please specify cause) Another condition (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Shock Hemorrhagic Documentation in the medical record indicates that this patient has been admitted with or diagnosed as having SHOCK and [any diagnoses consistent with hemorrhage] The following findings are also documented in the medical record: Hemoglobin decrease from ______ gm/dl Transfusion: ______ units of __________. Other treatment: Other clinical findings: Based on your medical judgment, can you further clarify in the progress notes the specific type of shock in this case Hemorrhagic shock Hypovolemic shock Post-procedural shock Other type of shock (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Syncope Documentation in the medical record indicates that this patient was admitted for or with SYNCOPE. Other documentation in the medical record includes: Based on your medical judgment, can you further clarify in the progress notes the most likely or suspected underlying cause, if any, of this symptom such as: [include all possible options] Cardiac arrhythmia Anemia / GI bleeding AV block Dehydration Hypoglyemia Cerebrovascular occlusion or embolism Seizure disorder Other cause (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! TIA Cause Documentation in the medical record indicates that this patient has been admitted or diagnosed with the symptoms of TIA (TRANSIENT ISCHEMIC ATTACK). The following information is also documented in the medical record: [include all that apply] Atrial fibrillation / Abnormal Heart Valve(s) / Recent MI Carotid Doppler / Echocardiogram / or MRA showing: Treatment with: (ASA, Aggrenox, Persantin, Plavix, Coumadin) Duration of Symptoms: Other: Based on your medical judgment, can you further clarify in the progress notes the most likely or suspected underlying cause of the TIA symptoms such as: CVA / Stroke Transient cerebral thrombosis or embolism Occlusion or stenosis of a precerebral/cerebral artery (partial or complete) Other cause (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Urosepsis Based on the documentation in the medical record, this patient is being treated for or diagnosed with UROSEPSIS. Based on your medical judgment, can you further clarify in the progress notes whether this term is intended to indicate: UTI ONLY SEPSIS DUE TO UTI Other (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Cause and effect UTI and catheter This patient was admitted with a UTI and also has a urinary catheter. Based on your medical judgment, can you please clarify in the medical record whether or not the UTI is related to or caused by the urinary catheter. In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Cause and effect Two diagnoses Based on the documentation in the medical record, this patient has been diagnosed with the following two conditions: _______________________, and _______________________ Based on your medical judgment, can you please clarify in the progress notes whether or not these two conditions are related to each other. Your response can include none or not applicable. In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Clarification of conflicting diagnoses Your assistance is needed to clarify apparent conflicting diagnoses in the medical record. For compliant coding and billing, we are required to obtain clarification of conflicting information directly from the attending physician. The diagnosis of _________ was documented on [Date] by [Provider]: The diagnosis of _________ was documented on [Date] by [Provider]: The following information is also documented in the medical record: [include all information supporting and not supporting both conditions] Based on your medical judgment, can you further clarify in the progress notes which (in your professional opinion) of these two conditions is the most correct. Your response can include none or not applicable. In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Clinical findings without a diagnosis Documentation in the record includes the following: Based on your medical judgment, can you please provide in the progress notes a diagnosis, if any, associated with the above findings. Please note that your response may include none or not applicable. In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Clinical Validation Query Your assistance with confirmation of a documented diagnosis is requested. Diagnosis: _______________________ Documentation in the medical record also includes: [add information indicating support and lack of support]: Based on your medical judgment, can you please clarify in the medical record whether: This diagnosis is not confirmed and/or it has been ruled out. This diagnosis is confirmed (if confirmed, please add additional supporting information to the medical record) Thank you! ___________________________________________________________________________ Clinical Validation Query Example for Sepsis Your assistance with confirmation/validation of a documented diagnosis is requested. Diagnosis: Sepsis Documentation in the medical record also includes: WBC 15.2 Temp = 99.8 RR = 18 Pulse = 75-89 Based on your medical judgment, can you please clarify in the medical record whether: This diagnosis is not confirmed and/or it has been ruled out. This diagnosis is confirmed (if confirmed, please add additional supporting information to the medical record) Confirmation of a diagnosis from an interpreted report We are not permitted to code a condition documented only in an interpreted medical report without provider confirmation of that condition. For compliant coding and billing, your assistance is needed with confirmation of a condition(s) identified in the following report (s): [include report with date & findings ]: The following information is also documented in the medical record: [include all information supporting and not supporting the condition(s)] Based on your medical judgment, can you please indicate in the progress notes whether or not you agree with this diagnosis(es). Your response can include none or not applicable. In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! Probable/suspected cause of symptom Based on the documentation in the medical record, this patient is being treated for or diagnosed with the symptom of ________________. Other documentation in the medical record indicates the following: Based on your medical judgment, can you further clarify in the progress notes the likely, probable or suspected diagnosis which is the underlying cause of these findings in the progress notes. Your response can include none or not applicable. In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you! General Query Template Documentation in the medical record indicates this patient has been admitted with or diagnosed as having _______________. The following is also documented in the medical record: _______ _______ _______ Based on your medical judgment, can you please clarify/provide in the progress notes ______________________________________________________such as: _____ _____ _____ Other (please specify) None of the above / Not applicable In responding to this request, please exercise your independent professional judgment. The fact that a question is asked does not imply that any particular diagnosis is desired or expected. Thank you!     page  PAGE \* MERGEFORMAT 28 Updated May 9, 2018 1 -/AJOPQRefg~յ{m{{[{{{{#hcthU>*CJOJQJ^JaJh\RCJOJQJ^JaJ$hehU5B*OJQJ^JphhehU5 hO;hUCJOJQJ^JaJhUCJOJQJ^JaJ,hehU5B*CJ OJQJ^JaJ phh_a5CJ aJ hehU5CJ aJ hU5CJ aJ hY hk}5CJ aJ hk}5CJ aJ .@AQRfxo $Ifgd]zrkd$$Ifl4 t0644 lap ytU $$Ifa$gd]z$a$gdk}fg~ $Ifgd]zqkd$$Ifl t0644 lap ytU~ $Ifgd]zqkd$$Ifl t0644 lap ytU $Ifgd]zqkd$$Ifl t0644 lap ytU $Ifgd]zqkd$$Ifl t0644 lap ytU $Ifgd]zqkd$$Ifl t0644 lap ytU $Ifgd]zqkd-$$Ifl t0644 lap ytU $Ifgd]zqkd$$Ifl t0644 lap ytU $Ifgd]zqkd;$$Ifl t0644 lap ytU      D E _ ` a x y z ʹ~veR~eR~e~eR~eR~e$hehU5B*OJQJ^Jph hO;hUCJOJQJ^JaJhehU5hUCJOJQJ^JaJ hhUhhUCJaJ$hhU5B*OJQJ^JphhhU5 hhUCJOJQJ^JaJ,h]hU5B*CJOJQJ^JaJphhbCJOJQJ^JaJ hphhUCJOJQJ^JaJ    $Ifgd]zqkd$$Ifl t0644 lap ytU  D $Ifgd]zqkdW$$Ifl t0644 lap ytUD E ` $Ifgd]zqkd$$Ifl t0644 lap ytU` a y $Ifgd]zqkde$$Ifl t0644 lap ytUy z $Ifgd]zqkd$$Ifl t0644 lap ytU $Ifgd]zqkd$$Ifl t0644 lap ytU $Ifgd]zqkd$$Ifl t0644 lap ytU $Ifgd]zqkd$$Ifl t0644 lap ytU $Ifgd]zqkd@ $$Ifl t0644 lap ytU  $Ifgd]zqkd $$Ifl t0644 lap ytU      * + , I K L b c q r s    ! $ 1 2 3 whhZC5hhZCCJaJhCJaJhZCCJaJhhU5$hhU5B*OJQJ^Jph hhUCJOJQJ^JaJhehU5 hO;hUCJOJQJ^JaJhUCJOJQJ^JaJ$hehU5B*OJQJ^Jph.   $Ifgd]zqkdN $$Ifl t0644 lap ytU  + $Ifgd]zqkd $$Ifl t0644 lap ytU+ , K $Ifgd]zqkd\ $$Ifl t0644 lap ytUK L b $Ifgd]zqkd $$Ifl t0644 lap ytUb c r $Ifgd]zqkdj $$Ifl t0644 lap ytUr s $Ifgd]zqkd $$Ifl t0644 lap ytU $Ifgd]zqkd $$Ifl t0644 lap ytU $Ifgd]zqkd$$Ifl t0644 lap ytU $Ifgd]zqkd$$Ifl t0644 lap ytU $Ifgd]zqkd7$$Ifl t0644 lap ytU $Ifgd]zqkd$$Ifl t0644 lap ytU $Ifgd]zqkdE$$Ifl t0644 lap ytU $Ifgd]zqkd$$Ifl t0644 lap ytU  $Ifgd]zqkdS$$Ifl t0644 lap ytU  $Ifgd]zqkd$$Ifl t0644 lap ytU  2 $Ifgd]zqkda$$Ifl t0644 lap ytU2 3 T $Ifgd]zqkd$$Ifl t0644 lap ytU3 F I T U | } 1 2 6 H I J K L N O 7 ǿǤϿDŽ|pdUhfhk}OJQJ^JaJhOJQJ^JaJhOJQJ^JaJhsuhk}5 hk}5hh t5hh tCJaJhehK 5hhK CJaJhwR^CJaJhaCJaJhUCJaJhehU5hO;hUCJaJh{hUCJaJhhU5h CJaJhhUCJaJT U | $Ifgd]zqkdu$$Ifl t0644 lap ytU| } $Ifgd]zqkd$$Ifl t0644 lap ytU $Ifgd]zqkd$$Ifl t0644 lap ytU $Ifgd`6qkd*$$Ifl t0644 lap ytU 1 $Ifgd`6qkd$$Ifl t0644 lap ytK 1 2 I $Ifgd]zqkdR$$Ifl t0644 lap yt tI J L M N O HI>||gdk}gdk}$a$gdk}qkd$$Ifl t0644 lap ytU7 B GNW\k>?;78:?@Plɿɿɲɿɿ}wkh_aOJQJ^JaJ hk}aJhi,B*aJphhshk}5B*aJphhWhc0JhchcB*phhcB*phjhcB*Uphhk}B*aJphhT9hk}B*aJphhT9hk}OJQJ^JaJhfhk}OJQJ^JaJhk}OJQJ^JaJ)>?89:l_ & Fdhx7$8$H$gdpl & Fd x7$8$H$gd$d x7$8$H$gdW d 7$8$H$gdWd (7$8$H$gdWgdk}gdk}lm>?AR^qyOYhw 纲wgh)(h5OJQJ^JaJhWOJQJ^JaJhhW6]hzhW# hh< hh hhWhh;?5hhW5 hh;?h-hnshW\ hW\ hW5\hhW5\hP9 hhWhWhhW5 h5'>Ks & F d (7$8$H$gd$d (7$8$H$gd.~d (7$8$H$gdLgd|y d 7$8$H$gdW & Fdh(7$8$H$gdplTtz,2=>JKLUrs|}Ŀȱ{rh^h^U^h.~h-aJh.~h-5aJh.~h_F5aJh.~h;?aJ h.~hA h.~h% h.~h h.~hHa h.~h[O h.~hch.~h7hhL hg75 hs5 h.C5h"3M hhfh|yh|yOJQJ^JaJh)(hbi5OJQJ^JaJh)(h)(5OJQJ^JaJ!s|}3Lf 7$8$H$gd* 7$8$H$gdx d 7$8$H$gd* d 7$8$H$gdf & F$d (7$8$H$gd$d (7$8$H$gdL & F d (7$8$H$gd$123JKLdefvgpüظ~wsl h35\hW hhd> hh9z h*5 hbi5h)(h)(5hbi hhg hh<h~"|hz hhfh* h.~h% h.~hn? h.~h/ h.~hL h.~h* h.~h6 h.~hfh.~h-\aJh.~h-aJ)"2469:Rdz 9:oxĻ}vvokohz hh< hh%h hh*h68h*h6 hh6 h*aJ h6aJhKh_F\aJhKh68\aJhKh68aJhKh_FaJ h3aJ hKhV hKh) hKh3 hKh< hKh%h3h9z5\):Y{!:Twgdx 7$8$H$gd* 7$8$H$gdx d 7$8$H$gdi & F%d (7$8$H$gd$d (7$8$H$gdi & Fx7$8$H$gd$VWXY% F W h i !ȼȶzpibi[T[i hhwC hh% hh3 hh.Jhh_F\aJhh.J5\aJhh.JaJhh_FaJhhk <aJ hk <aJ haJhhaJ hNaJhh.J5h` hh.Jhk < h*5h0sh0s5hx|T h.J6]h* hh<hh<5\ VWXY  % F i j )! d 7$8$H$gd.J & Fd(7$8$H$gdpld (7$8$H$gd.Jx7$8$H$^gd`d (7$8$H$gd*!!4!5!6!7!8!A!B!C!!!!!!!!!>"k"n"""""""""""๰ungn`YUQUhhv{ hk <h hk <hv{ hk <hl& hk <h|+hk <h_F\aJhk <h68\aJhk <h68aJhk <h_FaJhk <hk <aJ hk <aJ haJhk <haJhhr?5\hhr?5h@h7Uh7Uh7U5 h7U5 hhr?hhx|T6]hwC hh.Jhz)!*!6!7!A!B!C!!!!!!!!!""""" & Fd (7$8$H$gdpld (7$8$H$gd68d (7$8$H$^gdr?d (7$8$H$gdr?gdx|T 7$8$H$gdwC 7$8$H$gd.J""#####$+$a$b$c$!%9%E%e%n%~% & Fd (7$8$H$gd$d (7$8$H$gd68dh(7$8$H$gd>idh(7$8$H$gds 7$8$H$gds 7$8$H$gdr? d 7$8$H$gdr? & Fd (7$8$H$gdpl""########$$$&$)$*$]$`$a$c$d$$$$$$$$$%%% %!%ùҲ{qjcj\Xh68 h~"|h68 hd\aJ h-\aJh~"|h68\aJh3h68\aJh0eh685aJ h68aJh_Fh_FaJ hUnaJ h-aJhv{h/ hh)vYhh<5\hsh<5 hhJ4. hh< hs5h7Uh7U5h7Uhx|Thz hhr? hhl&!!%8%9%T%_%n%%%%&&#&4&5&6&&&&&''''''y''''''((8(D(E(F(G(l((()))))Ŀyrr hh.bhhO5\h+H hhO\ h~"|hOhhO5 hhO hh+shhO5 hhOhO hO5 hmf6]hh<6]hh<5\hz hh< h@hQ h@h(l$h(l$hQ,~%%%%%%%%&5&6&&&'''''''' & Fdhx7$8$H$gdpld (7$8$H$gdO 7$8$H$gd+s 7$8$H$gdx d 7$8$H$gd> & Fd (7$8$H$gd$''F(G(((((((())))))))))))gdf} 7$8$H$gdy_ d 7$8$H$gd.b 7$8$H$gdOd 7$8$H$^gd+H d 7$8$H$gdO))))))))))A*K*L*R*S*T*d*f*h******+++'+I+b+s++++ļΞ~vovhoaoZ h{"hm h{"h` h{"hX h{"h:h{"h`5h{"h685 h{"h< h{"h+shh<5\hhB5\hh%85\hh:5\hh:\hh5\ hy5\ hh<hZ h}5hy_hy_5hy_hO hhOh.b!)A*g*h***+b++++i,j,u,v,w,x,y,z,{,|,}, 7$8$H$gdZ 7$8$H$gdx & Fd (7$8$H$gd$ d 7$8$H$gd}d (7$8$H$gd}gdf}++++++G,P,t,u,,,,,,,,,-M-Q-R------------N.P...//a/b///½½¯ ||vo hhY)R hY)RaJhhY)R5\aJh 8h:KhHf5h:Khe+5he+hUkhY)R hhY)RhhY)RaJ hrW5 hV5 hY)R5hFEhg$hz hh<hh<5\ h{"h< h{"h] h{"h0 h{"h\*},~,,,,,,,,,,,,,,,,,,,Q-R--gdUkd x7$8$H$gdY)R 7$8$H$gdY)Rd (7$8$H$gdY)R 7$8$H$gdZ--e.....b/l///////0000000 7$8$H$gdZ 7$8$H$gdY)R d 7$8$H$gdY)Rd (7$8$H$gdY)R & F,xgd$ & Fd x7$8$H$gd$////}0000000p1u1{111111O2P2a2d2e222222222223333333¾¾¨¤‡‚}umh)hK5h)hJ5 h>>5 hK5hz hKh hKhFE hKhKhBbh.~h{" hFEh#1 hFEhFEh>>h#1hFEhFEhFE5h.~hFE5 *hY)R5 hY)R5 hzaJhhY)RaJ hhY)Rh 8hp(07181p1111111O2P2e2f2r2y22222222 & F07$8$H$gd$ & F/7$8$H$gd$ & F)x7$8$H$gd$ x7$8$H$gd3 7$8$H$gdFE2222223333333344445 55 & F x7$8$H$gd hh]] h)h h)hIH5 h)5 h)h\4_ h)hIH h)h+sh)hÿÿ|u|me]euh)h./5h)hIH5h)h+s5 h)hIH h)h+s hhv hhIUhx^8hIU hh zh z hEhE h)hE *hiOhvhEh) hh./hJhJhgg5hJhJ5] hr|6]hr|hz hKhr|hKhr|5\"v;w;;;;;;;;;;;<<=<<<<<<<=&=\= & Fd (7$8$H$gd$d x7$8$H$gdEd (7$8$H$gd./ 7$8$H$gdJ 7$8$H$gdr|\===>+>0>>>L>a>k>>>>p?q?|?~? 7$8$H$gdJ d 7$8$H$gdJ d 7$8$H$gd./hd x7$8$H$^hgdr= & F d x7$8$H$gdpl & F x7$8$H$gdpld (7$8$H$gd./ & Fd (7$8$H$gd$>>+>/>0>5>6>F>K>L>T>[>`>a>j>k>p>>>>>>>>N?W?{?|?}?~????@@@H@R@V@¸{tokghM hh) hM h\ hJhohh<5\ hh/!hZhJhJ5hJ hh>jhh./6]hz hh./hF|0hF|05\h)h./5\ h)h1=h)hE5\ h)h h)hE h)h#v h)hK`KqK~KKKȼȫ{wsokogogogokok`s`o hzMhzMh@h DhzMh;?hEh5CJOJQJ^JaJ hEhECJOJQJ^JaJ h nhzMCJOJQJ^JaJ h nhECJOJQJ^JaJh nh nhE5 h nhE h nh4mh nhzM5h nh4m5h4m hhEh6h6OJQJ^JaJ$KK$L7LZL~LL>M?MJMKMMMnMoMMMN 7$8$H$gdS3vdh(7$8$H$gdS3v 7$8$H$gdv< 7$8$H$gdJ 7$8$H$gdE d 7$8$H$gdE & F d 7$8$H$gd;? & F 7$8$H$gdpld (x7$8$H$gd;?KKKKLL#L/L6L7LZL}L~LM%MIMJMKMLMMMnMoMMMMNNN4N9N:N;NUNZN[N\NNNƿzslseslsese h<hS3v h<hi h<h{~hhS3v5\h5h{~ hhS3vhX hRYhX 5 hhv< hI}6] hE6] hh4mhz hhEhYh;?5\ hYh;?hYhE\hYh@\hYh;?\hYh\\hYh;?aJ%NN;N\NNNNCOXOoOOOOOOPPP & Fdx7$8$H$gdMn & Fd (7$8$H$gdpl d 7$8$H$gdS3vdh7$8$H$^gdS3v & F"dh7$8$H$gd$ 7$8$H$gdS3vNNNOO9OCOWOXOoOOOOOOmPvPPPPPPPPQQQ)Q4Q7Q[n[{[[[[[[[[\\wh"wh8A]h"wha]h"whLe]h"wh8A5h"whLe7 h"whLe h"wh8A h"whah8AhZha hh8Ah\wh\wh L5h\wh\w5hfthS|5hefhdLhh"5\ hh"hz,XXXXjYkYYY3ZAZHZZZ[7[o[[[[\ & Fx7$8$H$gdpl & Fxgdpl d 7$8$H$gd8A dh7$8$H$gd8A & F#gd$ 7$8$H$gd8Adh(7$8$H$gd8Agd L\ \\\\\\\\\\O]y]z]]]^^^^d <7$8$H$gdYd <7$8$H$gdQk 7$8$H$gdQk d 7$8$H$gdQk 7$8$H$gdftgd Lgd L 7$8$H$gd8A d 7$8$H$gd8A\ \^\\\\\\\\\\\\\O]z]]]^^^^<^Q^R^Z^[^e^n^^^^^^^^^_ _¾xxtptpti h"whchYh[Hh=s=hQk5 hchQkhchQk\ h=s=h5hQkh' h=s=hQk\h=s=hQk5\ h=s=hQk hhfthfthfth<5 h/W5hfthft5 h L5h Lh8Ahz hh8A h"wh8Ah"wh8A5\'^^^^^^^_,_-____```i```` d 7$8$H$gdJ 7$8$H$gd[Otgdx x7$8$H$gd[Ot d 7$8$H$gdQk & Fd <7$8$H$gd$ __+_,_-_______````i`r````````````aa"a$a@aVaWa_afakalaaļ~wsoskgsgggghi$h_h hj hJ5\hhJ5\h0hP\h0hP5\h0hJ5\ hhJh[Othh[Ot5 h=zL5hh5hJhh<6] hhVhz h=s=hQkh[Hh"wh[H5\ h"whc h"wh[H'``aaaabbbbbbbbbccccc d 7$8$H$gdJ d 7$8$H$gdc & Fd <7$8$H$gd$d <7$8$H$gdjd <7$8$H$gdJ & Fd <7$8$H$gd$aaaaaaaaaaaabb%b-b;bb?bWb`b~bbbbcccccccccccc=dGdַ֒֋{wpi h Bh2 hh2hhh65hh5 hhjhzh0hc5\ h0hch0h84\h84h84\h84hbihJ5hmhchJ\ hchJ hhJhjhch5h5h_hi$hJ hEhJ'cccccdd0eeeeeefffff d 7$8$H$gd(jdh(7$8$H$gd 7$8$H$gd]/d (7$8$H$gd  7$8$H$gdG0z d 7$8$H$gd d 7$8$H$gd2d `7$8$H$XD(gd2 7$8$H$gdGdQdndwdddddeeee-e.e/e0eeeeeeeefffffffffffffggg!g%g'g6g7g¾´°|xtotot| h^05hWhA_Oh~;h*h:]h*kK hh(jh]/h]/h(j5 hq5h]/h]/5h(jh2hh25\hz hh2hh2\ h~"|h2h Bh2\h Bh25\h Bh25 h Bh2 h Bhc+ffff7gigggggPhjhhhhy & Fd <x7$8$H$gdP & Fdh(7$8$H$gdpl & Fd x7$8$H$gd$ d 7$8$H$gd(jhd 7$8$H$^hgd(j & Fdhx7$8$H$gd$ & Fdh(7$8$H$gd$d (7$8$H$gd(j7g:gBgFgGgHgIgWg[ggghgigjgmgrgggggggggg h h0hhhhiiiPiiijjjj1jj?jjjjjj & F7$8$H$gd$ 7$8$H$gdA?dh(7$8$H$gd(j 7$8$H$gd9r 7$8$H$gd(jgd(j d 7$8$H$gd(jd gd(j & Fd <7$8$H$gdc kkk"kkkkkkkkk6l:l]llllllmmmmmmmmmmmbnonnnnnnoȡϓϏ{wsksgscshq\hmhtYhG0z5hG0zhjVQh9rh9rhjVQ5h9rh9r5h(jhzhh(j5\h-)h}5\ h-)hP h-)hjh-)h(j5 h-)h(j h-)h} hh(j h_TKh h_TKhA? h_TKh(j h_TKh-8 h_TKh} h_TKhc&jkXkkkkkk}llllmmmm 7$8$H$gd(j & Fd <7$8$H$gd} & Fd (7$8$H$gd-) & Fd (7$8$H$gdj d 7$8$H$gd(j dh7$8$H$gd(j & Fxgd$ & Fx7$8$H$gd$mmmmmmmtnunnnnn@oFo`oiosooooo & Fd <7$8$H$gdP & Fx7$8$H$gdpl 7$8$H$gdG0zd <7$8$H$gd(j 7$8$H$gd(j 7$8$H$gd9rooooo(o)o?oioqosooooooopppppppppppqqqqJqLqSqTqmqrqsqͼ~zvoh hq\hF@ hq\hhhs hhF@h$Rh$Rh65h|Fh5h$Rh$R5 hh: h~lh6hzhG0zhtYh-)hP5\ h-)h h-)hP h-)h># h-)hG0z h-)h}h-)h}5h-)hO5 h-)hO&opppppppqqqvqwqqqqqqqqqqq & Fd 7$8$H$gd$ 7$8$H$gd$R 7$8$H$gd: 7$8$H$gd9r 7$8$H$gdG0z d 7$8$H$gd6sqtqvqwqqqqqqqqIrMrSrmrrrrrrrrr3sssssssst~wswokc[WhJh$RhJ5h|FhJ5h_h: hz hh: hq\h hq\he8 hq\h hq\h-@ hq\h} hq\h+ hq\hOhq\h: 5hq\hO5\hq\hO\ hq\h) hq\h hq\h hq\h]Vzhq\h]Vz5\hq\h: 5\ hq\h: qqrrrrrs3s4sssssttUtVttt 7$8$H$gdJ 7$8$H$gd:  & Fd <7$8$H$gd & Fd <7$8$H$gdpl d 7$8$H$gdp d 7$8$H$gd: tStVttttu uuuuEuFuSu^ukuluuuuuuuuuuuv v vv$v%v%w.wFwHwJwOwPwTwwwwwwƾՠ}y}ht hh9h9hh95 h95hz hdh\Ph\Ph\PhJ5h\Ph\P5h\PhJ5\h\PhJ\ h\PhJh|FhW.hdh'K hdhdhdhJ5\ hdhJhJ hhJ-tttttuuuFuluuuuv vv%v@vcvvvGw & Fd <7$8$H$gdJ & Fd <7$8$H$gdd d 7$8$H$gdJ & Fd 7$8$H$gd$GwHwIwPwQwww4xoxxx y8yQyRyyyz & Fdh(7$8$H$gdx & Fdhx7$8$H$gd[d & Fd x7$8$H$gd$d x7$8$H$gd9 d 7$8$H$gd9d (7$8$H$gd9 7$8$H$gdJwx1x2x3x4xdxexoxxxxxyyyyzezfz{ {1{2{4{6{7{<{={>{J{K{L{M{{{{{{xqmemh''h''5h'' h''h h''h=h=h''h=5h''hZ!5h''hoV45 hZ!5 h=5 huPq5h9hJhh96]hz hh9hh95\hxhVh95 hVhV hVhhhVh95\hBU hVh9&zAzezfz%{&{1{2{3{4{5{6{L{M{{{4|Z| & Fd x7$8$H$gd$d x7$8$H$gd= d 7$8$H$gd=d (7$8$H$gd=d (7$8$H$gdJ d 7$8$H$gd9 & Fdh(7$8$H$gdx{{{{| |2|3|4|Y|Z|||||||||}}'}(}9}}}}I~R~w~x~y~z~{~~~ƿƿƸױכyojb] h5 ha5ha hiQha25=EMNO 01 7$8$H$gdbi 7$8$H$gd wM d 7$8$H$gd wM & Fd (7$8$H$gdC & Fd (7$8$H$gdpl d 7$8$H$gdS9 dh7$8$H$gd wMdh7$8$H$^gd wM & F"dh7$8$H$gd$*+,@ABDEFG 7$8$H$gdbi$a$gd$$a$gdZ$a$ %&(),34;?@ABDEFG즟즘 hiQhP hf"h{h`6hOh{CJmH sH hCJmH sH h0CJmH sH h{CJmH sH jh{UmHnHuh'mHnHuh{jh{Uh{mH sH < 001h/R :p#/ =!"#$% $$If!vh#v:V l4 t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065/ p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065/ p ytU$$If!vh#v:V l t065/ p ytU$$If!vh#v:V l t065/ p ytU$$If!vh#v:V l t065/ p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065/ p ytU$$If!vh#v:V l t065/ p ytU$$If!vh#v:V l t065/ p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t065p ytU$$If!vh#v:V l t06,5p ytU$$If!vh#v:V l t06,5p ytU$$If!vh#v:V l t06,5p ytU$$If!vh#v:V l t06,5/ p ytU$$If!vh#v:V l t06,5p ytU$$If!vh#v:V l t06,5/ p ytK $$If!vh#v:V l t06,5/ p yt t$$If!vh#v:V l t06,5p ytU%w0002 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@6666_HmH nH sH tH @`@ UkNormalCJ_HaJmH sH tH DA D Default Paragraph FontRi@R 0 Table Normal4 l4a (k ( 0No List bob xDefault 7$8$H$-B*CJOJQJ^J_HaJmH phsH tH jj x Table Grid7:V0@@@ V0Header ! mHsHtH6/!6 zJ0 Header CharCJaJ@ @2@ V0Footer ! mHsHtH6/A6 zJ0 Footer CharCJaJ6U`Q6 )p5 Hyperlink >*B*phBbB Zfont12 dCJOJQJaJ6s6 9zTable 3D effects 2:Vj.@j#j9jj 45\5\H!H l]Subtle Reference:>*B*phPMH`H f} No SpacingCJ_HaJmH sH tH b@b f List Paragraphd^CJOJPJQJ^JaJPP u Balloon TextCJOJQJaJmHsHtHN/N uBalloon Text CharCJOJQJ^JaJD D-0RevisionCJ_HaJmH sH tH B' B %Comment ReferenceCJaJ<<  % Comment TextCJaJ:: %Comment Text Char@j@ "%Comment Subject!5\F/!F !%Comment Subject Char5\Rv!1R 0Unresolved MentionB*phq B^BB -0 Normal (Web)$dd[$\$PK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭VGRU1a$N% ʣꂣKЛjVkUDRKQj/dR*SxMPsʧJ5$4vq^WCʽ D{>̳`3REB=꽻Ut Qy@֐\.X7<:+& 0h @>nƭBVqu ѡ{5kP?O&Cנ Aw0kPo۵(h[5($=CVs]mY2zw`nKDC]j%KXK 'P@$I=Y%C%gx'$!V(ekڤք'Qt!x7xbJ7 o߼W_y|nʒ;Fido/_1z/L?>o_;9:33`=—S,FĔ觑@)R8elmEv|!ո/,Ә%qh|'1:`ij.̳u'k CZ^WcK0'E8S߱sˮdΙ`K}A"NșM1I/AeހQתGF@A~eh-QR9C 5 ~d"9 0exp<^!͸~J7䒜t L䈝c\)Ic8E&]Sf~@Aw?'r3Ȱ&2@7k}̬naWJ}N1XGVh`L%Z`=`VKb*X=z%"sI<&n| .qc:?7/N<Z*`]u-]e|aѸ¾|mH{m3CԚ .ÕnAr)[;-ݑ$$`:Ʊ>NVl%kv:Ns _OuCX=mO4m's߸d|0n;pt2e}:zOrgI( 'B='8\L`"Ǚ 4F+8JI$rՑVLvVxNN";fVYx-,JfV<+k>hP!aLfh:HHX WQXt,:JU{,Z BpB)sֻڙӇiE4(=U\.O. +x"aMB[F7x"ytѫиK-zz>F>75eo5C9Z%c7ܼ%6M2ˊ 9B" N "1(IzZ~>Yr]H+9pd\4n(Kg\V$=]B,lוDA=eX)Ly5ot e㈮bW3gp : j$/g*QjZTa!e9#i5*j5ö fE`514g{7vnO(^ ,j~V9;kvv"adV݊oTAn7jah+y^@ARhW.GMuO "/e5[s󿬅`Z'WfPt~f}kA'0z|>ܙ|Uw{@՘tAm'`4T֠2j ۣhvWwA9 ZNU+Awvhv36V`^PK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!g theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] GG  00EEEH 3 7 l!"!%)+/3q6:>V@kC#FpIKN*RUX\ _aGd7g kosqtw{~vx'GPZewf~  D ` y   + K b r  2 T | 1 I >s)!"~%')},-0258v;\=~?ZBD!FGHKNP\T WX\^`cfhjmoqtGwzZ|~l5GQRSTUVWXY[\]^_`abcdfghijklmnopqrstuvxyz{|}~ GX),H!T # @H 0(  (  z  0d1?"? B S  ?t;G$ A' t #33ddddx&x{{ABEH  > B *1\pdx!!<$P$n&r&r((}++,,v//}00I3]3C7W72;F;==6AJAB!BE%EqFuFbHvHIIJJLMPPQQQRURTTUUVVWWXXZZ[[]]aabbFcKcdciceeuhhkko.oq qr s>vRv2yFyQzUzzzzzzz6}J}SgKY(<`tdxsw'os}u-AÖזABH333333333333333333333333333333333333333333333333333333333333333333333333333333333}}2 ,_v !#i )?BCDEH3SSTT}}2 $$Q%R%%%%&&&b''''''bggz},_vGGd&i )?H4/|~6pW>`j;]6#= WJTh u4a Ps%J a8cA+0$d?Bs&n*8v-N'GB.<Ì]P/ iz;J8̕%V>z4c>pVYWK?,K(@@BiE az VJn'DJ*D)L WTL`NFMA:aaqzN2V@QPNAGR SZ~ST^TO sTnލfU,X=g]r} a*t^f4+<g.}: 'g wwhm7mzH cnSaoX~xX(w> UyX|0(}#Xo<[~+y!Rhhh^h`B*OJQJo(phhH ^`OJQJo(o pp^p`OJ QJ o( @ @ ^@ `OJQJo( ^`OJQJo(o ^`OJ QJ o( ^`OJQJo( ^`OJQJo(o PP^P`OJ QJ o(h^`B*OJQJo(phhH ^`OJQJo(o   ^ `OJ QJ o(   ^ `OJQJo( xx^x`OJQJo(o HH^H`OJ QJ o( ^`OJQJo( ^`OJQJo(o ^`OJ QJ o(h^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`B*OJQJo(phhHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`B*OJQJo(phhHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHhh^h`B*OJQJo(phhHh8^8`B*OJQJo(phhHh^`OJ QJ o(hHh ^ `OJQJo(hHh ^ `OJQJ^Jo(hHohx^x`OJ QJ o(hHhH^H`OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hH ^`OJQJo("  ^`OJQJo("  pp^p`OJQJo("  @ @ ^@ `OJQJo("  ^`OJQJo("  ^`OJQJo("  ^`OJQJo("  ^`OJQJo("  PP^P`OJQJo(" 80^8`0o(. ^`hH. pL^p`LhH. @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PL^P`LhH.h^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh8^8`OJQJo(hHh^`OJQJ^Jo(hHoh ^ `OJ QJ o(hHh ^ `OJQJo(hHhx^x`OJQJ^Jo(hHohH^H`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hH^`OJQJo(hH^`OJQJ^Jo(hHop^p`OJ QJ o(hH@ ^@ `OJQJo(hH^`OJQJ^Jo(hHo^`OJ QJ o(hH^`OJQJo(hH^`OJQJ^Jo(hHoP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`B*OJQJo(phhHh^`B*OJQJo(ph   ^ `OJ QJ o(   ^ `OJQJo( xx^x`OJQJo(o HH^H`OJ QJ o( ^`OJQJo( ^`OJQJo(o ^`OJ QJ o(h8^8`B*OJQJo(phhHh^`OJQJ^Jo(hHoh ^ `OJ QJ o(hHh ^ `OJQJo(hHhx^x`OJQJ^Jo(hHohH^H`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hH^`.^`.pp^p`.@ @ ^@ `.^`.^`.^`.^`.PP^P`.h^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hH ^`OJQJo(^`OJQJ^Jo(o p^p`OJ QJ o( @ ^@ `OJQJo(^`OJQJ^Jo(o ^`OJ QJ o( ^`OJQJo(^`OJQJ^Jo(o P^P`OJ QJ o(^`OJQJo(hH^`OJQJ^Jo(hHop^p`OJ QJ o(hH@ ^@ `OJQJo(hH^`OJQJ^Jo(hHo^`OJ QJ o(hH^`OJQJo(hH^`OJQJ^Jo(hHoP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`B*OJQJo(phhHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh8^8`OJQJo(hHh^`OJQJ^Jo(hHoh ^ `OJ QJ o(hHh ^ `OJQJo(hHhx^x`OJQJ^Jo(hHohH^H`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh8^8`OJQJo(hHh^`OJQJ^Jo(hHoh ^ `OJ QJ o(hHh ^ `OJQJo(hHhx^x`OJQJ^Jo(hHohH^H`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`B*OJQJo(phhHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohp^p`OJ QJ o(hHh@ ^@ `OJQJo(hHh^`OJQJ^Jo(hHoh^`OJ QJ o(hHh^`OJQJo(hHh^`OJQJ^Jo(hHohP^P`OJ QJ o(hH4 &? cn'DJ<g@Qc>$aqzN7m8v-|0(}n*fUT^T/]P/iz;z VJTh ~wwh`iE#= +y]GR S <[~X(wGB.TLaot^fg]%V> Uy9>JsTBs&YWK?} aW=K(@@)L: 'gs% aNFMA+2B2E2cF44                                                                                                                    "hRSlմff5N(*r                                                                                                                      J                                  z@D$J&$R'0P^                                                                                                                                                                                    'hcb9E 3"cb9E ^{ cb9E  CrKEAjA)O0eD16cb9E];Tcb9E \>Ycb9E  6Uacb9E Xj^p  68&.ANQ ]`a~ln+|)O;&>GLNaov,*\?^^mllt &g$h('4#9m<FRZb_Qkw '7T:RcWKaf  D*3+IO[d]fa@-01Jae)qqzUVZy~y{{C *AOCNDZEF`LW f^hi ( l#-d9fGHT=[gyZ!&'*EORV{[gW')(*>bAwWX&ghqr)}]+/;&>kOOtRXRYm{z ALP(WvY\Aitx=5OUptuT%m=UWZjtrt@{D -3e9JJa~ =MJ_`i a#$d5fgl - A K b _~ "!= !)!4!F!0n!v!1""j" "'["]"'e"{"#G#P#8#pF#NG#N#Q#W#Z#-t#z#}#:$$$$8$i$(l$|$%I8%'w%Gw%%&]&''''2&'.;'['I_'"`'j't''4(4(#(=(H(S(e())) )u#)IC)Q)Q),Y)nm)> **'*9*t=*S*j*p*\+)+H!+4+'B+tK+e+|+,5,>9,[,^,h,~,-- - - --!-b$- *-k--F-L-Y-g-s-J4.J.Y.n.//./S6/I9/}/0HC0 I0Jf0x0F|0H1#1\&1?1U1uY1v^1t1x1~12| 2#2%02<2uk2tr2u23 3&3;33 43d<3kB3U3$\3`3~34k<4sO4oV4f4v4;y4:555s#5)5p1555:5}<5W5X5\5 o5)p5vu5x5y5{56666,#696>6P6Q6Y6h67X7*77n>7L7[7g7i7m7r7 8e8M8 8-86868,>8x^8 9E99)9A9F9I9P9T9hd9d9l9w|9i:&:+:/:0:J9:l:N; ;!;1;S;GT;Z;];d;es;z;<\<'<L < <k < <<<N0<G3<'C<L<~m< ==@,=,=0=1=<=>>>>!>>>U)><>>>jJ>>[>^>d>&f>q>y>?m??# ? ?r ???~?A?;?M?[?r?w?|?|?`*@3@z:@E@'n@o@u@ (A/A5AP6A8ADAMA]VA*kA BBgB -B`=BTB WB}B!CCCCZC)C/CVAVDVNZVWW*W/WWJWYfWvXX2#X4XAXDXUeX,qX|XYYYbYg Y%Y;YRYtY)vYZ *ZGZ[[[4 [[[.[:[:A[6D[l[s \\#\\cA\6Q\gZ\q\y\@]L]1b]|l]w]^@^Q^DR^wR^_*)_,_\4_B_]]_y_`}`h`)`.`6`7`hH`M`T`X`5n`G a!a-aSaXaoaXvabbb'bn)bBbJbQLbyb}bcc8)cNc{cdddEdPd[dyde eeo$e;4eHeLe1Qe3TeFf f"f7fHfTfWf_fmf ufgV/g_1g>gAgTgXg~^g*wgBh hM hphhFh;hH=hW@hFhkii;i>i Ki[i_ibi8fi}i jj95j>jlOjSjSj/_jvk>kU#kEk KkMkUk`bkCoktkTl+&l/l:lRlXlE_lm m%mm4mvmG n)nc0n7;npGnCKnMnUnanIgnMqno)oc5o5oCo_Go^oqovropp{3poIpBkp{puqq q7q DquPqQq`qrr)r9rUrhrns s s+sNsrs\*s+sq,s;s4cscsislws tftNt+t5t@t[Ot^tct7etHuVu"uV1u6ufBuHuq\usu#v(v1vS3vrTvjvkvuv*~vwwww www|w,w=wQHwXw _wix x x=!x%x;Px `xax yx|xy~>yHyNy5fyoxyIz zFzzG0z9zCEz]Vzdzuz{{ {{{{{.{G{M{p{v{x{Dy{||z|~"|^F|S|V\|^o|r|}} }}}}J7}@}I}P}f}}} ~8~d:~HL~&S~iW~b~e~n~t~{~fPz[lv{D /m5C78FKfu#!$m*./34690bi'w+(4>UB%FPx$15-@Xcef|".)JUcm^| 8<#B.3GgI\\x $#%+928EMNTfX4 BP$Wfmt 2 }$/|3uBGsN4_ r sxz/m})78?GZK[~!.3)9(HgR:v"*?ImS o &3M9Ss^:hn026J:v@CMW:]kppWv|}u(/LGVcefFZ@$`/6/>NAP5QYovyQ) 587_m'-/GwHJORU_alCt77kl[|u v&(HP\nek`v}nS ''K>HPTte%o+fPTVW n{.Y8:~;=_[[IpuxL!l5##@J\TUal`(<@6 $36%:PYY3]cdllty./2KSe nBd'EIX\]{Sc,<;@F@{DS]_gnr#Kdetjm v@-3Wahhv,-<3=;@`KKOdP ,5<ilsuwy6 6ZQ'UViqwx({*56xX7H#m-0*69FEz\`%l&0w2=EyMPXX0s0p4iPS^tE %$<GJ)SMi|,g55FI~KP*S^^ggpb#Ubv !v)80>A[~C %`0JhEuDz^44c7ls%,..CJc4#7B`ckm\qt} 0">%5D9EzMNNZgkLt]z*0ERU`ce A@9]]]cd?dkqB'**c463@\bhow=FMROVo+9;~='D-PUX]Kk|*DzKRYu5@P_d`oP~'"P)(/0eJl_bi Rc,eo \,'.9.0BCIox1ENMQNAV]u~((7< = a bs h,Wei@S4Z$d!j' g$HIOUir"w pC*4,+-BBHIL_`hiy|'+OCXt X E+17CK LKL^!gplmKhf i9 B&C\gln,w=-s:k<?/Qer{` ,6!HZd/ $/^0o88BBG'KO=v f"BEyYFfwo?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghiklmnopqstuvwxy~Root Entry F0~@Data z1TablehWordDocument >SummaryInformation(jDocumentSummaryInformation8rMsoDataStore@~@~QQDCKLUQQSMTM==2@~@~Item  PropertiesUCompObj r   F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q