Variable Format    Q#/Freq            Description/Label
 
BASEID   $BSIDFMT                      Unique SP Identification Number          
                         66,149        LOW-HIGH          BASEID Count                            
 
VERSION  VERSFMT                       Version Number                           
                         66,149                       1  Version 1                               
 
ENROLYR  SVYRFMT                       Enrollment Data Year                     
                         12,189                    2018  2018                                    
                         12,845                    2019  2019                                    
                         13,378                    2020  2020                                    
                         13,758                    2021  2021                                    
                         13,979                    2022  2022                                    
 
H_MAFF01 $MA2FLAG                      MA flag - Jan                            
                         36,179        FF                Original Medicare/FFS                   
                         27,718        MA                MA/Other Medicare Capitated Paymnt Plans
                          2,252        NO                Not Medicare Enrolled/Month             
 
H_MAFF02 $MA2FLAG                      MA flag - Feb                            
                         36,176        FF                Original Medicare/FFS                   
                         27,832        MA                MA/Other Medicare Capitated Paymnt Plans
                          2,141        NO                Not Medicare Enrolled/Month             
 
H_MAFF03 $MA2FLAG                      MA flag - Mar                            
                         36,252        FF                Original Medicare/FFS                   
                         27,938        MA                MA/Other Medicare Capitated Paymnt Plans
                          1,959        NO                Not Medicare Enrolled/Month             
 
H_MAFF04 $MA2FLAG                      MA flag - Apr                            
                         36,277        FF                Original Medicare/FFS                   
                         28,067        MA                MA/Other Medicare Capitated Paymnt Plans
                          1,805        NO                Not Medicare Enrolled/Month             
 
H_MAFF05 $MA2FLAG                      MA flag - May                            
                         36,326        FF                Original Medicare/FFS                   
                         28,200        MA                MA/Other Medicare Capitated Paymnt Plans
                          1,623        NO                Not Medicare Enrolled/Month             
 
H_MAFF06 $MA2FLAG                      MA flag - Jun                            
                         36,343        FF                Original Medicare/FFS                   
                         28,344        MA                MA/Other Medicare Capitated Paymnt Plans
                          1,462        NO                Not Medicare Enrolled/Month             
 
H_MAFF07 $MA2FLAG                      MA flag - Jul                            
                         36,361        FF                Original Medicare/FFS                   
                         28,518        MA                MA/Other Medicare Capitated Paymnt Plans
                          1,270        NO                Not Medicare Enrolled/Month             
 
H_MAFF08 $MA2FLAG                      MA flag - Aug                            
                         36,417        FF                Original Medicare/FFS                   
                         28,638        MA                MA/Other Medicare Capitated Paymnt Plans
                          1,094        NO                Not Medicare Enrolled/Month             
 
H_MAFF09 $MA2FLAG                      MA flag - Sep                            
                         36,463        FF                Original Medicare/FFS                   
                         28,806        MA                MA/Other Medicare Capitated Paymnt Plans
                            880        NO                Not Medicare Enrolled/Month             
 
H_MAFF10 $MA2FLAG                      MA flag - Oct                            
                         36,532        FF                Original Medicare/FFS                   
                         28,928        MA                MA/Other Medicare Capitated Paymnt Plans
                            689        NO                Not Medicare Enrolled/Month             
 
H_MAFF11 $MA2FLAG                      MA flag - Nov                            
                         36,554        FF                Original Medicare/FFS                   
                         29,034        MA                MA/Other Medicare Capitated Paymnt Plans
                            561        NO                Not Medicare Enrolled/Month             
 
H_MAFF12 $MA2FLAG                      MA flag - Dec                            
                         36,639        FF                Original Medicare/FFS                   
                         29,094        MA                MA/Other Medicare Capitated Paymnt Plans
                            416        NO                Not Medicare Enrolled/Month             
 
PTA_MONS MMCOVFMT                      Part A HI Coverage Months Count          
                         66,149                  0 - 12  Months of coverage                      
 
PTB_MONS MMCOVFMT                      Part B SMI Coverage Months Count         
                         66,149                  0 - 12  Months of coverage                      
 
H_PTD01  YNO8FMT                       PtD flag - Jan                           
                          2,252                       .  Not Medicare Enrolled/Month             
                         51,321                       1  Yes                                     
                         12,576                       2  No                                      
 
H_PTD02  YNO8FMT                       PtD flag - Feb                           
                          2,141                       .  Not Medicare Enrolled/Month             
                         51,458                       1  Yes                                     
                         12,550                       2  No                                      
 
H_PTD03  YNO8FMT                       PtD flag - Mar                           
                          1,959                       .  Not Medicare Enrolled/Month             
                         51,607                       1  Yes                                     
                         12,583                       2  No                                      
 
H_PTD04  YNO8FMT                       PtD flag - Apr                           
                          1,805                       .  Not Medicare Enrolled/Month             
                         51,727                       1  Yes                                     
                         12,617                       2  No                                      
 
H_PTD05  YNO8FMT                       PtD flag - May                           
                          1,623                       .  Not Medicare Enrolled/Month             
                         51,869                       1  Yes                                     
                         12,657                       2  No                                      
 
H_PTD06  YNO8FMT                       PtD flag - Jun                           
                          1,462                       .  Not Medicare Enrolled/Month             
                         52,030                       1  Yes                                     
                         12,657                       2  No                                      
 
H_PTD07  YNO8FMT                       PtD flag - Jul                           
                          1,270                       .  Not Medicare Enrolled/Month             
                         52,234                       1  Yes                                     
                         12,645                       2  No                                      
 
H_PTD08  YNO8FMT                       PtD flag - Aug                           
                          1,094                       .  Not Medicare Enrolled/Month             
                         52,404                       1  Yes                                     
                         12,651                       2  No                                      
 
H_PTD09  YNO8FMT                       PtD flag - Sep                           
                            880                       .  Not Medicare Enrolled/Month             
                         52,604                       1  Yes                                     
                         12,665                       2  No                                      
 
H_PTD10  YNO8FMT                       PtD flag - Oct                           
                            689                       .  Not Medicare Enrolled/Month             
                         52,778                       1  Yes                                     
                         12,682                       2  No                                      
 
H_PTD11  YNO8FMT                       PtD flag - Nov                           
                            561                       .  Not Medicare Enrolled/Month             
                         52,895                       1  Yes                                     
                         12,693                       2  No                                      
 
H_PTD12  YNO8FMT                       PtD flag - Dec                           
                            416                       .  Not Medicare Enrolled/Month             
                         53,008                       1  Yes                                     
                         12,725                       2  No                                      
 
H_DUAL01 $DUALMON                      Dual eligibility code - Jan              
                          2,252        00                Not enrolled in Medicare for the month  
                          1,794        01                QMB-only                                
                          7,467        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,258        03                SLMB-only                               
                            494        04                SLMB & full Medicaid covrge, + Rx drugs 
                            672        06                Qualifying individuals                  
                          2,581        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                             14        99                Unknown                                 
                         49,617        NA                Non-Medicaid                            
 
H_DUAL02 $DUALMON                      Dual eligibility code - Feb              
                          2,141        00                Not enrolled in Medicare for the month  
                          1,819        01                QMB-only                                
                          7,499        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,262        03                SLMB-only                               
                            496        04                SLMB & full Medicaid covrge, + Rx drugs 
                              1        05                QDWI                                    
                            671        06                Qualifying individuals                  
                          2,582        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                             11        99                Unknown                                 
                         49,667        NA                Non-Medicaid                            
 
H_DUAL03 $DUALMON                      Dual eligibility code - Mar              
                          1,959        00                Not enrolled in Medicare for the month  
                          1,826        01                QMB-only                                
                          7,545        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,263        03                SLMB-only                               
                            500        04                SLMB & full Medicaid covrge, + Rx drugs 
                              1        05                QDWI                                    
                            682        06                Qualifying individuals                  
                          2,610        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                             13        99                Unknown                                 
                         49,750        NA                Non-Medicaid                            
 
H_DUAL04 $DUALMON                      Dual eligibility code - Apr              
                          1,805        00                Not enrolled in Medicare for the month  
                          1,842        01                QMB-only                                
                          7,548        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,256        03                SLMB-only                               
                            501        04                SLMB & full Medicaid covrge, + Rx drugs 
                            688        06                Qualifying individuals                  
                          2,655        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              1        09                Other dual eligible, no Medicaid covrage
                             13        99                Unknown                                 
                         49,840        NA                Non-Medicaid                            
 
H_DUAL05 $DUALMON                      Dual eligibility code - May              
                          1,623        00                Not enrolled in Medicare for the month  
                          1,844        01                QMB-only                                
                          7,534        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,247        03                SLMB-only                               
                            508        04                SLMB & full Medicaid covrge, + Rx drugs 
                            691        06                Qualifying individuals                  
                          2,688        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              9        99                Unknown                                 
                         50,005        NA                Non-Medicaid                            
 
H_DUAL06 $DUALMON                      Dual eligibility code - Jun              
                          1,462        00                Not enrolled in Medicare for the month  
                          1,850        01                QMB-only                                
                          7,591        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,265        03                SLMB-only                               
                            515        04                SLMB & full Medicaid covrge, + Rx drugs 
                            689        06                Qualifying individuals                  
                          2,737        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                             12        99                Unknown                                 
                         50,028        NA                Non-Medicaid                            
 
H_DUAL07 $DUALMON                      Dual eligibility code - Jul              
                          1,270        00                Not enrolled in Medicare for the month  
                          1,878        01                QMB-only                                
                          7,642        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,272        03                SLMB-only                               
                            521        04                SLMB & full Medicaid covrge, + Rx drugs 
                            692        06                Qualifying individuals                  
                          2,736        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              7        99                Unknown                                 
                         50,131        NA                Non-Medicaid                            
 
H_DUAL08 $DUALMON                      Dual eligibility code - Aug              
                          1,094        00                Not enrolled in Medicare for the month  
                          1,890        01                QMB-only                                
                          7,673        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,269        03                SLMB-only                               
                            528        04                SLMB & full Medicaid covrge, + Rx drugs 
                            699        06                Qualifying individuals                  
                          2,766        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              7        99                Unknown                                 
                         50,223        NA                Non-Medicaid                            
 
H_DUAL09 $DUALMON                      Dual eligibility code - Sep              
                            880        00                Not enrolled in Medicare for the month  
                          1,892        01                QMB-only                                
                          7,777        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,285        03                SLMB-only                               
                            527        04                SLMB & full Medicaid covrge, + Rx drugs 
                            694        06                Qualifying individuals                  
                          2,758        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              6        99                Unknown                                 
                         50,330        NA                Non-Medicaid                            
 
H_DUAL10 $DUALMON                      Dual eligibility code - Oct              
                            689        00                Not enrolled in Medicare for the month  
                          1,899        01                QMB-only                                
                          7,815        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,282        03                SLMB-only                               
                            538        04                SLMB & full Medicaid covrge, + Rx drugs 
                            708        06                Qualifying individuals                  
                          2,778        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              8        99                Unknown                                 
                         50,432        NA                Non-Medicaid                            
 
H_DUAL11 $DUALMON                      Dual eligibility code - Nov              
                            561        00                Not enrolled in Medicare for the month  
                          1,897        01                QMB-only                                
                          7,841        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,293        03                SLMB-only                               
                            536        04                SLMB & full Medicaid covrge, + Rx drugs 
                            716        06                Qualifying individuals                  
                          2,781        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              8        99                Unknown                                 
                         50,516        NA                Non-Medicaid                            
 
H_DUAL12 $DUALMON                      Dual eligibility code - Dec              
                            416        00                Not enrolled in Medicare for the month  
                          1,914        01                QMB-only                                
                          7,887        02                QMB & full Medicaid covrge, + Rx drugs  
                          1,295        03                SLMB-only                               
                            535        04                SLMB & full Medicaid covrge, + Rx drugs 
                              1        05                QDWI                                    
                            719        06                Qualifying individuals                  
                          2,790        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                             11        99                Unknown                                 
                         50,581        NA                Non-Medicaid                            
 
H_PDLS01 $DLSFMT                       LIS Indicator - Jan                      
                          2,252        00                Not Medicare enrolled for the month     
                          4,118        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,260        02                Pt A and/or B +D;elig LIS 100%,low copay
                          4,006        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                          1,237        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             68        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            126        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            116        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             95        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         35,295        09                Pt A and/or B +D;no prem or cstshare sub
                          1,487        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,089        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                      
                          2,141        00                Not Medicare enrolled for the month     
                          4,159        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,293        02                Pt A and/or B +D;elig LIS 100%,low copay
                          4,026        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                          1,234        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             66        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            126        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            116        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             94        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         35,344        09                Pt A and/or B +D;no prem or cstshare sub
                          1,508        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,042        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                      
                          1,959        00                Not Medicare enrolled for the month     
                          4,221        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,335        02                Pt A and/or B +D;elig LIS 100%,low copay
                          4,042        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                          1,233        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             63        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            125        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            116        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             94        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         35,378        09                Pt A and/or B +D;no prem or cstshare sub
                          1,515        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,068        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                      
                          1,805        00                Not Medicare enrolled for the month     
                          4,258        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,362        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 
                          1,222        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             63        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            112        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            108        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             80        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         35,479        09                Pt A and/or B +D;no prem or cstshare sub
                          1,526        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,091        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                      
                          1,623        00                Not Medicare enrolled for the month     
                          4,308        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,389        02                Pt A and/or B +D;elig LIS 100%,low copay
                          4,057        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                          1,220        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             63        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            115        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            107        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             81        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         35,529        09                Pt A and/or B +D;no prem or cstshare sub
                          1,530        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,127        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                      
                          1,462        00                Not Medicare enrolled for the month     
                          4,347        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,437        02                Pt A and/or B +D;elig LIS 100%,low copay
                          4,065        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                          1,221        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             64        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            115        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            110        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             84        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         35,587        09                Pt A and/or B +D;no prem or cstshare sub
                          1,535        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,122        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                      
                          1,270        00                Not Medicare enrolled for the month     
                          4,376        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,495        02                Pt A and/or B +D;elig LIS 100%,low copay
                          4,084        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                          1,219        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             64        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            113        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            109        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             86        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         35,688        09                Pt A and/or B +D;no prem or cstshare sub
                          1,526        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,119        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                      
                          1,094        00                Not Medicare enrolled for the month     
                          4,419        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,538        02                Pt A and/or B +D;elig LIS 100%,low copay
                          4,094        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                          1,217        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             63        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            112        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            110        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             86        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         35,765        09                Pt A and/or B +D;no prem or cstshare sub
                          1,530        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,121        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                      
                            880        00                Not Medicare enrolled for the month     
                          4,491        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,567        02                Pt A and/or B +D;elig LIS 100%,low copay
                          4,109        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                          1,214        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             65        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            113        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            112        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             87        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         35,846        09                Pt A and/or B +D;no prem or cstshare sub
                          1,535        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,130        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                      
                            689        00                Not Medicare enrolled for the month     
                          4,532        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,606        02                Pt A and/or B +D;elig LIS 100%,low copay
                          4,123        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                          1,212        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             65        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            115        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            112        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             88        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         35,925        09                Pt A and/or B +D;no prem or cstshare sub
                          1,537        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,145        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                      
                            561        00                Not Medicare enrolled for the month     
                          4,577        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,615        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 
                          1,214        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             64        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            116        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            114        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             89        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         35,971        09                Pt A and/or B +D;no prem or cstshare sub
                          1,535        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,158        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                      
                            416        00                Not Medicare enrolled for the month     
                          4,619        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          6,646        02                Pt A and/or B +D;elig LIS 100%,low copay
                          4,146        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                          1,209        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             65        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                            117        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                            114        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             89        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                         36,003        09                Pt A and/or B +D;no prem or cstshare sub
                          1,535        10                Pt A and/or B,no D;employr recvs RDS sub
                         11,190        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
 
