Variable    Format      Q#/Freq        Description/Label
 
BASEID      $BSIDFMT                   Unique SP Identification Number                   
                         12,686        LOW-HIGH          BASEID Count                            
 
SURVEYYR    SVYRFMT                    Survey Year                                       
                         12,686                    2025  2025                                    
 
VERSION     VERSFMT                    Version Number                                    
                         12,686                       1  Version 1                               
 
H_DUAL01    $DUALMON                   Dual eligibity code - Jan                         
                            203        00                Not enrolled in Medicare for the month  
                            462        01                QMB-only                                
                          1,475        02                QMB & full Medicaid covrge, + Rx drugs  
                            229        03                SLMB-only                               
                             80        04                SLMB & full Medicaid covrge, + Rx drugs 
                            148        06                Qualifying individuals                  
                            319        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              2        99                Unknown                                 
                          9,768        NA                Non-Medicaid                            
 
H_DUAL02    $DUALMON                   Dual eligibity code - Feb                         
                            182        00                Not enrolled in Medicare for the month  
                            463        01                QMB-only                                
                          1,482        02                QMB & full Medicaid covrge, + Rx drugs  
                            223        03                SLMB-only                               
                             82        04                SLMB & full Medicaid covrge, + Rx drugs 
                            149        06                Qualifying individuals                  
                            325        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              2        99                Unknown                                 
                          9,778        NA                Non-Medicaid                            
 
H_DUAL03    $DUALMON                   Dual eligibity code - Mar                         
                            164        00                Not enrolled in Medicare for the month  
                            469        01                QMB-only                                
                          1,477        02                QMB & full Medicaid covrge, + Rx drugs  
                            231        03                SLMB-only                               
                             81        04                SLMB & full Medicaid covrge, + Rx drugs 
                            145        06                Qualifying individuals                  
                            328        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              2        99                Unknown                                 
                          9,789        NA                Non-Medicaid                            
 
H_DUAL04    $DUALMON                   Dual eligibity code - Apr                         
                            141        00                Not enrolled in Medicare for the month  
                            471        01                QMB-only                                
                          1,485        02                QMB & full Medicaid covrge, + Rx drugs  
                            234        03                SLMB-only                               
                             78        04                SLMB & full Medicaid covrge, + Rx drugs 
                            145        06                Qualifying individuals                  
                            315        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              2        99                Unknown                                 
                          9,815        NA                Non-Medicaid                            
 
H_DUAL05    $DUALMON                   Dual eligibity code - May                         
                            127        00                Not enrolled in Medicare for the month  
                            482        01                QMB-only                                
                          1,493        02                QMB & full Medicaid covrge, + Rx drugs  
                            229        03                SLMB-only                               
                             82        04                SLMB & full Medicaid covrge, + Rx drugs 
                            147        06                Qualifying individuals                  
                            308        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              2        99                Unknown                                 
                          9,816        NA                Non-Medicaid                            
 
H_DUAL06    $DUALMON                   Dual eligibity code - Jun                         
                            108        00                Not enrolled in Medicare for the month  
                            479        01                QMB-only                                
                          1,496        02                QMB & full Medicaid covrge, + Rx drugs  
                            227        03                SLMB-only                               
                             84        04                SLMB & full Medicaid covrge, + Rx drugs 
                            150        06                Qualifying individuals                  
                            307        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              2        99                Unknown                                 
                          9,833        NA                Non-Medicaid                            
 
H_DUAL07    $DUALMON                   Dual eligibity code - Jul                         
                             81        00                Not enrolled in Medicare for the month  
                            478        01                QMB-only                                
                          1,501        02                QMB & full Medicaid covrge, + Rx drugs  
                            225        03                SLMB-only                               
                             81        04                SLMB & full Medicaid covrge, + Rx drugs 
                            152        06                Qualifying individuals                  
                            312        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              2        99                Unknown                                 
                          9,854        NA                Non-Medicaid                            
 
H_DUAL08    $DUALMON                   Dual eligibity code - Aug                         
                             67        00                Not enrolled in Medicare for the month  
                            480        01                QMB-only                                
                          1,511        02                QMB & full Medicaid covrge, + Rx drugs  
                            228        03                SLMB-only                               
                             76        04                SLMB & full Medicaid covrge, + Rx drugs 
                            158        06                Qualifying individuals                  
                            307        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              2        99                Unknown                                 
                          9,857        NA                Non-Medicaid                            
 
H_DUAL09    $DUALMON                   Dual eligibity code - Sep                         
                             40        00                Not enrolled in Medicare for the month  
                            487        01                QMB-only                                
                          1,507        02                QMB & full Medicaid covrge, + Rx drugs  
                            232        03                SLMB-only                               
                             79        04                SLMB & full Medicaid covrge, + Rx drugs 
                            153        06                Qualifying individuals                  
                            300        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              2        99                Unknown                                 
                          9,886        NA                Non-Medicaid                            
 
H_DUAL10    $DUALMON                   Dual eligibity code - Oct                         
                             32        00                Not enrolled in Medicare for the month  
                            485        01                QMB-only                                
                          1,504        02                QMB & full Medicaid covrge, + Rx drugs  
                            231        03                SLMB-only                               
                             81        04                SLMB & full Medicaid covrge, + Rx drugs 
                            152        06                Qualifying individuals                  
                            299        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              2        99                Unknown                                 
                          9,900        NA                Non-Medicaid                            
 
H_DUAL11    $DUALMON                   Dual eligibity code - Nov                         
                             26        00                Not enrolled in Medicare for the month  
                            486        01                QMB-only                                
                          1,506        02                QMB & full Medicaid covrge, + Rx drugs  
                            227        03                SLMB-only                               
                             81        04                SLMB & full Medicaid covrge, + Rx drugs 
                            152        06                Qualifying individuals                  
                            296        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              2        99                Unknown                                 
                          9,910        NA                Non-Medicaid                            
 
H_DUAL12    $DUALMON                   Dual eligibity code - Dec                         
                             44        00                Not enrolled in Medicare for the month  
                            487        01                QMB-only                                
                          1,499        02                QMB & full Medicaid covrge, + Rx drugs  
                            226        03                SLMB-only                               
                             78        04                SLMB & full Medicaid covrge, + Rx drugs 
                            154        06                Qualifying individuals                  
                            296        08                Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                              2        99                Unknown                                 
                          9,900        NA                Non-Medicaid                            
 
H_OPMDCD    DUALFMT                    Medicare-Medicaid dual eligibility indic          
                          1,951                       1  FULL-Bene elig. full Medicaid benefits  
                          9,789                       2  NONDUAL-Bene not elig Medicaid benfits  
                            424                       3  PARTIAL-Bene elig part Medicd- not QMB  
                            522                       4  QMB ONLY-Bene elig for part Medicd-QMB  
 
H_MAFF01    $MA2FLAG                   MA flag -  Jan                                    
                          5,462        FF                Original Medicare/FFS                   
                          7,019        MA                MA/Other Medicare Capitated Paymnt Plans
                            205        NO                Not Medicare Enrolled/Month             
 
H_MAFF02    $MA2FLAG                   MA flag -  Feb                                    
                          5,434        FF                Original Medicare/FFS                   
                          7,068        MA                MA/Other Medicare Capitated Paymnt Plans
                            184        NO                Not Medicare Enrolled/Month             
 
H_MAFF03    $MA2FLAG                   MA flag -  Mar                                    
                          5,434        FF                Original Medicare/FFS                   
                          7,086        MA                MA/Other Medicare Capitated Paymnt Plans
                            166        NO                Not Medicare Enrolled/Month             
 
H_MAFF04    $MA2FLAG                   MA flag -  Apr                                    
                          5,460        FF                Original Medicare/FFS                   
                          7,083        MA                MA/Other Medicare Capitated Paymnt Plans
                            143        NO                Not Medicare Enrolled/Month             
 
H_MAFF05    $MA2FLAG                   MA flag -  May                                    
                          5,447        FF                Original Medicare/FFS                   
                          7,110        MA                MA/Other Medicare Capitated Paymnt Plans
                            129        NO                Not Medicare Enrolled/Month             
 
H_MAFF06    $MA2FLAG                   MA flag -  Jun                                    
                          5,440        FF                Original Medicare/FFS                   
                          7,136        MA                MA/Other Medicare Capitated Paymnt Plans
                            110        NO                Not Medicare Enrolled/Month             
 
H_MAFF07    $MA2FLAG                   MA flag -  Jul                                    
                          5,433        FF                Original Medicare/FFS                   
                          7,170        MA                MA/Other Medicare Capitated Paymnt Plans
                             83        NO                Not Medicare Enrolled/Month             
 
H_MAFF08    $MA2FLAG                   MA flag -  Aug                                    
                          5,424        FF                Original Medicare/FFS                   
                          7,193        MA                MA/Other Medicare Capitated Paymnt Plans
                             69        NO                Not Medicare Enrolled/Month             
 
H_MAFF09    $MA2FLAG                   MA flag -  Sep                                    
                          5,430        FF                Original Medicare/FFS                   
                          7,214        MA                MA/Other Medicare Capitated Paymnt Plans
                             42        NO                Not Medicare Enrolled/Month             
 
H_MAFF10    $MA2FLAG                   MA flag -  Oct                                    
                          5,427        FF                Original Medicare/FFS                   
                          7,225        MA                MA/Other Medicare Capitated Paymnt Plans
                             34        NO                Not Medicare Enrolled/Month             
 
H_MAFF11    $MA2FLAG                   MA flag -  Nov                                    
                          5,425        FF                Original Medicare/FFS                   
                          7,233        MA                MA/Other Medicare Capitated Paymnt Plans
                             28        NO                Not Medicare Enrolled/Month             
 
H_MAFF12    $MA2FLAG                   MA flag -  Dec                                    
                          5,421        FF                Original Medicare/FFS                   
                          7,219        MA                MA/Other Medicare Capitated Paymnt Plans
                             46        NO                Not Medicare Enrolled/Month             
 
H_MCDE01    $MCDCFMT                   Medicaid eligibility - Jan                        
                             70        A                 State Part A buy-in                     
                            472        B                 State Part B buy-in                     
                             31        C                 State Part A and B buy-in               
                             53        D                 State Part A and B QMB buy-in           
                         11,063        N                 No buy-in this month                    
                            805        Q                 State Part B QMB buy-in                 
                            192        S                 State Part B SLMB buy-in                
 
H_MCDE02    $MCDCFMT                   Medicaid eligibility - Feb                        
                             74        A                 State Part A buy-in                     
                            472        B                 State Part B buy-in                     
                             38        C                 State Part A and B buy-in               
                             54        D                 State Part A and B QMB buy-in           
                         11,044        N                 No buy-in this month                    
                            810        Q                 State Part B QMB buy-in                 
                            194        S                 State Part B SLMB buy-in                
 
H_MCDE03    $MCDCFMT                   Medicaid eligibility - Mar                        
                             73        A                 State Part A buy-in                     
                            473        B                 State Part B buy-in                     
                             38        C                 State Part A and B buy-in               
                             55        D                 State Part A and B QMB buy-in           
                         11,023        N                 No buy-in this month                    
                            828        Q                 State Part B QMB buy-in                 
                            196        S                 State Part B SLMB buy-in                
 
H_MCDE04    $MCDCFMT                   Medicaid eligibility - Apr                        
                             73        A                 State Part A buy-in                     
                            477        B                 State Part B buy-in                     
                             41        C                 State Part A and B buy-in               
                             57        D                 State Part A and B QMB buy-in           
                         11,006        N                 No buy-in this month                    
                            835        Q                 State Part B QMB buy-in                 
                            197        S                 State Part B SLMB buy-in                
 
H_MCDE05    $MCDCFMT                   Medicaid eligibility - May                        
                             71        A                 State Part A buy-in                     
                            481        B                 State Part B buy-in                     
                             42        C                 State Part A and B buy-in               
                             58        D                 State Part A and B QMB buy-in           
                         10,992        N                 No buy-in this month                    
                            842        Q                 State Part B QMB buy-in                 
                            200        S                 State Part B SLMB buy-in                
 
H_MCDE06    $MCDCFMT                   Medicaid eligibility - Jun                        
                             70        A                 State Part A buy-in                     
                            489        B                 State Part B buy-in                     
                             42        C                 State Part A and B buy-in               
                             59        D                 State Part A and B QMB buy-in           
                         10,978        N                 No buy-in this month                    
                            848        Q                 State Part B QMB buy-in                 
                            200        S                 State Part B SLMB buy-in                
 
H_MCDE07    $MCDCFMT                   Medicaid eligibility - Jul                        
                             69        A                 State Part A buy-in                     
                            500        B                 State Part B buy-in                     
                             42        C                 State Part A and B buy-in               
                             61        D                 State Part A and B QMB buy-in           
                         10,955        N                 No buy-in this month                    
                            854        Q                 State Part B QMB buy-in                 
                            205        S                 State Part B SLMB buy-in                
 
H_MCDE08    $MCDCFMT                   Medicaid eligibility - Aug                        
                             69        A                 State Part A buy-in                     
                            507        B                 State Part B buy-in                     
                             42        C                 State Part A and B buy-in               
                             61        D                 State Part A and B QMB buy-in           
                         10,940        N                 No buy-in this month                    
                            859        Q                 State Part B QMB buy-in                 
                            208        S                 State Part B SLMB buy-in                
 
H_MCDE09    $MCDCFMT                   Medicaid eligibility - Sep                        
                             69        A                 State Part A buy-in                     
                            506        B                 State Part B buy-in                     
                             41        C                 State Part A and B buy-in               
                             61        D                 State Part A and B QMB buy-in           
                         10,925        N                 No buy-in this month                    
                            866        Q                 State Part B QMB buy-in                 
                            218        S                 State Part B SLMB buy-in                
 
H_MCDE10    $MCDCFMT                   Medicaid eligibility - Oct                        
                             69        A                 State Part A buy-in                     
                            511        B                 State Part B buy-in                     
                             41        C                 State Part A and B buy-in               
                             61        D                 State Part A and B QMB buy-in           
                         10,919        N                 No buy-in this month                    
                            869        Q                 State Part B QMB buy-in                 
                            216        S                 State Part B SLMB buy-in                
 
H_MCDE11    $MCDCFMT                   Medicaid eligibility - Nov                        
                             68        A                 State Part A buy-in                     
                            509        B                 State Part B buy-in                     
                             42        C                 State Part A and B buy-in               
                             61        D                 State Part A and B QMB buy-in           
                         10,915        N                 No buy-in this month                    
                            875        Q                 State Part B QMB buy-in                 
                            216        S                 State Part B SLMB buy-in                
 
H_MCDE12    $MCDCFMT                   Medicaid eligibility - Dec                        
                             68        A                 State Part A buy-in                     
                            509        B                 State Part B buy-in                     
                             41        C                 State Part A and B buy-in               
                             61        D                 State Part A and B QMB buy-in           
                         10,923        N                 No buy-in this month                    
                            870        Q                 State Part B QMB buy-in                 
                            214        S                 State Part B SLMB buy-in                
 
H_PDLS01    $DLSFMT                    LIS Indicator - Jan                               
                            203        00                Not Medicare enrolled for the month     
                            527        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,338        02                Pt A and/or B +D;elig LIS 100%,low copay
                            928        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            293        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                          7,559        09                Pt A and/or B +D;no prem or cstshare sub
                            189        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,649        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                               
                            182        00                Not Medicare enrolled for the month     
                            534        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,343        02                Pt A and/or B +D;elig LIS 100%,low copay
                            932        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            298        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                          7,585        09                Pt A and/or B +D;no prem or cstshare sub
                            190        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,622        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                               
                            164        00                Not Medicare enrolled for the month     
                            548        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,347        02                Pt A and/or B +D;elig LIS 100%,low copay
                            932        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            293        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                          7,588        09                Pt A and/or B +D;no prem or cstshare sub
                            191        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,623        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                               
                            141        00                Not Medicare enrolled for the month     
                            556        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,349        02                Pt A and/or B +D;elig LIS 100%,low copay
                            932        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            291        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                          7,569        09                Pt A and/or B +D;no prem or cstshare sub
                            192        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,656        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                               
                            127        00                Not Medicare enrolled for the month     
                            567        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,348        02                Pt A and/or B +D;elig LIS 100%,low copay
                            936        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            293        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                          7,578        09                Pt A and/or B +D;no prem or cstshare sub
                            192        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,645        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                               
                            108        00                Not Medicare enrolled for the month     
                            574        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,350        02                Pt A and/or B +D;elig LIS 100%,low copay
                            942        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            290        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                          7,586        09                Pt A and/or B +D;no prem or cstshare sub
                            192        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,644        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                               
                             81        00                Not Medicare enrolled for the month     
                            586        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,353        02                Pt A and/or B +D;elig LIS 100%,low copay
                            940        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            289        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                          7,617        09                Pt A and/or B +D;no prem or cstshare sub
                            183        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,637        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                               
                             67        00                Not Medicare enrolled for the month     
                            589        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,357        02                Pt A and/or B +D;elig LIS 100%,low copay
                            944        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            288        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                          7,630        09                Pt A and/or B +D;no prem or cstshare sub
                            184        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,627        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                               
                             40        00                Not Medicare enrolled for the month     
                            596        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,356        02                Pt A and/or B +D;elig LIS 100%,low copay
                            948        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            292        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                          7,641        09                Pt A and/or B +D;no prem or cstshare sub
                            185        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,628        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                               
                             32        00                Not Medicare enrolled for the month     
                            601        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,358        02                Pt A and/or B +D;elig LIS 100%,low copay
                            947        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            291        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                          7,647        09                Pt A and/or B +D;no prem or cstshare sub
                            185        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,625        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                               
                             26        00                Not Medicare enrolled for the month     
                            609        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,351        02                Pt A and/or B +D;elig LIS 100%,low copay
                            954        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            290        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                          7,649        09                Pt A and/or B +D;no prem or cstshare sub
                            186        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,621        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                               
                             44        00                Not Medicare enrolled for the month     
                            607        01                Pt A and/or B +D;elig LIS 100%,no copay 
                          1,351        02                Pt A and/or B +D;elig LIS 100%,low copay
                            955        03                Pt A and/or B +D;elig LIS 100%,hi copay 
                            286        04                Pt A and/or B +D;enrld LIS 100%,hi copay
                          7,640        09                Pt A and/or B +D;no prem or cstshare sub
                            186        10                Pt A and/or B,no D;employr recvs RDS sub
                          1,617        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                               
                            213                       .  Unknown                                 
                            189                       1  Employer subsidized for the beneficiary 
                         12,284                       2  Employer not subsidized for the benefici
 
H_PDRS02    DRDSFMT                    RDS Indicator - Feb                               
                            191                       .  Unknown                                 
                            190                       1  Employer subsidized for the beneficiary 
                         12,305                       2  Employer not subsidized for the benefici
 
H_PDRS03    DRDSFMT                    RDS Indicator - Mar                               
                            174                       .  Unknown                                 
                            191                       1  Employer subsidized for the beneficiary 
                         12,321                       2  Employer not subsidized for the benefici
 
H_PDRS04    DRDSFMT                    RDS Indicator - Apr                               
                            153                       .  Unknown                                 
                            192                       1  Employer subsidized for the beneficiary 
                         12,341                       2  Employer not subsidized for the benefici
 
H_PDRS05    DRDSFMT                    RDS Indicator - May                               
                            140                       .  Unknown                                 
                            192                       1  Employer subsidized for the beneficiary 
                         12,354                       2  Employer not subsidized for the benefici
 
H_PDRS06    DRDSFMT                    RDS Indicator - Jun                               
                            120                       .  Unknown                                 
                            192                       1  Employer subsidized for the beneficiary 
                         12,374                       2  Employer not subsidized for the benefici
 
H_PDRS07    DRDSFMT                    RDS Indicator - Jul                               
                             89                       .  Unknown                                 
                            183                       1  Employer subsidized for the beneficiary 
                         12,414                       2  Employer not subsidized for the benefici
 
H_PDRS08    DRDSFMT                    RDS Indicator - Aug                               
                             72                       .  Unknown                                 
                            184                       1  Employer subsidized for the beneficiary 
                         12,430                       2  Employer not subsidized for the benefici
 
H_PDRS09    DRDSFMT                    RDS Indicator - Sep                               
                             44                       .  Unknown                                 
                            185                       1  Employer subsidized for the beneficiary 
                         12,457                       2  Employer not subsidized for the benefici
 
H_PDRS10    DRDSFMT                    RDS Indicator - Oct                               
                             36                       .  Unknown                                 
                            185                       1  Employer subsidized for the beneficiary 
                         12,465                       2  Employer not subsidized for the benefici
 
H_PDRS11    DRDSFMT                    RDS Indicator - Nov                               
                             30                       .  Unknown                                 
                            186                       1  Employer subsidized for the beneficiary 
                         12,470                       2  Employer not subsidized for the benefici
 
H_PDRS12    DRDSFMT                    RDS Indicator - Dec                               
                             48                       .  Unknown                                 
                            186                       1  Employer subsidized for the beneficiary 
                         12,452                       2  Employer not subsidized for the benefici
 
H_PRTC01                               Part C Contract ID - Jan                          
                              2                          Inapplicable/Missing                    
                            203        0                 Not Medicare Enrolled/Month             
                          7,019        Contract/Values   Contract/Segment/Plan ID                
                          5,462        N                 None                                    
 
H_PRTC02                               Part C Contract ID - Feb                          
                              2                          Inapplicable/Missing                    
                            182        0                 Not Medicare Enrolled/Month             
                          7,068        Contract/Values   Contract/Segment/Plan ID                
                          5,434        N                 None                                    
 
H_PRTC03                               Part C Contract ID - Mar                          
                              2                          Inapplicable/Missing                    
                            164        0                 Not Medicare Enrolled/Month             
                          7,086        Contract/Values   Contract/Segment/Plan ID                
                          5,434        N                 None                                    
 
H_PRTC04                               Part C Contract ID - Apr                          
                              2                          Inapplicable/Missing                    
                            141        0                 Not Medicare Enrolled/Month             
                          7,083        Contract/Values   Contract/Segment/Plan ID                
                          5,460        N                 None                                    
 
H_PRTC05                               Part C Contract ID - May                          
                              2                          Inapplicable/Missing                    
                            127        0                 Not Medicare Enrolled/Month             
                          7,110        Contract/Values   Contract/Segment/Plan ID                
                          5,447        N                 None                                    
 
H_PRTC06                               Part C Contract ID - Jun                          
                              2                          Inapplicable/Missing                    
                            108        0                 Not Medicare Enrolled/Month             
                          7,136        Contract/Values   Contract/Segment/Plan ID                
                          5,440        N                 None                                    
 
H_PRTC07                               Part C Contract ID - Jul                          
                              2                          Inapplicable/Missing                    
                             81        0                 Not Medicare Enrolled/Month             
                          7,170        Contract/Values   Contract/Segment/Plan ID                
                          5,433        N                 None                                    
 
H_PRTC08                               Part C Contract ID - Aug                          
                              2                          Inapplicable/Missing                    
                             67        0                 Not Medicare Enrolled/Month             
                          7,193        Contract/Values   Contract/Segment/Plan ID                
                          5,424        N                 None                                    
 
H_PRTC09                               Part C Contract ID - Sep                          
                              2                          Inapplicable/Missing                    
                             40        0                 Not Medicare Enrolled/Month             
                          7,214        Contract/Values   Contract/Segment/Plan ID                
                          5,430        N                 None                                    
 
H_PRTC10                               Part C Contract ID - Oct                          
                              2                          Inapplicable/Missing                    
                             32        0                 Not Medicare Enrolled/Month             
                          7,225        Contract/Values   Contract/Segment/Plan ID                
                          5,427        N                 None                                    
 
H_PRTC11                               Part C Contract ID - Nov                          
                              2                          Inapplicable/Missing                    
                             26        0                 Not Medicare Enrolled/Month             
                          7,233        Contract/Values   Contract/Segment/Plan ID                
                          5,425        N                 None                                    
 
H_PRTC12                               Part C Contract ID - Dec                          
                              2                          Inapplicable/Missing                    
                             44        0                 Not Medicare Enrolled/Month             
                          7,219        Contract/Values   Contract/Segment/Plan ID                
                          5,421        N                 None                                    
 
H_CPBP01                               Part C Plan Benefit Package - Jan                 
                          5,680                          Inapplicable/Missing                    
                          7,006        Contract/Values   Contract/Segment/Plan ID                
 
H_CPBP02                               Part C Plan Benefit Package - Feb                 
                          5,631                          Inapplicable/Missing                    
                          7,055        Contract/Values   Contract/Segment/Plan ID                
 
H_CPBP03                               Part C Plan Benefit Package - Mar                 
                          5,613                          Inapplicable/Missing                    
                          7,073        Contract/Values   Contract/Segment/Plan ID                
 
H_CPBP04                               Part C Plan Benefit Package - Apr                 
                          5,616                          Inapplicable/Missing                    
                          7,070        Contract/Values   Contract/Segment/Plan ID                
 
H_CPBP05                               Part C Plan Benefit Package - May                 
                          5,589                          Inapplicable/Missing                    
                          7,097        Contract/Values   Contract/Segment/Plan ID                
 
H_CPBP06                               Part C Plan Benefit Package - Jun                 
                          5,563                          Inapplicable/Missing                    
                          7,123        Contract/Values   Contract/Segment/Plan ID                
 
H_CPBP07                               Part C Plan Benefit Package - Jul                 
                          5,529                          Inapplicable/Missing                    
                          7,157        Contract/Values   Contract/Segment/Plan ID                
 
H_CPBP08                               Part C Plan Benefit Package - Aug                 
                          5,506                          Inapplicable/Missing                    
                          7,180        Contract/Values   Contract/Segment/Plan ID                
 
H_CPBP09                               Part C Plan Benefit Package - Sep                 
                          5,485                          Inapplicable/Missing                    
                          7,201        Contract/Values   Contract/Segment/Plan ID                
 
H_CPBP10                               Part C Plan Benefit Package - Oct                 
                          5,474                          Inapplicable/Missing                    
                          7,212        Contract/Values   Contract/Segment/Plan ID                
 
H_CPBP11                               Part C Plan Benefit Package - Nov                 
                          5,466                          Inapplicable/Missing                    
                          7,220        Contract/Values   Contract/Segment/Plan ID                
 
H_CPBP12                               Part C Plan Benefit Package - Dec                 
                          5,480                          Inapplicable/Missing                    
                          7,206        Contract/Values   Contract/Segment/Plan ID                
 
H_PRTD01                               Part D Contract ID - Jan                          
                             10                          Inapplicable/Missing                    
                            203        0                 Not Medicare Enrolled/Month             
                         10,645        Contract/Values   Contract/Segment/Plan ID                
                          1,828        N                 None                                    
 
H_PRTD02                               Part D Contract ID - Feb                          
                              9                          Inapplicable/Missing                    
                            182        0                 Not Medicare Enrolled/Month             
                         10,692        Contract/Values   Contract/Segment/Plan ID                
                          1,803        N                 None                                    
 
H_PRTD03                               Part D Contract ID - Mar                          
                             10                          Inapplicable/Missing                    
                            164        0                 Not Medicare Enrolled/Month             
                         10,708        Contract/Values   Contract/Segment/Plan ID                
                          1,804        N                 None                                    
 
H_PRTD04                               Part D Contract ID - Apr                          
                             12                          Inapplicable/Missing                    
                            141        0                 Not Medicare Enrolled/Month             
                         10,697        Contract/Values   Contract/Segment/Plan ID                
                          1,836        N                 None                                    
 
H_PRTD05                               Part D Contract ID - May                          
                             13                          Inapplicable/Missing                    
                            127        0                 Not Medicare Enrolled/Month             
                         10,722        Contract/Values   Contract/Segment/Plan ID                
                          1,824        N                 None                                    
 
H_PRTD06                               Part D Contract ID - Jun                          
                             12                          Inapplicable/Missing                    
                            108        0                 Not Medicare Enrolled/Month             
                         10,742        Contract/Values   Contract/Segment/Plan ID                
                          1,824        N                 None                                    
 
H_PRTD07                               Part D Contract ID - Jul                          
                              8                          Inapplicable/Missing                    
                             81        0                 Not Medicare Enrolled/Month             
                         10,785        Contract/Values   Contract/Segment/Plan ID                
                          1,812        N                 None                                    
 
H_PRTD08                               Part D Contract ID - Aug                          
                              5                          Inapplicable/Missing                    
                             67        0                 Not Medicare Enrolled/Month             
                         10,808        Contract/Values   Contract/Segment/Plan ID                
                          1,806        N                 None                                    
 
H_PRTD09                               Part D Contract ID - Sep                          
                              4                          Inapplicable/Missing                    
                             40        0                 Not Medicare Enrolled/Month             
                         10,833        Contract/Values   Contract/Segment/Plan ID                
                          1,809        N                 None                                    
 
H_PRTD10                               Part D Contract ID - Oct                          
                              4                          Inapplicable/Missing                    
                             32        0                 Not Medicare Enrolled/Month             
                         10,844        Contract/Values   Contract/Segment/Plan ID                
                          1,806        N                 None                                    
 
H_PRTD11                               Part D Contract ID - Nov                          
                              4                          Inapplicable/Missing                    
                             26        0                 Not Medicare Enrolled/Month             
                         10,853        Contract/Values   Contract/Segment/Plan ID                
                          1,803        N                 None                                    
 
H_PRTD12                               Part D Contract ID - Dec                          
                              4                          Inapplicable/Missing                    
                             44        0                 Not Medicare Enrolled/Month             
                         10,839        Contract/Values   Contract/Segment/Plan ID                
                          1,799        N                 None                                    
 
H_DPBP01                               Part D Plan Benefit Package - Jan                 
                          2,041                          Inapplicable/Missing                    
                         10,645        Contract/Values   Contract/Segment/Plan ID                
 
H_DPBP02                               Part D Plan Benefit Package - Feb                 
                          1,994                          Inapplicable/Missing                    
                         10,692        Contract/Values   Contract/Segment/Plan ID                
 
H_DPBP03                               Part D Plan Benefit Package - Mar                 
                          1,978                          Inapplicable/Missing                    
                         10,708        Contract/Values   Contract/Segment/Plan ID                
 
H_DPBP04                               Part D Plan Benefit Package - Apr                 
                          1,989                          Inapplicable/Missing                    
                         10,697        Contract/Values   Contract/Segment/Plan ID                
 
H_DPBP05                               Part D Plan Benefit Package - May                 
                          1,964                          Inapplicable/Missing                    
                         10,722        Contract/Values   Contract/Segment/Plan ID                
 
H_DPBP06                               Part D Plan Benefit Package - Jun                 
                          1,944                          Inapplicable/Missing                    
                         10,742        Contract/Values   Contract/Segment/Plan ID                
 
H_DPBP07                               Part D Plan Benefit Package - Jul                 
                          1,901                          Inapplicable/Missing                    
                         10,785        Contract/Values   Contract/Segment/Plan ID                
 
H_DPBP08                               Part D Plan Benefit Package - Aug                 
                          1,878                          Inapplicable/Missing                    
                         10,808        Contract/Values   Contract/Segment/Plan ID                
 
H_DPBP09                               Part D Plan Benefit Package - Sep                 
                          1,853                          Inapplicable/Missing                    
                         10,833        Contract/Values   Contract/Segment/Plan ID                
 
H_DPBP10                               Part D Plan Benefit Package - Oct                 
                          1,842                          Inapplicable/Missing                    
                         10,844        Contract/Values   Contract/Segment/Plan ID                
 
H_DPBP11                               Part D Plan Benefit Package - Nov                 
                          1,833                          Inapplicable/Missing                    
                         10,853        Contract/Values   Contract/Segment/Plan ID                
 
H_DPBP12                               Part D Plan Benefit Package - Dec                 
                          1,847                          Inapplicable/Missing                    
                         10,839        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM01                               Part D Segment ID: Jan                            
                          2,041                          Inapplicable/Missing                    
                         10,645        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM02                               Part D Segment ID: Feb                            
                          1,994                          Inapplicable/Missing                    
                         10,692        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM03                               Part D Segment ID: Mar                            
                          1,978                          Inapplicable/Missing                    
                         10,708        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM04                               Part D Segment ID: Apr                            
                          1,989                          Inapplicable/Missing                    
                         10,697        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM05                               Part D Segment ID: May                            
                          1,964                          Inapplicable/Missing                    
                         10,722        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM06                               Part D Segment ID: Jun                            
                          1,944                          Inapplicable/Missing                    
                         10,742        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM07                               Part D Segment ID: Jul                            
                          1,901                          Inapplicable/Missing                    
                         10,785        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM08                               Part D Segment ID: Aug                            
                          1,878                          Inapplicable/Missing                    
                         10,808        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM09                               Part D Segment ID: Sep                            
                          1,853                          Inapplicable/Missing                    
                         10,833        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM10                               Part D Segment ID: Oct                            
                          1,842                          Inapplicable/Missing                    
                         10,844        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM11                               Part D Segment ID: Nov                            
                          1,833                          Inapplicable/Missing                    
                         10,853        Contract/Values   Contract/Segment/Plan ID                
 
H_DSGM12                               Part D Segment ID: Dec                            
                          1,847                          Inapplicable/Missing                    
                         10,839        Contract/Values   Contract/Segment/Plan ID                
 
