RIC         1  2                                        C Record Identification Code

VERSION     3  1                                        C Version Number

BASEID      4  8  $BSIDFMT                              C Unique SP Identification Number

                             484,456             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
                             484,456                   PM Prescribed medicine
                                   0                   SD Separately billing physician
                                   0                   SL Separately billing lab

CORF       14  1  $INTRFMT                              C Community or facility

                             432,222                    C Community
                              52,234                    F Facility

AMTTOT     15  9  MONYFMT                               N Total payment

                             484,456                      Amount as $$$$$$.CC

AMTCARE    24  9  MONYFMT                               N Amount paid by Medicare

                             484,456                      Amount as $$$$$$.CC

AMTCAID    33  9  MONYFMT                               N Amount paid by Medicaid

                             484,456                      Amount as $$$$$$.CC

AMTHMOP    42  9  MONYFMT                               N Amount paid by private HMO

                             484,456                      Amount as $$$$$$.CC

AMTHMOM    51  9  MONYFMT                               N Amount paid by Medicare HMO

                             484,456                      Amount as $$$$$$.CC

AMTVA      60  9  MONYFMT                               N Amount paid by Veterans Administration

                             484,456                      Amount as $$$$$$.CC

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

                             484,456                      Amount as $$$$$$.CC

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

                             484,456                      Amount as $$$$$$.CC

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

                             484,456                      Amount as $$$$$$.CC

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

                             484,456                      Amount as $$$$$$.CC

AMTDISC   105  9  MONYFMT                               N Amount of uncollected SP liability

                             484,456                      Amount as $$$$$$.CC

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

                             484,456                      Amount as $$$$$$.CC

DRUGNAME  123 30                                        C Prescribed Medicine name

PMFORM    153  2  $FORMFMT                              C Prescribed Medicine form

                              29,871                      Not ascertained
                             407,320                    1 Pill
                               2,399                   10 Patch/pad
                                 416                   11 Topical gel/jelly
                               1,424                   12 Powder
                               3,626                    2 Liquid
                               8,828                    3 Drops
                               5,897                    4 Topical ointment
                                 163                    5 Suppository
                              14,321                    6 Inhalant/aerosol spray
                                 176                    7 Shampoo, soap
                               8,748                    8 Injection
                                 303                    9 I.V.
                                 964                   91 Other

STRNUNI1  155  2  $STRNFMT                              C Unit of strength

                             108,784                      Missing
                               3,090                   -8 Don't know
                              53,709                   -9 Not ascertained
                              15,063                    1 Micrograms
                             283,964                    2 Milligrams
                                 406                    3 Grains
                               4,597                    4 Milliequivalents (MEQ)
                               1,729                    5 Grams (GM,G)
                               8,107                    6 Percent
                                 531                    7 International units
                               3,258                    8 Units
                               1,218                   91 Other

STRNNUM1  157 10  STRNFMT                               N Number of units

                             108,784                    . Missing
                              64,911                   -9 Not ascertained
                               2,288                   -8 Don't know
                              11,331                    0 Zero
                             297,142                      Number of units of strength

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

                             108,784                      Missing
                             362,022                   -1 Inapplicable
                                 188                   -8 Don't know
                                 653                    1 Micrograms
                              12,141                    2 Milligrams
                                  10                    3 Grains
                                  32                    4 Milliequivalents (MEQ)
                                  18                    5 Grams (GM,G)
                                 228                    6 Percent
                                  32                    7 International units
                                 164                    8 Units
                                 184                   91 Other

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

                             108,784                    . Missing
                                   1                   -9 Not ascertained
                                  88                   -8 Don't know
                             362,438                   -1 Inapplicable
                                  47                    0 Zero
                              13,098                      Number of units of strength

TABNUM    179  8  TABFMT                                N Number of tablets

                             291,721                    . Missing
                              43,161                   -9 Not ascertained
                                 492                   -8 Don't know
                             149,082                1-999 Number of tablets in container

SUPPNUM   187  8  SUPPFMT                               N Number of suppositories

                             291,721                    . Missing or inapplicable
                             192,735                   -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

                             291,721                    . Missing
                             181,797                   -9 Not ascertained
                                 357                   -8 Don't know
                              10,581                      Number of units in container

AMTUNIT   205  2  $AMTFMT                               C Amount unit

                             291,721                      Missing
                               2,489                   -8 Don't know
                             179,308                   -9 Not ascertained
                                 539                    1 Ounces
                               2,063                    2 Grams
                               4,874                    3 Milliliters (ML, CC)
                                  65                    4 Milliequivalents (MEQ)
                                 221                    5 Milligrams (MG, MGM)
                                 346                    6 Micrograms (MCG)
                               2,356                    7 Doses, puffs, blisters
                                 474                   91 Other

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

                              22,750                   UN Unclassified drug products
                              23,146                   02 Analgesics
                                  34                   03 Analgesic and antihist combo
                                 364                   05 Anesthetics
                                  44                   08 Anti-obesity drugs
                                  46                   09 Antidotes
                              13,269                   11 Antiarthritics
                              14,683                   14 Antiasthmatics
                               5,344                   17 Antihistamines
                                 278                   18 Antihistimine/Decongestant comb
                              10,845                   20 Antiinfectives
                               7,486                   23 Antiinfectives, miscellaneous
                               2,131                   26 Antineoplastics
                               3,775                   29 Antiparkinson drugs
                              29,013                   32 Autonomic drugs
                              17,330                   35 Blood
                              28,691                   38 Cardiac drugs
                              90,062                   41 Cardiovascular
                              16,197                   44 CNS drugs
                                 451                   47 Contraceptives
                                 710                   50 Cough and cold preparations
                                 121                   53 Diagnostic
                              27,089                   56 Diuretics
                              10,316                   59 Electrolyte, caloric, & fluid rep.
                              13,084                   62 EENT preparations
                              31,770                   65 Gastrointestinal preparations
                               9,419                   68 Hormones
                              28,240                   71 Hypoglycemics
                                 921                   72 Immunosuppresant
                                   8                   74 Misc. medical supp., devices, & other
                               4,535                   77 Muscle relaxants
                              41,300                   80 Psychotherapeutic drugs
                               5,447                   83 Sedative and hypnotic drugs
                               7,064                   86 Skin preparations
                              15,241                   89 Thyroid preparations
                                 166                   92 Biologicals
                                  75                   94 Pre-natal vitamins
                               3,010                   95 Vitamins, all others
                                   0                   97 Psychotherapeutic drugs
                                   1                   98 Herbals
                                   0                   99 Unclassified drug products

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

                                 120                      Missing
                                   0                    B Both OTC and RX
                             482,650                    F Federal or legend drug
                               1,686                    O Over-the-counter drug
                                   0                    U Unknown

ISOPCARE  240  1  $IMPFMT                               C AMTCARE payment source imputed?

                             427,752                    0 Not imputed
                              56,704                    1 Imputed

ISOPCAID  241  1  $IMPFMT                               C AMTCAID payment source imputed?

                             461,820                    0 Not imputed
                              22,636                    1 Imputed

ISOPHMOP  242  1  $IMPFMT                               C AMTHMOP payment source imputed?

                             469,485                    0 Not imputed
                              14,971                    1 Imputed

ISOPHMOM  243  1  $IMPFMT                               C AMTHMPOM payment source imputed?

                             484,456                    0 Not imputed
                                   0                    1 Imputed

ISOPVA    244  1  $IMPFMT                               C AMTVA payment source imputed?

                             474,497                    0 Not imputed
                               9,959                    1 Imputed

ISOPPRVE  245  1  $IMPFMT                               C AMTPRVE payment source imputed?

                             426,150                    0 Not imputed
                              58,306                    1 Imputed

ISOPPRVI  246  1  $IMPFMT                               C AMTPRVI payment source imputed?

                             478,320                    0 Not imputed
                               6,136                    1 Imputed

ISOPUNK   247  1  $IMPFMT                               C AMTPRVU payment source imputed?

                             484,456                    0 Not imputed
                                   0                    1 Imputed

ISOPOOP   248  1  $IMPFMT                               C AMTOOP payment source imputed?

                             372,349                    0 Not imputed
                             112,107                    1 Imputed

ISOPDISC  249  1  $IMPFMT                               C AMTDISC payment source imputed?

                             326,603                    0 Not imputed
                             157,853                    1 Imputed

ISOPOTH   250  1  $IMPFMT                               C AMTOTH payment source imputed?

                             469,751                    0 Not imputed
                              14,705                    1 Imputed

IAMTTOT   251  1  $IMPFMT                               C AMTTOT payment amount imputed?

                             440,880                    0 Not imputed
                              43,576                    1 Imputed

IAMTCARE  252  1  $IMPFMT                               C AMTCARE payment amount imputed?

                             375,062                    0 Not imputed
                             109,394                    1 Imputed

IAMTCAID  253  1  $IMPFMT                               C AMTCAID payment amount imputed?

                             452,315                    0 Not imputed
                              32,141                    1 Imputed

IAMTHMOP  254  1  $IMPFMT                               C AMTHMOP payment amount imputed?

                             397,166                    0 Not imputed
                              87,290                    1 Imputed

IAMTHMOM  255  1  $IMPFMT                               C AMTHMPOM payment amount imputed?

                             484,456                    0 Not imputed
                                   0                    1 Imputed

IAMTVA    256  1  $IMPFMT                               C AMTVA payment amount imputed?

                             470,819                    0 Not imputed
                              13,637                    1 Imputed

IAMTPRVE  257  1  $IMPFMT                               C AMTPRVE payment amount imputed?

                             411,357                    0 Not imputed
                              73,099                    1 Imputed

IAMTPRVI  258  1  $IMPFMT                               C AMTPRVI payment amount imputed?

                             477,014                    0 Not imputed
                               7,442                    1 Imputed

IAMTPRVU  259  1  $IMPFMT                               C AMTPRVU payment amount imputed?

                             484,456                    0 Not imputed
                                   0                    1 Imputed

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

                             351,301                    0 Not imputed
                             133,155                    1 Imputed

IAMTDISC  261  1  $IMPFMT                               C Imputed discount amount

                             326,383                    0 Not imputed
                             158,073                    1 Imputed

IAMTOTH   262  1  $IMPFMT                               C Imputed other amount

                             467,884                    0 Not imputed
                              16,572                    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

                             192,735                    1 Survey Reported Event
                             108,784                    2 PDE Only Event
                             182,937                    3 Survey Reported Event matched to PDE

