Variable    Format      Q#/Freq        Description/Label
 
BASEID      $BSIDFMT                   Unique SP Identification Number                   
                         13,019        LOW-HIGH          BASEID Count                            
 
SURVEYYR    SVYRFMT                    Survey Year                                       
                         13,019                    2023  2023                                    
 
VERSION     VERSFMT                    Version Number                                    
                         13,019                       1  Version 1                               
 
H_DUAL01    $DUALMON                   Dual eligibity code - Jan                         
                            224        00                Not enrolled in Medicare for the month  
                            450        01                QMB-only                                
                          1,512        02                QMB & full Medicaid covrge, + Rx drugs  
                            278        03                SLMB-only                               
                             92        04                SLMB & full Medicaid covrge, + Rx drugs 
                              1        05                QDWI                                    
                            152        06                Qualifying individuals                  
                            443        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              2        99                Unknown                                 
                          9,865        NA                Non-Medicaid                            
 
H_DUAL02    $DUALMON                   Dual eligibity code - Feb                         
                            198        00                Not enrolled in Medicare for the month  
                            453        01                QMB-only                                
                          1,542        02                QMB & full Medicaid covrge, + Rx drugs  
                            280        03                SLMB-only                               
                             93        04                SLMB & full Medicaid covrge, + Rx drugs 
                              1        05                QDWI                                    
                            152        06                Qualifying individuals                  
                            422        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              2        99                Unknown                                 
                          9,876        NA                Non-Medicaid                            
 
H_DUAL03    $DUALMON                   Dual eligibity code - Mar                         
                            173        00                Not enrolled in Medicare for the month  
                            448        01                QMB-only                                
                          1,550        02                QMB & full Medicaid covrge, + Rx drugs  
                            278        03                SLMB-only                               
                             99        04                SLMB & full Medicaid covrge, + Rx drugs 
                              1        05                QDWI                                    
                            155        06                Qualifying individuals                  
                            431        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              2        99                Unknown                                 
                          9,882        NA                Non-Medicaid                            
 
H_DUAL04    $DUALMON                   Dual eligibity code - Apr                         
                            161        00                Not enrolled in Medicare for the month  
                            450        01                QMB-only                                
                          1,557        02                QMB & full Medicaid covrge, + Rx drugs  
                            277        03                SLMB-only                               
                            100        04                SLMB & full Medicaid covrge, + Rx drugs 
                              1        05                QDWI                                    
                            155        06                Qualifying individuals                  
                            437        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              2        99                Unknown                                 
                          9,879        NA                Non-Medicaid                            
 
H_DUAL05    $DUALMON                   Dual eligibity code - May                         
                            134        00                Not enrolled in Medicare for the month  
                            451        01                QMB-only                                
                          1,572        02                QMB & full Medicaid covrge, + Rx drugs  
                            277        03                SLMB-only                               
                             97        04                SLMB & full Medicaid covrge, + Rx drugs 
                              1        05                QDWI                                    
                            158        06                Qualifying individuals                  
                            431        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                          9,898        NA                Non-Medicaid                            
 
H_DUAL06    $DUALMON                   Dual eligibity code - Jun                         
                            107        00                Not enrolled in Medicare for the month  
                            449        01                QMB-only                                
                          1,571        02                QMB & full Medicaid covrge, + Rx drugs  
                            275        03                SLMB-only                               
                             93        04                SLMB & full Medicaid covrge, + Rx drugs 
                              1        05                QDWI                                    
                            159        06                Qualifying individuals                  
                            436        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                          9,928        NA                Non-Medicaid                            
 
H_DUAL07    $DUALMON                   Dual eligibity code - Jul                         
                             83        00                Not enrolled in Medicare for the month  
                            445        01                QMB-only                                
                          1,582        02                QMB & full Medicaid covrge, + Rx drugs  
                            277        03                SLMB-only                               
                             96        04                SLMB & full Medicaid covrge, + Rx drugs 
                              1        05                QDWI                                    
                            162        06                Qualifying individuals                  
                            425        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                          9,948        NA                Non-Medicaid                            
 
H_DUAL08    $DUALMON                   Dual eligibity code - Aug                         
                             55        00                Not enrolled in Medicare for the month  
                            444        01                QMB-only                                
                          1,569        02                QMB & full Medicaid covrge, + Rx drugs  
                            274        03                SLMB-only                               
                            100        04                SLMB & full Medicaid covrge, + Rx drugs 
                              1        05                QDWI                                    
                            164        06                Qualifying individuals                  
                            417        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                          9,995        NA                Non-Medicaid                            
 
H_DUAL09    $DUALMON                   Dual eligibity code - Sep                         
                             46        00                Not enrolled in Medicare for the month  
                            439        01                QMB-only                                
                          1,567        02                QMB & full Medicaid covrge, + Rx drugs  
                            276        03                SLMB-only                               
                             94        04                SLMB & full Medicaid covrge, + Rx drugs 
                              1        05                QDWI                                    
                            167        06                Qualifying individuals                  
                            411        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                         10,018        NA                Non-Medicaid                            
 
H_DUAL10    $DUALMON                   Dual eligibity code - Oct                         
                             34        00                Not enrolled in Medicare for the month  
                            430        01                QMB-only                                
                          1,570        02                QMB & full Medicaid covrge, + Rx drugs  
                            278        03                SLMB-only                               
                             89        04                SLMB & full Medicaid covrge, + Rx drugs 
                              1        05                QDWI                                    
                            165        06                Qualifying individuals                  
                            410        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                         10,042        NA                Non-Medicaid                            
 
H_DUAL11    $DUALMON                   Dual eligibity code - Nov                         
                             33        00                Not enrolled in Medicare for the month  
                            429        01                QMB-only                                
                          1,556        02                QMB & full Medicaid covrge, + Rx drugs  
                            280        03                SLMB-only                               
                             90        04                SLMB & full Medicaid covrge, + Rx drugs 
                            160        06                Qualifying individuals                  
                            409        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                         10,062        NA                Non-Medicaid                            
 
H_DUAL12    $DUALMON                   Dual eligibity code - Dec                         
                             49        00                Not enrolled in Medicare for the month  
                            426        01                QMB-only                                
                          1,556        02                QMB & full Medicaid covrge, + Rx drugs  
                            280        03                SLMB-only                               
                             89        04                SLMB & full Medicaid covrge, + Rx drugs 
                            154        06                Qualifying individuals                  
                            397        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                         10,068        NA                Non-Medicaid                            
 
H_OPMDCD    DUALFMT                    Medicare-Medicaid dual eligibility indic          
                          2,143                       1  FULL-Bene elig. full Medicaid benefits  
                          9,928                       2  NONDUAL-Bene not elig Medicaid benfits  
                            490                       3  PARTIAL-Bene elig part Medicd- not QMB  
                            458                       4  QMB ONLY-Bene elig for part Medicd-QMB  
 
H_MAFF01    $MA2FLAG                   MA flag -  Jan                                    
                          6,014        FF                Original Medicare/FFS                   
                          6,781        MA                MA/Other Medicare Capitated Paymnt Plans
                            224        NO                Not Medicare Enrolled/Month             
 
H_MAFF02    $MA2FLAG                   MA flag -  Feb                                    
                          6,008        FF                Original Medicare/FFS                   
                          6,813        MA                MA/Other Medicare Capitated Paymnt Plans
                            198        NO                Not Medicare Enrolled/Month             
 
H_MAFF03    $MA2FLAG                   MA flag -  Mar                                    
                          6,007        FF                Original Medicare/FFS                   
                          6,839        MA                MA/Other Medicare Capitated Paymnt Plans
                            173        NO                Not Medicare Enrolled/Month             
 
H_MAFF04    $MA2FLAG                   MA flag -  Apr                                    
                          5,989        FF                Original Medicare/FFS                   
                          6,869        MA                MA/Other Medicare Capitated Paymnt Plans
                            161        NO                Not Medicare Enrolled/Month             
 
H_MAFF05    $MA2FLAG                   MA flag -  May                                    
                          5,980        FF                Original Medicare/FFS                   
                          6,905        MA                MA/Other Medicare Capitated Paymnt Plans
                            134        NO                Not Medicare Enrolled/Month             
 
H_MAFF06    $MA2FLAG                   MA flag -  Jun                                    
                          5,974        FF                Original Medicare/FFS                   
                          6,938        MA                MA/Other Medicare Capitated Paymnt Plans
                            107        NO                Not Medicare Enrolled/Month             
 
H_MAFF07    $MA2FLAG                   MA flag -  Jul                                    
                          5,968        FF                Original Medicare/FFS                   
                          6,968        MA                MA/Other Medicare Capitated Paymnt Plans
                             83        NO                Not Medicare Enrolled/Month             
 
H_MAFF08    $MA2FLAG                   MA flag -  Aug                                    
                          5,973        FF                Original Medicare/FFS                   
                          6,991        MA                MA/Other Medicare Capitated Paymnt Plans
                             55        NO                Not Medicare Enrolled/Month             
 
H_MAFF09    $MA2FLAG                   MA flag -  Sep                                    
                          5,956        FF                Original Medicare/FFS                   
                          7,017        MA                MA/Other Medicare Capitated Paymnt Plans
                             46        NO                Not Medicare Enrolled/Month             
 
H_MAFF10    $MA2FLAG                   MA flag -  Oct                                    
                          5,961        FF                Original Medicare/FFS                   
                          7,024        MA                MA/Other Medicare Capitated Paymnt Plans
                             34        NO                Not Medicare Enrolled/Month             
 
H_MAFF11    $MA2FLAG                   MA flag -  Nov                                    
                          5,966        FF                Original Medicare/FFS                   
                          7,020        MA                MA/Other Medicare Capitated Paymnt Plans
                             33        NO                Not Medicare Enrolled/Month             
 
H_MAFF12    $MA2FLAG                   MA flag -  Dec                                    
                          5,955        FF                Original Medicare/FFS                   
                          7,015        MA                MA/Other Medicare Capitated Paymnt Plans
                             49        NO                Not Medicare Enrolled/Month             
 
H_MCDE01    $MCDCFMT                   Medicaid eligibility - Jan                        
                            875        B                 State Part B buy-in                     
                             59        C                 State Part A and B buy-in               
                            102        D                 State Part A and B QMB buy-in           
                         10,469        N                 No buy-in this month                    
                          1,183        Q                 State Part B QMB buy-in                 
                            331        S                 State Part B SLMB buy-in                
 
H_MCDE02    $MCDCFMT                   Medicaid eligibility - Feb                        
                              1        A                 State Part A buy-in                     
                            882        B                 State Part B buy-in                     
                             59        C                 State Part A and B buy-in               
                            103        D                 State Part A and B QMB buy-in           
                         10,420        N                 No buy-in this month                    
                          1,219        Q                 State Part B QMB buy-in                 
                            335        S                 State Part B SLMB buy-in                
 
H_MCDE03    $MCDCFMT                   Medicaid eligibility - Mar                        
                              1        A                 State Part A buy-in                     
                            883        B                 State Part B buy-in                     
                             60        C                 State Part A and B buy-in               
                            104        D                 State Part A and B QMB buy-in           
                         10,406        N                 No buy-in this month                    
                          1,226        Q                 State Part B QMB buy-in                 
                            339        S                 State Part B SLMB buy-in                
 
H_MCDE04    $MCDCFMT                   Medicaid eligibility - Apr                        
                              1        A                 State Part A buy-in                     
                            890        B                 State Part B buy-in                     
                             60        C                 State Part A and B buy-in               
                            104        D                 State Part A and B QMB buy-in           
                         10,389        N                 No buy-in this month                    
                          1,235        Q                 State Part B QMB buy-in                 
                            340        S                 State Part B SLMB buy-in                
 
H_MCDE05    $MCDCFMT                   Medicaid eligibility - May                        
                              1        A                 State Part A buy-in                     
                            893        B                 State Part B buy-in                     
                             61        C                 State Part A and B buy-in               
                            105        D                 State Part A and B QMB buy-in           
                         10,379        N                 No buy-in this month                    
                          1,238        Q                 State Part B QMB buy-in                 
                            342        S                 State Part B SLMB buy-in                
 
H_MCDE06    $MCDCFMT                   Medicaid eligibility - Jun                        
                              1        A                 State Part A buy-in                     
                            894        B                 State Part B buy-in                     
                             61        C                 State Part A and B buy-in               
                            106        D                 State Part A and B QMB buy-in           
                         10,383        N                 No buy-in this month                    
                          1,235        Q                 State Part B QMB buy-in                 
                            339        S                 State Part B SLMB buy-in                
 
H_MCDE07    $MCDCFMT                   Medicaid eligibility - Jul                        
                              1        A                 State Part A buy-in                     
                            900        B                 State Part B buy-in                     
                             62        C                 State Part A and B buy-in               
                            108        D                 State Part A and B QMB buy-in           
                         10,361        N                 No buy-in this month                    
                          1,242        Q                 State Part B QMB buy-in                 
                            345        S                 State Part B SLMB buy-in                
 
H_MCDE08    $MCDCFMT                   Medicaid eligibility - Aug                        
                              1        A                 State Part A buy-in                     
                            906        B                 State Part B buy-in                     
                             62        C                 State Part A and B buy-in               
                            108        D                 State Part A and B QMB buy-in           
                         10,354        N                 No buy-in this month                    
                          1,246        Q                 State Part B QMB buy-in                 
                            342        S                 State Part B SLMB buy-in                
 
H_MCDE09    $MCDCFMT                   Medicaid eligibility - Sep                        
                              2        A                 State Part A buy-in                     
                            907        B                 State Part B buy-in                     
                             62        C                 State Part A and B buy-in               
                            108        D                 State Part A and B QMB buy-in           
                         10,338        N                 No buy-in this month                    
                          1,259        Q                 State Part B QMB buy-in                 
                            343        S                 State Part B SLMB buy-in                
 
H_MCDE10    $MCDCFMT                   Medicaid eligibility - Oct                        
                              2        A                 State Part A buy-in                     
                            906        B                 State Part B buy-in                     
                             62        C                 State Part A and B buy-in               
                            108        D                 State Part A and B QMB buy-in           
                         10,338        N                 No buy-in this month                    
                          1,261        Q                 State Part B QMB buy-in                 
                            342        S                 State Part B SLMB buy-in                
 
H_MCDE11    $MCDCFMT                   Medicaid eligibility - Nov                        
                              2        A                 State Part A buy-in                     
                            895        B                 State Part B buy-in                     
                             62        C                 State Part A and B buy-in               
                            107        D                 State Part A and B QMB buy-in           
                         10,346        N                 No buy-in this month                    
                          1,260        Q                 State Part B QMB buy-in                 
                            347        S                 State Part B SLMB buy-in                
 
H_MCDE12    $MCDCFMT                   Medicaid eligibility - Dec                        
                              2        A                 State Part A buy-in                     
                            892        B                 State Part B buy-in                     
                             63        C                 State Part A and B buy-in               
                            106        D                 State Part A and B QMB buy-in           
                         10,347        N                 No buy-in this month                    
                          1,261        Q                 State Part B QMB buy-in                 
                            348        S                 State Part B SLMB buy-in                
 
H_PDLS01    $DLSFMT                    LIS Indicator - Jan                               
                            224        00                Not Medicare enrolled for the month     
                            464        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,459        02                Pt A and/or B +D;elig LIS 100%,low copay
                            999        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            240        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             10        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                             20        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                             26        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             17        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                          7,388        09                Pt A and/or B +D;no prem or cstshare sub
                            245        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,927        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                               
                            198        00                Not Medicare enrolled for the month     
                            472        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,463        02                Pt A and/or B +D;elig LIS 100%,low copay
                            998        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            240        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             10        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                             18        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                             28        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             17        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                          7,418        09                Pt A and/or B +D;no prem or cstshare sub
                            243        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,914        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                               
                            173        00                Not Medicare enrolled for the month     
                            478        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,476        02                Pt A and/or B +D;elig LIS 100%,low copay
                            993        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            238        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             10        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                             18        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                             28        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             17        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                          7,435        09                Pt A and/or B +D;no prem or cstshare sub
                            246        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,907        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                               
                            161        00                Not Medicare enrolled for the month     
                            484        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,486        02                Pt A and/or B +D;elig LIS 100%,low copay
                            994        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            242        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             10        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                             17        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                             29        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             16        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                          7,444        09                Pt A and/or B +D;no prem or cstshare sub
                            245        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,891        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                               
                            134        00                Not Medicare enrolled for the month     
                            495        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,490        02                Pt A and/or B +D;elig LIS 100%,low copay
                            994        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            242        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             10        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                             17        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                             30        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             16        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                          7,457        09                Pt A and/or B +D;no prem or cstshare sub
                            244        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,890        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                               
                            107        00                Not Medicare enrolled for the month     
                            502        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,491        02                Pt A and/or B +D;elig LIS 100%,low copay
                            994        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            243        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             10        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                             17        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                             30        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             16        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                          7,472        09                Pt A and/or B +D;no prem or cstshare sub
                            244        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,893        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                               
                             83        00                Not Medicare enrolled for the month     
                            509        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,496        02                Pt A and/or B +D;elig LIS 100%,low copay
                            992        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            244        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             10        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                             17        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                             30        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             16        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                          7,481        09                Pt A and/or B +D;no prem or cstshare sub
                            238        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,903        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                               
                             55        00                Not Medicare enrolled for the month     
                            519        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,502        02                Pt A and/or B +D;elig LIS 100%,low copay
                            995        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            242        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                              8        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                             17        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                             30        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             16        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                          7,494        09                Pt A and/or B +D;no prem or cstshare sub
                            242        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,899        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                               
                             46        00                Not Medicare enrolled for the month     
                            521        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,507        02                Pt A and/or B +D;elig LIS 100%,low copay
                            995        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            241        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                              9        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                             16        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                             30        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             16        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                          7,506        09                Pt A and/or B +D;no prem or cstshare sub
                            242        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,890        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                               
                             34        00                Not Medicare enrolled for the month     
                            536        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,513        02                Pt A and/or B +D;elig LIS 100%,low copay
                            990        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            241        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             10        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                             16        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                             29        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             16        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                          7,510        09                Pt A and/or B +D;no prem or cstshare sub
                            243        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,881        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                               
                             33        00                Not Medicare enrolled for the month     
                            555        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,503        02                Pt A and/or B +D;elig LIS 100%,low copay
                            984        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            240        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             10        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                             16        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                             29        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             15        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                          7,512        09                Pt A and/or B +D;no prem or cstshare sub
                            243        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,879        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                               
                             49        00                Not Medicare enrolled for the month     
                            562        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,503        02                Pt A and/or B +D;elig LIS 100%,low copay
                            979        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            240        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                             10        05                Pt A and/or B +D;enrld LIS 100%,15%copay
                             16        06                Pt A and/or B +D;enrld LIS 75%,15% copay
                             29        07                Pt A and/or B +D;enrld LIS 50%,15% copay
                             15        08                Pt A and/or B +D;enrld LIS 25%,15% copay
                          7,502        09                Pt A and/or B +D;no prem or cstshare sub
                            242        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,872        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_PDRS01    DRDSFMT                    RDS Indicator - Jan                               
                            237                       .  Unknown                                 
                            245                       1  Employer subsidized for the beneficiary 
                         12,537                       2  Employer not subsidized for the benefici
 
H_PDRS02    DRDSFMT                    RDS Indicator - Feb                               
                            209                       .  Unknown                                 
                            243                       1  Employer subsidized for the beneficiary 
                         12,567                       2  Employer not subsidized for the benefici
 
H_PDRS03    DRDSFMT                    RDS Indicator - Mar                               
                            185                       .  Unknown                                 
                            246                       1  Employer subsidized for the beneficiary 
                         12,588                       2  Employer not subsidized for the benefici
 
H_PDRS04    DRDSFMT                    RDS Indicator - Apr                               
                            173                       .  Unknown                                 
                            245                       1  Employer subsidized for the beneficiary 
                         12,601                       2  Employer not subsidized for the benefici
 
H_PDRS05    DRDSFMT                    RDS Indicator - May                               
                            147                       .  Unknown                                 
                            244                       1  Employer subsidized for the beneficiary 
                         12,628                       2  Employer not subsidized for the benefici
 
H_PDRS06    DRDSFMT                    RDS Indicator - Jun                               
                            119                       .  Unknown                                 
                            244                       1  Employer subsidized for the beneficiary 
                         12,656                       2  Employer not subsidized for the benefici
 
H_PDRS07    DRDSFMT                    RDS Indicator - Jul                               
                             93                       .  Unknown                                 
                            238                       1  Employer subsidized for the beneficiary 
                         12,688                       2  Employer not subsidized for the benefici
 
H_PDRS08    DRDSFMT                    RDS Indicator - Aug                               
                             61                       .  Unknown                                 
                            242                       1  Employer subsidized for the beneficiary 
                         12,716                       2  Employer not subsidized for the benefici
 
H_PDRS09    DRDSFMT                    RDS Indicator - Sep                               
                             52                       .  Unknown                                 
                            242                       1  Employer subsidized for the beneficiary 
                         12,725                       2  Employer not subsidized for the benefici
 
H_PDRS10    DRDSFMT                    RDS Indicator - Oct                               
                             40                       .  Unknown                                 
                            243                       1  Employer subsidized for the beneficiary 
                         12,736                       2  Employer not subsidized for the benefici
 
H_PDRS11    DRDSFMT                    RDS Indicator - Nov                               
                             39                       .  Unknown                                 
                            243                       1  Employer subsidized for the beneficiary 
                         12,737                       2  Employer not subsidized for the benefici
 
H_PDRS12    DRDSFMT                    RDS Indicator - Dec                               
                             55                       .  Unknown                                 
                            242                       1  Employer subsidized for the beneficiary 
                         12,722                       2  Employer not subsidized for the benefici
 
H_PRTC01                               Part C Contract ID - Jan                          
                            224        0                 Not Medicare Enrolled/Month             
                          6,781        Contract/Values   Contract/Segment/Plan ID                
                          6,014        N                 None                                    
 
H_PRTC02                               Part C Contract ID - Feb                          
                            198        0                 Not Medicare Enrolled/Month             
                          6,813        Contract/Values   Contract/Segment/Plan ID                
                          6,008        N                 None                                    
 
H_PRTC03                               Part C Contract ID - Mar                          
                            173        0                 Not Medicare Enrolled/Month             
                          6,839        Contract/Values   Contract/Segment/Plan ID                
                          6,007        N                 None                                    
 
H_PRTC04                               Part C Contract ID - Apr                          
                            161        0                 Not Medicare Enrolled/Month             
                          6,869        Contract/Values   Contract/Segment/Plan ID                
                          5,989        N                 None                                    
 
H_PRTC05                               Part C Contract ID - May                          
                            134        0                 Not Medicare Enrolled/Month             
                          6,905        Contract/Values   Contract/Segment/Plan ID                
                          5,980        N                 None                                    
 
H_PRTC06                               Part C Contract ID - Jun                          
                            107        0                 Not Medicare Enrolled/Month             
                          6,938        Contract/Values   Contract/Segment/Plan ID                
                          5,974        N                 None                                    
 
H_PRTC07                               Part C Contract ID - Jul                          
                             83        0                 Not Medicare Enrolled/Month             
                          6,968        Contract/Values   Contract/Segment/Plan ID                
                          5,968        N                 None                                    
 
H_PRTC08                               Part C Contract ID - Aug                          
                             55        0                 Not Medicare Enrolled/Month             
                          6,991        Contract/Values   Contract/Segment/Plan ID                
                          5,973        N                 None                                    
 
H_PRTC09                               Part C Contract ID - Sep                          
                             46        0                 Not Medicare Enrolled/Month             
                          7,017        Contract/Values   Contract/Segment/Plan ID                
                          5,956        N                 None                                    
 
H_PRTC10                               Part C Contract ID - Oct                          
                             34        0                 Not Medicare Enrolled/Month             
                          7,024        Contract/Values   Contract/Segment/Plan ID                
                          5,961        N                 None                                    
 
H_PRTC11                               Part C Contract ID - Nov                          
                             33        0                 Not Medicare Enrolled/Month             
                          7,020        Contract/Values   Contract/Segment/Plan ID                
                          5,966        N                 None                                    
 
H_PRTC12                               Part C Contract ID - Dec                          
                             49        0                 Not Medicare Enrolled/Month             
                          7,015        Contract/Values   Contract/Segment/Plan ID                
                          5,955        N                 None                                    
 
H_CPBP01                               Part C Plan Benefit Package - Jan                 
                          6,259                          Inapplicable/Missing                    
                          6,760        Contract/Values   Contract/Segment/Plan ID                
 
H_CPBP02                               Part C Plan Benefit Package - Feb                 
                          6,227                          Inapplicable/Missing                    
                          6,792        Contract/Values   Contract/Segment/Plan ID                
 
H_CPBP03                               Part C Plan Benefit Package - Mar                 
                          6,201                          Inapplicable/Missing                    
                          6,818        Contract/Values   Contract/Segment/Plan ID                
 
H_CPBP04                               Part C Plan Benefit Package - Apr                 
                          6,171                          Inapplicable/Missing                    
                          6,848        Contract/Values   Contract/Segment/Plan ID                
 
H_CPBP05                               Part C Plan Benefit Package - May                 
                          6,135                          Inapplicable/Missing                    
                          6,884        Contract/Values   Contract/Segment/Plan ID                
 
H_CPBP06                               Part C Plan Benefit Package - Jun                 
                          6,102                          Inapplicable/Missing                    
                          6,917        Contract/Values   Contract/Segment/Plan ID                
 
H_CPBP07                               Part C Plan Benefit Package - Jul                 
                          6,072                          Inapplicable/Missing                    
                          6,947        Contract/Values   Contract/Segment/Plan ID                
 
H_CPBP08                               Part C Plan Benefit Package - Aug                 
                          6,049                          Inapplicable/Missing                    
                          6,970        Contract/Values   Contract/Segment/Plan ID                
 
H_CPBP09                               Part C Plan Benefit Package - Sep                 
                          6,023                          Inapplicable/Missing                    
                          6,996        Contract/Values   Contract/Segment/Plan ID                
 
H_CPBP10                               Part C Plan Benefit Package - Oct                 
                          6,016                          Inapplicable/Missing                    
                          7,003        Contract/Values   Contract/Segment/Plan ID                
 
H_CPBP11                               Part C Plan Benefit Package - Nov                 
                          6,020                          Inapplicable/Missing                    
                          6,999        Contract/Values   Contract/Segment/Plan ID                
 
H_CPBP12                               Part C Plan Benefit Package - Dec                 
                          6,025                          Inapplicable/Missing                    
                          6,994        Contract/Values   Contract/Segment/Plan ID                
 
H_PRTD01                               Part D Contract ID - Jan                          
                             13                          Inapplicable/Missing                    
                            224        0                 Not Medicare Enrolled/Month             
                         10,623        Contract/Values   Contract/Segment/Plan ID                
                          2,159        N                 None                                    
 
H_PRTD02                               Part D Contract ID - Feb                          
                             11                          Inapplicable/Missing                    
                            198        0                 Not Medicare Enrolled/Month             
                         10,664        Contract/Values   Contract/Segment/Plan ID                
                          2,146        N                 None                                    
 
H_PRTD03                               Part D Contract ID - Mar                          
                             12                          Inapplicable/Missing                    
                            173        0                 Not Medicare Enrolled/Month             
                         10,693        Contract/Values   Contract/Segment/Plan ID                
                          2,141        N                 None                                    
 
H_PRTD04                               Part D Contract ID - Apr                          
                             12                          Inapplicable/Missing                    
                            161        0                 Not Medicare Enrolled/Month             
                         10,722        Contract/Values   Contract/Segment/Plan ID                
                          2,124        N                 None                                    
 
H_PRTD05                               Part D Contract ID - May                          
                             13                          Inapplicable/Missing                    
                            134        0                 Not Medicare Enrolled/Month             
                         10,751        Contract/Values   Contract/Segment/Plan ID                
                          2,121        N                 None                                    
 
H_PRTD06                               Part D Contract ID - Jun                          
                             12                          Inapplicable/Missing                    
                            107        0                 Not Medicare Enrolled/Month             
                         10,775        Contract/Values   Contract/Segment/Plan ID                
                          2,125        N                 None                                    
 
H_PRTD07                               Part D Contract ID - Jul                          
                             10                          Inapplicable/Missing                    
                             83        0                 Not Medicare Enrolled/Month             
                         10,795        Contract/Values   Contract/Segment/Plan ID                
                          2,131        N                 None                                    
 
H_PRTD08                               Part D Contract ID - Aug                          
                              6                          Inapplicable/Missing                    
                             55        0                 Not Medicare Enrolled/Month             
                         10,823        Contract/Values   Contract/Segment/Plan ID                
                          2,135        N                 None                                    
 
H_PRTD09                               Part D Contract ID - Sep                          
                              6                          Inapplicable/Missing                    
                             46        0                 Not Medicare Enrolled/Month             
                         10,841        Contract/Values   Contract/Segment/Plan ID                
                          2,126        N                 None                                    
 
H_PRTD10                               Part D Contract ID - Oct                          
                              6                          Inapplicable/Missing                    
                             34        0                 Not Medicare Enrolled/Month             
                         10,861        Contract/Values   Contract/Segment/Plan ID                
                          2,118        N                 None                                    
 
H_PRTD11                               Part D Contract ID - Nov                          
                              6                          Inapplicable/Missing                    
                             33        0                 Not Medicare Enrolled/Month             
                         10,864        Contract/Values   Contract/Segment/Plan ID                
                          2,116        N                 None                                    
 
H_PRTD12                               Part D Contract ID - Dec                          
                              6                          Inapplicable/Missing                    
                             49        0                 Not Medicare Enrolled/Month             
                         10,856        Contract/Values   Contract/Segment/Plan ID                
                          2,108        N                 None                                    
 
H_DPBP01                               Part D Plan Benefit Package - Jan                 
                          2,396                          Inapplicable/Missing                    
                         10,623        Contract/Values   Contract/Segment/Plan ID                
 
H_DPBP02                               Part D Plan Benefit Package - Feb                 
                          2,355                          Inapplicable/Missing                    
                         10,664        Contract/Values   Contract/Segment/Plan ID                
 
H_DPBP03                               Part D Plan Benefit Package - Mar                 
                          2,326                          Inapplicable/Missing                    
                         10,693        Contract/Values   Contract/Segment/Plan ID                
 
H_DPBP04                               Part D Plan Benefit Package - Apr                 
                          2,297                          Inapplicable/Missing                    
                         10,722        Contract/Values   Contract/Segment/Plan ID                
 
H_DPBP05                               Part D Plan Benefit Package - May                 
                          2,268                          Inapplicable/Missing                    
                         10,751        Contract/Values   Contract/Segment/Plan ID                
 
H_DPBP06                               Part D Plan Benefit Package - Jun                 
                          2,244                          Inapplicable/Missing                    
                         10,775        Contract/Values   Contract/Segment/Plan ID                
 
H_DPBP07                               Part D Plan Benefit Package - Jul                 
                          2,224                          Inapplicable/Missing                    
                         10,795        Contract/Values   Contract/Segment/Plan ID                
 
H_DPBP08                               Part D Plan Benefit Package - Aug                 
                          2,196                          Inapplicable/Missing                    
                         10,823        Contract/Values   Contract/Segment/Plan ID                
 
H_DPBP09                               Part D Plan Benefit Package - Sep                 
                          2,178                          Inapplicable/Missing                    
                         10,841        Contract/Values   Contract/Segment/Plan ID                
 
H_DPBP10                               Part D Plan Benefit Package - Oct                 
                          2,158                          Inapplicable/Missing                    
                         10,861        Contract/Values   Contract/Segment/Plan ID                
 
H_DPBP11                               Part D Plan Benefit Package - Nov                 
                          2,155                          Inapplicable/Missing                    
                         10,864        Contract/Values   Contract/Segment/Plan ID                
 
H_DPBP12                               Part D Plan Benefit Package - Dec                 
                          2,163                          Inapplicable/Missing                    
                         10,856        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM01                               Part D Segment ID: Jan                            
                          2,396                          Inapplicable/Missing                    
                         10,623        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM02                               Part D Segment ID: Feb                            
                          2,355                          Inapplicable/Missing                    
                         10,664        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM03                               Part D Segment ID: Mar                            
                          2,326                          Inapplicable/Missing                    
                         10,693        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM04                               Part D Segment ID: Apr                            
                          2,297                          Inapplicable/Missing                    
                         10,722        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM05                               Part D Segment ID: May                            
                          2,268                          Inapplicable/Missing                    
                         10,751        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM06                               Part D Segment ID: Jun                            
                          2,244                          Inapplicable/Missing                    
                         10,775        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM07                               Part D Segment ID: Jul                            
                          2,224                          Inapplicable/Missing                    
                         10,795        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM08                               Part D Segment ID: Aug                            
                          2,196                          Inapplicable/Missing                    
                         10,823        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM09                               Part D Segment ID: Sep                            
                          2,178                          Inapplicable/Missing                    
                         10,841        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM10                               Part D Segment ID: Oct                            
                          2,158                          Inapplicable/Missing                    
                         10,861        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM11                               Part D Segment ID: Nov                            
                          2,155                          Inapplicable/Missing                    
                         10,864        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM12                               Part D Segment ID: Dec                            
                          2,163                          Inapplicable/Missing                    
                         10,856        Contract/Values   Contract/Segment/Plan ID                
 
