RIC         1  2                                        C Record Identification Code

VERSION     3  1                                        C Version Number

BASEID      4  8  $BSIDFMT                              C Unique SP Identification Number

                             449,428             LOW-HIGH BASEID Count

TYPE       12  2  $EVNTTYP                              C Event type-Prescribed Medicine

                                   0                   DU Dental
                                   0                   ER Emergency Room
                                   0                   IP Inpatient
                                   0                   IU Institutional utilization
                                   0                   MP Medical provider
                                   0                   OM Other medical expense
                                   0                   OP Outpatient
                             449,428                   PM Prescribed medicine
                                   0                   SD Separately billing physician
                                   0                   SL Separately billing lab

CORF       14  1  $INTRFMT                              C Community or facility

                             400,659                    C Community
                              48,769                    F Facility

AMTTOT     15  9  MONYFMT                               N Total payment

                             449,428                      Amount as $$$$$$.CC

AMTCARE    24  9  MONYFMT                               N Amount paid by Medicare

                             449,428                      Amount as $$$$$$.CC

AMTCAID    33  9  MONYFMT                               N Amount paid by Medicaid

                             449,428                      Amount as $$$$$$.CC

AMTHMOP    42  9  MONYFMT                               N Amount paid by private HMO

                             449,428                      Amount as $$$$$$.CC

AMTHMOM    51  9  MONYFMT                               N Amount paid by Medicare HMO

                             449,428                      Amount as $$$$$$.CC

AMTVA      60  9  MONYFMT                               N Amount paid by Veterans Administration

                             449,428                      Amount as $$$$$$.CC

AMTPRVE    69  9  MONYFMT                               N Amt paid by employer-sponsored priv ins

                             449,428                      Amount as $$$$$$.CC

AMTPRVI    78  9  MONYFMT                               N Amt paid by individually-purch priv ins

                             449,428                      Amount as $$$$$$.CC

AMTPRVU    87  9  MONYFMT                               N Amt paid by priv ins (unknown purchased)

                             449,428                      Amount as $$$$$$.CC

AMTOOP     96  9  MONYFMT                               N Amount paid out-of-pocket (OOP)

                             449,428                      Amount as $$$$$$.CC

AMTDISC   105  9  MONYFMT                               N Amount of uncollected SP liability

                             449,428                      Amount as $$$$$$.CC

AMTOTH    114  9  MONYFMT                               N Amount paid by other payor(s)

                             449,428                      Amount as $$$$$$.CC

DRUGNAME  123 30                                        C Prescribed Medicine name

PMFORM    153  2  $FORMFMT                              C Prescribed Medicine form

                              20,080                      Not ascertained
                             384,456                    1 Pill
                               2,627                   10 Patch/pad
                                 359                   11 Topical gel/jelly
                               1,424                   12 Powder
                               4,294                    2 Liquid
                               8,802                    3 Drops
                               5,552                    4 Topical ointment
                                 239                    5 Suppository
                              13,273                    6 Inhalant/aerosol spray
                                 128                    7 Shampoo, soap
                               7,298                    8 Injection
                                 233                    9 I.V.
                                 663                   91 Other

STRNUNI1  155  2  $STRNFMT                              C Unit of strength

                              91,355                      Missing
                              10,530                   -8 Don't know
                              32,123                   -9 Not ascertained
                              12,546                    1 Micrograms
                             283,897                    2 Milligrams
                                 478                    3 Grains
                               4,368                    4 Milliequivalents (MEQ)
                               1,667                    5 Grams (GM,G)
                               8,547                    6 Percent
                                 565                    7 International units
                               2,951                    8 Units
                                 401                   91 Other

STRNNUM1  157 10  STRNFMT                               N Number of units

                              91,355                    . Missing
                              51,202                   -9 Not ascertained
                                 628                   -8 Don't know
                              12,716                    0 Zero
                             293,527                      Number of units of strength

STRNUNI2  167  2  $STRNFMT                              C Unit of strength/2nd combination

                              91,355                      Missing
                             335,552                   -1 Inapplicable
                                 587                   -8 Don't know
                                 868                    1 Micrograms
                              20,394                    2 Milligrams
                                  17                    3 Grains
                                  20                    4 Milliequivalents (MEQ)
                                  32                    5 Grams (GM,G)
                                 265                    6 Percent
                                  35                    7 International units
                                 242                    8 Units
                                  61                   91 Other

STRNNUM2  169 10  STRNFMT                               N Number of units/2nd combination

                              91,355                    . Missing
                                  27                   -8 Don't know
                             336,404                   -1 Inapplicable
                                  64                    0 Zero
                              21,578                      Number of units of strength

TABNUM    179  8  TABFMT                                N Number of tablets

                             268,793                    . Missing
                              32,075                   -9 Not ascertained
                                 782                   -8 Don't know
                             147,778                1-999 Number of tablets in container

SUPPNUM   187  8  SUPPFMT                               N Number of suppositories

                             268,793                    . Missing or inapplicable
                             180,635                   -9 Not ascertained
                                   0                 1-98 Number of suppositories in container
                                   0                   99 99 or more suppositories in container

AMTNUM    195 10  AMTFMT                                N Amount of prescr. medicine in container

                             268,793                    . Missing
                             170,111                   -9 Not ascertained
                                 138                   -8 Don't know
                              10,386                      Number of units in container

AMTUNIT   205  2  $AMTFMT                               C Amount unit

                             268,793                      Missing
                               3,745                   -8 Don't know
                             166,366                   -9 Not ascertained
                                 567                    1 Ounces
                               2,226                    2 Grams
                               5,297                    3 Milliliters (ML, CC)
                                  29                    4 Milliequivalents (MEQ)
                                 369                    5 Milligrams (MG, MGM)
                                 357                    6 Micrograms (MCG)
                               1,356                    7 Doses, puffs, blisters
                                 323                   91 Other

THERCC    237  2  $THERFMT                              C F.D.B. generic therapeutic class

                              15,170                      Unknown
                              18,139                   UN Unclassified drug products
                              19,844                   02 Analgesics
                                  26                   03 Analgesic and antihist combo
                                 273                   05 Anesthetics
                                  31                   08 Anti-obesity drugs
                                  39                   09 Antidotes
                              12,945                   11 Antiarthritics
                              12,906                   14 Antiasthmatics
                               5,620                   17 Antihistamines
                                 456                   18 Antihistimine/Decongestant comb
                               9,864                   20 Antiinfectives
                               7,345                   23 Antiinfectives, miscellaneous
                               2,180                   26 Antineoplastics
                               3,259                   29 Antiparkinson drugs
                              26,721                   32 Autonomic drugs
                              15,217                   35 Blood
                              27,492                   38 Cardiac drugs
                              79,192                   41 Cardiovascular
                              14,398                   44 CNS drugs
                                 389                   47 Contraceptives
                                 957                   50 Cough and cold preparations
                                 132                   53 Diagnostic
                              26,231                   56 Diuretics
                               9,154                   59 Electrolyte, caloric, & fluid rep.
                              11,796                   62 EENT preparations
                              27,550                   65 Gastrointestinal preparations
                               8,743                   68 Hormones
                              25,398                   71 Hypoglycemics
                                 887                   72 Immunosuppresant
                                   4                   74 Misc. medical supp., devices, & other
                               3,947                   77 Muscle relaxants
                              37,966                   80 Psychotherapeutic drugs
                               4,315                   83 Sedative and hypnotic drugs
                               5,828                   86 Skin preparations
                              13,686                   89 Thyroid preparations
                                  23                   92 Biologicals
                                 134                   94 Pre-natal vitamins
                               1,171                   95 Vitamins, all others
                                   0                   97 Psychotherapeutic drugs
                                   0                   99 Unclassified drug products

OTCLEG    239  1  $OTCFMT                               C Over-the-counter/legend indicator

                               1,725                      Missing
                               1,057                    B Both OTC and RX
                             442,630                    F Federal or legend drug
                               3,999                    O Over-the-counter drug
                                  17                    U Unknown

ISOPCARE  240  1  $IMPFMT                               C AMTCARE payment source imputed?

                             446,407                    0 Not imputed
                               3,021                    1 Imputed

ISOPCAID  241  1  $IMPFMT                               C AMTCAID payment source imputed?

                             426,651                    0 Not imputed
                              22,777                    1 Imputed

ISOPHMOP  242  1  $IMPFMT                               C AMTHMOP payment source imputed?

                             414,459                    0 Not imputed
                              34,969                    1 Imputed

ISOPHMOM  243  1  $IMPFMT                               C AMTHMPOM payment source imputed?

                             449,428                    0 Not imputed
                                   0                    1 Imputed

ISOPVA    244  1  $IMPFMT                               C AMTVA payment source imputed?

                             437,644                    0 Not imputed
                              11,784                    1 Imputed

ISOPPRVE  245  1  $IMPFMT                               C AMTPRVE payment source imputed?

                             389,813                    0 Not imputed
                              59,615                    1 Imputed

ISOPPRVI  246  1  $IMPFMT                               C AMTPRVI payment source imputed?

                             434,268                    0 Not imputed
                              15,160                    1 Imputed

ISOPUNK   247  1  $IMPFMT                               C AMTPRVU payment source imputed?

                             449,428                    0 Not imputed
                                   0                    1 Imputed

ISOPOOP   248  1  $IMPFMT                               C AMTOOP payment source imputed?

                             352,266                    0 Not imputed
                              97,162                    1 Imputed

ISOPDISC  249  1  $IMPFMT                               C AMTDISC payment source imputed?

                             280,260                    0 Not imputed
                             169,168                    1 Imputed

ISOPOTH   250  1  $IMPFMT                               C AMTOTH payment source imputed?

                             431,882                    0 Not imputed
                              17,546                    1 Imputed

IAMTTOT   251  1  $IMPFMT                               C AMTTOT payment amount imputed?

                             401,693                    0 Not imputed
                              47,735                    1 Imputed

IAMTCARE  252  1  $IMPFMT                               C AMTCARE payment amount imputed?

                             446,407                    0 Not imputed
                               3,021                    1 Imputed

IAMTCAID  253  1  $IMPFMT                               C AMTCAID payment amount imputed?

                             422,663                    0 Not imputed
                              26,765                    1 Imputed

IAMTHMOP  254  1  $IMPFMT                               C AMTHMOP payment amount imputed?

                             411,309                    0 Not imputed
                              38,119                    1 Imputed

IAMTHMOM  255  1  $IMPFMT                               C AMTHMPOM payment amount imputed?

                             449,428                    0 Not imputed
                                   0                    1 Imputed

IAMTVA    256  1  $IMPFMT                               C AMTVA payment amount imputed?

                             432,455                    0 Not imputed
                              16,973                    1 Imputed

IAMTPRVE  257  1  $IMPFMT                               C AMTPRVE payment amount imputed?

                             367,218                    0 Not imputed
                              82,210                    1 Imputed

IAMTPRVI  258  1  $IMPFMT                               C AMTPRVI payment amount imputed?

                             432,212                    0 Not imputed
                              17,216                    1 Imputed

IAMTPRVU  259  1  $IMPFMT                               C AMTPRVU payment amount imputed?

                             449,428                    0 Not imputed
                                   0                    1 Imputed

IAMTOOP   260  1  $IMPFMT                               C Imputed out-of-pocket amount

                             331,785                    0 Not imputed
                             117,643                    1 Imputed

IAMTDISC  261  1  $IMPFMT                               C Imputed discount amount

                             279,897                    0 Not imputed
                             169,531                    1 Imputed

IAMTOTH   262  1  $IMPFMT                               C Imputed other amount

                             429,129                    0 Not imputed
                              20,299                    1 Imputed

PMEID     263 16                                        C RICPME event ID

FDB_BN    279 30                                        C First Databank brand name

FDB_GNN   309 30                                        C First Databank generic name

FDB_STR   339 10                                        C First Databank strength

FDB_RTE   349 40                                        C First Databank Route

SERV_DT   389  8                                        C Service Date

NDC_CD    397 19                                        C NDC Code

QNTY      416  8                                        N Quantity

DAYSUPP   424  3                                        N Days Supplied

PDEFLAG   427  1  MATCH                                 N PDE Match Indicator

                             206,168                    1 Survey Reported Event
                              91,355                    2 PDE Only Event
                             151,905                    3 Survey Reported Event matched to PDE

