Variable Format    Q#/Freq            Description/Label
 
BASEID   $BSIDFMT                      Unique SP Identification Number          
                         67,288        LOW-HIGH          BASEID Count                            
 
VERSION  VERSFMT                       Version Number                           
                         67,288                       1  Version 1                               
 
ENROLYR  SVYRFMT                       Enrollment Data Year                     
                         12,375                    2017  2017                                    
                         13,076                    2018  2018                                    
                         13,612                    2019  2019                                    
                         13,998                    2020  2020                                    
                         14,227                    2021  2021                                    
 
H_MAFF01 $MA2FLAG                      MA flag - Jan                            
                         38,618        FF                Original Medicare/FFS                   
                         26,335        MA                MA/Other Medicare Capitated Paymnt Plans
                          2,335        NO                Not Medicare Enrolled/Month             
 
H_MAFF02 $MA2FLAG                      MA flag - Feb                            
                         38,627        FF                Original Medicare/FFS                   
                         26,457        MA                MA/Other Medicare Capitated Paymnt Plans
                          2,204        NO                Not Medicare Enrolled/Month             
 
H_MAFF03 $MA2FLAG                      MA flag - Mar                            
                         38,700        FF                Original Medicare/FFS                   
                         26,577        MA                MA/Other Medicare Capitated Paymnt Plans
                          2,011        NO                Not Medicare Enrolled/Month             
 
H_MAFF04 $MA2FLAG                      MA flag - Apr                            
                         38,747        FF                Original Medicare/FFS                   
                         26,691        MA                MA/Other Medicare Capitated Paymnt Plans
                          1,850        NO                Not Medicare Enrolled/Month             
 
H_MAFF05 $MA2FLAG                      MA flag - May                            
                         38,823        FF                Original Medicare/FFS                   
                         26,818        MA                MA/Other Medicare Capitated Paymnt Plans
                          1,647        NO                Not Medicare Enrolled/Month             
 
H_MAFF06 $MA2FLAG                      MA flag - Jun                            
                         38,880        FF                Original Medicare/FFS                   
                         26,925        MA                MA/Other Medicare Capitated Paymnt Plans
                          1,483        NO                Not Medicare Enrolled/Month             
 
H_MAFF07 $MA2FLAG                      MA flag - Jul                            
                         38,920        FF                Original Medicare/FFS                   
                         27,095        MA                MA/Other Medicare Capitated Paymnt Plans
                          1,273        NO                Not Medicare Enrolled/Month             
 
H_MAFF08 $MA2FLAG                      MA flag - Aug                            
                         38,977        FF                Original Medicare/FFS                   
                         27,212        MA                MA/Other Medicare Capitated Paymnt Plans
                          1,099        NO                Not Medicare Enrolled/Month             
 
H_MAFF09 $MA2FLAG                      MA flag - Sep                            
                         39,059        FF                Original Medicare/FFS                   
                         27,347        MA                MA/Other Medicare Capitated Paymnt Plans
                            882        NO                Not Medicare Enrolled/Month             
 
H_MAFF10 $MA2FLAG                      MA flag - Oct                            
                         39,122        FF                Original Medicare/FFS                   
                         27,447        MA                MA/Other Medicare Capitated Paymnt Plans
                            719        NO                Not Medicare Enrolled/Month             
 
H_MAFF11 $MA2FLAG                      MA flag - Nov                            
                         39,139        FF                Original Medicare/FFS                   
                         27,553        MA                MA/Other Medicare Capitated Paymnt Plans
                            596        NO                Not Medicare Enrolled/Month             
 
H_MAFF12 $MA2FLAG                      MA flag - Dec                            
                         39,231        FF                Original Medicare/FFS                   
                         27,592        MA                MA/Other Medicare Capitated Paymnt Plans
                            465        NO                Not Medicare Enrolled/Month             
 
PTA_MONS MMCOVFMT                      Part A HI Coverage Months Count          
                         67,288                  0 - 12  Months of coverage                      
 
PTB_MONS MMCOVFMT                      Part B SMI Coverage Months Count         
                         67,288                  0 - 12  Months of coverage                      
 
H_PTD01  YNO8FMT                       PtD flag - Jan                           
                          2,335                       .  Not Medicare Enrolled/Month             
                         51,385                       1  Yes                                     
                         13,568                       2  No                                      
 
H_PTD02  YNO8FMT                       PtD flag - Feb                           
                          2,204                       .  Not Medicare Enrolled/Month             
                         51,527                       1  Yes                                     
                         13,557                       2  No                                      
 
H_PTD03  YNO8FMT                       PtD flag - Mar                           
                          2,011                       .  Not Medicare Enrolled/Month             
                         51,704                       1  Yes                                     
                         13,573                       2  No                                      
 
H_PTD04  YNO8FMT                       PtD flag - Apr                           
                          1,850                       .  Not Medicare Enrolled/Month             
                         51,806                       1  Yes                                     
                         13,632                       2  No                                      
 
H_PTD05  YNO8FMT                       PtD flag - May                           
                          1,647                       .  Not Medicare Enrolled/Month             
                         51,955                       1  Yes                                     
                         13,686                       2  No                                      
 
H_PTD06  YNO8FMT                       PtD flag - Jun                           
                          1,483                       .  Not Medicare Enrolled/Month             
                         52,100                       1  Yes                                     
                         13,705                       2  No                                      
 
H_PTD07  YNO8FMT                       PtD flag - Jul                           
                          1,273                       .  Not Medicare Enrolled/Month             
                         52,342                       1  Yes                                     
                         13,673                       2  No                                      
 
H_PTD08  YNO8FMT                       PtD flag - Aug                           
                          1,099                       .  Not Medicare Enrolled/Month             
                         52,512                       1  Yes                                     
                         13,677                       2  No                                      
 
H_PTD09  YNO8FMT                       PtD flag - Sep                           
                            882                       .  Not Medicare Enrolled/Month             
                         52,733                       1  Yes                                     
                         13,673                       2  No                                      
 
H_PTD10  YNO8FMT                       PtD flag - Oct                           
                            719                       .  Not Medicare Enrolled/Month             
                         52,886                       1  Yes                                     
                         13,683                       2  No                                      
 
H_PTD11  YNO8FMT                       PtD flag - Nov                           
                            596                       .  Not Medicare Enrolled/Month             
                         53,004                       1  Yes                                     
                         13,688                       2  No                                      
 
H_PTD12  YNO8FMT                       PtD flag - Dec                           
                            465                       .  Not Medicare Enrolled/Month             
                         53,112                       1  Yes                                     
                         13,711                       2  No                                      
 
H_DUAL01 $DUALMON                      Dual eligibility code - Jan              
                          2,335        00                Not enrolled in Medicare for the month  
                          1,864        01                QMB-only                                
                          7,348        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,198        03                SLMB-only                               
                            443        04                SLMB & full Medicaid covrge, + Rx drugs 
                            669        06                Qualifying individuals                  
                          2,528        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                             11        99                Unknown                                 
                         50,892        NA                Non-Medicaid                            
 
H_DUAL02 $DUALMON                      Dual eligibility code - Feb              
                          2,204        00                Not enrolled in Medicare for the month  
                          1,889        01                QMB-only                                
                          7,368        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,187        03                SLMB-only                               
                            440        04                SLMB & full Medicaid covrge, + Rx drugs 
                              1        05                QDWI                                    
                            684        06                Qualifying individuals                  
                          2,555        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              9        99                Unknown                                 
                         50,951        NA                Non-Medicaid                            
 
H_DUAL03 $DUALMON                      Dual eligibility code - Mar              
                          2,011        00                Not enrolled in Medicare for the month  
                          1,889        01                QMB-only                                
                          7,424        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,189        03                SLMB-only                               
                            439        04                SLMB & full Medicaid covrge, + Rx drugs 
                              1        05                QDWI                                    
                            690        06                Qualifying individuals                  
                          2,579        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              6        99                Unknown                                 
                         51,060        NA                Non-Medicaid                            
 
H_DUAL04 $DUALMON                      Dual eligibility code - Apr              
                          1,850        00                Not enrolled in Medicare for the month  
                          1,906        01                QMB-only                                
                          7,428        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,179        03                SLMB-only                               
                            449        04                SLMB & full Medicaid covrge, + Rx drugs 
                            687        06                Qualifying individuals                  
                          2,622        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              1        09                Other dual eligible, no Medicaid covrage
                              6        99                Unknown                                 
                         51,160        NA                Non-Medicaid                            
 
H_DUAL05 $DUALMON                      Dual eligibility code - May              
                          1,647        00                Not enrolled in Medicare for the month  
                          1,916        01                QMB-only                                
                          7,455        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,178        03                SLMB-only                               
                            469        04                SLMB & full Medicaid covrge, + Rx drugs 
                            680        06                Qualifying individuals                  
                          2,656        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                             10        99                Unknown                                 
                         51,277        NA                Non-Medicaid                            
 
H_DUAL06 $DUALMON                      Dual eligibility code - Jun              
                          1,483        00                Not enrolled in Medicare for the month  
                          1,924        01                QMB-only                                
                          7,500        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,181        03                SLMB-only                               
                            480        04                SLMB & full Medicaid covrge, + Rx drugs 
                            678        06                Qualifying individuals                  
                          2,656        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                             11        99                Unknown                                 
                         51,375        NA                Non-Medicaid                            
 
H_DUAL07 $DUALMON                      Dual eligibility code - Jul              
                          1,273        00                Not enrolled in Medicare for the month  
                          1,941        01                QMB-only                                
                          7,542        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,191        03                SLMB-only                               
                            478        04                SLMB & full Medicaid covrge, + Rx drugs 
                            691        06                Qualifying individuals                  
                          2,665        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              8        99                Unknown                                 
                         51,499        NA                Non-Medicaid                            
 
H_DUAL08 $DUALMON                      Dual eligibility code - Aug              
                          1,099        00                Not enrolled in Medicare for the month  
                          1,949        01                QMB-only                                
                          7,589        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,190        03                SLMB-only                               
                            487        04                SLMB & full Medicaid covrge, + Rx drugs 
                            697        06                Qualifying individuals                  
                          2,681        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              9        99                Unknown                                 
                         51,587        NA                Non-Medicaid                            
 
H_DUAL09 $DUALMON                      Dual eligibility code - Sep              
                            882        00                Not enrolled in Medicare for the month  
                          1,950        01                QMB-only                                
                          7,662        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,200        03                SLMB-only                               
                            486        04                SLMB & full Medicaid covrge, + Rx drugs 
                            695        06                Qualifying individuals                  
                          2,669        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                             10        99                Unknown                                 
                         51,734        NA                Non-Medicaid                            
 
H_DUAL10 $DUALMON                      Dual eligibility code - Oct              
                            719        00                Not enrolled in Medicare for the month  
                          1,972        01                QMB-only                                
                          7,685        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,205        03                SLMB-only                               
                            501        04                SLMB & full Medicaid covrge, + Rx drugs 
                            692        06                Qualifying individuals                  
                          2,679        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              9        99                Unknown                                 
                         51,826        NA                Non-Medicaid                            
 
H_DUAL11 $DUALMON                      Dual eligibility code - Nov              
                            596        00                Not enrolled in Medicare for the month  
                          1,963        01                QMB-only                                
                          7,714        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,219        03                SLMB-only                               
                            501        04                SLMB & full Medicaid covrge, + Rx drugs 
                            689        06                Qualifying individuals                  
                          2,676        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              8        99                Unknown                                 
                         51,922        NA                Non-Medicaid                            
 
H_DUAL12 $DUALMON                      Dual eligibility code - Dec              
                            465        00                Not enrolled in Medicare for the month  
                          1,983        01                QMB-only                                
                          7,748        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,220        03                SLMB-only                               
                            505        04                SLMB & full Medicaid covrge, + Rx drugs 
                              1        05                QDWI                                    
                            694        06                Qualifying individuals                  
                          2,683        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              9        99                Unknown                                 
                         51,980        NA                Non-Medicaid                            
 
H_PDLS01 $DLSFMT                       LIS Indicator - Jan                      
                          2,335        00                Not Medicare enrolled for the month     
                          3,945        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,306        02                Pt A and/or B +D;elig LIS 100%,low copay
                          4,010        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                          1,331        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             76        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            152        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            167        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                            138        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         35,260        09                Pt A and/or B +D;no prem or cstshare sub
                          1,682        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,886        13                Pt A and/or B,no D;none of above cond   
         Notes:  The eligible categories are beneficiaries who are deemed eligible and these beneficiaries are automatically enrolled
 
H_PDLS02 $DLSFMT                       LIS Indicator - Feb                      
                          2,204        00                Not Medicare enrolled for the month     
                          3,991        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,348        02                Pt A and/or B +D;elig LIS 100%,low copay
                          4,034        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                          1,324        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             75        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            151        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            170        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                            137        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         35,297        09                Pt A and/or B +D;no prem or cstshare sub
                          1,702        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,855        13                Pt A and/or B,no D;none of above cond   
         Notes:  The eligible categories are beneficiaries who are deemed eligible and these beneficiaries are automatically enrolled
 
H_PDLS03 $DLSFMT                       LIS Indicator - Mar                      
                          2,011        00                Not Medicare enrolled for the month     
                          4,044        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,401        02                Pt A and/or B +D;elig LIS 100%,low copay
                          4,040        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                          1,320        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             72        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            151        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            171        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                            137        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         35,368        09                Pt A and/or B +D;no prem or cstshare sub
                          1,707        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,866        13                Pt A and/or B,no D;none of above cond   
         Notes:  The eligible categories are beneficiaries who are deemed eligible and these beneficiaries are automatically enrolled
 
H_PDLS04 $DLSFMT                       LIS Indicator - Apr                      
                          1,850        00                Not Medicare enrolled for the month     
                          4,096        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,438        02                Pt A and/or B +D;elig LIS 100%,low copay
                          4,043        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                          1,298        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             71        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            141        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            162        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                            124        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         35,433        09                Pt A and/or B +D;no prem or cstshare sub
                          1,720        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,912        13                Pt A and/or B,no D;none of above cond   
         Notes:  The eligible categories are beneficiaries who are deemed eligible and these beneficiaries are automatically enrolled
 
H_PDLS05 $DLSFMT                       LIS Indicator - May                      
                          1,647        00                Not Medicare enrolled for the month     
                          4,148        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,485        02                Pt A and/or B +D;elig LIS 100%,low copay
                          4,054        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                          1,297        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             70        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            143        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            162        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                            125        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         35,471        09                Pt A and/or B +D;no prem or cstshare sub
                          1,728        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,958        13                Pt A and/or B,no D;none of above cond   
         Notes:  The eligible categories are beneficiaries who are deemed eligible and these beneficiaries are automatically enrolled
 
H_PDLS06 $DLSFMT                       LIS Indicator - Jun                      
                          1,483        00                Not Medicare enrolled for the month     
                          4,202        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,520        02                Pt A and/or B +D;elig LIS 100%,low copay
                          4,063        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                          1,297        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             70        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            144        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            163        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                            128        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         35,513        09                Pt A and/or B +D;no prem or cstshare sub
                          1,734        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,971        13                Pt A and/or B,no D;none of above cond   
         Notes:  The eligible categories are beneficiaries who are deemed eligible and these beneficiaries are automatically enrolled
 
H_PDLS07 $DLSFMT                       LIS Indicator - Jul                      
                          1,273        00                Not Medicare enrolled for the month     
                          4,238        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,574        02                Pt A and/or B +D;elig LIS 100%,low copay
                          4,073        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                          1,302        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             70        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            141        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            162        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                            130        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         35,652        09                Pt A and/or B +D;no prem or cstshare sub
                          1,725        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,948        13                Pt A and/or B,no D;none of above cond   
         Notes:  The eligible categories are beneficiaries who are deemed eligible and these beneficiaries are automatically enrolled
 
H_PDLS08 $DLSFMT                       LIS Indicator - Aug                      
                          1,099        00                Not Medicare enrolled for the month     
                          4,285        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,609        02                Pt A and/or B +D;elig LIS 100%,low copay
                          4,073        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                          1,296        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             70        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            140        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            163        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                            131        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         35,745        09                Pt A and/or B +D;no prem or cstshare sub
                          1,725        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,952        13                Pt A and/or B,no D;none of above cond   
         Notes:  The eligible categories are beneficiaries who are deemed eligible and these beneficiaries are automatically enrolled
 
H_PDLS09 $DLSFMT                       LIS Indicator - Sep                      
                            882        00                Not Medicare enrolled for the month     
                          4,333        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,655        02                Pt A and/or B +D;elig LIS 100%,low copay
                          4,098        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                          1,289        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             72        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            143        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            167        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                            131        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         35,845        09                Pt A and/or B +D;no prem or cstshare sub
                          1,731        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,942        13                Pt A and/or B,no D;none of above cond   
         Notes:  The eligible categories are beneficiaries who are deemed eligible and these beneficiaries are automatically enrolled
 
H_PDLS10 $DLSFMT                       LIS Indicator - Oct                      
                            719        00                Not Medicare enrolled for the month     
                          4,379        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,689        02                Pt A and/or B +D;elig LIS 100%,low copay
                          4,105        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                          1,110        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             60        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            119        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            144        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                            117        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         36,163        09                Pt A and/or B +D;no prem or cstshare sub
                          1,731        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,952        13                Pt A and/or B,no D;none of above cond   
         Notes:  The eligible categories are beneficiaries who are deemed eligible and these beneficiaries are automatically enrolled
 
H_PDLS11 $DLSFMT                       LIS Indicator - Nov                      
                            596        00                Not Medicare enrolled for the month     
                          4,425        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,698        02                Pt A and/or B +D;elig LIS 100%,low copay
                          4,114        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                          1,283        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             71        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            144        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            164        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                            135        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         35,970        09                Pt A and/or B +D;no prem or cstshare sub
                          1,729        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,959        13                Pt A and/or B,no D;none of above cond   
         Notes:  The eligible categories are beneficiaries who are deemed eligible and these beneficiaries are automatically enrolled
 
H_PDLS12 $DLSFMT                       LIS Indicator - Dec                      
                            465        00                Not Medicare enrolled for the month     
                          4,468        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,729        02                Pt A and/or B +D;elig LIS 100%,low copay
                          4,135        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                          1,280        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             72        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            144        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            163        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                            139        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         35,982        09                Pt A and/or B +D;no prem or cstshare sub
                          1,726        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,985        13                Pt A and/or B,no D;none of above cond   
         Notes:  The eligible categories are beneficiaries who are deemed eligible and these beneficiaries are automatically enrolled
 
