edit in HackMD and export as SVG from inspector

```graphviz
digraph Heirarchy {

TREAT,COVERAGE,CLMATTCH,COVAUTH,HQUALIMP,HDM,COC [style=dotted]
"treatment-noa","payment-noa","operations-noa","care-planning","social-risk"[style=dashed]
HPAYMT,HOPERAT,TREAT[fontsize=20]
HPAYMT[label=<<u>HPAYMT</u>>]
HOPERAT[label=<<u>HOPERAT</u>>]
Treatment,Payment,"Health Care Operations","45 CFR 164.506 Treatment, Payment, and Health Care Operations" [fontsize=24,style=bold]
{Payment "Health Care Operations" Treatment}->"45 CFR 164.506 Treatment, Payment, and Health Care Operations"
"treatment-noa"->Treatment
"payment-noa"->Payment
"operations-noa"->"Health Care Operations"
COVERAGE->HPAYMT->Payment
CLMATTCH->HPAYMT
COVAUTH->HPAYMT
HQUALIMP->HOPERAT->"Health Care Operations"
HDM->HOPERAT
COC->TREAT->Treatment
"care-planning"->Treatment
"care-planning"->"Health Care Operations"
"social-risk"->Treatment
"social-risk"->"Health Care Operations"
}
```