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       *           A T T E N T I O N               *
       *                                           *
       *   THESE POS RECORD SPECIFICATIONS WERE    *
       *   PRODUCED FROM OUR DICTIONARY AT THE     *
       *   SAME TIME AS THE POS DATA FILE THAT     *
       *   YOU REQUESTED. YOU MAY WISH TO CHECK    *
       *   THESE SPECIFICATIONS TO SEE IF ANY      *
       *   CHANGES HAVE OCCURED SINCE YOUR RECEIPT *
       *   OF ANY PRIOR DOCUMENTATION.             *
       *                                           *
       *   FILE CREATION DATE = 07/01/2021         *
       *                                           *
       *********************************************
 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 1
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

   Provider Category Subtype Code                    2    1     2    VARCHAR2
     Description: Identifies the subtype of the provider, within the
                  primary category.  Used in reporting to show the
                  breakdown of provider categories, mainly for hospitals
                  and SNFs.
     SAS Name:    PRVDR_CTGRY_SBTYP_CD
     COBOL Name:  PRVDR-CTGRY-SBTYP-CD
     VALUES:      01=Short Term
                  02=Long Term
                  03=Religious Non-Medical Health Care Institutions
                  04=Psychiatric
                  05=Rehabilitation
                  06=Childrens Hospitals
                  07=Distinct Part Psychiatric Hospital
                  11=Critical Access Hospitals


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 2
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  20=Transplant Hospitals
                  22=Medicaid Only Short-Term Hospitals
                  23=Medicaid Only Childrens Hospitals
                  24=Medicaid Only Children's Psychiatric
                  25=Medicaid Only Psychiatric Hospitals
                  26=Medicaid Only Rehabilitation Hospitals
                  27=Medicaid Only Long-Term Hospitals

   Provider Category Code                            2    3     4    VARCHAR2
     Description: Identifies the type of provider participating in the
                  Medicare/Medicaid program.
     SAS Name:    PRVDR_CTGRY_CD
     COBOL Name:  PRVDR-CTGRY-CD
     VALUES:      01=Hospital

   CHOW Count                                        2    5     6    NUMBER
     Description: Number of times this provider has undergone a change of
                  ownership.
     SAS Name:    CHOW_CNT
     COBOL Name:  CHOW-CNT

   CHOW Date                                         8    7     14   DATE
     Description: Effective date of the most recent change of ownership for
                  this provider.
     SAS Name:    CHOW_DT
     COBOL Name:  CHOW-DT

   Address: City                                     28   15    42   VARCHAR2
     Description: City in which the provider is physically located.
     SAS Name:    CITY_NAME
     COBOL Name:  CITY-NAME

   Compliance: Acceptable POC                        1    43    43   VARCHAR2
     Description: Indicates if a provider is in compliance with program
                  requirements based on an acceptable plan for correction
                  of deficiencies.
     SAS Name:    ACPTBL_POC_SW
     COBOL Name:  ACPTBL-POC-SW

   Compliance: Status                                1    44    44   VARCHAR2
     Description: Compliance status of a provider at the time of
                  certification survey.
     SAS Name:    CMPLNC_STUS_CD
     COBOL Name:  CMPLNC-STUS-CD
     VALUES:      A=IN COMPLIANCE
                  B=NOT IN COMPLIANCE

   SSA County Code                                   3    45    47   VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the county where the provider is located.
     SAS Name:    SSA_CNTY_CD
     COBOL Name:  SSA-CNTY-CD

   Cross Ref Provider Number                         10   48    57   CHAR
     Description: Cross reference provider number
     SAS Name:    CROSS_REF_PROVIDER_NUMBER
     COBOL Name:  CROSS-REF-PROVIDER-NUMBER

   Certification Date                                8    58    65   DATE
     Description: Equal to the exit date of the initial visit of the Health
                  survey for certifications completed after July 28, 2012.
                  For certifications prior to that date, the certification
                  date is equal to the exit date of the initial visit of
                  the Health survey or LSC survey, whichever is later.


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 3
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     SAS Name:    CRTFCTN_DT
     COBOL Name:  CRTFCTN-DT

   Eligibility Indicator                             1    66    66   VARCHAR2
     Description: Indicates if a facility is eligible to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    ELGBLTY_SW
     COBOL Name:  ELGBLTY-SW

   Facility Name                                     50   67    116  VARCHAR2
     Description: Name of the provider certified to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    FAC_NAME
     COBOL Name:  FAC-NAME

   Medicare Administrative Contractor (MAC) or       5    117   121  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_CD
     COBOL Name:  INTRMDRY-CARR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 4
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 5
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 6
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 7
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)
                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 8
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   Medicaid Vendor Number                            15   122   136  VARCHAR2
     Description: Number which may be assigned to a provider by the state
                  Medicaid agency for external control or billing purposes.
     SAS Name:    MDCD_VNDR_NUM
     COBOL Name:  MDCD-VNDR-NUM

   Original Participation Date                       8    137   144  DATE
     Description: Date a provider is first approved to provide Medicare
                  and/or Medicaid services.
     SAS Name:    ORGNL_PRTCPTN_DT
     COBOL Name:  ORGNL-PRTCPTN-DT

   Prior CHOW Date                                   8    145   152  DATE
     Description: Effective date of the previous change of ownership for
                  this provider.
     SAS Name:    CHOW_PRIOR_DT
     COBOL Name:  CHOW-PRIOR-DT

   Prior Medicare Administrative Contractor (MAC) or 5    153   157  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the previous Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_PRIOR_CD
     COBOL Name:  INTRMDRY-CARR-PRIOR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 9
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 10
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 11
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 12
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)
                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 13
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   CCN                                               10   158   167  VARCHAR2
     Description: Six or ten position identification number that is
                  assigned to a certified provider.  This is the CMS
                  Certification Number.
     SAS Name:    PRVDR_NUM
     COBOL Name:  PRVDR-NUM

   Region Code                                       2    168   169  VARCHAR2
     Description: Indicates the CMS Regional Office responsible for the
                  certification of the provider.
     SAS Name:    RGN_CD
     COBOL Name:  RGN-CD
     VALUES:      01=Boston
                  02=New York
                  03=Philadelphia
                  04=Atlanta
                  05=Chicago
                  06=Dallas
                  07=Kansas City
                  08=Denver
                  09=San Francisco
                  10=Seattle

   Skeleton Record Indicator                         1    170   170  VARCHAR2
     Description: Indicates if the record is a skeleton record.  Only a
                  limited set of data is available for this provider; no
                  survey data exists.  Only provider categories
                  01,17,19,21and 22 can have skeleton providers.
     SAS Name:    SKLTN_REC_SW
     COBOL Name:  SKLTN-REC-SW

   State Abbreviation                                2    171   172  VARCHAR2
     Description: Two-character state abbreviation.
     SAS Name:    STATE_CD
     COBOL Name:  STATE-CD
     VALUES:      AK=ALASKA
                  AL=ALABAMA
                  AR=ARKANSAS
                  AS=AMERICAN SAMOA
                  AZ=ARIZONA
                  CA=CALIFORNIA
                  CN=CANADA
                  CO=COLORADO
                  CT=CONNECTICUT
                  DC=DISTRICT OF COLUMBIA
                  DE=DELAWARE
                  FL=FLORIDA
                  FN=INTERNATIONAL
                  GA=GEORGIA
                  GU=GUAM
                  HI=HAWAII
                  IA=IOWA
                  ID=IDAHO
                  IL=ILLINOIS
                  IN=INDIANA


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 14
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  KS=KANSAS
                  KY=KENTUCKY
                  LA=LOUISIANA
                  MA=MASSACHUSETTS
                  MD=MARYLAND
                  ME=MAINE
                  MI=MICHIGAN
                  MN=MINNESOTA
                  MO=MISSOURI
                  MP=SAIPAN
                  MS=MISSISSIPPI
                  MT=MONTANA
                  MX=MEXICO
                  NC=NORTH CAROLINA
                  ND=NORTH DAKOTA
                  NE=NEBRASKA
                  NH=NEW HAMPSHIRE
                  NJ=NEW JERSEY
                  NM=NEW MEXICO
                  NV=NEVADA
                  NY=NEW YORK
                  OH=OHIO
                  OK=OKLAHOMA
                  OR=OREGON
                  PA=PENNSYLVANIA
                  PR=PUERTO RICO
                  RI=RHODE ISLAND
                  SC=SOUTH CAROLINA
                  SD=SOUTH DAKOTA
                  TN=TENNESSEE
                  TX=TEXAS
                  UT=UTAH
                  VA=VIRGINIA
                  VI=VIRGIN ISLANDS
                  VT=VERMONT
                  WA=WASHINGTON
                  WI=WISCONSIN
                  WV=WEST VIRGINIA
                  WY=WYOMING

   SSA State Code                                    2    173   174  VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the state where the provider is located.
     SAS Name:    SSA_STATE_CD
     COBOL Name:  SSA-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  03=ARIZONA
                  04=ARKANSAS
                  05=CALIFORNIA
                  06=COLORADO
                  07=CONNECTICUT
                  08=DELAWARE
                  09=DISTRICT OF COLUMBIA
                  10=FLORIDA
                  11=GEORGIA
                  12=HAWAII
                  13=IDAHO
                  14=ILLINOIS
                  15=INDIANA
                  16=IOWA
                  17=KANSAS
                  18=KENTUCKY
                  19=LOUISIANA


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 15
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  20=MAINE
                  21=MARYLAND
                  22=MASSACHUSETTS
                  23=MICHIGAN
                  24=MINNESOTA
                  25=MISSISSIPPI
                  26=MISSOURI
                  27=MONTANA
                  28=NEBRASKA
                  29=NEVADA
                  30=NEW HAMPSHIRE
                  31=NEW JERSEY
                  32=NEW MEXICO
                  33=NEW YORK
                  34=NORTH CAROLINA
                  35=NORTH DAKOTA
                  36=OHIO
                  37=OKLAHOMA
                  38=OREGON
                  39=PENNSYLVANIA
                  40=PUERTO RICO
                  41=RHODE ISLAND
                  42=SOUTH CAROLINA
                  43=SOUTH DAKOTA
                  44=TENNESSEE
                  45=TEXAS
                  46=UTAH
                  47=VERMONT
                  48=VIRGIN ISLANDS
                  49=VIRGINIA
                  50=WASHINGTON
                  51=WEST VIRGINIA
                  52=WISCONSIN
                  53=WYOMING
                  54=AFRICA
                  56=CANADA
                  57=WEST INDIES
                  58=EUROPE
                  59=MEXICO
                  60=OCEANIA
                  61=PHILIPPINES
                  62=SOUTH AMERICA
                  63=UNITED STATES POSSESSIONS
                  64=AMERICAN SAMOA
                  65=GUAM
                  66=SAIPAN
                  99=INTERNATIONAL

   State Region Code                                 3    175   177  VARCHAR2
     Description: Identifies the region within a state where the provider
                  is located.
     SAS Name:    STATE_RGN_CD
     COBOL Name:  STATE-RGN-CD
     VALUES:      AK/001=ALASKA
                  AK/LAB=LABORATORIES
                  AK/NPH=NON-PARTICIPATING HOSPITAL
                  AL/001=ALABAMA
                  AL/LAB=LABORATORIES
                  AL/NPH=NON-PARTICIPATING HOSPITAL
                  AR/001=ARKANSAS
                  AR/LAB=LABORATORIES
                  AR/NPH=NON-PARTICIPATING HOSPITAL
                  AS/001=AMERICAN SAMOA
                  AS/LAB=LABORATORY


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 16
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  AS/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/AZ=PHOENIX
                  AZ/LAB=ARIZONA LAB
                  AZ/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/TUC=TUCSON
                  CA/001=CALIFORNIA
                  CA/BAK=BAKERSFIELD
                  CA/BER=SAN BERNARDINO
                  CA/EB=East Bay
                  CA/FR=FRESNO
                  CA/L1=L.A. WEST
                  CA/L2=L.A. NORTH
                  CA/L3=L.A. CENTRAL
                  CA/L4=L.A. EAST
                  CA/L5=SAN GABRIEL
                  CA/LA1=LA Region 1
                  CA/LA2=LA Region 2
                  CA/LA3=LA Region 3
                  CA/LA4=LA Acute/Ancillary
                  CA/LA5=LA HHA/Hospice
                  CA/LA6=LA ICF/DD/CLinics
                  CA/LAB=LABORATORIES
                  CA/M1=LAB. SOUTH
                  CA/M2=LAB. NORTH
                  CA/NPH=NON-PARTICIPATING HOSPITAL
                  CA/ORG=ORANGE
                  CA/RIV=RIVERSIDE
                  CA/S1=SACRAMENTO
                  CA/S3=CHICO
                  CA/SD=SAN DIEGO
                  CA/SF=SAN FRANCISCO
                  CA/SJ=SAN JOSE
                  CA/SR=SANTA ROSA
                  CA/VEN=VENTURA
                  CN/001=CANADA
                  CN/LAB=LABORATORY
                  CN/NPH=NON-PARTICIPATING HOSPITAL
                  CO/001=COLORADO
                  CO/LAB=LABORATORIES
                  CO/NPH=NON-PARTICIPATING HOSPITAL
                  CT/001=CONNECTICUT
                  CT/LAB=LABORATORIES
                  CT/NPH=NON-PARTICIPATING HOSPITAL
                  DC/001=DISTRICT OF COLUMBIA
                  DC/LAB=LABORATORIES
                  DC/NPH=NON-PARTICIPATING HOSPITAL
                  DE/001=DELAWARE
                  DE/LAB=LABORATORIES
                  DE/NPH=NON-PARTICIPATING HOSPITAL
                  FL/001=FLORIDA
                  FL/FTM=FT. MYERS
                  FL/GAI=GAINESVILLE
                  FL/JAX=JACKSONVILLE
                  FL/LAB=LABORATORIES
                  FL/LAN=LANTANA
                  FL/LAU=LAUDERHILL
                  FL/MIA=MIAMI
                  FL/NPH=NON-PARTICIPATING HOSPITAL
                  FL/ORL=ORLANDO
                  FL/PEN=PENSACOLA
                  FL/STP=ST. PETERSBURG
                  FL/TAL=TALLAHASSEE
                  FL/TAM=TAMPA
                  FM/001=FEDERATED STATES OF MICRO


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 17
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  FM/NPH=NON-PARTICIPATING HOSPITAL
                  FN/001=INTERNATIONAL
                  FN/LAB=LABORATORIES
                  FN/NPH=NON-PARTICIPATING HOSPITAL
                  GA/001=GEORGIA
                  GA/GAA=GEORGIA ALL
                  GA/GAC=GEORGIA CENTRAL
                  GA/GAE=GEORGIA EASTERN
                  GA/GAN=GEORGIA NORTH
                  GA/GAS=GEORGIA SOUTH
                  GA/GAW=GEORGIA WESTERN
                  GA/LAB=LABORATORIES
                  GA/NPH=NON-PARTICIPATING HOSPITAL
                  GU/001=GUAM
                  GU/LAB=LABORATORIES
                  GU/NPH=NON-PARTICIPATING HOSPITAL
                  HI/001=HAWAII
                  HI/LAB=LABORATORIES
                  HI/NPH=NON-PARTICIPATING HOSPITAL
                  IA/001=IOWA
                  IA/LAB=LABORATORIES
                  IA/NPH=NON-PARTICIPATING HOSPITAL
                  ID/001=IDAHO
                  ID/LAB=LABORATORIES
                  ID/NPH=NON-PARTICIPATING HOSPITAL
                  IL/001=ILLINOIS
                  IL/LAB=LABORATORIES
                  IL/NPH=NON-PARTICIPATING HOSPITAL
                  IN/001=INDIANA
                  IN/LAB=LABORATORIES
                  IN/NPH=NON-PARTICIPATING HOSPITAL
                  KS/001=KANSAS
                  KS/KCK=KANSAS CITY
                  KS/KDH=KDHE
                  KS/LAB=LABORATORIES
                  KS/LAW=LAWRENCE
                  KS/NC=NORTH CENTRAL KANSAS
                  KS/NE=NORTH EAST KANSAS
                  KS/NPH=NON-PARTICIPATING HOSPITAL
                  KS/NW=NORTH WEST KANSAS
                  KS/SC=SOUTH CENTRAL KANSAS
                  KS/SE=SOUTH EAST KANSAS
                  KS/SW=SOUTH WEST KANSAS
                  KS/WST=WEST
                  KY/2C1=HOPKINSVILLE
                  KY/2C2=LOUISVILLE
                  KY/2C3=LONDON
                  KY/2C4=LEXINGTON
                  KY/LAB=LABORATORIES
                  KY/NPH=NON-PARTICIPATING HOSPITAL
                  LA/001=LOUISIANA
                  LA/LA1=NEW ORLEANS
                  LA/LA2=MANDEVILLE
                  LA/LA3=LAFAYETTE
                  LA/LA4=MONROE
                  LA/LA5=SHREVEPORT
                  LA/LA6=ALEXANDRIA
                  LA/LAB=LABORATORIES
                  LA/LB1=CLIA NEW ORLEANS
                  LA/LB5=CLIA SHREVEPORT
                  LA/LB6=CLIA ALEXANDRIA
                  LA/NPH=NON-PARTICIPATING HOSPITAL
                  MA/001=MASSACHUSETTS
                  MA/LAB=LABORATORIES


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 18
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  MA/NPH=NON-PARTICIPATING HOSPITAL
                  MD/001=MARYLAND
                  MD/LAB=LABORATORIES
                  MD/NPH=NON-PARTICIPATING HOSPITAL
                  ME/001=MAINE
                  ME/LAB=LABORATORIES
                  ME/NPH=NON-PARTICIPATING HOSPITAL
                  MH/001=MARSHALL ISLANDS
                  MH/NPH=NON-PARTICIPATING HOSPITAL
                  MI/001=MICHIGAN
                  MI/LAB=LABORATORIES
                  MI/NPH=NON-PARTICIPATING HOSPITAL
                  MN/001=MINNESOTA
                  MN/LAB=LABORATORIES
                  MN/NPH=NON-PARTICIPATING HOSPITAL
                  MO/001=MISSOURI
                  MO/01=REGION01
                  MO/02=REGION02
                  MO/03=REGION 03
                  MO/04=REGION 04
                  MO/05=REGION 05
                  MO/06=REGION 06
                  MO/07=REGION 07
                  MO/1NH=REGION 1 NH
                  MO/2NH=REGION 2 NH
                  MO/3NH=REGION 3 NH
                  MO/4NH=REGION 4 NH
                  MO/5NH=REGION 5 NH
                  MO/6NH=REGION 6 NH
                  MO/7NH=REGION 7 NH
                  MO/LAB=LABORATORIES
                  MO/MO=STATEWIDE
                  MO/NPH=NON-PARTICIPATING HOSPITAL
                  MP/001=NORTHERN MARIANA ISLANDS
                  MP/LAB=LABORATORIES
                  MP/NPH=NON-PARTICIPATING HOSPITAL
                  MS/001=MISSISSIPPI
                  MS/LAB=LABORATORIES
                  MS/NPH=NON-PARTICIPATING HOSPITAL
                  MT/001=MONTANA
                  MT/LAB=LABORATORIES
                  MT/NPH=NON-PARTICIPATING HOSPITAL
                  MX/001=MEXICO
                  MX/LAB=LABORATORY
                  MX/NPH=NON-PARTICIPATING HOSPITAL
                  NC/001=NORTH CAROLINA
                  NC/LAB=LABORATORIES
                  NC/NCC=NORTH CAROLINA CENTRAL
                  NC/NCE=NORTH CAROLINA EAST
                  NC/NCN=NORTH CAROLINA NORTH
                  NC/NCS=NORTH CAROLINA SOUTH
                  NC/NCW=NORTH CAROLINA WEST
                  NC/NPH=NON-PARTICIPATING HOSPITAL
                  ND/001=NORTH DAKOTA
                  ND/LAB=LABORATORIES
                  ND/NPH=NON-PARTICIPATING HOSPITAL
                  NE/001=NEBRASKA
                  NE/1=NORTH CENTRAL
                  NE/2=CENTRAL
                  NE/3=NORTHEAST
                  NE/4=SOUTHEAST
                  NE/5=WESTERN
                  NE/LAB=LABORATORIES
                  NE/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 19
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  NH/001=NEW HAMPSHIRE
                  NH/LAB=LABORATORIES
                  NH/NPH=NON-PARTICIPATING HOSPITAL
                  NJ/001=NEW JERSEY
                  NJ/LAB=LABORATORIES
                  NJ/NPH=NON-PARTICIPATING HOSPITAL
                  NM/001=NEW MEXICO
                  NM/LAB=LABORATORIES
                  NM/NPH=NON-PARTICIPATING HOSPITAL
                  NV/001=NEVADA
                  NV/CC=CARSON CITY
                  NV/LAB=LABORATORIES
                  NV/LV=LAS VEGAS
                  NV/NPH=NON-PARTICIPATING HOSPITAL
                  NY/001=BUFFALO
                  NY/002=ROCHESTER
                  NY/003=SYRACUSE
                  NY/004=ALBANY
                  NY/005=NEW ROCHELLE
                  NY/006=NEW YORK CITY
                  NY/007=SUFFOLK/NASSAU COUNTY
                  NY/LAB=LABORATORIES
                  NY/NPH=NON-PARTICIPATING HOSPITAL
                  OH/001=OHIO
                  OH/LAB=LABORATORIES
                  OH/NPH=NON-PARTICIPATING HOSPITAL
                  OK/001=OKLAHOMA
                  OK/LAB=LABORATORIES
                  OK/NPH=NON-PARTICIPATING HOSPITAL
                  OR/001=OFFICE #1
                  OR/002=OFFICE #2
                  OR/003=OFFICE #3
                  OR/LAB=LABORATORIES
                  OR/NPH=NON-PARTICIPATING HOSPITAL
                  PA/001=PENNSYLVANIA
                  PA/LAB=LABORATORIES
                  PA/NPH=NON-PARTICIPATING HOSPITAL
                  PR/001=PUERTO RICO
                  PR/LAB=LABORATORIES
                  PR/NPH=NON-PARTICIPATING HOSPITAL
                  PW/001=PALAU
                  PW/NPH=NON-PARTICIPATING HOSPITAL
                  RI/001=RHODE ISLAND
                  RI/LAB=LABORATORIES
                  RI/NPH=NON-PARTICIPATING HOSPITAL
                  SC/001=SOUTH CAROLINA
                  SC/LAB=LABORATORIES
                  SC/NPH=NON-PARTICIPATING HOSPITAL
                  SD/001=SOUTH DAKOTA
                  SD/LAB=LABORATORIES
                  SD/NPH=NON-PARTICIPATING HOSPITAL
                  TN/001=TENNESSEE
                  TN/LAB=LABORATORIES
                  TN/NPH=NON-PARTICIPATING HOSPITAL
                  TN/TNC=TENNESSEE COOKEVILLE
                  TN/TNE=TENNESSEE EASTERN
                  TN/TNM=TENNESSEE MIDDLE
                  TN/TNW=TENNESSEE WESTERN
                  TX/001=TEXAS
                  TX/L01=AMARILLO-LTC
                  TX/L02=ABILENE-LTC
                  TX/L03=ARLINGTON-LTC
                  TX/L04=TYLER-LTC
                  TX/L05=TEMPLE-LTC


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 20
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  TX/L06=HOUSTON-LTC
                  TX/L07=SAN ANTONIO-LTC
                  TX/LAB=LABORATORIES
                  TX/NPH=NON-PARTICIPATING HOSPITAL
                  TX/TX1=NLTC REG 1, 7, 9, 10
                  TX/TX2=NLTC REG 2, 3
                  TX/TX4=NLTC REG 6
                  TX/TX5=NLTC REG 4, 5
                  TX/TX6=AUSTIN
                  TX/TX8=NLTC REG 8, 11
                  UT/001=UTAH
                  UT/LAB=LABORATORIES
                  UT/NPH=NON-PARTICIPATING HOSPITAL
                  VA/001=VIRGINIA
                  VA/LAB=LABORATORIES
                  VA/NPH=NON-PARTICIPATING HOSPITAL
                  VI/001=VIRGIN ISLANDS
                  VI/LAB=LABORATORIES
                  VI/NPH=NON-PARTICIPATING HOSPITAL
                  VT/001=VERMONT
                  VT/LAB=LABORATORIES
                  VT/NPH=NON-PARTICIPATING HOSPITAL
                  WA/001=ALL OTHERS (NON-LTC FAC)
                  WA/D1=SPOKANE & YAKIMA AREAS
                  WA/D1A=District 1, Unit A
                  WA/D1B=District 1, Unit B
                  WA/D1C=District 1, Unit C
                  WA/D1D=District 1, Unit D
                  WA/D1E=District 1, Unit E
                  WA/D2=SPOKANE & SE
                  WA/D2A=District 2, Unit A
                  WA/D2B=District 2, Unit B
                  WA/D2C=District 2, Unit C
                  WA/D2D=District 2, Unit D
                  WA/D2E=District 2, Unit E
                  WA/D2F=District 2, Unit F
                  WA/D2G=District 2, Unit G
                  WA/D2H=District 2, Unit H
                  WA/D2I=District 2, Unit I
                  WA/D2J=District 2, Unit J
                  WA/D3=NW WASHINGTON
                  WA/D3A=District 3, Unit A
                  WA/D3B=District 3, Unit B
                  WA/D3C=District 3, Unit C
                  WA/D3D=District 3, Unit D
                  WA/D3E=District 3, Unit E
                  WA/D3F=District 3, Unit F
                  WA/D3G=District 3, Unit G
                  WA/D4A=GREATER SEATTLE AREA
                  WA/D4B=S KING COUNTY
                  WA/D5A=PIERCE CTY & PENINSULA
                  WA/D5B=PIERCE CTY & GRAYS HARBOR
                  WA/D6=OLYMPIA AREA
                  WA/LAB=LABORATORIES
                  WA/NPH=NON-PARTICIPATING HOSPITAL
                  WI/001=WISCONSIN
                  WI/LAB=LABORATORIES
                  WI/NPH=NON-PARTICIPATING HOSPITAL
                  WV/001=WEST VIRGINIA
                  WV/LAB=LABORATORIES
                  WV/NPH=NON-PARTICIPATING HOSPITAL
                  WY/001=WYOMING
                  WY/LAB=LABORATORIES
                  WY/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 21
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Address: Street                                   50   178   227  VARCHAR2
     Description: Street address where the provider is located.
     SAS Name:    ST_ADR
     COBOL Name:  ST-ADR

   Telephone Number                                  10   228   237  VARCHAR2
     Description: Telephone number of the provider.
     SAS Name:    PHNE_NUM
     COBOL Name:  PHNE-NUM

   Termination Code                                  2    238   239  VARCHAR2
     Description: Indicates the current termination status for the
                  provider.
     SAS Name:    PGM_TRMNTN_CD
     COBOL Name:  PGM-TRMNTN-CD
     VALUES:      00=ACTIVE PROVIDER
                  01=VOLUNTARY-MERGER, CLOSURE
                  02=VOLUNTARY-DISSATISFACTION WITH REIMBURSEMENT
                  03=VOLUNTARY-RISK OF INVOLUNTARY TERMINATION
                  04=VOLUNTARY-OTHER REASON FOR WITHDRAWAL
                  05=INVOLUNTARY-FAILURE TO MEET HEALTH/SAFETY REQ
                  06=INVOLUNTARY-FAILURE TO MEET AGREEMENT
                  07=OTHER-PROVIDER STATUS CHANGE
                  08=NONPAYMENT OF FEES - CLIA Only
                  09=REV/UNSUCCESSFUL PARTICIPATION IN PT - CLIA Only
                  10=REV/OTHER REASON - CLIA Only
                  11=INCOMPLETE CLIA APPLICATION INFORMATION - CLIA Only
                  12=NO LONGER PERFORMING TESTS - CLIA Only
                  13=MULTIPLE TO SINGLE SITE CERTIFICATE - CLIA Only
                  14=SHARED LABORATORY - CLIA Only
                  15=FAILURE TO RENEW WAIVER PPM CERTIFICATE - CLIA Only
                  16=DUPLICATE CLIA NUMBER - CLIA Only
                  17=MAIL RETURNED NO FORWARD ADDRESS CERT ENDED - CLIA Only
                  20=NOTIFICATION BANKRUPTCY - CLIA Only
                  33=ACCREDITATION NOT CONFIRMED - CLIA Only
                  80=AWAITING STATE APPROVAL
                  99=OIG ACTION - DO NOT ACTIVATE - CLIA Only

   Termination or Expiration Date                    8    240   247  DATE
     Description: Date the provider was terminated.  For CLIA providers,
                  date the laboratory's certificate was terminated or the
                  expiration date of the current CLIA certificate.
     SAS Name:    TRMNTN_EXPRTN_DT
     COBOL Name:  TRMNTN-EXPRTN-DT

   Type of Action Code                               1    248   248  VARCHAR2
     Description: Identifies the reason for the certification.  Type of
                  action from the official survey record, CMS 1539 form.
     SAS Name:    CRTFCTN_ACTN_TYPE_CD
     COBOL Name:  CRTFCTN-ACTN-TYPE-CD
     VALUES:      1=INITIAL
                  2=RECERTIFICATION
                  3=TERMINATION
                  4=CHANGE OF OWNERSHIP
                  5=VALIDATION
                  8=FULL SURVEY AFTER COMPLAINT

   Ownership Type Code                               2    249   250  VARCHAR2
     Description: Indicates the ownership type of the provider.
     SAS Name:    GNRL_CNTL_TYPE_CD
     COBOL Name:  GNRL-CNTL-TYPE-CD
     VALUES:      01=CHURCH
                  02=PRIVATE (NOT FOR PROFIT)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 22
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  03=OTHER (SPECIFY)
                  04=PRIVATE (FOR PROFIT)
                  05=FEDERAL
                  06=STATE
                  07=LOCAL
                  08=HOSPITAL DISTRICT OR AUTHORITY
                  09=PHYSICIAN OWNERSHIP
                  10=TRIBAL

   Address: ZIP Code                                 5    251   255  VARCHAR2
     Description: Five-digit ZIP code for a provider's physical address.
     SAS Name:    ZIP_CD
     COBOL Name:  ZIP-CD

   FIPS State Code                                   2    256   257  VARCHAR2
     Description: FIPS State Code
     SAS Name:    FIPS_STATE_CD
     COBOL Name:  FIPS-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  04=ARIZONA
                  05=ARKANSAS
                  06=CALIFORNIA
                  08=COLORADO
                  09=CONNECTICUT
                  10=DELAWARE
                  11=DISTRICT OF COLUMBIA
                  12=FLORIDA
                  13=GEORGIA
                  15=HAWAII
                  16=IDAHO
                  17=ILLINOIS
                  18=INDIANA
                  19=IOWA
                  20=KANSAS
                  21=KENTUCKY
                  22=LOUISIANA
                  23=MAINE
                  24=MARYLAND
                  25=MASSACHUSETTS
                  26=MICHIGAN
                  27=MINNESOTA
                  28=MISSISSIPPI
                  29=MISSOURI
                  30=MONTANA
                  31=NEBRASKA
                  32=NEVADA
                  33=NEW HAMPSHIRE
                  34=NEW JERSEY
                  35=NEW MEXICO
                  36=NEW YORK
                  37=NORTH CAROLINA
                  38=NORTH DAKOTA
                  39=OHIO
                  40=OKLAHOMA
                  41=OREGON
                  42=PENNSYLVANIA
                  43=PUERTO RICO
                  44=RHODE ISLAND
                  45=SOUTH CAROLINA
                  46=SOUTH DAKOTA
                  47=TENNESSEE
                  48=TEXAS
                  49=UTAH


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 23
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  50=VERMONT
                  51=VIRGINIA
                  53=WASHINGTON
                  54=WEST VIRGINIA
                  55=WISCONSIN
                  56=WYOMING
                  60=AMERICAN SAMOA
                  66=GUAM
                  69=SAIPAN/MARIANA IS.
                  78=VIRGIN ISLANDS

   FIPS County Code                                  3    258   260  VARCHAR2
     Description: FIPS County Code
     SAS Name:    FIPS_CNTY_CD
     COBOL Name:  FIPS-CNTY-CD

   CBSA Urban Rural Indicator                        1    261   261  VARCHAR2
     Description: CBSA (Core Based Statistical Area) indicates whether the
                  county is defined as Urban or Rural.
     SAS Name:    CBSA_URBN_RRL_IND
     COBOL Name:  CBSA-URBN-RRL-IND

   CBSA Code                                         5    262   266  VARCHAR2
     Description: CBSA (Core Based Statistical Area) geographic entities
                  defined by the U.S. Office of Management and Budget (OMB)
                  on June 6, 2003 for use by Federal statistical agencies
                  in collecting, tabulating, and publishing Federal
                  statistics.  CBSA collectively refers to MSA.
     SAS Name:    CBSA_CD
     COBOL Name:  CBSA-CD

   Accreditation Effective Date                      8    267   274  DATE
     Description: Effective date of the period of accreditation associated
                  with this certification.
     SAS Name:    ACRDTN_EFCTV_DT
     COBOL Name:  ACRDTN-EFCTV-DT

   Accreditation Expiration Date                     8    275   282  DATE
     Description: Expiration date of the period of accreditation associated
                  with this certification.
     SAS Name:    ACRDTN_EXPRTN_DT
     COBOL Name:  ACRDTN-EXPRTN-DT

  *Accreditation Type Code                           1    283   283  VARCHAR2
     Description: Indicates an accrediting organization deeming the
                  provider.  If a provider is deemed by multiple
                  accrediting organizations then the accrediting
                  organization with the earliest active deeming effective
                  date is displayed in this field.
     SAS Name:    ACRDTN_TYPE_CD
     COBOL Name:  ACRDTN-TYPE-CD
     VALUES:      0=NOT ACCREDITED
                  1=JC
                  2=AOA/HFAP
                  3=DNV
                  7=ACHC
                  9=CIHQ

   Affiliated Count: Ambulance Services              2    284   285  NUMBER
     Description: Number of affiliated Medicare participating ambulance
                  services.
     SAS Name:    TOT_AFLTD_AMBLNC_SRVC_CNT
     COBOL Name:  TOT-AFLTD-AMBLNC-SRVC-CNT



 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 24
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

   Affiliated Count: ASC                             2    286   287  NUMBER
     Description: Number of affiliated Medicare participating ambulatory
                  surgery centers.
     SAS Name:    TOT_AFLTD_ASC_CNT
     COBOL Name:  TOT-AFLTD-ASC-CNT

   Affiliated Count: Co-Located Hospital             2    288   289  NUMBER
     Description: Number of affiliated Medicare participating co-located
                  hospitals.
     SAS Name:    TOT_COLCTD_HOSP_CNT
     COBOL Name:  TOT-COLCTD-HOSP-CNT

   Affiliated Count: ESRD                            2    290   291  NUMBER
     Description: Number of affiliated Medicare participating end-stage
                  renal disease units.
     SAS Name:    TOT_AFLTD_ESRD_CNT
     COBOL Name:  TOT-AFLTD-ESRD-CNT

   Affiliated Count: FQHC                            2    292   293  NUMBER
     Description: Number of affiliated Medicare participating federally
                  qualified health centers.
     SAS Name:    TOT_AFLTD_FQHC_CNT
     COBOL Name:  TOT-AFLTD-FQHC-CNT

   Affiliated Count: HHA                             2    294   295  NUMBER
     Description: Number of affiliated Medicare participating home health
                  agencies.
     SAS Name:    TOT_AFLTD_HHA_CNT
     COBOL Name:  TOT-AFLTD-HHA-CNT

   Affiliated Count: Hospice                         2    296   297  NUMBER
     Description: Number of affiliated Medicare participating hospices.
     SAS Name:    TOT_AFLTD_HOSPC_CNT
     COBOL Name:  TOT-AFLTD-HOSPC-CNT

   Affiliated Count: OPO                             2    298   299  NUMBER
     Description: Number of affiliated Medicare participating organ
                  procurement organizations.
     SAS Name:    TOT_AFLTD_OPO_CNT
     COBOL Name:  TOT-AFLTD-OPO-CNT

   Affiliated Count: PRTF                            2    300   301  NUMBER
     Description: Number of affiliated Medicare participating psychiatric
                  residential treatment facilities.
     SAS Name:    TOT_AFLTD_PRTF_CNT
     COBOL Name:  TOT-AFLTD-PRTF-CNT

   Affiliated Count: RHC                             2    302   303  NUMBER
     Description: Number of affiliated Medicare participating rural health
                  centers.
     SAS Name:    TOT_AFLTD_RHC_CNT
     COBOL Name:  TOT-AFLTD-RHC-CNT

   Affiliated Count: SNF                             2    304   305  NUMBER
     Description: Number of affiliated Medicare participating skilled
                  nursing facilities.
     SAS Name:    TOT_AFLTD_SNF_CNT
     COBOL Name:  TOT-AFLTD-SNF-CNT

   Affiliated Count: Total                           2    306   307  NUMBER
     Description: Number of affiliated providers.
     SAS Name:    AFLTD_PRVDR_CNT
     COBOL Name:  AFLTD-PRVDR-CNT



 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 25
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

   Affiliated Resident Program: Allopathic           1    308   308  VARCHAR2
     Description: Indicates if the provider has an affiliated allopathic
                  resident program.
     SAS Name:    RSDNT_PGM_ALPTHC_SW
     COBOL Name:  RSDNT-PGM-ALPTHC-SW

   Affiliated Resident Program: Dental               1    309   309  VARCHAR2
     Description: Indicates if the provider has an affiliated dental
                  resident program.
     SAS Name:    RSDNT_PGM_DNTL_SW
     COBOL Name:  RSDNT-PGM-DNTL-SW

   Affiliated Resident Program: Osteopathic          1    310   310  VARCHAR2
     Description: Indicates if the provider has an affiliated osteopathic
                  resident program.
     SAS Name:    RSDNT_PGM_OSTPTHC_SW
     COBOL Name:  RSDNT-PGM-OSTPTHC-SW

   Affiliated Resident Program: Other                1    311   311  VARCHAR2
     Description: Indicates if the provider has any other affiliated
                  resident program.
     SAS Name:    RSDNT_PGM_OTHR_SW
     COBOL Name:  RSDNT-PGM-OTHR-SW

   Affiliated Resident Program: Podiatric            1    312   312  VARCHAR2
     Description: Indicates if the provider has an affiliated podiatric
                  resident program.
     SAS Name:    RSDNT_PGM_PDTRC_SW
     COBOL Name:  RSDNT-PGM-PDTRC-SW

   Services: Pharmacy Code                           1    314   314  CHAR
     Description: Indicates how pharmaceutical services are provided.
     SAS Name:    PHRMCY_SRVC_CD
     COBOL Name:  PHRMCY-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Bed Count Override Indicator                      1    325   325  CHAR
     Description: Indicates if the regional office has approved a
                  significant bed count change from the previous
                  certification.
     SAS Name:    OVRRD_BED_CNT_SW
     COBOL Name:  OVRRD-BED-CNT-SW

   Bed Count: Certified                              4    326   329  NUMBER
     Description: Number of beds in Medicare and/or Medicaid certified
                  areas within a facility.
     SAS Name:    CRTFD_BED_CNT
     COBOL Name:  CRTFD-BED-CNT

   Bed Count: Total                                  4    373   376  NUMBER
     Description: Total number of beds in a provider, including those in
                  non-participating or non-licensed areas.
     SAS Name:    BED_CNT
     COBOL Name:  BED-CNT

   CAH Psychiatric DPU Indicator                     1    381   381  VARCHAR2
     Description: Indicates if a Critical Access Hospital has a psychiatric
                  Prospective Payment System-excluded distinct part unit.
     SAS Name:    CAH_PSYCH_DPU_SW
     COBOL Name:  CAH-PSYCH-DPU-SW



 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 26
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

   CAH Rehabilitation DPU Indicator                  1    382   382  VARCHAR2
     Description: Indicates if a Critical Access Hospital rehabilitation
                  unit has a Prospective Payment System-excluded distinct
                  part unit.
     SAS Name:    CAH_REHAB_DPU_SW
     COBOL Name:  CAH-REHAB-DPU-SW

   CAH Swing Bed Indicator                           1    383   383  VARCHAR2
     Description: Indicates if a Critical Access Hospital has been approved
                  to provide nursing home and/or hospital services.
     SAS Name:    CAH_SB_SW
     COBOL Name:  CAH-SB-SW

   Cardiac Catheterization Procedure Room Count      4    384   387  NUMBER
     Description: Number of cardiac catheterization procedure rooms.
     SAS Name:    CRDC_CTHRTZTN_PRCDR_ROOMS_CNT
     COBOL Name:  CRDC-CTHRTZTN-PRCDR-ROOMS-CNT

   Category-specific Facility Type Code              2    388   389  VARCHAR2
     Description: Indicates the category-specific facility type code, for
                  certain provider categories only.
     SAS Name:    GNRL_FAC_TYPE_CD
     COBOL Name:  GNRL-FAC-TYPE-CD
     VALUES:      01=Short - Term
                  02=Long - Term
                  03=Religious Non-Medical Health Care Institution
                  04=Psychiatric
                  05=Rehabilitation
                  06=Childrens
                  07=Distinct Part Psychiatric Hospital
                  11=Critical Access Hospitals

   CLIA ID Number 1                                  10   391   400  CHAR
     Description: CLIA ID number 1
     SAS Name:    CLIA_ID_NUMBER_1
     COBOL Name:  CLIA-ID-NUMBER-1

   CLIA ID Number 2                                  10   401   410  CHAR
     Description: CLIA ID number 2
     SAS Name:    CLIA_ID_NUMBER_2
     COBOL Name:  CLIA-ID-NUMBER-2

   CLIA ID Number 3                                  10   411   420  CHAR
     Description: CLIA ID number 3
     SAS Name:    CLIA_ID_NUMBER_3
     COBOL Name:  CLIA-ID-NUMBER-3

   CLIA ID Number 4                                  10   421   430  CHAR
     Description: CLIA ID number 4
     SAS Name:    CLIA_ID_NUMBER_4
     COBOL Name:  CLIA-ID-NUMBER-4

   CLIA ID Number 5                                  10   431   440  CHAR
     Description: CLIA ID number 5
     SAS Name:    CLIA_ID_NUMBER_5
     COBOL Name:  CLIA-ID-NUMBER-5

   Co-Location Indicator                             1    441   441  VARCHAR2
     Description: Indicates if the facility shares a location with another
                  hospital.
     SAS Name:    COLCTN_STUS_SW
     COBOL Name:  COLCTN-STUS-SW

   Compliance: 24-Hour RN Waiver Indicator           1    442   442  CHAR


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                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Indicates if a waiver of the 24-hour registered nurse
                  staffing requirements has been recommended for a Skilled
                  Nursing Facility or Nursing Facility.
     SAS Name:    RN_24_HR_WVR_SW
     COBOL Name:  RN-24-HR-WVR-SW

   Compliance: LSC Waiver Indicator                  1    445   445  CHAR
     Description: Indicates if a waiver of any life safety code provision
                  has been recommended for a provider.
     SAS Name:    LSC_WVR_SW
     COBOL Name:  LSC-WVR-SW

   Endoscopy Procedure Room Count                    4    447   450  NUMBER
     Description: Number of endoscopy procedure rooms.
     SAS Name:    ENDSCPY_PRCDR_ROOMS_CNT
     COBOL Name:  ENDSCPY-PRCDR-ROOMS-CNT

   Fax Phone Number                                  10   454   463  VARCHAR2
     Description: 10-digit fax phone number of the primary contact or the
                  operator of the provider.
     SAS Name:    FAX_PHNE_NUM
     COBOL Name:  FAX-PHNE-NUM

   Fiscal Year End Date (MMDD)                       4    464   467  VARCHAR2
     Description: End date, consisting of the month and day, of the
                  provider's fiscal year.
     SAS Name:    FY_END_MO_DAY_CD
     COBOL Name:  FY-END-MO-DAY-CD

   Medical School Affiliation Code                   1    495   495  VARCHAR2
     Description: Type of affiliation that a hospital has with a medical
                  school.
     SAS Name:    MDCL_SCHL_AFLTN_CD
     COBOL Name:  MDCL-SCHL-AFLTN-CD
     VALUES:      1=MAJOR
                  2=LIMITED
                  3=GRADUATE
                  4=NO AFFILIATION

   Medicare or Medicaid Participating Provider Indicator 1    506   506  VARCHAR2
     Description: Indicates if a provider is participating in the Medicaid
                  or Medicare or both programs.
     SAS Name:    MDCD_MDCR_PRTCPTG_PRVDR_SW
     COBOL Name:  MDCD-MDCR-PRTCPTG-PRVDR-SW

   Necessary Provider Designation Date               8    552   559  DATE
     Description: Date the provider was designated as a Necessary Provider.
     SAS Name:    NCRY_PRVDR_DSGNTD_DT
     COBOL Name:  NCRY-PRVDR-DSGNTD-DT

   Necessary Provider Indicator                      1    560   560  VARCHAR2
     Description: Indicates if the provider is designated as Necessary
                  Provider.
     SAS Name:    NCRY_PRVDR_DSGNTD_AS_SW
     COBOL Name:  NCRY-PRVDR-DSGNTD-AS-SW

   Necessary Provider Lost Designation Date          8    561   568  DATE
     Description: Date the provider lost designation as a Necessary
                  Provider.
     SAS Name:    NCRY_PRVDR_LOST_DT
     COBOL Name:  NCRY-PRVDR-LOST-DT

   Non-Participating Hospital Meets 1861(e) Indicator 1    569   569  VARCHAR2
     Description: Indicates if a non-participating emergency hospital meets


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 28
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  the definition of 'hospital' contained in Section 1861(e)
                  of the Social Security Act.
     SAS Name:    MEET_1861_SW
     COBOL Name:  MEET-1861-SW

   Non-Participating Hospital Type Code              1    570   570  VARCHAR2
     Description: Indicates if a non-participating hospital is classified
                  as a federal hospital or an emergency non-federal
                  hospital.
     SAS Name:    NPP_TYPE_CD
     COBOL Name:  NPP-TYPE-CD
     VALUES:      E=Non-Participating Emergency Hospital
                  F=Non-Participating Federal Hospital

   Off-Site Count: Cancer Hospital Satellites        4    571   574  NUMBER
     Description: Number of off-site satellites of a cancer hospital.
     SAS Name:    TOT_OFSITE_CNCR_HOSP_CNT
     COBOL Name:  TOT-OFSITE-CNCR-HOSP-CNT

   Off-Site Count: Childrens Hospital Satellites     4    575   578  NUMBER
     Description: Number of off-site satellites of a children's hospital.
     SAS Name:    TOT_OFSITE_CHLDRN_HOSP_CNT
     COBOL Name:  TOT-OFSITE-CHLDRN-HOSP-CNT

   Off-Site Count: Emergency Departments             4    579   582  NUMBER
     Description: Number of off-site emergency departments.
     SAS Name:    TOT_OFSITE_EMER_DEPT_CNT
     COBOL Name:  TOT-OFSITE-EMER-DEPT-CNT

   Off-Site Count: Inpatient Remote Locations        4    583   586  NUMBER
     Description: Number of inpatient remote locations.
     SAS Name:    TOT_OFSITE_INPTNT_LCTN_CNT
     COBOL Name:  TOT-OFSITE-INPTNT-LCTN-CNT

   Off-Site Count: LTC Hospital Satellites           4    587   590  NUMBER
     Description: Number of off-site satellites of a long term care
                  hospital.
     SAS Name:    TOT_OFSITE_LTC_HOSP_CNT
     COBOL Name:  TOT-OFSITE-LTC-HOSP-CNT

   Off-Site Count: Ophthalmic Surgery Units          4    591   594  NUMBER
     Description: Number of off-site ophthalmic surgery units.
     SAS Name:    TOT_OFSITE_OPTHLMC_SRGRY_CNT
     COBOL Name:  TOT-OFSITE-OPTHLMC-SRGRY-CNT

   Off-Site Count: Other Locations                   4    595   598  NUMBER
     Description: Number of other off-site locations.
     SAS Name:    TOT_OFSITE_OTHR_LCTN_CNT
     COBOL Name:  TOT-OFSITE-OTHR-LCTN-CNT

   Off-Site Count: Psychiatric Hospitals             4    599   602  NUMBER
     Description: Number of off-site psychiatric hospitals.
     SAS Name:    TOT_OFSITE_PSYCH_HOSP_CNT
     COBOL Name:  TOT-OFSITE-PSYCH-HOSP-CNT

   Off-Site Count: Psychiatric Units                 4    603   606  NUMBER
     Description: Number of off-site psychiatric units.
     SAS Name:    TOT_OFSITE_PSYCH_UNIT_CNT
     COBOL Name:  TOT-OFSITE-PSYCH-UNIT-CNT

   Off-Site Count: Rehabilitation Hospitals          4    607   610  NUMBER
     Description: Number of off-site rehabilitation hospitals.
     SAS Name:    TOT_OFSITE_REHAB_HOSP_CNT
     COBOL Name:  TOT-OFSITE-REHAB-HOSP-CNT


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                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Off-Site Count: Rehabilitation Units              4    611   614  NUMBER
     Description: Number of off-site rehabilitation units.
     SAS Name:    TOT_OFSITE_REHAB_UNIT_CNT
     COBOL Name:  TOT-OFSITE-REHAB-UNIT-CNT

   Off-Site Count: Urgent Care Centers               4    615   618  NUMBER
     Description: Number of off-site urgent care centers.
     SAS Name:    TOT_OFSITE_URGNT_CARE_CNTR_CNT
     COBOL Name:  TOT-OFSITE-URGNT-CARE-CNTR-CNT

   Off-Site Location Count                           3    619   621  NUMBER
     Description: Number of off-site locations.
     SAS Name:    OFSITE_LCTN_CNT
     COBOL Name:  OFSITE-LCTN-CNT

   Operating Room Count                              4    622   625  NUMBER
     Description: Number of operating rooms in an ambulatory surgical
                  center.
     SAS Name:    OPRTG_ROOM_CNT
     COBOL Name:  OPRTG-ROOM-CNT

   Program Participation Code                        1    640   640  CHAR
     Description: Indicates if the provider participates in Medicare,
                  Medicaid, or both programs.
     SAS Name:    PGM_PRTCPTN_CD
     COBOL Name:  PGM-PRTCPTN-CD
     VALUES:      1=MEDICARE ONLY
                  2=MEDICAID ONLY
                  3=MEDICARE AND MEDICAID

   Province Code                                     2    642   643  VARCHAR2
     Description: Canadian province where a non-participating emergency
                  hospital is located.
     SAS Name:    PRVNC_CD
     COBOL Name:  PRVNC-CD
     VALUES:      AB=ALBERTA
                  BC=BRITISH COLUMBIA
                  LB=LABRADOR
                  MB=MANITOBA
                  NB=NEW BRUNSWICK
                  NF=NEWFOUNDLAND
                  NS=NOVA SCOTIA
                  NT=NORTHWEST TERRITORIES
                  ON=ONTARIO
                  PE=PRINCE EDWARD ISLAND
                  PQ=QUEBEC
                  SK=SASKATCHEWAN
                  YT=YUKON TERRITORY

   Psychiatric Unit Bed Count                        3    644   646  NUMBER
     Description: Number of beds in a Prospective Payment System (PPS)
                  -exempt psychiatric unit of a hospital.
     SAS Name:    PSYCH_UNIT_BED_CNT
     COBOL Name:  PSYCH-UNIT-BED-CNT

   Psychiatric Unit Effective Date                   8    647   654  DATE
     Description: Date a psychiatric unit of a hospital became exempt from
                  the Prospective Payment System (PPS).
     SAS Name:    PSYCH_UNIT_EFCTV_DT
     COBOL Name:  PSYCH-UNIT-EFCTV-DT

   Psychiatric Unit Indicator                        1    655   655  VARCHAR2
     Description: Indicates if a hospital has a Prospective Payment System


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                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  (PPS) -exempt psychiatric unit.
     SAS Name:    PSYCH_UNIT_SW
     COBOL Name:  PSYCH-UNIT-SW

   Psychiatric Unit Termination Code                 1    656   656  VARCHAR2
     Description: Indicates the reason that a psychiatric unit of a
                  hospital is no longer exempt from Prospective Payment
                  System (PPS).
     SAS Name:    PSYCH_UNIT_TRMNTN_CD
     COBOL Name:  PSYCH-UNIT-TRMNTN-CD
     VALUES:      0=ACTIVE
                  1=VOLUNTARY-MERGER OR CLOSURE
                  2=VOLUNTARY-DISSATISFIED WITH REIMBURSEMENT
                  3=RISK OF INVOLUNTARY TERMINATION
                  4=VOLUNTARY-OTHER
                  5=FAILURE TO MEET HEALTH/SAFETY
                  6=FAILURE TO MEET AGREEMENT
                  7=PROVIDER STATUS CHANGE

   Psychiatric Unit Termination Date                 8    657   664  DATE
     Description: Date a psychiatric unit of a hospital is no longer exempt
                  from the Prospective Payment System (PPS).
     SAS Name:    PSYCH_UNIT_TRMNTN_DT
     COBOL Name:  PSYCH-UNIT-TRMNTN-DT

   Rehabilitation Unit Bed Count                     3    665   667  NUMBER
     Description: Number of beds in a Prospective Payment System (PPS)
                  -exempt rehabilitation unit of a hospital.
     SAS Name:    REHAB_UNIT_BED_CNT
     COBOL Name:  REHAB-UNIT-BED-CNT

   Rehabilitation Unit Effective Date                8    668   675  DATE
     Description: Date a rehabilitation unit of a hospital became exempt
                  from the Prospective Payment System (PPS).
     SAS Name:    REHAB_UNIT_EFCTV_DT
     COBOL Name:  REHAB-UNIT-EFCTV-DT

   Rehabilitation Unit Indicator                     1    676   676  VARCHAR2
     Description: Indicates if a hospital has a Prospective Payment System
                  (PPS) -exempt rehabilitation unit.
     SAS Name:    REHAB_UNIT_SW
     COBOL Name:  REHAB-UNIT-SW

   Rehabilitation Unit Termination Code              1    677   677  VARCHAR2
     Description: Indicates the reason that a rehabilitation unit hospital
                  is no longer exempt from Prospective Payment System
                  (PPS).
     SAS Name:    REHAB_UNIT_TRMNTN_CD
     COBOL Name:  REHAB-UNIT-TRMNTN-CD
     VALUES:      0=ACTIVE
                  1=VOLUNTARY-MERGER OR CLOSURE
                  2=VOLUNTARY-DISSATISFIED WITH REIMBURSEMENT
                  3=RISK OF INVOLUNTARY TERMINATION
                  4=VOLUNTARY-OTHER
                  5=FAILURE TO MEET HEALTH/SAFETY
                  6=FAILURE TO MEET AGREEMENT
                  7=PROVIDER STATUS CHANGE

   Rehabilitation Unit Termination Date              8    678   685  DATE
     Description: Date a rehabilitation unit of a hospital is no longer
                  exempt from the Prospective Payment System (PPS).
     SAS Name:    REHAB_UNIT_TRMNTN_DT
     COBOL Name:  REHAB-UNIT-TRMNTN-DT



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                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

   Related Provider Number                           10   686   695  CHAR
     Description: Related provider number
     SAS Name:    RELATED_PROVIDER_NUMBER
     COBOL Name:  RELATED-PROVIDER-NUMBER

   Services: Acute Renal Dialysis Code               1    696   696  VARCHAR2
     Description: Indicates how acute renal dialysis services are provided.
     SAS Name:    ACUTE_RNL_DLYS_SRVC_CD
     COBOL Name:  ACUTE-RNL-DLYS-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Adult Inpatient Psychiatric Code        1    697   697  VARCHAR2
     Description: Indicates how adult inpatient psychiatric services are
                  provided.
     SAS Name:    PSYCH_SRVC_CD
     COBOL Name:  PSYCH-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Alcohol and/or Drug Code                1    699   699  VARCHAR2
     Description: Indicates how alcohol and/or drug services are provided.
     SAS Name:    ALCHL_DRUG_SRVC_CD
     COBOL Name:  ALCHL-DRUG-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Anesthesia Code                         1    700   700  VARCHAR2
     Description: Indicates how anesthesia services are provided.
     SAS Name:    ANSTHSA_SRVC_CD
     COBOL Name:  ANSTHSA-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Audiology Code                          1    702   702  VARCHAR2
     Description: Indicates how audiology services are provided.
     SAS Name:    AUDLGY_SRVC_CD
     COBOL Name:  AUDLGY-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Burn Care Unit Code                     1    706   706  VARCHAR2
     Description: Indicates how burn care unit services are provided.
     SAS Name:    BURN_CARE_UNIT_SRVC_CD
     COBOL Name:  BURN-CARE-UNIT-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Cardiac Catheterization Lab Code        1    707   707  VARCHAR2
     Description: Indicates how cardiac catheterization lab services are
                  provided.
     SAS Name:    CRDC_CTHRTZTN_LAB_SRVC_CD


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                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     COBOL Name:  CRDC-CTHRTZTN-LAB-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Cardiac Thoracic Surgery Code           1    708   708  VARCHAR2
     Description: Indicates how cardiac thoracic surgery services are
                  provided.
     SAS Name:    OPEN_HRT_SRGRY_SRVC_CD
     COBOL Name:  OPEN-HRT-SRGRY-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: CARF Inpatient Rehabilitation Code      1    709   709  VARCHAR2
     Description: Indicates how Commission on Accreditation of
                  Rehabilitation Facilities inpatient rehabilitation
                  services are provided.
     SAS Name:    CARF_IP_REHAB_SRVC_CD
     COBOL Name:  CARF-IP-REHAB-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Chemotherapy Code                       1    710   710  VARCHAR2
     Description: Indicates how chemotherapy services are provided.
     SAS Name:    CHMTHRPY_SRVC_CD
     COBOL Name:  CHMTHRPY-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Chiropractic Code                       1    711   711  VARCHAR2
     Description: Indicates how chiropractic services are provided.
     SAS Name:    CHRPRCTIC_SRVC_CD
     COBOL Name:  CHRPRCTIC-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Clinical Laboratory Code                1    715   715  VARCHAR2
     Description: Indicates how clinical laboratory services are provided.
     SAS Name:    CL_SRVC_CD
     COBOL Name:  CL-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Coronary Care Unit Code                 1    716   716  VARCHAR2
     Description: Indicates how Coronary Care Unit services are provided.
     SAS Name:    CRNRY_CARE_UNIT_SRVC_CD
     COBOL Name:  CRNRY-CARE-UNIT-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: CT Scan Code                            1    718   718  VARCHAR2


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                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Indicates how CT scan services are provided.
     SAS Name:    CT_SCAN_SRVC_CD
     COBOL Name:  CT-SCAN-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Dental Code                             1    719   719  VARCHAR2
     Description: Indicates how dental services are provided.
     SAS Name:    DNTL_SRVC_CD
     COBOL Name:  DNTL-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Designated Trauma Center Code           1    723   723  VARCHAR2
     Description: Indicates how designated trauma center services are
                  provided.
     SAS Name:    SHCK_TRMA_SRVC_CD
     COBOL Name:  SHCK-TRMA-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Diagnostic Radiology Code               1    724   724  VARCHAR2
     Description: Indicates how diagnostic radiology services are provided.
     SAS Name:    DGNSTC_RDLGY_SRVC_CD
     COBOL Name:  DGNSTC-RDLGY-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Dietary Code                            1    725   725  VARCHAR2
     Description: Indicates how dietary services are provided.
     SAS Name:    DTRY_SRVC_CD
     COBOL Name:  DTRY-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Emergency Department Code               1    729   729  VARCHAR2
     Description: Indicates how dedicated emergency department services are
                  provided.
     SAS Name:    DCTD_ER_SRVC_CD
     COBOL Name:  DCTD-ER-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Emergency Psychiatric Code              1    730   730  VARCHAR2
     Description: Indicates how emergency psychiatric services are
                  provided.
     SAS Name:    EMER_PSYCH_SRVC_CD
     COBOL Name:  EMER-PSYCH-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT


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                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Services: ESWL Code                               1    731   731  VARCHAR2
     Description: Indicates how extracorporeal shockwave lithotripter
                  services are provided.
     SAS Name:    XTRCRPRL_SHCK_LTHTRPTR_SRVC_CD
     COBOL Name:  XTRCRPRL-SHCK-LTHTRPTR-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Forensic Psychiatric Code               1    732   732  VARCHAR2
     Description: Indicates how forensic psychiatric services are provided.
     SAS Name:    FRNSC_PSYCH_SRVC_CD
     COBOL Name:  FRNSC-PSYCH-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Geriatric Psychiatric Code              1    733   733  VARCHAR2
     Description: Indicates how geriatric psychiatric services are
                  provided.
     SAS Name:    GRTRC_PSYCH_SRVC_CD
     COBOL Name:  GRTRC-PSYCH-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Gerontological Specialty Code           1    734   734  VARCHAR2
     Description: Indicates how gerontological specialty services are
                  provided.
     SAS Name:    GRNTLGCL_SPCLTY_SRVC_CD
     COBOL Name:  GRNTLGCL-SPCLTY-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Inpatient Surgical Code                 1    741   741  VARCHAR2
     Description: Indicates how inpatient surgical services are provided.
     SAS Name:    IP_SRGCL_SRVC_CD
     COBOL Name:  IP-SRGCL-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Medical Surgical ICU Code               1    745   745  VARCHAR2
     Description: Indicates how medical surgical intensive care unit
                  services are provided.
     SAS Name:    ICU_SRVC_CD
     COBOL Name:  ICU-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Medicare Certified Transplant Center Code 1    746   746  VARCHAR2
     Description: Indicates how Medicare certified transplant center
                  services are provided.
     SAS Name:    MDCR_TRNSPLNT_CNTR_SRVC_CD
     COBOL Name:  MDCR-TRNSPLNT-CNTR-SRVC-CD


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                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: MRI Code                                1    750   750  VARCHAR2
     Description: Indicates how magnetic resonance imaging services are
                  provided.
     SAS Name:    MGNTC_RSNC_IMG_SRVC_CD
     COBOL Name:  MGNTC-RSNC-IMG-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Neonatal ICU Code                       1    751   751  VARCHAR2
     Description: Indicates how neonatal intensive care unit services are
                  provided.
     SAS Name:    NEONTL_ICU_SRVC_CD
     COBOL Name:  NEONTL-ICU-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Neonatal Nursery Code                   1    752   752  VARCHAR2
     Description: Indicates how neonatal nursery services are provided.
     SAS Name:    NEONTL_NRSRY_SRVC_CD
     COBOL Name:  NEONTL-NRSRY-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Neurosurgical Code                      1    753   753  VARCHAR2
     Description: Indicates how neurosurgical services are provided.
     SAS Name:    NRSRGCL_SRVC_CD
     COBOL Name:  NRSRGCL-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Non-Medicare Organ Transplant Code      1    754   754  VARCHAR2
     Description: Indicates how non-Medicare certified organ transplant
                  services are provided.
     SAS Name:    ORGN_TRNSPLNT_SRVC_CD
     COBOL Name:  ORGN-TRNSPLNT-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Nuclear Medicine Code                   1    755   755  VARCHAR2
     Description: Indicates how nuclear medicine services are provided.
     SAS Name:    NUCLR_MDCN_SRVC_CD
     COBOL Name:  NUCLR-MDCN-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Obstetrics Code                         1    764   764  VARCHAR2
     Description: Indicates how obstetrics services are provided.


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                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     SAS Name:    OB_SRVC_CD
     COBOL Name:  OB-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Ophthalmic Surgery Code                 1    765   765  VARCHAR2
     Description: Indicates how ophthalmic surgery services are provided.
     SAS Name:    OPTHLMC_SRGY_SRVC_CD
     COBOL Name:  OPTHLMC-SRGY-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Optometric Code                         1    766   766  VARCHAR2
     Description: Indicates how optometric services are provided.
     SAS Name:    OPTMTRC_SRVC_CD
     COBOL Name:  OPTMTRC-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: OR Code                                 1    767   767  VARCHAR2
     Description: Indicates how operating room services are provided.
     SAS Name:    OPRTG_ROOM_SRVC_CD
     COBOL Name:  OPRTG-ROOM-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Orthopedic Surgery Code                 1    768   768  VARCHAR2
     Description: Indicates how orthopedic surgery services are provided.
     SAS Name:    ORTHPDC_SRGY_SRVC_CD
     COBOL Name:  ORTHPDC-SRGY-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: OT Code                                 1    775   775  CHAR
     Description: Indicates how occupational therapy services are provided.
     SAS Name:    OT_SRVC_CD
     COBOL Name:  OT-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Outpatient Code                         1    780   780  VARCHAR2
     Description: Indicates how outpatient services are provided.
     SAS Name:    OP_SRVC_CD
     COBOL Name:  OP-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Outpatient Psychiatric Code             1    781   781  VARCHAR2
     Description: Indicates how outpatient psychiatric services are
                  provided.


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                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     SAS Name:    OP_PSYCH_SRVC_CD
     COBOL Name:  OP-PSYCH-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Outpatient Rehabilitation Code          1    782   782  VARCHAR2
     Description: Indicates how outpatient rehabilitation services are
                  provided.
     SAS Name:    OP_REHAB_SRVC_CD
     COBOL Name:  OP-REHAB-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Outpatient Surgery Code                 1    783   783  VARCHAR2
     Description: Indicates how outpatient surgery services are provided.
     SAS Name:    OP_SRGRY_UNIT_SRVC_CD
     COBOL Name:  OP-SRGRY-UNIT-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Pediatric Code                          1    784   784  VARCHAR2
     Description: Indicates how pediatric services are provided.
     SAS Name:    PED_SRVC_CD
     COBOL Name:  PED-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Pediatric ICU Code                      1    785   785  VARCHAR2
     Description: Indicates how pediatric ICU services are provided.
     SAS Name:    PED_ICU_SRVC_CD
     COBOL Name:  PED-ICU-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: PET Scan Code                           1    788   788  VARCHAR2
     Description: Indicates how Positron Emissions Tomography scan services
                  are provided.
     SAS Name:    PET_SCAN_SRVC_CD
     COBOL Name:  PET-SCAN-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Postoperative Recovery Room Code        1    805   805  VARCHAR2
     Description: Indicates how postoperative recovery room services are
                  provided.
     SAS Name:    PSTOPRTV_RCVRY_SRVC_CD
     COBOL Name:  PSTOPRTV-RCVRY-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT



 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 38
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

   Services: Psychiatric Child and/or Adolescent Code 1    806   806  VARCHAR2
     Description: Indicates how child and/or adolescent psychiatric
                  services are provided.
     SAS Name:    CHLD_ADLSCNT_PSYCH_SRVC_CD
     COBOL Name:  CHLD-ADLSCNT-PSYCH-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: PT Code                                 1    813   813  CHAR
     Description: Indicates how physical therapy services are provided.
     SAS Name:    PT_SRVC_CD
     COBOL Name:  PT-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Reconstructive Surgery Code             1    817   817  VARCHAR2
     Description: Indicates how reconstructive surgery services are
                  provided.
     SAS Name:    RCNSTRCTN_SRGY_SRVC_CD
     COBOL Name:  RCNSTRCTN-SRGY-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Respiratory Care Code                   1    821   821  VARCHAR2
     Description: Indicates how respiratory care services are provided.
     SAS Name:    RSPRTRY_CARE_SRVC_CD
     COBOL Name:  RSPRTRY-CARE-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Social Code                             1    826   826  VARCHAR2
     Description: Indicates how social services are provided.
     SAS Name:    SCL_SRVC_CD
     COBOL Name:  SCL-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Speech Pathology Code                   1    833   833  CHAR
     Description: Indicates how speech pathology services are provided.
     SAS Name:    SPCH_PTHLGY_SRVC_CD
     COBOL Name:  SPCH-PTHLGY-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Surgical ICU Code                       1    838   838  VARCHAR2
     Description: Indicates how surgical intensive care unit services are
                  provided.
     SAS Name:    SRGCL_ICU_SRVC_CD
     COBOL Name:  SRGCL-ICU-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 39
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Therapeutic Radiology Code              1    848   848  VARCHAR2
     Description: Indicates how therapeutic radiology services are
                  provided.
     SAS Name:    THRPTC_RDLGY_SRVC_CD
     COBOL Name:  THRPTC-RDLGY-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Services: Urgent Care Center Code                 1    852   852  VARCHAR2
     Description: Indicates how urgent care center services are provided.
     SAS Name:    URGNT_CARE_SRVC_CD
     COBOL Name:  URGNT-CARE-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=PROVIDED BY STAFF AND UNDER ARRANGEMENT

   Staff Count Override Indicator                    1    861   861  CHAR
     Description: Indicates if the regional office has approved a
                  significant staff count change from the previous
                  certification.
     SAS Name:    OVRRD_STFG_SW
     COBOL Name:  OVRRD-STFG-SW

   Staff Count: Other Personnel                      8    902   909  NUMBER
     Description: Number of full-time equivalent other personnel employed
                  by a provider
     SAS Name:    PRSNEL_OTHR_CNT
     COBOL Name:  PRSNEL-OTHR-CNT

   Staff Count: CRNA                                 8    950   957  NUMBER
     Description: Number of full-time equivalent Certified Registered Nurse
                  Anesthetists employed by a provider.
     SAS Name:    CRNA_CNT
     COBOL Name:  CRNA-CNT

   Staff Count: Dietitian                            8    982   989  NUMBER
     Description: Number of full-time equivalent dietitians employed by a
                  provider.
     SAS Name:    DIETN_CNT
     COBOL Name:  DIETN-CNT

   Staff Count: Lab Technician                       8    1094  1101 NUMBER
     Description: Number of full-time equivalent laboratory technicians
                  employed by a provider.
     SAS Name:    LAB_TCHNCN_CNT
     COBOL Name:  LAB-TCHNCN-CNT

   Staff Count: LPN/LVN - Employee                   8    1110  1117 NUMBER
     Description: Number of full-time equivalent licensed practical or
                  vocational nurses employed by a provider.
     SAS Name:    LPN_LVN_CNT
     COBOL Name:  LPN-LVN-CNT

   Staff Count: Medical Social Worker - Employee     8    1174  1181 NUMBER
     Description: Number of full-time equivalent medical social workers
                  employed by a provider.
     SAS Name:    MDCL_SCL_WORKR_CNT
     COBOL Name:  MDCL-SCL-WORKR-CNT



 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 40
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

   Staff Count: Medical Technologist                 8    1190  1197 NUMBER
     Description: Number of full-time equivalent medical technologists
                  employed by a provider.
     SAS Name:    MDCL_TCHNLGST_CNT
     COBOL Name:  MDCL-TCHNLGST-CNT

   Staff Count: Nuclear Medicine Technician          8    1246  1253 NUMBER
     Description: Number of full-time equivalent nuclear medicine
                  technicians employed by a provider.
     SAS Name:    NUCLR_MDCN_TCHNCN_CNT
     COBOL Name:  NUCLR-MDCN-TCHNCN-CNT

   Staff Count: Nurse Practitioner                   8    1278  1285 NUMBER
     Description: Number of full-time equivalent nurse practitioners
                  employed by a provider.
     SAS Name:    NRS_PRCTNR_CNT
     COBOL Name:  NRS-PRCTNR-CNT

   Staff Count: OT - Total                           8    1310  1317 NUMBER
     Description: Total number of full-time equivalent occupational
                  therapists employed by a provider.
     SAS Name:    OCPTNL_THRPST_CNT
     COBOL Name:  OCPTNL-THRPST-CNT

   Staff Count: Physician - Employee                 8    1542  1549 NUMBER
     Description: Number of full-time equivalent physicians employed by a
                  provider.
     SAS Name:    PHYSN_CNT
     COBOL Name:  PHYSN-CNT

   Staff Count: Physician Assistant                  8    1558  1565 NUMBER
     Description: Number of full-time equivalent physician assistants
                  employed by a provider.
     SAS Name:    PHYSN_ASTNT_CNT
     COBOL Name:  PHYSN-ASTNT-CNT

   Staff Count: Physician Resident                   8    1590  1597 NUMBER
     Description: Number of full-time equivalent physician - residents
                  employed by a provider.
     SAS Name:    RSDNT_PHYSN_CNT
     COBOL Name:  RSDNT-PHYSN-CNT

   Staff Count: Psychologist                         8    1622  1629 NUMBER
     Description: Number of full-time equivalent psychologists employed by
                  a provider.
     SAS Name:    PSYCHLGST_CNT
     COBOL Name:  PSYCHLGST-CNT

   Staff Count: PT                                   8    1638  1645 NUMBER
     Description: Number of full-time equivalent physical therapists
                  employed by a provider.
     SAS Name:    PHYS_THRPST_CNT
     COBOL Name:  PHYS-THRPST-CNT

   Staff Count: Radiology Technician                 8    1726  1733 NUMBER
     Description: Number of full-time equivalent radiology technicians
                  employed by a provider.
     SAS Name:    RDLGY_TCHNCN_CNT
     COBOL Name:  RDLGY-TCHNCN-CNT

   Staff Count: Registered Pharmacist                8    1734  1741 NUMBER
     Description: Number of full-time equivalent registered pharmacists
                  employed by the provider.
     SAS Name:    REG_PHRMCST_CNT


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 41
                 Hospital, CATEGORY = "01" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     COBOL Name:  REG-PHRMCST-CNT

   Staff Count: Respiratory Therapist                8    1742  1749 NUMBER
     Description: Number of full-time equivalent respiratory therapists
                  employed by a provider.
     SAS Name:    INHLTN_THRPST_CNT
     COBOL Name:  INHLTN-THRPST-CNT

   Staff Count: RN                                   8    1750  1757 NUMBER
     Description: Number of full-time equivalent registered nurses employed
                  by a provider.
     SAS Name:    RN_CNT
     COBOL Name:  RN-CNT

   Staff Count: Speech Pathologist/Audiologist       8    1886  1893 NUMBER
     Description: Number of full-time equivalent speech pathologists or
                  audiologists employed by the provider.
     SAS Name:    SPCH_PTHLGST_AUDLGST_CNT
     COBOL Name:  SPCH-PTHLGST-AUDLGST-CNT

   Swing Bed Indicator                               1    1967  1967 VARCHAR2
     Description: Indicates if a hospital provides swing bed services (beds
                  can be used for either hospital or long term care
                  services).
     SAS Name:    SB_SW
     COBOL Name:  SB-SW

   Swing Bed Size Code                               1    1968  1968 VARCHAR2
     Description: Indicates the size of a hospital providing swing bed
                  services (beds can be used for either hospital or long
                  term care services).
     SAS Name:    SB_SIZE_CD
     COBOL Name:  SB-SIZE-CD
     VALUES:      1=49 OR FEWER BEDS
                  2=50 TO 99 BEDS
                  3=100 OR MORE BEDS






























 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 1
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Provider Category Subtype Code                    2    1     2    VARCHAR2
     Description: Identifies the subtype of the provider, within the
                  primary category.  Used in reporting to show the
                  breakdown of provider categories, mainly for hospitals
                  and SNFs.
     SAS Name:    PRVDR_CTGRY_SBTYP_CD
     COBOL Name:  PRVDR-CTGRY-SBTYP-CD
     VALUES:      03=Title 18/19

   Provider Category Code                            2    3     4    VARCHAR2
     Description: Identifies the type of provider participating in the
                  Medicare/Medicaid program.
     SAS Name:    PRVDR_CTGRY_CD
     COBOL Name:  PRVDR-CTGRY-CD
     VALUES:      02=Skilled Nursing Facility/Nursing Facility (Dually Certified)

   CHOW Count                                        2    5     6    NUMBER
     Description: Number of times this provider has undergone a change of
                  ownership.
     SAS Name:    CHOW_CNT
     COBOL Name:  CHOW-CNT

   CHOW Date                                         8    7     14   DATE
     Description: Effective date of the most recent change of ownership for
                  this provider.
     SAS Name:    CHOW_DT
     COBOL Name:  CHOW-DT

   Address: City                                     28   15    42   VARCHAR2
     Description: City in which the provider is physically located.
     SAS Name:    CITY_NAME
     COBOL Name:  CITY-NAME

   Compliance: Acceptable POC                        1    43    43   VARCHAR2
     Description: Indicates if a provider is in compliance with program
                  requirements based on an acceptable plan for correction
                  of deficiencies.
     SAS Name:    ACPTBL_POC_SW
     COBOL Name:  ACPTBL-POC-SW

   Compliance: Status                                1    44    44   VARCHAR2
     Description: Compliance status of a provider at the time of
                  certification survey.
     SAS Name:    CMPLNC_STUS_CD
     COBOL Name:  CMPLNC-STUS-CD
     VALUES:      A=IN COMPLIANCE
                  B=NOT IN COMPLIANCE

   SSA County Code                                   3    45    47   VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the county where the provider is located.
     SAS Name:    SSA_CNTY_CD
     COBOL Name:  SSA-CNTY-CD

   Cross Ref Provider Number                         10   48    57   CHAR
     Description: Cross reference provider number
     SAS Name:    CROSS_REF_PROVIDER_NUMBER
     COBOL Name:  CROSS-REF-PROVIDER-NUMBER

   Certification Date                                8    58    65   DATE
     Description: Equal to the exit date of the initial visit of the Health
                  survey for certifications completed after July 28, 2012.


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 2
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  For certifications prior to that date, the certification
                  date is equal to the exit date of the initial visit of
                  the Health survey or LSC survey, whichever is later.
     SAS Name:    CRTFCTN_DT
     COBOL Name:  CRTFCTN-DT

   Eligibility Indicator                             1    66    66   VARCHAR2
     Description: Indicates if a facility is eligible to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    ELGBLTY_SW
     COBOL Name:  ELGBLTY-SW

   Facility Name                                     50   67    116  VARCHAR2
     Description: Name of the provider certified to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    FAC_NAME
     COBOL Name:  FAC-NAME

   Medicare Administrative Contractor (MAC) or       5    117   121  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_CD
     COBOL Name:  INTRMDRY-CARR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 3
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 4
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 5
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 6
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 7
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   Medicaid Vendor Number                            15   122   136  VARCHAR2
     Description: Number which may be assigned to a provider by the state
                  Medicaid agency for external control or billing purposes.
     SAS Name:    MDCD_VNDR_NUM
     COBOL Name:  MDCD-VNDR-NUM

   Original Participation Date                       8    137   144  DATE
     Description: Date a provider is first approved to provide Medicare
                  and/or Medicaid services.
     SAS Name:    ORGNL_PRTCPTN_DT
     COBOL Name:  ORGNL-PRTCPTN-DT

   Prior CHOW Date                                   8    145   152  DATE
     Description: Effective date of the previous change of ownership for
                  this provider.
     SAS Name:    CHOW_PRIOR_DT
     COBOL Name:  CHOW-PRIOR-DT

   Prior Medicare Administrative Contractor (MAC) or 5    153   157  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the previous Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_PRIOR_CD
     COBOL Name:  INTRMDRY-CARR-PRIOR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 8
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 9
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 10
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 11
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 12
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)
                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   CCN                                               10   158   167  VARCHAR2
     Description: Six or ten position identification number that is
                  assigned to a certified provider.  This is the CMS
                  Certification Number.
     SAS Name:    PRVDR_NUM
     COBOL Name:  PRVDR-NUM

   Region Code                                       2    168   169  VARCHAR2
     Description: Indicates the CMS Regional Office responsible for the
                  certification of the provider.
     SAS Name:    RGN_CD
     COBOL Name:  RGN-CD
     VALUES:      01=Boston
                  02=New York
                  03=Philadelphia
                  04=Atlanta
                  05=Chicago
                  06=Dallas
                  07=Kansas City
                  08=Denver
                  09=San Francisco
                  10=Seattle

   Skeleton Record Indicator                         1    170   170  VARCHAR2
     Description: Indicates if the record is a skeleton record.  Only a
                  limited set of data is available for this provider; no
                  survey data exists.  Only provider categories
                  01,17,19,21and 22 can have skeleton providers.
     SAS Name:    SKLTN_REC_SW
     COBOL Name:  SKLTN-REC-SW

   State Abbreviation                                2    171   172  VARCHAR2
     Description: Two-character state abbreviation.
     SAS Name:    STATE_CD
     COBOL Name:  STATE-CD
     VALUES:      AK=ALASKA
                  AL=ALABAMA
                  AR=ARKANSAS
                  AS=AMERICAN SAMOA
                  AZ=ARIZONA
                  CA=CALIFORNIA


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 13
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  CN=CANADA
                  CO=COLORADO
                  CT=CONNECTICUT
                  DC=DISTRICT OF COLUMBIA
                  DE=DELAWARE
                  FL=FLORIDA
                  FN=INTERNATIONAL
                  GA=GEORGIA
                  GU=GUAM
                  HI=HAWAII
                  IA=IOWA
                  ID=IDAHO
                  IL=ILLINOIS
                  IN=INDIANA
                  KS=KANSAS
                  KY=KENTUCKY
                  LA=LOUISIANA
                  MA=MASSACHUSETTS
                  MD=MARYLAND
                  ME=MAINE
                  MI=MICHIGAN
                  MN=MINNESOTA
                  MO=MISSOURI
                  MP=SAIPAN
                  MS=MISSISSIPPI
                  MT=MONTANA
                  MX=MEXICO
                  NC=NORTH CAROLINA
                  ND=NORTH DAKOTA
                  NE=NEBRASKA
                  NH=NEW HAMPSHIRE
                  NJ=NEW JERSEY
                  NM=NEW MEXICO
                  NV=NEVADA
                  NY=NEW YORK
                  OH=OHIO
                  OK=OKLAHOMA
                  OR=OREGON
                  PA=PENNSYLVANIA
                  PR=PUERTO RICO
                  RI=RHODE ISLAND
                  SC=SOUTH CAROLINA
                  SD=SOUTH DAKOTA
                  TN=TENNESSEE
                  TX=TEXAS
                  UT=UTAH
                  VA=VIRGINIA
                  VI=VIRGIN ISLANDS
                  VT=VERMONT
                  WA=WASHINGTON
                  WI=WISCONSIN
                  WV=WEST VIRGINIA
                  WY=WYOMING

   SSA State Code                                    2    173   174  VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the state where the provider is located.
     SAS Name:    SSA_STATE_CD
     COBOL Name:  SSA-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  03=ARIZONA
                  04=ARKANSAS


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 14
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  05=CALIFORNIA
                  06=COLORADO
                  07=CONNECTICUT
                  08=DELAWARE
                  09=DISTRICT OF COLUMBIA
                  10=FLORIDA
                  11=GEORGIA
                  12=HAWAII
                  13=IDAHO
                  14=ILLINOIS
                  15=INDIANA
                  16=IOWA
                  17=KANSAS
                  18=KENTUCKY
                  19=LOUISIANA
                  20=MAINE
                  21=MARYLAND
                  22=MASSACHUSETTS
                  23=MICHIGAN
                  24=MINNESOTA
                  25=MISSISSIPPI
                  26=MISSOURI
                  27=MONTANA
                  28=NEBRASKA
                  29=NEVADA
                  30=NEW HAMPSHIRE
                  31=NEW JERSEY
                  32=NEW MEXICO
                  33=NEW YORK
                  34=NORTH CAROLINA
                  35=NORTH DAKOTA
                  36=OHIO
                  37=OKLAHOMA
                  38=OREGON
                  39=PENNSYLVANIA
                  40=PUERTO RICO
                  41=RHODE ISLAND
                  42=SOUTH CAROLINA
                  43=SOUTH DAKOTA
                  44=TENNESSEE
                  45=TEXAS
                  46=UTAH
                  47=VERMONT
                  48=VIRGIN ISLANDS
                  49=VIRGINIA
                  50=WASHINGTON
                  51=WEST VIRGINIA
                  52=WISCONSIN
                  53=WYOMING
                  54=AFRICA
                  56=CANADA
                  57=WEST INDIES
                  58=EUROPE
                  59=MEXICO
                  60=OCEANIA
                  61=PHILIPPINES
                  62=SOUTH AMERICA
                  63=UNITED STATES POSSESSIONS
                  64=AMERICAN SAMOA
                  65=GUAM
                  66=SAIPAN
                  99=INTERNATIONAL



 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 15
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

   State Region Code                                 3    175   177  VARCHAR2
     Description: Identifies the region within a state where the provider
                  is located.
     SAS Name:    STATE_RGN_CD
     COBOL Name:  STATE-RGN-CD
     VALUES:      AK/001=ALASKA
                  AK/LAB=LABORATORIES
                  AK/NPH=NON-PARTICIPATING HOSPITAL
                  AL/001=ALABAMA
                  AL/LAB=LABORATORIES
                  AL/NPH=NON-PARTICIPATING HOSPITAL
                  AR/001=ARKANSAS
                  AR/LAB=LABORATORIES
                  AR/NPH=NON-PARTICIPATING HOSPITAL
                  AS/001=AMERICAN SAMOA
                  AS/LAB=LABORATORY
                  AS/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/AZ=PHOENIX
                  AZ/LAB=ARIZONA LAB
                  AZ/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/TUC=TUCSON
                  CA/001=CALIFORNIA
                  CA/BAK=BAKERSFIELD
                  CA/BER=SAN BERNARDINO
                  CA/EB=East Bay
                  CA/FR=FRESNO
                  CA/L1=L.A. WEST
                  CA/L2=L.A. NORTH
                  CA/L3=L.A. CENTRAL
                  CA/L4=L.A. EAST
                  CA/L5=SAN GABRIEL
                  CA/LA1=LA Region 1
                  CA/LA2=LA Region 2
                  CA/LA3=LA Region 3
                  CA/LA4=LA Acute/Ancillary
                  CA/LA5=LA HHA/Hospice
                  CA/LA6=LA ICF/DD/CLinics
                  CA/LAB=LABORATORIES
                  CA/M1=LAB. SOUTH
                  CA/M2=LAB. NORTH
                  CA/NPH=NON-PARTICIPATING HOSPITAL
                  CA/ORG=ORANGE
                  CA/RIV=RIVERSIDE
                  CA/S1=SACRAMENTO
                  CA/S3=CHICO
                  CA/SD=SAN DIEGO
                  CA/SF=SAN FRANCISCO
                  CA/SJ=SAN JOSE
                  CA/SR=SANTA ROSA
                  CA/VEN=VENTURA
                  CN/001=CANADA
                  CN/LAB=LABORATORY
                  CN/NPH=NON-PARTICIPATING HOSPITAL
                  CO/001=COLORADO
                  CO/LAB=LABORATORIES
                  CO/NPH=NON-PARTICIPATING HOSPITAL
                  CT/001=CONNECTICUT
                  CT/LAB=LABORATORIES
                  CT/NPH=NON-PARTICIPATING HOSPITAL
                  DC/001=DISTRICT OF COLUMBIA
                  DC/LAB=LABORATORIES
                  DC/NPH=NON-PARTICIPATING HOSPITAL
                  DE/001=DELAWARE


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                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  DE/LAB=LABORATORIES
                  DE/NPH=NON-PARTICIPATING HOSPITAL
                  FL/001=FLORIDA
                  FL/FTM=FT. MYERS
                  FL/GAI=GAINESVILLE
                  FL/JAX=JACKSONVILLE
                  FL/LAB=LABORATORIES
                  FL/LAN=LANTANA
                  FL/LAU=LAUDERHILL
                  FL/MIA=MIAMI
                  FL/NPH=NON-PARTICIPATING HOSPITAL
                  FL/ORL=ORLANDO
                  FL/PEN=PENSACOLA
                  FL/STP=ST. PETERSBURG
                  FL/TAL=TALLAHASSEE
                  FL/TAM=TAMPA
                  FM/001=FEDERATED STATES OF MICRO
                  FM/NPH=NON-PARTICIPATING HOSPITAL
                  FN/001=INTERNATIONAL
                  FN/LAB=LABORATORIES
                  FN/NPH=NON-PARTICIPATING HOSPITAL
                  GA/001=GEORGIA
                  GA/GAA=GEORGIA ALL
                  GA/GAC=GEORGIA CENTRAL
                  GA/GAE=GEORGIA EASTERN
                  GA/GAN=GEORGIA NORTH
                  GA/GAS=GEORGIA SOUTH
                  GA/GAW=GEORGIA WESTERN
                  GA/LAB=LABORATORIES
                  GA/NPH=NON-PARTICIPATING HOSPITAL
                  GU/001=GUAM
                  GU/LAB=LABORATORIES
                  GU/NPH=NON-PARTICIPATING HOSPITAL
                  HI/001=HAWAII
                  HI/LAB=LABORATORIES
                  HI/NPH=NON-PARTICIPATING HOSPITAL
                  IA/001=IOWA
                  IA/LAB=LABORATORIES
                  IA/NPH=NON-PARTICIPATING HOSPITAL
                  ID/001=IDAHO
                  ID/LAB=LABORATORIES
                  ID/NPH=NON-PARTICIPATING HOSPITAL
                  IL/001=ILLINOIS
                  IL/LAB=LABORATORIES
                  IL/NPH=NON-PARTICIPATING HOSPITAL
                  IN/001=INDIANA
                  IN/LAB=LABORATORIES
                  IN/NPH=NON-PARTICIPATING HOSPITAL
                  KS/001=KANSAS
                  KS/KCK=KANSAS CITY
                  KS/KDH=KDHE
                  KS/LAB=LABORATORIES
                  KS/LAW=LAWRENCE
                  KS/NC=NORTH CENTRAL KANSAS
                  KS/NE=NORTH EAST KANSAS
                  KS/NPH=NON-PARTICIPATING HOSPITAL
                  KS/NW=NORTH WEST KANSAS
                  KS/SC=SOUTH CENTRAL KANSAS
                  KS/SE=SOUTH EAST KANSAS
                  KS/SW=SOUTH WEST KANSAS
                  KS/WST=WEST
                  KY/2C1=HOPKINSVILLE
                  KY/2C2=LOUISVILLE


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                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  KY/2C3=LONDON
                  KY/2C4=LEXINGTON
                  KY/LAB=LABORATORIES
                  KY/NPH=NON-PARTICIPATING HOSPITAL
                  LA/001=LOUISIANA
                  LA/LA1=NEW ORLEANS
                  LA/LA2=MANDEVILLE
                  LA/LA3=LAFAYETTE
                  LA/LA4=MONROE
                  LA/LA5=SHREVEPORT
                  LA/LA6=ALEXANDRIA
                  LA/LAB=LABORATORIES
                  LA/LB1=CLIA NEW ORLEANS
                  LA/LB5=CLIA SHREVEPORT
                  LA/LB6=CLIA ALEXANDRIA
                  LA/NPH=NON-PARTICIPATING HOSPITAL
                  MA/001=MASSACHUSETTS
                  MA/LAB=LABORATORIES
                  MA/NPH=NON-PARTICIPATING HOSPITAL
                  MD/001=MARYLAND
                  MD/LAB=LABORATORIES
                  MD/NPH=NON-PARTICIPATING HOSPITAL
                  ME/001=MAINE
                  ME/LAB=LABORATORIES
                  ME/NPH=NON-PARTICIPATING HOSPITAL
                  MH/001=MARSHALL ISLANDS
                  MH/NPH=NON-PARTICIPATING HOSPITAL
                  MI/001=MICHIGAN
                  MI/LAB=LABORATORIES
                  MI/NPH=NON-PARTICIPATING HOSPITAL
                  MN/001=MINNESOTA
                  MN/LAB=LABORATORIES
                  MN/NPH=NON-PARTICIPATING HOSPITAL
                  MO/001=MISSOURI
                  MO/01=REGION01
                  MO/02=REGION02
                  MO/03=REGION 03
                  MO/04=REGION 04
                  MO/05=REGION 05
                  MO/06=REGION 06
                  MO/07=REGION 07
                  MO/1NH=REGION 1 NH
                  MO/2NH=REGION 2 NH
                  MO/3NH=REGION 3 NH
                  MO/4NH=REGION 4 NH
                  MO/5NH=REGION 5 NH
                  MO/6NH=REGION 6 NH
                  MO/7NH=REGION 7 NH
                  MO/LAB=LABORATORIES
                  MO/MO=STATEWIDE
                  MO/NPH=NON-PARTICIPATING HOSPITAL
                  MP/001=NORTHERN MARIANA ISLANDS
                  MP/LAB=LABORATORIES
                  MP/NPH=NON-PARTICIPATING HOSPITAL
                  MS/001=MISSISSIPPI
                  MS/LAB=LABORATORIES
                  MS/NPH=NON-PARTICIPATING HOSPITAL
                  MT/001=MONTANA
                  MT/LAB=LABORATORIES
                  MT/NPH=NON-PARTICIPATING HOSPITAL
                  MX/001=MEXICO
                  MX/LAB=LABORATORY
                  MX/NPH=NON-PARTICIPATING HOSPITAL


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 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  NC/001=NORTH CAROLINA
                  NC/LAB=LABORATORIES
                  NC/NCC=NORTH CAROLINA CENTRAL
                  NC/NCE=NORTH CAROLINA EAST
                  NC/NCN=NORTH CAROLINA NORTH
                  NC/NCS=NORTH CAROLINA SOUTH
                  NC/NCW=NORTH CAROLINA WEST
                  NC/NPH=NON-PARTICIPATING HOSPITAL
                  ND/001=NORTH DAKOTA
                  ND/LAB=LABORATORIES
                  ND/NPH=NON-PARTICIPATING HOSPITAL
                  NE/001=NEBRASKA
                  NE/1=NORTH CENTRAL
                  NE/2=CENTRAL
                  NE/3=NORTHEAST
                  NE/4=SOUTHEAST
                  NE/5=WESTERN
                  NE/LAB=LABORATORIES
                  NE/NPH=NON-PARTICIPATING HOSPITAL
                  NH/001=NEW HAMPSHIRE
                  NH/LAB=LABORATORIES
                  NH/NPH=NON-PARTICIPATING HOSPITAL
                  NJ/001=NEW JERSEY
                  NJ/LAB=LABORATORIES
                  NJ/NPH=NON-PARTICIPATING HOSPITAL
                  NM/001=NEW MEXICO
                  NM/LAB=LABORATORIES
                  NM/NPH=NON-PARTICIPATING HOSPITAL
                  NV/001=NEVADA
                  NV/CC=CARSON CITY
                  NV/LAB=LABORATORIES
                  NV/LV=LAS VEGAS
                  NV/NPH=NON-PARTICIPATING HOSPITAL
                  NY/001=BUFFALO
                  NY/002=ROCHESTER
                  NY/003=SYRACUSE
                  NY/004=ALBANY
                  NY/005=NEW ROCHELLE
                  NY/006=NEW YORK CITY
                  NY/007=SUFFOLK/NASSAU COUNTY
                  NY/LAB=LABORATORIES
                  NY/NPH=NON-PARTICIPATING HOSPITAL
                  OH/001=OHIO
                  OH/LAB=LABORATORIES
                  OH/NPH=NON-PARTICIPATING HOSPITAL
                  OK/001=OKLAHOMA
                  OK/LAB=LABORATORIES
                  OK/NPH=NON-PARTICIPATING HOSPITAL
                  OR/001=OFFICE #1
                  OR/002=OFFICE #2
                  OR/003=OFFICE #3
                  OR/LAB=LABORATORIES
                  OR/NPH=NON-PARTICIPATING HOSPITAL
                  PA/001=PENNSYLVANIA
                  PA/LAB=LABORATORIES
                  PA/NPH=NON-PARTICIPATING HOSPITAL
                  PR/001=PUERTO RICO
                  PR/LAB=LABORATORIES
                  PR/NPH=NON-PARTICIPATING HOSPITAL
                  PW/001=PALAU
                  PW/NPH=NON-PARTICIPATING HOSPITAL
                  RI/001=RHODE ISLAND
                  RI/LAB=LABORATORIES


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 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  RI/NPH=NON-PARTICIPATING HOSPITAL
                  SC/001=SOUTH CAROLINA
                  SC/LAB=LABORATORIES
                  SC/NPH=NON-PARTICIPATING HOSPITAL
                  SD/001=SOUTH DAKOTA
                  SD/LAB=LABORATORIES
                  SD/NPH=NON-PARTICIPATING HOSPITAL
                  TN/001=TENNESSEE
                  TN/LAB=LABORATORIES
                  TN/NPH=NON-PARTICIPATING HOSPITAL
                  TN/TNC=TENNESSEE COOKEVILLE
                  TN/TNE=TENNESSEE EASTERN
                  TN/TNM=TENNESSEE MIDDLE
                  TN/TNW=TENNESSEE WESTERN
                  TX/001=TEXAS
                  TX/L01=AMARILLO-LTC
                  TX/L02=ABILENE-LTC
                  TX/L03=ARLINGTON-LTC
                  TX/L04=TYLER-LTC
                  TX/L05=TEMPLE-LTC
                  TX/L06=HOUSTON-LTC
                  TX/L07=SAN ANTONIO-LTC
                  TX/LAB=LABORATORIES
                  TX/NPH=NON-PARTICIPATING HOSPITAL
                  TX/TX1=NLTC REG 1, 7, 9, 10
                  TX/TX2=NLTC REG 2, 3
                  TX/TX4=NLTC REG 6
                  TX/TX5=NLTC REG 4, 5
                  TX/TX6=AUSTIN
                  TX/TX8=NLTC REG 8, 11
                  UT/001=UTAH
                  UT/LAB=LABORATORIES
                  UT/NPH=NON-PARTICIPATING HOSPITAL
                  VA/001=VIRGINIA
                  VA/LAB=LABORATORIES
                  VA/NPH=NON-PARTICIPATING HOSPITAL
                  VI/001=VIRGIN ISLANDS
                  VI/LAB=LABORATORIES
                  VI/NPH=NON-PARTICIPATING HOSPITAL
                  VT/001=VERMONT
                  VT/LAB=LABORATORIES
                  VT/NPH=NON-PARTICIPATING HOSPITAL
                  WA/001=ALL OTHERS (NON-LTC FAC)
                  WA/D1=SPOKANE & YAKIMA AREAS
                  WA/D1A=District 1, Unit A
                  WA/D1B=District 1, Unit B
                  WA/D1C=District 1, Unit C
                  WA/D1D=District 1, Unit D
                  WA/D1E=District 1, Unit E
                  WA/D2=SPOKANE & SE
                  WA/D2A=District 2, Unit A
                  WA/D2B=District 2, Unit B
                  WA/D2C=District 2, Unit C
                  WA/D2D=District 2, Unit D
                  WA/D2E=District 2, Unit E
                  WA/D2F=District 2, Unit F
                  WA/D2G=District 2, Unit G
                  WA/D2H=District 2, Unit H
                  WA/D2I=District 2, Unit I
                  WA/D2J=District 2, Unit J
                  WA/D3=NW WASHINGTON
                  WA/D3A=District 3, Unit A
                  WA/D3B=District 3, Unit B


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 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  WA/D3C=District 3, Unit C
                  WA/D3D=District 3, Unit D
                  WA/D3E=District 3, Unit E
                  WA/D3F=District 3, Unit F
                  WA/D3G=District 3, Unit G
                  WA/D4A=GREATER SEATTLE AREA
                  WA/D4B=S KING COUNTY
                  WA/D5A=PIERCE CTY & PENINSULA
                  WA/D5B=PIERCE CTY & GRAYS HARBOR
                  WA/D6=OLYMPIA AREA
                  WA/LAB=LABORATORIES
                  WA/NPH=NON-PARTICIPATING HOSPITAL
                  WI/001=WISCONSIN
                  WI/LAB=LABORATORIES
                  WI/NPH=NON-PARTICIPATING HOSPITAL
                  WV/001=WEST VIRGINIA
                  WV/LAB=LABORATORIES
                  WV/NPH=NON-PARTICIPATING HOSPITAL
                  WY/001=WYOMING
                  WY/LAB=LABORATORIES
                  WY/NPH=NON-PARTICIPATING HOSPITAL

   Address: Street                                   50   178   227  VARCHAR2
     Description: Street address where the provider is located.
     SAS Name:    ST_ADR
     COBOL Name:  ST-ADR

   Telephone Number                                  10   228   237  VARCHAR2
     Description: Telephone number of the provider.
     SAS Name:    PHNE_NUM
     COBOL Name:  PHNE-NUM

   Termination Code                                  2    238   239  VARCHAR2
     Description: Indicates the current termination status for the
                  provider.
     SAS Name:    PGM_TRMNTN_CD
     COBOL Name:  PGM-TRMNTN-CD
     VALUES:      00=ACTIVE PROVIDER
                  01=VOLUNTARY-MERGER, CLOSURE
                  02=VOLUNTARY-DISSATISFACTION WITH REIMBURSEMENT
                  03=VOLUNTARY-RISK OF INVOLUNTARY TERMINATION
                  04=VOLUNTARY-OTHER REASON FOR WITHDRAWAL
                  05=INVOLUNTARY-FAILURE TO MEET HEALTH/SAFETY REQ
                  06=INVOLUNTARY-FAILURE TO MEET AGREEMENT
                  07=OTHER-PROVIDER STATUS CHANGE
                  08=NONPAYMENT OF FEES - CLIA Only
                  09=REV/UNSUCCESSFUL PARTICIPATION IN PT - CLIA Only
                  10=REV/OTHER REASON - CLIA Only
                  11=INCOMPLETE CLIA APPLICATION INFORMATION - CLIA Only
                  12=NO LONGER PERFORMING TESTS - CLIA Only
                  13=MULTIPLE TO SINGLE SITE CERTIFICATE - CLIA Only
                  14=SHARED LABORATORY - CLIA Only
                  15=FAILURE TO RENEW WAIVER PPM CERTIFICATE - CLIA Only
                  16=DUPLICATE CLIA NUMBER - CLIA Only
                  17=MAIL RETURNED NO FORWARD ADDRESS CERT ENDED - CLIA Only
                  20=NOTIFICATION BANKRUPTCY - CLIA Only
                  33=ACCREDITATION NOT CONFIRMED - CLIA Only
                  80=AWAITING STATE APPROVAL
                  99=OIG ACTION - DO NOT ACTIVATE - CLIA Only

   Termination or Expiration Date                    8    240   247  DATE
     Description: Date the provider was terminated.  For CLIA providers,
                  date the laboratory's certificate was terminated or the


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                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  expiration date of the current CLIA certificate.
     SAS Name:    TRMNTN_EXPRTN_DT
     COBOL Name:  TRMNTN-EXPRTN-DT

   Type of Action Code                               1    248   248  VARCHAR2
     Description: Identifies the reason for the certification.  Type of
                  action from the official survey record, CMS 1539 form.
     SAS Name:    CRTFCTN_ACTN_TYPE_CD
     COBOL Name:  CRTFCTN-ACTN-TYPE-CD
     VALUES:      1=INITIAL
                  2=RECERTIFICATION
                  3=TERMINATION
                  4=CHANGE OF OWNERSHIP
                  5=VALIDATION
                  8=FULL SURVEY AFTER COMPLAINT

   Ownership Type Code                               2    249   250  VARCHAR2
     Description: Indicates the ownership type of the provider.
     SAS Name:    GNRL_CNTL_TYPE_CD
     COBOL Name:  GNRL-CNTL-TYPE-CD
     VALUES:      01=FOR PROFIT - INDIVIDUAL
                  02=FOR PROFIT - PARTNERSHIP
                  03=FOR PROFIT - CORPORATION
                  04=NONPROFIT - CHURCH RELATED
                  05=NONPROFIT - CORPORATION
                  06=NONPROFIT - OTHER
                  07=GOVERNMENT - STATE
                  08=GOVERNMENT - COUNTY
                  09=GOVERNMENT - CITY
                  10=GOVERNMENT - CITY/COUNTY
                  11=GOVERNMENT - HOSPITAL DISTRICT
                  12=GOVERNMENT - FEDERAL
                  13=FOR PROFIT - LIMITED LIABILITY CORPORATION

   Address: ZIP Code                                 5    251   255  VARCHAR2
     Description: Five-digit ZIP code for a provider's physical address.
     SAS Name:    ZIP_CD
     COBOL Name:  ZIP-CD

   FIPS State Code                                   2    256   257  VARCHAR2
     Description: FIPS State Code
     SAS Name:    FIPS_STATE_CD
     COBOL Name:  FIPS-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  04=ARIZONA
                  05=ARKANSAS
                  06=CALIFORNIA
                  08=COLORADO
                  09=CONNECTICUT
                  10=DELAWARE
                  11=DISTRICT OF COLUMBIA
                  12=FLORIDA
                  13=GEORGIA
                  15=HAWAII
                  16=IDAHO
                  17=ILLINOIS
                  18=INDIANA
                  19=IOWA
                  20=KANSAS
                  21=KENTUCKY
                  22=LOUISIANA
                  23=MAINE


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 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  24=MARYLAND
                  25=MASSACHUSETTS
                  26=MICHIGAN
                  27=MINNESOTA
                  28=MISSISSIPPI
                  29=MISSOURI
                  30=MONTANA
                  31=NEBRASKA
                  32=NEVADA
                  33=NEW HAMPSHIRE
                  34=NEW JERSEY
                  35=NEW MEXICO
                  36=NEW YORK
                  37=NORTH CAROLINA
                  38=NORTH DAKOTA
                  39=OHIO
                  40=OKLAHOMA
                  41=OREGON
                  42=PENNSYLVANIA
                  43=PUERTO RICO
                  44=RHODE ISLAND
                  45=SOUTH CAROLINA
                  46=SOUTH DAKOTA
                  47=TENNESSEE
                  48=TEXAS
                  49=UTAH
                  50=VERMONT
                  51=VIRGINIA
                  53=WASHINGTON
                  54=WEST VIRGINIA
                  55=WISCONSIN
                  56=WYOMING
                  60=AMERICAN SAMOA
                  66=GUAM
                  69=SAIPAN/MARIANA IS.
                  78=VIRGIN ISLANDS

   FIPS County Code                                  3    258   260  VARCHAR2
     Description: FIPS County Code
     SAS Name:    FIPS_CNTY_CD
     COBOL Name:  FIPS-CNTY-CD

   CBSA Urban Rural Indicator                        1    261   261  VARCHAR2
     Description: CBSA (Core Based Statistical Area) indicates whether the
                  county is defined as Urban or Rural.
     SAS Name:    CBSA_URBN_RRL_IND
     COBOL Name:  CBSA-URBN-RRL-IND

   CBSA Code                                         5    262   266  VARCHAR2
     Description: CBSA (Core Based Statistical Area) geographic entities
                  defined by the U.S. Office of Management and Budget (OMB)
                  on June 6, 2003 for use by Federal statistical agencies
                  in collecting, tabulating, and publishing Federal
                  statistics.  CBSA collectively refers to MSA.
     SAS Name:    CBSA_CD
     COBOL Name:  CBSA-CD

   Bed Count Override Indicator                      1    325   325  CHAR
     Description: Indicates if the regional office has approved a
                  significant bed count change from the previous
                  certification.
     SAS Name:    OVRRD_BED_CNT_SW
     COBOL Name:  OVRRD-BED-CNT-SW


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 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Bed Count: Certified                              4    326   329  NUMBER
     Description: Number of beds in Medicare and/or Medicaid certified
                  areas within a facility.
     SAS Name:    CRTFD_BED_CNT
     COBOL Name:  CRTFD-BED-CNT

   Bed Count: Medicaid NF                            4    334   337  NUMBER
     Description: Number of Medicaid-certified Nursing Facility beds.
     SAS Name:    MDCD_NF_BED_CNT
     COBOL Name:  MDCD-NF-BED-CNT

   Bed Count: Medicare SNF                           4    338   341  NUMBER
     Description: Number of Medicare-certified Skilled Nursing Facility
                  beds.
     SAS Name:    MDCR_SNF_BED_CNT
     COBOL Name:  MDCR-SNF-BED-CNT

   Bed Count: Medicare/Medicaid SNF                  4    342   345  NUMBER
     Description: Number of dually certified (Medicare/Medicaid) beds in a
                  Skilled Nursing Facility.
     SAS Name:    MDCR_MDCD_SNF_BED_CNT
     COBOL Name:  MDCR-MDCD-SNF-BED-CNT

   Bed Count: Special Care - AIDS                    3    346   348  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents with AIDS.
     SAS Name:    AIDS_BED_CNT
     COBOL Name:  AIDS-BED-CNT

   Bed Count: Special Care - Alzheimers              3    349   351  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents with Alzheimer's disease.
     SAS Name:    ALZHMR_BED_CNT
     COBOL Name:  ALZHMR-BED-CNT

   Bed Count: Special Care - Dialysis                3    352   354  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents who require dialysis.
     SAS Name:    DLYS_BED_CNT
     COBOL Name:  DLYS-BED-CNT

   Bed Count: Special Care - Disabled Children       3    355   357  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  disabled children.
     SAS Name:    DSBL_CHLDRN_BED_CNT
     COBOL Name:  DSBL-CHLDRN-BED-CNT

   Bed Count: Special Care - Head Trauma             3    358   360  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents with head trauma.
     SAS Name:    HEAD_TRMA_BED_CNT
     COBOL Name:  HEAD-TRMA-BED-CNT

   Bed Count: Special Care - Hospice                 3    361   363  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents who require hospice care.
     SAS Name:    HOSPC_BED_CNT
     COBOL Name:  HOSPC-BED-CNT

   Bed Count: Special Care - Huntingtons Disease     3    364   366  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents with Huntington's disease.


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 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     SAS Name:    HNTGTN_DEASE_BED_CNT
     COBOL Name:  HNTGTN-DEASE-BED-CNT

   Bed Count: Special Care - Specialized Rehab       3    367   369  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents with specialized rehab needs.
     SAS Name:    REHAB_BED_CNT
     COBOL Name:  REHAB-BED-CNT

   Bed Count: Special Care - Ventilator              3    370   372  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents requiring a ventilator and/or respiratory care.
     SAS Name:    VNTLTR_BED_CNT
     COBOL Name:  VNTLTR-BED-CNT

   Bed Count: Total                                  4    373   376  NUMBER
     Description: Total number of beds in a provider, including those in
                  non-participating or non-licensed areas.
     SAS Name:    BED_CNT
     COBOL Name:  BED-CNT

   Compliance: 24-Hour RN Waiver Indicator           1    442   442  CHAR
     Description: Indicates if a waiver of the 24-hour registered nurse
                  staffing requirements has been recommended for a Skilled
                  Nursing Facility or Nursing Facility.
     SAS Name:    RN_24_HR_WVR_SW
     COBOL Name:  RN-24-HR-WVR-SW

   Compliance: 7-Day RN Waiver Indicator             1    443   443  VARCHAR2
     Description: Indicates if a waiver of the 7-day registered nurse
                  staffing requirements has been recommended for a Skilled
                  Nursing Facility.
     SAS Name:    RN_7_DAY_WVR_SW
     COBOL Name:  RN-7-DAY-WVR-SW

   Compliance: Beds Per Room Waiver Indicator        1    444   444  CHAR
     Description: Indicates if a waiver of the beds per room requirement
                  has been recommended for a facility.
     SAS Name:    BED_PER_ROOM_WVR_SW
     COBOL Name:  BED-PER-ROOM-WVR-SW

   Compliance: LSC Waiver Indicator                  1    445   445  CHAR
     Description: Indicates if a waiver of any life safety code provision
                  has been recommended for a provider.
     SAS Name:    LSC_WVR_SW
     COBOL Name:  LSC-WVR-SW

   Compliance: Patient Room Size Waiver Indicator    1    446   446  CHAR
     Description: Indicates if a waiver of the patient room size provision
                  has been recommended for a provider.
     SAS Name:    ROOM_SIZE_WVR_SW
     COBOL Name:  ROOM-SIZE-WVR-SW

   Experimental Research Conducted Indicator         1    453   453  VARCHAR2
     Description: Indicates if a facility conducts experimental research.
     SAS Name:    EXPRMT_RSRCH_CNDCTD_SW
     COBOL Name:  EXPRMT-RSRCH-CNDCTD-SW

   Fiscal Year End Date (MMDD)                       4    464   467  VARCHAR2
     Description: End date, consisting of the month and day, of the
                  provider's fiscal year.
     SAS Name:    FY_END_MO_DAY_CD
     COBOL Name:  FY-END-MO-DAY-CD


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                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Hospital Based Indicator                          1    483   483  CHAR
     Description: Indicates if the provider is based in a hospital.
     SAS Name:    HOSP_BSD_SW
     COBOL Name:  HOSP-BSD-SW

   LTC Cross Ref Provider Number                     10   485   494  CHAR
     Description: LTC cross ref provider number
     SAS Name:    LTC_CROSS_REF_PROVIDER_NUMBER
     COBOL Name:  LTC-CROSS-REF-PROVIDER-NUMBER

   Multiple Facility Organization Name               38   513   550  CHAR
     Description: Name of the multi-facility organization that owns the
                  facility.
     SAS Name:    MLT_FAC_ORG_NAME
     COBOL Name:  MLT-FAC-ORG-NAME

   Multiple Facility Organization Owned Indicator    1    551   551  CHAR
     Description: Indicates if a facility is owned by an organization that
                  owns (or leases) two or more long term care facilities.
     SAS Name:    MLT_OWND_FAC_ORG_SW
     COBOL Name:  MLT-OWND-FAC-ORG-SW

   Organized Family Group Indicator                  1    626   626  VARCHAR2
     Description: Indicates if the facility has an organized group of
                  family members of residents.
     SAS Name:    ORGNZ_FMLY_MBR_GRP_SW
     COBOL Name:  ORGNZ-FMLY-MBR-GRP-SW

   Organized Resident Group Indicator                1    627   627  VARCHAR2
     Description: Indicates if the facility has an organized residents
                  group.
     SAS Name:    ORGNZ_RSDNT_GRP_SW
     COBOL Name:  ORGNZ-RSDNT-GRP-SW

   Program Participation Code                        1    640   640  CHAR
     Description: Indicates if the provider participates in Medicare,
                  Medicaid, or both programs.
     SAS Name:    PGM_PRTCPTN_CD
     COBOL Name:  PGM-PRTCPTN-CD
     VALUES:      1=MEDICARE ONLY
                  2=MEDICAID ONLY
                  3=MEDICARE AND MEDICAID

   Related Provider Number                           10   686   695  CHAR
     Description: Related provider number
     SAS Name:    RELATED_PROVIDER_NUMBER
     COBOL Name:  RELATED-PROVIDER-NUMBER

   Services: Blood Administration Off-Site Residents 1    703   703  VARCHAR2
   Indicator
     Description: Indicates if blood administration and storage services
                  are provided off-site to residents.
     SAS Name:    BLOOD_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  BLOOD-SRVC-OFSITE-RSDNT-SW

   Services: Blood Administration On-Site Nonresidents 1    704   704  VARCHAR2
   Indicator
     Description: Indicates if blood administration and storage services
                  are provided on-site to nonresidents.
     SAS Name:    BLOOD_SRVC_ONST_NRSDNT_SW
     COBOL Name:  BLOOD-SRVC-ONST-NRSDNT-SW



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                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

   Services: Blood Administration On-Site Residents  1    705   705  VARCHAR2
   Indicator
     Description: Indicates if blood administration and storage services
                  are provided on-site to residents.
     SAS Name:    BLOOD_SRVC_ONST_RSDNT_SW
     COBOL Name:  BLOOD-SRVC-ONST-RSDNT-SW

   Services: Clinical Laboratory - Off-Site Residents 1    712   712  VARCHAR2
   Indicator
     Description: Indicates if clinical laboratory services are provided
                  off-site to residents.
     SAS Name:    CL_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  CL-SRVC-OFSITE-RSDNT-SW

   Services: Clinical Laboratory - On-Site Nonresidents 1    713   713  VARCHAR2
   Indicator
     Description: Indicates if clinical laboratory services are provided
                  on-site to nonresidents.
     SAS Name:    CL_SRVC_ONST_NRSDNT_SW
     COBOL Name:  CL-SRVC-ONST-NRSDNT-SW

   Services: Clinical Laboratory - On-Site Residents 1    714   714  VARCHAR2
   Indicator
     Description: Indicates if clinical laboratory services are provided
                  on-site to residents.
     SAS Name:    CL_SRVC_ONST_RSDNT_SW
     COBOL Name:  CL-SRVC-ONST-RSDNT-SW

   Services: Dental Off-Site Residents Indicator     1    720   720  VARCHAR2
     Description: Indicates if dental services are provided off-site to
                  residents.
     SAS Name:    DNTL_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  DNTL-SRVC-OFSITE-RSDNT-SW

   Services: Dental On-Site Nonresidents Indicator   1    721   721  VARCHAR2
     Description: Indicates if dental services are provided on-site to
                  nonresidents.
     SAS Name:    DNTL_SRVC_ONST_NRSDNT_SW
     COBOL Name:  DNTL-SRVC-ONST-NRSDNT-SW

   Services: Dental On-Site Residents Indicator      1    722   722  VARCHAR2
     Description: Indicates if dental services are provided on-site to
                  residents.
     SAS Name:    DNTL_SRVC_ONST_RSDNT_SW
     COBOL Name:  DNTL-SRVC-ONST-RSDNT-SW

   Services: Dietary Off-Site Residents Indicator    1    726   726  VARCHAR2
     Description: Indicates if dietary services are provided off-site to
                  residents.
     SAS Name:    DTRY_OFSITE_RSDNT_SW
     COBOL Name:  DTRY-OFSITE-RSDNT-SW

   Services: Dietary On-Site Nonresidents Indicator  1    727   727  VARCHAR2
     Description: Indicates if dietary services are provided on-site to
                  nonresidents.
     SAS Name:    DTRY_ONST_NRSDNT_SW
     COBOL Name:  DTRY-ONST-NRSDNT-SW

   Services: Dietary On-Site Residents Indicator     1    728   728  VARCHAR2
     Description: Indicates if dietary services are provided on-site to
                  residents.
     SAS Name:    DTRY_ONST_RSDNT_SW
     COBOL Name:  DTRY-ONST-RSDNT-SW


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 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Services: Housekeeping Off-Site Residents Indicator 1    738   738  VARCHAR2
     Description: Indicates if housekeeping services are provided off-site
                  to residents.
     SAS Name:    HSEKPNG_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  HSEKPNG-SRVC-OFSITE-RSDNT-SW

   Services: Housekeeping On-Site Nonresidents Indicator 1    739   739  VARCHAR2
     Description: Indicates if housekeeping services are provided on-site
                  to nonresidents.
     SAS Name:    HSEKPNG_SRVC_ONST_NRSDNT_SW
     COBOL Name:  HSEKPNG-SRVC-ONST-NRSDNT-SW

   Services: Housekeeping On-Site Residents Indicator 1    740   740  VARCHAR2
     Description: Indicates if housekeeping services are provided on-site
                  to residents.
     SAS Name:    HSEKPNG_SRVC_ONST_RSDNT_SW
     COBOL Name:  HSEKPNG-SRVC-ONST-RSDNT-SW

   Services: Mental Health Off-Site Residents Indicator 1    747   747  VARCHAR2
     Description: Indicates if mental health services are provided off-site
                  to residents.
     SAS Name:    MENTL_HLTH_OFSITE_RSDNT_SW
     COBOL Name:  MENTL-HLTH-OFSITE-RSDNT-SW

   Services: Mental Health On-Site Nonresidents      1    748   748  VARCHAR2
   Indicator
     Description: Indicates if mental health services are provided on-site
                  to nonresidents.
     SAS Name:    MENTL_HLTH_ONST_NRSDNT_SW
     COBOL Name:  MENTL-HLTH-ONST-NRSDNT-SW

   Services: Mental Health On-Site Residents Indicator 1    749   749  VARCHAR2
     Description: Indicates if mental health services are provided on-site
                  to residents.
     SAS Name:    MENTL_HLTH_ONST_RSDNT_SW
     COBOL Name:  MENTL-HLTH-ONST-RSDNT-SW

   Services: Nursing Off-Site Residents Indicator    1    760   760  VARCHAR2
     Description: Indicates if nursing services are provided off-site to
                  residents.
     SAS Name:    NRSNG_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  NRSNG-SRVC-OFSITE-RSDNT-SW

   Services: Nursing On-Site Nonresidents Indicator  1    761   761  VARCHAR2
     Description: Indicates if nursing services are provided on-site to
                  nonresidents.
     SAS Name:    NRSNG_SRVC_ONST_NRSDNT_SW
     COBOL Name:  NRSNG-SRVC-ONST-NRSDNT-SW

   Services: Nursing On-Site Residents Indicator     1    762   762  VARCHAR2
     Description: Indicates if nursing services are provided on-site to
                  residents.
     SAS Name:    NRSNG_SRVC_ONST_RSDNT_SW
     COBOL Name:  NRSNG-SRVC-ONST-RSDNT-SW

   Services: OT Off-Site Residents Indicator         1    776   776  VARCHAR2
     Description: Indicates if occupational therapy services are provided
                  off-site to residents.
     SAS Name:    OT_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  OT-SRVC-OFSITE-RSDNT-SW

   Services: OT On-Site Nonresidents Indicator       1    777   777  VARCHAR2


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 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Indicates if occupational therapy services are provided
                  on-site to nonresidents.
     SAS Name:    OT_SRVC_ONST_NRSDNT_SW
     COBOL Name:  OT-SRVC-ONST-NRSDNT-SW

   Services: OT On-Site Residents Indicator          1    778   778  VARCHAR2
     Description: Indicates if occupational therapy services are provided
                  on-site to residents.
     SAS Name:    OT_SRVC_ONST_RSDNT_SW
     COBOL Name:  OT-SRVC-ONST-RSDNT-SW

   Services: Pharmacy Off-Site Residents Indicator   1    789   789  VARCHAR2
     Description: Indicates if pharmacy services are provided off-site to
                  residents.
     SAS Name:    PHRMCY_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  PHRMCY-SRVC-OFSITE-RSDNT-SW

   Services: Pharmacy On-Site Nonresidents Indicator 1    790   790  VARCHAR2
     Description: Indicates if pharmacy services are provided on-site to
                  nonresidents.
     SAS Name:    PHRMCY_SRVC_ONST_NRSDNT_SW
     COBOL Name:  PHRMCY-SRVC-ONST-NRSDNT-SW

   Services: Pharmacy On-Site Residents Indicator    1    791   791  VARCHAR2
     Description: Indicates if pharmacy services are provided on-site to
                  residents.
     SAS Name:    PHRMCY_SRVC_ONST_RSDNT_SW
     COBOL Name:  PHRMCY-SRVC-ONST-RSDNT-SW

   Services: Physician Extender Off-Site Residents   1    796   796  VARCHAR2
   Indicator
     Description: Indicates if physician extender services are provided
                  off-site to residents.
     SAS Name:    PHYSN_EXT_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  PHYSN-EXT-SRVC-OFSITE-RSDNT-SW

   Services: Physician Extender On-Site Nonresidents 1    797   797  VARCHAR2
   Indicator
     Description: Indicates if physician extender services are provided
                  on-site to nonresidents.
     SAS Name:    PHYSN_EXT_SRVC_ONST_NRSDNT_SW
     COBOL Name:  PHYSN-EXT-SRVC-ONST-NRSDNT-SW

   Services: Physician Extender On-Site Residents    1    798   798  VARCHAR2
   Indicator
     Description: Indicates if physician extender services are provided
                  on-site to residents.
     SAS Name:    PHYSN_EXT_SRVC_ONST_RSDNT_SW
     COBOL Name:  PHYSN-EXT-SRVC-ONST-RSDNT-SW

   Services: Physician Off-Site Residents Indicator  1    799   799  VARCHAR2
     Description: Indicates if physician services are provided off-site to
                  residents.
     SAS Name:    PHYSN_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  PHYSN-SRVC-OFSITE-RSDNT-SW

   Services: Physician On-Site Nonresidents Indicator 1    800   800  VARCHAR2
     Description: Indicates if physician services are provided on-site to
                  nonresidents.
     SAS Name:    PHYSN_SRVC_ONST_NRSDNT_SW
     COBOL Name:  PHYSN-SRVC-ONST-NRSDNT-SW

   Services: Physician On-Site Residents Indicator   1    801   801  VARCHAR2


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 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Indicates if physician services are provided on-site to
                  residents.
     SAS Name:    PHYSN_SRVC_ONST_RSDNT_SW
     COBOL Name:  PHYSN-SRVC-ONST-RSDNT-SW

   Services: Podiatry Off-Site Residents Indicator   1    802   802  VARCHAR2
     Description: Indicates if podiatry services are provided off-site to
                  residents.
     SAS Name:    PDTRY_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  PDTRY-SRVC-OFSITE-RSDNT-SW

   Services: Podiatry On-Site Nonresidents Indicator 1    803   803  VARCHAR2
     Description: Indicates if podiatry services are provided on-site to
                  nonresidents.
     SAS Name:    PDTRY_SRVC_ONST_NRSDNT_SW
     COBOL Name:  PDTRY-SRVC-ONST-NRSDNT-SW

   Services: Podiatry On-Site Residents Indicator    1    804   804  VARCHAR2
     Description: Indicates if podiatry services are provided on-site to
                  residents.
     SAS Name:    PDTRY_SRVC_ONST_RSDNT_SW
     COBOL Name:  PDTRY-SRVC-ONST-RSDNT-SW

   Services: PT Off-Site Residents Indicator         1    814   814  VARCHAR2
     Description: Indicates if physical therapy services are provided
                  off-site to residents.
     SAS Name:    PT_OFSITE_RSDNT_SW
     COBOL Name:  PT-OFSITE-RSDNT-SW

   Services: PT On-Site Nonresidents Indicator       1    815   815  VARCHAR2
     Description: Indicates if physical therapy services are provided
                  on-site to nonresidents.
     SAS Name:    PT_ONST_NRSDNT_SW
     COBOL Name:  PT-ONST-NRSDNT-SW

   Services: PT On-Site Residents Indicator          1    816   816  VARCHAR2
     Description: Indicates if physical therapy services are provided
                  on-site to residents.
     SAS Name:    PT_ONST_RSDNT_SW
     COBOL Name:  PT-ONST-RSDNT-SW

   Services: Social Work Off-Site Residents Indicator 1    827   827  VARCHAR2
     Description: Indicates if social work services are provided off-site
                  to residents.
     SAS Name:    SCL_WORK_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  SCL-WORK-SRVC-OFSITE-RSDNT-SW

   Services: Social Work On-Site Nonresidents Indicator 1    828   828  VARCHAR2
     Description: Indicates if social work services are provided on-site to
                  nonresidents.
     SAS Name:    SCL_WORK_SRVC_ONST_NRSDNT_SW
     COBOL Name:  SCL-WORK-SRVC-ONST-NRSDNT-SW

   Services: Social Work On-Site Residents Indicator 1    829   829  VARCHAR2
     Description: Indicates if social work services are provided on-site to
                  residents.
     SAS Name:    SCL_WORK_SRVC_ONST_RSDNT_SW
     COBOL Name:  SCL-WORK-SRVC-ONST-RSDNT-SW

   Services: Speech Pathology Off-Site Residents     1    834   834  VARCHAR2
   Indicator
     Description: Indicates if speech/language pathology services are
                  provided off-site to residents.


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 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     SAS Name:    SPCH_PTHLGY_OFSITE_RSDNT_SW
     COBOL Name:  SPCH-PTHLGY-OFSITE-RSDNT-SW

   Services: Speech Pathology On-Site Nonresidents   1    835   835  VARCHAR2
   Indicator
     Description: Indicates if speech/language pathology services are
                  provided on-site to nonresidents.
     SAS Name:    SPCH_PTHLGY_ONST_NRSDNT_SW
     COBOL Name:  SPCH-PTHLGY-ONST-NRSDNT-SW

   Services: Speech Pathology On-Site Residents      1    836   836  VARCHAR2
   Indicator
     Description: Indicates if speech/language pathology services are
                  provided on-site to residents.
     SAS Name:    SPCH_PTHLGY_ONST_RSDNT_SW
     COBOL Name:  SPCH-PTHLGY-ONST-RSDNT-SW

   Services: Therapeutic - Other Activities Staff -  1    839   839  VARCHAR2
   Off-Site Residents Indicator
     Description: Indicates if therapeutic services are provided off-site
                  to residents by other activities staff.
     SAS Name:    ACTVTY_OTHR_OFSITE_RSDNT_SW
     COBOL Name:  ACTVTY-OTHR-OFSITE-RSDNT-SW

   Services: Therapeutic - Other Activities Staff -  1    840   840  VARCHAR2
   On-Site Nonresidents Indicator
     Description: Indicates if therapeutic services are provided on-site to
                  nonresidents by other activities staff.
     SAS Name:    ACTVTY_OTHR_ONST_NRSDNT_SW
     COBOL Name:  ACTVTY-OTHR-ONST-NRSDNT-SW

   Services: Therapeutic - Other Activities Staff -  1    841   841  VARCHAR2
   On-Site Residents Indicator
     Description: Indicates if therapeutic services are provided on-site to
                  residents by other activities staff.
     SAS Name:    ACTVTY_OTHR_ONST_RSDNT_SW
     COBOL Name:  ACTVTY-OTHR-ONST-RSDNT-SW

   Services: Therapeutic - Other Social Services Staff - 1    842   842  VARCHAR2
   Off-Site Residents Indicator
     Description: Indicates if other therapeutic social services are
                  provided off-site to residents.
     SAS Name:    SCL_SRVC_OTHR_OFSITE_RSDNT_SW
     COBOL Name:  SCL-SRVC-OTHR-OFSITE-RSDNT-SW

   Services: Therapeutic - Other Social Services Staff - 1    843   843  VARCHAR2
   On-Site Nonresidents Indicator
     Description: Indicates if other therapeutic social services are
                  provided on-site to nonresidents.
     SAS Name:    SCL_SRVC_OTHR_ONST_NRSDNT_SW
     COBOL Name:  SCL-SRVC-OTHR-ONST-NRSDNT-SW

   Services: Therapeutic - Other Social Services Staff - 1    844   844  VARCHAR2
   On-Site Residents Indicator
     Description: Indicates if other therapeutic social services are
                  provided on-site to residents.
     SAS Name:    SCL_SRVC_OTHR_ONST_RSDNT_SW
     COBOL Name:  SCL-SRVC-OTHR-ONST-RSDNT-SW

   Services: Therapeutic - Qualified Activities      1    845   845  VARCHAR2
   Professional - Off-Site Residents Indicator
     Description: Indicates if therapeutic services are provided off-site
                  to residents by qualified activities professionals.


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 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     SAS Name:    ACTVTY_OFSITE_RSDNT_SW
     COBOL Name:  ACTVTY-OFSITE-RSDNT-SW

   Services: Therapeutic - Qualified Activities      1    846   846  VARCHAR2
   Professional - On-Site Nonresidents Indicator
     Description: Indicates if therapeutic services are provided on-site to
                  nonresidents by qualified activities professionals.
     SAS Name:    ACTVTY_ONST_NRSDNT_SW
     COBOL Name:  ACTVTY-ONST-NRSDNT-SW

   Services: Therapeutic - Qualified Activities      1    847   847  VARCHAR2
   Professional - On-Site Residents Indicator
     Description: Indicates if therapeutic services are provided on-site to
                  residents by qualified activities professionals.
     SAS Name:    ACTVTY_ONST_RSDNT_SW
     COBOL Name:  ACTVTY-ONST-RSDNT-SW

   Services: Therapeutic Recreational Specialty Off-Site 1    849   849  VARCHAR2
   Residents Indicator
     Description: Indicates if therapeutic recreation specialist services
                  are provided off-site to residents.
     SAS Name:    THRPTC_RCRTNL_OFSITE_RSDNT_SW
     COBOL Name:  THRPTC-RCRTNL-OFSITE-RSDNT-SW

   Services: Therapeutic Recreational Specialty On-Site 1    850   850  VARCHAR2
   Nonresidents Indicator
     Description: Indicates if therapeutic recreation specialist services
                  are provided on-site to nonresidents.
     SAS Name:    THRPTC_RCRTNL_ONST_NRSDNT_SW
     COBOL Name:  THRPTC-RCRTNL-ONST-NRSDNT-SW

   Services: Therapeutic Recreational Specialty On-Site 1    851   851  VARCHAR2
   Residents Indicator
     Description: Indicates if therapeutic recreation specialist services
                  are provided on-site to residents.
     SAS Name:    THRPTC_RCRTNL_ONST_RSDNT_SW
     COBOL Name:  THRPTC-RCRTNL-ONST-RSDNT-SW

   Services: Vocational Off-Site Residents Indicator 1    854   854  VARCHAR2
     Description: Indicates if vocational services are provided off-site to
                  residents.
     SAS Name:    VCTNL_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  VCTNL-SRVC-OFSITE-RSDNT-SW

   Services: Vocational On-Site Nonresidents Indicator 1    855   855  VARCHAR2
     Description: Indicates if vocational services are provided on-site to
                  nonresidents.
     SAS Name:    VCTNL_SRVC_ONST_NRSDNT_SW
     COBOL Name:  VCTNL-SRVC-ONST-NRSDNT-SW

   Services: Vocational On-Site Residents Indicator  1    856   856  VARCHAR2
     Description: Indicates if vocational services are provided on-site to
                  residents.
     SAS Name:    VCTNL_SRVC_ONST_RSDNT_SW
     COBOL Name:  VCTNL-SRVC-ONST-RSDNT-SW

   Services: X-ray Off-Site Residents Indicator      1    857   857  VARCHAR2
     Description: Indicates if diagnostic X-ray services are provided
                  off-site to residents.
     SAS Name:    DGNSTC_XRAY_OFSITE_RSDNT_SW
     COBOL Name:  DGNSTC-XRAY-OFSITE-RSDNT-SW

   Services: X-ray On-Site Nonresidents Indicator    1    858   858  VARCHAR2


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 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Indicates if diagnostic X-ray services are provided
                  on-site to nonresidents.
     SAS Name:    DGNSTC_XRAY_ONST_NRSDNT_SW
     COBOL Name:  DGNSTC-XRAY-ONST-NRSDNT-SW

   Services: X-ray On-Site Residents Indicator       1    859   859  VARCHAR2
     Description: Indicates if diagnostic X-ray services are provided
                  on-site to residents.
     SAS Name:    DGNSTC_XRAY_ONST_RSDNT_SW
     COBOL Name:  DGNSTC-XRAY-ONST-RSDNT-SW

   Staff Count Override Indicator                    1    861   861  CHAR
     Description: Indicates if the regional office has approved a
                  significant staff count change from the previous
                  certification.
     SAS Name:    OVRRD_STFG_SW
     COBOL Name:  OVRRD-STFG-SW

   Staff Count: Administrative Staff - Contract      8    862   869  NUMBER
     Description: Number of full-time equivalent administrative staff under
                  contract to a facility.
     SAS Name:    PROFNL_ADMIN_CNTRCT_CNT
     COBOL Name:  PROFNL-ADMIN-CNTRCT-CNT

   Staff Count: Administrative Staff - Full-Time     8    870   877  NUMBER
     Description: Number of full-time equivalent administrative staff
                  employed on a full-time basis by a facility.
     SAS Name:    PROFNL_ADMIN_FLTM_CNT
     COBOL Name:  PROFNL-ADMIN-FLTM-CNT

   Staff Count: Administrative Staff - Part-Time     8    878   885  NUMBER
     Description: Number of full-time equivalent administrative staff
                  employed on a part-time basis by a facility.
     SAS Name:    PROFNL_ADMIN_PRTM_CNT
     COBOL Name:  PROFNL-ADMIN-PRTM-CNT

   Staff Count: Certified Nurse Aide - Contract      8    910   917  NUMBER
     Description: Number of full-time equivalent certified nurse aides
                  under contract to a facility.
     SAS Name:    NRS_AIDE_CNTRCT_CNT
     COBOL Name:  NRS-AIDE-CNTRCT-CNT

   Staff Count: Certified Nurse Aide - Full-Time     8    918   925  NUMBER
     Description: Number of full-time equivalent certified nurse aides
                  employed full-time by a facility.
     SAS Name:    NRS_AIDE_FLTM_CNT
     COBOL Name:  NRS-AIDE-FLTM-CNT

   Staff Count: Certified Nurse Aide - Part-Time     8    926   933  NUMBER
     Description: Number of full-time equivalent certified nurse aides
                  employed part-time by a facility.
     SAS Name:    NRS_AIDE_PRTM_CNT
     COBOL Name:  NRS-AIDE-PRTM-CNT

   Staff Count: Dentist - Contract                   8    958   965  NUMBER
     Description: Number of full-time equivalent dentists under contract to
                  a facility.
     SAS Name:    DNTST_CNTRCT_CNT
     COBOL Name:  DNTST-CNTRCT-CNT

   Staff Count: Dentist - Full-Time                  8    966   973  NUMBER
     Description: Number of full-time equivalent dentists employed full
                  time by a facility.


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 33
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     SAS Name:    DNTST_FLTM_CNT
     COBOL Name:  DNTST-FLTM-CNT

   Staff Count: Dentist - Part-Time                  8    974   981  NUMBER
     Description: Number of full-time equivalent dentists employed part
                  time by a facility.
     SAS Name:    DNTST_PRTM_CNT
     COBOL Name:  DNTST-PRTM-CNT

   Staff Count: Dietitian - Contract                 8    990   997  NUMBER
     Description: Number of full-time equivalent dietitians under contract
                  to a facility.
     SAS Name:    DIETN_CNTRCT_CNT
     COBOL Name:  DIETN-CNTRCT-CNT

   Staff Count: Dietitian - Full-Time                8    998   1005 NUMBER
     Description: Number of full-time equivalent dietitians employed full
                  time by a facility.
     SAS Name:    DIETN_FLTM_CNT
     COBOL Name:  DIETN-FLTM-CNT

   Staff Count: Dietitian - Part-Time                8    1006  1013 NUMBER
     Description: Number of full-time equivalent dietitians employed part
                  time by a facility.
     SAS Name:    DIETN_PRTM_CNT
     COBOL Name:  DIETN-PRTM-CNT

   Staff Count: Food Service Worker - Contract       8    1022  1029 NUMBER
     Description: Number of full-time equivalent food service personnel
                  under contract to a facility.
     SAS Name:    FOOD_SRVC_CNTRCT_CNT
     COBOL Name:  FOOD-SRVC-CNTRCT-CNT

   Staff Count: Food Service Worker - Full-Time      8    1030  1037 NUMBER
     Description: Number of full-time equivalent food service personnel
                  employed  full-time by a facility.
     SAS Name:    FOOD_SRVC_FLTM_CNT
     COBOL Name:  FOOD-SRVC-FLTM-CNT

   Staff Count: Food Service Worker - Part-Time      8    1038  1045 NUMBER
     Description: Number of full-time equivalent food service personnel
                  employed  part-time by a facility.
     SAS Name:    FOOD_SRVC_PRTM_CNT
     COBOL Name:  FOOD-SRVC-PRTM-CNT

   Staff Count: Housekeeping - Contract              8    1070  1077 NUMBER
     Description: Number of full-time equivalent housekeeping personnel
                  under contract to a facility.
     SAS Name:    HSEKPNG_CNTRCT_CNT
     COBOL Name:  HSEKPNG-CNTRCT-CNT

   Staff Count: Housekeeping - Full-Time             8    1078  1085 NUMBER
     Description: Number of full-time equivalent housekeeping personnel
                  employed  full-time by a facility.
     SAS Name:    HSEKPNG_FLTM_CNT
     COBOL Name:  HSEKPNG-FLTM-CNT

   Staff Count: Housekeeping - Part-Time             8    1086  1093 NUMBER
     Description: Number of full-time equivalent housekeeping personnel
                  employed  part-time by a facility.
     SAS Name:    HSEKPNG_PRTM_CNT
     COBOL Name:  HSEKPNG-PRTM-CNT



 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 34
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

   Staff Count: LPN/LVN - Contract                   8    1118  1125 NUMBER
     Description: Number of full-time equivalent licensed
                  practical/vocational nurses under contract to a facility.
     SAS Name:    LPN_LVN_CNTRCT_CNT
     COBOL Name:  LPN-LVN-CNTRCT-CNT

   Staff Count: LPN/LVN - Full-Time                  8    1126  1133 NUMBER
     Description: Number of full-time equivalent licensed
                  practical/vocational nurses employed full-time by a
                  facility.
     SAS Name:    LPN_LVN_FLTM_CNT
     COBOL Name:  LPN-LVN-FLTM-CNT

   Staff Count: LPN/LVN - Part-Time                  8    1134  1141 NUMBER
     Description: Number of full-time equivalent licensed
                  practical/vocational nurses employed part-time by a
                  facility.
     SAS Name:    LPN_LVN_PRTM_CNT
     COBOL Name:  LPN-LVN-PRTM-CNT

   Staff Count: Medical Director - Contract          8    1150  1157 NUMBER
     Description: Number of full-time equivalent medical directors under
                  contract to a facility.
     SAS Name:    MDCL_DRCTR_CNTRCT_CNT
     COBOL Name:  MDCL-DRCTR-CNTRCT-CNT

   Staff Count: Medical Director - Full-Time         8    1158  1165 NUMBER
     Description: Number of full-time equivalent medical directors employed
                  full-time by a facility.
     SAS Name:    MDCL_DRCTR_FLTM_CNT
     COBOL Name:  MDCL-DRCTR-FLTM-CNT

   Staff Count: Medical Director - Part-Time         8    1166  1173 NUMBER
     Description: Number of full-time equivalent medical directors employed
                  part-time by a facility.
     SAS Name:    MDCL_DRCTR_PRTM_CNT
     COBOL Name:  MDCL-DRCTR-PRTM-CNT

   Staff Count: Medication Aide/Technician - Contract 8    1198  1205 NUMBER
     Description: Number of full-time equivalent medication aides/
                  technicians under contract to a facility.
     SAS Name:    MDCTN_AIDE_CNTRCT_CNT
     COBOL Name:  MDCTN-AIDE-CNTRCT-CNT

   Staff Count: Medication Aide/Technician - Full-Time 8    1206  1213 NUMBER
     Description: Number of full-time equivalent medication aides/
                  technicians employed full-time by a facility.
     SAS Name:    MDCTN_AIDE_FLTM_CNT
     COBOL Name:  MDCTN-AIDE-FLTM-CNT

   Staff Count: Medication Aide/Technician - Part-Time 8    1214  1221 NUMBER
     Description: Number of full-time equivalent medication aides/
                  technicians employed part-time by a facility.
     SAS Name:    MDCTN_AIDE_PRTM_CNT
     COBOL Name:  MDCTN-AIDE-PRTM-CNT

   Staff Count: Mental Health Services - Contract    8    1222  1229 NUMBER
     Description: Number of full-time equivalent mental health services
                  personnel under contract to a facility.
     SAS Name:    MENTL_HLTH_SRVC_CNTRCT_CNT
     COBOL Name:  MENTL-HLTH-SRVC-CNTRCT-CNT

   Staff Count: Mental Health Services - Full-Time   8    1230  1237 NUMBER


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 35
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Number of full-time equivalent mental health services
                  personnel employed full-time by a facility.
     SAS Name:    MENTL_HLTH_SRVC_FLTM_CNT
     COBOL Name:  MENTL-HLTH-SRVC-FLTM-CNT

   Staff Count: Mental Health Services - Part-Time   8    1238  1245 NUMBER
     Description: Number of full-time equivalent mental health services
                  personnel employed part-time by a facility.
     SAS Name:    MENTL_HLTH_SRVC_PRTM_CNT
     COBOL Name:  MENTL-HLTH-SRVC-PRTM-CNT

   Staff Count: Nurse Aide in Training - Contract    8    1254  1261 NUMBER
     Description: Number of full-time equivalent nurse aides in training
                  under contract to a facility.
     SAS Name:    NAT_CNTRCT_CNT
     COBOL Name:  NAT-CNTRCT-CNT

   Staff Count: Nurse Aide in Training - Full-Time   8    1262  1269 NUMBER
     Description: Number of full-time equivalent nurse aides in training
                  employed full-time by a facility.
     SAS Name:    NAT_FLTM_CNT
     COBOL Name:  NAT-FLTM-CNT

   Staff Count: Nurse Aide in Training - Part-Time   8    1270  1277 NUMBER
     Description: Number of full-time equivalent nurse aides in training
                  employed part-time by a facility.
     SAS Name:    NAT_PRTM_CNT
     COBOL Name:  NAT-PRTM-CNT

   Staff Count: Nurse With Administrative Duties -   8    1286  1293 NUMBER
   Contract
     Description: Number of full-time equivalent nurses with administrative
                  duties under contract to a facility.
     SAS Name:    NRS_ADMINV_CNTRCT_CNT
     COBOL Name:  NRS-ADMINV-CNTRCT-CNT

   Staff Count: Nurse With Administrative Duties -   8    1294  1301 NUMBER
   Full-Time
     Description: Number of full-time equivalent nurses with administrative
                  duties employed full-time by a facility.
     SAS Name:    NRS_ADMINV_FLTM_CNT
     COBOL Name:  NRS-ADMINV-FLTM-CNT

   Staff Count: Nurse With Administrative Duties -   8    1302  1309 NUMBER
   Part-Time
     Description: Number of full-time equivalent nurses with administrative
                  duties employed part-time by a facility.
     SAS Name:    NRS_ADMINV_PRTM_CNT
     COBOL Name:  NRS-ADMINV-PRTM-CNT

   Staff Count: OT - Arrangement                     8    1318  1325 NUMBER
     Description: Number of full-time equivalent occupational therapists
                  under arrangement to the provider
     SAS Name:    OCPTNL_THRPST_CNTRCT_CNT
     COBOL Name:  OCPTNL-THRPST-CNTRCT-CNT

   Staff Count: OT - Full-Time                       8    1326  1333 NUMBER
     Description: Number of full-time equivalent occupational therapists
                  employed full-time by a facility.
     SAS Name:    OCPTNL_THRPST_FLTM_CNT
     COBOL Name:  OCPTNL-THRPST-FLTM-CNT

   Staff Count: OT - Part-Time                       8    1334  1341 NUMBER


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 36
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Number of full-time equivalent occupational therapists
                  employed part-time by a facility.
     SAS Name:    OCPTNL_THRPST_PRTM_CNT
     COBOL Name:  OCPTNL-THRPST-PRTM-CNT

   Staff Count: OT Aide - Contract                   8    1342  1349 NUMBER
     Description: Number of full-time equivalent occupational therapy aides
                  under contract to a facility.
     SAS Name:    OT_AIDE_CNTRCT_CNT
     COBOL Name:  OT-AIDE-CNTRCT-CNT

   Staff Count: OT Aide - Full-Time                  8    1350  1357 NUMBER
     Description: Number of full-time equivalent occupational therapy aides
                  employed full-time by a facility.
     SAS Name:    OT_AIDE_FLTM_CNT
     COBOL Name:  OT-AIDE-FLTM-CNT

   Staff Count: OT Aide - Part-Time                  8    1358  1365 NUMBER
     Description: Number of full-time equivalent occupational therapy aides
                  employed part-time by a facility.
     SAS Name:    OT_AIDE_PRTM_CNT
     COBOL Name:  OT-AIDE-PRTM-CNT

   Staff Count: OT Assistant - Contract              8    1366  1373 NUMBER
     Description: Number of full-time equivalent occupational therapy
                  assistants under contract to a facility.
     SAS Name:    OT_ASTNT_CNTRCT_CNT
     COBOL Name:  OT-ASTNT-CNTRCT-CNT

   Staff Count: OT Assistant - Full-Time             8    1374  1381 NUMBER
     Description: Number of full-time equivalent occupational therapy
                  assistants employed full-time by a facility.
     SAS Name:    OT_ASTNT_FLTM_CNT
     COBOL Name:  OT-ASTNT-FLTM-CNT

   Staff Count: OT Assistant - Part-Time             8    1382  1389 NUMBER
     Description: Number of full-time equivalent occupational therapy
                  assistants employed part-time by a facility.
     SAS Name:    OT_ASTNT_PRTM_CNT
     COBOL Name:  OT-ASTNT-PRTM-CNT

   Staff Count: Other Activities - Contract          8    1398  1405 NUMBER
     Description: Number of full-time equivalent other activities staff
                  providing therapeutic services under contract to a
                  facility.
     SAS Name:    ACTVTY_STF_OTHR_CNTRCT_CNT
     COBOL Name:  ACTVTY-STF-OTHR-CNTRCT-CNT

   Staff Count: Other Activities - Full-Time         8    1406  1413 NUMBER
     Description: Number of full-time equivalent other activities staff
                  providing therapeutic services employed full time by a
                  facility.
     SAS Name:    ACTVTY_STF_OTHR_FLTM_CNT
     COBOL Name:  ACTVTY-STF-OTHR-FLTM-CNT

   Staff Count: Other Activities - Part-Time         8    1414  1421 NUMBER
     Description: Number of full-time equivalent other activities staff
                  providing therapeutic services employed part time by a
                  facility.
     SAS Name:    ACTVTY_STF_OTHR_PRTM_CNT
     COBOL Name:  ACTVTY-STF-OTHR-PRTM-CNT

   Staff Count: Other Physician - Contract           8    1422  1429 NUMBER


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 37
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Number of full-time equivalent other physicians under
                  contract to a facility.
     SAS Name:    PHYSN_OTHR_CNTRCT_CNT
     COBOL Name:  PHYSN-OTHR-CNTRCT-CNT

   Staff Count: Other Physician - Full-Time          8    1430  1437 NUMBER
     Description: Number of full-time equivalent other physicians employed
                  full-time by a facility.
     SAS Name:    PHYSN_OTHR_FLTM_CNT
     COBOL Name:  PHYSN-OTHR-FLTM-CNT

   Staff Count: Other Physician - Part-Time          8    1438  1445 NUMBER
     Description: Number of full-time equivalent other physicians employed
                  part-time by a facility.
     SAS Name:    PHYSN_OTHR_PRTM_CNT
     COBOL Name:  PHYSN-OTHR-PRTM-CNT

   Staff Count: Other Social Services - Contract     8    1446  1453 NUMBER
     Description: Number of full-time equivalent other social services
                  staff under contract to a facility.
     SAS Name:    SCL_SRVC_OTHR_STF_CNTRCT_CNT
     COBOL Name:  SCL-SRVC-OTHR-STF-CNTRCT-CNT

   Staff Count: Other Social Services - Full-Time    8    1454  1461 NUMBER
     Description: Number of full-time equivalent other social services
                  staff employed full time by a facility.
     SAS Name:    SCL_SRVC_OTHR_STF_FLTM_CNT
     COBOL Name:  SCL-SRVC-OTHR-STF-FLTM-CNT

   Staff Count: Other Social Services - Part-Time    8    1462  1469 NUMBER
     Description: Number of full-time equivalent other social services
                  staff employed part time by a facility.
     SAS Name:    SCL_SRVC_OTHR_STF_PRTM_CNT
     COBOL Name:  SCL-SRVC-OTHR-STF-PRTM-CNT

   Staff Count: Other Staff - Contract               8    1470  1477 NUMBER
     Description: Number of full-time equivalent staff not included in any
                  other categories under contract to the facility.
     SAS Name:    STF_OTHR_CNTRCT_CNT
     COBOL Name:  STF-OTHR-CNTRCT-CNT

   Staff Count: Other Staff - Full-Time              8    1478  1485 NUMBER
     Description: Number of full-time equivalent persons not included in
                  any other categories employed full-time by the facility.
     SAS Name:    STF_OTHR_FLTM_CNT
     COBOL Name:  STF-OTHR-FLTM-CNT

   Staff Count: Other Staff - Part-Time              8    1486  1493 NUMBER
     Description: Number of full-time equivalent persons not included in
                  any other categories employed part-time by the facility.
     SAS Name:    STF_OTHR_PRTM_CNT
     COBOL Name:  STF-OTHR-PRTM-CNT

   Staff Count: Pharmacist - Contract                8    1494  1501 NUMBER
     Description: Number of full-time equivalent pharmacists under contract
                  to a facility.
     SAS Name:    PHRMCST_CNTRCT_CNT
     COBOL Name:  PHRMCST-CNTRCT-CNT

   Staff Count: Pharmacist - Full-Time               8    1502  1509 NUMBER
     Description: Number of full-time equivalent pharmacists employed
                  full-time by a facility.
     SAS Name:    PHRMCST_FLTM_CNT


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 38
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     COBOL Name:  PHRMCST-FLTM-CNT

   Staff Count: Pharmacist - Part-Time               8    1510  1517 NUMBER
     Description: Number of full-time equivalent pharmacists employed
                  part-time by a facility.
     SAS Name:    PHRMCST_PRTM_CNT
     COBOL Name:  PHRMCST-PRTM-CNT

   Staff Count: Physical Therapist - Contract        8    1518  1525 NUMBER
     Description: Number of full-time equivalent physical therapists under
                  contract to a facility.
     SAS Name:    PHYS_THRPST_CNTRCT_CNT
     COBOL Name:  PHYS-THRPST-CNTRCT-CNT

   Staff Count: Physical Therapist - Full-Time       8    1526  1533 NUMBER
     Description: Number of full-time equivalent physical therapists
                  employed full-time by a facility.
     SAS Name:    PHYS_THRPST_FLTM_CNT
     COBOL Name:  PHYS-THRPST-FLTM-CNT

   Staff Count: Physical Therapist - Part-Time       8    1534  1541 NUMBER
     Description: Number of full-time equivalent physical therapists
                  employed part-time by a facility.
     SAS Name:    PHYS_THRPST_PRTM_CNT
     COBOL Name:  PHYS-THRPST-PRTM-CNT

   Staff Count: Physician Extender - Contract        8    1566  1573 NUMBER
     Description: Number of full-time equivalent physician extenders under
                  contract to the facility.
     SAS Name:    PHYSN_EXT_CNTRCT_CNT
     COBOL Name:  PHYSN-EXT-CNTRCT-CNT

   Staff Count: Physician Extender - Full-Time       8    1574  1581 NUMBER
     Description: Number of full-time equivalent physician extenders
                  employed full-time by the facility.
     SAS Name:    PHYSN_EXT_FLTM_CNT
     COBOL Name:  PHYSN-EXT-FLTM-CNT

   Staff Count: Physician Extender - Part-Time       8    1582  1589 NUMBER
     Description: Number of full-time equivalent physician extenders
                  employed part-time by the facility.
     SAS Name:    PHYSN_EXT_PRTM_CNT
     COBOL Name:  PHYSN-EXT-PRTM-CNT

   Staff Count: Podiatrist - Contract                8    1598  1605 NUMBER
     Description: Number of full-time equivalent podiatrists under contract
                  to a facility.
     SAS Name:    PDTRST_CNTRCT_CNT
     COBOL Name:  PDTRST-CNTRCT-CNT

   Staff Count: Podiatrist - Full-Time               8    1606  1613 NUMBER
     Description: Number of full-time equivalent podiatrists employed
                  full-time by a facility.
     SAS Name:    PDTRST_FLTM_CNT
     COBOL Name:  PDTRST-FLTM-CNT

   Staff Count: Podiatrist - Part-Time               8    1614  1621 NUMBER
     Description: Number of full-time equivalent podiatrists employed
                  part-time by a facility.
     SAS Name:    PDTRST_PRTM_CNT
     COBOL Name:  PDTRST-PRTM-CNT

   Staff Count: PT Aide - Contract                   8    1654  1661 NUMBER


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 39
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Number of full-time equivalent physical therapy aides
                  under contract to a facility.
     SAS Name:    PT_AIDE_CNTRCT_CNT
     COBOL Name:  PT-AIDE-CNTRCT-CNT

   Staff Count: PT Aide - Full-Time                  8    1662  1669 NUMBER
     Description: Number of full-time equivalent physical therapy aides
                  employed full-time by a facility.
     SAS Name:    PT_AIDE_FLTM_CNT
     COBOL Name:  PT-AIDE-FLTM-CNT

   Staff Count: PT Aide - Part-Time                  8    1670  1677 NUMBER
     Description: Number of full-time equivalent physical therapy aides
                  employed part-time by a facility.
     SAS Name:    PT_AIDE_PRTM_CNT
     COBOL Name:  PT-AIDE-PRTM-CNT

   Staff Count: PT Assistant - Contract              8    1678  1685 NUMBER
     Description: Number of full-time equivalent physical therapy
                  assistants under contract to a facility.
     SAS Name:    PT_ASTNT_CNTRCT_CNT
     COBOL Name:  PT-ASTNT-CNTRCT-CNT

   Staff Count: PT Assistant - Full-Time             8    1686  1693 NUMBER
     Description: Number of full-time equivalent physical therapy
                  assistants employed full-time by a facility.
     SAS Name:    PT_ASTNT_FLTM_CNT
     COBOL Name:  PT-ASTNT-FLTM-CNT

   Staff Count: PT Assistant - Part-Time             8    1694  1701 NUMBER
     Description: Number of full-time equivalent physical therapy
                  assistants employed part-time by a facility.
     SAS Name:    PT_ASTNT_PRTM_CNT
     COBOL Name:  PT-ASTNT-PRTM-CNT

   Staff Count: Qualified Activities Professional -  8    1702  1709 NUMBER
   Contract
     Description: Number of full-time equivalent qualified activities
                  professionals providing therapeutic services under
                  contract to a facility.
     SAS Name:    ACTVTY_PROFNL_CNTRCT_CNT
     COBOL Name:  ACTVTY-PROFNL-CNTRCT-CNT

   Staff Count: Qualified Activities Professional -  8    1710  1717 NUMBER
   Full-Time
     Description: Number of full-time equivalent qualified activities
                  professionals providing therapeutic services employed
                  full time by a facility.
     SAS Name:    ACTVTY_PROFNL_FLTM_CNT
     COBOL Name:  ACTVTY-PROFNL-FLTM-CNT

   Staff Count: Qualified Activities Professional -  8    1718  1725 NUMBER
   Part-Time
     Description: Number of full-time equivalent qualified activities
                  professionals providing therapeutic services employed
                  part time by a facility.
     SAS Name:    ACTVTY_PROFNL_PRTM_CNT
     COBOL Name:  ACTVTY-PROFNL-PRTM-CNT

   Staff Count: RN - Contract                        8    1758  1765 NUMBER
     Description: Number of full-time equivalent registered nurses under
                  contract to a facility.
     SAS Name:    RN_CNTRCT_CNT


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 40
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     COBOL Name:  RN-CNTRCT-CNT

   Staff Count: RN - Full-Time                       8    1766  1773 NUMBER
     Description: Number of full-time equivalent registered nurses employed
                  full-time by a facility.
     SAS Name:    RN_FLTM_CNT
     COBOL Name:  RN-FLTM-CNT

   Staff Count: RN - Part-Time                       8    1774  1781 NUMBER
     Description: Number of full-time equivalent registered nurses employed
                  part-time by a facility.
     SAS Name:    RN_PRTM_CNT
     COBOL Name:  RN-PRTM-CNT

   Staff Count: RN Director of Nursing - Contract    8    1790  1797 NUMBER
     Description: Number of full-time equivalent registered nurse directors
                  of nursing under contract to a facility.
     SAS Name:    RN_DRCTR_CNTRCT_CNT
     COBOL Name:  RN-DRCTR-CNTRCT-CNT

   Staff Count: RN Director of Nursing - Full-Time   8    1798  1805 NUMBER
     Description: Number of full-time equivalent registered nurse directors
                  of nursing employed full-time by a facility.
     SAS Name:    RN_DRCTR_FLTM_CNT
     COBOL Name:  RN-DRCTR-FLTM-CNT

   Staff Count: RN Director of Nursing - Part-Time   8    1806  1813 NUMBER
     Description: Number of full-time equivalent registered nurse directors
                  of nursing employed part-time by a facility.
     SAS Name:    RN_DRCTR_PRTM_CNT
     COBOL Name:  RN-DRCTR-PRTM-CNT

   Staff Count: Social Worker - Contract             8    1822  1829 NUMBER
     Description: Number of full-time equivalent social workers under
                  contract to a facility.
     SAS Name:    SCL_WORKR_CNTRCT_CNT
     COBOL Name:  SCL-WORKR-CNTRCT-CNT

   Staff Count: Social Worker - Full-Time            8    1830  1837 NUMBER
     Description: Number of full-time equivalent social workers employed
                  full-time by a facility.
     SAS Name:    SCL_WORKR_FLTM_CNT
     COBOL Name:  SCL-WORKR-FLTM-CNT

   Staff Count: Social Worker - Part-Time            8    1838  1845 NUMBER
     Description: Number of full-time equivalent social workers employed
                  part-time by a facility.
     SAS Name:    SCL_WORKR_PRTM_CNT
     COBOL Name:  SCL-WORKR-PRTM-CNT

   Staff Count: Speech Pathologist - Contract        8    1854  1861 NUMBER
     Description: Number of full-time equivalent speech pathologists under
                  contract to a facility.
     SAS Name:    SPCH_PTHLGST_CNTRCT_CNT
     COBOL Name:  SPCH-PTHLGST-CNTRCT-CNT

   Staff Count: Speech Pathologist - Full-Time       8    1862  1869 NUMBER
     Description: Number of full-time equivalent speech pathologists
                  employed full-time by a facility.
     SAS Name:    SPCH_PTHLGST_FLTM_CNT
     COBOL Name:  SPCH-PTHLGST-FLTM-CNT

   Staff Count: Speech Pathologist - Part-Time       8    1870  1877 NUMBER


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 41
 Skilled Nursing Facility/Nursing Facility (Dually Certified), CATEGORY = "02"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Number of full-time equivalent speech pathologists
                  employed part-time by a facility.
     SAS Name:    SPCH_PTHLGST_PRTM_CNT
     COBOL Name:  SPCH-PTHLGST-PRTM-CNT

   Staff Count: Therapeutic Recreational Specialist - 8    1910  1917 NUMBER
   Contract
     Description: Number of full-time equivalent therapeutic recreation
                  specialist staff under contract to a facility.
     SAS Name:    THRPTC_RCRTNL_CNTRCT_CNT
     COBOL Name:  THRPTC-RCRTNL-CNTRCT-CNT

   Staff Count: Therapeutic Recreational Specialist - 8    1918  1925 NUMBER
   Full-Time
     Description: Number of full-time equivalent therapeutic recreation
                  specialist staff employed full-time by a facility.
     SAS Name:    THRPTC_RCRTNL_FLTM_CNT
     COBOL Name:  THRPTC-RCRTNL-FLTM-CNT

   Staff Count: Therapeutic Recreational Specialist - 8    1926  1933 NUMBER
   Part-Time
     Description: Number of  full-time equivalent therapeutic recreation
                  specialist staff employed full-time by a facility.
     SAS Name:    THRPTC_RCRTNL_PRTM_CNT
     COBOL Name:  THRPTC-RCRTNL-PRTM-CNT








































 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 1
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Provider Category Subtype Code                    2    1     2    VARCHAR2
     Description: Identifies the subtype of the provider, within the
                  primary category.  Used in reporting to show the
                  breakdown of provider categories, mainly for hospitals
                  and SNFs.
     SAS Name:    PRVDR_CTGRY_SBTYP_CD
     COBOL Name:  PRVDR-CTGRY-SBTYP-CD
     VALUES:      03=Title 18/19

   Provider Category Code                            2    3     4    VARCHAR2
     Description: Identifies the type of provider participating in the
                  Medicare/Medicaid program.
     SAS Name:    PRVDR_CTGRY_CD
     COBOL Name:  PRVDR-CTGRY-CD
     VALUES:      03=Skilled Nursing Facility/Nursing Facility (Distinct Part)

   CHOW Count                                        2    5     6    NUMBER
     Description: Number of times this provider has undergone a change of
                  ownership.
     SAS Name:    CHOW_CNT
     COBOL Name:  CHOW-CNT

   CHOW Date                                         8    7     14   DATE
     Description: Effective date of the most recent change of ownership for
                  this provider.
     SAS Name:    CHOW_DT
     COBOL Name:  CHOW-DT

   Address: City                                     28   15    42   VARCHAR2
     Description: City in which the provider is physically located.
     SAS Name:    CITY_NAME
     COBOL Name:  CITY-NAME

   Compliance: Acceptable POC                        1    43    43   VARCHAR2
     Description: Indicates if a provider is in compliance with program
                  requirements based on an acceptable plan for correction
                  of deficiencies.
     SAS Name:    ACPTBL_POC_SW
     COBOL Name:  ACPTBL-POC-SW

   Compliance: Status                                1    44    44   VARCHAR2
     Description: Compliance status of a provider at the time of
                  certification survey.
     SAS Name:    CMPLNC_STUS_CD
     COBOL Name:  CMPLNC-STUS-CD
     VALUES:      A=IN COMPLIANCE
                  B=NOT IN COMPLIANCE

   SSA County Code                                   3    45    47   VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the county where the provider is located.
     SAS Name:    SSA_CNTY_CD
     COBOL Name:  SSA-CNTY-CD

   Cross Ref Provider Number                         10   48    57   CHAR
     Description: Cross reference provider number
     SAS Name:    CROSS_REF_PROVIDER_NUMBER
     COBOL Name:  CROSS-REF-PROVIDER-NUMBER

   Certification Date                                8    58    65   DATE
     Description: Equal to the exit date of the initial visit of the Health
                  survey for certifications completed after July 28, 2012.


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 2
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  For certifications prior to that date, the certification
                  date is equal to the exit date of the initial visit of
                  the Health survey or LSC survey, whichever is later.
     SAS Name:    CRTFCTN_DT
     COBOL Name:  CRTFCTN-DT

   Eligibility Indicator                             1    66    66   VARCHAR2
     Description: Indicates if a facility is eligible to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    ELGBLTY_SW
     COBOL Name:  ELGBLTY-SW

   Facility Name                                     50   67    116  VARCHAR2
     Description: Name of the provider certified to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    FAC_NAME
     COBOL Name:  FAC-NAME

   Medicare Administrative Contractor (MAC) or       5    117   121  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_CD
     COBOL Name:  INTRMDRY-CARR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 3
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 4
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 5
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 6
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 7
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   Medicaid Vendor Number                            15   122   136  VARCHAR2
     Description: Number which may be assigned to a provider by the state
                  Medicaid agency for external control or billing purposes.
     SAS Name:    MDCD_VNDR_NUM
     COBOL Name:  MDCD-VNDR-NUM

   Original Participation Date                       8    137   144  DATE
     Description: Date a provider is first approved to provide Medicare
                  and/or Medicaid services.
     SAS Name:    ORGNL_PRTCPTN_DT
     COBOL Name:  ORGNL-PRTCPTN-DT

   Prior CHOW Date                                   8    145   152  DATE
     Description: Effective date of the previous change of ownership for
                  this provider.
     SAS Name:    CHOW_PRIOR_DT
     COBOL Name:  CHOW-PRIOR-DT

   Prior Medicare Administrative Contractor (MAC) or 5    153   157  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the previous Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_PRIOR_CD
     COBOL Name:  INTRMDRY-CARR-PRIOR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 8
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 9
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 10
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 11
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 12
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)
                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   CCN                                               10   158   167  VARCHAR2
     Description: Six or ten position identification number that is
                  assigned to a certified provider.  This is the CMS
                  Certification Number.
     SAS Name:    PRVDR_NUM
     COBOL Name:  PRVDR-NUM

   Region Code                                       2    168   169  VARCHAR2
     Description: Indicates the CMS Regional Office responsible for the
                  certification of the provider.
     SAS Name:    RGN_CD
     COBOL Name:  RGN-CD
     VALUES:      01=Boston
                  02=New York
                  03=Philadelphia
                  04=Atlanta
                  05=Chicago
                  06=Dallas
                  07=Kansas City
                  08=Denver
                  09=San Francisco
                  10=Seattle

   Skeleton Record Indicator                         1    170   170  VARCHAR2
     Description: Indicates if the record is a skeleton record.  Only a
                  limited set of data is available for this provider; no
                  survey data exists.  Only provider categories
                  01,17,19,21and 22 can have skeleton providers.
     SAS Name:    SKLTN_REC_SW
     COBOL Name:  SKLTN-REC-SW

   State Abbreviation                                2    171   172  VARCHAR2
     Description: Two-character state abbreviation.
     SAS Name:    STATE_CD
     COBOL Name:  STATE-CD
     VALUES:      AK=ALASKA
                  AL=ALABAMA
                  AR=ARKANSAS
                  AS=AMERICAN SAMOA
                  AZ=ARIZONA
                  CA=CALIFORNIA


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 13
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  CN=CANADA
                  CO=COLORADO
                  CT=CONNECTICUT
                  DC=DISTRICT OF COLUMBIA
                  DE=DELAWARE
                  FL=FLORIDA
                  FN=INTERNATIONAL
                  GA=GEORGIA
                  GU=GUAM
                  HI=HAWAII
                  IA=IOWA
                  ID=IDAHO
                  IL=ILLINOIS
                  IN=INDIANA
                  KS=KANSAS
                  KY=KENTUCKY
                  LA=LOUISIANA
                  MA=MASSACHUSETTS
                  MD=MARYLAND
                  ME=MAINE
                  MI=MICHIGAN
                  MN=MINNESOTA
                  MO=MISSOURI
                  MP=SAIPAN
                  MS=MISSISSIPPI
                  MT=MONTANA
                  MX=MEXICO
                  NC=NORTH CAROLINA
                  ND=NORTH DAKOTA
                  NE=NEBRASKA
                  NH=NEW HAMPSHIRE
                  NJ=NEW JERSEY
                  NM=NEW MEXICO
                  NV=NEVADA
                  NY=NEW YORK
                  OH=OHIO
                  OK=OKLAHOMA
                  OR=OREGON
                  PA=PENNSYLVANIA
                  PR=PUERTO RICO
                  RI=RHODE ISLAND
                  SC=SOUTH CAROLINA
                  SD=SOUTH DAKOTA
                  TN=TENNESSEE
                  TX=TEXAS
                  UT=UTAH
                  VA=VIRGINIA
                  VI=VIRGIN ISLANDS
                  VT=VERMONT
                  WA=WASHINGTON
                  WI=WISCONSIN
                  WV=WEST VIRGINIA
                  WY=WYOMING

   SSA State Code                                    2    173   174  VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the state where the provider is located.
     SAS Name:    SSA_STATE_CD
     COBOL Name:  SSA-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  03=ARIZONA
                  04=ARKANSAS


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 14
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  05=CALIFORNIA
                  06=COLORADO
                  07=CONNECTICUT
                  08=DELAWARE
                  09=DISTRICT OF COLUMBIA
                  10=FLORIDA
                  11=GEORGIA
                  12=HAWAII
                  13=IDAHO
                  14=ILLINOIS
                  15=INDIANA
                  16=IOWA
                  17=KANSAS
                  18=KENTUCKY
                  19=LOUISIANA
                  20=MAINE
                  21=MARYLAND
                  22=MASSACHUSETTS
                  23=MICHIGAN
                  24=MINNESOTA
                  25=MISSISSIPPI
                  26=MISSOURI
                  27=MONTANA
                  28=NEBRASKA
                  29=NEVADA
                  30=NEW HAMPSHIRE
                  31=NEW JERSEY
                  32=NEW MEXICO
                  33=NEW YORK
                  34=NORTH CAROLINA
                  35=NORTH DAKOTA
                  36=OHIO
                  37=OKLAHOMA
                  38=OREGON
                  39=PENNSYLVANIA
                  40=PUERTO RICO
                  41=RHODE ISLAND
                  42=SOUTH CAROLINA
                  43=SOUTH DAKOTA
                  44=TENNESSEE
                  45=TEXAS
                  46=UTAH
                  47=VERMONT
                  48=VIRGIN ISLANDS
                  49=VIRGINIA
                  50=WASHINGTON
                  51=WEST VIRGINIA
                  52=WISCONSIN
                  53=WYOMING
                  54=AFRICA
                  56=CANADA
                  57=WEST INDIES
                  58=EUROPE
                  59=MEXICO
                  60=OCEANIA
                  61=PHILIPPINES
                  62=SOUTH AMERICA
                  63=UNITED STATES POSSESSIONS
                  64=AMERICAN SAMOA
                  65=GUAM
                  66=SAIPAN
                  99=INTERNATIONAL



 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 15
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

   State Region Code                                 3    175   177  VARCHAR2
     Description: Identifies the region within a state where the provider
                  is located.
     SAS Name:    STATE_RGN_CD
     COBOL Name:  STATE-RGN-CD
     VALUES:      AK/001=ALASKA
                  AK/LAB=LABORATORIES
                  AK/NPH=NON-PARTICIPATING HOSPITAL
                  AL/001=ALABAMA
                  AL/LAB=LABORATORIES
                  AL/NPH=NON-PARTICIPATING HOSPITAL
                  AR/001=ARKANSAS
                  AR/LAB=LABORATORIES
                  AR/NPH=NON-PARTICIPATING HOSPITAL
                  AS/001=AMERICAN SAMOA
                  AS/LAB=LABORATORY
                  AS/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/AZ=PHOENIX
                  AZ/LAB=ARIZONA LAB
                  AZ/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/TUC=TUCSON
                  CA/001=CALIFORNIA
                  CA/BAK=BAKERSFIELD
                  CA/BER=SAN BERNARDINO
                  CA/EB=East Bay
                  CA/FR=FRESNO
                  CA/L1=L.A. WEST
                  CA/L2=L.A. NORTH
                  CA/L3=L.A. CENTRAL
                  CA/L4=L.A. EAST
                  CA/L5=SAN GABRIEL
                  CA/LA1=LA Region 1
                  CA/LA2=LA Region 2
                  CA/LA3=LA Region 3
                  CA/LA4=LA Acute/Ancillary
                  CA/LA5=LA HHA/Hospice
                  CA/LA6=LA ICF/DD/CLinics
                  CA/LAB=LABORATORIES
                  CA/M1=LAB. SOUTH
                  CA/M2=LAB. NORTH
                  CA/NPH=NON-PARTICIPATING HOSPITAL
                  CA/ORG=ORANGE
                  CA/RIV=RIVERSIDE
                  CA/S1=SACRAMENTO
                  CA/S3=CHICO
                  CA/SD=SAN DIEGO
                  CA/SF=SAN FRANCISCO
                  CA/SJ=SAN JOSE
                  CA/SR=SANTA ROSA
                  CA/VEN=VENTURA
                  CN/001=CANADA
                  CN/LAB=LABORATORY
                  CN/NPH=NON-PARTICIPATING HOSPITAL
                  CO/001=COLORADO
                  CO/LAB=LABORATORIES
                  CO/NPH=NON-PARTICIPATING HOSPITAL
                  CT/001=CONNECTICUT
                  CT/LAB=LABORATORIES
                  CT/NPH=NON-PARTICIPATING HOSPITAL
                  DC/001=DISTRICT OF COLUMBIA
                  DC/LAB=LABORATORIES
                  DC/NPH=NON-PARTICIPATING HOSPITAL
                  DE/001=DELAWARE


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 16
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  DE/LAB=LABORATORIES
                  DE/NPH=NON-PARTICIPATING HOSPITAL
                  FL/001=FLORIDA
                  FL/FTM=FT. MYERS
                  FL/GAI=GAINESVILLE
                  FL/JAX=JACKSONVILLE
                  FL/LAB=LABORATORIES
                  FL/LAN=LANTANA
                  FL/LAU=LAUDERHILL
                  FL/MIA=MIAMI
                  FL/NPH=NON-PARTICIPATING HOSPITAL
                  FL/ORL=ORLANDO
                  FL/PEN=PENSACOLA
                  FL/STP=ST. PETERSBURG
                  FL/TAL=TALLAHASSEE
                  FL/TAM=TAMPA
                  FM/001=FEDERATED STATES OF MICRO
                  FM/NPH=NON-PARTICIPATING HOSPITAL
                  FN/001=INTERNATIONAL
                  FN/LAB=LABORATORIES
                  FN/NPH=NON-PARTICIPATING HOSPITAL
                  GA/001=GEORGIA
                  GA/GAA=GEORGIA ALL
                  GA/GAC=GEORGIA CENTRAL
                  GA/GAE=GEORGIA EASTERN
                  GA/GAN=GEORGIA NORTH
                  GA/GAS=GEORGIA SOUTH
                  GA/GAW=GEORGIA WESTERN
                  GA/LAB=LABORATORIES
                  GA/NPH=NON-PARTICIPATING HOSPITAL
                  GU/001=GUAM
                  GU/LAB=LABORATORIES
                  GU/NPH=NON-PARTICIPATING HOSPITAL
                  HI/001=HAWAII
                  HI/LAB=LABORATORIES
                  HI/NPH=NON-PARTICIPATING HOSPITAL
                  IA/001=IOWA
                  IA/LAB=LABORATORIES
                  IA/NPH=NON-PARTICIPATING HOSPITAL
                  ID/001=IDAHO
                  ID/LAB=LABORATORIES
                  ID/NPH=NON-PARTICIPATING HOSPITAL
                  IL/001=ILLINOIS
                  IL/LAB=LABORATORIES
                  IL/NPH=NON-PARTICIPATING HOSPITAL
                  IN/001=INDIANA
                  IN/LAB=LABORATORIES
                  IN/NPH=NON-PARTICIPATING HOSPITAL
                  KS/001=KANSAS
                  KS/KCK=KANSAS CITY
                  KS/KDH=KDHE
                  KS/LAB=LABORATORIES
                  KS/LAW=LAWRENCE
                  KS/NC=NORTH CENTRAL KANSAS
                  KS/NE=NORTH EAST KANSAS
                  KS/NPH=NON-PARTICIPATING HOSPITAL
                  KS/NW=NORTH WEST KANSAS
                  KS/SC=SOUTH CENTRAL KANSAS
                  KS/SE=SOUTH EAST KANSAS
                  KS/SW=SOUTH WEST KANSAS
                  KS/WST=WEST
                  KY/2C1=HOPKINSVILLE
                  KY/2C2=LOUISVILLE


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 17
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  KY/2C3=LONDON
                  KY/2C4=LEXINGTON
                  KY/LAB=LABORATORIES
                  KY/NPH=NON-PARTICIPATING HOSPITAL
                  LA/001=LOUISIANA
                  LA/LA1=NEW ORLEANS
                  LA/LA2=MANDEVILLE
                  LA/LA3=LAFAYETTE
                  LA/LA4=MONROE
                  LA/LA5=SHREVEPORT
                  LA/LA6=ALEXANDRIA
                  LA/LAB=LABORATORIES
                  LA/LB1=CLIA NEW ORLEANS
                  LA/LB5=CLIA SHREVEPORT
                  LA/LB6=CLIA ALEXANDRIA
                  LA/NPH=NON-PARTICIPATING HOSPITAL
                  MA/001=MASSACHUSETTS
                  MA/LAB=LABORATORIES
                  MA/NPH=NON-PARTICIPATING HOSPITAL
                  MD/001=MARYLAND
                  MD/LAB=LABORATORIES
                  MD/NPH=NON-PARTICIPATING HOSPITAL
                  ME/001=MAINE
                  ME/LAB=LABORATORIES
                  ME/NPH=NON-PARTICIPATING HOSPITAL
                  MH/001=MARSHALL ISLANDS
                  MH/NPH=NON-PARTICIPATING HOSPITAL
                  MI/001=MICHIGAN
                  MI/LAB=LABORATORIES
                  MI/NPH=NON-PARTICIPATING HOSPITAL
                  MN/001=MINNESOTA
                  MN/LAB=LABORATORIES
                  MN/NPH=NON-PARTICIPATING HOSPITAL
                  MO/001=MISSOURI
                  MO/01=REGION01
                  MO/02=REGION02
                  MO/03=REGION 03
                  MO/04=REGION 04
                  MO/05=REGION 05
                  MO/06=REGION 06
                  MO/07=REGION 07
                  MO/1NH=REGION 1 NH
                  MO/2NH=REGION 2 NH
                  MO/3NH=REGION 3 NH
                  MO/4NH=REGION 4 NH
                  MO/5NH=REGION 5 NH
                  MO/6NH=REGION 6 NH
                  MO/7NH=REGION 7 NH
                  MO/LAB=LABORATORIES
                  MO/MO=STATEWIDE
                  MO/NPH=NON-PARTICIPATING HOSPITAL
                  MP/001=NORTHERN MARIANA ISLANDS
                  MP/LAB=LABORATORIES
                  MP/NPH=NON-PARTICIPATING HOSPITAL
                  MS/001=MISSISSIPPI
                  MS/LAB=LABORATORIES
                  MS/NPH=NON-PARTICIPATING HOSPITAL
                  MT/001=MONTANA
                  MT/LAB=LABORATORIES
                  MT/NPH=NON-PARTICIPATING HOSPITAL
                  MX/001=MEXICO
                  MX/LAB=LABORATORY
                  MX/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 18
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  NC/001=NORTH CAROLINA
                  NC/LAB=LABORATORIES
                  NC/NCC=NORTH CAROLINA CENTRAL
                  NC/NCE=NORTH CAROLINA EAST
                  NC/NCN=NORTH CAROLINA NORTH
                  NC/NCS=NORTH CAROLINA SOUTH
                  NC/NCW=NORTH CAROLINA WEST
                  NC/NPH=NON-PARTICIPATING HOSPITAL
                  ND/001=NORTH DAKOTA
                  ND/LAB=LABORATORIES
                  ND/NPH=NON-PARTICIPATING HOSPITAL
                  NE/001=NEBRASKA
                  NE/1=NORTH CENTRAL
                  NE/2=CENTRAL
                  NE/3=NORTHEAST
                  NE/4=SOUTHEAST
                  NE/5=WESTERN
                  NE/LAB=LABORATORIES
                  NE/NPH=NON-PARTICIPATING HOSPITAL
                  NH/001=NEW HAMPSHIRE
                  NH/LAB=LABORATORIES
                  NH/NPH=NON-PARTICIPATING HOSPITAL
                  NJ/001=NEW JERSEY
                  NJ/LAB=LABORATORIES
                  NJ/NPH=NON-PARTICIPATING HOSPITAL
                  NM/001=NEW MEXICO
                  NM/LAB=LABORATORIES
                  NM/NPH=NON-PARTICIPATING HOSPITAL
                  NV/001=NEVADA
                  NV/CC=CARSON CITY
                  NV/LAB=LABORATORIES
                  NV/LV=LAS VEGAS
                  NV/NPH=NON-PARTICIPATING HOSPITAL
                  NY/001=BUFFALO
                  NY/002=ROCHESTER
                  NY/003=SYRACUSE
                  NY/004=ALBANY
                  NY/005=NEW ROCHELLE
                  NY/006=NEW YORK CITY
                  NY/007=SUFFOLK/NASSAU COUNTY
                  NY/LAB=LABORATORIES
                  NY/NPH=NON-PARTICIPATING HOSPITAL
                  OH/001=OHIO
                  OH/LAB=LABORATORIES
                  OH/NPH=NON-PARTICIPATING HOSPITAL
                  OK/001=OKLAHOMA
                  OK/LAB=LABORATORIES
                  OK/NPH=NON-PARTICIPATING HOSPITAL
                  OR/001=OFFICE #1
                  OR/002=OFFICE #2
                  OR/003=OFFICE #3
                  OR/LAB=LABORATORIES
                  OR/NPH=NON-PARTICIPATING HOSPITAL
                  PA/001=PENNSYLVANIA
                  PA/LAB=LABORATORIES
                  PA/NPH=NON-PARTICIPATING HOSPITAL
                  PR/001=PUERTO RICO
                  PR/LAB=LABORATORIES
                  PR/NPH=NON-PARTICIPATING HOSPITAL
                  PW/001=PALAU
                  PW/NPH=NON-PARTICIPATING HOSPITAL
                  RI/001=RHODE ISLAND
                  RI/LAB=LABORATORIES


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   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  RI/NPH=NON-PARTICIPATING HOSPITAL
                  SC/001=SOUTH CAROLINA
                  SC/LAB=LABORATORIES
                  SC/NPH=NON-PARTICIPATING HOSPITAL
                  SD/001=SOUTH DAKOTA
                  SD/LAB=LABORATORIES
                  SD/NPH=NON-PARTICIPATING HOSPITAL
                  TN/001=TENNESSEE
                  TN/LAB=LABORATORIES
                  TN/NPH=NON-PARTICIPATING HOSPITAL
                  TN/TNC=TENNESSEE COOKEVILLE
                  TN/TNE=TENNESSEE EASTERN
                  TN/TNM=TENNESSEE MIDDLE
                  TN/TNW=TENNESSEE WESTERN
                  TX/001=TEXAS
                  TX/L01=AMARILLO-LTC
                  TX/L02=ABILENE-LTC
                  TX/L03=ARLINGTON-LTC
                  TX/L04=TYLER-LTC
                  TX/L05=TEMPLE-LTC
                  TX/L06=HOUSTON-LTC
                  TX/L07=SAN ANTONIO-LTC
                  TX/LAB=LABORATORIES
                  TX/NPH=NON-PARTICIPATING HOSPITAL
                  TX/TX1=NLTC REG 1, 7, 9, 10
                  TX/TX2=NLTC REG 2, 3
                  TX/TX4=NLTC REG 6
                  TX/TX5=NLTC REG 4, 5
                  TX/TX6=AUSTIN
                  TX/TX8=NLTC REG 8, 11
                  UT/001=UTAH
                  UT/LAB=LABORATORIES
                  UT/NPH=NON-PARTICIPATING HOSPITAL
                  VA/001=VIRGINIA
                  VA/LAB=LABORATORIES
                  VA/NPH=NON-PARTICIPATING HOSPITAL
                  VI/001=VIRGIN ISLANDS
                  VI/LAB=LABORATORIES
                  VI/NPH=NON-PARTICIPATING HOSPITAL
                  VT/001=VERMONT
                  VT/LAB=LABORATORIES
                  VT/NPH=NON-PARTICIPATING HOSPITAL
                  WA/001=ALL OTHERS (NON-LTC FAC)
                  WA/D1=SPOKANE & YAKIMA AREAS
                  WA/D1A=District 1, Unit A
                  WA/D1B=District 1, Unit B
                  WA/D1C=District 1, Unit C
                  WA/D1D=District 1, Unit D
                  WA/D1E=District 1, Unit E
                  WA/D2=SPOKANE & SE
                  WA/D2A=District 2, Unit A
                  WA/D2B=District 2, Unit B
                  WA/D2C=District 2, Unit C
                  WA/D2D=District 2, Unit D
                  WA/D2E=District 2, Unit E
                  WA/D2F=District 2, Unit F
                  WA/D2G=District 2, Unit G
                  WA/D2H=District 2, Unit H
                  WA/D2I=District 2, Unit I
                  WA/D2J=District 2, Unit J
                  WA/D3=NW WASHINGTON
                  WA/D3A=District 3, Unit A
                  WA/D3B=District 3, Unit B


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   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  WA/D3C=District 3, Unit C
                  WA/D3D=District 3, Unit D
                  WA/D3E=District 3, Unit E
                  WA/D3F=District 3, Unit F
                  WA/D3G=District 3, Unit G
                  WA/D4A=GREATER SEATTLE AREA
                  WA/D4B=S KING COUNTY
                  WA/D5A=PIERCE CTY & PENINSULA
                  WA/D5B=PIERCE CTY & GRAYS HARBOR
                  WA/D6=OLYMPIA AREA
                  WA/LAB=LABORATORIES
                  WA/NPH=NON-PARTICIPATING HOSPITAL
                  WI/001=WISCONSIN
                  WI/LAB=LABORATORIES
                  WI/NPH=NON-PARTICIPATING HOSPITAL
                  WV/001=WEST VIRGINIA
                  WV/LAB=LABORATORIES
                  WV/NPH=NON-PARTICIPATING HOSPITAL
                  WY/001=WYOMING
                  WY/LAB=LABORATORIES
                  WY/NPH=NON-PARTICIPATING HOSPITAL

   Address: Street                                   50   178   227  VARCHAR2
     Description: Street address where the provider is located.
     SAS Name:    ST_ADR
     COBOL Name:  ST-ADR

   Telephone Number                                  10   228   237  VARCHAR2
     Description: Telephone number of the provider.
     SAS Name:    PHNE_NUM
     COBOL Name:  PHNE-NUM

   Termination Code                                  2    238   239  VARCHAR2
     Description: Indicates the current termination status for the
                  provider.
     SAS Name:    PGM_TRMNTN_CD
     COBOL Name:  PGM-TRMNTN-CD
     VALUES:      00=ACTIVE PROVIDER
                  01=VOLUNTARY-MERGER, CLOSURE
                  02=VOLUNTARY-DISSATISFACTION WITH REIMBURSEMENT
                  03=VOLUNTARY-RISK OF INVOLUNTARY TERMINATION
                  04=VOLUNTARY-OTHER REASON FOR WITHDRAWAL
                  05=INVOLUNTARY-FAILURE TO MEET HEALTH/SAFETY REQ
                  06=INVOLUNTARY-FAILURE TO MEET AGREEMENT
                  07=OTHER-PROVIDER STATUS CHANGE
                  08=NONPAYMENT OF FEES - CLIA Only
                  09=REV/UNSUCCESSFUL PARTICIPATION IN PT - CLIA Only
                  10=REV/OTHER REASON - CLIA Only
                  11=INCOMPLETE CLIA APPLICATION INFORMATION - CLIA Only
                  12=NO LONGER PERFORMING TESTS - CLIA Only
                  13=MULTIPLE TO SINGLE SITE CERTIFICATE - CLIA Only
                  14=SHARED LABORATORY - CLIA Only
                  15=FAILURE TO RENEW WAIVER PPM CERTIFICATE - CLIA Only
                  16=DUPLICATE CLIA NUMBER - CLIA Only
                  17=MAIL RETURNED NO FORWARD ADDRESS CERT ENDED - CLIA Only
                  20=NOTIFICATION BANKRUPTCY - CLIA Only
                  33=ACCREDITATION NOT CONFIRMED - CLIA Only
                  80=AWAITING STATE APPROVAL
                  99=OIG ACTION - DO NOT ACTIVATE - CLIA Only

   Termination or Expiration Date                    8    240   247  DATE
     Description: Date the provider was terminated.  For CLIA providers,
                  date the laboratory's certificate was terminated or the


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   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  expiration date of the current CLIA certificate.
     SAS Name:    TRMNTN_EXPRTN_DT
     COBOL Name:  TRMNTN-EXPRTN-DT

   Type of Action Code                               1    248   248  VARCHAR2
     Description: Identifies the reason for the certification.  Type of
                  action from the official survey record, CMS 1539 form.
     SAS Name:    CRTFCTN_ACTN_TYPE_CD
     COBOL Name:  CRTFCTN-ACTN-TYPE-CD
     VALUES:      1=INITIAL
                  2=RECERTIFICATION
                  3=TERMINATION
                  4=CHANGE OF OWNERSHIP
                  5=VALIDATION
                  8=FULL SURVEY AFTER COMPLAINT

   Ownership Type Code                               2    249   250  VARCHAR2
     Description: Indicates the ownership type of the provider.
     SAS Name:    GNRL_CNTL_TYPE_CD
     COBOL Name:  GNRL-CNTL-TYPE-CD
     VALUES:      01=FOR PROFIT - INDIVIDUAL
                  02=FOR PROFIT - PARTNERSHIP
                  03=FOR PROFIT - CORPORATION
                  04=NONPROFIT - CHURCH RELATED
                  05=NONPROFIT - CORPORATION
                  06=NONPROFIT - OTHER
                  07=GOVERNMENT - STATE
                  08=GOVERNMENT - COUNTY
                  09=GOVERNMENT - CITY
                  10=GOVERNMENT - CITY/COUNTY
                  11=GOVERNMENT - HOSPITAL DISTRICT
                  12=GOVERNMENT - FEDERAL
                  13=FOR PROFIT - LIMITED LIABILITY CORPORATION

   Address: ZIP Code                                 5    251   255  VARCHAR2
     Description: Five-digit ZIP code for a provider's physical address.
     SAS Name:    ZIP_CD
     COBOL Name:  ZIP-CD

   FIPS State Code                                   2    256   257  VARCHAR2
     Description: FIPS State Code
     SAS Name:    FIPS_STATE_CD
     COBOL Name:  FIPS-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  04=ARIZONA
                  05=ARKANSAS
                  06=CALIFORNIA
                  08=COLORADO
                  09=CONNECTICUT
                  10=DELAWARE
                  11=DISTRICT OF COLUMBIA
                  12=FLORIDA
                  13=GEORGIA
                  15=HAWAII
                  16=IDAHO
                  17=ILLINOIS
                  18=INDIANA
                  19=IOWA
                  20=KANSAS
                  21=KENTUCKY
                  22=LOUISIANA
                  23=MAINE


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   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  24=MARYLAND
                  25=MASSACHUSETTS
                  26=MICHIGAN
                  27=MINNESOTA
                  28=MISSISSIPPI
                  29=MISSOURI
                  30=MONTANA
                  31=NEBRASKA
                  32=NEVADA
                  33=NEW HAMPSHIRE
                  34=NEW JERSEY
                  35=NEW MEXICO
                  36=NEW YORK
                  37=NORTH CAROLINA
                  38=NORTH DAKOTA
                  39=OHIO
                  40=OKLAHOMA
                  41=OREGON
                  42=PENNSYLVANIA
                  43=PUERTO RICO
                  44=RHODE ISLAND
                  45=SOUTH CAROLINA
                  46=SOUTH DAKOTA
                  47=TENNESSEE
                  48=TEXAS
                  49=UTAH
                  50=VERMONT
                  51=VIRGINIA
                  53=WASHINGTON
                  54=WEST VIRGINIA
                  55=WISCONSIN
                  56=WYOMING
                  60=AMERICAN SAMOA
                  66=GUAM
                  69=SAIPAN/MARIANA IS.
                  78=VIRGIN ISLANDS

   FIPS County Code                                  3    258   260  VARCHAR2
     Description: FIPS County Code
     SAS Name:    FIPS_CNTY_CD
     COBOL Name:  FIPS-CNTY-CD

   CBSA Urban Rural Indicator                        1    261   261  VARCHAR2
     Description: CBSA (Core Based Statistical Area) indicates whether the
                  county is defined as Urban or Rural.
     SAS Name:    CBSA_URBN_RRL_IND
     COBOL Name:  CBSA-URBN-RRL-IND

   CBSA Code                                         5    262   266  VARCHAR2
     Description: CBSA (Core Based Statistical Area) geographic entities
                  defined by the U.S. Office of Management and Budget (OMB)
                  on June 6, 2003 for use by Federal statistical agencies
                  in collecting, tabulating, and publishing Federal
                  statistics.  CBSA collectively refers to MSA.
     SAS Name:    CBSA_CD
     COBOL Name:  CBSA-CD

   Bed Count Override Indicator                      1    325   325  CHAR
     Description: Indicates if the regional office has approved a
                  significant bed count change from the previous
                  certification.
     SAS Name:    OVRRD_BED_CNT_SW
     COBOL Name:  OVRRD-BED-CNT-SW


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   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Bed Count: Certified                              4    326   329  NUMBER
     Description: Number of beds in Medicare and/or Medicaid certified
                  areas within a facility.
     SAS Name:    CRTFD_BED_CNT
     COBOL Name:  CRTFD-BED-CNT

   Bed Count: Medicaid NF                            4    334   337  NUMBER
     Description: Number of Medicaid-certified Nursing Facility beds.
     SAS Name:    MDCD_NF_BED_CNT
     COBOL Name:  MDCD-NF-BED-CNT

   Bed Count: Medicare SNF                           4    338   341  NUMBER
     Description: Number of Medicare-certified Skilled Nursing Facility
                  beds.
     SAS Name:    MDCR_SNF_BED_CNT
     COBOL Name:  MDCR-SNF-BED-CNT

   Bed Count: Medicare/Medicaid SNF                  4    342   345  NUMBER
     Description: Number of dually certified (Medicare/Medicaid) beds in a
                  Skilled Nursing Facility.
     SAS Name:    MDCR_MDCD_SNF_BED_CNT
     COBOL Name:  MDCR-MDCD-SNF-BED-CNT

   Bed Count: Special Care - AIDS                    3    346   348  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents with AIDS.
     SAS Name:    AIDS_BED_CNT
     COBOL Name:  AIDS-BED-CNT

   Bed Count: Special Care - Alzheimers              3    349   351  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents with Alzheimer's disease.
     SAS Name:    ALZHMR_BED_CNT
     COBOL Name:  ALZHMR-BED-CNT

   Bed Count: Special Care - Dialysis                3    352   354  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents who require dialysis.
     SAS Name:    DLYS_BED_CNT
     COBOL Name:  DLYS-BED-CNT

   Bed Count: Special Care - Disabled Children       3    355   357  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  disabled children.
     SAS Name:    DSBL_CHLDRN_BED_CNT
     COBOL Name:  DSBL-CHLDRN-BED-CNT

   Bed Count: Special Care - Head Trauma             3    358   360  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents with head trauma.
     SAS Name:    HEAD_TRMA_BED_CNT
     COBOL Name:  HEAD-TRMA-BED-CNT

   Bed Count: Special Care - Hospice                 3    361   363  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents who require hospice care.
     SAS Name:    HOSPC_BED_CNT
     COBOL Name:  HOSPC-BED-CNT

   Bed Count: Special Care - Huntingtons Disease     3    364   366  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents with Huntington's disease.


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   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     SAS Name:    HNTGTN_DEASE_BED_CNT
     COBOL Name:  HNTGTN-DEASE-BED-CNT

   Bed Count: Special Care - Specialized Rehab       3    367   369  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents with specialized rehab needs.
     SAS Name:    REHAB_BED_CNT
     COBOL Name:  REHAB-BED-CNT

   Bed Count: Special Care - Ventilator              3    370   372  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents requiring a ventilator and/or respiratory care.
     SAS Name:    VNTLTR_BED_CNT
     COBOL Name:  VNTLTR-BED-CNT

   Bed Count: Total                                  4    373   376  NUMBER
     Description: Total number of beds in a provider, including those in
                  non-participating or non-licensed areas.
     SAS Name:    BED_CNT
     COBOL Name:  BED-CNT

   Compliance: 24-Hour RN Waiver Indicator           1    442   442  CHAR
     Description: Indicates if a waiver of the 24-hour registered nurse
                  staffing requirements has been recommended for a Skilled
                  Nursing Facility or Nursing Facility.
     SAS Name:    RN_24_HR_WVR_SW
     COBOL Name:  RN-24-HR-WVR-SW

   Compliance: 7-Day RN Waiver Indicator             1    443   443  VARCHAR2
     Description: Indicates if a waiver of the 7-day registered nurse
                  staffing requirements has been recommended for a Skilled
                  Nursing Facility.
     SAS Name:    RN_7_DAY_WVR_SW
     COBOL Name:  RN-7-DAY-WVR-SW

   Compliance: Beds Per Room Waiver Indicator        1    444   444  CHAR
     Description: Indicates if a waiver of the beds per room requirement
                  has been recommended for a facility.
     SAS Name:    BED_PER_ROOM_WVR_SW
     COBOL Name:  BED-PER-ROOM-WVR-SW

   Compliance: LSC Waiver Indicator                  1    445   445  CHAR
     Description: Indicates if a waiver of any life safety code provision
                  has been recommended for a provider.
     SAS Name:    LSC_WVR_SW
     COBOL Name:  LSC-WVR-SW

   Compliance: Patient Room Size Waiver Indicator    1    446   446  CHAR
     Description: Indicates if a waiver of the patient room size provision
                  has been recommended for a provider.
     SAS Name:    ROOM_SIZE_WVR_SW
     COBOL Name:  ROOM-SIZE-WVR-SW

   Experimental Research Conducted Indicator         1    453   453  VARCHAR2
     Description: Indicates if a facility conducts experimental research.
     SAS Name:    EXPRMT_RSRCH_CNDCTD_SW
     COBOL Name:  EXPRMT-RSRCH-CNDCTD-SW

   Fiscal Year End Date (MMDD)                       4    464   467  VARCHAR2
     Description: End date, consisting of the month and day, of the
                  provider's fiscal year.
     SAS Name:    FY_END_MO_DAY_CD
     COBOL Name:  FY-END-MO-DAY-CD


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   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Hospital Based Indicator                          1    483   483  CHAR
     Description: Indicates if the provider is based in a hospital.
     SAS Name:    HOSP_BSD_SW
     COBOL Name:  HOSP-BSD-SW

   LTC Cross Ref Provider Number                     10   485   494  CHAR
     Description: LTC cross ref provider number
     SAS Name:    LTC_CROSS_REF_PROVIDER_NUMBER
     COBOL Name:  LTC-CROSS-REF-PROVIDER-NUMBER

   Multiple Facility Organization Name               38   513   550  CHAR
     Description: Name of the multi-facility organization that owns the
                  facility.
     SAS Name:    MLT_FAC_ORG_NAME
     COBOL Name:  MLT-FAC-ORG-NAME

   Multiple Facility Organization Owned Indicator    1    551   551  CHAR
     Description: Indicates if a facility is owned by an organization that
                  owns (or leases) two or more long term care facilities.
     SAS Name:    MLT_OWND_FAC_ORG_SW
     COBOL Name:  MLT-OWND-FAC-ORG-SW

   Organized Family Group Indicator                  1    626   626  VARCHAR2
     Description: Indicates if the facility has an organized group of
                  family members of residents.
     SAS Name:    ORGNZ_FMLY_MBR_GRP_SW
     COBOL Name:  ORGNZ-FMLY-MBR-GRP-SW

   Organized Resident Group Indicator                1    627   627  VARCHAR2
     Description: Indicates if the facility has an organized residents
                  group.
     SAS Name:    ORGNZ_RSDNT_GRP_SW
     COBOL Name:  ORGNZ-RSDNT-GRP-SW

   Program Participation Code                        1    640   640  CHAR
     Description: Indicates if the provider participates in Medicare,
                  Medicaid, or both programs.
     SAS Name:    PGM_PRTCPTN_CD
     COBOL Name:  PGM-PRTCPTN-CD
     VALUES:      1=MEDICARE ONLY
                  2=MEDICAID ONLY
                  3=MEDICARE AND MEDICAID

   Related Provider Number                           10   686   695  CHAR
     Description: Related provider number
     SAS Name:    RELATED_PROVIDER_NUMBER
     COBOL Name:  RELATED-PROVIDER-NUMBER

   Services: Blood Administration Off-Site Residents 1    703   703  VARCHAR2
   Indicator
     Description: Indicates if blood administration and storage services
                  are provided off-site to residents.
     SAS Name:    BLOOD_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  BLOOD-SRVC-OFSITE-RSDNT-SW

   Services: Blood Administration On-Site Nonresidents 1    704   704  VARCHAR2
   Indicator
     Description: Indicates if blood administration and storage services
                  are provided on-site to nonresidents.
     SAS Name:    BLOOD_SRVC_ONST_NRSDNT_SW
     COBOL Name:  BLOOD-SRVC-ONST-NRSDNT-SW



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   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

   Services: Blood Administration On-Site Residents  1    705   705  VARCHAR2
   Indicator
     Description: Indicates if blood administration and storage services
                  are provided on-site to residents.
     SAS Name:    BLOOD_SRVC_ONST_RSDNT_SW
     COBOL Name:  BLOOD-SRVC-ONST-RSDNT-SW

   Services: Clinical Laboratory - Off-Site Residents 1    712   712  VARCHAR2
   Indicator
     Description: Indicates if clinical laboratory services are provided
                  off-site to residents.
     SAS Name:    CL_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  CL-SRVC-OFSITE-RSDNT-SW

   Services: Clinical Laboratory - On-Site Nonresidents 1    713   713  VARCHAR2
   Indicator
     Description: Indicates if clinical laboratory services are provided
                  on-site to nonresidents.
     SAS Name:    CL_SRVC_ONST_NRSDNT_SW
     COBOL Name:  CL-SRVC-ONST-NRSDNT-SW

   Services: Clinical Laboratory - On-Site Residents 1    714   714  VARCHAR2
   Indicator
     Description: Indicates if clinical laboratory services are provided
                  on-site to residents.
     SAS Name:    CL_SRVC_ONST_RSDNT_SW
     COBOL Name:  CL-SRVC-ONST-RSDNT-SW

   Services: Dental Off-Site Residents Indicator     1    720   720  VARCHAR2
     Description: Indicates if dental services are provided off-site to
                  residents.
     SAS Name:    DNTL_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  DNTL-SRVC-OFSITE-RSDNT-SW

   Services: Dental On-Site Nonresidents Indicator   1    721   721  VARCHAR2
     Description: Indicates if dental services are provided on-site to
                  nonresidents.
     SAS Name:    DNTL_SRVC_ONST_NRSDNT_SW
     COBOL Name:  DNTL-SRVC-ONST-NRSDNT-SW

   Services: Dental On-Site Residents Indicator      1    722   722  VARCHAR2
     Description: Indicates if dental services are provided on-site to
                  residents.
     SAS Name:    DNTL_SRVC_ONST_RSDNT_SW
     COBOL Name:  DNTL-SRVC-ONST-RSDNT-SW

   Services: Dietary Off-Site Residents Indicator    1    726   726  VARCHAR2
     Description: Indicates if dietary services are provided off-site to
                  residents.
     SAS Name:    DTRY_OFSITE_RSDNT_SW
     COBOL Name:  DTRY-OFSITE-RSDNT-SW

   Services: Dietary On-Site Nonresidents Indicator  1    727   727  VARCHAR2
     Description: Indicates if dietary services are provided on-site to
                  nonresidents.
     SAS Name:    DTRY_ONST_NRSDNT_SW
     COBOL Name:  DTRY-ONST-NRSDNT-SW

   Services: Dietary On-Site Residents Indicator     1    728   728  VARCHAR2
     Description: Indicates if dietary services are provided on-site to
                  residents.
     SAS Name:    DTRY_ONST_RSDNT_SW
     COBOL Name:  DTRY-ONST-RSDNT-SW


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   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Services: Housekeeping Off-Site Residents Indicator 1    738   738  VARCHAR2
     Description: Indicates if housekeeping services are provided off-site
                  to residents.
     SAS Name:    HSEKPNG_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  HSEKPNG-SRVC-OFSITE-RSDNT-SW

   Services: Housekeeping On-Site Nonresidents Indicator 1    739   739  VARCHAR2
     Description: Indicates if housekeeping services are provided on-site
                  to nonresidents.
     SAS Name:    HSEKPNG_SRVC_ONST_NRSDNT_SW
     COBOL Name:  HSEKPNG-SRVC-ONST-NRSDNT-SW

   Services: Housekeeping On-Site Residents Indicator 1    740   740  VARCHAR2
     Description: Indicates if housekeeping services are provided on-site
                  to residents.
     SAS Name:    HSEKPNG_SRVC_ONST_RSDNT_SW
     COBOL Name:  HSEKPNG-SRVC-ONST-RSDNT-SW

   Services: Mental Health Off-Site Residents Indicator 1    747   747  VARCHAR2
     Description: Indicates if mental health services are provided off-site
                  to residents.
     SAS Name:    MENTL_HLTH_OFSITE_RSDNT_SW
     COBOL Name:  MENTL-HLTH-OFSITE-RSDNT-SW

   Services: Mental Health On-Site Nonresidents      1    748   748  VARCHAR2
   Indicator
     Description: Indicates if mental health services are provided on-site
                  to nonresidents.
     SAS Name:    MENTL_HLTH_ONST_NRSDNT_SW
     COBOL Name:  MENTL-HLTH-ONST-NRSDNT-SW

   Services: Mental Health On-Site Residents Indicator 1    749   749  VARCHAR2
     Description: Indicates if mental health services are provided on-site
                  to residents.
     SAS Name:    MENTL_HLTH_ONST_RSDNT_SW
     COBOL Name:  MENTL-HLTH-ONST-RSDNT-SW

   Services: Nursing Off-Site Residents Indicator    1    760   760  VARCHAR2
     Description: Indicates if nursing services are provided off-site to
                  residents.
     SAS Name:    NRSNG_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  NRSNG-SRVC-OFSITE-RSDNT-SW

   Services: Nursing On-Site Nonresidents Indicator  1    761   761  VARCHAR2
     Description: Indicates if nursing services are provided on-site to
                  nonresidents.
     SAS Name:    NRSNG_SRVC_ONST_NRSDNT_SW
     COBOL Name:  NRSNG-SRVC-ONST-NRSDNT-SW

   Services: Nursing On-Site Residents Indicator     1    762   762  VARCHAR2
     Description: Indicates if nursing services are provided on-site to
                  residents.
     SAS Name:    NRSNG_SRVC_ONST_RSDNT_SW
     COBOL Name:  NRSNG-SRVC-ONST-RSDNT-SW

   Services: OT Off-Site Residents Indicator         1    776   776  VARCHAR2
     Description: Indicates if occupational therapy services are provided
                  off-site to residents.
     SAS Name:    OT_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  OT-SRVC-OFSITE-RSDNT-SW

   Services: OT On-Site Nonresidents Indicator       1    777   777  VARCHAR2


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 28
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Indicates if occupational therapy services are provided
                  on-site to nonresidents.
     SAS Name:    OT_SRVC_ONST_NRSDNT_SW
     COBOL Name:  OT-SRVC-ONST-NRSDNT-SW

   Services: OT On-Site Residents Indicator          1    778   778  VARCHAR2
     Description: Indicates if occupational therapy services are provided
                  on-site to residents.
     SAS Name:    OT_SRVC_ONST_RSDNT_SW
     COBOL Name:  OT-SRVC-ONST-RSDNT-SW

   Services: Pharmacy Off-Site Residents Indicator   1    789   789  VARCHAR2
     Description: Indicates if pharmacy services are provided off-site to
                  residents.
     SAS Name:    PHRMCY_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  PHRMCY-SRVC-OFSITE-RSDNT-SW

   Services: Pharmacy On-Site Nonresidents Indicator 1    790   790  VARCHAR2
     Description: Indicates if pharmacy services are provided on-site to
                  nonresidents.
     SAS Name:    PHRMCY_SRVC_ONST_NRSDNT_SW
     COBOL Name:  PHRMCY-SRVC-ONST-NRSDNT-SW

   Services: Pharmacy On-Site Residents Indicator    1    791   791  VARCHAR2
     Description: Indicates if pharmacy services are provided on-site to
                  residents.
     SAS Name:    PHRMCY_SRVC_ONST_RSDNT_SW
     COBOL Name:  PHRMCY-SRVC-ONST-RSDNT-SW

   Services: Physician Extender Off-Site Residents   1    796   796  VARCHAR2
   Indicator
     Description: Indicates if physician extender services are provided
                  off-site to residents.
     SAS Name:    PHYSN_EXT_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  PHYSN-EXT-SRVC-OFSITE-RSDNT-SW

   Services: Physician Extender On-Site Nonresidents 1    797   797  VARCHAR2
   Indicator
     Description: Indicates if physician extender services are provided
                  on-site to nonresidents.
     SAS Name:    PHYSN_EXT_SRVC_ONST_NRSDNT_SW
     COBOL Name:  PHYSN-EXT-SRVC-ONST-NRSDNT-SW

   Services: Physician Extender On-Site Residents    1    798   798  VARCHAR2
   Indicator
     Description: Indicates if physician extender services are provided
                  on-site to residents.
     SAS Name:    PHYSN_EXT_SRVC_ONST_RSDNT_SW
     COBOL Name:  PHYSN-EXT-SRVC-ONST-RSDNT-SW

   Services: Physician Off-Site Residents Indicator  1    799   799  VARCHAR2
     Description: Indicates if physician services are provided off-site to
                  residents.
     SAS Name:    PHYSN_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  PHYSN-SRVC-OFSITE-RSDNT-SW

   Services: Physician On-Site Nonresidents Indicator 1    800   800  VARCHAR2
     Description: Indicates if physician services are provided on-site to
                  nonresidents.
     SAS Name:    PHYSN_SRVC_ONST_NRSDNT_SW
     COBOL Name:  PHYSN-SRVC-ONST-NRSDNT-SW

   Services: Physician On-Site Residents Indicator   1    801   801  VARCHAR2


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 29
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Indicates if physician services are provided on-site to
                  residents.
     SAS Name:    PHYSN_SRVC_ONST_RSDNT_SW
     COBOL Name:  PHYSN-SRVC-ONST-RSDNT-SW

   Services: Podiatry Off-Site Residents Indicator   1    802   802  VARCHAR2
     Description: Indicates if podiatry services are provided off-site to
                  residents.
     SAS Name:    PDTRY_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  PDTRY-SRVC-OFSITE-RSDNT-SW

   Services: Podiatry On-Site Nonresidents Indicator 1    803   803  VARCHAR2
     Description: Indicates if podiatry services are provided on-site to
                  nonresidents.
     SAS Name:    PDTRY_SRVC_ONST_NRSDNT_SW
     COBOL Name:  PDTRY-SRVC-ONST-NRSDNT-SW

   Services: Podiatry On-Site Residents Indicator    1    804   804  VARCHAR2
     Description: Indicates if podiatry services are provided on-site to
                  residents.
     SAS Name:    PDTRY_SRVC_ONST_RSDNT_SW
     COBOL Name:  PDTRY-SRVC-ONST-RSDNT-SW

   Services: PT Off-Site Residents Indicator         1    814   814  VARCHAR2
     Description: Indicates if physical therapy services are provided
                  off-site to residents.
     SAS Name:    PT_OFSITE_RSDNT_SW
     COBOL Name:  PT-OFSITE-RSDNT-SW

   Services: PT On-Site Nonresidents Indicator       1    815   815  VARCHAR2
     Description: Indicates if physical therapy services are provided
                  on-site to nonresidents.
     SAS Name:    PT_ONST_NRSDNT_SW
     COBOL Name:  PT-ONST-NRSDNT-SW

   Services: PT On-Site Residents Indicator          1    816   816  VARCHAR2
     Description: Indicates if physical therapy services are provided
                  on-site to residents.
     SAS Name:    PT_ONST_RSDNT_SW
     COBOL Name:  PT-ONST-RSDNT-SW

   Services: Social Work Off-Site Residents Indicator 1    827   827  VARCHAR2
     Description: Indicates if social work services are provided off-site
                  to residents.
     SAS Name:    SCL_WORK_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  SCL-WORK-SRVC-OFSITE-RSDNT-SW

   Services: Social Work On-Site Nonresidents Indicator 1    828   828  VARCHAR2
     Description: Indicates if social work services are provided on-site to
                  nonresidents.
     SAS Name:    SCL_WORK_SRVC_ONST_NRSDNT_SW
     COBOL Name:  SCL-WORK-SRVC-ONST-NRSDNT-SW

   Services: Social Work On-Site Residents Indicator 1    829   829  VARCHAR2
     Description: Indicates if social work services are provided on-site to
                  residents.
     SAS Name:    SCL_WORK_SRVC_ONST_RSDNT_SW
     COBOL Name:  SCL-WORK-SRVC-ONST-RSDNT-SW

   Services: Speech Pathology Off-Site Residents     1    834   834  VARCHAR2
   Indicator
     Description: Indicates if speech/language pathology services are
                  provided off-site to residents.


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 30
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     SAS Name:    SPCH_PTHLGY_OFSITE_RSDNT_SW
     COBOL Name:  SPCH-PTHLGY-OFSITE-RSDNT-SW

   Services: Speech Pathology On-Site Nonresidents   1    835   835  VARCHAR2
   Indicator
     Description: Indicates if speech/language pathology services are
                  provided on-site to nonresidents.
     SAS Name:    SPCH_PTHLGY_ONST_NRSDNT_SW
     COBOL Name:  SPCH-PTHLGY-ONST-NRSDNT-SW

   Services: Speech Pathology On-Site Residents      1    836   836  VARCHAR2
   Indicator
     Description: Indicates if speech/language pathology services are
                  provided on-site to residents.
     SAS Name:    SPCH_PTHLGY_ONST_RSDNT_SW
     COBOL Name:  SPCH-PTHLGY-ONST-RSDNT-SW

   Services: Therapeutic - Other Activities Staff -  1    839   839  VARCHAR2
   Off-Site Residents Indicator
     Description: Indicates if therapeutic services are provided off-site
                  to residents by other activities staff.
     SAS Name:    ACTVTY_OTHR_OFSITE_RSDNT_SW
     COBOL Name:  ACTVTY-OTHR-OFSITE-RSDNT-SW

   Services: Therapeutic - Other Activities Staff -  1    840   840  VARCHAR2
   On-Site Nonresidents Indicator
     Description: Indicates if therapeutic services are provided on-site to
                  nonresidents by other activities staff.
     SAS Name:    ACTVTY_OTHR_ONST_NRSDNT_SW
     COBOL Name:  ACTVTY-OTHR-ONST-NRSDNT-SW

   Services: Therapeutic - Other Activities Staff -  1    841   841  VARCHAR2
   On-Site Residents Indicator
     Description: Indicates if therapeutic services are provided on-site to
                  residents by other activities staff.
     SAS Name:    ACTVTY_OTHR_ONST_RSDNT_SW
     COBOL Name:  ACTVTY-OTHR-ONST-RSDNT-SW

   Services: Therapeutic - Other Social Services Staff - 1    842   842  VARCHAR2
   Off-Site Residents Indicator
     Description: Indicates if other therapeutic social services are
                  provided off-site to residents.
     SAS Name:    SCL_SRVC_OTHR_OFSITE_RSDNT_SW
     COBOL Name:  SCL-SRVC-OTHR-OFSITE-RSDNT-SW

   Services: Therapeutic - Other Social Services Staff - 1    843   843  VARCHAR2
   On-Site Nonresidents Indicator
     Description: Indicates if other therapeutic social services are
                  provided on-site to nonresidents.
     SAS Name:    SCL_SRVC_OTHR_ONST_NRSDNT_SW
     COBOL Name:  SCL-SRVC-OTHR-ONST-NRSDNT-SW

   Services: Therapeutic - Other Social Services Staff - 1    844   844  VARCHAR2
   On-Site Residents Indicator
     Description: Indicates if other therapeutic social services are
                  provided on-site to residents.
     SAS Name:    SCL_SRVC_OTHR_ONST_RSDNT_SW
     COBOL Name:  SCL-SRVC-OTHR-ONST-RSDNT-SW

   Services: Therapeutic - Qualified Activities      1    845   845  VARCHAR2
   Professional - Off-Site Residents Indicator
     Description: Indicates if therapeutic services are provided off-site
                  to residents by qualified activities professionals.


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 31
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     SAS Name:    ACTVTY_OFSITE_RSDNT_SW
     COBOL Name:  ACTVTY-OFSITE-RSDNT-SW

   Services: Therapeutic - Qualified Activities      1    846   846  VARCHAR2
   Professional - On-Site Nonresidents Indicator
     Description: Indicates if therapeutic services are provided on-site to
                  nonresidents by qualified activities professionals.
     SAS Name:    ACTVTY_ONST_NRSDNT_SW
     COBOL Name:  ACTVTY-ONST-NRSDNT-SW

   Services: Therapeutic - Qualified Activities      1    847   847  VARCHAR2
   Professional - On-Site Residents Indicator
     Description: Indicates if therapeutic services are provided on-site to
                  residents by qualified activities professionals.
     SAS Name:    ACTVTY_ONST_RSDNT_SW
     COBOL Name:  ACTVTY-ONST-RSDNT-SW

   Services: Therapeutic Recreational Specialty Off-Site 1    849   849  VARCHAR2
   Residents Indicator
     Description: Indicates if therapeutic recreation specialist services
                  are provided off-site to residents.
     SAS Name:    THRPTC_RCRTNL_OFSITE_RSDNT_SW
     COBOL Name:  THRPTC-RCRTNL-OFSITE-RSDNT-SW

   Services: Therapeutic Recreational Specialty On-Site 1    850   850  VARCHAR2
   Nonresidents Indicator
     Description: Indicates if therapeutic recreation specialist services
                  are provided on-site to nonresidents.
     SAS Name:    THRPTC_RCRTNL_ONST_NRSDNT_SW
     COBOL Name:  THRPTC-RCRTNL-ONST-NRSDNT-SW

   Services: Therapeutic Recreational Specialty On-Site 1    851   851  VARCHAR2
   Residents Indicator
     Description: Indicates if therapeutic recreation specialist services
                  are provided on-site to residents.
     SAS Name:    THRPTC_RCRTNL_ONST_RSDNT_SW
     COBOL Name:  THRPTC-RCRTNL-ONST-RSDNT-SW

   Services: Vocational Off-Site Residents Indicator 1    854   854  VARCHAR2
     Description: Indicates if vocational services are provided off-site to
                  residents.
     SAS Name:    VCTNL_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  VCTNL-SRVC-OFSITE-RSDNT-SW

   Services: Vocational On-Site Nonresidents Indicator 1    855   855  VARCHAR2
     Description: Indicates if vocational services are provided on-site to
                  nonresidents.
     SAS Name:    VCTNL_SRVC_ONST_NRSDNT_SW
     COBOL Name:  VCTNL-SRVC-ONST-NRSDNT-SW

   Services: Vocational On-Site Residents Indicator  1    856   856  VARCHAR2
     Description: Indicates if vocational services are provided on-site to
                  residents.
     SAS Name:    VCTNL_SRVC_ONST_RSDNT_SW
     COBOL Name:  VCTNL-SRVC-ONST-RSDNT-SW

   Services: X-ray Off-Site Residents Indicator      1    857   857  VARCHAR2
     Description: Indicates if diagnostic X-ray services are provided
                  off-site to residents.
     SAS Name:    DGNSTC_XRAY_OFSITE_RSDNT_SW
     COBOL Name:  DGNSTC-XRAY-OFSITE-RSDNT-SW

   Services: X-ray On-Site Nonresidents Indicator    1    858   858  VARCHAR2


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 32
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Indicates if diagnostic X-ray services are provided
                  on-site to nonresidents.
     SAS Name:    DGNSTC_XRAY_ONST_NRSDNT_SW
     COBOL Name:  DGNSTC-XRAY-ONST-NRSDNT-SW

   Services: X-ray On-Site Residents Indicator       1    859   859  VARCHAR2
     Description: Indicates if diagnostic X-ray services are provided
                  on-site to residents.
     SAS Name:    DGNSTC_XRAY_ONST_RSDNT_SW
     COBOL Name:  DGNSTC-XRAY-ONST-RSDNT-SW

   Staff Count Override Indicator                    1    861   861  CHAR
     Description: Indicates if the regional office has approved a
                  significant staff count change from the previous
                  certification.
     SAS Name:    OVRRD_STFG_SW
     COBOL Name:  OVRRD-STFG-SW

   Staff Count: Administrative Staff - Contract      8    862   869  NUMBER
     Description: Number of full-time equivalent administrative staff under
                  contract to a facility.
     SAS Name:    PROFNL_ADMIN_CNTRCT_CNT
     COBOL Name:  PROFNL-ADMIN-CNTRCT-CNT

   Staff Count: Administrative Staff - Full-Time     8    870   877  NUMBER
     Description: Number of full-time equivalent administrative staff
                  employed on a full-time basis by a facility.
     SAS Name:    PROFNL_ADMIN_FLTM_CNT
     COBOL Name:  PROFNL-ADMIN-FLTM-CNT

   Staff Count: Administrative Staff - Part-Time     8    878   885  NUMBER
     Description: Number of full-time equivalent administrative staff
                  employed on a part-time basis by a facility.
     SAS Name:    PROFNL_ADMIN_PRTM_CNT
     COBOL Name:  PROFNL-ADMIN-PRTM-CNT

   Staff Count: Certified Nurse Aide - Contract      8    910   917  NUMBER
     Description: Number of full-time equivalent certified nurse aides
                  under contract to a facility.
     SAS Name:    NRS_AIDE_CNTRCT_CNT
     COBOL Name:  NRS-AIDE-CNTRCT-CNT

   Staff Count: Certified Nurse Aide - Full-Time     8    918   925  NUMBER
     Description: Number of full-time equivalent certified nurse aides
                  employed full-time by a facility.
     SAS Name:    NRS_AIDE_FLTM_CNT
     COBOL Name:  NRS-AIDE-FLTM-CNT

   Staff Count: Certified Nurse Aide - Part-Time     8    926   933  NUMBER
     Description: Number of full-time equivalent certified nurse aides
                  employed part-time by a facility.
     SAS Name:    NRS_AIDE_PRTM_CNT
     COBOL Name:  NRS-AIDE-PRTM-CNT

   Staff Count: Dentist - Contract                   8    958   965  NUMBER
     Description: Number of full-time equivalent dentists under contract to
                  a facility.
     SAS Name:    DNTST_CNTRCT_CNT
     COBOL Name:  DNTST-CNTRCT-CNT

   Staff Count: Dentist - Full-Time                  8    966   973  NUMBER
     Description: Number of full-time equivalent dentists employed full
                  time by a facility.


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 33
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     SAS Name:    DNTST_FLTM_CNT
     COBOL Name:  DNTST-FLTM-CNT

   Staff Count: Dentist - Part-Time                  8    974   981  NUMBER
     Description: Number of full-time equivalent dentists employed part
                  time by a facility.
     SAS Name:    DNTST_PRTM_CNT
     COBOL Name:  DNTST-PRTM-CNT

   Staff Count: Dietitian - Contract                 8    990   997  NUMBER
     Description: Number of full-time equivalent dietitians under contract
                  to a facility.
     SAS Name:    DIETN_CNTRCT_CNT
     COBOL Name:  DIETN-CNTRCT-CNT

   Staff Count: Dietitian - Full-Time                8    998   1005 NUMBER
     Description: Number of full-time equivalent dietitians employed full
                  time by a facility.
     SAS Name:    DIETN_FLTM_CNT
     COBOL Name:  DIETN-FLTM-CNT

   Staff Count: Dietitian - Part-Time                8    1006  1013 NUMBER
     Description: Number of full-time equivalent dietitians employed part
                  time by a facility.
     SAS Name:    DIETN_PRTM_CNT
     COBOL Name:  DIETN-PRTM-CNT

   Staff Count: Food Service Worker - Contract       8    1022  1029 NUMBER
     Description: Number of full-time equivalent food service personnel
                  under contract to a facility.
     SAS Name:    FOOD_SRVC_CNTRCT_CNT
     COBOL Name:  FOOD-SRVC-CNTRCT-CNT

   Staff Count: Food Service Worker - Full-Time      8    1030  1037 NUMBER
     Description: Number of full-time equivalent food service personnel
                  employed  full-time by a facility.
     SAS Name:    FOOD_SRVC_FLTM_CNT
     COBOL Name:  FOOD-SRVC-FLTM-CNT

   Staff Count: Food Service Worker - Part-Time      8    1038  1045 NUMBER
     Description: Number of full-time equivalent food service personnel
                  employed  part-time by a facility.
     SAS Name:    FOOD_SRVC_PRTM_CNT
     COBOL Name:  FOOD-SRVC-PRTM-CNT

   Staff Count: Housekeeping - Contract              8    1070  1077 NUMBER
     Description: Number of full-time equivalent housekeeping personnel
                  under contract to a facility.
     SAS Name:    HSEKPNG_CNTRCT_CNT
     COBOL Name:  HSEKPNG-CNTRCT-CNT

   Staff Count: Housekeeping - Full-Time             8    1078  1085 NUMBER
     Description: Number of full-time equivalent housekeeping personnel
                  employed  full-time by a facility.
     SAS Name:    HSEKPNG_FLTM_CNT
     COBOL Name:  HSEKPNG-FLTM-CNT

   Staff Count: Housekeeping - Part-Time             8    1086  1093 NUMBER
     Description: Number of full-time equivalent housekeeping personnel
                  employed  part-time by a facility.
     SAS Name:    HSEKPNG_PRTM_CNT
     COBOL Name:  HSEKPNG-PRTM-CNT



 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 34
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

   Staff Count: LPN/LVN - Contract                   8    1118  1125 NUMBER
     Description: Number of full-time equivalent licensed
                  practical/vocational nurses under contract to a facility.
     SAS Name:    LPN_LVN_CNTRCT_CNT
     COBOL Name:  LPN-LVN-CNTRCT-CNT

   Staff Count: LPN/LVN - Full-Time                  8    1126  1133 NUMBER
     Description: Number of full-time equivalent licensed
                  practical/vocational nurses employed full-time by a
                  facility.
     SAS Name:    LPN_LVN_FLTM_CNT
     COBOL Name:  LPN-LVN-FLTM-CNT

   Staff Count: LPN/LVN - Part-Time                  8    1134  1141 NUMBER
     Description: Number of full-time equivalent licensed
                  practical/vocational nurses employed part-time by a
                  facility.
     SAS Name:    LPN_LVN_PRTM_CNT
     COBOL Name:  LPN-LVN-PRTM-CNT

   Staff Count: Medical Director - Contract          8    1150  1157 NUMBER
     Description: Number of full-time equivalent medical directors under
                  contract to a facility.
     SAS Name:    MDCL_DRCTR_CNTRCT_CNT
     COBOL Name:  MDCL-DRCTR-CNTRCT-CNT

   Staff Count: Medical Director - Full-Time         8    1158  1165 NUMBER
     Description: Number of full-time equivalent medical directors employed
                  full-time by a facility.
     SAS Name:    MDCL_DRCTR_FLTM_CNT
     COBOL Name:  MDCL-DRCTR-FLTM-CNT

   Staff Count: Medical Director - Part-Time         8    1166  1173 NUMBER
     Description: Number of full-time equivalent medical directors employed
                  part-time by a facility.
     SAS Name:    MDCL_DRCTR_PRTM_CNT
     COBOL Name:  MDCL-DRCTR-PRTM-CNT

   Staff Count: Medication Aide/Technician - Contract 8    1198  1205 NUMBER
     Description: Number of full-time equivalent medication aides/
                  technicians under contract to a facility.
     SAS Name:    MDCTN_AIDE_CNTRCT_CNT
     COBOL Name:  MDCTN-AIDE-CNTRCT-CNT

   Staff Count: Medication Aide/Technician - Full-Time 8    1206  1213 NUMBER
     Description: Number of full-time equivalent medication aides/
                  technicians employed full-time by a facility.
     SAS Name:    MDCTN_AIDE_FLTM_CNT
     COBOL Name:  MDCTN-AIDE-FLTM-CNT

   Staff Count: Medication Aide/Technician - Part-Time 8    1214  1221 NUMBER
     Description: Number of full-time equivalent medication aides/
                  technicians employed part-time by a facility.
     SAS Name:    MDCTN_AIDE_PRTM_CNT
     COBOL Name:  MDCTN-AIDE-PRTM-CNT

   Staff Count: Mental Health Services - Contract    8    1222  1229 NUMBER
     Description: Number of full-time equivalent mental health services
                  personnel under contract to a facility.
     SAS Name:    MENTL_HLTH_SRVC_CNTRCT_CNT
     COBOL Name:  MENTL-HLTH-SRVC-CNTRCT-CNT

   Staff Count: Mental Health Services - Full-Time   8    1230  1237 NUMBER


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 35
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Number of full-time equivalent mental health services
                  personnel employed full-time by a facility.
     SAS Name:    MENTL_HLTH_SRVC_FLTM_CNT
     COBOL Name:  MENTL-HLTH-SRVC-FLTM-CNT

   Staff Count: Mental Health Services - Part-Time   8    1238  1245 NUMBER
     Description: Number of full-time equivalent mental health services
                  personnel employed part-time by a facility.
     SAS Name:    MENTL_HLTH_SRVC_PRTM_CNT
     COBOL Name:  MENTL-HLTH-SRVC-PRTM-CNT

   Staff Count: Nurse Aide in Training - Contract    8    1254  1261 NUMBER
     Description: Number of full-time equivalent nurse aides in training
                  under contract to a facility.
     SAS Name:    NAT_CNTRCT_CNT
     COBOL Name:  NAT-CNTRCT-CNT

   Staff Count: Nurse Aide in Training - Full-Time   8    1262  1269 NUMBER
     Description: Number of full-time equivalent nurse aides in training
                  employed full-time by a facility.
     SAS Name:    NAT_FLTM_CNT
     COBOL Name:  NAT-FLTM-CNT

   Staff Count: Nurse Aide in Training - Part-Time   8    1270  1277 NUMBER
     Description: Number of full-time equivalent nurse aides in training
                  employed part-time by a facility.
     SAS Name:    NAT_PRTM_CNT
     COBOL Name:  NAT-PRTM-CNT

   Staff Count: Nurse With Administrative Duties -   8    1286  1293 NUMBER
   Contract
     Description: Number of full-time equivalent nurses with administrative
                  duties under contract to a facility.
     SAS Name:    NRS_ADMINV_CNTRCT_CNT
     COBOL Name:  NRS-ADMINV-CNTRCT-CNT

   Staff Count: Nurse With Administrative Duties -   8    1294  1301 NUMBER
   Full-Time
     Description: Number of full-time equivalent nurses with administrative
                  duties employed full-time by a facility.
     SAS Name:    NRS_ADMINV_FLTM_CNT
     COBOL Name:  NRS-ADMINV-FLTM-CNT

   Staff Count: Nurse With Administrative Duties -   8    1302  1309 NUMBER
   Part-Time
     Description: Number of full-time equivalent nurses with administrative
                  duties employed part-time by a facility.
     SAS Name:    NRS_ADMINV_PRTM_CNT
     COBOL Name:  NRS-ADMINV-PRTM-CNT

   Staff Count: OT - Arrangement                     8    1318  1325 NUMBER
     Description: Number of full-time equivalent occupational therapists
                  under arrangement to the provider
     SAS Name:    OCPTNL_THRPST_CNTRCT_CNT
     COBOL Name:  OCPTNL-THRPST-CNTRCT-CNT

   Staff Count: OT - Full-Time                       8    1326  1333 NUMBER
     Description: Number of full-time equivalent occupational therapists
                  employed full-time by a facility.
     SAS Name:    OCPTNL_THRPST_FLTM_CNT
     COBOL Name:  OCPTNL-THRPST-FLTM-CNT

   Staff Count: OT - Part-Time                       8    1334  1341 NUMBER


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 36
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Number of full-time equivalent occupational therapists
                  employed part-time by a facility.
     SAS Name:    OCPTNL_THRPST_PRTM_CNT
     COBOL Name:  OCPTNL-THRPST-PRTM-CNT

   Staff Count: OT Aide - Contract                   8    1342  1349 NUMBER
     Description: Number of full-time equivalent occupational therapy aides
                  under contract to a facility.
     SAS Name:    OT_AIDE_CNTRCT_CNT
     COBOL Name:  OT-AIDE-CNTRCT-CNT

   Staff Count: OT Aide - Full-Time                  8    1350  1357 NUMBER
     Description: Number of full-time equivalent occupational therapy aides
                  employed full-time by a facility.
     SAS Name:    OT_AIDE_FLTM_CNT
     COBOL Name:  OT-AIDE-FLTM-CNT

   Staff Count: OT Aide - Part-Time                  8    1358  1365 NUMBER
     Description: Number of full-time equivalent occupational therapy aides
                  employed part-time by a facility.
     SAS Name:    OT_AIDE_PRTM_CNT
     COBOL Name:  OT-AIDE-PRTM-CNT

   Staff Count: OT Assistant - Contract              8    1366  1373 NUMBER
     Description: Number of full-time equivalent occupational therapy
                  assistants under contract to a facility.
     SAS Name:    OT_ASTNT_CNTRCT_CNT
     COBOL Name:  OT-ASTNT-CNTRCT-CNT

   Staff Count: OT Assistant - Full-Time             8    1374  1381 NUMBER
     Description: Number of full-time equivalent occupational therapy
                  assistants employed full-time by a facility.
     SAS Name:    OT_ASTNT_FLTM_CNT
     COBOL Name:  OT-ASTNT-FLTM-CNT

   Staff Count: OT Assistant - Part-Time             8    1382  1389 NUMBER
     Description: Number of full-time equivalent occupational therapy
                  assistants employed part-time by a facility.
     SAS Name:    OT_ASTNT_PRTM_CNT
     COBOL Name:  OT-ASTNT-PRTM-CNT

   Staff Count: Other Activities - Contract          8    1398  1405 NUMBER
     Description: Number of full-time equivalent other activities staff
                  providing therapeutic services under contract to a
                  facility.
     SAS Name:    ACTVTY_STF_OTHR_CNTRCT_CNT
     COBOL Name:  ACTVTY-STF-OTHR-CNTRCT-CNT

   Staff Count: Other Activities - Full-Time         8    1406  1413 NUMBER
     Description: Number of full-time equivalent other activities staff
                  providing therapeutic services employed full time by a
                  facility.
     SAS Name:    ACTVTY_STF_OTHR_FLTM_CNT
     COBOL Name:  ACTVTY-STF-OTHR-FLTM-CNT

   Staff Count: Other Activities - Part-Time         8    1414  1421 NUMBER
     Description: Number of full-time equivalent other activities staff
                  providing therapeutic services employed part time by a
                  facility.
     SAS Name:    ACTVTY_STF_OTHR_PRTM_CNT
     COBOL Name:  ACTVTY-STF-OTHR-PRTM-CNT

   Staff Count: Other Physician - Contract           8    1422  1429 NUMBER


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 37
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Number of full-time equivalent other physicians under
                  contract to a facility.
     SAS Name:    PHYSN_OTHR_CNTRCT_CNT
     COBOL Name:  PHYSN-OTHR-CNTRCT-CNT

   Staff Count: Other Physician - Full-Time          8    1430  1437 NUMBER
     Description: Number of full-time equivalent other physicians employed
                  full-time by a facility.
     SAS Name:    PHYSN_OTHR_FLTM_CNT
     COBOL Name:  PHYSN-OTHR-FLTM-CNT

   Staff Count: Other Physician - Part-Time          8    1438  1445 NUMBER
     Description: Number of full-time equivalent other physicians employed
                  part-time by a facility.
     SAS Name:    PHYSN_OTHR_PRTM_CNT
     COBOL Name:  PHYSN-OTHR-PRTM-CNT

   Staff Count: Other Social Services - Contract     8    1446  1453 NUMBER
     Description: Number of full-time equivalent other social services
                  staff under contract to a facility.
     SAS Name:    SCL_SRVC_OTHR_STF_CNTRCT_CNT
     COBOL Name:  SCL-SRVC-OTHR-STF-CNTRCT-CNT

   Staff Count: Other Social Services - Full-Time    8    1454  1461 NUMBER
     Description: Number of full-time equivalent other social services
                  staff employed full time by a facility.
     SAS Name:    SCL_SRVC_OTHR_STF_FLTM_CNT
     COBOL Name:  SCL-SRVC-OTHR-STF-FLTM-CNT

   Staff Count: Other Social Services - Part-Time    8    1462  1469 NUMBER
     Description: Number of full-time equivalent other social services
                  staff employed part time by a facility.
     SAS Name:    SCL_SRVC_OTHR_STF_PRTM_CNT
     COBOL Name:  SCL-SRVC-OTHR-STF-PRTM-CNT

   Staff Count: Other Staff - Contract               8    1470  1477 NUMBER
     Description: Number of full-time equivalent staff not included in any
                  other categories under contract to the facility.
     SAS Name:    STF_OTHR_CNTRCT_CNT
     COBOL Name:  STF-OTHR-CNTRCT-CNT

   Staff Count: Other Staff - Full-Time              8    1478  1485 NUMBER
     Description: Number of full-time equivalent persons not included in
                  any other categories employed full-time by the facility.
     SAS Name:    STF_OTHR_FLTM_CNT
     COBOL Name:  STF-OTHR-FLTM-CNT

   Staff Count: Other Staff - Part-Time              8    1486  1493 NUMBER
     Description: Number of full-time equivalent persons not included in
                  any other categories employed part-time by the facility.
     SAS Name:    STF_OTHR_PRTM_CNT
     COBOL Name:  STF-OTHR-PRTM-CNT

   Staff Count: Pharmacist - Contract                8    1494  1501 NUMBER
     Description: Number of full-time equivalent pharmacists under contract
                  to a facility.
     SAS Name:    PHRMCST_CNTRCT_CNT
     COBOL Name:  PHRMCST-CNTRCT-CNT

   Staff Count: Pharmacist - Full-Time               8    1502  1509 NUMBER
     Description: Number of full-time equivalent pharmacists employed
                  full-time by a facility.
     SAS Name:    PHRMCST_FLTM_CNT


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 38
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     COBOL Name:  PHRMCST-FLTM-CNT

   Staff Count: Pharmacist - Part-Time               8    1510  1517 NUMBER
     Description: Number of full-time equivalent pharmacists employed
                  part-time by a facility.
     SAS Name:    PHRMCST_PRTM_CNT
     COBOL Name:  PHRMCST-PRTM-CNT

   Staff Count: Physical Therapist - Contract        8    1518  1525 NUMBER
     Description: Number of full-time equivalent physical therapists under
                  contract to a facility.
     SAS Name:    PHYS_THRPST_CNTRCT_CNT
     COBOL Name:  PHYS-THRPST-CNTRCT-CNT

   Staff Count: Physical Therapist - Full-Time       8    1526  1533 NUMBER
     Description: Number of full-time equivalent physical therapists
                  employed full-time by a facility.
     SAS Name:    PHYS_THRPST_FLTM_CNT
     COBOL Name:  PHYS-THRPST-FLTM-CNT

   Staff Count: Physical Therapist - Part-Time       8    1534  1541 NUMBER
     Description: Number of full-time equivalent physical therapists
                  employed part-time by a facility.
     SAS Name:    PHYS_THRPST_PRTM_CNT
     COBOL Name:  PHYS-THRPST-PRTM-CNT

   Staff Count: Physician Extender - Contract        8    1566  1573 NUMBER
     Description: Number of full-time equivalent physician extenders under
                  contract to the facility.
     SAS Name:    PHYSN_EXT_CNTRCT_CNT
     COBOL Name:  PHYSN-EXT-CNTRCT-CNT

   Staff Count: Physician Extender - Full-Time       8    1574  1581 NUMBER
     Description: Number of full-time equivalent physician extenders
                  employed full-time by the facility.
     SAS Name:    PHYSN_EXT_FLTM_CNT
     COBOL Name:  PHYSN-EXT-FLTM-CNT

   Staff Count: Physician Extender - Part-Time       8    1582  1589 NUMBER
     Description: Number of full-time equivalent physician extenders
                  employed part-time by the facility.
     SAS Name:    PHYSN_EXT_PRTM_CNT
     COBOL Name:  PHYSN-EXT-PRTM-CNT

   Staff Count: Podiatrist - Contract                8    1598  1605 NUMBER
     Description: Number of full-time equivalent podiatrists under contract
                  to a facility.
     SAS Name:    PDTRST_CNTRCT_CNT
     COBOL Name:  PDTRST-CNTRCT-CNT

   Staff Count: Podiatrist - Full-Time               8    1606  1613 NUMBER
     Description: Number of full-time equivalent podiatrists employed
                  full-time by a facility.
     SAS Name:    PDTRST_FLTM_CNT
     COBOL Name:  PDTRST-FLTM-CNT

   Staff Count: Podiatrist - Part-Time               8    1614  1621 NUMBER
     Description: Number of full-time equivalent podiatrists employed
                  part-time by a facility.
     SAS Name:    PDTRST_PRTM_CNT
     COBOL Name:  PDTRST-PRTM-CNT

   Staff Count: PT Aide - Contract                   8    1654  1661 NUMBER


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 39
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Number of full-time equivalent physical therapy aides
                  under contract to a facility.
     SAS Name:    PT_AIDE_CNTRCT_CNT
     COBOL Name:  PT-AIDE-CNTRCT-CNT

   Staff Count: PT Aide - Full-Time                  8    1662  1669 NUMBER
     Description: Number of full-time equivalent physical therapy aides
                  employed full-time by a facility.
     SAS Name:    PT_AIDE_FLTM_CNT
     COBOL Name:  PT-AIDE-FLTM-CNT

   Staff Count: PT Aide - Part-Time                  8    1670  1677 NUMBER
     Description: Number of full-time equivalent physical therapy aides
                  employed part-time by a facility.
     SAS Name:    PT_AIDE_PRTM_CNT
     COBOL Name:  PT-AIDE-PRTM-CNT

   Staff Count: PT Assistant - Contract              8    1678  1685 NUMBER
     Description: Number of full-time equivalent physical therapy
                  assistants under contract to a facility.
     SAS Name:    PT_ASTNT_CNTRCT_CNT
     COBOL Name:  PT-ASTNT-CNTRCT-CNT

   Staff Count: PT Assistant - Full-Time             8    1686  1693 NUMBER
     Description: Number of full-time equivalent physical therapy
                  assistants employed full-time by a facility.
     SAS Name:    PT_ASTNT_FLTM_CNT
     COBOL Name:  PT-ASTNT-FLTM-CNT

   Staff Count: PT Assistant - Part-Time             8    1694  1701 NUMBER
     Description: Number of full-time equivalent physical therapy
                  assistants employed part-time by a facility.
     SAS Name:    PT_ASTNT_PRTM_CNT
     COBOL Name:  PT-ASTNT-PRTM-CNT

   Staff Count: Qualified Activities Professional -  8    1702  1709 NUMBER
   Contract
     Description: Number of full-time equivalent qualified activities
                  professionals providing therapeutic services under
                  contract to a facility.
     SAS Name:    ACTVTY_PROFNL_CNTRCT_CNT
     COBOL Name:  ACTVTY-PROFNL-CNTRCT-CNT

   Staff Count: Qualified Activities Professional -  8    1710  1717 NUMBER
   Full-Time
     Description: Number of full-time equivalent qualified activities
                  professionals providing therapeutic services employed
                  full time by a facility.
     SAS Name:    ACTVTY_PROFNL_FLTM_CNT
     COBOL Name:  ACTVTY-PROFNL-FLTM-CNT

   Staff Count: Qualified Activities Professional -  8    1718  1725 NUMBER
   Part-Time
     Description: Number of full-time equivalent qualified activities
                  professionals providing therapeutic services employed
                  part time by a facility.
     SAS Name:    ACTVTY_PROFNL_PRTM_CNT
     COBOL Name:  ACTVTY-PROFNL-PRTM-CNT

   Staff Count: RN - Contract                        8    1758  1765 NUMBER
     Description: Number of full-time equivalent registered nurses under
                  contract to a facility.
     SAS Name:    RN_CNTRCT_CNT


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 40
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     COBOL Name:  RN-CNTRCT-CNT

   Staff Count: RN - Full-Time                       8    1766  1773 NUMBER
     Description: Number of full-time equivalent registered nurses employed
                  full-time by a facility.
     SAS Name:    RN_FLTM_CNT
     COBOL Name:  RN-FLTM-CNT

   Staff Count: RN - Part-Time                       8    1774  1781 NUMBER
     Description: Number of full-time equivalent registered nurses employed
                  part-time by a facility.
     SAS Name:    RN_PRTM_CNT
     COBOL Name:  RN-PRTM-CNT

   Staff Count: RN Director of Nursing - Contract    8    1790  1797 NUMBER
     Description: Number of full-time equivalent registered nurse directors
                  of nursing under contract to a facility.
     SAS Name:    RN_DRCTR_CNTRCT_CNT
     COBOL Name:  RN-DRCTR-CNTRCT-CNT

   Staff Count: RN Director of Nursing - Full-Time   8    1798  1805 NUMBER
     Description: Number of full-time equivalent registered nurse directors
                  of nursing employed full-time by a facility.
     SAS Name:    RN_DRCTR_FLTM_CNT
     COBOL Name:  RN-DRCTR-FLTM-CNT

   Staff Count: RN Director of Nursing - Part-Time   8    1806  1813 NUMBER
     Description: Number of full-time equivalent registered nurse directors
                  of nursing employed part-time by a facility.
     SAS Name:    RN_DRCTR_PRTM_CNT
     COBOL Name:  RN-DRCTR-PRTM-CNT

   Staff Count: Social Worker - Contract             8    1822  1829 NUMBER
     Description: Number of full-time equivalent social workers under
                  contract to a facility.
     SAS Name:    SCL_WORKR_CNTRCT_CNT
     COBOL Name:  SCL-WORKR-CNTRCT-CNT

   Staff Count: Social Worker - Full-Time            8    1830  1837 NUMBER
     Description: Number of full-time equivalent social workers employed
                  full-time by a facility.
     SAS Name:    SCL_WORKR_FLTM_CNT
     COBOL Name:  SCL-WORKR-FLTM-CNT

   Staff Count: Social Worker - Part-Time            8    1838  1845 NUMBER
     Description: Number of full-time equivalent social workers employed
                  part-time by a facility.
     SAS Name:    SCL_WORKR_PRTM_CNT
     COBOL Name:  SCL-WORKR-PRTM-CNT

   Staff Count: Speech Pathologist - Contract        8    1854  1861 NUMBER
     Description: Number of full-time equivalent speech pathologists under
                  contract to a facility.
     SAS Name:    SPCH_PTHLGST_CNTRCT_CNT
     COBOL Name:  SPCH-PTHLGST-CNTRCT-CNT

   Staff Count: Speech Pathologist - Full-Time       8    1862  1869 NUMBER
     Description: Number of full-time equivalent speech pathologists
                  employed full-time by a facility.
     SAS Name:    SPCH_PTHLGST_FLTM_CNT
     COBOL Name:  SPCH-PTHLGST-FLTM-CNT

   Staff Count: Speech Pathologist - Part-Time       8    1870  1877 NUMBER


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 41
   Skilled Nursing Facility/Nursing Facility (Distinct Part), CATEGORY = "03"
                              (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Number of full-time equivalent speech pathologists
                  employed part-time by a facility.
     SAS Name:    SPCH_PTHLGST_PRTM_CNT
     COBOL Name:  SPCH-PTHLGST-PRTM-CNT

   Staff Count: Therapeutic Recreational Specialist - 8    1910  1917 NUMBER
   Contract
     Description: Number of full-time equivalent therapeutic recreation
                  specialist staff under contract to a facility.
     SAS Name:    THRPTC_RCRTNL_CNTRCT_CNT
     COBOL Name:  THRPTC-RCRTNL-CNTRCT-CNT

   Staff Count: Therapeutic Recreational Specialist - 8    1918  1925 NUMBER
   Full-Time
     Description: Number of full-time equivalent therapeutic recreation
                  specialist staff employed full-time by a facility.
     SAS Name:    THRPTC_RCRTNL_FLTM_CNT
     COBOL Name:  THRPTC-RCRTNL-FLTM-CNT

   Staff Count: Therapeutic Recreational Specialist - 8    1926  1933 NUMBER
   Part-Time
     Description: Number of  full-time equivalent therapeutic recreation
                  specialist staff employed full-time by a facility.
     SAS Name:    THRPTC_RCRTNL_PRTM_CNT
     COBOL Name:  THRPTC-RCRTNL-PRTM-CNT








































 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 1
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Provider Category Subtype Code                    2    1     2    VARCHAR2
     Description: Identifies the subtype of the provider, within the
                  primary category.  Used in reporting to show the
                  breakdown of provider categories, mainly for hospitals
                  and SNFs.
     SAS Name:    PRVDR_CTGRY_SBTYP_CD
     COBOL Name:  PRVDR-CTGRY-SBTYP-CD
     VALUES:      01=Title 18 Only

   Provider Category Code                            2    3     4    VARCHAR2
     Description: Identifies the type of provider participating in the
                  Medicare/Medicaid program.
     SAS Name:    PRVDR_CTGRY_CD
     COBOL Name:  PRVDR-CTGRY-CD
     VALUES:      04=Skilled Nursing Facility

   CHOW Count                                        2    5     6    NUMBER
     Description: Number of times this provider has undergone a change of
                  ownership.
     SAS Name:    CHOW_CNT
     COBOL Name:  CHOW-CNT

   CHOW Date                                         8    7     14   DATE
     Description: Effective date of the most recent change of ownership for
                  this provider.
     SAS Name:    CHOW_DT
     COBOL Name:  CHOW-DT

   Address: City                                     28   15    42   VARCHAR2
     Description: City in which the provider is physically located.
     SAS Name:    CITY_NAME
     COBOL Name:  CITY-NAME

   Compliance: Acceptable POC                        1    43    43   VARCHAR2
     Description: Indicates if a provider is in compliance with program
                  requirements based on an acceptable plan for correction
                  of deficiencies.
     SAS Name:    ACPTBL_POC_SW
     COBOL Name:  ACPTBL-POC-SW

   Compliance: Status                                1    44    44   VARCHAR2
     Description: Compliance status of a provider at the time of
                  certification survey.
     SAS Name:    CMPLNC_STUS_CD
     COBOL Name:  CMPLNC-STUS-CD
     VALUES:      A=IN COMPLIANCE
                  B=NOT IN COMPLIANCE

   SSA County Code                                   3    45    47   VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the county where the provider is located.
     SAS Name:    SSA_CNTY_CD
     COBOL Name:  SSA-CNTY-CD

   Cross Ref Provider Number                         10   48    57   CHAR
     Description: Cross reference provider number
     SAS Name:    CROSS_REF_PROVIDER_NUMBER
     COBOL Name:  CROSS-REF-PROVIDER-NUMBER

   Certification Date                                8    58    65   DATE
     Description: Equal to the exit date of the initial visit of the Health
                  survey for certifications completed after July 28, 2012.
                  For certifications prior to that date, the certification


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 2
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  date is equal to the exit date of the initial visit of
                  the Health survey or LSC survey, whichever is later.
     SAS Name:    CRTFCTN_DT
     COBOL Name:  CRTFCTN-DT

   Eligibility Indicator                             1    66    66   VARCHAR2
     Description: Indicates if a facility is eligible to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    ELGBLTY_SW
     COBOL Name:  ELGBLTY-SW

   Facility Name                                     50   67    116  VARCHAR2
     Description: Name of the provider certified to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    FAC_NAME
     COBOL Name:  FAC-NAME

   Medicare Administrative Contractor (MAC) or       5    117   121  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_CD
     COBOL Name:  INTRMDRY-CARR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 3
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 4
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 5
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 6
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)
                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 7
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   Medicaid Vendor Number                            15   122   136  VARCHAR2
     Description: Number which may be assigned to a provider by the state
                  Medicaid agency for external control or billing purposes.
     SAS Name:    MDCD_VNDR_NUM
     COBOL Name:  MDCD-VNDR-NUM

   Original Participation Date                       8    137   144  DATE
     Description: Date a provider is first approved to provide Medicare
                  and/or Medicaid services.
     SAS Name:    ORGNL_PRTCPTN_DT
     COBOL Name:  ORGNL-PRTCPTN-DT

   Prior CHOW Date                                   8    145   152  DATE
     Description: Effective date of the previous change of ownership for
                  this provider.
     SAS Name:    CHOW_PRIOR_DT
     COBOL Name:  CHOW-PRIOR-DT

   Prior Medicare Administrative Contractor (MAC) or 5    153   157  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the previous Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_PRIOR_CD
     COBOL Name:  INTRMDRY-CARR-PRIOR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 8
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 9
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 10
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 11
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 12
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   CCN                                               10   158   167  VARCHAR2
     Description: Six or ten position identification number that is
                  assigned to a certified provider.  This is the CMS
                  Certification Number.
     SAS Name:    PRVDR_NUM
     COBOL Name:  PRVDR-NUM

   Region Code                                       2    168   169  VARCHAR2
     Description: Indicates the CMS Regional Office responsible for the
                  certification of the provider.
     SAS Name:    RGN_CD
     COBOL Name:  RGN-CD
     VALUES:      01=Boston
                  02=New York
                  03=Philadelphia
                  04=Atlanta
                  05=Chicago
                  06=Dallas
                  07=Kansas City
                  08=Denver
                  09=San Francisco
                  10=Seattle

   Skeleton Record Indicator                         1    170   170  VARCHAR2
     Description: Indicates if the record is a skeleton record.  Only a
                  limited set of data is available for this provider; no
                  survey data exists.  Only provider categories
                  01,17,19,21and 22 can have skeleton providers.
     SAS Name:    SKLTN_REC_SW
     COBOL Name:  SKLTN-REC-SW

   State Abbreviation                                2    171   172  VARCHAR2
     Description: Two-character state abbreviation.
     SAS Name:    STATE_CD
     COBOL Name:  STATE-CD
     VALUES:      AK=ALASKA
                  AL=ALABAMA
                  AR=ARKANSAS
                  AS=AMERICAN SAMOA
                  AZ=ARIZONA
                  CA=CALIFORNIA
                  CN=CANADA
                  CO=COLORADO
                  CT=CONNECTICUT
                  DC=DISTRICT OF COLUMBIA
                  DE=DELAWARE
                  FL=FLORIDA
                  FN=INTERNATIONAL
                  GA=GEORGIA
                  GU=GUAM
                  HI=HAWAII
                  IA=IOWA
                  ID=IDAHO


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 13
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  IL=ILLINOIS
                  IN=INDIANA
                  KS=KANSAS
                  KY=KENTUCKY
                  LA=LOUISIANA
                  MA=MASSACHUSETTS
                  MD=MARYLAND
                  ME=MAINE
                  MI=MICHIGAN
                  MN=MINNESOTA
                  MO=MISSOURI
                  MP=SAIPAN
                  MS=MISSISSIPPI
                  MT=MONTANA
                  MX=MEXICO
                  NC=NORTH CAROLINA
                  ND=NORTH DAKOTA
                  NE=NEBRASKA
                  NH=NEW HAMPSHIRE
                  NJ=NEW JERSEY
                  NM=NEW MEXICO
                  NV=NEVADA
                  NY=NEW YORK
                  OH=OHIO
                  OK=OKLAHOMA
                  OR=OREGON
                  PA=PENNSYLVANIA
                  PR=PUERTO RICO
                  RI=RHODE ISLAND
                  SC=SOUTH CAROLINA
                  SD=SOUTH DAKOTA
                  TN=TENNESSEE
                  TX=TEXAS
                  UT=UTAH
                  VA=VIRGINIA
                  VI=VIRGIN ISLANDS
                  VT=VERMONT
                  WA=WASHINGTON
                  WI=WISCONSIN
                  WV=WEST VIRGINIA
                  WY=WYOMING

   SSA State Code                                    2    173   174  VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the state where the provider is located.
     SAS Name:    SSA_STATE_CD
     COBOL Name:  SSA-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  03=ARIZONA
                  04=ARKANSAS
                  05=CALIFORNIA
                  06=COLORADO
                  07=CONNECTICUT
                  08=DELAWARE
                  09=DISTRICT OF COLUMBIA
                  10=FLORIDA
                  11=GEORGIA
                  12=HAWAII
                  13=IDAHO
                  14=ILLINOIS
                  15=INDIANA
                  16=IOWA
                  17=KANSAS


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 14
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  18=KENTUCKY
                  19=LOUISIANA
                  20=MAINE
                  21=MARYLAND
                  22=MASSACHUSETTS
                  23=MICHIGAN
                  24=MINNESOTA
                  25=MISSISSIPPI
                  26=MISSOURI
                  27=MONTANA
                  28=NEBRASKA
                  29=NEVADA
                  30=NEW HAMPSHIRE
                  31=NEW JERSEY
                  32=NEW MEXICO
                  33=NEW YORK
                  34=NORTH CAROLINA
                  35=NORTH DAKOTA
                  36=OHIO
                  37=OKLAHOMA
                  38=OREGON
                  39=PENNSYLVANIA
                  40=PUERTO RICO
                  41=RHODE ISLAND
                  42=SOUTH CAROLINA
                  43=SOUTH DAKOTA
                  44=TENNESSEE
                  45=TEXAS
                  46=UTAH
                  47=VERMONT
                  48=VIRGIN ISLANDS
                  49=VIRGINIA
                  50=WASHINGTON
                  51=WEST VIRGINIA
                  52=WISCONSIN
                  53=WYOMING
                  54=AFRICA
                  56=CANADA
                  57=WEST INDIES
                  58=EUROPE
                  59=MEXICO
                  60=OCEANIA
                  61=PHILIPPINES
                  62=SOUTH AMERICA
                  63=UNITED STATES POSSESSIONS
                  64=AMERICAN SAMOA
                  65=GUAM
                  66=SAIPAN
                  99=INTERNATIONAL

   State Region Code                                 3    175   177  VARCHAR2
     Description: Identifies the region within a state where the provider
                  is located.
     SAS Name:    STATE_RGN_CD
     COBOL Name:  STATE-RGN-CD
     VALUES:      AK/001=ALASKA
                  AK/LAB=LABORATORIES
                  AK/NPH=NON-PARTICIPATING HOSPITAL
                  AL/001=ALABAMA
                  AL/LAB=LABORATORIES
                  AL/NPH=NON-PARTICIPATING HOSPITAL
                  AR/001=ARKANSAS
                  AR/LAB=LABORATORIES
                  AR/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 15
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  AS/001=AMERICAN SAMOA
                  AS/LAB=LABORATORY
                  AS/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/AZ=PHOENIX
                  AZ/LAB=ARIZONA LAB
                  AZ/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/TUC=TUCSON
                  CA/001=CALIFORNIA
                  CA/BAK=BAKERSFIELD
                  CA/BER=SAN BERNARDINO
                  CA/EB=East Bay
                  CA/FR=FRESNO
                  CA/L1=L.A. WEST
                  CA/L2=L.A. NORTH
                  CA/L3=L.A. CENTRAL
                  CA/L4=L.A. EAST
                  CA/L5=SAN GABRIEL
                  CA/LA1=LA Region 1
                  CA/LA2=LA Region 2
                  CA/LA3=LA Region 3
                  CA/LA4=LA Acute/Ancillary
                  CA/LA5=LA HHA/Hospice
                  CA/LA6=LA ICF/DD/CLinics
                  CA/LAB=LABORATORIES
                  CA/M1=LAB. SOUTH
                  CA/M2=LAB. NORTH
                  CA/NPH=NON-PARTICIPATING HOSPITAL
                  CA/ORG=ORANGE
                  CA/RIV=RIVERSIDE
                  CA/S1=SACRAMENTO
                  CA/S3=CHICO
                  CA/SD=SAN DIEGO
                  CA/SF=SAN FRANCISCO
                  CA/SJ=SAN JOSE
                  CA/SR=SANTA ROSA
                  CA/VEN=VENTURA
                  CN/001=CANADA
                  CN/LAB=LABORATORY
                  CN/NPH=NON-PARTICIPATING HOSPITAL
                  CO/001=COLORADO
                  CO/LAB=LABORATORIES
                  CO/NPH=NON-PARTICIPATING HOSPITAL
                  CT/001=CONNECTICUT
                  CT/LAB=LABORATORIES
                  CT/NPH=NON-PARTICIPATING HOSPITAL
                  DC/001=DISTRICT OF COLUMBIA
                  DC/LAB=LABORATORIES
                  DC/NPH=NON-PARTICIPATING HOSPITAL
                  DE/001=DELAWARE
                  DE/LAB=LABORATORIES
                  DE/NPH=NON-PARTICIPATING HOSPITAL
                  FL/001=FLORIDA
                  FL/FTM=FT. MYERS
                  FL/GAI=GAINESVILLE
                  FL/JAX=JACKSONVILLE
                  FL/LAB=LABORATORIES
                  FL/LAN=LANTANA
                  FL/LAU=LAUDERHILL
                  FL/MIA=MIAMI
                  FL/NPH=NON-PARTICIPATING HOSPITAL
                  FL/ORL=ORLANDO
                  FL/PEN=PENSACOLA
                  FL/STP=ST. PETERSBURG
                  FL/TAL=TALLAHASSEE


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 16
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  FL/TAM=TAMPA
                  FM/001=FEDERATED STATES OF MICRO
                  FM/NPH=NON-PARTICIPATING HOSPITAL
                  FN/001=INTERNATIONAL
                  FN/LAB=LABORATORIES
                  FN/NPH=NON-PARTICIPATING HOSPITAL
                  GA/001=GEORGIA
                  GA/GAA=GEORGIA ALL
                  GA/GAC=GEORGIA CENTRAL
                  GA/GAE=GEORGIA EASTERN
                  GA/GAN=GEORGIA NORTH
                  GA/GAS=GEORGIA SOUTH
                  GA/GAW=GEORGIA WESTERN
                  GA/LAB=LABORATORIES
                  GA/NPH=NON-PARTICIPATING HOSPITAL
                  GU/001=GUAM
                  GU/LAB=LABORATORIES
                  GU/NPH=NON-PARTICIPATING HOSPITAL
                  HI/001=HAWAII
                  HI/LAB=LABORATORIES
                  HI/NPH=NON-PARTICIPATING HOSPITAL
                  IA/001=IOWA
                  IA/LAB=LABORATORIES
                  IA/NPH=NON-PARTICIPATING HOSPITAL
                  ID/001=IDAHO
                  ID/LAB=LABORATORIES
                  ID/NPH=NON-PARTICIPATING HOSPITAL
                  IL/001=ILLINOIS
                  IL/LAB=LABORATORIES
                  IL/NPH=NON-PARTICIPATING HOSPITAL
                  IN/001=INDIANA
                  IN/LAB=LABORATORIES
                  IN/NPH=NON-PARTICIPATING HOSPITAL
                  KS/001=KANSAS
                  KS/KCK=KANSAS CITY
                  KS/KDH=KDHE
                  KS/LAB=LABORATORIES
                  KS/LAW=LAWRENCE
                  KS/NC=NORTH CENTRAL KANSAS
                  KS/NE=NORTH EAST KANSAS
                  KS/NPH=NON-PARTICIPATING HOSPITAL
                  KS/NW=NORTH WEST KANSAS
                  KS/SC=SOUTH CENTRAL KANSAS
                  KS/SE=SOUTH EAST KANSAS
                  KS/SW=SOUTH WEST KANSAS
                  KS/WST=WEST
                  KY/2C1=HOPKINSVILLE
                  KY/2C2=LOUISVILLE
                  KY/2C3=LONDON
                  KY/2C4=LEXINGTON
                  KY/LAB=LABORATORIES
                  KY/NPH=NON-PARTICIPATING HOSPITAL
                  LA/001=LOUISIANA
                  LA/LA1=NEW ORLEANS
                  LA/LA2=MANDEVILLE
                  LA/LA3=LAFAYETTE
                  LA/LA4=MONROE
                  LA/LA5=SHREVEPORT
                  LA/LA6=ALEXANDRIA
                  LA/LAB=LABORATORIES
                  LA/LB1=CLIA NEW ORLEANS
                  LA/LB5=CLIA SHREVEPORT
                  LA/LB6=CLIA ALEXANDRIA
                  LA/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 17
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  MA/001=MASSACHUSETTS
                  MA/LAB=LABORATORIES
                  MA/NPH=NON-PARTICIPATING HOSPITAL
                  MD/001=MARYLAND
                  MD/LAB=LABORATORIES
                  MD/NPH=NON-PARTICIPATING HOSPITAL
                  ME/001=MAINE
                  ME/LAB=LABORATORIES
                  ME/NPH=NON-PARTICIPATING HOSPITAL
                  MH/001=MARSHALL ISLANDS
                  MH/NPH=NON-PARTICIPATING HOSPITAL
                  MI/001=MICHIGAN
                  MI/LAB=LABORATORIES
                  MI/NPH=NON-PARTICIPATING HOSPITAL
                  MN/001=MINNESOTA
                  MN/LAB=LABORATORIES
                  MN/NPH=NON-PARTICIPATING HOSPITAL
                  MO/001=MISSOURI
                  MO/01=REGION01
                  MO/02=REGION02
                  MO/03=REGION 03
                  MO/04=REGION 04
                  MO/05=REGION 05
                  MO/06=REGION 06
                  MO/07=REGION 07
                  MO/1NH=REGION 1 NH
                  MO/2NH=REGION 2 NH
                  MO/3NH=REGION 3 NH
                  MO/4NH=REGION 4 NH
                  MO/5NH=REGION 5 NH
                  MO/6NH=REGION 6 NH
                  MO/7NH=REGION 7 NH
                  MO/LAB=LABORATORIES
                  MO/MO=STATEWIDE
                  MO/NPH=NON-PARTICIPATING HOSPITAL
                  MP/001=NORTHERN MARIANA ISLANDS
                  MP/LAB=LABORATORIES
                  MP/NPH=NON-PARTICIPATING HOSPITAL
                  MS/001=MISSISSIPPI
                  MS/LAB=LABORATORIES
                  MS/NPH=NON-PARTICIPATING HOSPITAL
                  MT/001=MONTANA
                  MT/LAB=LABORATORIES
                  MT/NPH=NON-PARTICIPATING HOSPITAL
                  MX/001=MEXICO
                  MX/LAB=LABORATORY
                  MX/NPH=NON-PARTICIPATING HOSPITAL
                  NC/001=NORTH CAROLINA
                  NC/LAB=LABORATORIES
                  NC/NCC=NORTH CAROLINA CENTRAL
                  NC/NCE=NORTH CAROLINA EAST
                  NC/NCN=NORTH CAROLINA NORTH
                  NC/NCS=NORTH CAROLINA SOUTH
                  NC/NCW=NORTH CAROLINA WEST
                  NC/NPH=NON-PARTICIPATING HOSPITAL
                  ND/001=NORTH DAKOTA
                  ND/LAB=LABORATORIES
                  ND/NPH=NON-PARTICIPATING HOSPITAL
                  NE/001=NEBRASKA
                  NE/1=NORTH CENTRAL
                  NE/2=CENTRAL
                  NE/3=NORTHEAST
                  NE/4=SOUTHEAST
                  NE/5=WESTERN


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 18
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  NE/LAB=LABORATORIES
                  NE/NPH=NON-PARTICIPATING HOSPITAL
                  NH/001=NEW HAMPSHIRE
                  NH/LAB=LABORATORIES
                  NH/NPH=NON-PARTICIPATING HOSPITAL
                  NJ/001=NEW JERSEY
                  NJ/LAB=LABORATORIES
                  NJ/NPH=NON-PARTICIPATING HOSPITAL
                  NM/001=NEW MEXICO
                  NM/LAB=LABORATORIES
                  NM/NPH=NON-PARTICIPATING HOSPITAL
                  NV/001=NEVADA
                  NV/CC=CARSON CITY
                  NV/LAB=LABORATORIES
                  NV/LV=LAS VEGAS
                  NV/NPH=NON-PARTICIPATING HOSPITAL
                  NY/001=BUFFALO
                  NY/002=ROCHESTER
                  NY/003=SYRACUSE
                  NY/004=ALBANY
                  NY/005=NEW ROCHELLE
                  NY/006=NEW YORK CITY
                  NY/007=SUFFOLK/NASSAU COUNTY
                  NY/LAB=LABORATORIES
                  NY/NPH=NON-PARTICIPATING HOSPITAL
                  OH/001=OHIO
                  OH/LAB=LABORATORIES
                  OH/NPH=NON-PARTICIPATING HOSPITAL
                  OK/001=OKLAHOMA
                  OK/LAB=LABORATORIES
                  OK/NPH=NON-PARTICIPATING HOSPITAL
                  OR/001=OFFICE #1
                  OR/002=OFFICE #2
                  OR/003=OFFICE #3
                  OR/LAB=LABORATORIES
                  OR/NPH=NON-PARTICIPATING HOSPITAL
                  PA/001=PENNSYLVANIA
                  PA/LAB=LABORATORIES
                  PA/NPH=NON-PARTICIPATING HOSPITAL
                  PR/001=PUERTO RICO
                  PR/LAB=LABORATORIES
                  PR/NPH=NON-PARTICIPATING HOSPITAL
                  PW/001=PALAU
                  PW/NPH=NON-PARTICIPATING HOSPITAL
                  RI/001=RHODE ISLAND
                  RI/LAB=LABORATORIES
                  RI/NPH=NON-PARTICIPATING HOSPITAL
                  SC/001=SOUTH CAROLINA
                  SC/LAB=LABORATORIES
                  SC/NPH=NON-PARTICIPATING HOSPITAL
                  SD/001=SOUTH DAKOTA
                  SD/LAB=LABORATORIES
                  SD/NPH=NON-PARTICIPATING HOSPITAL
                  TN/001=TENNESSEE
                  TN/LAB=LABORATORIES
                  TN/NPH=NON-PARTICIPATING HOSPITAL
                  TN/TNC=TENNESSEE COOKEVILLE
                  TN/TNE=TENNESSEE EASTERN
                  TN/TNM=TENNESSEE MIDDLE
                  TN/TNW=TENNESSEE WESTERN
                  TX/001=TEXAS
                  TX/L01=AMARILLO-LTC
                  TX/L02=ABILENE-LTC
                  TX/L03=ARLINGTON-LTC


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 19
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  TX/L04=TYLER-LTC
                  TX/L05=TEMPLE-LTC
                  TX/L06=HOUSTON-LTC
                  TX/L07=SAN ANTONIO-LTC
                  TX/LAB=LABORATORIES
                  TX/NPH=NON-PARTICIPATING HOSPITAL
                  TX/TX1=NLTC REG 1, 7, 9, 10
                  TX/TX2=NLTC REG 2, 3
                  TX/TX4=NLTC REG 6
                  TX/TX5=NLTC REG 4, 5
                  TX/TX6=AUSTIN
                  TX/TX8=NLTC REG 8, 11
                  UT/001=UTAH
                  UT/LAB=LABORATORIES
                  UT/NPH=NON-PARTICIPATING HOSPITAL
                  VA/001=VIRGINIA
                  VA/LAB=LABORATORIES
                  VA/NPH=NON-PARTICIPATING HOSPITAL
                  VI/001=VIRGIN ISLANDS
                  VI/LAB=LABORATORIES
                  VI/NPH=NON-PARTICIPATING HOSPITAL
                  VT/001=VERMONT
                  VT/LAB=LABORATORIES
                  VT/NPH=NON-PARTICIPATING HOSPITAL
                  WA/001=ALL OTHERS (NON-LTC FAC)
                  WA/D1=SPOKANE & YAKIMA AREAS
                  WA/D1A=District 1, Unit A
                  WA/D1B=District 1, Unit B
                  WA/D1C=District 1, Unit C
                  WA/D1D=District 1, Unit D
                  WA/D1E=District 1, Unit E
                  WA/D2=SPOKANE & SE
                  WA/D2A=District 2, Unit A
                  WA/D2B=District 2, Unit B
                  WA/D2C=District 2, Unit C
                  WA/D2D=District 2, Unit D
                  WA/D2E=District 2, Unit E
                  WA/D2F=District 2, Unit F
                  WA/D2G=District 2, Unit G
                  WA/D2H=District 2, Unit H
                  WA/D2I=District 2, Unit I
                  WA/D2J=District 2, Unit J
                  WA/D3=NW WASHINGTON
                  WA/D3A=District 3, Unit A
                  WA/D3B=District 3, Unit B
                  WA/D3C=District 3, Unit C
                  WA/D3D=District 3, Unit D
                  WA/D3E=District 3, Unit E
                  WA/D3F=District 3, Unit F
                  WA/D3G=District 3, Unit G
                  WA/D4A=GREATER SEATTLE AREA
                  WA/D4B=S KING COUNTY
                  WA/D5A=PIERCE CTY & PENINSULA
                  WA/D5B=PIERCE CTY & GRAYS HARBOR
                  WA/D6=OLYMPIA AREA
                  WA/LAB=LABORATORIES
                  WA/NPH=NON-PARTICIPATING HOSPITAL
                  WI/001=WISCONSIN
                  WI/LAB=LABORATORIES
                  WI/NPH=NON-PARTICIPATING HOSPITAL
                  WV/001=WEST VIRGINIA
                  WV/LAB=LABORATORIES
                  WV/NPH=NON-PARTICIPATING HOSPITAL
                  WY/001=WYOMING


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         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  WY/LAB=LABORATORIES
                  WY/NPH=NON-PARTICIPATING HOSPITAL

   Address: Street                                   50   178   227  VARCHAR2
     Description: Street address where the provider is located.
     SAS Name:    ST_ADR
     COBOL Name:  ST-ADR

   Telephone Number                                  10   228   237  VARCHAR2
     Description: Telephone number of the provider.
     SAS Name:    PHNE_NUM
     COBOL Name:  PHNE-NUM

   Termination Code                                  2    238   239  VARCHAR2
     Description: Indicates the current termination status for the
                  provider.
     SAS Name:    PGM_TRMNTN_CD
     COBOL Name:  PGM-TRMNTN-CD
     VALUES:      00=ACTIVE PROVIDER
                  01=VOLUNTARY-MERGER, CLOSURE
                  02=VOLUNTARY-DISSATISFACTION WITH REIMBURSEMENT
                  03=VOLUNTARY-RISK OF INVOLUNTARY TERMINATION
                  04=VOLUNTARY-OTHER REASON FOR WITHDRAWAL
                  05=INVOLUNTARY-FAILURE TO MEET HEALTH/SAFETY REQ
                  06=INVOLUNTARY-FAILURE TO MEET AGREEMENT
                  07=OTHER-PROVIDER STATUS CHANGE
                  08=NONPAYMENT OF FEES - CLIA Only
                  09=REV/UNSUCCESSFUL PARTICIPATION IN PT - CLIA Only
                  10=REV/OTHER REASON - CLIA Only
                  11=INCOMPLETE CLIA APPLICATION INFORMATION - CLIA Only
                  12=NO LONGER PERFORMING TESTS - CLIA Only
                  13=MULTIPLE TO SINGLE SITE CERTIFICATE - CLIA Only
                  14=SHARED LABORATORY - CLIA Only
                  15=FAILURE TO RENEW WAIVER PPM CERTIFICATE - CLIA Only
                  16=DUPLICATE CLIA NUMBER - CLIA Only
                  17=MAIL RETURNED NO FORWARD ADDRESS CERT ENDED - CLIA Only
                  20=NOTIFICATION BANKRUPTCY - CLIA Only
                  33=ACCREDITATION NOT CONFIRMED - CLIA Only
                  80=AWAITING STATE APPROVAL
                  99=OIG ACTION - DO NOT ACTIVATE - CLIA Only

   Termination or Expiration Date                    8    240   247  DATE
     Description: Date the provider was terminated.  For CLIA providers,
                  date the laboratory's certificate was terminated or the
                  expiration date of the current CLIA certificate.
     SAS Name:    TRMNTN_EXPRTN_DT
     COBOL Name:  TRMNTN-EXPRTN-DT

   Type of Action Code                               1    248   248  VARCHAR2
     Description: Identifies the reason for the certification.  Type of
                  action from the official survey record, CMS 1539 form.
     SAS Name:    CRTFCTN_ACTN_TYPE_CD
     COBOL Name:  CRTFCTN-ACTN-TYPE-CD
     VALUES:      1=INITIAL
                  2=RECERTIFICATION
                  3=TERMINATION
                  4=CHANGE OF OWNERSHIP
                  5=VALIDATION
                  8=FULL SURVEY AFTER COMPLAINT

   Ownership Type Code                               2    249   250  VARCHAR2
     Description: Indicates the ownership type of the provider.
     SAS Name:    GNRL_CNTL_TYPE_CD
     COBOL Name:  GNRL-CNTL-TYPE-CD


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         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     VALUES:      01=FOR PROFIT - INDIVIDUAL
                  02=FOR PROFIT - PARTNERSHIP
                  03=FOR PROFIT - CORPORATION
                  04=NONPROFIT - CHURCH RELATED
                  05=NONPROFIT - CORPORATION
                  06=NONPROFIT - OTHER
                  07=GOVERNMENT - STATE
                  08=GOVERNMENT - COUNTY
                  09=GOVERNMENT - CITY
                  10=GOVERNMENT - CITY/COUNTY
                  11=GOVERNMENT - HOSPITAL DISTRICT
                  12=GOVERNMENT - FEDERAL
                  13=FOR PROFIT - LIMITED LIABILITY CORPORATION

   Address: ZIP Code                                 5    251   255  VARCHAR2
     Description: Five-digit ZIP code for a provider's physical address.
     SAS Name:    ZIP_CD
     COBOL Name:  ZIP-CD

   FIPS State Code                                   2    256   257  VARCHAR2
     Description: FIPS State Code
     SAS Name:    FIPS_STATE_CD
     COBOL Name:  FIPS-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  04=ARIZONA
                  05=ARKANSAS
                  06=CALIFORNIA
                  08=COLORADO
                  09=CONNECTICUT
                  10=DELAWARE
                  11=DISTRICT OF COLUMBIA
                  12=FLORIDA
                  13=GEORGIA
                  15=HAWAII
                  16=IDAHO
                  17=ILLINOIS
                  18=INDIANA
                  19=IOWA
                  20=KANSAS
                  21=KENTUCKY
                  22=LOUISIANA
                  23=MAINE
                  24=MARYLAND
                  25=MASSACHUSETTS
                  26=MICHIGAN
                  27=MINNESOTA
                  28=MISSISSIPPI
                  29=MISSOURI
                  30=MONTANA
                  31=NEBRASKA
                  32=NEVADA
                  33=NEW HAMPSHIRE
                  34=NEW JERSEY
                  35=NEW MEXICO
                  36=NEW YORK
                  37=NORTH CAROLINA
                  38=NORTH DAKOTA
                  39=OHIO
                  40=OKLAHOMA
                  41=OREGON
                  42=PENNSYLVANIA
                  43=PUERTO RICO
                  44=RHODE ISLAND


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   SHORT DESCRIPTION                                LEN  START END    TYPE

                  45=SOUTH CAROLINA
                  46=SOUTH DAKOTA
                  47=TENNESSEE
                  48=TEXAS
                  49=UTAH
                  50=VERMONT
                  51=VIRGINIA
                  53=WASHINGTON
                  54=WEST VIRGINIA
                  55=WISCONSIN
                  56=WYOMING
                  60=AMERICAN SAMOA
                  66=GUAM
                  69=SAIPAN/MARIANA IS.
                  78=VIRGIN ISLANDS

   FIPS County Code                                  3    258   260  VARCHAR2
     Description: FIPS County Code
     SAS Name:    FIPS_CNTY_CD
     COBOL Name:  FIPS-CNTY-CD

   CBSA Urban Rural Indicator                        1    261   261  VARCHAR2
     Description: CBSA (Core Based Statistical Area) indicates whether the
                  county is defined as Urban or Rural.
     SAS Name:    CBSA_URBN_RRL_IND
     COBOL Name:  CBSA-URBN-RRL-IND

   CBSA Code                                         5    262   266  VARCHAR2
     Description: CBSA (Core Based Statistical Area) geographic entities
                  defined by the U.S. Office of Management and Budget (OMB)
                  on June 6, 2003 for use by Federal statistical agencies
                  in collecting, tabulating, and publishing Federal
                  statistics.  CBSA collectively refers to MSA.
     SAS Name:    CBSA_CD
     COBOL Name:  CBSA-CD

   Bed Count Override Indicator                      1    325   325  CHAR
     Description: Indicates if the regional office has approved a
                  significant bed count change from the previous
                  certification.
     SAS Name:    OVRRD_BED_CNT_SW
     COBOL Name:  OVRRD-BED-CNT-SW

   Bed Count: Certified                              4    326   329  NUMBER
     Description: Number of beds in Medicare and/or Medicaid certified
                  areas within a facility.
     SAS Name:    CRTFD_BED_CNT
     COBOL Name:  CRTFD-BED-CNT

   Bed Count: Medicaid NF                            4    334   337  NUMBER
     Description: Number of Medicaid-certified Nursing Facility beds.
     SAS Name:    MDCD_NF_BED_CNT
     COBOL Name:  MDCD-NF-BED-CNT

   Bed Count: Medicare SNF                           4    338   341  NUMBER
     Description: Number of Medicare-certified Skilled Nursing Facility
                  beds.
     SAS Name:    MDCR_SNF_BED_CNT
     COBOL Name:  MDCR-SNF-BED-CNT

   Bed Count: Medicare/Medicaid SNF                  4    342   345  NUMBER
     Description: Number of dually certified (Medicare/Medicaid) beds in a
                  Skilled Nursing Facility.
     SAS Name:    MDCR_MDCD_SNF_BED_CNT


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   SHORT DESCRIPTION                                LEN  START END    TYPE

     COBOL Name:  MDCR-MDCD-SNF-BED-CNT

   Bed Count: Special Care - AIDS                    3    346   348  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents with AIDS.
     SAS Name:    AIDS_BED_CNT
     COBOL Name:  AIDS-BED-CNT

   Bed Count: Special Care - Alzheimers              3    349   351  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents with Alzheimer's disease.
     SAS Name:    ALZHMR_BED_CNT
     COBOL Name:  ALZHMR-BED-CNT

   Bed Count: Special Care - Dialysis                3    352   354  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents who require dialysis.
     SAS Name:    DLYS_BED_CNT
     COBOL Name:  DLYS-BED-CNT

   Bed Count: Special Care - Disabled Children       3    355   357  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  disabled children.
     SAS Name:    DSBL_CHLDRN_BED_CNT
     COBOL Name:  DSBL-CHLDRN-BED-CNT

   Bed Count: Special Care - Head Trauma             3    358   360  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents with head trauma.
     SAS Name:    HEAD_TRMA_BED_CNT
     COBOL Name:  HEAD-TRMA-BED-CNT

   Bed Count: Special Care - Hospice                 3    361   363  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents who require hospice care.
     SAS Name:    HOSPC_BED_CNT
     COBOL Name:  HOSPC-BED-CNT

   Bed Count: Special Care - Huntingtons Disease     3    364   366  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents with Huntington's disease.
     SAS Name:    HNTGTN_DEASE_BED_CNT
     COBOL Name:  HNTGTN-DEASE-BED-CNT

   Bed Count: Special Care - Specialized Rehab       3    367   369  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents with specialized rehab needs.
     SAS Name:    REHAB_BED_CNT
     COBOL Name:  REHAB-BED-CNT

   Bed Count: Special Care - Ventilator              3    370   372  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents requiring a ventilator and/or respiratory care.
     SAS Name:    VNTLTR_BED_CNT
     COBOL Name:  VNTLTR-BED-CNT

   Bed Count: Total                                  4    373   376  NUMBER
     Description: Total number of beds in a provider, including those in
                  non-participating or non-licensed areas.
     SAS Name:    BED_CNT
     COBOL Name:  BED-CNT

   Compliance: 24-Hour RN Waiver Indicator           1    442   442  CHAR
     Description: Indicates if a waiver of the 24-hour registered nurse


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         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  staffing requirements has been recommended for a Skilled
                  Nursing Facility or Nursing Facility.
     SAS Name:    RN_24_HR_WVR_SW
     COBOL Name:  RN-24-HR-WVR-SW

   Compliance: 7-Day RN Waiver Indicator             1    443   443  VARCHAR2
     Description: Indicates if a waiver of the 7-day registered nurse
                  staffing requirements has been recommended for a Skilled
                  Nursing Facility.
     SAS Name:    RN_7_DAY_WVR_SW
     COBOL Name:  RN-7-DAY-WVR-SW

   Compliance: Beds Per Room Waiver Indicator        1    444   444  CHAR
     Description: Indicates if a waiver of the beds per room requirement
                  has been recommended for a facility.
     SAS Name:    BED_PER_ROOM_WVR_SW
     COBOL Name:  BED-PER-ROOM-WVR-SW

   Compliance: LSC Waiver Indicator                  1    445   445  CHAR
     Description: Indicates if a waiver of any life safety code provision
                  has been recommended for a provider.
     SAS Name:    LSC_WVR_SW
     COBOL Name:  LSC-WVR-SW

   Compliance: Patient Room Size Waiver Indicator    1    446   446  CHAR
     Description: Indicates if a waiver of the patient room size provision
                  has been recommended for a provider.
     SAS Name:    ROOM_SIZE_WVR_SW
     COBOL Name:  ROOM-SIZE-WVR-SW

   Experimental Research Conducted Indicator         1    453   453  VARCHAR2
     Description: Indicates if a facility conducts experimental research.
     SAS Name:    EXPRMT_RSRCH_CNDCTD_SW
     COBOL Name:  EXPRMT-RSRCH-CNDCTD-SW

   Fiscal Year End Date (MMDD)                       4    464   467  VARCHAR2
     Description: End date, consisting of the month and day, of the
                  provider's fiscal year.
     SAS Name:    FY_END_MO_DAY_CD
     COBOL Name:  FY-END-MO-DAY-CD

   Hospital Based Indicator                          1    483   483  CHAR
     Description: Indicates if the provider is based in a hospital.
     SAS Name:    HOSP_BSD_SW
     COBOL Name:  HOSP-BSD-SW

   LTC Cross Ref Provider Number                     10   485   494  CHAR
     Description: LTC cross ref provider number
     SAS Name:    LTC_CROSS_REF_PROVIDER_NUMBER
     COBOL Name:  LTC-CROSS-REF-PROVIDER-NUMBER

   Multiple Facility Organization Name               38   513   550  CHAR
     Description: Name of the multi-facility organization that owns the
                  facility.
     SAS Name:    MLT_FAC_ORG_NAME
     COBOL Name:  MLT-FAC-ORG-NAME

   Multiple Facility Organization Owned Indicator    1    551   551  CHAR
     Description: Indicates if a facility is owned by an organization that
                  owns (or leases) two or more long term care facilities.
     SAS Name:    MLT_OWND_FAC_ORG_SW
     COBOL Name:  MLT-OWND-FAC-ORG-SW

   Organized Family Group Indicator                  1    626   626  VARCHAR2


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         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Indicates if the facility has an organized group of
                  family members of residents.
     SAS Name:    ORGNZ_FMLY_MBR_GRP_SW
     COBOL Name:  ORGNZ-FMLY-MBR-GRP-SW

   Organized Resident Group Indicator                1    627   627  VARCHAR2
     Description: Indicates if the facility has an organized residents
                  group.
     SAS Name:    ORGNZ_RSDNT_GRP_SW
     COBOL Name:  ORGNZ-RSDNT-GRP-SW

   Program Participation Code                        1    640   640  CHAR
     Description: Indicates if the provider participates in Medicare,
                  Medicaid, or both programs.
     SAS Name:    PGM_PRTCPTN_CD
     COBOL Name:  PGM-PRTCPTN-CD
     VALUES:      1=MEDICARE ONLY
                  2=MEDICAID ONLY
                  3=MEDICARE AND MEDICAID

   Related Provider Number                           10   686   695  CHAR
     Description: Related provider number
     SAS Name:    RELATED_PROVIDER_NUMBER
     COBOL Name:  RELATED-PROVIDER-NUMBER

   Services: Blood Administration Off-Site Residents 1    703   703  VARCHAR2
   Indicator
     Description: Indicates if blood administration and storage services
                  are provided off-site to residents.
     SAS Name:    BLOOD_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  BLOOD-SRVC-OFSITE-RSDNT-SW

   Services: Blood Administration On-Site Nonresidents 1    704   704  VARCHAR2
   Indicator
     Description: Indicates if blood administration and storage services
                  are provided on-site to nonresidents.
     SAS Name:    BLOOD_SRVC_ONST_NRSDNT_SW
     COBOL Name:  BLOOD-SRVC-ONST-NRSDNT-SW

   Services: Blood Administration On-Site Residents  1    705   705  VARCHAR2
   Indicator
     Description: Indicates if blood administration and storage services
                  are provided on-site to residents.
     SAS Name:    BLOOD_SRVC_ONST_RSDNT_SW
     COBOL Name:  BLOOD-SRVC-ONST-RSDNT-SW

   Services: Clinical Laboratory - Off-Site Residents 1    712   712  VARCHAR2
   Indicator
     Description: Indicates if clinical laboratory services are provided
                  off-site to residents.
     SAS Name:    CL_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  CL-SRVC-OFSITE-RSDNT-SW

   Services: Clinical Laboratory - On-Site Nonresidents 1    713   713  VARCHAR2
   Indicator
     Description: Indicates if clinical laboratory services are provided
                  on-site to nonresidents.
     SAS Name:    CL_SRVC_ONST_NRSDNT_SW
     COBOL Name:  CL-SRVC-ONST-NRSDNT-SW

   Services: Clinical Laboratory - On-Site Residents 1    714   714  VARCHAR2
   Indicator
     Description: Indicates if clinical laboratory services are provided
                  on-site to residents.


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         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     SAS Name:    CL_SRVC_ONST_RSDNT_SW
     COBOL Name:  CL-SRVC-ONST-RSDNT-SW

   Services: Dental Off-Site Residents Indicator     1    720   720  VARCHAR2
     Description: Indicates if dental services are provided off-site to
                  residents.
     SAS Name:    DNTL_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  DNTL-SRVC-OFSITE-RSDNT-SW

   Services: Dental On-Site Nonresidents Indicator   1    721   721  VARCHAR2
     Description: Indicates if dental services are provided on-site to
                  nonresidents.
     SAS Name:    DNTL_SRVC_ONST_NRSDNT_SW
     COBOL Name:  DNTL-SRVC-ONST-NRSDNT-SW

   Services: Dental On-Site Residents Indicator      1    722   722  VARCHAR2
     Description: Indicates if dental services are provided on-site to
                  residents.
     SAS Name:    DNTL_SRVC_ONST_RSDNT_SW
     COBOL Name:  DNTL-SRVC-ONST-RSDNT-SW

   Services: Dietary Off-Site Residents Indicator    1    726   726  VARCHAR2
     Description: Indicates if dietary services are provided off-site to
                  residents.
     SAS Name:    DTRY_OFSITE_RSDNT_SW
     COBOL Name:  DTRY-OFSITE-RSDNT-SW

   Services: Dietary On-Site Nonresidents Indicator  1    727   727  VARCHAR2
     Description: Indicates if dietary services are provided on-site to
                  nonresidents.
     SAS Name:    DTRY_ONST_NRSDNT_SW
     COBOL Name:  DTRY-ONST-NRSDNT-SW

   Services: Dietary On-Site Residents Indicator     1    728   728  VARCHAR2
     Description: Indicates if dietary services are provided on-site to
                  residents.
     SAS Name:    DTRY_ONST_RSDNT_SW
     COBOL Name:  DTRY-ONST-RSDNT-SW

   Services: Housekeeping Off-Site Residents Indicator 1    738   738  VARCHAR2
     Description: Indicates if housekeeping services are provided off-site
                  to residents.
     SAS Name:    HSEKPNG_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  HSEKPNG-SRVC-OFSITE-RSDNT-SW

   Services: Housekeeping On-Site Nonresidents Indicator 1    739   739  VARCHAR2
     Description: Indicates if housekeeping services are provided on-site
                  to nonresidents.
     SAS Name:    HSEKPNG_SRVC_ONST_NRSDNT_SW
     COBOL Name:  HSEKPNG-SRVC-ONST-NRSDNT-SW

   Services: Housekeeping On-Site Residents Indicator 1    740   740  VARCHAR2
     Description: Indicates if housekeeping services are provided on-site
                  to residents.
     SAS Name:    HSEKPNG_SRVC_ONST_RSDNT_SW
     COBOL Name:  HSEKPNG-SRVC-ONST-RSDNT-SW

   Services: Mental Health Off-Site Residents Indicator 1    747   747  VARCHAR2
     Description: Indicates if mental health services are provided off-site
                  to residents.
     SAS Name:    MENTL_HLTH_OFSITE_RSDNT_SW
     COBOL Name:  MENTL-HLTH-OFSITE-RSDNT-SW

   Services: Mental Health On-Site Nonresidents      1    748   748  VARCHAR2


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         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

   Indicator
     Description: Indicates if mental health services are provided on-site
                  to nonresidents.
     SAS Name:    MENTL_HLTH_ONST_NRSDNT_SW
     COBOL Name:  MENTL-HLTH-ONST-NRSDNT-SW

   Services: Mental Health On-Site Residents Indicator 1    749   749  VARCHAR2
     Description: Indicates if mental health services are provided on-site
                  to residents.
     SAS Name:    MENTL_HLTH_ONST_RSDNT_SW
     COBOL Name:  MENTL-HLTH-ONST-RSDNT-SW

   Services: Nursing Off-Site Residents Indicator    1    760   760  VARCHAR2
     Description: Indicates if nursing services are provided off-site to
                  residents.
     SAS Name:    NRSNG_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  NRSNG-SRVC-OFSITE-RSDNT-SW

   Services: Nursing On-Site Nonresidents Indicator  1    761   761  VARCHAR2
     Description: Indicates if nursing services are provided on-site to
                  nonresidents.
     SAS Name:    NRSNG_SRVC_ONST_NRSDNT_SW
     COBOL Name:  NRSNG-SRVC-ONST-NRSDNT-SW

   Services: Nursing On-Site Residents Indicator     1    762   762  VARCHAR2
     Description: Indicates if nursing services are provided on-site to
                  residents.
     SAS Name:    NRSNG_SRVC_ONST_RSDNT_SW
     COBOL Name:  NRSNG-SRVC-ONST-RSDNT-SW

   Services: OT Off-Site Residents Indicator         1    776   776  VARCHAR2
     Description: Indicates if occupational therapy services are provided
                  off-site to residents.
     SAS Name:    OT_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  OT-SRVC-OFSITE-RSDNT-SW

   Services: OT On-Site Nonresidents Indicator       1    777   777  VARCHAR2
     Description: Indicates if occupational therapy services are provided
                  on-site to nonresidents.
     SAS Name:    OT_SRVC_ONST_NRSDNT_SW
     COBOL Name:  OT-SRVC-ONST-NRSDNT-SW

   Services: OT On-Site Residents Indicator          1    778   778  VARCHAR2
     Description: Indicates if occupational therapy services are provided
                  on-site to residents.
     SAS Name:    OT_SRVC_ONST_RSDNT_SW
     COBOL Name:  OT-SRVC-ONST-RSDNT-SW

   Services: Pharmacy Off-Site Residents Indicator   1    789   789  VARCHAR2
     Description: Indicates if pharmacy services are provided off-site to
                  residents.
     SAS Name:    PHRMCY_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  PHRMCY-SRVC-OFSITE-RSDNT-SW

   Services: Pharmacy On-Site Nonresidents Indicator 1    790   790  VARCHAR2
     Description: Indicates if pharmacy services are provided on-site to
                  nonresidents.
     SAS Name:    PHRMCY_SRVC_ONST_NRSDNT_SW
     COBOL Name:  PHRMCY-SRVC-ONST-NRSDNT-SW

   Services: Pharmacy On-Site Residents Indicator    1    791   791  VARCHAR2
     Description: Indicates if pharmacy services are provided on-site to
                  residents.
     SAS Name:    PHRMCY_SRVC_ONST_RSDNT_SW


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         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     COBOL Name:  PHRMCY-SRVC-ONST-RSDNT-SW

   Services: Physician Extender Off-Site Residents   1    796   796  VARCHAR2
   Indicator
     Description: Indicates if physician extender services are provided
                  off-site to residents.
     SAS Name:    PHYSN_EXT_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  PHYSN-EXT-SRVC-OFSITE-RSDNT-SW

   Services: Physician Extender On-Site Nonresidents 1    797   797  VARCHAR2
   Indicator
     Description: Indicates if physician extender services are provided
                  on-site to nonresidents.
     SAS Name:    PHYSN_EXT_SRVC_ONST_NRSDNT_SW
     COBOL Name:  PHYSN-EXT-SRVC-ONST-NRSDNT-SW

   Services: Physician Extender On-Site Residents    1    798   798  VARCHAR2
   Indicator
     Description: Indicates if physician extender services are provided
                  on-site to residents.
     SAS Name:    PHYSN_EXT_SRVC_ONST_RSDNT_SW
     COBOL Name:  PHYSN-EXT-SRVC-ONST-RSDNT-SW

   Services: Physician Off-Site Residents Indicator  1    799   799  VARCHAR2
     Description: Indicates if physician services are provided off-site to
                  residents.
     SAS Name:    PHYSN_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  PHYSN-SRVC-OFSITE-RSDNT-SW

   Services: Physician On-Site Nonresidents Indicator 1    800   800  VARCHAR2
     Description: Indicates if physician services are provided on-site to
                  nonresidents.
     SAS Name:    PHYSN_SRVC_ONST_NRSDNT_SW
     COBOL Name:  PHYSN-SRVC-ONST-NRSDNT-SW

   Services: Physician On-Site Residents Indicator   1    801   801  VARCHAR2
     Description: Indicates if physician services are provided on-site to
                  residents.
     SAS Name:    PHYSN_SRVC_ONST_RSDNT_SW
     COBOL Name:  PHYSN-SRVC-ONST-RSDNT-SW

   Services: Podiatry Off-Site Residents Indicator   1    802   802  VARCHAR2
     Description: Indicates if podiatry services are provided off-site to
                  residents.
     SAS Name:    PDTRY_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  PDTRY-SRVC-OFSITE-RSDNT-SW

   Services: Podiatry On-Site Nonresidents Indicator 1    803   803  VARCHAR2
     Description: Indicates if podiatry services are provided on-site to
                  nonresidents.
     SAS Name:    PDTRY_SRVC_ONST_NRSDNT_SW
     COBOL Name:  PDTRY-SRVC-ONST-NRSDNT-SW

   Services: Podiatry On-Site Residents Indicator    1    804   804  VARCHAR2
     Description: Indicates if podiatry services are provided on-site to
                  residents.
     SAS Name:    PDTRY_SRVC_ONST_RSDNT_SW
     COBOL Name:  PDTRY-SRVC-ONST-RSDNT-SW

   Services: PT Off-Site Residents Indicator         1    814   814  VARCHAR2
     Description: Indicates if physical therapy services are provided
                  off-site to residents.
     SAS Name:    PT_OFSITE_RSDNT_SW
     COBOL Name:  PT-OFSITE-RSDNT-SW


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         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Services: PT On-Site Nonresidents Indicator       1    815   815  VARCHAR2
     Description: Indicates if physical therapy services are provided
                  on-site to nonresidents.
     SAS Name:    PT_ONST_NRSDNT_SW
     COBOL Name:  PT-ONST-NRSDNT-SW

   Services: PT On-Site Residents Indicator          1    816   816  VARCHAR2
     Description: Indicates if physical therapy services are provided
                  on-site to residents.
     SAS Name:    PT_ONST_RSDNT_SW
     COBOL Name:  PT-ONST-RSDNT-SW

   Services: Social Work Off-Site Residents Indicator 1    827   827  VARCHAR2
     Description: Indicates if social work services are provided off-site
                  to residents.
     SAS Name:    SCL_WORK_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  SCL-WORK-SRVC-OFSITE-RSDNT-SW

   Services: Social Work On-Site Nonresidents Indicator 1    828   828  VARCHAR2
     Description: Indicates if social work services are provided on-site to
                  nonresidents.
     SAS Name:    SCL_WORK_SRVC_ONST_NRSDNT_SW
     COBOL Name:  SCL-WORK-SRVC-ONST-NRSDNT-SW

   Services: Social Work On-Site Residents Indicator 1    829   829  VARCHAR2
     Description: Indicates if social work services are provided on-site to
                  residents.
     SAS Name:    SCL_WORK_SRVC_ONST_RSDNT_SW
     COBOL Name:  SCL-WORK-SRVC-ONST-RSDNT-SW

   Services: Speech Pathology Off-Site Residents     1    834   834  VARCHAR2
   Indicator
     Description: Indicates if speech/language pathology services are
                  provided off-site to residents.
     SAS Name:    SPCH_PTHLGY_OFSITE_RSDNT_SW
     COBOL Name:  SPCH-PTHLGY-OFSITE-RSDNT-SW

   Services: Speech Pathology On-Site Nonresidents   1    835   835  VARCHAR2
   Indicator
     Description: Indicates if speech/language pathology services are
                  provided on-site to nonresidents.
     SAS Name:    SPCH_PTHLGY_ONST_NRSDNT_SW
     COBOL Name:  SPCH-PTHLGY-ONST-NRSDNT-SW

   Services: Speech Pathology On-Site Residents      1    836   836  VARCHAR2
   Indicator
     Description: Indicates if speech/language pathology services are
                  provided on-site to residents.
     SAS Name:    SPCH_PTHLGY_ONST_RSDNT_SW
     COBOL Name:  SPCH-PTHLGY-ONST-RSDNT-SW

   Services: Therapeutic - Other Activities Staff -  1    839   839  VARCHAR2
   Off-Site Residents Indicator
     Description: Indicates if therapeutic services are provided off-site
                  to residents by other activities staff.
     SAS Name:    ACTVTY_OTHR_OFSITE_RSDNT_SW
     COBOL Name:  ACTVTY-OTHR-OFSITE-RSDNT-SW

   Services: Therapeutic - Other Activities Staff -  1    840   840  VARCHAR2
   On-Site Nonresidents Indicator
     Description: Indicates if therapeutic services are provided on-site to
                  nonresidents by other activities staff.
     SAS Name:    ACTVTY_OTHR_ONST_NRSDNT_SW


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   SHORT DESCRIPTION                                LEN  START END    TYPE

     COBOL Name:  ACTVTY-OTHR-ONST-NRSDNT-SW

   Services: Therapeutic - Other Activities Staff -  1    841   841  VARCHAR2
   On-Site Residents Indicator
     Description: Indicates if therapeutic services are provided on-site to
                  residents by other activities staff.
     SAS Name:    ACTVTY_OTHR_ONST_RSDNT_SW
     COBOL Name:  ACTVTY-OTHR-ONST-RSDNT-SW

   Services: Therapeutic - Other Social Services Staff - 1    842   842  VARCHAR2
   Off-Site Residents Indicator
     Description: Indicates if other therapeutic social services are
                  provided off-site to residents.
     SAS Name:    SCL_SRVC_OTHR_OFSITE_RSDNT_SW
     COBOL Name:  SCL-SRVC-OTHR-OFSITE-RSDNT-SW

   Services: Therapeutic - Other Social Services Staff - 1    843   843  VARCHAR2
   On-Site Nonresidents Indicator
     Description: Indicates if other therapeutic social services are
                  provided on-site to nonresidents.
     SAS Name:    SCL_SRVC_OTHR_ONST_NRSDNT_SW
     COBOL Name:  SCL-SRVC-OTHR-ONST-NRSDNT-SW

   Services: Therapeutic - Other Social Services Staff - 1    844   844  VARCHAR2
   On-Site Residents Indicator
     Description: Indicates if other therapeutic social services are
                  provided on-site to residents.
     SAS Name:    SCL_SRVC_OTHR_ONST_RSDNT_SW
     COBOL Name:  SCL-SRVC-OTHR-ONST-RSDNT-SW

   Services: Therapeutic - Qualified Activities      1    845   845  VARCHAR2
   Professional - Off-Site Residents Indicator
     Description: Indicates if therapeutic services are provided off-site
                  to residents by qualified activities professionals.
     SAS Name:    ACTVTY_OFSITE_RSDNT_SW
     COBOL Name:  ACTVTY-OFSITE-RSDNT-SW

   Services: Therapeutic - Qualified Activities      1    846   846  VARCHAR2
   Professional - On-Site Nonresidents Indicator
     Description: Indicates if therapeutic services are provided on-site to
                  nonresidents by qualified activities professionals.
     SAS Name:    ACTVTY_ONST_NRSDNT_SW
     COBOL Name:  ACTVTY-ONST-NRSDNT-SW

   Services: Therapeutic - Qualified Activities      1    847   847  VARCHAR2
   Professional - On-Site Residents Indicator
     Description: Indicates if therapeutic services are provided on-site to
                  residents by qualified activities professionals.
     SAS Name:    ACTVTY_ONST_RSDNT_SW
     COBOL Name:  ACTVTY-ONST-RSDNT-SW

   Services: Therapeutic Recreational Specialty Off-Site 1    849   849  VARCHAR2
   Residents Indicator
     Description: Indicates if therapeutic recreation specialist services
                  are provided off-site to residents.
     SAS Name:    THRPTC_RCRTNL_OFSITE_RSDNT_SW
     COBOL Name:  THRPTC-RCRTNL-OFSITE-RSDNT-SW

   Services: Therapeutic Recreational Specialty On-Site 1    850   850  VARCHAR2
   Nonresidents Indicator
     Description: Indicates if therapeutic recreation specialist services
                  are provided on-site to nonresidents.
     SAS Name:    THRPTC_RCRTNL_ONST_NRSDNT_SW
     COBOL Name:  THRPTC-RCRTNL-ONST-NRSDNT-SW


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         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Services: Therapeutic Recreational Specialty On-Site 1    851   851  VARCHAR2
   Residents Indicator
     Description: Indicates if therapeutic recreation specialist services
                  are provided on-site to residents.
     SAS Name:    THRPTC_RCRTNL_ONST_RSDNT_SW
     COBOL Name:  THRPTC-RCRTNL-ONST-RSDNT-SW

   Services: Vocational Off-Site Residents Indicator 1    854   854  VARCHAR2
     Description: Indicates if vocational services are provided off-site to
                  residents.
     SAS Name:    VCTNL_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  VCTNL-SRVC-OFSITE-RSDNT-SW

   Services: Vocational On-Site Nonresidents Indicator 1    855   855  VARCHAR2
     Description: Indicates if vocational services are provided on-site to
                  nonresidents.
     SAS Name:    VCTNL_SRVC_ONST_NRSDNT_SW
     COBOL Name:  VCTNL-SRVC-ONST-NRSDNT-SW

   Services: Vocational On-Site Residents Indicator  1    856   856  VARCHAR2
     Description: Indicates if vocational services are provided on-site to
                  residents.
     SAS Name:    VCTNL_SRVC_ONST_RSDNT_SW
     COBOL Name:  VCTNL-SRVC-ONST-RSDNT-SW

   Services: X-ray Off-Site Residents Indicator      1    857   857  VARCHAR2
     Description: Indicates if diagnostic X-ray services are provided
                  off-site to residents.
     SAS Name:    DGNSTC_XRAY_OFSITE_RSDNT_SW
     COBOL Name:  DGNSTC-XRAY-OFSITE-RSDNT-SW

   Services: X-ray On-Site Nonresidents Indicator    1    858   858  VARCHAR2
     Description: Indicates if diagnostic X-ray services are provided
                  on-site to nonresidents.
     SAS Name:    DGNSTC_XRAY_ONST_NRSDNT_SW
     COBOL Name:  DGNSTC-XRAY-ONST-NRSDNT-SW

   Services: X-ray On-Site Residents Indicator       1    859   859  VARCHAR2
     Description: Indicates if diagnostic X-ray services are provided
                  on-site to residents.
     SAS Name:    DGNSTC_XRAY_ONST_RSDNT_SW
     COBOL Name:  DGNSTC-XRAY-ONST-RSDNT-SW

   Staff Count Override Indicator                    1    861   861  CHAR
     Description: Indicates if the regional office has approved a
                  significant staff count change from the previous
                  certification.
     SAS Name:    OVRRD_STFG_SW
     COBOL Name:  OVRRD-STFG-SW

   Staff Count: Administrative Staff - Contract      8    862   869  NUMBER
     Description: Number of full-time equivalent administrative staff under
                  contract to a facility.
     SAS Name:    PROFNL_ADMIN_CNTRCT_CNT
     COBOL Name:  PROFNL-ADMIN-CNTRCT-CNT

   Staff Count: Administrative Staff - Full-Time     8    870   877  NUMBER
     Description: Number of full-time equivalent administrative staff
                  employed on a full-time basis by a facility.
     SAS Name:    PROFNL_ADMIN_FLTM_CNT
     COBOL Name:  PROFNL-ADMIN-FLTM-CNT

   Staff Count: Administrative Staff - Part-Time     8    878   885  NUMBER


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         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Number of full-time equivalent administrative staff
                  employed on a part-time basis by a facility.
     SAS Name:    PROFNL_ADMIN_PRTM_CNT
     COBOL Name:  PROFNL-ADMIN-PRTM-CNT

   Staff Count: Certified Nurse Aide - Contract      8    910   917  NUMBER
     Description: Number of full-time equivalent certified nurse aides
                  under contract to a facility.
     SAS Name:    NRS_AIDE_CNTRCT_CNT
     COBOL Name:  NRS-AIDE-CNTRCT-CNT

   Staff Count: Certified Nurse Aide - Full-Time     8    918   925  NUMBER
     Description: Number of full-time equivalent certified nurse aides
                  employed full-time by a facility.
     SAS Name:    NRS_AIDE_FLTM_CNT
     COBOL Name:  NRS-AIDE-FLTM-CNT

   Staff Count: Certified Nurse Aide - Part-Time     8    926   933  NUMBER
     Description: Number of full-time equivalent certified nurse aides
                  employed part-time by a facility.
     SAS Name:    NRS_AIDE_PRTM_CNT
     COBOL Name:  NRS-AIDE-PRTM-CNT

   Staff Count: Dentist - Contract                   8    958   965  NUMBER
     Description: Number of full-time equivalent dentists under contract to
                  a facility.
     SAS Name:    DNTST_CNTRCT_CNT
     COBOL Name:  DNTST-CNTRCT-CNT

   Staff Count: Dentist - Full-Time                  8    966   973  NUMBER
     Description: Number of full-time equivalent dentists employed full
                  time by a facility.
     SAS Name:    DNTST_FLTM_CNT
     COBOL Name:  DNTST-FLTM-CNT

   Staff Count: Dentist - Part-Time                  8    974   981  NUMBER
     Description: Number of full-time equivalent dentists employed part
                  time by a facility.
     SAS Name:    DNTST_PRTM_CNT
     COBOL Name:  DNTST-PRTM-CNT

   Staff Count: Dietitian - Contract                 8    990   997  NUMBER
     Description: Number of full-time equivalent dietitians under contract
                  to a facility.
     SAS Name:    DIETN_CNTRCT_CNT
     COBOL Name:  DIETN-CNTRCT-CNT

   Staff Count: Dietitian - Full-Time                8    998   1005 NUMBER
     Description: Number of full-time equivalent dietitians employed full
                  time by a facility.
     SAS Name:    DIETN_FLTM_CNT
     COBOL Name:  DIETN-FLTM-CNT

   Staff Count: Dietitian - Part-Time                8    1006  1013 NUMBER
     Description: Number of full-time equivalent dietitians employed part
                  time by a facility.
     SAS Name:    DIETN_PRTM_CNT
     COBOL Name:  DIETN-PRTM-CNT

   Staff Count: Food Service Worker - Contract       8    1022  1029 NUMBER
     Description: Number of full-time equivalent food service personnel
                  under contract to a facility.
     SAS Name:    FOOD_SRVC_CNTRCT_CNT
     COBOL Name:  FOOD-SRVC-CNTRCT-CNT


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 33
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Staff Count: Food Service Worker - Full-Time      8    1030  1037 NUMBER
     Description: Number of full-time equivalent food service personnel
                  employed  full-time by a facility.
     SAS Name:    FOOD_SRVC_FLTM_CNT
     COBOL Name:  FOOD-SRVC-FLTM-CNT

   Staff Count: Food Service Worker - Part-Time      8    1038  1045 NUMBER
     Description: Number of full-time equivalent food service personnel
                  employed  part-time by a facility.
     SAS Name:    FOOD_SRVC_PRTM_CNT
     COBOL Name:  FOOD-SRVC-PRTM-CNT

   Staff Count: Housekeeping - Contract              8    1070  1077 NUMBER
     Description: Number of full-time equivalent housekeeping personnel
                  under contract to a facility.
     SAS Name:    HSEKPNG_CNTRCT_CNT
     COBOL Name:  HSEKPNG-CNTRCT-CNT

   Staff Count: Housekeeping - Full-Time             8    1078  1085 NUMBER
     Description: Number of full-time equivalent housekeeping personnel
                  employed  full-time by a facility.
     SAS Name:    HSEKPNG_FLTM_CNT
     COBOL Name:  HSEKPNG-FLTM-CNT

   Staff Count: Housekeeping - Part-Time             8    1086  1093 NUMBER
     Description: Number of full-time equivalent housekeeping personnel
                  employed  part-time by a facility.
     SAS Name:    HSEKPNG_PRTM_CNT
     COBOL Name:  HSEKPNG-PRTM-CNT

   Staff Count: LPN/LVN - Contract                   8    1118  1125 NUMBER
     Description: Number of full-time equivalent licensed
                  practical/vocational nurses under contract to a facility.
     SAS Name:    LPN_LVN_CNTRCT_CNT
     COBOL Name:  LPN-LVN-CNTRCT-CNT

   Staff Count: LPN/LVN - Full-Time                  8    1126  1133 NUMBER
     Description: Number of full-time equivalent licensed
                  practical/vocational nurses employed full-time by a
                  facility.
     SAS Name:    LPN_LVN_FLTM_CNT
     COBOL Name:  LPN-LVN-FLTM-CNT

   Staff Count: LPN/LVN - Part-Time                  8    1134  1141 NUMBER
     Description: Number of full-time equivalent licensed
                  practical/vocational nurses employed part-time by a
                  facility.
     SAS Name:    LPN_LVN_PRTM_CNT
     COBOL Name:  LPN-LVN-PRTM-CNT

   Staff Count: Medical Director - Contract          8    1150  1157 NUMBER
     Description: Number of full-time equivalent medical directors under
                  contract to a facility.
     SAS Name:    MDCL_DRCTR_CNTRCT_CNT
     COBOL Name:  MDCL-DRCTR-CNTRCT-CNT

   Staff Count: Medical Director - Full-Time         8    1158  1165 NUMBER
     Description: Number of full-time equivalent medical directors employed
                  full-time by a facility.
     SAS Name:    MDCL_DRCTR_FLTM_CNT
     COBOL Name:  MDCL-DRCTR-FLTM-CNT

   Staff Count: Medical Director - Part-Time         8    1166  1173 NUMBER


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 34
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Number of full-time equivalent medical directors employed
                  part-time by a facility.
     SAS Name:    MDCL_DRCTR_PRTM_CNT
     COBOL Name:  MDCL-DRCTR-PRTM-CNT

   Staff Count: Medication Aide/Technician - Contract 8    1198  1205 NUMBER
     Description: Number of full-time equivalent medication aides/
                  technicians under contract to a facility.
     SAS Name:    MDCTN_AIDE_CNTRCT_CNT
     COBOL Name:  MDCTN-AIDE-CNTRCT-CNT

   Staff Count: Medication Aide/Technician - Full-Time 8    1206  1213 NUMBER
     Description: Number of full-time equivalent medication aides/
                  technicians employed full-time by a facility.
     SAS Name:    MDCTN_AIDE_FLTM_CNT
     COBOL Name:  MDCTN-AIDE-FLTM-CNT

   Staff Count: Medication Aide/Technician - Part-Time 8    1214  1221 NUMBER
     Description: Number of full-time equivalent medication aides/
                  technicians employed part-time by a facility.
     SAS Name:    MDCTN_AIDE_PRTM_CNT
     COBOL Name:  MDCTN-AIDE-PRTM-CNT

   Staff Count: Mental Health Services - Contract    8    1222  1229 NUMBER
     Description: Number of full-time equivalent mental health services
                  personnel under contract to a facility.
     SAS Name:    MENTL_HLTH_SRVC_CNTRCT_CNT
     COBOL Name:  MENTL-HLTH-SRVC-CNTRCT-CNT

   Staff Count: Mental Health Services - Full-Time   8    1230  1237 NUMBER
     Description: Number of full-time equivalent mental health services
                  personnel employed full-time by a facility.
     SAS Name:    MENTL_HLTH_SRVC_FLTM_CNT
     COBOL Name:  MENTL-HLTH-SRVC-FLTM-CNT

   Staff Count: Mental Health Services - Part-Time   8    1238  1245 NUMBER
     Description: Number of full-time equivalent mental health services
                  personnel employed part-time by a facility.
     SAS Name:    MENTL_HLTH_SRVC_PRTM_CNT
     COBOL Name:  MENTL-HLTH-SRVC-PRTM-CNT

   Staff Count: Nurse Aide in Training - Contract    8    1254  1261 NUMBER
     Description: Number of full-time equivalent nurse aides in training
                  under contract to a facility.
     SAS Name:    NAT_CNTRCT_CNT
     COBOL Name:  NAT-CNTRCT-CNT

   Staff Count: Nurse Aide in Training - Full-Time   8    1262  1269 NUMBER
     Description: Number of full-time equivalent nurse aides in training
                  employed full-time by a facility.
     SAS Name:    NAT_FLTM_CNT
     COBOL Name:  NAT-FLTM-CNT

   Staff Count: Nurse Aide in Training - Part-Time   8    1270  1277 NUMBER
     Description: Number of full-time equivalent nurse aides in training
                  employed part-time by a facility.
     SAS Name:    NAT_PRTM_CNT
     COBOL Name:  NAT-PRTM-CNT

   Staff Count: Nurse With Administrative Duties -   8    1286  1293 NUMBER
   Contract
     Description: Number of full-time equivalent nurses with administrative
                  duties under contract to a facility.
     SAS Name:    NRS_ADMINV_CNTRCT_CNT


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 35
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     COBOL Name:  NRS-ADMINV-CNTRCT-CNT

   Staff Count: Nurse With Administrative Duties -   8    1294  1301 NUMBER
   Full-Time
     Description: Number of full-time equivalent nurses with administrative
                  duties employed full-time by a facility.
     SAS Name:    NRS_ADMINV_FLTM_CNT
     COBOL Name:  NRS-ADMINV-FLTM-CNT

   Staff Count: Nurse With Administrative Duties -   8    1302  1309 NUMBER
   Part-Time
     Description: Number of full-time equivalent nurses with administrative
                  duties employed part-time by a facility.
     SAS Name:    NRS_ADMINV_PRTM_CNT
     COBOL Name:  NRS-ADMINV-PRTM-CNT

   Staff Count: OT - Arrangement                     8    1318  1325 NUMBER
     Description: Number of full-time equivalent occupational therapists
                  under arrangement to the provider
     SAS Name:    OCPTNL_THRPST_CNTRCT_CNT
     COBOL Name:  OCPTNL-THRPST-CNTRCT-CNT

   Staff Count: OT - Full-Time                       8    1326  1333 NUMBER
     Description: Number of full-time equivalent occupational therapists
                  employed full-time by a facility.
     SAS Name:    OCPTNL_THRPST_FLTM_CNT
     COBOL Name:  OCPTNL-THRPST-FLTM-CNT

   Staff Count: OT - Part-Time                       8    1334  1341 NUMBER
     Description: Number of full-time equivalent occupational therapists
                  employed part-time by a facility.
     SAS Name:    OCPTNL_THRPST_PRTM_CNT
     COBOL Name:  OCPTNL-THRPST-PRTM-CNT

   Staff Count: OT Aide - Contract                   8    1342  1349 NUMBER
     Description: Number of full-time equivalent occupational therapy aides
                  under contract to a facility.
     SAS Name:    OT_AIDE_CNTRCT_CNT
     COBOL Name:  OT-AIDE-CNTRCT-CNT

   Staff Count: OT Aide - Full-Time                  8    1350  1357 NUMBER
     Description: Number of full-time equivalent occupational therapy aides
                  employed full-time by a facility.
     SAS Name:    OT_AIDE_FLTM_CNT
     COBOL Name:  OT-AIDE-FLTM-CNT

   Staff Count: OT Aide - Part-Time                  8    1358  1365 NUMBER
     Description: Number of full-time equivalent occupational therapy aides
                  employed part-time by a facility.
     SAS Name:    OT_AIDE_PRTM_CNT
     COBOL Name:  OT-AIDE-PRTM-CNT

   Staff Count: OT Assistant - Contract              8    1366  1373 NUMBER
     Description: Number of full-time equivalent occupational therapy
                  assistants under contract to a facility.
     SAS Name:    OT_ASTNT_CNTRCT_CNT
     COBOL Name:  OT-ASTNT-CNTRCT-CNT

   Staff Count: OT Assistant - Full-Time             8    1374  1381 NUMBER
     Description: Number of full-time equivalent occupational therapy
                  assistants employed full-time by a facility.
     SAS Name:    OT_ASTNT_FLTM_CNT
     COBOL Name:  OT-ASTNT-FLTM-CNT



 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 36
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

   Staff Count: OT Assistant - Part-Time             8    1382  1389 NUMBER
     Description: Number of full-time equivalent occupational therapy
                  assistants employed part-time by a facility.
     SAS Name:    OT_ASTNT_PRTM_CNT
     COBOL Name:  OT-ASTNT-PRTM-CNT

   Staff Count: Other Activities - Contract          8    1398  1405 NUMBER
     Description: Number of full-time equivalent other activities staff
                  providing therapeutic services under contract to a
                  facility.
     SAS Name:    ACTVTY_STF_OTHR_CNTRCT_CNT
     COBOL Name:  ACTVTY-STF-OTHR-CNTRCT-CNT

   Staff Count: Other Activities - Full-Time         8    1406  1413 NUMBER
     Description: Number of full-time equivalent other activities staff
                  providing therapeutic services employed full time by a
                  facility.
     SAS Name:    ACTVTY_STF_OTHR_FLTM_CNT
     COBOL Name:  ACTVTY-STF-OTHR-FLTM-CNT

   Staff Count: Other Activities - Part-Time         8    1414  1421 NUMBER
     Description: Number of full-time equivalent other activities staff
                  providing therapeutic services employed part time by a
                  facility.
     SAS Name:    ACTVTY_STF_OTHR_PRTM_CNT
     COBOL Name:  ACTVTY-STF-OTHR-PRTM-CNT

   Staff Count: Other Physician - Contract           8    1422  1429 NUMBER
     Description: Number of full-time equivalent other physicians under
                  contract to a facility.
     SAS Name:    PHYSN_OTHR_CNTRCT_CNT
     COBOL Name:  PHYSN-OTHR-CNTRCT-CNT

   Staff Count: Other Physician - Full-Time          8    1430  1437 NUMBER
     Description: Number of full-time equivalent other physicians employed
                  full-time by a facility.
     SAS Name:    PHYSN_OTHR_FLTM_CNT
     COBOL Name:  PHYSN-OTHR-FLTM-CNT

   Staff Count: Other Physician - Part-Time          8    1438  1445 NUMBER
     Description: Number of full-time equivalent other physicians employed
                  part-time by a facility.
     SAS Name:    PHYSN_OTHR_PRTM_CNT
     COBOL Name:  PHYSN-OTHR-PRTM-CNT

   Staff Count: Other Social Services - Contract     8    1446  1453 NUMBER
     Description: Number of full-time equivalent other social services
                  staff under contract to a facility.
     SAS Name:    SCL_SRVC_OTHR_STF_CNTRCT_CNT
     COBOL Name:  SCL-SRVC-OTHR-STF-CNTRCT-CNT

   Staff Count: Other Social Services - Full-Time    8    1454  1461 NUMBER
     Description: Number of full-time equivalent other social services
                  staff employed full time by a facility.
     SAS Name:    SCL_SRVC_OTHR_STF_FLTM_CNT
     COBOL Name:  SCL-SRVC-OTHR-STF-FLTM-CNT

   Staff Count: Other Social Services - Part-Time    8    1462  1469 NUMBER
     Description: Number of full-time equivalent other social services
                  staff employed part time by a facility.
     SAS Name:    SCL_SRVC_OTHR_STF_PRTM_CNT
     COBOL Name:  SCL-SRVC-OTHR-STF-PRTM-CNT

   Staff Count: Other Staff - Contract               8    1470  1477 NUMBER


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 37
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Number of full-time equivalent staff not included in any
                  other categories under contract to the facility.
     SAS Name:    STF_OTHR_CNTRCT_CNT
     COBOL Name:  STF-OTHR-CNTRCT-CNT

   Staff Count: Other Staff - Full-Time              8    1478  1485 NUMBER
     Description: Number of full-time equivalent persons not included in
                  any other categories employed full-time by the facility.
     SAS Name:    STF_OTHR_FLTM_CNT
     COBOL Name:  STF-OTHR-FLTM-CNT

   Staff Count: Other Staff - Part-Time              8    1486  1493 NUMBER
     Description: Number of full-time equivalent persons not included in
                  any other categories employed part-time by the facility.
     SAS Name:    STF_OTHR_PRTM_CNT
     COBOL Name:  STF-OTHR-PRTM-CNT

   Staff Count: Pharmacist - Contract                8    1494  1501 NUMBER
     Description: Number of full-time equivalent pharmacists under contract
                  to a facility.
     SAS Name:    PHRMCST_CNTRCT_CNT
     COBOL Name:  PHRMCST-CNTRCT-CNT

   Staff Count: Pharmacist - Full-Time               8    1502  1509 NUMBER
     Description: Number of full-time equivalent pharmacists employed
                  full-time by a facility.
     SAS Name:    PHRMCST_FLTM_CNT
     COBOL Name:  PHRMCST-FLTM-CNT

   Staff Count: Pharmacist - Part-Time               8    1510  1517 NUMBER
     Description: Number of full-time equivalent pharmacists employed
                  part-time by a facility.
     SAS Name:    PHRMCST_PRTM_CNT
     COBOL Name:  PHRMCST-PRTM-CNT

   Staff Count: Physical Therapist - Contract        8    1518  1525 NUMBER
     Description: Number of full-time equivalent physical therapists under
                  contract to a facility.
     SAS Name:    PHYS_THRPST_CNTRCT_CNT
     COBOL Name:  PHYS-THRPST-CNTRCT-CNT

   Staff Count: Physical Therapist - Full-Time       8    1526  1533 NUMBER
     Description: Number of full-time equivalent physical therapists
                  employed full-time by a facility.
     SAS Name:    PHYS_THRPST_FLTM_CNT
     COBOL Name:  PHYS-THRPST-FLTM-CNT

   Staff Count: Physical Therapist - Part-Time       8    1534  1541 NUMBER
     Description: Number of full-time equivalent physical therapists
                  employed part-time by a facility.
     SAS Name:    PHYS_THRPST_PRTM_CNT
     COBOL Name:  PHYS-THRPST-PRTM-CNT

   Staff Count: Physician Extender - Contract        8    1566  1573 NUMBER
     Description: Number of full-time equivalent physician extenders under
                  contract to the facility.
     SAS Name:    PHYSN_EXT_CNTRCT_CNT
     COBOL Name:  PHYSN-EXT-CNTRCT-CNT

   Staff Count: Physician Extender - Full-Time       8    1574  1581 NUMBER
     Description: Number of full-time equivalent physician extenders
                  employed full-time by the facility.
     SAS Name:    PHYSN_EXT_FLTM_CNT
     COBOL Name:  PHYSN-EXT-FLTM-CNT


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         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Staff Count: Physician Extender - Part-Time       8    1582  1589 NUMBER
     Description: Number of full-time equivalent physician extenders
                  employed part-time by the facility.
     SAS Name:    PHYSN_EXT_PRTM_CNT
     COBOL Name:  PHYSN-EXT-PRTM-CNT

   Staff Count: Podiatrist - Contract                8    1598  1605 NUMBER
     Description: Number of full-time equivalent podiatrists under contract
                  to a facility.
     SAS Name:    PDTRST_CNTRCT_CNT
     COBOL Name:  PDTRST-CNTRCT-CNT

   Staff Count: Podiatrist - Full-Time               8    1606  1613 NUMBER
     Description: Number of full-time equivalent podiatrists employed
                  full-time by a facility.
     SAS Name:    PDTRST_FLTM_CNT
     COBOL Name:  PDTRST-FLTM-CNT

   Staff Count: Podiatrist - Part-Time               8    1614  1621 NUMBER
     Description: Number of full-time equivalent podiatrists employed
                  part-time by a facility.
     SAS Name:    PDTRST_PRTM_CNT
     COBOL Name:  PDTRST-PRTM-CNT

   Staff Count: PT Aide - Contract                   8    1654  1661 NUMBER
     Description: Number of full-time equivalent physical therapy aides
                  under contract to a facility.
     SAS Name:    PT_AIDE_CNTRCT_CNT
     COBOL Name:  PT-AIDE-CNTRCT-CNT

   Staff Count: PT Aide - Full-Time                  8    1662  1669 NUMBER
     Description: Number of full-time equivalent physical therapy aides
                  employed full-time by a facility.
     SAS Name:    PT_AIDE_FLTM_CNT
     COBOL Name:  PT-AIDE-FLTM-CNT

   Staff Count: PT Aide - Part-Time                  8    1670  1677 NUMBER
     Description: Number of full-time equivalent physical therapy aides
                  employed part-time by a facility.
     SAS Name:    PT_AIDE_PRTM_CNT
     COBOL Name:  PT-AIDE-PRTM-CNT

   Staff Count: PT Assistant - Contract              8    1678  1685 NUMBER
     Description: Number of full-time equivalent physical therapy
                  assistants under contract to a facility.
     SAS Name:    PT_ASTNT_CNTRCT_CNT
     COBOL Name:  PT-ASTNT-CNTRCT-CNT

   Staff Count: PT Assistant - Full-Time             8    1686  1693 NUMBER
     Description: Number of full-time equivalent physical therapy
                  assistants employed full-time by a facility.
     SAS Name:    PT_ASTNT_FLTM_CNT
     COBOL Name:  PT-ASTNT-FLTM-CNT

   Staff Count: PT Assistant - Part-Time             8    1694  1701 NUMBER
     Description: Number of full-time equivalent physical therapy
                  assistants employed part-time by a facility.
     SAS Name:    PT_ASTNT_PRTM_CNT
     COBOL Name:  PT-ASTNT-PRTM-CNT

   Staff Count: Qualified Activities Professional -  8    1702  1709 NUMBER
   Contract
     Description: Number of full-time equivalent qualified activities


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 39
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  professionals providing therapeutic services under
                  contract to a facility.
     SAS Name:    ACTVTY_PROFNL_CNTRCT_CNT
     COBOL Name:  ACTVTY-PROFNL-CNTRCT-CNT

   Staff Count: Qualified Activities Professional -  8    1710  1717 NUMBER
   Full-Time
     Description: Number of full-time equivalent qualified activities
                  professionals providing therapeutic services employed
                  full time by a facility.
     SAS Name:    ACTVTY_PROFNL_FLTM_CNT
     COBOL Name:  ACTVTY-PROFNL-FLTM-CNT

   Staff Count: Qualified Activities Professional -  8    1718  1725 NUMBER
   Part-Time
     Description: Number of full-time equivalent qualified activities
                  professionals providing therapeutic services employed
                  part time by a facility.
     SAS Name:    ACTVTY_PROFNL_PRTM_CNT
     COBOL Name:  ACTVTY-PROFNL-PRTM-CNT

   Staff Count: RN - Contract                        8    1758  1765 NUMBER
     Description: Number of full-time equivalent registered nurses under
                  contract to a facility.
     SAS Name:    RN_CNTRCT_CNT
     COBOL Name:  RN-CNTRCT-CNT

   Staff Count: RN - Full-Time                       8    1766  1773 NUMBER
     Description: Number of full-time equivalent registered nurses employed
                  full-time by a facility.
     SAS Name:    RN_FLTM_CNT
     COBOL Name:  RN-FLTM-CNT

   Staff Count: RN - Part-Time                       8    1774  1781 NUMBER
     Description: Number of full-time equivalent registered nurses employed
                  part-time by a facility.
     SAS Name:    RN_PRTM_CNT
     COBOL Name:  RN-PRTM-CNT

   Staff Count: RN Director of Nursing - Contract    8    1790  1797 NUMBER
     Description: Number of full-time equivalent registered nurse directors
                  of nursing under contract to a facility.
     SAS Name:    RN_DRCTR_CNTRCT_CNT
     COBOL Name:  RN-DRCTR-CNTRCT-CNT

   Staff Count: RN Director of Nursing - Full-Time   8    1798  1805 NUMBER
     Description: Number of full-time equivalent registered nurse directors
                  of nursing employed full-time by a facility.
     SAS Name:    RN_DRCTR_FLTM_CNT
     COBOL Name:  RN-DRCTR-FLTM-CNT

   Staff Count: RN Director of Nursing - Part-Time   8    1806  1813 NUMBER
     Description: Number of full-time equivalent registered nurse directors
                  of nursing employed part-time by a facility.
     SAS Name:    RN_DRCTR_PRTM_CNT
     COBOL Name:  RN-DRCTR-PRTM-CNT

   Staff Count: Social Worker - Contract             8    1822  1829 NUMBER
     Description: Number of full-time equivalent social workers under
                  contract to a facility.
     SAS Name:    SCL_WORKR_CNTRCT_CNT
     COBOL Name:  SCL-WORKR-CNTRCT-CNT

   Staff Count: Social Worker - Full-Time            8    1830  1837 NUMBER


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 40
         Skilled Nursing Facility, CATEGORY = "04" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Number of full-time equivalent social workers employed
                  full-time by a facility.
     SAS Name:    SCL_WORKR_FLTM_CNT
     COBOL Name:  SCL-WORKR-FLTM-CNT

   Staff Count: Social Worker - Part-Time            8    1838  1845 NUMBER
     Description: Number of full-time equivalent social workers employed
                  part-time by a facility.
     SAS Name:    SCL_WORKR_PRTM_CNT
     COBOL Name:  SCL-WORKR-PRTM-CNT

   Staff Count: Speech Pathologist - Contract        8    1854  1861 NUMBER
     Description: Number of full-time equivalent speech pathologists under
                  contract to a facility.
     SAS Name:    SPCH_PTHLGST_CNTRCT_CNT
     COBOL Name:  SPCH-PTHLGST-CNTRCT-CNT

   Staff Count: Speech Pathologist - Full-Time       8    1862  1869 NUMBER
     Description: Number of full-time equivalent speech pathologists
                  employed full-time by a facility.
     SAS Name:    SPCH_PTHLGST_FLTM_CNT
     COBOL Name:  SPCH-PTHLGST-FLTM-CNT

   Staff Count: Speech Pathologist - Part-Time       8    1870  1877 NUMBER
     Description: Number of full-time equivalent speech pathologists
                  employed part-time by a facility.
     SAS Name:    SPCH_PTHLGST_PRTM_CNT
     COBOL Name:  SPCH-PTHLGST-PRTM-CNT

   Staff Count: Therapeutic Recreational Specialist - 8    1910  1917 NUMBER
   Contract
     Description: Number of full-time equivalent therapeutic recreation
                  specialist staff under contract to a facility.
     SAS Name:    THRPTC_RCRTNL_CNTRCT_CNT
     COBOL Name:  THRPTC-RCRTNL-CNTRCT-CNT

   Staff Count: Therapeutic Recreational Specialist - 8    1918  1925 NUMBER
   Full-Time
     Description: Number of full-time equivalent therapeutic recreation
                  specialist staff employed full-time by a facility.
     SAS Name:    THRPTC_RCRTNL_FLTM_CNT
     COBOL Name:  THRPTC-RCRTNL-FLTM-CNT

   Staff Count: Therapeutic Recreational Specialist - 8    1926  1933 NUMBER
   Part-Time
     Description: Number of  full-time equivalent therapeutic recreation
                  specialist staff employed full-time by a facility.
     SAS Name:    THRPTC_RCRTNL_PRTM_CNT
     COBOL Name:  THRPTC-RCRTNL-PRTM-CNT

















 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 1
            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Provider Category Subtype Code                    2    1     2    VARCHAR2
     Description: Identifies the subtype of the provider, within the
                  primary category.  Used in reporting to show the
                  breakdown of provider categories, mainly for hospitals
                  and SNFs.
     SAS Name:    PRVDR_CTGRY_SBTYP_CD
     COBOL Name:  PRVDR-CTGRY-SBTYP-CD
     VALUES:      01=Home Health Agency

   Provider Category Code                            2    3     4    VARCHAR2
     Description: Identifies the type of provider participating in the
                  Medicare/Medicaid program.
     SAS Name:    PRVDR_CTGRY_CD
     COBOL Name:  PRVDR-CTGRY-CD
     VALUES:      05=Home Health Agency

   CHOW Count                                        2    5     6    NUMBER
     Description: Number of times this provider has undergone a change of
                  ownership.
     SAS Name:    CHOW_CNT
     COBOL Name:  CHOW-CNT

   CHOW Date                                         8    7     14   DATE
     Description: Effective date of the most recent change of ownership for
                  this provider.
     SAS Name:    CHOW_DT
     COBOL Name:  CHOW-DT

   Address: City                                     28   15    42   VARCHAR2
     Description: City in which the provider is physically located.
     SAS Name:    CITY_NAME
     COBOL Name:  CITY-NAME

   Compliance: Acceptable POC                        1    43    43   VARCHAR2
     Description: Indicates if a provider is in compliance with program
                  requirements based on an acceptable plan for correction
                  of deficiencies.
     SAS Name:    ACPTBL_POC_SW
     COBOL Name:  ACPTBL-POC-SW

   Compliance: Status                                1    44    44   VARCHAR2
     Description: Compliance status of a provider at the time of
                  certification survey.
     SAS Name:    CMPLNC_STUS_CD
     COBOL Name:  CMPLNC-STUS-CD
     VALUES:      A=IN COMPLIANCE
                  B=NOT IN COMPLIANCE

   SSA County Code                                   3    45    47   VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the county where the provider is located.
     SAS Name:    SSA_CNTY_CD
     COBOL Name:  SSA-CNTY-CD

   Cross Ref Provider Number                         10   48    57   CHAR
     Description: Cross reference provider number
     SAS Name:    CROSS_REF_PROVIDER_NUMBER
     COBOL Name:  CROSS-REF-PROVIDER-NUMBER

   Certification Date                                8    58    65   DATE
     Description: Equal to the exit date of the initial visit of the Health
                  survey for certifications completed after July 28, 2012.
                  For certifications prior to that date, the certification


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 2
            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  date is equal to the exit date of the initial visit of
                  the Health survey or LSC survey, whichever is later.
     SAS Name:    CRTFCTN_DT
     COBOL Name:  CRTFCTN-DT

   Eligibility Indicator                             1    66    66   VARCHAR2
     Description: Indicates if a facility is eligible to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    ELGBLTY_SW
     COBOL Name:  ELGBLTY-SW

   Facility Name                                     50   67    116  VARCHAR2
     Description: Name of the provider certified to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    FAC_NAME
     COBOL Name:  FAC-NAME

   Medicare Administrative Contractor (MAC) or       5    117   121  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_CD
     COBOL Name:  INTRMDRY-CARR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 3
            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 4
            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 5
            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 6
            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)
                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 7
            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   Medicaid Vendor Number                            15   122   136  VARCHAR2
     Description: Number which may be assigned to a provider by the state
                  Medicaid agency for external control or billing purposes.
     SAS Name:    MDCD_VNDR_NUM
     COBOL Name:  MDCD-VNDR-NUM

   Original Participation Date                       8    137   144  DATE
     Description: Date a provider is first approved to provide Medicare
                  and/or Medicaid services.
     SAS Name:    ORGNL_PRTCPTN_DT
     COBOL Name:  ORGNL-PRTCPTN-DT

   Prior CHOW Date                                   8    145   152  DATE
     Description: Effective date of the previous change of ownership for
                  this provider.
     SAS Name:    CHOW_PRIOR_DT
     COBOL Name:  CHOW-PRIOR-DT

   Prior Medicare Administrative Contractor (MAC) or 5    153   157  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the previous Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_PRIOR_CD
     COBOL Name:  INTRMDRY-CARR-PRIOR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 8
            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 9
            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 10
            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 11
            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 12
            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   CCN                                               10   158   167  VARCHAR2
     Description: Six or ten position identification number that is
                  assigned to a certified provider.  This is the CMS
                  Certification Number.
     SAS Name:    PRVDR_NUM
     COBOL Name:  PRVDR-NUM

   Region Code                                       2    168   169  VARCHAR2
     Description: Indicates the CMS Regional Office responsible for the
                  certification of the provider.
     SAS Name:    RGN_CD
     COBOL Name:  RGN-CD
     VALUES:      01=Boston
                  02=New York
                  03=Philadelphia
                  04=Atlanta
                  05=Chicago
                  06=Dallas
                  07=Kansas City
                  08=Denver
                  09=San Francisco
                  10=Seattle

   Skeleton Record Indicator                         1    170   170  VARCHAR2
     Description: Indicates if the record is a skeleton record.  Only a
                  limited set of data is available for this provider; no
                  survey data exists.  Only provider categories
                  01,17,19,21and 22 can have skeleton providers.
     SAS Name:    SKLTN_REC_SW
     COBOL Name:  SKLTN-REC-SW

   State Abbreviation                                2    171   172  VARCHAR2
     Description: Two-character state abbreviation.
     SAS Name:    STATE_CD
     COBOL Name:  STATE-CD
     VALUES:      AK=ALASKA
                  AL=ALABAMA
                  AR=ARKANSAS
                  AS=AMERICAN SAMOA
                  AZ=ARIZONA
                  CA=CALIFORNIA
                  CN=CANADA
                  CO=COLORADO
                  CT=CONNECTICUT
                  DC=DISTRICT OF COLUMBIA
                  DE=DELAWARE
                  FL=FLORIDA
                  FN=INTERNATIONAL
                  GA=GEORGIA
                  GU=GUAM
                  HI=HAWAII
                  IA=IOWA
                  ID=IDAHO


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 13
            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  IL=ILLINOIS
                  IN=INDIANA
                  KS=KANSAS
                  KY=KENTUCKY
                  LA=LOUISIANA
                  MA=MASSACHUSETTS
                  MD=MARYLAND
                  ME=MAINE
                  MI=MICHIGAN
                  MN=MINNESOTA
                  MO=MISSOURI
                  MP=SAIPAN
                  MS=MISSISSIPPI
                  MT=MONTANA
                  MX=MEXICO
                  NC=NORTH CAROLINA
                  ND=NORTH DAKOTA
                  NE=NEBRASKA
                  NH=NEW HAMPSHIRE
                  NJ=NEW JERSEY
                  NM=NEW MEXICO
                  NV=NEVADA
                  NY=NEW YORK
                  OH=OHIO
                  OK=OKLAHOMA
                  OR=OREGON
                  PA=PENNSYLVANIA
                  PR=PUERTO RICO
                  RI=RHODE ISLAND
                  SC=SOUTH CAROLINA
                  SD=SOUTH DAKOTA
                  TN=TENNESSEE
                  TX=TEXAS
                  UT=UTAH
                  VA=VIRGINIA
                  VI=VIRGIN ISLANDS
                  VT=VERMONT
                  WA=WASHINGTON
                  WI=WISCONSIN
                  WV=WEST VIRGINIA
                  WY=WYOMING

   SSA State Code                                    2    173   174  VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the state where the provider is located.
     SAS Name:    SSA_STATE_CD
     COBOL Name:  SSA-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  03=ARIZONA
                  04=ARKANSAS
                  05=CALIFORNIA
                  06=COLORADO
                  07=CONNECTICUT
                  08=DELAWARE
                  09=DISTRICT OF COLUMBIA
                  10=FLORIDA
                  11=GEORGIA
                  12=HAWAII
                  13=IDAHO
                  14=ILLINOIS
                  15=INDIANA
                  16=IOWA
                  17=KANSAS


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 14
            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  18=KENTUCKY
                  19=LOUISIANA
                  20=MAINE
                  21=MARYLAND
                  22=MASSACHUSETTS
                  23=MICHIGAN
                  24=MINNESOTA
                  25=MISSISSIPPI
                  26=MISSOURI
                  27=MONTANA
                  28=NEBRASKA
                  29=NEVADA
                  30=NEW HAMPSHIRE
                  31=NEW JERSEY
                  32=NEW MEXICO
                  33=NEW YORK
                  34=NORTH CAROLINA
                  35=NORTH DAKOTA
                  36=OHIO
                  37=OKLAHOMA
                  38=OREGON
                  39=PENNSYLVANIA
                  40=PUERTO RICO
                  41=RHODE ISLAND
                  42=SOUTH CAROLINA
                  43=SOUTH DAKOTA
                  44=TENNESSEE
                  45=TEXAS
                  46=UTAH
                  47=VERMONT
                  48=VIRGIN ISLANDS
                  49=VIRGINIA
                  50=WASHINGTON
                  51=WEST VIRGINIA
                  52=WISCONSIN
                  53=WYOMING
                  54=AFRICA
                  56=CANADA
                  57=WEST INDIES
                  58=EUROPE
                  59=MEXICO
                  60=OCEANIA
                  61=PHILIPPINES
                  62=SOUTH AMERICA
                  63=UNITED STATES POSSESSIONS
                  64=AMERICAN SAMOA
                  65=GUAM
                  66=SAIPAN
                  99=INTERNATIONAL

   State Region Code                                 3    175   177  VARCHAR2
     Description: Identifies the region within a state where the provider
                  is located.
     SAS Name:    STATE_RGN_CD
     COBOL Name:  STATE-RGN-CD
     VALUES:      AK/001=ALASKA
                  AK/LAB=LABORATORIES
                  AK/NPH=NON-PARTICIPATING HOSPITAL
                  AL/001=ALABAMA
                  AL/LAB=LABORATORIES
                  AL/NPH=NON-PARTICIPATING HOSPITAL
                  AR/001=ARKANSAS
                  AR/LAB=LABORATORIES
                  AR/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 15
            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  AS/001=AMERICAN SAMOA
                  AS/LAB=LABORATORY
                  AS/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/AZ=PHOENIX
                  AZ/LAB=ARIZONA LAB
                  AZ/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/TUC=TUCSON
                  CA/001=CALIFORNIA
                  CA/BAK=BAKERSFIELD
                  CA/BER=SAN BERNARDINO
                  CA/EB=East Bay
                  CA/FR=FRESNO
                  CA/L1=L.A. WEST
                  CA/L2=L.A. NORTH
                  CA/L3=L.A. CENTRAL
                  CA/L4=L.A. EAST
                  CA/L5=SAN GABRIEL
                  CA/LA1=LA Region 1
                  CA/LA2=LA Region 2
                  CA/LA3=LA Region 3
                  CA/LA4=LA Acute/Ancillary
                  CA/LA5=LA HHA/Hospice
                  CA/LA6=LA ICF/DD/CLinics
                  CA/LAB=LABORATORIES
                  CA/M1=LAB. SOUTH
                  CA/M2=LAB. NORTH
                  CA/NPH=NON-PARTICIPATING HOSPITAL
                  CA/ORG=ORANGE
                  CA/RIV=RIVERSIDE
                  CA/S1=SACRAMENTO
                  CA/S3=CHICO
                  CA/SD=SAN DIEGO
                  CA/SF=SAN FRANCISCO
                  CA/SJ=SAN JOSE
                  CA/SR=SANTA ROSA
                  CA/VEN=VENTURA
                  CN/001=CANADA
                  CN/LAB=LABORATORY
                  CN/NPH=NON-PARTICIPATING HOSPITAL
                  CO/001=COLORADO
                  CO/LAB=LABORATORIES
                  CO/NPH=NON-PARTICIPATING HOSPITAL
                  CT/001=CONNECTICUT
                  CT/LAB=LABORATORIES
                  CT/NPH=NON-PARTICIPATING HOSPITAL
                  DC/001=DISTRICT OF COLUMBIA
                  DC/LAB=LABORATORIES
                  DC/NPH=NON-PARTICIPATING HOSPITAL
                  DE/001=DELAWARE
                  DE/LAB=LABORATORIES
                  DE/NPH=NON-PARTICIPATING HOSPITAL
                  FL/001=FLORIDA
                  FL/FTM=FT. MYERS
                  FL/GAI=GAINESVILLE
                  FL/JAX=JACKSONVILLE
                  FL/LAB=LABORATORIES
                  FL/LAN=LANTANA
                  FL/LAU=LAUDERHILL
                  FL/MIA=MIAMI
                  FL/NPH=NON-PARTICIPATING HOSPITAL
                  FL/ORL=ORLANDO
                  FL/PEN=PENSACOLA
                  FL/STP=ST. PETERSBURG
                  FL/TAL=TALLAHASSEE


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 16
            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  FL/TAM=TAMPA
                  FM/001=FEDERATED STATES OF MICRO
                  FM/NPH=NON-PARTICIPATING HOSPITAL
                  FN/001=INTERNATIONAL
                  FN/LAB=LABORATORIES
                  FN/NPH=NON-PARTICIPATING HOSPITAL
                  GA/001=GEORGIA
                  GA/GAA=GEORGIA ALL
                  GA/GAC=GEORGIA CENTRAL
                  GA/GAE=GEORGIA EASTERN
                  GA/GAN=GEORGIA NORTH
                  GA/GAS=GEORGIA SOUTH
                  GA/GAW=GEORGIA WESTERN
                  GA/LAB=LABORATORIES
                  GA/NPH=NON-PARTICIPATING HOSPITAL
                  GU/001=GUAM
                  GU/LAB=LABORATORIES
                  GU/NPH=NON-PARTICIPATING HOSPITAL
                  HI/001=HAWAII
                  HI/LAB=LABORATORIES
                  HI/NPH=NON-PARTICIPATING HOSPITAL
                  IA/001=IOWA
                  IA/LAB=LABORATORIES
                  IA/NPH=NON-PARTICIPATING HOSPITAL
                  ID/001=IDAHO
                  ID/LAB=LABORATORIES
                  ID/NPH=NON-PARTICIPATING HOSPITAL
                  IL/001=ILLINOIS
                  IL/LAB=LABORATORIES
                  IL/NPH=NON-PARTICIPATING HOSPITAL
                  IN/001=INDIANA
                  IN/LAB=LABORATORIES
                  IN/NPH=NON-PARTICIPATING HOSPITAL
                  KS/001=KANSAS
                  KS/KCK=KANSAS CITY
                  KS/KDH=KDHE
                  KS/LAB=LABORATORIES
                  KS/LAW=LAWRENCE
                  KS/NC=NORTH CENTRAL KANSAS
                  KS/NE=NORTH EAST KANSAS
                  KS/NPH=NON-PARTICIPATING HOSPITAL
                  KS/NW=NORTH WEST KANSAS
                  KS/SC=SOUTH CENTRAL KANSAS
                  KS/SE=SOUTH EAST KANSAS
                  KS/SW=SOUTH WEST KANSAS
                  KS/WST=WEST
                  KY/2C1=HOPKINSVILLE
                  KY/2C2=LOUISVILLE
                  KY/2C3=LONDON
                  KY/2C4=LEXINGTON
                  KY/LAB=LABORATORIES
                  KY/NPH=NON-PARTICIPATING HOSPITAL
                  LA/001=LOUISIANA
                  LA/LA1=NEW ORLEANS
                  LA/LA2=MANDEVILLE
                  LA/LA3=LAFAYETTE
                  LA/LA4=MONROE
                  LA/LA5=SHREVEPORT
                  LA/LA6=ALEXANDRIA
                  LA/LAB=LABORATORIES
                  LA/LB1=CLIA NEW ORLEANS
                  LA/LB5=CLIA SHREVEPORT
                  LA/LB6=CLIA ALEXANDRIA
                  LA/NPH=NON-PARTICIPATING HOSPITAL


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            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  MA/001=MASSACHUSETTS
                  MA/LAB=LABORATORIES
                  MA/NPH=NON-PARTICIPATING HOSPITAL
                  MD/001=MARYLAND
                  MD/LAB=LABORATORIES
                  MD/NPH=NON-PARTICIPATING HOSPITAL
                  ME/001=MAINE
                  ME/LAB=LABORATORIES
                  ME/NPH=NON-PARTICIPATING HOSPITAL
                  MH/001=MARSHALL ISLANDS
                  MH/NPH=NON-PARTICIPATING HOSPITAL
                  MI/001=MICHIGAN
                  MI/LAB=LABORATORIES
                  MI/NPH=NON-PARTICIPATING HOSPITAL
                  MN/001=MINNESOTA
                  MN/LAB=LABORATORIES
                  MN/NPH=NON-PARTICIPATING HOSPITAL
                  MO/001=MISSOURI
                  MO/01=REGION01
                  MO/02=REGION02
                  MO/03=REGION 03
                  MO/04=REGION 04
                  MO/05=REGION 05
                  MO/06=REGION 06
                  MO/07=REGION 07
                  MO/1NH=REGION 1 NH
                  MO/2NH=REGION 2 NH
                  MO/3NH=REGION 3 NH
                  MO/4NH=REGION 4 NH
                  MO/5NH=REGION 5 NH
                  MO/6NH=REGION 6 NH
                  MO/7NH=REGION 7 NH
                  MO/LAB=LABORATORIES
                  MO/MO=STATEWIDE
                  MO/NPH=NON-PARTICIPATING HOSPITAL
                  MP/001=NORTHERN MARIANA ISLANDS
                  MP/LAB=LABORATORIES
                  MP/NPH=NON-PARTICIPATING HOSPITAL
                  MS/001=MISSISSIPPI
                  MS/LAB=LABORATORIES
                  MS/NPH=NON-PARTICIPATING HOSPITAL
                  MT/001=MONTANA
                  MT/LAB=LABORATORIES
                  MT/NPH=NON-PARTICIPATING HOSPITAL
                  MX/001=MEXICO
                  MX/LAB=LABORATORY
                  MX/NPH=NON-PARTICIPATING HOSPITAL
                  NC/001=NORTH CAROLINA
                  NC/LAB=LABORATORIES
                  NC/NCC=NORTH CAROLINA CENTRAL
                  NC/NCE=NORTH CAROLINA EAST
                  NC/NCN=NORTH CAROLINA NORTH
                  NC/NCS=NORTH CAROLINA SOUTH
                  NC/NCW=NORTH CAROLINA WEST
                  NC/NPH=NON-PARTICIPATING HOSPITAL
                  ND/001=NORTH DAKOTA
                  ND/LAB=LABORATORIES
                  ND/NPH=NON-PARTICIPATING HOSPITAL
                  NE/001=NEBRASKA
                  NE/1=NORTH CENTRAL
                  NE/2=CENTRAL
                  NE/3=NORTHEAST
                  NE/4=SOUTHEAST
                  NE/5=WESTERN


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            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  NE/LAB=LABORATORIES
                  NE/NPH=NON-PARTICIPATING HOSPITAL
                  NH/001=NEW HAMPSHIRE
                  NH/LAB=LABORATORIES
                  NH/NPH=NON-PARTICIPATING HOSPITAL
                  NJ/001=NEW JERSEY
                  NJ/LAB=LABORATORIES
                  NJ/NPH=NON-PARTICIPATING HOSPITAL
                  NM/001=NEW MEXICO
                  NM/LAB=LABORATORIES
                  NM/NPH=NON-PARTICIPATING HOSPITAL
                  NV/001=NEVADA
                  NV/CC=CARSON CITY
                  NV/LAB=LABORATORIES
                  NV/LV=LAS VEGAS
                  NV/NPH=NON-PARTICIPATING HOSPITAL
                  NY/001=BUFFALO
                  NY/002=ROCHESTER
                  NY/003=SYRACUSE
                  NY/004=ALBANY
                  NY/005=NEW ROCHELLE
                  NY/006=NEW YORK CITY
                  NY/007=SUFFOLK/NASSAU COUNTY
                  NY/LAB=LABORATORIES
                  NY/NPH=NON-PARTICIPATING HOSPITAL
                  OH/001=OHIO
                  OH/LAB=LABORATORIES
                  OH/NPH=NON-PARTICIPATING HOSPITAL
                  OK/001=OKLAHOMA
                  OK/LAB=LABORATORIES
                  OK/NPH=NON-PARTICIPATING HOSPITAL
                  OR/001=OFFICE #1
                  OR/002=OFFICE #2
                  OR/003=OFFICE #3
                  OR/LAB=LABORATORIES
                  OR/NPH=NON-PARTICIPATING HOSPITAL
                  PA/001=PENNSYLVANIA
                  PA/LAB=LABORATORIES
                  PA/NPH=NON-PARTICIPATING HOSPITAL
                  PR/001=PUERTO RICO
                  PR/LAB=LABORATORIES
                  PR/NPH=NON-PARTICIPATING HOSPITAL
                  PW/001=PALAU
                  PW/NPH=NON-PARTICIPATING HOSPITAL
                  RI/001=RHODE ISLAND
                  RI/LAB=LABORATORIES
                  RI/NPH=NON-PARTICIPATING HOSPITAL
                  SC/001=SOUTH CAROLINA
                  SC/LAB=LABORATORIES
                  SC/NPH=NON-PARTICIPATING HOSPITAL
                  SD/001=SOUTH DAKOTA
                  SD/LAB=LABORATORIES
                  SD/NPH=NON-PARTICIPATING HOSPITAL
                  TN/001=TENNESSEE
                  TN/LAB=LABORATORIES
                  TN/NPH=NON-PARTICIPATING HOSPITAL
                  TN/TNC=TENNESSEE COOKEVILLE
                  TN/TNE=TENNESSEE EASTERN
                  TN/TNM=TENNESSEE MIDDLE
                  TN/TNW=TENNESSEE WESTERN
                  TX/001=TEXAS
                  TX/L01=AMARILLO-LTC
                  TX/L02=ABILENE-LTC
                  TX/L03=ARLINGTON-LTC


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            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  TX/L04=TYLER-LTC
                  TX/L05=TEMPLE-LTC
                  TX/L06=HOUSTON-LTC
                  TX/L07=SAN ANTONIO-LTC
                  TX/LAB=LABORATORIES
                  TX/NPH=NON-PARTICIPATING HOSPITAL
                  TX/TX1=NLTC REG 1, 7, 9, 10
                  TX/TX2=NLTC REG 2, 3
                  TX/TX4=NLTC REG 6
                  TX/TX5=NLTC REG 4, 5
                  TX/TX6=AUSTIN
                  TX/TX8=NLTC REG 8, 11
                  UT/001=UTAH
                  UT/LAB=LABORATORIES
                  UT/NPH=NON-PARTICIPATING HOSPITAL
                  VA/001=VIRGINIA
                  VA/LAB=LABORATORIES
                  VA/NPH=NON-PARTICIPATING HOSPITAL
                  VI/001=VIRGIN ISLANDS
                  VI/LAB=LABORATORIES
                  VI/NPH=NON-PARTICIPATING HOSPITAL
                  VT/001=VERMONT
                  VT/LAB=LABORATORIES
                  VT/NPH=NON-PARTICIPATING HOSPITAL
                  WA/001=ALL OTHERS (NON-LTC FAC)
                  WA/D1=SPOKANE & YAKIMA AREAS
                  WA/D1A=District 1, Unit A
                  WA/D1B=District 1, Unit B
                  WA/D1C=District 1, Unit C
                  WA/D1D=District 1, Unit D
                  WA/D1E=District 1, Unit E
                  WA/D2=SPOKANE & SE
                  WA/D2A=District 2, Unit A
                  WA/D2B=District 2, Unit B
                  WA/D2C=District 2, Unit C
                  WA/D2D=District 2, Unit D
                  WA/D2E=District 2, Unit E
                  WA/D2F=District 2, Unit F
                  WA/D2G=District 2, Unit G
                  WA/D2H=District 2, Unit H
                  WA/D2I=District 2, Unit I
                  WA/D2J=District 2, Unit J
                  WA/D3=NW WASHINGTON
                  WA/D3A=District 3, Unit A
                  WA/D3B=District 3, Unit B
                  WA/D3C=District 3, Unit C
                  WA/D3D=District 3, Unit D
                  WA/D3E=District 3, Unit E
                  WA/D3F=District 3, Unit F
                  WA/D3G=District 3, Unit G
                  WA/D4A=GREATER SEATTLE AREA
                  WA/D4B=S KING COUNTY
                  WA/D5A=PIERCE CTY & PENINSULA
                  WA/D5B=PIERCE CTY & GRAYS HARBOR
                  WA/D6=OLYMPIA AREA
                  WA/LAB=LABORATORIES
                  WA/NPH=NON-PARTICIPATING HOSPITAL
                  WI/001=WISCONSIN
                  WI/LAB=LABORATORIES
                  WI/NPH=NON-PARTICIPATING HOSPITAL
                  WV/001=WEST VIRGINIA
                  WV/LAB=LABORATORIES
                  WV/NPH=NON-PARTICIPATING HOSPITAL
                  WY/001=WYOMING


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            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  WY/LAB=LABORATORIES
                  WY/NPH=NON-PARTICIPATING HOSPITAL

   Address: Street                                   50   178   227  VARCHAR2
     Description: Street address where the provider is located.
     SAS Name:    ST_ADR
     COBOL Name:  ST-ADR

   Telephone Number                                  10   228   237  VARCHAR2
     Description: Telephone number of the provider.
     SAS Name:    PHNE_NUM
     COBOL Name:  PHNE-NUM

   Termination Code                                  2    238   239  VARCHAR2
     Description: Indicates the current termination status for the
                  provider.
     SAS Name:    PGM_TRMNTN_CD
     COBOL Name:  PGM-TRMNTN-CD
     VALUES:      00=ACTIVE PROVIDER
                  01=VOLUNTARY-MERGER, CLOSURE
                  02=VOLUNTARY-DISSATISFACTION WITH REIMBURSEMENT
                  03=VOLUNTARY-RISK OF INVOLUNTARY TERMINATION
                  04=VOLUNTARY-OTHER REASON FOR WITHDRAWAL
                  05=INVOLUNTARY-FAILURE TO MEET HEALTH/SAFETY REQ
                  06=INVOLUNTARY-FAILURE TO MEET AGREEMENT
                  07=OTHER-PROVIDER STATUS CHANGE
                  08=NONPAYMENT OF FEES - CLIA Only
                  09=REV/UNSUCCESSFUL PARTICIPATION IN PT - CLIA Only
                  10=REV/OTHER REASON - CLIA Only
                  11=INCOMPLETE CLIA APPLICATION INFORMATION - CLIA Only
                  12=NO LONGER PERFORMING TESTS - CLIA Only
                  13=MULTIPLE TO SINGLE SITE CERTIFICATE - CLIA Only
                  14=SHARED LABORATORY - CLIA Only
                  15=FAILURE TO RENEW WAIVER PPM CERTIFICATE - CLIA Only
                  16=DUPLICATE CLIA NUMBER - CLIA Only
                  17=MAIL RETURNED NO FORWARD ADDRESS CERT ENDED - CLIA Only
                  20=NOTIFICATION BANKRUPTCY - CLIA Only
                  33=ACCREDITATION NOT CONFIRMED - CLIA Only
                  80=AWAITING STATE APPROVAL
                  99=OIG ACTION - DO NOT ACTIVATE - CLIA Only

   Termination or Expiration Date                    8    240   247  DATE
     Description: Date the provider was terminated.  For CLIA providers,
                  date the laboratory's certificate was terminated or the
                  expiration date of the current CLIA certificate.
     SAS Name:    TRMNTN_EXPRTN_DT
     COBOL Name:  TRMNTN-EXPRTN-DT

   Type of Action Code                               1    248   248  VARCHAR2
     Description: Identifies the reason for the certification.  Type of
                  action from the official survey record, CMS 1539 form.
     SAS Name:    CRTFCTN_ACTN_TYPE_CD
     COBOL Name:  CRTFCTN-ACTN-TYPE-CD
     VALUES:      1=INITIAL
                  2=RECERTIFICATION
                  3=TERMINATION
                  4=CHANGE OF OWNERSHIP
                  5=VALIDATION
                  8=FULL SURVEY AFTER COMPLAINT

   Ownership Type Code                               2    249   250  VARCHAR2
     Description: Indicates the ownership type of the provider.
     SAS Name:    GNRL_CNTL_TYPE_CD
     COBOL Name:  GNRL-CNTL-TYPE-CD


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            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     VALUES:      01=VOLUNTARY NON PROFIT - RELIGIOUS AFFILIATION
                  02=VOLUNTARY NON-PROFIT - PRIVATE
                  03=VOLUNTARY NON-PROFIT - OTHER
                  04=PROPRIETARY
                  05=GOVERNMENT - STATE/COUNTY
                  06=GOVERNMENT - COMBINATION GOVT & VOLUNTARY
                  07=GOVERNMENT - LOCAL

   Address: ZIP Code                                 5    251   255  VARCHAR2
     Description: Five-digit ZIP code for a provider's physical address.
     SAS Name:    ZIP_CD
     COBOL Name:  ZIP-CD

   FIPS State Code                                   2    256   257  VARCHAR2
     Description: FIPS State Code
     SAS Name:    FIPS_STATE_CD
     COBOL Name:  FIPS-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  04=ARIZONA
                  05=ARKANSAS
                  06=CALIFORNIA
                  08=COLORADO
                  09=CONNECTICUT
                  10=DELAWARE
                  11=DISTRICT OF COLUMBIA
                  12=FLORIDA
                  13=GEORGIA
                  15=HAWAII
                  16=IDAHO
                  17=ILLINOIS
                  18=INDIANA
                  19=IOWA
                  20=KANSAS
                  21=KENTUCKY
                  22=LOUISIANA
                  23=MAINE
                  24=MARYLAND
                  25=MASSACHUSETTS
                  26=MICHIGAN
                  27=MINNESOTA
                  28=MISSISSIPPI
                  29=MISSOURI
                  30=MONTANA
                  31=NEBRASKA
                  32=NEVADA
                  33=NEW HAMPSHIRE
                  34=NEW JERSEY
                  35=NEW MEXICO
                  36=NEW YORK
                  37=NORTH CAROLINA
                  38=NORTH DAKOTA
                  39=OHIO
                  40=OKLAHOMA
                  41=OREGON
                  42=PENNSYLVANIA
                  43=PUERTO RICO
                  44=RHODE ISLAND
                  45=SOUTH CAROLINA
                  46=SOUTH DAKOTA
                  47=TENNESSEE
                  48=TEXAS
                  49=UTAH
                  50=VERMONT


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            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  51=VIRGINIA
                  53=WASHINGTON
                  54=WEST VIRGINIA
                  55=WISCONSIN
                  56=WYOMING
                  60=AMERICAN SAMOA
                  66=GUAM
                  69=SAIPAN/MARIANA IS.
                  78=VIRGIN ISLANDS

   FIPS County Code                                  3    258   260  VARCHAR2
     Description: FIPS County Code
     SAS Name:    FIPS_CNTY_CD
     COBOL Name:  FIPS-CNTY-CD

   CBSA Urban Rural Indicator                        1    261   261  VARCHAR2
     Description: CBSA (Core Based Statistical Area) indicates whether the
                  county is defined as Urban or Rural.
     SAS Name:    CBSA_URBN_RRL_IND
     COBOL Name:  CBSA-URBN-RRL-IND

   CBSA Code                                         5    262   266  VARCHAR2
     Description: CBSA (Core Based Statistical Area) geographic entities
                  defined by the U.S. Office of Management and Budget (OMB)
                  on June 6, 2003 for use by Federal statistical agencies
                  in collecting, tabulating, and publishing Federal
                  statistics.  CBSA collectively refers to MSA.
     SAS Name:    CBSA_CD
     COBOL Name:  CBSA-CD

  *Accreditation Type Code                           1    283   283  VARCHAR2
     Description: Indicates an accrediting organization deeming the
                  provider.  If a provider is deemed by multiple
                  accrediting organizations then the accrediting
                  organization with the earliest active deeming effective
                  date is displayed in this field.
     SAS Name:    ACRDTN_TYPE_CD
     COBOL Name:  ACRDTN-TYPE-CD
     VALUES:      0=UNACCREDITED
                  1=JC
                  2=CHAP
                  3=ACHC

   Services: Laboratory Code                         1    313   313  CHAR
     Description: Indicates how laboratory services are provided.
     SAS Name:    LAB_SRVC_CD
     COBOL Name:  LAB-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Services: Pharmacy Code                           1    314   314  CHAR
     Description: Indicates how pharmaceutical services are provided.
     SAS Name:    PHRMCY_SRVC_CD
     COBOL Name:  PHRMCY-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Branch Count                                      3    377   379  NUMBER
     Description: Number of branches operated by the home health agency.
     SAS Name:    BRNCH_CNT


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            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     COBOL Name:  BRNCH-CNT

   Branch Operation Indicator                        1    380   380  VARCHAR2
     Description: Indicates if the home health agency operates any
                  branches.
     SAS Name:    BRNCH_OPRTN_SW
     COBOL Name:  BRNCH-OPRTN-SW

   Category-specific Facility Type Code              2    388   389  VARCHAR2
     Description: Indicates the category-specific facility type code, for
                  certain provider categories only.
     SAS Name:    GNRL_FAC_TYPE_CD
     COBOL Name:  GNRL-FAC-TYPE-CD
     VALUES:      01=Visiting Nurse Association
                  02=Combination Government Voluntary
                  03=Official Health Agency
                  04=Rehabilitation Facility Based Program
                  05=Hospital Based Program
                  06=Skilled Nursing Facility Based Program
                  07=Other

   CHOW Indicator                                    1    390   390  VARCHAR2
     Description: Indicates if the home health agency has undergone a
                  change of ownership since the last survey.
     SAS Name:    CHOW_SW
     COBOL Name:  CHOW-SW

   Fiscal Year End Date (MMDD)                       4    464   467  VARCHAR2
     Description: End date, consisting of the month and day, of the
                  provider's fiscal year.
     SAS Name:    FY_END_MO_DAY_CD
     COBOL Name:  FY-END-MO-DAY-CD

   HHA Qualified For OPT Indicator                   1    479   479  VARCHAR2
     Description: Indicates if a home health agency is qualified to provide
                  outpatient physical therapy/speech services.
     SAS Name:    HHA_QLFYD_OPT_SPCH_SW
     COBOL Name:  HHA-QLFYD-OPT-SPCH-SW

   Home Health Aide Training Program Code            1    480   480  VARCHAR2
     Description: Indicates how the agency provides home health aide
                  training and competency evaluation programs.
     SAS Name:    HH_AIDE_TRNG_PGM_CD
     COBOL Name:  HH-AIDE-TRNG-PGM-CD
     VALUES:      1=HOME HEALTH AIDE TRAINING
                  2=HOME HEALTH AIDE COMPETENCY EVALUATION PROG.
                  3=HOME HEALTH AIDE TRAINING/COMPETENCY PROGRAMS
                  4=NEITHER

   Hospice Indicator                                 1    482   482  VARCHAR2
     Description: Indicates if the home health agency also participates in
                  the Medicare program as a hospice.
     SAS Name:    MDCR_HOSPC_SW
     COBOL Name:  MDCR-HOSPC-SW

   Medicare Hospice Provider Num                     10   496   505  CHAR
     Description: Medicare hospice provider number
     SAS Name:    MEDICARE_HOSPICE_PROVIDER_NUM
     COBOL Name:  MEDICARE-HOSPICE-PROVIDER-NUM

   Medicare Medicaid Prvdr Number                    6    507   512  CHAR
     Description: Medicare/Medicaid provider number
     SAS Name:    MEDICARE_MEDICAID_PRVDR_NUMBER
     COBOL Name:  MEDICARE-MEDICAID-PRVDR-NUMBER


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            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Program Participation Code                        1    640   640  CHAR
     Description: Indicates if the provider participates in Medicare,
                  Medicaid, or both programs.
     SAS Name:    PGM_PRTCPTN_CD
     COBOL Name:  PGM-PRTCPTN-CD
     VALUES:      1=MEDICARE ONLY
                  2=MEDICAID ONLY
                  3=MEDICARE AND MEDICAID

   Related Provider Number                           10   686   695  CHAR
     Description: Related provider number
     SAS Name:    RELATED_PROVIDER_NUMBER
     COBOL Name:  RELATED-PROVIDER-NUMBER

   Services: Home Health Aide Code                   1    698   698  CHAR
     Description: Indicates how home health aide services are provided.
     SAS Name:    HH_AIDE_SRVC_CD
     COBOL Name:  HH-AIDE-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Services: Appliance and Equipment Code            1    701   701  VARCHAR2
     Description: Indicates how appliance and equipment services are
                  provided by a home health agency.
     SAS Name:    APLNC_EQUIP_SRVC_CD
     COBOL Name:  APLNC-EQUIP-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Services: Interns and Residents Code              1    742   742  VARCHAR2
     Description: Indicates how intern and resident services are provided
                  by a home health agency.
     SAS Name:    INTRN_RSDNT_SRVC_CD
     COBOL Name:  INTRN-RSDNT-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Services: Medical Social Code                     1    743   743  CHAR
     Description: Indicates how medical social services are provided.
     SAS Name:    MDCL_SCL_SRVC_CD
     COBOL Name:  MDCL-SCL-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Services: Nursing Code                            1    759   759  CHAR
     Description: Indicates how nursing services are provided.
     SAS Name:    NRSNG_SRVC_CD
     COBOL Name:  NRSNG-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Services: Nutritional Guidance Code               1    763   763  VARCHAR2
     Description: Indicates how nutritional guidance services are provided


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            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  by a home health agency.
     SAS Name:    NTRTNL_GDNC_SRVC_CD
     COBOL Name:  NTRTNL-GDNC-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Services: OT Code                                 1    775   775  CHAR
     Description: Indicates how occupational therapy services are provided.
     SAS Name:    OT_SRVC_CD
     COBOL Name:  OT-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Services: Other Code                              1    779   779  CHAR
     Description: Indicates how other services are provided.
     SAS Name:    OTHR_SRVC_CD
     COBOL Name:  OTHR-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Services: PT Code                                 1    813   813  CHAR
     Description: Indicates how physical therapy services are provided.
     SAS Name:    PT_SRVC_CD
     COBOL Name:  PT-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Services: Speech Therapy Code                     1    837   837  VARCHAR2
     Description: Indicates how speech therapy services are provided by the
                  home health agency.
     SAS Name:    SPCH_THRPY_SRVC_CD
     COBOL Name:  SPCH-THRPY-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Services: Vocational Guidance Code                1    853   853  VARCHAR2
     Description: Indicates how vocational guidance services are provided
                  by the home health agency.
     SAS Name:    VCTNL_GDNC_SRVC_CD
     COBOL Name:  VCTNL-GDNC-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Staff Count Override Indicator                    1    861   861  CHAR
     Description: Indicates if the regional office has approved a
                  significant staff count change from the previous
                  certification.
     SAS Name:    OVRRD_STFG_SW
     COBOL Name:  OVRRD-STFG-SW

   Staff Count: Other Personnel                      8    902   909  NUMBER
     Description: Number of full-time equivalent other personnel employed


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            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  by a provider
     SAS Name:    PRSNEL_OTHR_CNT
     COBOL Name:  PRSNEL-OTHR-CNT

   Staff Count: Dietitian                            8    982   989  NUMBER
     Description: Number of full-time equivalent dietitians employed by a
                  provider.
     SAS Name:    DIETN_CNT
     COBOL Name:  DIETN-CNT

   Staff Count: Home Health Aide                     8    1046  1053 NUMBER
     Description: Number of full-time equivalent home health aides employed
                  by a home health agency.
     SAS Name:    HH_AIDE_CNT
     COBOL Name:  HH-AIDE-CNT

   Staff Count: LPN/LVN - Employee                   8    1110  1117 NUMBER
     Description: Number of full-time equivalent licensed practical or
                  vocational nurses employed by a provider.
     SAS Name:    LPN_LVN_CNT
     COBOL Name:  LPN-LVN-CNT

   Staff Count: OT - Total                           8    1310  1317 NUMBER
     Description: Total number of full-time equivalent occupational
                  therapists employed by a provider.
     SAS Name:    OCPTNL_THRPST_CNT
     COBOL Name:  OCPTNL-THRPST-CNT

   Staff Count: PT                                   8    1630  1637 NUMBER
     Description: Number of full-time equivalent physical therapists
                  employed by a provider.
     SAS Name:    PHYS_THRPST_STF_CNT
     COBOL Name:  PHYS-THRPST-STF-CNT

   Staff Count: Registered Pharmacist                8    1734  1741 NUMBER
     Description: Number of full-time equivalent registered pharmacists
                  employed by the provider.
     SAS Name:    REG_PHRMCST_CNT
     COBOL Name:  REG-PHRMCST-CNT

   Staff Count: RN                                   8    1750  1757 NUMBER
     Description: Number of full-time equivalent registered nurses employed
                  by a provider.
     SAS Name:    RN_CNT
     COBOL Name:  RN-CNT

   Staff Count: Social Worker                        8    1814  1821 NUMBER
     Description: Number of full-time equivalent social workers employed by
                  the provider.
     SAS Name:    SCL_WORKR_CNT
     COBOL Name:  SCL-WORKR-CNT

   Staff Count: Speech Pathologist/Audiologist       8    1886  1893 NUMBER
     Description: Number of full-time equivalent speech pathologists or
                  audiologists employed by the provider.
     SAS Name:    SPCH_PTHLGST_AUDLGST_CNT
     COBOL Name:  SPCH-PTHLGST-AUDLGST-CNT

   Subunit Count                                     3    1952  1954 NUMBER
     Description: Number of subunits operated by the home health agency.
     SAS Name:    SBUNIT_CNT
     COBOL Name:  SBUNIT-CNT

   Subunit Indicator                                 1    1955  1955 VARCHAR2


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 27
            Home Health Agency, CATEGORY = "05" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Indicates if the home health agency is a subunit of
                  another agency.
     SAS Name:    SBUNIT_SW
     COBOL Name:  SBUNIT-SW

   Subunit Operation Indicator                       1    1956  1956 VARCHAR2
     Description: Indicates if the home health agency operates any
                  subunits.
     SAS Name:    SBUNIT_OPRTN_SW
     COBOL Name:  SBUNIT-OPRTN-SW
























































 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 1
Psychiatric Residential Treatment Facility, CATEGORY = "06" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Provider Category Subtype Code                    2    1     2    VARCHAR2
     Description: Identifies the subtype of the provider, within the
                  primary category.  Used in reporting to show the
                  breakdown of provider categories, mainly for hospitals
                  and SNFs.
     SAS Name:    PRVDR_CTGRY_SBTYP_CD
     COBOL Name:  PRVDR-CTGRY-SBTYP-CD
     VALUES:      01=Psychiatric Residential Treatment

   Provider Category Code                            2    3     4    VARCHAR2
     Description: Identifies the type of provider participating in the
                  Medicare/Medicaid program.
     SAS Name:    PRVDR_CTGRY_CD
     COBOL Name:  PRVDR-CTGRY-CD
     VALUES:      06=Psychiatric Residential Treatment Facility

   CHOW Count                                        2    5     6    NUMBER
     Description: Number of times this provider has undergone a change of
                  ownership.
     SAS Name:    CHOW_CNT
     COBOL Name:  CHOW-CNT

   CHOW Date                                         8    7     14   DATE
     Description: Effective date of the most recent change of ownership for
                  this provider.
     SAS Name:    CHOW_DT
     COBOL Name:  CHOW-DT

   Address: City                                     28   15    42   VARCHAR2
     Description: City in which the provider is physically located.
     SAS Name:    CITY_NAME
     COBOL Name:  CITY-NAME

   Compliance: Acceptable POC                        1    43    43   VARCHAR2
     Description: Indicates if a provider is in compliance with program
                  requirements based on an acceptable plan for correction
                  of deficiencies.
     SAS Name:    ACPTBL_POC_SW
     COBOL Name:  ACPTBL-POC-SW

   Compliance: Status                                1    44    44   VARCHAR2
     Description: Compliance status of a provider at the time of
                  certification survey.
     SAS Name:    CMPLNC_STUS_CD
     COBOL Name:  CMPLNC-STUS-CD
     VALUES:      A=IN COMPLIANCE
                  B=NOT IN COMPLIANCE

   SSA County Code                                   3    45    47   VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the county where the provider is located.
     SAS Name:    SSA_CNTY_CD
     COBOL Name:  SSA-CNTY-CD

   Cross Ref Provider Number                         10   48    57   CHAR
     Description: Cross reference provider number
     SAS Name:    CROSS_REF_PROVIDER_NUMBER
     COBOL Name:  CROSS-REF-PROVIDER-NUMBER

   Certification Date                                8    58    65   DATE
     Description: Equal to the exit date of the initial visit of the Health
                  survey for certifications completed after July 28, 2012.
                  For certifications prior to that date, the certification


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 2
Psychiatric Residential Treatment Facility, CATEGORY = "06" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  date is equal to the exit date of the initial visit of
                  the Health survey or LSC survey, whichever is later.
     SAS Name:    CRTFCTN_DT
     COBOL Name:  CRTFCTN-DT

   Eligibility Indicator                             1    66    66   VARCHAR2
     Description: Indicates if a facility is eligible to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    ELGBLTY_SW
     COBOL Name:  ELGBLTY-SW

   Facility Name                                     50   67    116  VARCHAR2
     Description: Name of the provider certified to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    FAC_NAME
     COBOL Name:  FAC-NAME

   Medicare Administrative Contractor (MAC) or       5    117   121  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_CD
     COBOL Name:  INTRMDRY-CARR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 3
Psychiatric Residential Treatment Facility, CATEGORY = "06" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 4
Psychiatric Residential Treatment Facility, CATEGORY = "06" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 5
Psychiatric Residential Treatment Facility, CATEGORY = "06" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 6
Psychiatric Residential Treatment Facility, CATEGORY = "06" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)
                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 7
Psychiatric Residential Treatment Facility, CATEGORY = "06" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   Medicaid Vendor Number                            15   122   136  VARCHAR2
     Description: Number which may be assigned to a provider by the state
                  Medicaid agency for external control or billing purposes.
     SAS Name:    MDCD_VNDR_NUM
     COBOL Name:  MDCD-VNDR-NUM

   Original Participation Date                       8    137   144  DATE
     Description: Date a provider is first approved to provide Medicare
                  and/or Medicaid services.
     SAS Name:    ORGNL_PRTCPTN_DT
     COBOL Name:  ORGNL-PRTCPTN-DT

   Prior CHOW Date                                   8    145   152  DATE
     Description: Effective date of the previous change of ownership for
                  this provider.
     SAS Name:    CHOW_PRIOR_DT
     COBOL Name:  CHOW-PRIOR-DT

   Prior Medicare Administrative Contractor (MAC) or 5    153   157  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the previous Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_PRIOR_CD
     COBOL Name:  INTRMDRY-CARR-PRIOR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 8
Psychiatric Residential Treatment Facility, CATEGORY = "06" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 9
Psychiatric Residential Treatment Facility, CATEGORY = "06" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 10
Psychiatric Residential Treatment Facility, CATEGORY = "06" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 11
Psychiatric Residential Treatment Facility, CATEGORY = "06" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 12
Psychiatric Residential Treatment Facility, CATEGORY = "06" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   CCN                                               10   158   167  VARCHAR2
     Description: Six or ten position identification number that is
                  assigned to a certified provider.  This is the CMS
                  Certification Number.
     SAS Name:    PRVDR_NUM
     COBOL Name:  PRVDR-NUM

   Region Code                                       2    168   169  VARCHAR2
     Description: Indicates the CMS Regional Office responsible for the
                  certification of the provider.
     SAS Name:    RGN_CD
     COBOL Name:  RGN-CD
     VALUES:      01=Boston
                  02=New York
                  03=Philadelphia
                  04=Atlanta
                  05=Chicago
                  06=Dallas
                  07=Kansas City
                  08=Denver
                  09=San Francisco
                  10=Seattle

   Skeleton Record Indicator                         1    170   170  VARCHAR2
     Description: Indicates if the record is a skeleton record.  Only a
                  limited set of data is available for this provider; no
                  survey data exists.  Only provider categories
                  01,17,19,21and 22 can have skeleton providers.
     SAS Name:    SKLTN_REC_SW
     COBOL Name:  SKLTN-REC-SW

   State Abbreviation                                2    171   172  VARCHAR2
     Description: Two-character state abbreviation.
     SAS Name:    STATE_CD
     COBOL Name:  STATE-CD
     VALUES:      AK=ALASKA
                  AL=ALABAMA
                  AR=ARKANSAS
                  AS=AMERICAN SAMOA
                  AZ=ARIZONA
                  CA=CALIFORNIA
                  CN=CANADA
                  CO=COLORADO
                  CT=CONNECTICUT
                  DC=DISTRICT OF COLUMBIA
                  DE=DELAWARE
                  FL=FLORIDA
                  FN=INTERNATIONAL
                  GA=GEORGIA
                  GU=GUAM
                  HI=HAWAII
                  IA=IOWA
                  ID=IDAHO


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 13
Psychiatric Residential Treatment Facility, CATEGORY = "06" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  IL=ILLINOIS
                  IN=INDIANA
                  KS=KANSAS
                  KY=KENTUCKY
                  LA=LOUISIANA
                  MA=MASSACHUSETTS
                  MD=MARYLAND
                  ME=MAINE
                  MI=MICHIGAN
                  MN=MINNESOTA
                  MO=MISSOURI
                  MP=SAIPAN
                  MS=MISSISSIPPI
                  MT=MONTANA
                  MX=MEXICO
                  NC=NORTH CAROLINA
                  ND=NORTH DAKOTA
                  NE=NEBRASKA
                  NH=NEW HAMPSHIRE
                  NJ=NEW JERSEY
                  NM=NEW MEXICO
                  NV=NEVADA
                  NY=NEW YORK
                  OH=OHIO
                  OK=OKLAHOMA
                  OR=OREGON
                  PA=PENNSYLVANIA
                  PR=PUERTO RICO
                  RI=RHODE ISLAND
                  SC=SOUTH CAROLINA
                  SD=SOUTH DAKOTA
                  TN=TENNESSEE
                  TX=TEXAS
                  UT=UTAH
                  VA=VIRGINIA
                  VI=VIRGIN ISLANDS
                  VT=VERMONT
                  WA=WASHINGTON
                  WI=WISCONSIN
                  WV=WEST VIRGINIA
                  WY=WYOMING

   SSA State Code                                    2    173   174  VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the state where the provider is located.
     SAS Name:    SSA_STATE_CD
     COBOL Name:  SSA-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  03=ARIZONA
                  04=ARKANSAS
                  05=CALIFORNIA
                  06=COLORADO
                  07=CONNECTICUT
                  08=DELAWARE
                  09=DISTRICT OF COLUMBIA
                  10=FLORIDA
                  11=GEORGIA
                  12=HAWAII
                  13=IDAHO
                  14=ILLINOIS
                  15=INDIANA
                  16=IOWA
                  17=KANSAS


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 14
Psychiatric Residential Treatment Facility, CATEGORY = "06" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  18=KENTUCKY
                  19=LOUISIANA
                  20=MAINE
                  21=MARYLAND
                  22=MASSACHUSETTS
                  23=MICHIGAN
                  24=MINNESOTA
                  25=MISSISSIPPI
                  26=MISSOURI
                  27=MONTANA
                  28=NEBRASKA
                  29=NEVADA
                  30=NEW HAMPSHIRE
                  31=NEW JERSEY
                  32=NEW MEXICO
                  33=NEW YORK
                  34=NORTH CAROLINA
                  35=NORTH DAKOTA
                  36=OHIO
                  37=OKLAHOMA
                  38=OREGON
                  39=PENNSYLVANIA
                  40=PUERTO RICO
                  41=RHODE ISLAND
                  42=SOUTH CAROLINA
                  43=SOUTH DAKOTA
                  44=TENNESSEE
                  45=TEXAS
                  46=UTAH
                  47=VERMONT
                  48=VIRGIN ISLANDS
                  49=VIRGINIA
                  50=WASHINGTON
                  51=WEST VIRGINIA
                  52=WISCONSIN
                  53=WYOMING
                  54=AFRICA
                  56=CANADA
                  57=WEST INDIES
                  58=EUROPE
                  59=MEXICO
                  60=OCEANIA
                  61=PHILIPPINES
                  62=SOUTH AMERICA
                  63=UNITED STATES POSSESSIONS
                  64=AMERICAN SAMOA
                  65=GUAM
                  66=SAIPAN
                  99=INTERNATIONAL

   State Region Code                                 3    175   177  VARCHAR2
     Description: Identifies the region within a state where the provider
                  is located.
     SAS Name:    STATE_RGN_CD
     COBOL Name:  STATE-RGN-CD
     VALUES:      AK/001=ALASKA
                  AK/LAB=LABORATORIES
                  AK/NPH=NON-PARTICIPATING HOSPITAL
                  AL/001=ALABAMA
                  AL/LAB=LABORATORIES
                  AL/NPH=NON-PARTICIPATING HOSPITAL
                  AR/001=ARKANSAS
                  AR/LAB=LABORATORIES
                  AR/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 15
Psychiatric Residential Treatment Facility, CATEGORY = "06" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  AS/001=AMERICAN SAMOA
                  AS/LAB=LABORATORY
                  AS/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/AZ=PHOENIX
                  AZ/LAB=ARIZONA LAB
                  AZ/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/TUC=TUCSON
                  CA/001=CALIFORNIA
                  CA/BAK=BAKERSFIELD
                  CA/BER=SAN BERNARDINO
                  CA/EB=East Bay
                  CA/FR=FRESNO
                  CA/L1=L.A. WEST
                  CA/L2=L.A. NORTH
                  CA/L3=L.A. CENTRAL
                  CA/L4=L.A. EAST
                  CA/L5=SAN GABRIEL
                  CA/LA1=LA Region 1
                  CA/LA2=LA Region 2
                  CA/LA3=LA Region 3
                  CA/LA4=LA Acute/Ancillary
                  CA/LA5=LA HHA/Hospice
                  CA/LA6=LA ICF/DD/CLinics
                  CA/LAB=LABORATORIES
                  CA/M1=LAB. SOUTH
                  CA/M2=LAB. NORTH
                  CA/NPH=NON-PARTICIPATING HOSPITAL
                  CA/ORG=ORANGE
                  CA/RIV=RIVERSIDE
                  CA/S1=SACRAMENTO
                  CA/S3=CHICO
                  CA/SD=SAN DIEGO
                  CA/SF=SAN FRANCISCO
                  CA/SJ=SAN JOSE
                  CA/SR=SANTA ROSA
                  CA/VEN=VENTURA
                  CN/001=CANADA
                  CN/LAB=LABORATORY
                  CN/NPH=NON-PARTICIPATING HOSPITAL
                  CO/001=COLORADO
                  CO/LAB=LABORATORIES
                  CO/NPH=NON-PARTICIPATING HOSPITAL
                  CT/001=CONNECTICUT
                  CT/LAB=LABORATORIES
                  CT/NPH=NON-PARTICIPATING HOSPITAL
                  DC/001=DISTRICT OF COLUMBIA
                  DC/LAB=LABORATORIES
                  DC/NPH=NON-PARTICIPATING HOSPITAL
                  DE/001=DELAWARE
                  DE/LAB=LABORATORIES
                  DE/NPH=NON-PARTICIPATING HOSPITAL
                  FL/001=FLORIDA
                  FL/FTM=FT. MYERS
                  FL/GAI=GAINESVILLE
                  FL/JAX=JACKSONVILLE
                  FL/LAB=LABORATORIES
                  FL/LAN=LANTANA
                  FL/LAU=LAUDERHILL
                  FL/MIA=MIAMI
                  FL/NPH=NON-PARTICIPATING HOSPITAL
                  FL/ORL=ORLANDO
                  FL/PEN=PENSACOLA
                  FL/STP=ST. PETERSBURG
                  FL/TAL=TALLAHASSEE


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 16
Psychiatric Residential Treatment Facility, CATEGORY = "06" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  FL/TAM=TAMPA
                  FM/001=FEDERATED STATES OF MICRO
                  FM/NPH=NON-PARTICIPATING HOSPITAL
                  FN/001=INTERNATIONAL
                  FN/LAB=LABORATORIES
                  FN/NPH=NON-PARTICIPATING HOSPITAL
                  GA/001=GEORGIA
                  GA/GAA=GEORGIA ALL
                  GA/GAC=GEORGIA CENTRAL
                  GA/GAE=GEORGIA EASTERN
                  GA/GAN=GEORGIA NORTH
                  GA/GAS=GEORGIA SOUTH
                  GA/GAW=GEORGIA WESTERN
                  GA/LAB=LABORATORIES
                  GA/NPH=NON-PARTICIPATING HOSPITAL
                  GU/001=GUAM
                  GU/LAB=LABORATORIES
                  GU/NPH=NON-PARTICIPATING HOSPITAL
                  HI/001=HAWAII
                  HI/LAB=LABORATORIES
                  HI/NPH=NON-PARTICIPATING HOSPITAL
                  IA/001=IOWA
                  IA/LAB=LABORATORIES
                  IA/NPH=NON-PARTICIPATING HOSPITAL
                  ID/001=IDAHO
                  ID/LAB=LABORATORIES
                  ID/NPH=NON-PARTICIPATING HOSPITAL
                  IL/001=ILLINOIS
                  IL/LAB=LABORATORIES
                  IL/NPH=NON-PARTICIPATING HOSPITAL
                  IN/001=INDIANA
                  IN/LAB=LABORATORIES
                  IN/NPH=NON-PARTICIPATING HOSPITAL
                  KS/001=KANSAS
                  KS/KCK=KANSAS CITY
                  KS/KDH=KDHE
                  KS/LAB=LABORATORIES
                  KS/LAW=LAWRENCE
                  KS/NC=NORTH CENTRAL KANSAS
                  KS/NE=NORTH EAST KANSAS
                  KS/NPH=NON-PARTICIPATING HOSPITAL
                  KS/NW=NORTH WEST KANSAS
                  KS/SC=SOUTH CENTRAL KANSAS
                  KS/SE=SOUTH EAST KANSAS
                  KS/SW=SOUTH WEST KANSAS
                  KS/WST=WEST
                  KY/2C1=HOPKINSVILLE
                  KY/2C2=LOUISVILLE
                  KY/2C3=LONDON
                  KY/2C4=LEXINGTON
                  KY/LAB=LABORATORIES
                  KY/NPH=NON-PARTICIPATING HOSPITAL
                  LA/001=LOUISIANA
                  LA/LA1=NEW ORLEANS
                  LA/LA2=MANDEVILLE
                  LA/LA3=LAFAYETTE
                  LA/LA4=MONROE
                  LA/LA5=SHREVEPORT
                  LA/LA6=ALEXANDRIA
                  LA/LAB=LABORATORIES
                  LA/LB1=CLIA NEW ORLEANS
                  LA/LB5=CLIA SHREVEPORT
                  LA/LB6=CLIA ALEXANDRIA
                  LA/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 17
Psychiatric Residential Treatment Facility, CATEGORY = "06" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  MA/001=MASSACHUSETTS
                  MA/LAB=LABORATORIES
                  MA/NPH=NON-PARTICIPATING HOSPITAL
                  MD/001=MARYLAND
                  MD/LAB=LABORATORIES
                  MD/NPH=NON-PARTICIPATING HOSPITAL
                  ME/001=MAINE
                  ME/LAB=LABORATORIES
                  ME/NPH=NON-PARTICIPATING HOSPITAL
                  MH/001=MARSHALL ISLANDS
                  MH/NPH=NON-PARTICIPATING HOSPITAL
                  MI/001=MICHIGAN
                  MI/LAB=LABORATORIES
                  MI/NPH=NON-PARTICIPATING HOSPITAL
                  MN/001=MINNESOTA
                  MN/LAB=LABORATORIES
                  MN/NPH=NON-PARTICIPATING HOSPITAL
                  MO/001=MISSOURI
                  MO/01=REGION01
                  MO/02=REGION02
                  MO/03=REGION 03
                  MO/04=REGION 04
                  MO/05=REGION 05
                  MO/06=REGION 06
                  MO/07=REGION 07
                  MO/1NH=REGION 1 NH
                  MO/2NH=REGION 2 NH
                  MO/3NH=REGION 3 NH
                  MO/4NH=REGION 4 NH
                  MO/5NH=REGION 5 NH
                  MO/6NH=REGION 6 NH
                  MO/7NH=REGION 7 NH
                  MO/LAB=LABORATORIES
                  MO/MO=STATEWIDE
                  MO/NPH=NON-PARTICIPATING HOSPITAL
                  MP/001=NORTHERN MARIANA ISLANDS
                  MP/LAB=LABORATORIES
                  MP/NPH=NON-PARTICIPATING HOSPITAL
                  MS/001=MISSISSIPPI
                  MS/LAB=LABORATORIES
                  MS/NPH=NON-PARTICIPATING HOSPITAL
                  MT/001=MONTANA
                  MT/LAB=LABORATORIES
                  MT/NPH=NON-PARTICIPATING HOSPITAL
                  MX/001=MEXICO
                  MX/LAB=LABORATORY
                  MX/NPH=NON-PARTICIPATING HOSPITAL
                  NC/001=NORTH CAROLINA
                  NC/LAB=LABORATORIES
                  NC/NCC=NORTH CAROLINA CENTRAL
                  NC/NCE=NORTH CAROLINA EAST
                  NC/NCN=NORTH CAROLINA NORTH
                  NC/NCS=NORTH CAROLINA SOUTH
                  NC/NCW=NORTH CAROLINA WEST
                  NC/NPH=NON-PARTICIPATING HOSPITAL
                  ND/001=NORTH DAKOTA
                  ND/LAB=LABORATORIES
                  ND/NPH=NON-PARTICIPATING HOSPITAL
                  NE/001=NEBRASKA
                  NE/1=NORTH CENTRAL
                  NE/2=CENTRAL
                  NE/3=NORTHEAST
                  NE/4=SOUTHEAST
                  NE/5=WESTERN


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 18
Psychiatric Residential Treatment Facility, CATEGORY = "06" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  NE/LAB=LABORATORIES
                  NE/NPH=NON-PARTICIPATING HOSPITAL
                  NH/001=NEW HAMPSHIRE
                  NH/LAB=LABORATORIES
                  NH/NPH=NON-PARTICIPATING HOSPITAL
                  NJ/001=NEW JERSEY
                  NJ/LAB=LABORATORIES
                  NJ/NPH=NON-PARTICIPATING HOSPITAL
                  NM/001=NEW MEXICO
                  NM/LAB=LABORATORIES
                  NM/NPH=NON-PARTICIPATING HOSPITAL
                  NV/001=NEVADA
                  NV/CC=CARSON CITY
                  NV/LAB=LABORATORIES
                  NV/LV=LAS VEGAS
                  NV/NPH=NON-PARTICIPATING HOSPITAL
                  NY/001=BUFFALO
                  NY/002=ROCHESTER
                  NY/003=SYRACUSE
                  NY/004=ALBANY
                  NY/005=NEW ROCHELLE
                  NY/006=NEW YORK CITY
                  NY/007=SUFFOLK/NASSAU COUNTY
                  NY/LAB=LABORATORIES
                  NY/NPH=NON-PARTICIPATING HOSPITAL
                  OH/001=OHIO
                  OH/LAB=LABORATORIES
                  OH/NPH=NON-PARTICIPATING HOSPITAL
                  OK/001=OKLAHOMA
                  OK/LAB=LABORATORIES
                  OK/NPH=NON-PARTICIPATING HOSPITAL
                  OR/001=OFFICE #1
                  OR/002=OFFICE #2
                  OR/003=OFFICE #3
                  OR/LAB=LABORATORIES
                  OR/NPH=NON-PARTICIPATING HOSPITAL
                  PA/001=PENNSYLVANIA
                  PA/LAB=LABORATORIES
                  PA/NPH=NON-PARTICIPATING HOSPITAL
                  PR/001=PUERTO RICO
                  PR/LAB=LABORATORIES
                  PR/NPH=NON-PARTICIPATING HOSPITAL
                  PW/001=PALAU
                  PW/NPH=NON-PARTICIPATING HOSPITAL
                  RI/001=RHODE ISLAND
                  RI/LAB=LABORATORIES
                  RI/NPH=NON-PARTICIPATING HOSPITAL
                  SC/001=SOUTH CAROLINA
                  SC/LAB=LABORATORIES
                  SC/NPH=NON-PARTICIPATING HOSPITAL
                  SD/001=SOUTH DAKOTA
                  SD/LAB=LABORATORIES
                  SD/NPH=NON-PARTICIPATING HOSPITAL
                  TN/001=TENNESSEE
                  TN/LAB=LABORATORIES
                  TN/NPH=NON-PARTICIPATING HOSPITAL
                  TN/TNC=TENNESSEE COOKEVILLE
                  TN/TNE=TENNESSEE EASTERN
                  TN/TNM=TENNESSEE MIDDLE
                  TN/TNW=TENNESSEE WESTERN
                  TX/001=TEXAS
                  TX/L01=AMARILLO-LTC
                  TX/L02=ABILENE-LTC
                  TX/L03=ARLINGTON-LTC


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Psychiatric Residential Treatment Facility, CATEGORY = "06" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  TX/L04=TYLER-LTC
                  TX/L05=TEMPLE-LTC
                  TX/L06=HOUSTON-LTC
                  TX/L07=SAN ANTONIO-LTC
                  TX/LAB=LABORATORIES
                  TX/NPH=NON-PARTICIPATING HOSPITAL
                  TX/TX1=NLTC REG 1, 7, 9, 10
                  TX/TX2=NLTC REG 2, 3
                  TX/TX4=NLTC REG 6
                  TX/TX5=NLTC REG 4, 5
                  TX/TX6=AUSTIN
                  TX/TX8=NLTC REG 8, 11
                  UT/001=UTAH
                  UT/LAB=LABORATORIES
                  UT/NPH=NON-PARTICIPATING HOSPITAL
                  VA/001=VIRGINIA
                  VA/LAB=LABORATORIES
                  VA/NPH=NON-PARTICIPATING HOSPITAL
                  VI/001=VIRGIN ISLANDS
                  VI/LAB=LABORATORIES
                  VI/NPH=NON-PARTICIPATING HOSPITAL
                  VT/001=VERMONT
                  VT/LAB=LABORATORIES
                  VT/NPH=NON-PARTICIPATING HOSPITAL
                  WA/001=ALL OTHERS (NON-LTC FAC)
                  WA/D1=SPOKANE & YAKIMA AREAS
                  WA/D1A=District 1, Unit A
                  WA/D1B=District 1, Unit B
                  WA/D1C=District 1, Unit C
                  WA/D1D=District 1, Unit D
                  WA/D1E=District 1, Unit E
                  WA/D2=SPOKANE & SE
                  WA/D2A=District 2, Unit A
                  WA/D2B=District 2, Unit B
                  WA/D2C=District 2, Unit C
                  WA/D2D=District 2, Unit D
                  WA/D2E=District 2, Unit E
                  WA/D2F=District 2, Unit F
                  WA/D2G=District 2, Unit G
                  WA/D2H=District 2, Unit H
                  WA/D2I=District 2, Unit I
                  WA/D2J=District 2, Unit J
                  WA/D3=NW WASHINGTON
                  WA/D3A=District 3, Unit A
                  WA/D3B=District 3, Unit B
                  WA/D3C=District 3, Unit C
                  WA/D3D=District 3, Unit D
                  WA/D3E=District 3, Unit E
                  WA/D3F=District 3, Unit F
                  WA/D3G=District 3, Unit G
                  WA/D4A=GREATER SEATTLE AREA
                  WA/D4B=S KING COUNTY
                  WA/D5A=PIERCE CTY & PENINSULA
                  WA/D5B=PIERCE CTY & GRAYS HARBOR
                  WA/D6=OLYMPIA AREA
                  WA/LAB=LABORATORIES
                  WA/NPH=NON-PARTICIPATING HOSPITAL
                  WI/001=WISCONSIN
                  WI/LAB=LABORATORIES
                  WI/NPH=NON-PARTICIPATING HOSPITAL
                  WV/001=WEST VIRGINIA
                  WV/LAB=LABORATORIES
                  WV/NPH=NON-PARTICIPATING HOSPITAL
                  WY/001=WYOMING


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Psychiatric Residential Treatment Facility, CATEGORY = "06" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  WY/LAB=LABORATORIES
                  WY/NPH=NON-PARTICIPATING HOSPITAL

   Address: Street                                   50   178   227  VARCHAR2
     Description: Street address where the provider is located.
     SAS Name:    ST_ADR
     COBOL Name:  ST-ADR

   Telephone Number                                  10   228   237  VARCHAR2
     Description: Telephone number of the provider.
     SAS Name:    PHNE_NUM
     COBOL Name:  PHNE-NUM

   Termination Code                                  2    238   239  VARCHAR2
     Description: Indicates the current termination status for the
                  provider.
     SAS Name:    PGM_TRMNTN_CD
     COBOL Name:  PGM-TRMNTN-CD
     VALUES:      00=ACTIVE PROVIDER
                  01=VOLUNTARY-MERGER, CLOSURE
                  02=VOLUNTARY-DISSATISFACTION WITH REIMBURSEMENT
                  03=VOLUNTARY-RISK OF INVOLUNTARY TERMINATION
                  04=VOLUNTARY-OTHER REASON FOR WITHDRAWAL
                  05=INVOLUNTARY-FAILURE TO MEET HEALTH/SAFETY REQ
                  06=INVOLUNTARY-FAILURE TO MEET AGREEMENT
                  07=OTHER-PROVIDER STATUS CHANGE
                  08=NONPAYMENT OF FEES - CLIA Only
                  09=REV/UNSUCCESSFUL PARTICIPATION IN PT - CLIA Only
                  10=REV/OTHER REASON - CLIA Only
                  11=INCOMPLETE CLIA APPLICATION INFORMATION - CLIA Only
                  12=NO LONGER PERFORMING TESTS - CLIA Only
                  13=MULTIPLE TO SINGLE SITE CERTIFICATE - CLIA Only
                  14=SHARED LABORATORY - CLIA Only
                  15=FAILURE TO RENEW WAIVER PPM CERTIFICATE - CLIA Only
                  16=DUPLICATE CLIA NUMBER - CLIA Only
                  17=MAIL RETURNED NO FORWARD ADDRESS CERT ENDED - CLIA Only
                  20=NOTIFICATION BANKRUPTCY - CLIA Only
                  33=ACCREDITATION NOT CONFIRMED - CLIA Only
                  80=AWAITING STATE APPROVAL
                  99=OIG ACTION - DO NOT ACTIVATE - CLIA Only

   Termination or Expiration Date                    8    240   247  DATE
     Description: Date the provider was terminated.  For CLIA providers,
                  date the laboratory's certificate was terminated or the
                  expiration date of the current CLIA certificate.
     SAS Name:    TRMNTN_EXPRTN_DT
     COBOL Name:  TRMNTN-EXPRTN-DT

   Type of Action Code                               1    248   248  VARCHAR2
     Description: Identifies the reason for the certification.  Type of
                  action from the official survey record, CMS 1539 form.
     SAS Name:    CRTFCTN_ACTN_TYPE_CD
     COBOL Name:  CRTFCTN-ACTN-TYPE-CD
     VALUES:      1=INITIAL
                  2=RECERTIFICATION
                  3=TERMINATION
                  4=CHANGE OF OWNERSHIP
                  5=VALIDATION
                  8=FULL SURVEY AFTER COMPLAINT

   Ownership Type Code                               2    249   250  VARCHAR2
     Description: Indicates the ownership type of the provider.
     SAS Name:    GNRL_CNTL_TYPE_CD
     COBOL Name:  GNRL-CNTL-TYPE-CD


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Psychiatric Residential Treatment Facility, CATEGORY = "06" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     VALUES:      01=PRIVATE NON PROFIT
                  02=PROPRIETARY
                  03=RELIGIOUS AFFILIATION
                  04=VOL. NON-PROF. - RELIGIOUS AFF.
                  05=FOR PROFIT
                  06=NOT FOR PROFIT
                  07=CORPORATION
                  08=STATE
                  09=LOCAL GOVERNMENT

   Address: ZIP Code                                 5    251   255  VARCHAR2
     Description: Five-digit ZIP code for a provider's physical address.
     SAS Name:    ZIP_CD
     COBOL Name:  ZIP-CD

   FIPS State Code                                   2    256   257  VARCHAR2
     Description: FIPS State Code
     SAS Name:    FIPS_STATE_CD
     COBOL Name:  FIPS-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  04=ARIZONA
                  05=ARKANSAS
                  06=CALIFORNIA
                  08=COLORADO
                  09=CONNECTICUT
                  10=DELAWARE
                  11=DISTRICT OF COLUMBIA
                  12=FLORIDA
                  13=GEORGIA
                  15=HAWAII
                  16=IDAHO
                  17=ILLINOIS
                  18=INDIANA
                  19=IOWA
                  20=KANSAS
                  21=KENTUCKY
                  22=LOUISIANA
                  23=MAINE
                  24=MARYLAND
                  25=MASSACHUSETTS
                  26=MICHIGAN
                  27=MINNESOTA
                  28=MISSISSIPPI
                  29=MISSOURI
                  30=MONTANA
                  31=NEBRASKA
                  32=NEVADA
                  33=NEW HAMPSHIRE
                  34=NEW JERSEY
                  35=NEW MEXICO
                  36=NEW YORK
                  37=NORTH CAROLINA
                  38=NORTH DAKOTA
                  39=OHIO
                  40=OKLAHOMA
                  41=OREGON
                  42=PENNSYLVANIA
                  43=PUERTO RICO
                  44=RHODE ISLAND
                  45=SOUTH CAROLINA
                  46=SOUTH DAKOTA
                  47=TENNESSEE
                  48=TEXAS


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Psychiatric Residential Treatment Facility, CATEGORY = "06" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  49=UTAH
                  50=VERMONT
                  51=VIRGINIA
                  53=WASHINGTON
                  54=WEST VIRGINIA
                  55=WISCONSIN
                  56=WYOMING
                  60=AMERICAN SAMOA
                  66=GUAM
                  69=SAIPAN/MARIANA IS.
                  78=VIRGIN ISLANDS

   FIPS County Code                                  3    258   260  VARCHAR2
     Description: FIPS County Code
     SAS Name:    FIPS_CNTY_CD
     COBOL Name:  FIPS-CNTY-CD

   CBSA Urban Rural Indicator                        1    261   261  VARCHAR2
     Description: CBSA (Core Based Statistical Area) indicates whether the
                  county is defined as Urban or Rural.
     SAS Name:    CBSA_URBN_RRL_IND
     COBOL Name:  CBSA-URBN-RRL-IND

   CBSA Code                                         5    262   266  VARCHAR2
     Description: CBSA (Core Based Statistical Area) geographic entities
                  defined by the U.S. Office of Management and Budget (OMB)
                  on June 6, 2003 for use by Federal statistical agencies
                  in collecting, tabulating, and publishing Federal
                  statistics.  CBSA collectively refers to MSA.
     SAS Name:    CBSA_CD
     COBOL Name:  CBSA-CD

   Bed Count: Total                                  4    373   376  NUMBER
     Description: Total number of beds in a provider, including those in
                  non-participating or non-licensed areas.
     SAS Name:    BED_CNT
     COBOL Name:  BED-CNT

   Fiscal Year End Date (MMDD)                       4    464   467  VARCHAR2
     Description: End date, consisting of the month and day, of the
                  provider's fiscal year.
     SAS Name:    FY_END_MO_DAY_CD
     COBOL Name:  FY-END-MO-DAY-CD























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          Portable X-Ray Supplier, CATEGORY = "07" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Provider Category Subtype Code                    2    1     2    VARCHAR2
     Description: Identifies the subtype of the provider, within the
                  primary category.  Used in reporting to show the
                  breakdown of provider categories, mainly for hospitals
                  and SNFs.
     SAS Name:    PRVDR_CTGRY_SBTYP_CD
     COBOL Name:  PRVDR-CTGRY-SBTYP-CD
     VALUES:      01=X-Ray

   Provider Category Code                            2    3     4    VARCHAR2
     Description: Identifies the type of provider participating in the
                  Medicare/Medicaid program.
     SAS Name:    PRVDR_CTGRY_CD
     COBOL Name:  PRVDR-CTGRY-CD
     VALUES:      07=Portable X-Ray Supplier

   CHOW Count                                        2    5     6    NUMBER
     Description: Number of times this provider has undergone a change of
                  ownership.
     SAS Name:    CHOW_CNT
     COBOL Name:  CHOW-CNT

   CHOW Date                                         8    7     14   DATE
     Description: Effective date of the most recent change of ownership for
                  this provider.
     SAS Name:    CHOW_DT
     COBOL Name:  CHOW-DT

   Address: City                                     28   15    42   VARCHAR2
     Description: City in which the provider is physically located.
     SAS Name:    CITY_NAME
     COBOL Name:  CITY-NAME

   Compliance: Acceptable POC                        1    43    43   VARCHAR2
     Description: Indicates if a provider is in compliance with program
                  requirements based on an acceptable plan for correction
                  of deficiencies.
     SAS Name:    ACPTBL_POC_SW
     COBOL Name:  ACPTBL-POC-SW

   Compliance: Status                                1    44    44   VARCHAR2
     Description: Compliance status of a provider at the time of
                  certification survey.
     SAS Name:    CMPLNC_STUS_CD
     COBOL Name:  CMPLNC-STUS-CD
     VALUES:      A=IN COMPLIANCE
                  B=NOT IN COMPLIANCE

   SSA County Code                                   3    45    47   VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the county where the provider is located.
     SAS Name:    SSA_CNTY_CD
     COBOL Name:  SSA-CNTY-CD

   Cross Ref Provider Number                         10   48    57   CHAR
     Description: Cross reference provider number
     SAS Name:    CROSS_REF_PROVIDER_NUMBER
     COBOL Name:  CROSS-REF-PROVIDER-NUMBER

   Certification Date                                8    58    65   DATE
     Description: Equal to the exit date of the initial visit of the Health
                  survey for certifications completed after July 28, 2012.
                  For certifications prior to that date, the certification


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 2
          Portable X-Ray Supplier, CATEGORY = "07" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  date is equal to the exit date of the initial visit of
                  the Health survey or LSC survey, whichever is later.
     SAS Name:    CRTFCTN_DT
     COBOL Name:  CRTFCTN-DT

   Eligibility Indicator                             1    66    66   VARCHAR2
     Description: Indicates if a facility is eligible to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    ELGBLTY_SW
     COBOL Name:  ELGBLTY-SW

   Facility Name                                     50   67    116  VARCHAR2
     Description: Name of the provider certified to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    FAC_NAME
     COBOL Name:  FAC-NAME

   Medicare Administrative Contractor (MAC) or       5    117   121  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_CD
     COBOL Name:  INTRMDRY-CARR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)


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          Portable X-Ray Supplier, CATEGORY = "07" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)


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          Portable X-Ray Supplier, CATEGORY = "07" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)


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   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 6
          Portable X-Ray Supplier, CATEGORY = "07" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)
                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 7
          Portable X-Ray Supplier, CATEGORY = "07" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   Medicaid Vendor Number                            15   122   136  VARCHAR2
     Description: Number which may be assigned to a provider by the state
                  Medicaid agency for external control or billing purposes.
     SAS Name:    MDCD_VNDR_NUM
     COBOL Name:  MDCD-VNDR-NUM

   Original Participation Date                       8    137   144  DATE
     Description: Date a provider is first approved to provide Medicare
                  and/or Medicaid services.
     SAS Name:    ORGNL_PRTCPTN_DT
     COBOL Name:  ORGNL-PRTCPTN-DT

   Prior CHOW Date                                   8    145   152  DATE
     Description: Effective date of the previous change of ownership for
                  this provider.
     SAS Name:    CHOW_PRIOR_DT
     COBOL Name:  CHOW-PRIOR-DT

   Prior Medicare Administrative Contractor (MAC) or 5    153   157  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the previous Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_PRIOR_CD
     COBOL Name:  INTRMDRY-CARR-PRIOR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 8
          Portable X-Ray Supplier, CATEGORY = "07" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 9
          Portable X-Ray Supplier, CATEGORY = "07" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 10
          Portable X-Ray Supplier, CATEGORY = "07" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 11
          Portable X-Ray Supplier, CATEGORY = "07" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 12
          Portable X-Ray Supplier, CATEGORY = "07" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   CCN                                               10   158   167  VARCHAR2
     Description: Six or ten position identification number that is
                  assigned to a certified provider.  This is the CMS
                  Certification Number.
     SAS Name:    PRVDR_NUM
     COBOL Name:  PRVDR-NUM

   Region Code                                       2    168   169  VARCHAR2
     Description: Indicates the CMS Regional Office responsible for the
                  certification of the provider.
     SAS Name:    RGN_CD
     COBOL Name:  RGN-CD
     VALUES:      01=Boston
                  02=New York
                  03=Philadelphia
                  04=Atlanta
                  05=Chicago
                  06=Dallas
                  07=Kansas City
                  08=Denver
                  09=San Francisco
                  10=Seattle

   Skeleton Record Indicator                         1    170   170  VARCHAR2
     Description: Indicates if the record is a skeleton record.  Only a
                  limited set of data is available for this provider; no
                  survey data exists.  Only provider categories
                  01,17,19,21and 22 can have skeleton providers.
     SAS Name:    SKLTN_REC_SW
     COBOL Name:  SKLTN-REC-SW

   State Abbreviation                                2    171   172  VARCHAR2
     Description: Two-character state abbreviation.
     SAS Name:    STATE_CD
     COBOL Name:  STATE-CD
     VALUES:      AK=ALASKA
                  AL=ALABAMA
                  AR=ARKANSAS
                  AS=AMERICAN SAMOA
                  AZ=ARIZONA
                  CA=CALIFORNIA
                  CN=CANADA
                  CO=COLORADO
                  CT=CONNECTICUT
                  DC=DISTRICT OF COLUMBIA
                  DE=DELAWARE
                  FL=FLORIDA
                  FN=INTERNATIONAL
                  GA=GEORGIA
                  GU=GUAM
                  HI=HAWAII
                  IA=IOWA
                  ID=IDAHO


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 13
          Portable X-Ray Supplier, CATEGORY = "07" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  IL=ILLINOIS
                  IN=INDIANA
                  KS=KANSAS
                  KY=KENTUCKY
                  LA=LOUISIANA
                  MA=MASSACHUSETTS
                  MD=MARYLAND
                  ME=MAINE
                  MI=MICHIGAN
                  MN=MINNESOTA
                  MO=MISSOURI
                  MP=SAIPAN
                  MS=MISSISSIPPI
                  MT=MONTANA
                  MX=MEXICO
                  NC=NORTH CAROLINA
                  ND=NORTH DAKOTA
                  NE=NEBRASKA
                  NH=NEW HAMPSHIRE
                  NJ=NEW JERSEY
                  NM=NEW MEXICO
                  NV=NEVADA
                  NY=NEW YORK
                  OH=OHIO
                  OK=OKLAHOMA
                  OR=OREGON
                  PA=PENNSYLVANIA
                  PR=PUERTO RICO
                  RI=RHODE ISLAND
                  SC=SOUTH CAROLINA
                  SD=SOUTH DAKOTA
                  TN=TENNESSEE
                  TX=TEXAS
                  UT=UTAH
                  VA=VIRGINIA
                  VI=VIRGIN ISLANDS
                  VT=VERMONT
                  WA=WASHINGTON
                  WI=WISCONSIN
                  WV=WEST VIRGINIA
                  WY=WYOMING

   SSA State Code                                    2    173   174  VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the state where the provider is located.
     SAS Name:    SSA_STATE_CD
     COBOL Name:  SSA-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  03=ARIZONA
                  04=ARKANSAS
                  05=CALIFORNIA
                  06=COLORADO
                  07=CONNECTICUT
                  08=DELAWARE
                  09=DISTRICT OF COLUMBIA
                  10=FLORIDA
                  11=GEORGIA
                  12=HAWAII
                  13=IDAHO
                  14=ILLINOIS
                  15=INDIANA
                  16=IOWA
                  17=KANSAS


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 14
          Portable X-Ray Supplier, CATEGORY = "07" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  18=KENTUCKY
                  19=LOUISIANA
                  20=MAINE
                  21=MARYLAND
                  22=MASSACHUSETTS
                  23=MICHIGAN
                  24=MINNESOTA
                  25=MISSISSIPPI
                  26=MISSOURI
                  27=MONTANA
                  28=NEBRASKA
                  29=NEVADA
                  30=NEW HAMPSHIRE
                  31=NEW JERSEY
                  32=NEW MEXICO
                  33=NEW YORK
                  34=NORTH CAROLINA
                  35=NORTH DAKOTA
                  36=OHIO
                  37=OKLAHOMA
                  38=OREGON
                  39=PENNSYLVANIA
                  40=PUERTO RICO
                  41=RHODE ISLAND
                  42=SOUTH CAROLINA
                  43=SOUTH DAKOTA
                  44=TENNESSEE
                  45=TEXAS
                  46=UTAH
                  47=VERMONT
                  48=VIRGIN ISLANDS
                  49=VIRGINIA
                  50=WASHINGTON
                  51=WEST VIRGINIA
                  52=WISCONSIN
                  53=WYOMING
                  54=AFRICA
                  56=CANADA
                  57=WEST INDIES
                  58=EUROPE
                  59=MEXICO
                  60=OCEANIA
                  61=PHILIPPINES
                  62=SOUTH AMERICA
                  63=UNITED STATES POSSESSIONS
                  64=AMERICAN SAMOA
                  65=GUAM
                  66=SAIPAN
                  99=INTERNATIONAL

   State Region Code                                 3    175   177  VARCHAR2
     Description: Identifies the region within a state where the provider
                  is located.
     SAS Name:    STATE_RGN_CD
     COBOL Name:  STATE-RGN-CD
     VALUES:      AK/001=ALASKA
                  AK/LAB=LABORATORIES
                  AK/NPH=NON-PARTICIPATING HOSPITAL
                  AL/001=ALABAMA
                  AL/LAB=LABORATORIES
                  AL/NPH=NON-PARTICIPATING HOSPITAL
                  AR/001=ARKANSAS
                  AR/LAB=LABORATORIES
                  AR/NPH=NON-PARTICIPATING HOSPITAL


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          Portable X-Ray Supplier, CATEGORY = "07" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  AS/001=AMERICAN SAMOA
                  AS/LAB=LABORATORY
                  AS/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/AZ=PHOENIX
                  AZ/LAB=ARIZONA LAB
                  AZ/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/TUC=TUCSON
                  CA/001=CALIFORNIA
                  CA/BAK=BAKERSFIELD
                  CA/BER=SAN BERNARDINO
                  CA/EB=East Bay
                  CA/FR=FRESNO
                  CA/L1=L.A. WEST
                  CA/L2=L.A. NORTH
                  CA/L3=L.A. CENTRAL
                  CA/L4=L.A. EAST
                  CA/L5=SAN GABRIEL
                  CA/LA1=LA Region 1
                  CA/LA2=LA Region 2
                  CA/LA3=LA Region 3
                  CA/LA4=LA Acute/Ancillary
                  CA/LA5=LA HHA/Hospice
                  CA/LA6=LA ICF/DD/CLinics
                  CA/LAB=LABORATORIES
                  CA/M1=LAB. SOUTH
                  CA/M2=LAB. NORTH
                  CA/NPH=NON-PARTICIPATING HOSPITAL
                  CA/ORG=ORANGE
                  CA/RIV=RIVERSIDE
                  CA/S1=SACRAMENTO
                  CA/S3=CHICO
                  CA/SD=SAN DIEGO
                  CA/SF=SAN FRANCISCO
                  CA/SJ=SAN JOSE
                  CA/SR=SANTA ROSA
                  CA/VEN=VENTURA
                  CN/001=CANADA
                  CN/LAB=LABORATORY
                  CN/NPH=NON-PARTICIPATING HOSPITAL
                  CO/001=COLORADO
                  CO/LAB=LABORATORIES
                  CO/NPH=NON-PARTICIPATING HOSPITAL
                  CT/001=CONNECTICUT
                  CT/LAB=LABORATORIES
                  CT/NPH=NON-PARTICIPATING HOSPITAL
                  DC/001=DISTRICT OF COLUMBIA
                  DC/LAB=LABORATORIES
                  DC/NPH=NON-PARTICIPATING HOSPITAL
                  DE/001=DELAWARE
                  DE/LAB=LABORATORIES
                  DE/NPH=NON-PARTICIPATING HOSPITAL
                  FL/001=FLORIDA
                  FL/FTM=FT. MYERS
                  FL/GAI=GAINESVILLE
                  FL/JAX=JACKSONVILLE
                  FL/LAB=LABORATORIES
                  FL/LAN=LANTANA
                  FL/LAU=LAUDERHILL
                  FL/MIA=MIAMI
                  FL/NPH=NON-PARTICIPATING HOSPITAL
                  FL/ORL=ORLANDO
                  FL/PEN=PENSACOLA
                  FL/STP=ST. PETERSBURG
                  FL/TAL=TALLAHASSEE


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 16
          Portable X-Ray Supplier, CATEGORY = "07" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  FL/TAM=TAMPA
                  FM/001=FEDERATED STATES OF MICRO
                  FM/NPH=NON-PARTICIPATING HOSPITAL
                  FN/001=INTERNATIONAL
                  FN/LAB=LABORATORIES
                  FN/NPH=NON-PARTICIPATING HOSPITAL
                  GA/001=GEORGIA
                  GA/GAA=GEORGIA ALL
                  GA/GAC=GEORGIA CENTRAL
                  GA/GAE=GEORGIA EASTERN
                  GA/GAN=GEORGIA NORTH
                  GA/GAS=GEORGIA SOUTH
                  GA/GAW=GEORGIA WESTERN
                  GA/LAB=LABORATORIES
                  GA/NPH=NON-PARTICIPATING HOSPITAL
                  GU/001=GUAM
                  GU/LAB=LABORATORIES
                  GU/NPH=NON-PARTICIPATING HOSPITAL
                  HI/001=HAWAII
                  HI/LAB=LABORATORIES
                  HI/NPH=NON-PARTICIPATING HOSPITAL
                  IA/001=IOWA
                  IA/LAB=LABORATORIES
                  IA/NPH=NON-PARTICIPATING HOSPITAL
                  ID/001=IDAHO
                  ID/LAB=LABORATORIES
                  ID/NPH=NON-PARTICIPATING HOSPITAL
                  IL/001=ILLINOIS
                  IL/LAB=LABORATORIES
                  IL/NPH=NON-PARTICIPATING HOSPITAL
                  IN/001=INDIANA
                  IN/LAB=LABORATORIES
                  IN/NPH=NON-PARTICIPATING HOSPITAL
                  KS/001=KANSAS
                  KS/KCK=KANSAS CITY
                  KS/KDH=KDHE
                  KS/LAB=LABORATORIES
                  KS/LAW=LAWRENCE
                  KS/NC=NORTH CENTRAL KANSAS
                  KS/NE=NORTH EAST KANSAS
                  KS/NPH=NON-PARTICIPATING HOSPITAL
                  KS/NW=NORTH WEST KANSAS
                  KS/SC=SOUTH CENTRAL KANSAS
                  KS/SE=SOUTH EAST KANSAS
                  KS/SW=SOUTH WEST KANSAS
                  KS/WST=WEST
                  KY/2C1=HOPKINSVILLE
                  KY/2C2=LOUISVILLE
                  KY/2C3=LONDON
                  KY/2C4=LEXINGTON
                  KY/LAB=LABORATORIES
                  KY/NPH=NON-PARTICIPATING HOSPITAL
                  LA/001=LOUISIANA
                  LA/LA1=NEW ORLEANS
                  LA/LA2=MANDEVILLE
                  LA/LA3=LAFAYETTE
                  LA/LA4=MONROE
                  LA/LA5=SHREVEPORT
                  LA/LA6=ALEXANDRIA
                  LA/LAB=LABORATORIES
                  LA/LB1=CLIA NEW ORLEANS
                  LA/LB5=CLIA SHREVEPORT
                  LA/LB6=CLIA ALEXANDRIA
                  LA/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 17
          Portable X-Ray Supplier, CATEGORY = "07" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  MA/001=MASSACHUSETTS
                  MA/LAB=LABORATORIES
                  MA/NPH=NON-PARTICIPATING HOSPITAL
                  MD/001=MARYLAND
                  MD/LAB=LABORATORIES
                  MD/NPH=NON-PARTICIPATING HOSPITAL
                  ME/001=MAINE
                  ME/LAB=LABORATORIES
                  ME/NPH=NON-PARTICIPATING HOSPITAL
                  MH/001=MARSHALL ISLANDS
                  MH/NPH=NON-PARTICIPATING HOSPITAL
                  MI/001=MICHIGAN
                  MI/LAB=LABORATORIES
                  MI/NPH=NON-PARTICIPATING HOSPITAL
                  MN/001=MINNESOTA
                  MN/LAB=LABORATORIES
                  MN/NPH=NON-PARTICIPATING HOSPITAL
                  MO/001=MISSOURI
                  MO/01=REGION01
                  MO/02=REGION02
                  MO/03=REGION 03
                  MO/04=REGION 04
                  MO/05=REGION 05
                  MO/06=REGION 06
                  MO/07=REGION 07
                  MO/1NH=REGION 1 NH
                  MO/2NH=REGION 2 NH
                  MO/3NH=REGION 3 NH
                  MO/4NH=REGION 4 NH
                  MO/5NH=REGION 5 NH
                  MO/6NH=REGION 6 NH
                  MO/7NH=REGION 7 NH
                  MO/LAB=LABORATORIES
                  MO/MO=STATEWIDE
                  MO/NPH=NON-PARTICIPATING HOSPITAL
                  MP/001=NORTHERN MARIANA ISLANDS
                  MP/LAB=LABORATORIES
                  MP/NPH=NON-PARTICIPATING HOSPITAL
                  MS/001=MISSISSIPPI
                  MS/LAB=LABORATORIES
                  MS/NPH=NON-PARTICIPATING HOSPITAL
                  MT/001=MONTANA
                  MT/LAB=LABORATORIES
                  MT/NPH=NON-PARTICIPATING HOSPITAL
                  MX/001=MEXICO
                  MX/LAB=LABORATORY
                  MX/NPH=NON-PARTICIPATING HOSPITAL
                  NC/001=NORTH CAROLINA
                  NC/LAB=LABORATORIES
                  NC/NCC=NORTH CAROLINA CENTRAL
                  NC/NCE=NORTH CAROLINA EAST
                  NC/NCN=NORTH CAROLINA NORTH
                  NC/NCS=NORTH CAROLINA SOUTH
                  NC/NCW=NORTH CAROLINA WEST
                  NC/NPH=NON-PARTICIPATING HOSPITAL
                  ND/001=NORTH DAKOTA
                  ND/LAB=LABORATORIES
                  ND/NPH=NON-PARTICIPATING HOSPITAL
                  NE/001=NEBRASKA
                  NE/1=NORTH CENTRAL
                  NE/2=CENTRAL
                  NE/3=NORTHEAST
                  NE/4=SOUTHEAST
                  NE/5=WESTERN


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 18
          Portable X-Ray Supplier, CATEGORY = "07" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  NE/LAB=LABORATORIES
                  NE/NPH=NON-PARTICIPATING HOSPITAL
                  NH/001=NEW HAMPSHIRE
                  NH/LAB=LABORATORIES
                  NH/NPH=NON-PARTICIPATING HOSPITAL
                  NJ/001=NEW JERSEY
                  NJ/LAB=LABORATORIES
                  NJ/NPH=NON-PARTICIPATING HOSPITAL
                  NM/001=NEW MEXICO
                  NM/LAB=LABORATORIES
                  NM/NPH=NON-PARTICIPATING HOSPITAL
                  NV/001=NEVADA
                  NV/CC=CARSON CITY
                  NV/LAB=LABORATORIES
                  NV/LV=LAS VEGAS
                  NV/NPH=NON-PARTICIPATING HOSPITAL
                  NY/001=BUFFALO
                  NY/002=ROCHESTER
                  NY/003=SYRACUSE
                  NY/004=ALBANY
                  NY/005=NEW ROCHELLE
                  NY/006=NEW YORK CITY
                  NY/007=SUFFOLK/NASSAU COUNTY
                  NY/LAB=LABORATORIES
                  NY/NPH=NON-PARTICIPATING HOSPITAL
                  OH/001=OHIO
                  OH/LAB=LABORATORIES
                  OH/NPH=NON-PARTICIPATING HOSPITAL
                  OK/001=OKLAHOMA
                  OK/LAB=LABORATORIES
                  OK/NPH=NON-PARTICIPATING HOSPITAL
                  OR/001=OFFICE #1
                  OR/002=OFFICE #2
                  OR/003=OFFICE #3
                  OR/LAB=LABORATORIES
                  OR/NPH=NON-PARTICIPATING HOSPITAL
                  PA/001=PENNSYLVANIA
                  PA/LAB=LABORATORIES
                  PA/NPH=NON-PARTICIPATING HOSPITAL
                  PR/001=PUERTO RICO
                  PR/LAB=LABORATORIES
                  PR/NPH=NON-PARTICIPATING HOSPITAL
                  PW/001=PALAU
                  PW/NPH=NON-PARTICIPATING HOSPITAL
                  RI/001=RHODE ISLAND
                  RI/LAB=LABORATORIES
                  RI/NPH=NON-PARTICIPATING HOSPITAL
                  SC/001=SOUTH CAROLINA
                  SC/LAB=LABORATORIES
                  SC/NPH=NON-PARTICIPATING HOSPITAL
                  SD/001=SOUTH DAKOTA
                  SD/LAB=LABORATORIES
                  SD/NPH=NON-PARTICIPATING HOSPITAL
                  TN/001=TENNESSEE
                  TN/LAB=LABORATORIES
                  TN/NPH=NON-PARTICIPATING HOSPITAL
                  TN/TNC=TENNESSEE COOKEVILLE
                  TN/TNE=TENNESSEE EASTERN
                  TN/TNM=TENNESSEE MIDDLE
                  TN/TNW=TENNESSEE WESTERN
                  TX/001=TEXAS
                  TX/L01=AMARILLO-LTC
                  TX/L02=ABILENE-LTC
                  TX/L03=ARLINGTON-LTC


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 19
          Portable X-Ray Supplier, CATEGORY = "07" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  TX/L04=TYLER-LTC
                  TX/L05=TEMPLE-LTC
                  TX/L06=HOUSTON-LTC
                  TX/L07=SAN ANTONIO-LTC
                  TX/LAB=LABORATORIES
                  TX/NPH=NON-PARTICIPATING HOSPITAL
                  TX/TX1=NLTC REG 1, 7, 9, 10
                  TX/TX2=NLTC REG 2, 3
                  TX/TX4=NLTC REG 6
                  TX/TX5=NLTC REG 4, 5
                  TX/TX6=AUSTIN
                  TX/TX8=NLTC REG 8, 11
                  UT/001=UTAH
                  UT/LAB=LABORATORIES
                  UT/NPH=NON-PARTICIPATING HOSPITAL
                  VA/001=VIRGINIA
                  VA/LAB=LABORATORIES
                  VA/NPH=NON-PARTICIPATING HOSPITAL
                  VI/001=VIRGIN ISLANDS
                  VI/LAB=LABORATORIES
                  VI/NPH=NON-PARTICIPATING HOSPITAL
                  VT/001=VERMONT
                  VT/LAB=LABORATORIES
                  VT/NPH=NON-PARTICIPATING HOSPITAL
                  WA/001=ALL OTHERS (NON-LTC FAC)
                  WA/D1=SPOKANE & YAKIMA AREAS
                  WA/D1A=District 1, Unit A
                  WA/D1B=District 1, Unit B
                  WA/D1C=District 1, Unit C
                  WA/D1D=District 1, Unit D
                  WA/D1E=District 1, Unit E
                  WA/D2=SPOKANE & SE
                  WA/D2A=District 2, Unit A
                  WA/D2B=District 2, Unit B
                  WA/D2C=District 2, Unit C
                  WA/D2D=District 2, Unit D
                  WA/D2E=District 2, Unit E
                  WA/D2F=District 2, Unit F
                  WA/D2G=District 2, Unit G
                  WA/D2H=District 2, Unit H
                  WA/D2I=District 2, Unit I
                  WA/D2J=District 2, Unit J
                  WA/D3=NW WASHINGTON
                  WA/D3A=District 3, Unit A
                  WA/D3B=District 3, Unit B
                  WA/D3C=District 3, Unit C
                  WA/D3D=District 3, Unit D
                  WA/D3E=District 3, Unit E
                  WA/D3F=District 3, Unit F
                  WA/D3G=District 3, Unit G
                  WA/D4A=GREATER SEATTLE AREA
                  WA/D4B=S KING COUNTY
                  WA/D5A=PIERCE CTY & PENINSULA
                  WA/D5B=PIERCE CTY & GRAYS HARBOR
                  WA/D6=OLYMPIA AREA
                  WA/LAB=LABORATORIES
                  WA/NPH=NON-PARTICIPATING HOSPITAL
                  WI/001=WISCONSIN
                  WI/LAB=LABORATORIES
                  WI/NPH=NON-PARTICIPATING HOSPITAL
                  WV/001=WEST VIRGINIA
                  WV/LAB=LABORATORIES
                  WV/NPH=NON-PARTICIPATING HOSPITAL
                  WY/001=WYOMING


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          Portable X-Ray Supplier, CATEGORY = "07" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  WY/LAB=LABORATORIES
                  WY/NPH=NON-PARTICIPATING HOSPITAL

   Address: Street                                   50   178   227  VARCHAR2
     Description: Street address where the provider is located.
     SAS Name:    ST_ADR
     COBOL Name:  ST-ADR

   Telephone Number                                  10   228   237  VARCHAR2
     Description: Telephone number of the provider.
     SAS Name:    PHNE_NUM
     COBOL Name:  PHNE-NUM

   Termination Code                                  2    238   239  VARCHAR2
     Description: Indicates the current termination status for the
                  provider.
     SAS Name:    PGM_TRMNTN_CD
     COBOL Name:  PGM-TRMNTN-CD
     VALUES:      00=ACTIVE PROVIDER
                  01=VOLUNTARY-MERGER, CLOSURE
                  02=VOLUNTARY-DISSATISFACTION WITH REIMBURSEMENT
                  03=VOLUNTARY-RISK OF INVOLUNTARY TERMINATION
                  04=VOLUNTARY-OTHER REASON FOR WITHDRAWAL
                  05=INVOLUNTARY-FAILURE TO MEET HEALTH/SAFETY REQ
                  06=INVOLUNTARY-FAILURE TO MEET AGREEMENT
                  07=OTHER-PROVIDER STATUS CHANGE
                  08=NONPAYMENT OF FEES - CLIA Only
                  09=REV/UNSUCCESSFUL PARTICIPATION IN PT - CLIA Only
                  10=REV/OTHER REASON - CLIA Only
                  11=INCOMPLETE CLIA APPLICATION INFORMATION - CLIA Only
                  12=NO LONGER PERFORMING TESTS - CLIA Only
                  13=MULTIPLE TO SINGLE SITE CERTIFICATE - CLIA Only
                  14=SHARED LABORATORY - CLIA Only
                  15=FAILURE TO RENEW WAIVER PPM CERTIFICATE - CLIA Only
                  16=DUPLICATE CLIA NUMBER - CLIA Only
                  17=MAIL RETURNED NO FORWARD ADDRESS CERT ENDED - CLIA Only
                  20=NOTIFICATION BANKRUPTCY - CLIA Only
                  33=ACCREDITATION NOT CONFIRMED - CLIA Only
                  80=AWAITING STATE APPROVAL
                  99=OIG ACTION - DO NOT ACTIVATE - CLIA Only

   Termination or Expiration Date                    8    240   247  DATE
     Description: Date the provider was terminated.  For CLIA providers,
                  date the laboratory's certificate was terminated or the
                  expiration date of the current CLIA certificate.
     SAS Name:    TRMNTN_EXPRTN_DT
     COBOL Name:  TRMNTN-EXPRTN-DT

   Type of Action Code                               1    248   248  VARCHAR2
     Description: Identifies the reason for the certification.  Type of
                  action from the official survey record, CMS 1539 form.
     SAS Name:    CRTFCTN_ACTN_TYPE_CD
     COBOL Name:  CRTFCTN-ACTN-TYPE-CD
     VALUES:      1=INITIAL
                  2=RECERTIFICATION
                  3=TERMINATION
                  4=CHANGE OF OWNERSHIP
                  5=VALIDATION
                  8=FULL SURVEY AFTER COMPLAINT

   Ownership Type Code                               2    249   250  VARCHAR2
     Description: Indicates the ownership type of the provider.
     SAS Name:    GNRL_CNTL_TYPE_CD
     COBOL Name:  GNRL-CNTL-TYPE-CD


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 21
          Portable X-Ray Supplier, CATEGORY = "07" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     VALUES:      01=INDIVIDUAL
                  02=PARTNERSHIP
                  03=CORPORATION
                  04=OTHER THAN PRIVATE

   Address: ZIP Code                                 5    251   255  VARCHAR2
     Description: Five-digit ZIP code for a provider's physical address.
     SAS Name:    ZIP_CD
     COBOL Name:  ZIP-CD

   FIPS State Code                                   2    256   257  VARCHAR2
     Description: FIPS State Code
     SAS Name:    FIPS_STATE_CD
     COBOL Name:  FIPS-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  04=ARIZONA
                  05=ARKANSAS
                  06=CALIFORNIA
                  08=COLORADO
                  09=CONNECTICUT
                  10=DELAWARE
                  11=DISTRICT OF COLUMBIA
                  12=FLORIDA
                  13=GEORGIA
                  15=HAWAII
                  16=IDAHO
                  17=ILLINOIS
                  18=INDIANA
                  19=IOWA
                  20=KANSAS
                  21=KENTUCKY
                  22=LOUISIANA
                  23=MAINE
                  24=MARYLAND
                  25=MASSACHUSETTS
                  26=MICHIGAN
                  27=MINNESOTA
                  28=MISSISSIPPI
                  29=MISSOURI
                  30=MONTANA
                  31=NEBRASKA
                  32=NEVADA
                  33=NEW HAMPSHIRE
                  34=NEW JERSEY
                  35=NEW MEXICO
                  36=NEW YORK
                  37=NORTH CAROLINA
                  38=NORTH DAKOTA
                  39=OHIO
                  40=OKLAHOMA
                  41=OREGON
                  42=PENNSYLVANIA
                  43=PUERTO RICO
                  44=RHODE ISLAND
                  45=SOUTH CAROLINA
                  46=SOUTH DAKOTA
                  47=TENNESSEE
                  48=TEXAS
                  49=UTAH
                  50=VERMONT
                  51=VIRGINIA
                  53=WASHINGTON
                  54=WEST VIRGINIA


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 22
          Portable X-Ray Supplier, CATEGORY = "07" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  55=WISCONSIN
                  56=WYOMING
                  60=AMERICAN SAMOA
                  66=GUAM
                  69=SAIPAN/MARIANA IS.
                  78=VIRGIN ISLANDS

   FIPS County Code                                  3    258   260  VARCHAR2
     Description: FIPS County Code
     SAS Name:    FIPS_CNTY_CD
     COBOL Name:  FIPS-CNTY-CD

   CBSA Urban Rural Indicator                        1    261   261  VARCHAR2
     Description: CBSA (Core Based Statistical Area) indicates whether the
                  county is defined as Urban or Rural.
     SAS Name:    CBSA_URBN_RRL_IND
     COBOL Name:  CBSA-URBN-RRL-IND

   CBSA Code                                         5    262   266  VARCHAR2
     Description: CBSA (Core Based Statistical Area) geographic entities
                  defined by the U.S. Office of Management and Budget (OMB)
                  on June 6, 2003 for use by Federal statistical agencies
                  in collecting, tabulating, and publishing Federal
                  statistics.  CBSA collectively refers to MSA.
     SAS Name:    CBSA_CD
     COBOL Name:  CBSA-CD

   Fiscal Year End Date (MMDD)                       4    464   467  VARCHAR2
     Description: End date, consisting of the month and day, of the
                  provider's fiscal year.
     SAS Name:    FY_END_MO_DAY_CD
     COBOL Name:  FY-END-MO-DAY-CD

   Staff Count: Other Personnel                      8    902   909  NUMBER
     Description: Number of full-time equivalent other personnel employed
                  by a provider
     SAS Name:    PRSNEL_OTHR_CNT
     COBOL Name:  PRSNEL-OTHR-CNT

   Technologist Count: 24-Month Radiologic School    8    1969  1976 NUMBER
     Description: Number of full-time equivalent technologists who are
                  graduates of a 24-month approved school of radiologic
                  technology.
     SAS Name:    TCHNLGST_2_YR_RDLGC_CNT
     COBOL Name:  TCHNLGST-2-YR-RDLGC-CNT

   Technologist Count: Associate Degree              8    1977  1984 NUMBER
     Description: Number of full-time equivalent technologists with an
                  Associate degree in radiologic technology.
     SAS Name:    TCHNLGST_ASCT_DGR_CNT
     COBOL Name:  TCHNLGST-ASCT-DGR-CNT

   Technologist Count: BS or BA Degree               8    1985  1992 NUMBER
     Description: Number of full-time equivalent technologists with a
                  Bachelor of Science or Bachelor of Arts degree in
                  radiologic technology.
     SAS Name:    TCHNLGST_BS_BA_DGR_CNT
     COBOL Name:  TCHNLGST-BS-BA-DGR-CNT








 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 1
  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Provider Category Subtype Code                    2    1     2    VARCHAR2
     Description: Identifies the subtype of the provider, within the
                  primary category.  Used in reporting to show the
                  breakdown of provider categories, mainly for hospitals
                  and SNFs.
     SAS Name:    PRVDR_CTGRY_SBTYP_CD
     COBOL Name:  PRVDR-CTGRY-SBTYP-CD
     VALUES:      01=OPT or Speech Pathology

   Provider Category Code                            2    3     4    VARCHAR2
     Description: Identifies the type of provider participating in the
                  Medicare/Medicaid program.
     SAS Name:    PRVDR_CTGRY_CD
     COBOL Name:  PRVDR-CTGRY-CD
     VALUES:      08=Outpatient Physical Therapy/Speech Pathology

   CHOW Count                                        2    5     6    NUMBER
     Description: Number of times this provider has undergone a change of
                  ownership.
     SAS Name:    CHOW_CNT
     COBOL Name:  CHOW-CNT

   CHOW Date                                         8    7     14   DATE
     Description: Effective date of the most recent change of ownership for
                  this provider.
     SAS Name:    CHOW_DT
     COBOL Name:  CHOW-DT

   Address: City                                     28   15    42   VARCHAR2
     Description: City in which the provider is physically located.
     SAS Name:    CITY_NAME
     COBOL Name:  CITY-NAME

   Compliance: Acceptable POC                        1    43    43   VARCHAR2
     Description: Indicates if a provider is in compliance with program
                  requirements based on an acceptable plan for correction
                  of deficiencies.
     SAS Name:    ACPTBL_POC_SW
     COBOL Name:  ACPTBL-POC-SW

   Compliance: Status                                1    44    44   VARCHAR2
     Description: Compliance status of a provider at the time of
                  certification survey.
     SAS Name:    CMPLNC_STUS_CD
     COBOL Name:  CMPLNC-STUS-CD
     VALUES:      A=IN COMPLIANCE
                  B=NOT IN COMPLIANCE

   SSA County Code                                   3    45    47   VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the county where the provider is located.
     SAS Name:    SSA_CNTY_CD
     COBOL Name:  SSA-CNTY-CD

   Cross Ref Provider Number                         10   48    57   CHAR
     Description: Cross reference provider number
     SAS Name:    CROSS_REF_PROVIDER_NUMBER
     COBOL Name:  CROSS-REF-PROVIDER-NUMBER

   Certification Date                                8    58    65   DATE
     Description: Equal to the exit date of the initial visit of the Health
                  survey for certifications completed after July 28, 2012.


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  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  For certifications prior to that date, the certification
                  date is equal to the exit date of the initial visit of
                  the Health survey or LSC survey, whichever is later.
     SAS Name:    CRTFCTN_DT
     COBOL Name:  CRTFCTN-DT

   Eligibility Indicator                             1    66    66   VARCHAR2
     Description: Indicates if a facility is eligible to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    ELGBLTY_SW
     COBOL Name:  ELGBLTY-SW

   Facility Name                                     50   67    116  VARCHAR2
     Description: Name of the provider certified to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    FAC_NAME
     COBOL Name:  FAC-NAME

   Medicare Administrative Contractor (MAC) or       5    117   121  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_CD
     COBOL Name:  INTRMDRY-CARR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 3
  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 4
  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 5
  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 6
  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 7
  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   Medicaid Vendor Number                            15   122   136  VARCHAR2
     Description: Number which may be assigned to a provider by the state
                  Medicaid agency for external control or billing purposes.
     SAS Name:    MDCD_VNDR_NUM
     COBOL Name:  MDCD-VNDR-NUM

   Original Participation Date                       8    137   144  DATE
     Description: Date a provider is first approved to provide Medicare
                  and/or Medicaid services.
     SAS Name:    ORGNL_PRTCPTN_DT
     COBOL Name:  ORGNL-PRTCPTN-DT

   Prior CHOW Date                                   8    145   152  DATE
     Description: Effective date of the previous change of ownership for
                  this provider.
     SAS Name:    CHOW_PRIOR_DT
     COBOL Name:  CHOW-PRIOR-DT

   Prior Medicare Administrative Contractor (MAC) or 5    153   157  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the previous Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_PRIOR_CD
     COBOL Name:  INTRMDRY-CARR-PRIOR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 8
  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 9
  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 10
  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 11
  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 12
  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)
                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   CCN                                               10   158   167  VARCHAR2
     Description: Six or ten position identification number that is
                  assigned to a certified provider.  This is the CMS
                  Certification Number.
     SAS Name:    PRVDR_NUM
     COBOL Name:  PRVDR-NUM

   Region Code                                       2    168   169  VARCHAR2
     Description: Indicates the CMS Regional Office responsible for the
                  certification of the provider.
     SAS Name:    RGN_CD
     COBOL Name:  RGN-CD
     VALUES:      01=Boston
                  02=New York
                  03=Philadelphia
                  04=Atlanta
                  05=Chicago
                  06=Dallas
                  07=Kansas City
                  08=Denver
                  09=San Francisco
                  10=Seattle

   Skeleton Record Indicator                         1    170   170  VARCHAR2
     Description: Indicates if the record is a skeleton record.  Only a
                  limited set of data is available for this provider; no
                  survey data exists.  Only provider categories
                  01,17,19,21and 22 can have skeleton providers.
     SAS Name:    SKLTN_REC_SW
     COBOL Name:  SKLTN-REC-SW

   State Abbreviation                                2    171   172  VARCHAR2
     Description: Two-character state abbreviation.
     SAS Name:    STATE_CD
     COBOL Name:  STATE-CD
     VALUES:      AK=ALASKA
                  AL=ALABAMA
                  AR=ARKANSAS
                  AS=AMERICAN SAMOA
                  AZ=ARIZONA
                  CA=CALIFORNIA


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 13
  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  CN=CANADA
                  CO=COLORADO
                  CT=CONNECTICUT
                  DC=DISTRICT OF COLUMBIA
                  DE=DELAWARE
                  FL=FLORIDA
                  FN=INTERNATIONAL
                  GA=GEORGIA
                  GU=GUAM
                  HI=HAWAII
                  IA=IOWA
                  ID=IDAHO
                  IL=ILLINOIS
                  IN=INDIANA
                  KS=KANSAS
                  KY=KENTUCKY
                  LA=LOUISIANA
                  MA=MASSACHUSETTS
                  MD=MARYLAND
                  ME=MAINE
                  MI=MICHIGAN
                  MN=MINNESOTA
                  MO=MISSOURI
                  MP=SAIPAN
                  MS=MISSISSIPPI
                  MT=MONTANA
                  MX=MEXICO
                  NC=NORTH CAROLINA
                  ND=NORTH DAKOTA
                  NE=NEBRASKA
                  NH=NEW HAMPSHIRE
                  NJ=NEW JERSEY
                  NM=NEW MEXICO
                  NV=NEVADA
                  NY=NEW YORK
                  OH=OHIO
                  OK=OKLAHOMA
                  OR=OREGON
                  PA=PENNSYLVANIA
                  PR=PUERTO RICO
                  RI=RHODE ISLAND
                  SC=SOUTH CAROLINA
                  SD=SOUTH DAKOTA
                  TN=TENNESSEE
                  TX=TEXAS
                  UT=UTAH
                  VA=VIRGINIA
                  VI=VIRGIN ISLANDS
                  VT=VERMONT
                  WA=WASHINGTON
                  WI=WISCONSIN
                  WV=WEST VIRGINIA
                  WY=WYOMING

   SSA State Code                                    2    173   174  VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the state where the provider is located.
     SAS Name:    SSA_STATE_CD
     COBOL Name:  SSA-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  03=ARIZONA
                  04=ARKANSAS


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 14
  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  05=CALIFORNIA
                  06=COLORADO
                  07=CONNECTICUT
                  08=DELAWARE
                  09=DISTRICT OF COLUMBIA
                  10=FLORIDA
                  11=GEORGIA
                  12=HAWAII
                  13=IDAHO
                  14=ILLINOIS
                  15=INDIANA
                  16=IOWA
                  17=KANSAS
                  18=KENTUCKY
                  19=LOUISIANA
                  20=MAINE
                  21=MARYLAND
                  22=MASSACHUSETTS
                  23=MICHIGAN
                  24=MINNESOTA
                  25=MISSISSIPPI
                  26=MISSOURI
                  27=MONTANA
                  28=NEBRASKA
                  29=NEVADA
                  30=NEW HAMPSHIRE
                  31=NEW JERSEY
                  32=NEW MEXICO
                  33=NEW YORK
                  34=NORTH CAROLINA
                  35=NORTH DAKOTA
                  36=OHIO
                  37=OKLAHOMA
                  38=OREGON
                  39=PENNSYLVANIA
                  40=PUERTO RICO
                  41=RHODE ISLAND
                  42=SOUTH CAROLINA
                  43=SOUTH DAKOTA
                  44=TENNESSEE
                  45=TEXAS
                  46=UTAH
                  47=VERMONT
                  48=VIRGIN ISLANDS
                  49=VIRGINIA
                  50=WASHINGTON
                  51=WEST VIRGINIA
                  52=WISCONSIN
                  53=WYOMING
                  54=AFRICA
                  56=CANADA
                  57=WEST INDIES
                  58=EUROPE
                  59=MEXICO
                  60=OCEANIA
                  61=PHILIPPINES
                  62=SOUTH AMERICA
                  63=UNITED STATES POSSESSIONS
                  64=AMERICAN SAMOA
                  65=GUAM
                  66=SAIPAN
                  99=INTERNATIONAL



 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 15
  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

   State Region Code                                 3    175   177  VARCHAR2
     Description: Identifies the region within a state where the provider
                  is located.
     SAS Name:    STATE_RGN_CD
     COBOL Name:  STATE-RGN-CD
     VALUES:      AK/001=ALASKA
                  AK/LAB=LABORATORIES
                  AK/NPH=NON-PARTICIPATING HOSPITAL
                  AL/001=ALABAMA
                  AL/LAB=LABORATORIES
                  AL/NPH=NON-PARTICIPATING HOSPITAL
                  AR/001=ARKANSAS
                  AR/LAB=LABORATORIES
                  AR/NPH=NON-PARTICIPATING HOSPITAL
                  AS/001=AMERICAN SAMOA
                  AS/LAB=LABORATORY
                  AS/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/AZ=PHOENIX
                  AZ/LAB=ARIZONA LAB
                  AZ/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/TUC=TUCSON
                  CA/001=CALIFORNIA
                  CA/BAK=BAKERSFIELD
                  CA/BER=SAN BERNARDINO
                  CA/EB=East Bay
                  CA/FR=FRESNO
                  CA/L1=L.A. WEST
                  CA/L2=L.A. NORTH
                  CA/L3=L.A. CENTRAL
                  CA/L4=L.A. EAST
                  CA/L5=SAN GABRIEL
                  CA/LA1=LA Region 1
                  CA/LA2=LA Region 2
                  CA/LA3=LA Region 3
                  CA/LA4=LA Acute/Ancillary
                  CA/LA5=LA HHA/Hospice
                  CA/LA6=LA ICF/DD/CLinics
                  CA/LAB=LABORATORIES
                  CA/M1=LAB. SOUTH
                  CA/M2=LAB. NORTH
                  CA/NPH=NON-PARTICIPATING HOSPITAL
                  CA/ORG=ORANGE
                  CA/RIV=RIVERSIDE
                  CA/S1=SACRAMENTO
                  CA/S3=CHICO
                  CA/SD=SAN DIEGO
                  CA/SF=SAN FRANCISCO
                  CA/SJ=SAN JOSE
                  CA/SR=SANTA ROSA
                  CA/VEN=VENTURA
                  CN/001=CANADA
                  CN/LAB=LABORATORY
                  CN/NPH=NON-PARTICIPATING HOSPITAL
                  CO/001=COLORADO
                  CO/LAB=LABORATORIES
                  CO/NPH=NON-PARTICIPATING HOSPITAL
                  CT/001=CONNECTICUT
                  CT/LAB=LABORATORIES
                  CT/NPH=NON-PARTICIPATING HOSPITAL
                  DC/001=DISTRICT OF COLUMBIA
                  DC/LAB=LABORATORIES
                  DC/NPH=NON-PARTICIPATING HOSPITAL
                  DE/001=DELAWARE


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 16
  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  DE/LAB=LABORATORIES
                  DE/NPH=NON-PARTICIPATING HOSPITAL
                  FL/001=FLORIDA
                  FL/FTM=FT. MYERS
                  FL/GAI=GAINESVILLE
                  FL/JAX=JACKSONVILLE
                  FL/LAB=LABORATORIES
                  FL/LAN=LANTANA
                  FL/LAU=LAUDERHILL
                  FL/MIA=MIAMI
                  FL/NPH=NON-PARTICIPATING HOSPITAL
                  FL/ORL=ORLANDO
                  FL/PEN=PENSACOLA
                  FL/STP=ST. PETERSBURG
                  FL/TAL=TALLAHASSEE
                  FL/TAM=TAMPA
                  FM/001=FEDERATED STATES OF MICRO
                  FM/NPH=NON-PARTICIPATING HOSPITAL
                  FN/001=INTERNATIONAL
                  FN/LAB=LABORATORIES
                  FN/NPH=NON-PARTICIPATING HOSPITAL
                  GA/001=GEORGIA
                  GA/GAA=GEORGIA ALL
                  GA/GAC=GEORGIA CENTRAL
                  GA/GAE=GEORGIA EASTERN
                  GA/GAN=GEORGIA NORTH
                  GA/GAS=GEORGIA SOUTH
                  GA/GAW=GEORGIA WESTERN
                  GA/LAB=LABORATORIES
                  GA/NPH=NON-PARTICIPATING HOSPITAL
                  GU/001=GUAM
                  GU/LAB=LABORATORIES
                  GU/NPH=NON-PARTICIPATING HOSPITAL
                  HI/001=HAWAII
                  HI/LAB=LABORATORIES
                  HI/NPH=NON-PARTICIPATING HOSPITAL
                  IA/001=IOWA
                  IA/LAB=LABORATORIES
                  IA/NPH=NON-PARTICIPATING HOSPITAL
                  ID/001=IDAHO
                  ID/LAB=LABORATORIES
                  ID/NPH=NON-PARTICIPATING HOSPITAL
                  IL/001=ILLINOIS
                  IL/LAB=LABORATORIES
                  IL/NPH=NON-PARTICIPATING HOSPITAL
                  IN/001=INDIANA
                  IN/LAB=LABORATORIES
                  IN/NPH=NON-PARTICIPATING HOSPITAL
                  KS/001=KANSAS
                  KS/KCK=KANSAS CITY
                  KS/KDH=KDHE
                  KS/LAB=LABORATORIES
                  KS/LAW=LAWRENCE
                  KS/NC=NORTH CENTRAL KANSAS
                  KS/NE=NORTH EAST KANSAS
                  KS/NPH=NON-PARTICIPATING HOSPITAL
                  KS/NW=NORTH WEST KANSAS
                  KS/SC=SOUTH CENTRAL KANSAS
                  KS/SE=SOUTH EAST KANSAS
                  KS/SW=SOUTH WEST KANSAS
                  KS/WST=WEST
                  KY/2C1=HOPKINSVILLE
                  KY/2C2=LOUISVILLE


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 17
  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  KY/2C3=LONDON
                  KY/2C4=LEXINGTON
                  KY/LAB=LABORATORIES
                  KY/NPH=NON-PARTICIPATING HOSPITAL
                  LA/001=LOUISIANA
                  LA/LA1=NEW ORLEANS
                  LA/LA2=MANDEVILLE
                  LA/LA3=LAFAYETTE
                  LA/LA4=MONROE
                  LA/LA5=SHREVEPORT
                  LA/LA6=ALEXANDRIA
                  LA/LAB=LABORATORIES
                  LA/LB1=CLIA NEW ORLEANS
                  LA/LB5=CLIA SHREVEPORT
                  LA/LB6=CLIA ALEXANDRIA
                  LA/NPH=NON-PARTICIPATING HOSPITAL
                  MA/001=MASSACHUSETTS
                  MA/LAB=LABORATORIES
                  MA/NPH=NON-PARTICIPATING HOSPITAL
                  MD/001=MARYLAND
                  MD/LAB=LABORATORIES
                  MD/NPH=NON-PARTICIPATING HOSPITAL
                  ME/001=MAINE
                  ME/LAB=LABORATORIES
                  ME/NPH=NON-PARTICIPATING HOSPITAL
                  MH/001=MARSHALL ISLANDS
                  MH/NPH=NON-PARTICIPATING HOSPITAL
                  MI/001=MICHIGAN
                  MI/LAB=LABORATORIES
                  MI/NPH=NON-PARTICIPATING HOSPITAL
                  MN/001=MINNESOTA
                  MN/LAB=LABORATORIES
                  MN/NPH=NON-PARTICIPATING HOSPITAL
                  MO/001=MISSOURI
                  MO/01=REGION01
                  MO/02=REGION02
                  MO/03=REGION 03
                  MO/04=REGION 04
                  MO/05=REGION 05
                  MO/06=REGION 06
                  MO/07=REGION 07
                  MO/1NH=REGION 1 NH
                  MO/2NH=REGION 2 NH
                  MO/3NH=REGION 3 NH
                  MO/4NH=REGION 4 NH
                  MO/5NH=REGION 5 NH
                  MO/6NH=REGION 6 NH
                  MO/7NH=REGION 7 NH
                  MO/LAB=LABORATORIES
                  MO/MO=STATEWIDE
                  MO/NPH=NON-PARTICIPATING HOSPITAL
                  MP/001=NORTHERN MARIANA ISLANDS
                  MP/LAB=LABORATORIES
                  MP/NPH=NON-PARTICIPATING HOSPITAL
                  MS/001=MISSISSIPPI
                  MS/LAB=LABORATORIES
                  MS/NPH=NON-PARTICIPATING HOSPITAL
                  MT/001=MONTANA
                  MT/LAB=LABORATORIES
                  MT/NPH=NON-PARTICIPATING HOSPITAL
                  MX/001=MEXICO
                  MX/LAB=LABORATORY
                  MX/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 18
  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  NC/001=NORTH CAROLINA
                  NC/LAB=LABORATORIES
                  NC/NCC=NORTH CAROLINA CENTRAL
                  NC/NCE=NORTH CAROLINA EAST
                  NC/NCN=NORTH CAROLINA NORTH
                  NC/NCS=NORTH CAROLINA SOUTH
                  NC/NCW=NORTH CAROLINA WEST
                  NC/NPH=NON-PARTICIPATING HOSPITAL
                  ND/001=NORTH DAKOTA
                  ND/LAB=LABORATORIES
                  ND/NPH=NON-PARTICIPATING HOSPITAL
                  NE/001=NEBRASKA
                  NE/1=NORTH CENTRAL
                  NE/2=CENTRAL
                  NE/3=NORTHEAST
                  NE/4=SOUTHEAST
                  NE/5=WESTERN
                  NE/LAB=LABORATORIES
                  NE/NPH=NON-PARTICIPATING HOSPITAL
                  NH/001=NEW HAMPSHIRE
                  NH/LAB=LABORATORIES
                  NH/NPH=NON-PARTICIPATING HOSPITAL
                  NJ/001=NEW JERSEY
                  NJ/LAB=LABORATORIES
                  NJ/NPH=NON-PARTICIPATING HOSPITAL
                  NM/001=NEW MEXICO
                  NM/LAB=LABORATORIES
                  NM/NPH=NON-PARTICIPATING HOSPITAL
                  NV/001=NEVADA
                  NV/CC=CARSON CITY
                  NV/LAB=LABORATORIES
                  NV/LV=LAS VEGAS
                  NV/NPH=NON-PARTICIPATING HOSPITAL
                  NY/001=BUFFALO
                  NY/002=ROCHESTER
                  NY/003=SYRACUSE
                  NY/004=ALBANY
                  NY/005=NEW ROCHELLE
                  NY/006=NEW YORK CITY
                  NY/007=SUFFOLK/NASSAU COUNTY
                  NY/LAB=LABORATORIES
                  NY/NPH=NON-PARTICIPATING HOSPITAL
                  OH/001=OHIO
                  OH/LAB=LABORATORIES
                  OH/NPH=NON-PARTICIPATING HOSPITAL
                  OK/001=OKLAHOMA
                  OK/LAB=LABORATORIES
                  OK/NPH=NON-PARTICIPATING HOSPITAL
                  OR/001=OFFICE #1
                  OR/002=OFFICE #2
                  OR/003=OFFICE #3
                  OR/LAB=LABORATORIES
                  OR/NPH=NON-PARTICIPATING HOSPITAL
                  PA/001=PENNSYLVANIA
                  PA/LAB=LABORATORIES
                  PA/NPH=NON-PARTICIPATING HOSPITAL
                  PR/001=PUERTO RICO
                  PR/LAB=LABORATORIES
                  PR/NPH=NON-PARTICIPATING HOSPITAL
                  PW/001=PALAU
                  PW/NPH=NON-PARTICIPATING HOSPITAL
                  RI/001=RHODE ISLAND
                  RI/LAB=LABORATORIES


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 19
  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  RI/NPH=NON-PARTICIPATING HOSPITAL
                  SC/001=SOUTH CAROLINA
                  SC/LAB=LABORATORIES
                  SC/NPH=NON-PARTICIPATING HOSPITAL
                  SD/001=SOUTH DAKOTA
                  SD/LAB=LABORATORIES
                  SD/NPH=NON-PARTICIPATING HOSPITAL
                  TN/001=TENNESSEE
                  TN/LAB=LABORATORIES
                  TN/NPH=NON-PARTICIPATING HOSPITAL
                  TN/TNC=TENNESSEE COOKEVILLE
                  TN/TNE=TENNESSEE EASTERN
                  TN/TNM=TENNESSEE MIDDLE
                  TN/TNW=TENNESSEE WESTERN
                  TX/001=TEXAS
                  TX/L01=AMARILLO-LTC
                  TX/L02=ABILENE-LTC
                  TX/L03=ARLINGTON-LTC
                  TX/L04=TYLER-LTC
                  TX/L05=TEMPLE-LTC
                  TX/L06=HOUSTON-LTC
                  TX/L07=SAN ANTONIO-LTC
                  TX/LAB=LABORATORIES
                  TX/NPH=NON-PARTICIPATING HOSPITAL
                  TX/TX1=NLTC REG 1, 7, 9, 10
                  TX/TX2=NLTC REG 2, 3
                  TX/TX4=NLTC REG 6
                  TX/TX5=NLTC REG 4, 5
                  TX/TX6=AUSTIN
                  TX/TX8=NLTC REG 8, 11
                  UT/001=UTAH
                  UT/LAB=LABORATORIES
                  UT/NPH=NON-PARTICIPATING HOSPITAL
                  VA/001=VIRGINIA
                  VA/LAB=LABORATORIES
                  VA/NPH=NON-PARTICIPATING HOSPITAL
                  VI/001=VIRGIN ISLANDS
                  VI/LAB=LABORATORIES
                  VI/NPH=NON-PARTICIPATING HOSPITAL
                  VT/001=VERMONT
                  VT/LAB=LABORATORIES
                  VT/NPH=NON-PARTICIPATING HOSPITAL
                  WA/001=ALL OTHERS (NON-LTC FAC)
                  WA/D1=SPOKANE & YAKIMA AREAS
                  WA/D1A=District 1, Unit A
                  WA/D1B=District 1, Unit B
                  WA/D1C=District 1, Unit C
                  WA/D1D=District 1, Unit D
                  WA/D1E=District 1, Unit E
                  WA/D2=SPOKANE & SE
                  WA/D2A=District 2, Unit A
                  WA/D2B=District 2, Unit B
                  WA/D2C=District 2, Unit C
                  WA/D2D=District 2, Unit D
                  WA/D2E=District 2, Unit E
                  WA/D2F=District 2, Unit F
                  WA/D2G=District 2, Unit G
                  WA/D2H=District 2, Unit H
                  WA/D2I=District 2, Unit I
                  WA/D2J=District 2, Unit J
                  WA/D3=NW WASHINGTON
                  WA/D3A=District 3, Unit A
                  WA/D3B=District 3, Unit B


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  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  WA/D3C=District 3, Unit C
                  WA/D3D=District 3, Unit D
                  WA/D3E=District 3, Unit E
                  WA/D3F=District 3, Unit F
                  WA/D3G=District 3, Unit G
                  WA/D4A=GREATER SEATTLE AREA
                  WA/D4B=S KING COUNTY
                  WA/D5A=PIERCE CTY & PENINSULA
                  WA/D5B=PIERCE CTY & GRAYS HARBOR
                  WA/D6=OLYMPIA AREA
                  WA/LAB=LABORATORIES
                  WA/NPH=NON-PARTICIPATING HOSPITAL
                  WI/001=WISCONSIN
                  WI/LAB=LABORATORIES
                  WI/NPH=NON-PARTICIPATING HOSPITAL
                  WV/001=WEST VIRGINIA
                  WV/LAB=LABORATORIES
                  WV/NPH=NON-PARTICIPATING HOSPITAL
                  WY/001=WYOMING
                  WY/LAB=LABORATORIES
                  WY/NPH=NON-PARTICIPATING HOSPITAL

   Address: Street                                   50   178   227  VARCHAR2
     Description: Street address where the provider is located.
     SAS Name:    ST_ADR
     COBOL Name:  ST-ADR

   Telephone Number                                  10   228   237  VARCHAR2
     Description: Telephone number of the provider.
     SAS Name:    PHNE_NUM
     COBOL Name:  PHNE-NUM

   Termination Code                                  2    238   239  VARCHAR2
     Description: Indicates the current termination status for the
                  provider.
     SAS Name:    PGM_TRMNTN_CD
     COBOL Name:  PGM-TRMNTN-CD
     VALUES:      00=ACTIVE PROVIDER
                  01=VOLUNTARY-MERGER, CLOSURE
                  02=VOLUNTARY-DISSATISFACTION WITH REIMBURSEMENT
                  03=VOLUNTARY-RISK OF INVOLUNTARY TERMINATION
                  04=VOLUNTARY-OTHER REASON FOR WITHDRAWAL
                  05=INVOLUNTARY-FAILURE TO MEET HEALTH/SAFETY REQ
                  06=INVOLUNTARY-FAILURE TO MEET AGREEMENT
                  07=OTHER-PROVIDER STATUS CHANGE
                  08=NONPAYMENT OF FEES - CLIA Only
                  09=REV/UNSUCCESSFUL PARTICIPATION IN PT - CLIA Only
                  10=REV/OTHER REASON - CLIA Only
                  11=INCOMPLETE CLIA APPLICATION INFORMATION - CLIA Only
                  12=NO LONGER PERFORMING TESTS - CLIA Only
                  13=MULTIPLE TO SINGLE SITE CERTIFICATE - CLIA Only
                  14=SHARED LABORATORY - CLIA Only
                  15=FAILURE TO RENEW WAIVER PPM CERTIFICATE - CLIA Only
                  16=DUPLICATE CLIA NUMBER - CLIA Only
                  17=MAIL RETURNED NO FORWARD ADDRESS CERT ENDED - CLIA Only
                  20=NOTIFICATION BANKRUPTCY - CLIA Only
                  33=ACCREDITATION NOT CONFIRMED - CLIA Only
                  80=AWAITING STATE APPROVAL
                  99=OIG ACTION - DO NOT ACTIVATE - CLIA Only

   Termination or Expiration Date                    8    240   247  DATE
     Description: Date the provider was terminated.  For CLIA providers,
                  date the laboratory's certificate was terminated or the


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 21
  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  expiration date of the current CLIA certificate.
     SAS Name:    TRMNTN_EXPRTN_DT
     COBOL Name:  TRMNTN-EXPRTN-DT

   Type of Action Code                               1    248   248  VARCHAR2
     Description: Identifies the reason for the certification.  Type of
                  action from the official survey record, CMS 1539 form.
     SAS Name:    CRTFCTN_ACTN_TYPE_CD
     COBOL Name:  CRTFCTN-ACTN-TYPE-CD
     VALUES:      1=INITIAL
                  2=RECERTIFICATION
                  3=TERMINATION
                  4=CHANGE OF OWNERSHIP
                  5=VALIDATION
                  8=FULL SURVEY AFTER COMPLAINT

   Ownership Type Code                               2    249   250  VARCHAR2
     Description: Indicates the ownership type of the provider.
     SAS Name:    GNRL_CNTL_TYPE_CD
     COBOL Name:  GNRL-CNTL-TYPE-CD
     VALUES:      01=VOLUNTARY NON PROFIT OTHER THAN CHURCH
                  02=VOLUNTARY NON PROFIT CHURCH
                  03=STATE GOVERNMENT
                  04=LOCAL GOVERNMENT
                  05=COMBINATION GOVERNMENT & VOLUNTARY
                  06=PROPRIETARY

   Address: ZIP Code                                 5    251   255  VARCHAR2
     Description: Five-digit ZIP code for a provider's physical address.
     SAS Name:    ZIP_CD
     COBOL Name:  ZIP-CD

   FIPS State Code                                   2    256   257  VARCHAR2
     Description: FIPS State Code
     SAS Name:    FIPS_STATE_CD
     COBOL Name:  FIPS-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  04=ARIZONA
                  05=ARKANSAS
                  06=CALIFORNIA
                  08=COLORADO
                  09=CONNECTICUT
                  10=DELAWARE
                  11=DISTRICT OF COLUMBIA
                  12=FLORIDA
                  13=GEORGIA
                  15=HAWAII
                  16=IDAHO
                  17=ILLINOIS
                  18=INDIANA
                  19=IOWA
                  20=KANSAS
                  21=KENTUCKY
                  22=LOUISIANA
                  23=MAINE
                  24=MARYLAND
                  25=MASSACHUSETTS
                  26=MICHIGAN
                  27=MINNESOTA
                  28=MISSISSIPPI
                  29=MISSOURI
                  30=MONTANA


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 22
  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  31=NEBRASKA
                  32=NEVADA
                  33=NEW HAMPSHIRE
                  34=NEW JERSEY
                  35=NEW MEXICO
                  36=NEW YORK
                  37=NORTH CAROLINA
                  38=NORTH DAKOTA
                  39=OHIO
                  40=OKLAHOMA
                  41=OREGON
                  42=PENNSYLVANIA
                  43=PUERTO RICO
                  44=RHODE ISLAND
                  45=SOUTH CAROLINA
                  46=SOUTH DAKOTA
                  47=TENNESSEE
                  48=TEXAS
                  49=UTAH
                  50=VERMONT
                  51=VIRGINIA
                  53=WASHINGTON
                  54=WEST VIRGINIA
                  55=WISCONSIN
                  56=WYOMING
                  60=AMERICAN SAMOA
                  66=GUAM
                  69=SAIPAN/MARIANA IS.
                  78=VIRGIN ISLANDS

   FIPS County Code                                  3    258   260  VARCHAR2
     Description: FIPS County Code
     SAS Name:    FIPS_CNTY_CD
     COBOL Name:  FIPS-CNTY-CD

   CBSA Urban Rural Indicator                        1    261   261  VARCHAR2
     Description: CBSA (Core Based Statistical Area) indicates whether the
                  county is defined as Urban or Rural.
     SAS Name:    CBSA_URBN_RRL_IND
     COBOL Name:  CBSA-URBN-RRL-IND

   CBSA Code                                         5    262   266  VARCHAR2
     Description: CBSA (Core Based Statistical Area) geographic entities
                  defined by the U.S. Office of Management and Budget (OMB)
                  on June 6, 2003 for use by Federal statistical agencies
                  in collecting, tabulating, and publishing Federal
                  statistics.  CBSA collectively refers to MSA.
     SAS Name:    CBSA_CD
     COBOL Name:  CBSA-CD

  *Accreditation Type Code                           1    283   283  VARCHAR2
     Description: Indicates an accrediting organization deeming the
                  provider.  If a provider is deemed by multiple
                  accrediting organizations then the accrediting
                  organization with the earliest active deeming effective
                  date is displayed in this field.
     SAS Name:    ACRDTN_TYPE_CD
     COBOL Name:  ACRDTN-TYPE-CD
     VALUES:      0=UNACCREDITED
                  1=AAAASF

   Category-specific Facility Type Code              2    388   389  VARCHAR2
     Description: Indicates the category-specific facility type code, for


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 23
  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  certain provider categories only.
     SAS Name:    GNRL_FAC_TYPE_CD
     COBOL Name:  GNRL-FAC-TYPE-CD
     VALUES:      01=Hospital
                  02=Skilled Nursing Facility
                  03=Home Health Agency
                  04=Rehabilitation Agency
                  05=Public Clinic
                  06=Private Clinic
                  07=Public Health Agency

   Fiscal Year End Date (MMDD)                       4    464   467  VARCHAR2
     Description: End date, consisting of the month and day, of the
                  provider's fiscal year.
     SAS Name:    FY_END_MO_DAY_CD
     COBOL Name:  FY-END-MO-DAY-CD

   Related Provider Number                           10   686   695  CHAR
     Description: Related provider number
     SAS Name:    RELATED_PROVIDER_NUMBER
     COBOL Name:  RELATED-PROVIDER-NUMBER

   Services: OT Code                                 1    775   775  CHAR
     Description: Indicates how occupational therapy services are provided.
     SAS Name:    OT_SRVC_CD
     COBOL Name:  OT-SRVC-CD
     VALUES:      0=Not Provided
                  1=Provided

   Services: PT Code                                 1    813   813  CHAR
     Description: Indicates how physical therapy services are provided.
     SAS Name:    PT_SRVC_CD
     COBOL Name:  PT-SRVC-CD
     VALUES:      0=Not Provided
                  1=Provided

   Services: Speech Pathology Code                   1    833   833  CHAR
     Description: Indicates how speech pathology services are provided.
     SAS Name:    SPCH_PTHLGY_SRVC_CD
     COBOL Name:  SPCH-PTHLGY-SRVC-CD
     VALUES:      0=Not Provided
                  1=Provided

   Staff Count: OT - Total                           8    1310  1317 NUMBER
     Description: Total number of full-time equivalent occupational
                  therapists employed by a provider.
     SAS Name:    OCPTNL_THRPST_CNT
     COBOL Name:  OCPTNL-THRPST-CNT

   Staff Count: OT - Arrangement                     8    1318  1325 NUMBER
     Description: Number of full-time equivalent occupational therapists
                  under arrangement to the provider
     SAS Name:    OCPTNL_THRPST_CNTRCT_CNT
     COBOL Name:  OCPTNL-THRPST-CNTRCT-CNT

   Staff Count: OT - Full-Time                       8    1326  1333 NUMBER
     Description: Number of full-time equivalent occupational therapists
                  employed full-time by a facility.
     SAS Name:    OCPTNL_THRPST_FLTM_CNT
     COBOL Name:  OCPTNL-THRPST-FLTM-CNT

   Staff Count: PT                                   8    1630  1637 NUMBER
     Description: Number of full-time equivalent physical therapists


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 24
  Outpatient Physical Therapy/Speech Pathology, CATEGORY = "08" (SEE POSITIONS
                                      3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  employed by a provider.
     SAS Name:    PHYS_THRPST_STF_CNT
     COBOL Name:  PHYS-THRPST-STF-CNT

   Staff Count: PT                                   8    1638  1645 NUMBER
     Description: Number of full-time equivalent physical therapists
                  employed by a provider.
     SAS Name:    PHYS_THRPST_CNT
     COBOL Name:  PHYS-THRPST-CNT

   Staff Count: PT - Arrangement                     8    1646  1653 NUMBER
     Description: Total number of full-time equivalent physical therapists
                  at the outpatient physical therapy facility.
     SAS Name:    PHYS_THRPST_ARNGMT_CNT
     COBOL Name:  PHYS-THRPST-ARNGMT-CNT

   Staff Count: Speech Pathologist - Arrangement     8    1846  1853 NUMBER
     Description: Number of full-time equivalent speech pathologists under
                  arrangement to the outpatient physical therapy facility.
     SAS Name:    SPCH_PTHLGST_ARNGMT_CNT
     COBOL Name:  SPCH-PTHLGST-ARNGMT-CNT

   Staff Count: Speech Pathologist - Full-Time       8    1862  1869 NUMBER
     Description: Number of full-time equivalent speech pathologists
                  employed full-time by a facility.
     SAS Name:    SPCH_PTHLGST_FLTM_CNT
     COBOL Name:  SPCH-PTHLGST-FLTM-CNT

   Staff Count: Speech Pathologist - Total           8    1878  1885 NUMBER
     Description: Total number of full-time equivalent speech pathologists
                  at the outpatient physical therapy facility.
     SAS Name:    SPCH_PTHLGST_CNT
     COBOL Name:  SPCH-PTHLGST-CNT
































 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 1
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Provider Category Subtype Code                    2    1     2    VARCHAR2
     Description: Identifies the subtype of the provider, within the
                  primary category.  Used in reporting to show the
                  breakdown of provider categories, mainly for hospitals
                  and SNFs.
     SAS Name:    PRVDR_CTGRY_SBTYP_CD
     COBOL Name:  PRVDR-CTGRY-SBTYP-CD
     VALUES:      01=End Stage Renal Disease

   Provider Category Code                            2    3     4    VARCHAR2
     Description: Identifies the type of provider participating in the
                  Medicare/Medicaid program.
     SAS Name:    PRVDR_CTGRY_CD
     COBOL Name:  PRVDR-CTGRY-CD
     VALUES:      09=End Stage Renal Disease Facility

   CHOW Count                                        2    5     6    NUMBER
     Description: Number of times this provider has undergone a change of
                  ownership.
     SAS Name:    CHOW_CNT
     COBOL Name:  CHOW-CNT

   CHOW Date                                         8    7     14   DATE
     Description: Effective date of the most recent change of ownership for
                  this provider.
     SAS Name:    CHOW_DT
     COBOL Name:  CHOW-DT

   Address: City                                     28   15    42   VARCHAR2
     Description: City in which the provider is physically located.
     SAS Name:    CITY_NAME
     COBOL Name:  CITY-NAME

   Compliance: Acceptable POC                        1    43    43   VARCHAR2
     Description: Indicates if a provider is in compliance with program
                  requirements based on an acceptable plan for correction
                  of deficiencies.
     SAS Name:    ACPTBL_POC_SW
     COBOL Name:  ACPTBL-POC-SW

   Compliance: Status                                1    44    44   VARCHAR2
     Description: Compliance status of a provider at the time of
                  certification survey.
     SAS Name:    CMPLNC_STUS_CD
     COBOL Name:  CMPLNC-STUS-CD
     VALUES:      A=IN COMPLIANCE
                  B=NOT IN COMPLIANCE

   SSA County Code                                   3    45    47   VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the county where the provider is located.
     SAS Name:    SSA_CNTY_CD
     COBOL Name:  SSA-CNTY-CD

   Cross Ref Provider Number                         10   48    57   CHAR
     Description: Cross reference provider number
     SAS Name:    CROSS_REF_PROVIDER_NUMBER
     COBOL Name:  CROSS-REF-PROVIDER-NUMBER

   Certification Date                                8    58    65   DATE
     Description: Equal to the exit date of the initial visit of the Health
                  survey for certifications completed after July 28, 2012.
                  For certifications prior to that date, the certification


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 2
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  date is equal to the exit date of the initial visit of
                  the Health survey or LSC survey, whichever is later.
     SAS Name:    CRTFCTN_DT
     COBOL Name:  CRTFCTN-DT

   Eligibility Indicator                             1    66    66   VARCHAR2
     Description: Indicates if a facility is eligible to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    ELGBLTY_SW
     COBOL Name:  ELGBLTY-SW

   Facility Name                                     50   67    116  VARCHAR2
     Description: Name of the provider certified to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    FAC_NAME
     COBOL Name:  FAC-NAME

   Medicare Administrative Contractor (MAC) or       5    117   121  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_CD
     COBOL Name:  INTRMDRY-CARR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 3
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 4
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 5
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 6
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)
                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 7
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   Medicaid Vendor Number                            15   122   136  VARCHAR2
     Description: Number which may be assigned to a provider by the state
                  Medicaid agency for external control or billing purposes.
     SAS Name:    MDCD_VNDR_NUM
     COBOL Name:  MDCD-VNDR-NUM

   Original Participation Date                       8    137   144  DATE
     Description: Date a provider is first approved to provide Medicare
                  and/or Medicaid services.
     SAS Name:    ORGNL_PRTCPTN_DT
     COBOL Name:  ORGNL-PRTCPTN-DT

   Prior CHOW Date                                   8    145   152  DATE
     Description: Effective date of the previous change of ownership for
                  this provider.
     SAS Name:    CHOW_PRIOR_DT
     COBOL Name:  CHOW-PRIOR-DT

   Prior Medicare Administrative Contractor (MAC) or 5    153   157  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the previous Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_PRIOR_CD
     COBOL Name:  INTRMDRY-CARR-PRIOR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 8
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 9
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 10
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 11
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 12
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   CCN                                               10   158   167  VARCHAR2
     Description: Six or ten position identification number that is
                  assigned to a certified provider.  This is the CMS
                  Certification Number.
     SAS Name:    PRVDR_NUM
     COBOL Name:  PRVDR-NUM

   Region Code                                       2    168   169  VARCHAR2
     Description: Indicates the CMS Regional Office responsible for the
                  certification of the provider.
     SAS Name:    RGN_CD
     COBOL Name:  RGN-CD
     VALUES:      01=Boston
                  02=New York
                  03=Philadelphia
                  04=Atlanta
                  05=Chicago
                  06=Dallas
                  07=Kansas City
                  08=Denver
                  09=San Francisco
                  10=Seattle

   Skeleton Record Indicator                         1    170   170  VARCHAR2
     Description: Indicates if the record is a skeleton record.  Only a
                  limited set of data is available for this provider; no
                  survey data exists.  Only provider categories
                  01,17,19,21and 22 can have skeleton providers.
     SAS Name:    SKLTN_REC_SW
     COBOL Name:  SKLTN-REC-SW

   State Abbreviation                                2    171   172  VARCHAR2
     Description: Two-character state abbreviation.
     SAS Name:    STATE_CD
     COBOL Name:  STATE-CD
     VALUES:      AK=ALASKA
                  AL=ALABAMA
                  AR=ARKANSAS
                  AS=AMERICAN SAMOA
                  AZ=ARIZONA
                  CA=CALIFORNIA
                  CN=CANADA
                  CO=COLORADO
                  CT=CONNECTICUT
                  DC=DISTRICT OF COLUMBIA
                  DE=DELAWARE
                  FL=FLORIDA
                  FN=INTERNATIONAL
                  GA=GEORGIA
                  GU=GUAM
                  HI=HAWAII
                  IA=IOWA
                  ID=IDAHO


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 13
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  IL=ILLINOIS
                  IN=INDIANA
                  KS=KANSAS
                  KY=KENTUCKY
                  LA=LOUISIANA
                  MA=MASSACHUSETTS
                  MD=MARYLAND
                  ME=MAINE
                  MI=MICHIGAN
                  MN=MINNESOTA
                  MO=MISSOURI
                  MP=SAIPAN
                  MS=MISSISSIPPI
                  MT=MONTANA
                  MX=MEXICO
                  NC=NORTH CAROLINA
                  ND=NORTH DAKOTA
                  NE=NEBRASKA
                  NH=NEW HAMPSHIRE
                  NJ=NEW JERSEY
                  NM=NEW MEXICO
                  NV=NEVADA
                  NY=NEW YORK
                  OH=OHIO
                  OK=OKLAHOMA
                  OR=OREGON
                  PA=PENNSYLVANIA
                  PR=PUERTO RICO
                  RI=RHODE ISLAND
                  SC=SOUTH CAROLINA
                  SD=SOUTH DAKOTA
                  TN=TENNESSEE
                  TX=TEXAS
                  UT=UTAH
                  VA=VIRGINIA
                  VI=VIRGIN ISLANDS
                  VT=VERMONT
                  WA=WASHINGTON
                  WI=WISCONSIN
                  WV=WEST VIRGINIA
                  WY=WYOMING

   SSA State Code                                    2    173   174  VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the state where the provider is located.
     SAS Name:    SSA_STATE_CD
     COBOL Name:  SSA-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  03=ARIZONA
                  04=ARKANSAS
                  05=CALIFORNIA
                  06=COLORADO
                  07=CONNECTICUT
                  08=DELAWARE
                  09=DISTRICT OF COLUMBIA
                  10=FLORIDA
                  11=GEORGIA
                  12=HAWAII
                  13=IDAHO
                  14=ILLINOIS
                  15=INDIANA
                  16=IOWA
                  17=KANSAS


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 14
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  18=KENTUCKY
                  19=LOUISIANA
                  20=MAINE
                  21=MARYLAND
                  22=MASSACHUSETTS
                  23=MICHIGAN
                  24=MINNESOTA
                  25=MISSISSIPPI
                  26=MISSOURI
                  27=MONTANA
                  28=NEBRASKA
                  29=NEVADA
                  30=NEW HAMPSHIRE
                  31=NEW JERSEY
                  32=NEW MEXICO
                  33=NEW YORK
                  34=NORTH CAROLINA
                  35=NORTH DAKOTA
                  36=OHIO
                  37=OKLAHOMA
                  38=OREGON
                  39=PENNSYLVANIA
                  40=PUERTO RICO
                  41=RHODE ISLAND
                  42=SOUTH CAROLINA
                  43=SOUTH DAKOTA
                  44=TENNESSEE
                  45=TEXAS
                  46=UTAH
                  47=VERMONT
                  48=VIRGIN ISLANDS
                  49=VIRGINIA
                  50=WASHINGTON
                  51=WEST VIRGINIA
                  52=WISCONSIN
                  53=WYOMING
                  54=AFRICA
                  56=CANADA
                  57=WEST INDIES
                  58=EUROPE
                  59=MEXICO
                  60=OCEANIA
                  61=PHILIPPINES
                  62=SOUTH AMERICA
                  63=UNITED STATES POSSESSIONS
                  64=AMERICAN SAMOA
                  65=GUAM
                  66=SAIPAN
                  99=INTERNATIONAL

   State Region Code                                 3    175   177  VARCHAR2
     Description: Identifies the region within a state where the provider
                  is located.
     SAS Name:    STATE_RGN_CD
     COBOL Name:  STATE-RGN-CD
     VALUES:      AK/001=ALASKA
                  AK/LAB=LABORATORIES
                  AK/NPH=NON-PARTICIPATING HOSPITAL
                  AL/001=ALABAMA
                  AL/LAB=LABORATORIES
                  AL/NPH=NON-PARTICIPATING HOSPITAL
                  AR/001=ARKANSAS
                  AR/LAB=LABORATORIES
                  AR/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 15
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  AS/001=AMERICAN SAMOA
                  AS/LAB=LABORATORY
                  AS/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/AZ=PHOENIX
                  AZ/LAB=ARIZONA LAB
                  AZ/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/TUC=TUCSON
                  CA/001=CALIFORNIA
                  CA/BAK=BAKERSFIELD
                  CA/BER=SAN BERNARDINO
                  CA/EB=East Bay
                  CA/FR=FRESNO
                  CA/L1=L.A. WEST
                  CA/L2=L.A. NORTH
                  CA/L3=L.A. CENTRAL
                  CA/L4=L.A. EAST
                  CA/L5=SAN GABRIEL
                  CA/LA1=LA Region 1
                  CA/LA2=LA Region 2
                  CA/LA3=LA Region 3
                  CA/LA4=LA Acute/Ancillary
                  CA/LA5=LA HHA/Hospice
                  CA/LA6=LA ICF/DD/CLinics
                  CA/LAB=LABORATORIES
                  CA/M1=LAB. SOUTH
                  CA/M2=LAB. NORTH
                  CA/NPH=NON-PARTICIPATING HOSPITAL
                  CA/ORG=ORANGE
                  CA/RIV=RIVERSIDE
                  CA/S1=SACRAMENTO
                  CA/S3=CHICO
                  CA/SD=SAN DIEGO
                  CA/SF=SAN FRANCISCO
                  CA/SJ=SAN JOSE
                  CA/SR=SANTA ROSA
                  CA/VEN=VENTURA
                  CN/001=CANADA
                  CN/LAB=LABORATORY
                  CN/NPH=NON-PARTICIPATING HOSPITAL
                  CO/001=COLORADO
                  CO/LAB=LABORATORIES
                  CO/NPH=NON-PARTICIPATING HOSPITAL
                  CT/001=CONNECTICUT
                  CT/LAB=LABORATORIES
                  CT/NPH=NON-PARTICIPATING HOSPITAL
                  DC/001=DISTRICT OF COLUMBIA
                  DC/LAB=LABORATORIES
                  DC/NPH=NON-PARTICIPATING HOSPITAL
                  DE/001=DELAWARE
                  DE/LAB=LABORATORIES
                  DE/NPH=NON-PARTICIPATING HOSPITAL
                  FL/001=FLORIDA
                  FL/FTM=FT. MYERS
                  FL/GAI=GAINESVILLE
                  FL/JAX=JACKSONVILLE
                  FL/LAB=LABORATORIES
                  FL/LAN=LANTANA
                  FL/LAU=LAUDERHILL
                  FL/MIA=MIAMI
                  FL/NPH=NON-PARTICIPATING HOSPITAL
                  FL/ORL=ORLANDO
                  FL/PEN=PENSACOLA
                  FL/STP=ST. PETERSBURG
                  FL/TAL=TALLAHASSEE


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 16
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  FL/TAM=TAMPA
                  FM/001=FEDERATED STATES OF MICRO
                  FM/NPH=NON-PARTICIPATING HOSPITAL
                  FN/001=INTERNATIONAL
                  FN/LAB=LABORATORIES
                  FN/NPH=NON-PARTICIPATING HOSPITAL
                  GA/001=GEORGIA
                  GA/GAA=GEORGIA ALL
                  GA/GAC=GEORGIA CENTRAL
                  GA/GAE=GEORGIA EASTERN
                  GA/GAN=GEORGIA NORTH
                  GA/GAS=GEORGIA SOUTH
                  GA/GAW=GEORGIA WESTERN
                  GA/LAB=LABORATORIES
                  GA/NPH=NON-PARTICIPATING HOSPITAL
                  GU/001=GUAM
                  GU/LAB=LABORATORIES
                  GU/NPH=NON-PARTICIPATING HOSPITAL
                  HI/001=HAWAII
                  HI/LAB=LABORATORIES
                  HI/NPH=NON-PARTICIPATING HOSPITAL
                  IA/001=IOWA
                  IA/LAB=LABORATORIES
                  IA/NPH=NON-PARTICIPATING HOSPITAL
                  ID/001=IDAHO
                  ID/LAB=LABORATORIES
                  ID/NPH=NON-PARTICIPATING HOSPITAL
                  IL/001=ILLINOIS
                  IL/LAB=LABORATORIES
                  IL/NPH=NON-PARTICIPATING HOSPITAL
                  IN/001=INDIANA
                  IN/LAB=LABORATORIES
                  IN/NPH=NON-PARTICIPATING HOSPITAL
                  KS/001=KANSAS
                  KS/KCK=KANSAS CITY
                  KS/KDH=KDHE
                  KS/LAB=LABORATORIES
                  KS/LAW=LAWRENCE
                  KS/NC=NORTH CENTRAL KANSAS
                  KS/NE=NORTH EAST KANSAS
                  KS/NPH=NON-PARTICIPATING HOSPITAL
                  KS/NW=NORTH WEST KANSAS
                  KS/SC=SOUTH CENTRAL KANSAS
                  KS/SE=SOUTH EAST KANSAS
                  KS/SW=SOUTH WEST KANSAS
                  KS/WST=WEST
                  KY/2C1=HOPKINSVILLE
                  KY/2C2=LOUISVILLE
                  KY/2C3=LONDON
                  KY/2C4=LEXINGTON
                  KY/LAB=LABORATORIES
                  KY/NPH=NON-PARTICIPATING HOSPITAL
                  LA/001=LOUISIANA
                  LA/LA1=NEW ORLEANS
                  LA/LA2=MANDEVILLE
                  LA/LA3=LAFAYETTE
                  LA/LA4=MONROE
                  LA/LA5=SHREVEPORT
                  LA/LA6=ALEXANDRIA
                  LA/LAB=LABORATORIES
                  LA/LB1=CLIA NEW ORLEANS
                  LA/LB5=CLIA SHREVEPORT
                  LA/LB6=CLIA ALEXANDRIA
                  LA/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 17
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  MA/001=MASSACHUSETTS
                  MA/LAB=LABORATORIES
                  MA/NPH=NON-PARTICIPATING HOSPITAL
                  MD/001=MARYLAND
                  MD/LAB=LABORATORIES
                  MD/NPH=NON-PARTICIPATING HOSPITAL
                  ME/001=MAINE
                  ME/LAB=LABORATORIES
                  ME/NPH=NON-PARTICIPATING HOSPITAL
                  MH/001=MARSHALL ISLANDS
                  MH/NPH=NON-PARTICIPATING HOSPITAL
                  MI/001=MICHIGAN
                  MI/LAB=LABORATORIES
                  MI/NPH=NON-PARTICIPATING HOSPITAL
                  MN/001=MINNESOTA
                  MN/LAB=LABORATORIES
                  MN/NPH=NON-PARTICIPATING HOSPITAL
                  MO/001=MISSOURI
                  MO/01=REGION01
                  MO/02=REGION02
                  MO/03=REGION 03
                  MO/04=REGION 04
                  MO/05=REGION 05
                  MO/06=REGION 06
                  MO/07=REGION 07
                  MO/1NH=REGION 1 NH
                  MO/2NH=REGION 2 NH
                  MO/3NH=REGION 3 NH
                  MO/4NH=REGION 4 NH
                  MO/5NH=REGION 5 NH
                  MO/6NH=REGION 6 NH
                  MO/7NH=REGION 7 NH
                  MO/LAB=LABORATORIES
                  MO/MO=STATEWIDE
                  MO/NPH=NON-PARTICIPATING HOSPITAL
                  MP/001=NORTHERN MARIANA ISLANDS
                  MP/LAB=LABORATORIES
                  MP/NPH=NON-PARTICIPATING HOSPITAL
                  MS/001=MISSISSIPPI
                  MS/LAB=LABORATORIES
                  MS/NPH=NON-PARTICIPATING HOSPITAL
                  MT/001=MONTANA
                  MT/LAB=LABORATORIES
                  MT/NPH=NON-PARTICIPATING HOSPITAL
                  MX/001=MEXICO
                  MX/LAB=LABORATORY
                  MX/NPH=NON-PARTICIPATING HOSPITAL
                  NC/001=NORTH CAROLINA
                  NC/LAB=LABORATORIES
                  NC/NCC=NORTH CAROLINA CENTRAL
                  NC/NCE=NORTH CAROLINA EAST
                  NC/NCN=NORTH CAROLINA NORTH
                  NC/NCS=NORTH CAROLINA SOUTH
                  NC/NCW=NORTH CAROLINA WEST
                  NC/NPH=NON-PARTICIPATING HOSPITAL
                  ND/001=NORTH DAKOTA
                  ND/LAB=LABORATORIES
                  ND/NPH=NON-PARTICIPATING HOSPITAL
                  NE/001=NEBRASKA
                  NE/1=NORTH CENTRAL
                  NE/2=CENTRAL
                  NE/3=NORTHEAST
                  NE/4=SOUTHEAST
                  NE/5=WESTERN


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 18
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  NE/LAB=LABORATORIES
                  NE/NPH=NON-PARTICIPATING HOSPITAL
                  NH/001=NEW HAMPSHIRE
                  NH/LAB=LABORATORIES
                  NH/NPH=NON-PARTICIPATING HOSPITAL
                  NJ/001=NEW JERSEY
                  NJ/LAB=LABORATORIES
                  NJ/NPH=NON-PARTICIPATING HOSPITAL
                  NM/001=NEW MEXICO
                  NM/LAB=LABORATORIES
                  NM/NPH=NON-PARTICIPATING HOSPITAL
                  NV/001=NEVADA
                  NV/CC=CARSON CITY
                  NV/LAB=LABORATORIES
                  NV/LV=LAS VEGAS
                  NV/NPH=NON-PARTICIPATING HOSPITAL
                  NY/001=BUFFALO
                  NY/002=ROCHESTER
                  NY/003=SYRACUSE
                  NY/004=ALBANY
                  NY/005=NEW ROCHELLE
                  NY/006=NEW YORK CITY
                  NY/007=SUFFOLK/NASSAU COUNTY
                  NY/LAB=LABORATORIES
                  NY/NPH=NON-PARTICIPATING HOSPITAL
                  OH/001=OHIO
                  OH/LAB=LABORATORIES
                  OH/NPH=NON-PARTICIPATING HOSPITAL
                  OK/001=OKLAHOMA
                  OK/LAB=LABORATORIES
                  OK/NPH=NON-PARTICIPATING HOSPITAL
                  OR/001=OFFICE #1
                  OR/002=OFFICE #2
                  OR/003=OFFICE #3
                  OR/LAB=LABORATORIES
                  OR/NPH=NON-PARTICIPATING HOSPITAL
                  PA/001=PENNSYLVANIA
                  PA/LAB=LABORATORIES
                  PA/NPH=NON-PARTICIPATING HOSPITAL
                  PR/001=PUERTO RICO
                  PR/LAB=LABORATORIES
                  PR/NPH=NON-PARTICIPATING HOSPITAL
                  PW/001=PALAU
                  PW/NPH=NON-PARTICIPATING HOSPITAL
                  RI/001=RHODE ISLAND
                  RI/LAB=LABORATORIES
                  RI/NPH=NON-PARTICIPATING HOSPITAL
                  SC/001=SOUTH CAROLINA
                  SC/LAB=LABORATORIES
                  SC/NPH=NON-PARTICIPATING HOSPITAL
                  SD/001=SOUTH DAKOTA
                  SD/LAB=LABORATORIES
                  SD/NPH=NON-PARTICIPATING HOSPITAL
                  TN/001=TENNESSEE
                  TN/LAB=LABORATORIES
                  TN/NPH=NON-PARTICIPATING HOSPITAL
                  TN/TNC=TENNESSEE COOKEVILLE
                  TN/TNE=TENNESSEE EASTERN
                  TN/TNM=TENNESSEE MIDDLE
                  TN/TNW=TENNESSEE WESTERN
                  TX/001=TEXAS
                  TX/L01=AMARILLO-LTC
                  TX/L02=ABILENE-LTC
                  TX/L03=ARLINGTON-LTC


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 19
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  TX/L04=TYLER-LTC
                  TX/L05=TEMPLE-LTC
                  TX/L06=HOUSTON-LTC
                  TX/L07=SAN ANTONIO-LTC
                  TX/LAB=LABORATORIES
                  TX/NPH=NON-PARTICIPATING HOSPITAL
                  TX/TX1=NLTC REG 1, 7, 9, 10
                  TX/TX2=NLTC REG 2, 3
                  TX/TX4=NLTC REG 6
                  TX/TX5=NLTC REG 4, 5
                  TX/TX6=AUSTIN
                  TX/TX8=NLTC REG 8, 11
                  UT/001=UTAH
                  UT/LAB=LABORATORIES
                  UT/NPH=NON-PARTICIPATING HOSPITAL
                  VA/001=VIRGINIA
                  VA/LAB=LABORATORIES
                  VA/NPH=NON-PARTICIPATING HOSPITAL
                  VI/001=VIRGIN ISLANDS
                  VI/LAB=LABORATORIES
                  VI/NPH=NON-PARTICIPATING HOSPITAL
                  VT/001=VERMONT
                  VT/LAB=LABORATORIES
                  VT/NPH=NON-PARTICIPATING HOSPITAL
                  WA/001=ALL OTHERS (NON-LTC FAC)
                  WA/D1=SPOKANE & YAKIMA AREAS
                  WA/D1A=District 1, Unit A
                  WA/D1B=District 1, Unit B
                  WA/D1C=District 1, Unit C
                  WA/D1D=District 1, Unit D
                  WA/D1E=District 1, Unit E
                  WA/D2=SPOKANE & SE
                  WA/D2A=District 2, Unit A
                  WA/D2B=District 2, Unit B
                  WA/D2C=District 2, Unit C
                  WA/D2D=District 2, Unit D
                  WA/D2E=District 2, Unit E
                  WA/D2F=District 2, Unit F
                  WA/D2G=District 2, Unit G
                  WA/D2H=District 2, Unit H
                  WA/D2I=District 2, Unit I
                  WA/D2J=District 2, Unit J
                  WA/D3=NW WASHINGTON
                  WA/D3A=District 3, Unit A
                  WA/D3B=District 3, Unit B
                  WA/D3C=District 3, Unit C
                  WA/D3D=District 3, Unit D
                  WA/D3E=District 3, Unit E
                  WA/D3F=District 3, Unit F
                  WA/D3G=District 3, Unit G
                  WA/D4A=GREATER SEATTLE AREA
                  WA/D4B=S KING COUNTY
                  WA/D5A=PIERCE CTY & PENINSULA
                  WA/D5B=PIERCE CTY & GRAYS HARBOR
                  WA/D6=OLYMPIA AREA
                  WA/LAB=LABORATORIES
                  WA/NPH=NON-PARTICIPATING HOSPITAL
                  WI/001=WISCONSIN
                  WI/LAB=LABORATORIES
                  WI/NPH=NON-PARTICIPATING HOSPITAL
                  WV/001=WEST VIRGINIA
                  WV/LAB=LABORATORIES
                  WV/NPH=NON-PARTICIPATING HOSPITAL
                  WY/001=WYOMING


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 20
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  WY/LAB=LABORATORIES
                  WY/NPH=NON-PARTICIPATING HOSPITAL

   Address: Street                                   50   178   227  VARCHAR2
     Description: Street address where the provider is located.
     SAS Name:    ST_ADR
     COBOL Name:  ST-ADR

   Telephone Number                                  10   228   237  VARCHAR2
     Description: Telephone number of the provider.
     SAS Name:    PHNE_NUM
     COBOL Name:  PHNE-NUM

   Termination Code                                  2    238   239  VARCHAR2
     Description: Indicates the current termination status for the
                  provider.
     SAS Name:    PGM_TRMNTN_CD
     COBOL Name:  PGM-TRMNTN-CD
     VALUES:      00=ACTIVE PROVIDER
                  01=VOLUNTARY-MERGER, CLOSURE
                  02=VOLUNTARY-DISSATISFACTION WITH REIMBURSEMENT
                  03=VOLUNTARY-RISK OF INVOLUNTARY TERMINATION
                  04=VOLUNTARY-OTHER REASON FOR WITHDRAWAL
                  05=INVOLUNTARY-FAILURE TO MEET HEALTH/SAFETY REQ
                  06=INVOLUNTARY-FAILURE TO MEET AGREEMENT
                  07=OTHER-PROVIDER STATUS CHANGE
                  08=NONPAYMENT OF FEES - CLIA Only
                  09=REV/UNSUCCESSFUL PARTICIPATION IN PT - CLIA Only
                  10=REV/OTHER REASON - CLIA Only
                  11=INCOMPLETE CLIA APPLICATION INFORMATION - CLIA Only
                  12=NO LONGER PERFORMING TESTS - CLIA Only
                  13=MULTIPLE TO SINGLE SITE CERTIFICATE - CLIA Only
                  14=SHARED LABORATORY - CLIA Only
                  15=FAILURE TO RENEW WAIVER PPM CERTIFICATE - CLIA Only
                  16=DUPLICATE CLIA NUMBER - CLIA Only
                  17=MAIL RETURNED NO FORWARD ADDRESS CERT ENDED - CLIA Only
                  20=NOTIFICATION BANKRUPTCY - CLIA Only
                  33=ACCREDITATION NOT CONFIRMED - CLIA Only
                  80=AWAITING STATE APPROVAL
                  99=OIG ACTION - DO NOT ACTIVATE - CLIA Only

   Termination or Expiration Date                    8    240   247  DATE
     Description: Date the provider was terminated.  For CLIA providers,
                  date the laboratory's certificate was terminated or the
                  expiration date of the current CLIA certificate.
     SAS Name:    TRMNTN_EXPRTN_DT
     COBOL Name:  TRMNTN-EXPRTN-DT

   Type of Action Code                               1    248   248  VARCHAR2
     Description: Identifies the reason for the certification.  Type of
                  action from the official survey record, CMS 1539 form.
     SAS Name:    CRTFCTN_ACTN_TYPE_CD
     COBOL Name:  CRTFCTN-ACTN-TYPE-CD
     VALUES:      1=INITIAL
                  2=RECERTIFICATION
                  3=TERMINATION
                  4=CHANGE OF OWNERSHIP
                  5=VALIDATION
                  8=FULL SURVEY AFTER COMPLAINT

   Ownership Type Code                               2    249   250  VARCHAR2
     Description: Indicates the ownership type of the provider.
     SAS Name:    GNRL_CNTL_TYPE_CD
     COBOL Name:  GNRL-CNTL-TYPE-CD


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     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     VALUES:      01=FOR PROFIT
                  02=NOT FOR PROFIT
                  03=PUBLIC

   Address: ZIP Code                                 5    251   255  VARCHAR2
     Description: Five-digit ZIP code for a provider's physical address.
     SAS Name:    ZIP_CD
     COBOL Name:  ZIP-CD

   FIPS State Code                                   2    256   257  VARCHAR2
     Description: FIPS State Code
     SAS Name:    FIPS_STATE_CD
     COBOL Name:  FIPS-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  04=ARIZONA
                  05=ARKANSAS
                  06=CALIFORNIA
                  08=COLORADO
                  09=CONNECTICUT
                  10=DELAWARE
                  11=DISTRICT OF COLUMBIA
                  12=FLORIDA
                  13=GEORGIA
                  15=HAWAII
                  16=IDAHO
                  17=ILLINOIS
                  18=INDIANA
                  19=IOWA
                  20=KANSAS
                  21=KENTUCKY
                  22=LOUISIANA
                  23=MAINE
                  24=MARYLAND
                  25=MASSACHUSETTS
                  26=MICHIGAN
                  27=MINNESOTA
                  28=MISSISSIPPI
                  29=MISSOURI
                  30=MONTANA
                  31=NEBRASKA
                  32=NEVADA
                  33=NEW HAMPSHIRE
                  34=NEW JERSEY
                  35=NEW MEXICO
                  36=NEW YORK
                  37=NORTH CAROLINA
                  38=NORTH DAKOTA
                  39=OHIO
                  40=OKLAHOMA
                  41=OREGON
                  42=PENNSYLVANIA
                  43=PUERTO RICO
                  44=RHODE ISLAND
                  45=SOUTH CAROLINA
                  46=SOUTH DAKOTA
                  47=TENNESSEE
                  48=TEXAS
                  49=UTAH
                  50=VERMONT
                  51=VIRGINIA
                  53=WASHINGTON
                  54=WEST VIRGINIA
                  55=WISCONSIN


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 22
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  56=WYOMING
                  60=AMERICAN SAMOA
                  66=GUAM
                  69=SAIPAN/MARIANA IS.
                  78=VIRGIN ISLANDS

   FIPS County Code                                  3    258   260  VARCHAR2
     Description: FIPS County Code
     SAS Name:    FIPS_CNTY_CD
     COBOL Name:  FIPS-CNTY-CD

   CBSA Urban Rural Indicator                        1    261   261  VARCHAR2
     Description: CBSA (Core Based Statistical Area) indicates whether the
                  county is defined as Urban or Rural.
     SAS Name:    CBSA_URBN_RRL_IND
     COBOL Name:  CBSA-URBN-RRL-IND

   CBSA Code                                         5    262   266  VARCHAR2
     Description: CBSA (Core Based Statistical Area) geographic entities
                  defined by the U.S. Office of Management and Budget (OMB)
                  on June 6, 2003 for use by Federal statistical agencies
                  in collecting, tabulating, and publishing Federal
                  statistics.  CBSA collectively refers to MSA.
     SAS Name:    CBSA_CD
     COBOL Name:  CBSA-CD

  *Accreditation Type Code                           1    283   283  VARCHAR2
     Description: Indicates an accrediting organization deeming the
                  provider.  If a provider is deemed by multiple
                  accrediting organizations then the accrediting
                  organization with the earliest active deeming effective
                  date is displayed in this field.
     SAS Name:    ACRDTN_TYPE_CD
     COBOL Name:  ACRDTN-TYPE-CD
     VALUES:      0=UNACCREDITED
                  1=NDAC
                  3=ACHC

   ESRD Network Number                               2    451   452  VARCHAR2
     Description: Number of the network to which the end-stage renal
                  disease facility is assigned.
     SAS Name:    ESRD_NTWRK_NUM
     COBOL Name:  ESRD-NTWRK-NUM
     VALUES:      01=CONN-MAINE-MASS-NEW HAMP-RHODE ISLAND-VERMONT
                  02=NEW YORK
                  03=NEW JERSEY, PUERTO RICO AND VIRGIN ISLAND
                  04=DELAWARE AND PENNSYLVANIA
                  05=DIST OF COLUM-MARYLAND-VIRGINIA-WEST VIRGINIA
                  06=GEORGIA, SOUTH CAROLINA AND NORTH CAROLINA
                  07=FLORIDA
                  08=ALABAMA, MISSISSIPPI AND TENNESSEE
                  09=INDIANA, KENTUCKY AND OHIO
                  10=ILLINOIS
                  11=MICH-MINN-NORTH DAKOTA-SOUTH DAKOTA-WISCONSIN
                  12=IOWA, KANSAS, MISSOURI AND NEBRASKA
                  13=ARKANSAS, LOUISIANA AND OKLAHOMA
                  14=TEXAS
                  15=ARIZONA-COLO-NEVADA-NEW MEXI-UTAH AND WYOMING
                  16=ALASKA, IDAHO, MONTANA, OREGON AND WASHINGTON
                  17=COUNTIES IN NORTHERN CALIF, HAWAII, AS, GUAM
                  18=COUNTIES IN SOUTHERN CALIFORNIA

   Fiscal Year End Date (MMDD)                       4    464   467  VARCHAR2
     Description: End date, consisting of the month and day, of the


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 23
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  provider's fiscal year.
     SAS Name:    FY_END_MO_DAY_CD
     COBOL Name:  FY-END-MO-DAY-CD

   Home Training and Support services only HD and PD 1    481   481  VARCHAR2
   indicator-Obsolete June 2017
     Description: This field has been deleted.
     SAS Name:    HOME_TRNG_SPRT_ONLY_SRVC_SW
     COBOL Name:  HOME-TRNG-SPRT-ONLY-SRVC-SW

   Hospital Based Indicator                          1    483   483  CHAR
     Description: Indicates if the provider is based in a hospital.
     SAS Name:    HOSP_BSD_SW
     COBOL Name:  HOSP-BSD-SW

   In-Center Nocturnal Hemodialysis Services Indicator 1    484   484  VARCHAR2
     Description: Indicates if in-center nocturnal hemodialysis services
                  are provided.
     SAS Name:    INCNTR_NCTRNL_SRVC_SW
     COBOL Name:  INCNTR-NCTRNL-SRVC-SW

   Multiple Facility Organization Name               38   513   550  CHAR
     Description: Name of the multi-facility organization that owns the
                  facility.
     SAS Name:    MLT_FAC_ORG_NAME
     COBOL Name:  MLT-FAC-ORG-NAME

   Multiple Facility Organization Owned Indicator    1    551   551  CHAR
     Description: Indicates if a facility is owned by an organization that
                  owns (or leases) two or more long term care facilities.
     SAS Name:    MLT_OWND_FAC_ORG_SW
     COBOL Name:  MLT-OWND-FAC-ORG-SW

   Related Provider Number                           10   686   695  CHAR
     Description: Related provider number
     SAS Name:    RELATED_PROVIDER_NUMBER
     COBOL Name:  RELATED-PROVIDER-NUMBER

   Services: Hemodialysis Home Training/Support      1    735   735  VARCHAR2
   Indicator
     Description: Indicates if the facility provides home training and
                  support for hemodialysis.
     SAS Name:    SP_HOME_TRNG_SPRT_HD_SW
     COBOL Name:  SP-HOME-TRNG-SPRT-HD-SW

   Services: Hemodialysis Indicator                  1    736   736  VARCHAR2
     Description: Indicates if hemodialysis service is provided.
     SAS Name:    HMDLYS_SRVC_SW
     COBOL Name:  HMDLYS-SRVC-SW

   Services: Peritoneal Dialysis Home Training/Support 1    786   786  VARCHAR2
   Indicator
     Description: Indicates if the facility provides home training and
                  support for peritoneal dialysis.
     SAS Name:    SP_HOME_TRNG_SPRT_PD_SW
     COBOL Name:  SP-HOME-TRNG-SPRT-PD-SW

   Services: Peritoneal Dialysis Indicator           1    787   787  VARCHAR2
     Description: Indicates if peritoneal dialysis service is provided.
     SAS Name:    PRTNL_DLYS_SRVC_SW
     COBOL Name:  PRTNL-DLYS-SRVC-SW

   Staff Count: Other Personnel                      8    902   909  NUMBER
     Description: Number of full-time equivalent other personnel employed


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 24
     End Stage Renal Disease Facility, CATEGORY = "09" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  by a provider
     SAS Name:    PRSNEL_OTHR_CNT
     COBOL Name:  PRSNEL-OTHR-CNT

   Staff Count: Dietitian                            8    982   989  NUMBER
     Description: Number of full-time equivalent dietitians employed by a
                  provider.
     SAS Name:    DIETN_CNT
     COBOL Name:  DIETN-CNT

   Staff Count: LPN                                  8    1102  1109 NUMBER
     Description: Number of licensed practical nurses.
     SAS Name:    LPN_CNT
     COBOL Name:  LPN-CNT

   Staff Count: RN                                   8    1750  1757 NUMBER
     Description: Number of full-time equivalent registered nurses employed
                  by a provider.
     SAS Name:    RN_CNT
     COBOL Name:  RN-CNT

   Staff Count: Social Worker                        8    1814  1821 NUMBER
     Description: Number of full-time equivalent social workers employed by
                  the provider.
     SAS Name:    SCL_WORKR_CNT
     COBOL Name:  SCL-WORKR-CNT

   Staff Count: Technical Staff                      8    1894  1901 NUMBER
     Description: Number of full-time equivalent technical staff (water,
                  machine) employed by a facility.
     SAS Name:    TCHNCL_STF_NUM
     COBOL Name:  TCHNCL-STF-NUM

   Staff Count: Technician                           8    1902  1909 NUMBER
     Description: Number of full-time equivalent technicians employed by a
                  facility.
     SAS Name:    TCHNCN_CNT
     COBOL Name:  TCHNCN-CNT

   Total Approved Stations                           3    1993  1995 NUMBER
     Description: Total number of approved dialysis stations in an
                  end-stage renal disease facility.
     SAS Name:    DLYS_STN_CNT
     COBOL Name:  DLYS-STN-CNT






















 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 1
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Provider Category Subtype Code                    2    1     2    VARCHAR2
     Description: Identifies the subtype of the provider, within the
                  primary category.  Used in reporting to show the
                  breakdown of provider categories, mainly for hospitals
                  and SNFs.
     SAS Name:    PRVDR_CTGRY_SBTYP_CD
     COBOL Name:  PRVDR-CTGRY-SBTYP-CD
     VALUES:      02=Title 19 Only

   Provider Category Code                            2    3     4    VARCHAR2
     Description: Identifies the type of provider participating in the
                  Medicare/Medicaid program.
     SAS Name:    PRVDR_CTGRY_CD
     COBOL Name:  PRVDR-CTGRY-CD
     VALUES:      10=Nursing Facility

   CHOW Count                                        2    5     6    NUMBER
     Description: Number of times this provider has undergone a change of
                  ownership.
     SAS Name:    CHOW_CNT
     COBOL Name:  CHOW-CNT

   CHOW Date                                         8    7     14   DATE
     Description: Effective date of the most recent change of ownership for
                  this provider.
     SAS Name:    CHOW_DT
     COBOL Name:  CHOW-DT

   Address: City                                     28   15    42   VARCHAR2
     Description: City in which the provider is physically located.
     SAS Name:    CITY_NAME
     COBOL Name:  CITY-NAME

   Compliance: Acceptable POC                        1    43    43   VARCHAR2
     Description: Indicates if a provider is in compliance with program
                  requirements based on an acceptable plan for correction
                  of deficiencies.
     SAS Name:    ACPTBL_POC_SW
     COBOL Name:  ACPTBL-POC-SW

   Compliance: Status                                1    44    44   VARCHAR2
     Description: Compliance status of a provider at the time of
                  certification survey.
     SAS Name:    CMPLNC_STUS_CD
     COBOL Name:  CMPLNC-STUS-CD
     VALUES:      A=IN COMPLIANCE
                  B=NOT IN COMPLIANCE

   SSA County Code                                   3    45    47   VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the county where the provider is located.
     SAS Name:    SSA_CNTY_CD
     COBOL Name:  SSA-CNTY-CD

   Cross Ref Provider Number                         10   48    57   CHAR
     Description: Cross reference provider number
     SAS Name:    CROSS_REF_PROVIDER_NUMBER
     COBOL Name:  CROSS-REF-PROVIDER-NUMBER

   Certification Date                                8    58    65   DATE
     Description: Equal to the exit date of the initial visit of the Health
                  survey for certifications completed after July 28, 2012.
                  For certifications prior to that date, the certification


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 2
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  date is equal to the exit date of the initial visit of
                  the Health survey or LSC survey, whichever is later.
     SAS Name:    CRTFCTN_DT
     COBOL Name:  CRTFCTN-DT

   Eligibility Indicator                             1    66    66   VARCHAR2
     Description: Indicates if a facility is eligible to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    ELGBLTY_SW
     COBOL Name:  ELGBLTY-SW

   Facility Name                                     50   67    116  VARCHAR2
     Description: Name of the provider certified to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    FAC_NAME
     COBOL Name:  FAC-NAME

   Medicare Administrative Contractor (MAC) or       5    117   121  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_CD
     COBOL Name:  INTRMDRY-CARR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 3
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 4
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 5
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 6
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)
                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 7
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   Medicaid Vendor Number                            15   122   136  VARCHAR2
     Description: Number which may be assigned to a provider by the state
                  Medicaid agency for external control or billing purposes.
     SAS Name:    MDCD_VNDR_NUM
     COBOL Name:  MDCD-VNDR-NUM

   Original Participation Date                       8    137   144  DATE
     Description: Date a provider is first approved to provide Medicare
                  and/or Medicaid services.
     SAS Name:    ORGNL_PRTCPTN_DT
     COBOL Name:  ORGNL-PRTCPTN-DT

   Prior CHOW Date                                   8    145   152  DATE
     Description: Effective date of the previous change of ownership for
                  this provider.
     SAS Name:    CHOW_PRIOR_DT
     COBOL Name:  CHOW-PRIOR-DT

   Prior Medicare Administrative Contractor (MAC) or 5    153   157  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the previous Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_PRIOR_CD
     COBOL Name:  INTRMDRY-CARR-PRIOR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 8
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 9
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 10
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 11
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 12
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   CCN                                               10   158   167  VARCHAR2
     Description: Six or ten position identification number that is
                  assigned to a certified provider.  This is the CMS
                  Certification Number.
     SAS Name:    PRVDR_NUM
     COBOL Name:  PRVDR-NUM

   Region Code                                       2    168   169  VARCHAR2
     Description: Indicates the CMS Regional Office responsible for the
                  certification of the provider.
     SAS Name:    RGN_CD
     COBOL Name:  RGN-CD
     VALUES:      01=Boston
                  02=New York
                  03=Philadelphia
                  04=Atlanta
                  05=Chicago
                  06=Dallas
                  07=Kansas City
                  08=Denver
                  09=San Francisco
                  10=Seattle

   Skeleton Record Indicator                         1    170   170  VARCHAR2
     Description: Indicates if the record is a skeleton record.  Only a
                  limited set of data is available for this provider; no
                  survey data exists.  Only provider categories
                  01,17,19,21and 22 can have skeleton providers.
     SAS Name:    SKLTN_REC_SW
     COBOL Name:  SKLTN-REC-SW

   State Abbreviation                                2    171   172  VARCHAR2
     Description: Two-character state abbreviation.
     SAS Name:    STATE_CD
     COBOL Name:  STATE-CD
     VALUES:      AK=ALASKA
                  AL=ALABAMA
                  AR=ARKANSAS
                  AS=AMERICAN SAMOA
                  AZ=ARIZONA
                  CA=CALIFORNIA
                  CN=CANADA
                  CO=COLORADO
                  CT=CONNECTICUT
                  DC=DISTRICT OF COLUMBIA
                  DE=DELAWARE
                  FL=FLORIDA
                  FN=INTERNATIONAL
                  GA=GEORGIA
                  GU=GUAM
                  HI=HAWAII
                  IA=IOWA
                  ID=IDAHO


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 13
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  IL=ILLINOIS
                  IN=INDIANA
                  KS=KANSAS
                  KY=KENTUCKY
                  LA=LOUISIANA
                  MA=MASSACHUSETTS
                  MD=MARYLAND
                  ME=MAINE
                  MI=MICHIGAN
                  MN=MINNESOTA
                  MO=MISSOURI
                  MP=SAIPAN
                  MS=MISSISSIPPI
                  MT=MONTANA
                  MX=MEXICO
                  NC=NORTH CAROLINA
                  ND=NORTH DAKOTA
                  NE=NEBRASKA
                  NH=NEW HAMPSHIRE
                  NJ=NEW JERSEY
                  NM=NEW MEXICO
                  NV=NEVADA
                  NY=NEW YORK
                  OH=OHIO
                  OK=OKLAHOMA
                  OR=OREGON
                  PA=PENNSYLVANIA
                  PR=PUERTO RICO
                  RI=RHODE ISLAND
                  SC=SOUTH CAROLINA
                  SD=SOUTH DAKOTA
                  TN=TENNESSEE
                  TX=TEXAS
                  UT=UTAH
                  VA=VIRGINIA
                  VI=VIRGIN ISLANDS
                  VT=VERMONT
                  WA=WASHINGTON
                  WI=WISCONSIN
                  WV=WEST VIRGINIA
                  WY=WYOMING

   SSA State Code                                    2    173   174  VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the state where the provider is located.
     SAS Name:    SSA_STATE_CD
     COBOL Name:  SSA-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  03=ARIZONA
                  04=ARKANSAS
                  05=CALIFORNIA
                  06=COLORADO
                  07=CONNECTICUT
                  08=DELAWARE
                  09=DISTRICT OF COLUMBIA
                  10=FLORIDA
                  11=GEORGIA
                  12=HAWAII
                  13=IDAHO
                  14=ILLINOIS
                  15=INDIANA
                  16=IOWA
                  17=KANSAS


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 14
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  18=KENTUCKY
                  19=LOUISIANA
                  20=MAINE
                  21=MARYLAND
                  22=MASSACHUSETTS
                  23=MICHIGAN
                  24=MINNESOTA
                  25=MISSISSIPPI
                  26=MISSOURI
                  27=MONTANA
                  28=NEBRASKA
                  29=NEVADA
                  30=NEW HAMPSHIRE
                  31=NEW JERSEY
                  32=NEW MEXICO
                  33=NEW YORK
                  34=NORTH CAROLINA
                  35=NORTH DAKOTA
                  36=OHIO
                  37=OKLAHOMA
                  38=OREGON
                  39=PENNSYLVANIA
                  40=PUERTO RICO
                  41=RHODE ISLAND
                  42=SOUTH CAROLINA
                  43=SOUTH DAKOTA
                  44=TENNESSEE
                  45=TEXAS
                  46=UTAH
                  47=VERMONT
                  48=VIRGIN ISLANDS
                  49=VIRGINIA
                  50=WASHINGTON
                  51=WEST VIRGINIA
                  52=WISCONSIN
                  53=WYOMING
                  54=AFRICA
                  56=CANADA
                  57=WEST INDIES
                  58=EUROPE
                  59=MEXICO
                  60=OCEANIA
                  61=PHILIPPINES
                  62=SOUTH AMERICA
                  63=UNITED STATES POSSESSIONS
                  64=AMERICAN SAMOA
                  65=GUAM
                  66=SAIPAN
                  99=INTERNATIONAL

   State Region Code                                 3    175   177  VARCHAR2
     Description: Identifies the region within a state where the provider
                  is located.
     SAS Name:    STATE_RGN_CD
     COBOL Name:  STATE-RGN-CD
     VALUES:      AK/001=ALASKA
                  AK/LAB=LABORATORIES
                  AK/NPH=NON-PARTICIPATING HOSPITAL
                  AL/001=ALABAMA
                  AL/LAB=LABORATORIES
                  AL/NPH=NON-PARTICIPATING HOSPITAL
                  AR/001=ARKANSAS
                  AR/LAB=LABORATORIES
                  AR/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 15
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  AS/001=AMERICAN SAMOA
                  AS/LAB=LABORATORY
                  AS/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/AZ=PHOENIX
                  AZ/LAB=ARIZONA LAB
                  AZ/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/TUC=TUCSON
                  CA/001=CALIFORNIA
                  CA/BAK=BAKERSFIELD
                  CA/BER=SAN BERNARDINO
                  CA/EB=East Bay
                  CA/FR=FRESNO
                  CA/L1=L.A. WEST
                  CA/L2=L.A. NORTH
                  CA/L3=L.A. CENTRAL
                  CA/L4=L.A. EAST
                  CA/L5=SAN GABRIEL
                  CA/LA1=LA Region 1
                  CA/LA2=LA Region 2
                  CA/LA3=LA Region 3
                  CA/LA4=LA Acute/Ancillary
                  CA/LA5=LA HHA/Hospice
                  CA/LA6=LA ICF/DD/CLinics
                  CA/LAB=LABORATORIES
                  CA/M1=LAB. SOUTH
                  CA/M2=LAB. NORTH
                  CA/NPH=NON-PARTICIPATING HOSPITAL
                  CA/ORG=ORANGE
                  CA/RIV=RIVERSIDE
                  CA/S1=SACRAMENTO
                  CA/S3=CHICO
                  CA/SD=SAN DIEGO
                  CA/SF=SAN FRANCISCO
                  CA/SJ=SAN JOSE
                  CA/SR=SANTA ROSA
                  CA/VEN=VENTURA
                  CN/001=CANADA
                  CN/LAB=LABORATORY
                  CN/NPH=NON-PARTICIPATING HOSPITAL
                  CO/001=COLORADO
                  CO/LAB=LABORATORIES
                  CO/NPH=NON-PARTICIPATING HOSPITAL
                  CT/001=CONNECTICUT
                  CT/LAB=LABORATORIES
                  CT/NPH=NON-PARTICIPATING HOSPITAL
                  DC/001=DISTRICT OF COLUMBIA
                  DC/LAB=LABORATORIES
                  DC/NPH=NON-PARTICIPATING HOSPITAL
                  DE/001=DELAWARE
                  DE/LAB=LABORATORIES
                  DE/NPH=NON-PARTICIPATING HOSPITAL
                  FL/001=FLORIDA
                  FL/FTM=FT. MYERS
                  FL/GAI=GAINESVILLE
                  FL/JAX=JACKSONVILLE
                  FL/LAB=LABORATORIES
                  FL/LAN=LANTANA
                  FL/LAU=LAUDERHILL
                  FL/MIA=MIAMI
                  FL/NPH=NON-PARTICIPATING HOSPITAL
                  FL/ORL=ORLANDO
                  FL/PEN=PENSACOLA
                  FL/STP=ST. PETERSBURG
                  FL/TAL=TALLAHASSEE


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 16
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  FL/TAM=TAMPA
                  FM/001=FEDERATED STATES OF MICRO
                  FM/NPH=NON-PARTICIPATING HOSPITAL
                  FN/001=INTERNATIONAL
                  FN/LAB=LABORATORIES
                  FN/NPH=NON-PARTICIPATING HOSPITAL
                  GA/001=GEORGIA
                  GA/GAA=GEORGIA ALL
                  GA/GAC=GEORGIA CENTRAL
                  GA/GAE=GEORGIA EASTERN
                  GA/GAN=GEORGIA NORTH
                  GA/GAS=GEORGIA SOUTH
                  GA/GAW=GEORGIA WESTERN
                  GA/LAB=LABORATORIES
                  GA/NPH=NON-PARTICIPATING HOSPITAL
                  GU/001=GUAM
                  GU/LAB=LABORATORIES
                  GU/NPH=NON-PARTICIPATING HOSPITAL
                  HI/001=HAWAII
                  HI/LAB=LABORATORIES
                  HI/NPH=NON-PARTICIPATING HOSPITAL
                  IA/001=IOWA
                  IA/LAB=LABORATORIES
                  IA/NPH=NON-PARTICIPATING HOSPITAL
                  ID/001=IDAHO
                  ID/LAB=LABORATORIES
                  ID/NPH=NON-PARTICIPATING HOSPITAL
                  IL/001=ILLINOIS
                  IL/LAB=LABORATORIES
                  IL/NPH=NON-PARTICIPATING HOSPITAL
                  IN/001=INDIANA
                  IN/LAB=LABORATORIES
                  IN/NPH=NON-PARTICIPATING HOSPITAL
                  KS/001=KANSAS
                  KS/KCK=KANSAS CITY
                  KS/KDH=KDHE
                  KS/LAB=LABORATORIES
                  KS/LAW=LAWRENCE
                  KS/NC=NORTH CENTRAL KANSAS
                  KS/NE=NORTH EAST KANSAS
                  KS/NPH=NON-PARTICIPATING HOSPITAL
                  KS/NW=NORTH WEST KANSAS
                  KS/SC=SOUTH CENTRAL KANSAS
                  KS/SE=SOUTH EAST KANSAS
                  KS/SW=SOUTH WEST KANSAS
                  KS/WST=WEST
                  KY/2C1=HOPKINSVILLE
                  KY/2C2=LOUISVILLE
                  KY/2C3=LONDON
                  KY/2C4=LEXINGTON
                  KY/LAB=LABORATORIES
                  KY/NPH=NON-PARTICIPATING HOSPITAL
                  LA/001=LOUISIANA
                  LA/LA1=NEW ORLEANS
                  LA/LA2=MANDEVILLE
                  LA/LA3=LAFAYETTE
                  LA/LA4=MONROE
                  LA/LA5=SHREVEPORT
                  LA/LA6=ALEXANDRIA
                  LA/LAB=LABORATORIES
                  LA/LB1=CLIA NEW ORLEANS
                  LA/LB5=CLIA SHREVEPORT
                  LA/LB6=CLIA ALEXANDRIA
                  LA/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 17
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  MA/001=MASSACHUSETTS
                  MA/LAB=LABORATORIES
                  MA/NPH=NON-PARTICIPATING HOSPITAL
                  MD/001=MARYLAND
                  MD/LAB=LABORATORIES
                  MD/NPH=NON-PARTICIPATING HOSPITAL
                  ME/001=MAINE
                  ME/LAB=LABORATORIES
                  ME/NPH=NON-PARTICIPATING HOSPITAL
                  MH/001=MARSHALL ISLANDS
                  MH/NPH=NON-PARTICIPATING HOSPITAL
                  MI/001=MICHIGAN
                  MI/LAB=LABORATORIES
                  MI/NPH=NON-PARTICIPATING HOSPITAL
                  MN/001=MINNESOTA
                  MN/LAB=LABORATORIES
                  MN/NPH=NON-PARTICIPATING HOSPITAL
                  MO/001=MISSOURI
                  MO/01=REGION01
                  MO/02=REGION02
                  MO/03=REGION 03
                  MO/04=REGION 04
                  MO/05=REGION 05
                  MO/06=REGION 06
                  MO/07=REGION 07
                  MO/1NH=REGION 1 NH
                  MO/2NH=REGION 2 NH
                  MO/3NH=REGION 3 NH
                  MO/4NH=REGION 4 NH
                  MO/5NH=REGION 5 NH
                  MO/6NH=REGION 6 NH
                  MO/7NH=REGION 7 NH
                  MO/LAB=LABORATORIES
                  MO/MO=STATEWIDE
                  MO/NPH=NON-PARTICIPATING HOSPITAL
                  MP/001=NORTHERN MARIANA ISLANDS
                  MP/LAB=LABORATORIES
                  MP/NPH=NON-PARTICIPATING HOSPITAL
                  MS/001=MISSISSIPPI
                  MS/LAB=LABORATORIES
                  MS/NPH=NON-PARTICIPATING HOSPITAL
                  MT/001=MONTANA
                  MT/LAB=LABORATORIES
                  MT/NPH=NON-PARTICIPATING HOSPITAL
                  MX/001=MEXICO
                  MX/LAB=LABORATORY
                  MX/NPH=NON-PARTICIPATING HOSPITAL
                  NC/001=NORTH CAROLINA
                  NC/LAB=LABORATORIES
                  NC/NCC=NORTH CAROLINA CENTRAL
                  NC/NCE=NORTH CAROLINA EAST
                  NC/NCN=NORTH CAROLINA NORTH
                  NC/NCS=NORTH CAROLINA SOUTH
                  NC/NCW=NORTH CAROLINA WEST
                  NC/NPH=NON-PARTICIPATING HOSPITAL
                  ND/001=NORTH DAKOTA
                  ND/LAB=LABORATORIES
                  ND/NPH=NON-PARTICIPATING HOSPITAL
                  NE/001=NEBRASKA
                  NE/1=NORTH CENTRAL
                  NE/2=CENTRAL
                  NE/3=NORTHEAST
                  NE/4=SOUTHEAST
                  NE/5=WESTERN


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 18
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  NE/LAB=LABORATORIES
                  NE/NPH=NON-PARTICIPATING HOSPITAL
                  NH/001=NEW HAMPSHIRE
                  NH/LAB=LABORATORIES
                  NH/NPH=NON-PARTICIPATING HOSPITAL
                  NJ/001=NEW JERSEY
                  NJ/LAB=LABORATORIES
                  NJ/NPH=NON-PARTICIPATING HOSPITAL
                  NM/001=NEW MEXICO
                  NM/LAB=LABORATORIES
                  NM/NPH=NON-PARTICIPATING HOSPITAL
                  NV/001=NEVADA
                  NV/CC=CARSON CITY
                  NV/LAB=LABORATORIES
                  NV/LV=LAS VEGAS
                  NV/NPH=NON-PARTICIPATING HOSPITAL
                  NY/001=BUFFALO
                  NY/002=ROCHESTER
                  NY/003=SYRACUSE
                  NY/004=ALBANY
                  NY/005=NEW ROCHELLE
                  NY/006=NEW YORK CITY
                  NY/007=SUFFOLK/NASSAU COUNTY
                  NY/LAB=LABORATORIES
                  NY/NPH=NON-PARTICIPATING HOSPITAL
                  OH/001=OHIO
                  OH/LAB=LABORATORIES
                  OH/NPH=NON-PARTICIPATING HOSPITAL
                  OK/001=OKLAHOMA
                  OK/LAB=LABORATORIES
                  OK/NPH=NON-PARTICIPATING HOSPITAL
                  OR/001=OFFICE #1
                  OR/002=OFFICE #2
                  OR/003=OFFICE #3
                  OR/LAB=LABORATORIES
                  OR/NPH=NON-PARTICIPATING HOSPITAL
                  PA/001=PENNSYLVANIA
                  PA/LAB=LABORATORIES
                  PA/NPH=NON-PARTICIPATING HOSPITAL
                  PR/001=PUERTO RICO
                  PR/LAB=LABORATORIES
                  PR/NPH=NON-PARTICIPATING HOSPITAL
                  PW/001=PALAU
                  PW/NPH=NON-PARTICIPATING HOSPITAL
                  RI/001=RHODE ISLAND
                  RI/LAB=LABORATORIES
                  RI/NPH=NON-PARTICIPATING HOSPITAL
                  SC/001=SOUTH CAROLINA
                  SC/LAB=LABORATORIES
                  SC/NPH=NON-PARTICIPATING HOSPITAL
                  SD/001=SOUTH DAKOTA
                  SD/LAB=LABORATORIES
                  SD/NPH=NON-PARTICIPATING HOSPITAL
                  TN/001=TENNESSEE
                  TN/LAB=LABORATORIES
                  TN/NPH=NON-PARTICIPATING HOSPITAL
                  TN/TNC=TENNESSEE COOKEVILLE
                  TN/TNE=TENNESSEE EASTERN
                  TN/TNM=TENNESSEE MIDDLE
                  TN/TNW=TENNESSEE WESTERN
                  TX/001=TEXAS
                  TX/L01=AMARILLO-LTC
                  TX/L02=ABILENE-LTC
                  TX/L03=ARLINGTON-LTC


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             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  TX/L04=TYLER-LTC
                  TX/L05=TEMPLE-LTC
                  TX/L06=HOUSTON-LTC
                  TX/L07=SAN ANTONIO-LTC
                  TX/LAB=LABORATORIES
                  TX/NPH=NON-PARTICIPATING HOSPITAL
                  TX/TX1=NLTC REG 1, 7, 9, 10
                  TX/TX2=NLTC REG 2, 3
                  TX/TX4=NLTC REG 6
                  TX/TX5=NLTC REG 4, 5
                  TX/TX6=AUSTIN
                  TX/TX8=NLTC REG 8, 11
                  UT/001=UTAH
                  UT/LAB=LABORATORIES
                  UT/NPH=NON-PARTICIPATING HOSPITAL
                  VA/001=VIRGINIA
                  VA/LAB=LABORATORIES
                  VA/NPH=NON-PARTICIPATING HOSPITAL
                  VI/001=VIRGIN ISLANDS
                  VI/LAB=LABORATORIES
                  VI/NPH=NON-PARTICIPATING HOSPITAL
                  VT/001=VERMONT
                  VT/LAB=LABORATORIES
                  VT/NPH=NON-PARTICIPATING HOSPITAL
                  WA/001=ALL OTHERS (NON-LTC FAC)
                  WA/D1=SPOKANE & YAKIMA AREAS
                  WA/D1A=District 1, Unit A
                  WA/D1B=District 1, Unit B
                  WA/D1C=District 1, Unit C
                  WA/D1D=District 1, Unit D
                  WA/D1E=District 1, Unit E
                  WA/D2=SPOKANE & SE
                  WA/D2A=District 2, Unit A
                  WA/D2B=District 2, Unit B
                  WA/D2C=District 2, Unit C
                  WA/D2D=District 2, Unit D
                  WA/D2E=District 2, Unit E
                  WA/D2F=District 2, Unit F
                  WA/D2G=District 2, Unit G
                  WA/D2H=District 2, Unit H
                  WA/D2I=District 2, Unit I
                  WA/D2J=District 2, Unit J
                  WA/D3=NW WASHINGTON
                  WA/D3A=District 3, Unit A
                  WA/D3B=District 3, Unit B
                  WA/D3C=District 3, Unit C
                  WA/D3D=District 3, Unit D
                  WA/D3E=District 3, Unit E
                  WA/D3F=District 3, Unit F
                  WA/D3G=District 3, Unit G
                  WA/D4A=GREATER SEATTLE AREA
                  WA/D4B=S KING COUNTY
                  WA/D5A=PIERCE CTY & PENINSULA
                  WA/D5B=PIERCE CTY & GRAYS HARBOR
                  WA/D6=OLYMPIA AREA
                  WA/LAB=LABORATORIES
                  WA/NPH=NON-PARTICIPATING HOSPITAL
                  WI/001=WISCONSIN
                  WI/LAB=LABORATORIES
                  WI/NPH=NON-PARTICIPATING HOSPITAL
                  WV/001=WEST VIRGINIA
                  WV/LAB=LABORATORIES
                  WV/NPH=NON-PARTICIPATING HOSPITAL
                  WY/001=WYOMING


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             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  WY/LAB=LABORATORIES
                  WY/NPH=NON-PARTICIPATING HOSPITAL

   Address: Street                                   50   178   227  VARCHAR2
     Description: Street address where the provider is located.
     SAS Name:    ST_ADR
     COBOL Name:  ST-ADR

   Telephone Number                                  10   228   237  VARCHAR2
     Description: Telephone number of the provider.
     SAS Name:    PHNE_NUM
     COBOL Name:  PHNE-NUM

   Termination Code                                  2    238   239  VARCHAR2
     Description: Indicates the current termination status for the
                  provider.
     SAS Name:    PGM_TRMNTN_CD
     COBOL Name:  PGM-TRMNTN-CD
     VALUES:      00=ACTIVE PROVIDER
                  01=VOLUNTARY-MERGER, CLOSURE
                  02=VOLUNTARY-DISSATISFACTION WITH REIMBURSEMENT
                  03=VOLUNTARY-RISK OF INVOLUNTARY TERMINATION
                  04=VOLUNTARY-OTHER REASON FOR WITHDRAWAL
                  05=INVOLUNTARY-FAILURE TO MEET HEALTH/SAFETY REQ
                  06=INVOLUNTARY-FAILURE TO MEET AGREEMENT
                  07=OTHER-PROVIDER STATUS CHANGE
                  08=NONPAYMENT OF FEES - CLIA Only
                  09=REV/UNSUCCESSFUL PARTICIPATION IN PT - CLIA Only
                  10=REV/OTHER REASON - CLIA Only
                  11=INCOMPLETE CLIA APPLICATION INFORMATION - CLIA Only
                  12=NO LONGER PERFORMING TESTS - CLIA Only
                  13=MULTIPLE TO SINGLE SITE CERTIFICATE - CLIA Only
                  14=SHARED LABORATORY - CLIA Only
                  15=FAILURE TO RENEW WAIVER PPM CERTIFICATE - CLIA Only
                  16=DUPLICATE CLIA NUMBER - CLIA Only
                  17=MAIL RETURNED NO FORWARD ADDRESS CERT ENDED - CLIA Only
                  20=NOTIFICATION BANKRUPTCY - CLIA Only
                  33=ACCREDITATION NOT CONFIRMED - CLIA Only
                  80=AWAITING STATE APPROVAL
                  99=OIG ACTION - DO NOT ACTIVATE - CLIA Only

   Termination or Expiration Date                    8    240   247  DATE
     Description: Date the provider was terminated.  For CLIA providers,
                  date the laboratory's certificate was terminated or the
                  expiration date of the current CLIA certificate.
     SAS Name:    TRMNTN_EXPRTN_DT
     COBOL Name:  TRMNTN-EXPRTN-DT

   Type of Action Code                               1    248   248  VARCHAR2
     Description: Identifies the reason for the certification.  Type of
                  action from the official survey record, CMS 1539 form.
     SAS Name:    CRTFCTN_ACTN_TYPE_CD
     COBOL Name:  CRTFCTN-ACTN-TYPE-CD
     VALUES:      1=INITIAL
                  2=RECERTIFICATION
                  3=TERMINATION
                  4=CHANGE OF OWNERSHIP
                  5=VALIDATION
                  8=FULL SURVEY AFTER COMPLAINT

   Ownership Type Code                               2    249   250  VARCHAR2
     Description: Indicates the ownership type of the provider.
     SAS Name:    GNRL_CNTL_TYPE_CD
     COBOL Name:  GNRL-CNTL-TYPE-CD


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             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     VALUES:      01=FOR PROFIT - INDIVIDUAL
                  02=FOR PROFIT - PARTNERSHIP
                  03=FOR PROFIT - CORPORATION
                  04=NONPROFIT - CHURCH RELATED
                  05=NONPROFIT - CORPORATION
                  06=NONPROFIT - OTHER
                  07=GOVERNMENT - STATE
                  08=GOVERNMENT - COUNTY
                  09=GOVERNMENT - CITY
                  10=GOVERNMENT - CITY/COUNTY
                  11=GOVERNMENT - HOSPITAL DISTRICT
                  12=GOVERNMENT - FEDERAL
                  13=FOR PROFIT - LIMITED LIABILITY CORPORATION

   Address: ZIP Code                                 5    251   255  VARCHAR2
     Description: Five-digit ZIP code for a provider's physical address.
     SAS Name:    ZIP_CD
     COBOL Name:  ZIP-CD

   FIPS State Code                                   2    256   257  VARCHAR2
     Description: FIPS State Code
     SAS Name:    FIPS_STATE_CD
     COBOL Name:  FIPS-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  04=ARIZONA
                  05=ARKANSAS
                  06=CALIFORNIA
                  08=COLORADO
                  09=CONNECTICUT
                  10=DELAWARE
                  11=DISTRICT OF COLUMBIA
                  12=FLORIDA
                  13=GEORGIA
                  15=HAWAII
                  16=IDAHO
                  17=ILLINOIS
                  18=INDIANA
                  19=IOWA
                  20=KANSAS
                  21=KENTUCKY
                  22=LOUISIANA
                  23=MAINE
                  24=MARYLAND
                  25=MASSACHUSETTS
                  26=MICHIGAN
                  27=MINNESOTA
                  28=MISSISSIPPI
                  29=MISSOURI
                  30=MONTANA
                  31=NEBRASKA
                  32=NEVADA
                  33=NEW HAMPSHIRE
                  34=NEW JERSEY
                  35=NEW MEXICO
                  36=NEW YORK
                  37=NORTH CAROLINA
                  38=NORTH DAKOTA
                  39=OHIO
                  40=OKLAHOMA
                  41=OREGON
                  42=PENNSYLVANIA
                  43=PUERTO RICO
                  44=RHODE ISLAND


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             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  45=SOUTH CAROLINA
                  46=SOUTH DAKOTA
                  47=TENNESSEE
                  48=TEXAS
                  49=UTAH
                  50=VERMONT
                  51=VIRGINIA
                  53=WASHINGTON
                  54=WEST VIRGINIA
                  55=WISCONSIN
                  56=WYOMING
                  60=AMERICAN SAMOA
                  66=GUAM
                  69=SAIPAN/MARIANA IS.
                  78=VIRGIN ISLANDS

   FIPS County Code                                  3    258   260  VARCHAR2
     Description: FIPS County Code
     SAS Name:    FIPS_CNTY_CD
     COBOL Name:  FIPS-CNTY-CD

   CBSA Urban Rural Indicator                        1    261   261  VARCHAR2
     Description: CBSA (Core Based Statistical Area) indicates whether the
                  county is defined as Urban or Rural.
     SAS Name:    CBSA_URBN_RRL_IND
     COBOL Name:  CBSA-URBN-RRL-IND

   CBSA Code                                         5    262   266  VARCHAR2
     Description: CBSA (Core Based Statistical Area) geographic entities
                  defined by the U.S. Office of Management and Budget (OMB)
                  on June 6, 2003 for use by Federal statistical agencies
                  in collecting, tabulating, and publishing Federal
                  statistics.  CBSA collectively refers to MSA.
     SAS Name:    CBSA_CD
     COBOL Name:  CBSA-CD

   Bed Count Override Indicator                      1    325   325  CHAR
     Description: Indicates if the regional office has approved a
                  significant bed count change from the previous
                  certification.
     SAS Name:    OVRRD_BED_CNT_SW
     COBOL Name:  OVRRD-BED-CNT-SW

   Bed Count: Certified                              4    326   329  NUMBER
     Description: Number of beds in Medicare and/or Medicaid certified
                  areas within a facility.
     SAS Name:    CRTFD_BED_CNT
     COBOL Name:  CRTFD-BED-CNT

   Bed Count: Medicaid NF                            4    334   337  NUMBER
     Description: Number of Medicaid-certified Nursing Facility beds.
     SAS Name:    MDCD_NF_BED_CNT
     COBOL Name:  MDCD-NF-BED-CNT

   Bed Count: Medicare SNF                           4    338   341  NUMBER
     Description: Number of Medicare-certified Skilled Nursing Facility
                  beds.
     SAS Name:    MDCR_SNF_BED_CNT
     COBOL Name:  MDCR-SNF-BED-CNT

   Bed Count: Medicare/Medicaid SNF                  4    342   345  NUMBER
     Description: Number of dually certified (Medicare/Medicaid) beds in a
                  Skilled Nursing Facility.
     SAS Name:    MDCR_MDCD_SNF_BED_CNT


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             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     COBOL Name:  MDCR-MDCD-SNF-BED-CNT

   Bed Count: Special Care - AIDS                    3    346   348  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents with AIDS.
     SAS Name:    AIDS_BED_CNT
     COBOL Name:  AIDS-BED-CNT

   Bed Count: Special Care - Alzheimers              3    349   351  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents with Alzheimer's disease.
     SAS Name:    ALZHMR_BED_CNT
     COBOL Name:  ALZHMR-BED-CNT

   Bed Count: Special Care - Dialysis                3    352   354  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents who require dialysis.
     SAS Name:    DLYS_BED_CNT
     COBOL Name:  DLYS-BED-CNT

   Bed Count: Special Care - Disabled Children       3    355   357  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  disabled children.
     SAS Name:    DSBL_CHLDRN_BED_CNT
     COBOL Name:  DSBL-CHLDRN-BED-CNT

   Bed Count: Special Care - Head Trauma             3    358   360  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents with head trauma.
     SAS Name:    HEAD_TRMA_BED_CNT
     COBOL Name:  HEAD-TRMA-BED-CNT

   Bed Count: Special Care - Hospice                 3    361   363  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents who require hospice care.
     SAS Name:    HOSPC_BED_CNT
     COBOL Name:  HOSPC-BED-CNT

   Bed Count: Special Care - Huntingtons Disease     3    364   366  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents with Huntington's disease.
     SAS Name:    HNTGTN_DEASE_BED_CNT
     COBOL Name:  HNTGTN-DEASE-BED-CNT

   Bed Count: Special Care - Specialized Rehab       3    367   369  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents with specialized rehab needs.
     SAS Name:    REHAB_BED_CNT
     COBOL Name:  REHAB-BED-CNT

   Bed Count: Special Care - Ventilator              3    370   372  NUMBER
     Description: Number of beds in a special care unit dedicated for
                  residents requiring a ventilator and/or respiratory care.
     SAS Name:    VNTLTR_BED_CNT
     COBOL Name:  VNTLTR-BED-CNT

   Bed Count: Total                                  4    373   376  NUMBER
     Description: Total number of beds in a provider, including those in
                  non-participating or non-licensed areas.
     SAS Name:    BED_CNT
     COBOL Name:  BED-CNT

   Compliance: 24-Hour RN Waiver Indicator           1    442   442  CHAR
     Description: Indicates if a waiver of the 24-hour registered nurse


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             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  staffing requirements has been recommended for a Skilled
                  Nursing Facility or Nursing Facility.
     SAS Name:    RN_24_HR_WVR_SW
     COBOL Name:  RN-24-HR-WVR-SW

   Compliance: 7-Day RN Waiver Indicator             1    443   443  VARCHAR2
     Description: Indicates if a waiver of the 7-day registered nurse
                  staffing requirements has been recommended for a Skilled
                  Nursing Facility.
     SAS Name:    RN_7_DAY_WVR_SW
     COBOL Name:  RN-7-DAY-WVR-SW

   Compliance: Beds Per Room Waiver Indicator        1    444   444  CHAR
     Description: Indicates if a waiver of the beds per room requirement
                  has been recommended for a facility.
     SAS Name:    BED_PER_ROOM_WVR_SW
     COBOL Name:  BED-PER-ROOM-WVR-SW

   Compliance: LSC Waiver Indicator                  1    445   445  CHAR
     Description: Indicates if a waiver of any life safety code provision
                  has been recommended for a provider.
     SAS Name:    LSC_WVR_SW
     COBOL Name:  LSC-WVR-SW

   Compliance: Patient Room Size Waiver Indicator    1    446   446  CHAR
     Description: Indicates if a waiver of the patient room size provision
                  has been recommended for a provider.
     SAS Name:    ROOM_SIZE_WVR_SW
     COBOL Name:  ROOM-SIZE-WVR-SW

   Experimental Research Conducted Indicator         1    453   453  VARCHAR2
     Description: Indicates if a facility conducts experimental research.
     SAS Name:    EXPRMT_RSRCH_CNDCTD_SW
     COBOL Name:  EXPRMT-RSRCH-CNDCTD-SW

   Fiscal Year End Date (MMDD)                       4    464   467  VARCHAR2
     Description: End date, consisting of the month and day, of the
                  provider's fiscal year.
     SAS Name:    FY_END_MO_DAY_CD
     COBOL Name:  FY-END-MO-DAY-CD

   Hospital Based Indicator                          1    483   483  CHAR
     Description: Indicates if the provider is based in a hospital.
     SAS Name:    HOSP_BSD_SW
     COBOL Name:  HOSP-BSD-SW

   LTC Cross Ref Provider Number                     10   485   494  CHAR
     Description: LTC cross ref provider number
     SAS Name:    LTC_CROSS_REF_PROVIDER_NUMBER
     COBOL Name:  LTC-CROSS-REF-PROVIDER-NUMBER

   Multiple Facility Organization Name               38   513   550  CHAR
     Description: Name of the multi-facility organization that owns the
                  facility.
     SAS Name:    MLT_FAC_ORG_NAME
     COBOL Name:  MLT-FAC-ORG-NAME

   Multiple Facility Organization Owned Indicator    1    551   551  CHAR
     Description: Indicates if a facility is owned by an organization that
                  owns (or leases) two or more long term care facilities.
     SAS Name:    MLT_OWND_FAC_ORG_SW
     COBOL Name:  MLT-OWND-FAC-ORG-SW

   Organized Family Group Indicator                  1    626   626  VARCHAR2


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             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Indicates if the facility has an organized group of
                  family members of residents.
     SAS Name:    ORGNZ_FMLY_MBR_GRP_SW
     COBOL Name:  ORGNZ-FMLY-MBR-GRP-SW

   Organized Resident Group Indicator                1    627   627  VARCHAR2
     Description: Indicates if the facility has an organized residents
                  group.
     SAS Name:    ORGNZ_RSDNT_GRP_SW
     COBOL Name:  ORGNZ-RSDNT-GRP-SW

   Program Participation Code                        1    640   640  CHAR
     Description: Indicates if the provider participates in Medicare,
                  Medicaid, or both programs.
     SAS Name:    PGM_PRTCPTN_CD
     COBOL Name:  PGM-PRTCPTN-CD
     VALUES:      1=MEDICARE ONLY
                  2=MEDICAID ONLY
                  3=MEDICARE AND MEDICAID

   Related Provider Number                           10   686   695  CHAR
     Description: Related provider number
     SAS Name:    RELATED_PROVIDER_NUMBER
     COBOL Name:  RELATED-PROVIDER-NUMBER

   Services: Blood Administration Off-Site Residents 1    703   703  VARCHAR2
   Indicator
     Description: Indicates if blood administration and storage services
                  are provided off-site to residents.
     SAS Name:    BLOOD_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  BLOOD-SRVC-OFSITE-RSDNT-SW

   Services: Blood Administration On-Site Nonresidents 1    704   704  VARCHAR2
   Indicator
     Description: Indicates if blood administration and storage services
                  are provided on-site to nonresidents.
     SAS Name:    BLOOD_SRVC_ONST_NRSDNT_SW
     COBOL Name:  BLOOD-SRVC-ONST-NRSDNT-SW

   Services: Blood Administration On-Site Residents  1    705   705  VARCHAR2
   Indicator
     Description: Indicates if blood administration and storage services
                  are provided on-site to residents.
     SAS Name:    BLOOD_SRVC_ONST_RSDNT_SW
     COBOL Name:  BLOOD-SRVC-ONST-RSDNT-SW

   Services: Clinical Laboratory - Off-Site Residents 1    712   712  VARCHAR2
   Indicator
     Description: Indicates if clinical laboratory services are provided
                  off-site to residents.
     SAS Name:    CL_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  CL-SRVC-OFSITE-RSDNT-SW

   Services: Clinical Laboratory - On-Site Nonresidents 1    713   713  VARCHAR2
   Indicator
     Description: Indicates if clinical laboratory services are provided
                  on-site to nonresidents.
     SAS Name:    CL_SRVC_ONST_NRSDNT_SW
     COBOL Name:  CL-SRVC-ONST-NRSDNT-SW

   Services: Clinical Laboratory - On-Site Residents 1    714   714  VARCHAR2
   Indicator
     Description: Indicates if clinical laboratory services are provided
                  on-site to residents.


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             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     SAS Name:    CL_SRVC_ONST_RSDNT_SW
     COBOL Name:  CL-SRVC-ONST-RSDNT-SW

   Services: Dental Off-Site Residents Indicator     1    720   720  VARCHAR2
     Description: Indicates if dental services are provided off-site to
                  residents.
     SAS Name:    DNTL_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  DNTL-SRVC-OFSITE-RSDNT-SW

   Services: Dental On-Site Nonresidents Indicator   1    721   721  VARCHAR2
     Description: Indicates if dental services are provided on-site to
                  nonresidents.
     SAS Name:    DNTL_SRVC_ONST_NRSDNT_SW
     COBOL Name:  DNTL-SRVC-ONST-NRSDNT-SW

   Services: Dental On-Site Residents Indicator      1    722   722  VARCHAR2
     Description: Indicates if dental services are provided on-site to
                  residents.
     SAS Name:    DNTL_SRVC_ONST_RSDNT_SW
     COBOL Name:  DNTL-SRVC-ONST-RSDNT-SW

   Services: Dietary Off-Site Residents Indicator    1    726   726  VARCHAR2
     Description: Indicates if dietary services are provided off-site to
                  residents.
     SAS Name:    DTRY_OFSITE_RSDNT_SW
     COBOL Name:  DTRY-OFSITE-RSDNT-SW

   Services: Dietary On-Site Nonresidents Indicator  1    727   727  VARCHAR2
     Description: Indicates if dietary services are provided on-site to
                  nonresidents.
     SAS Name:    DTRY_ONST_NRSDNT_SW
     COBOL Name:  DTRY-ONST-NRSDNT-SW

   Services: Dietary On-Site Residents Indicator     1    728   728  VARCHAR2
     Description: Indicates if dietary services are provided on-site to
                  residents.
     SAS Name:    DTRY_ONST_RSDNT_SW
     COBOL Name:  DTRY-ONST-RSDNT-SW

   Services: Housekeeping Off-Site Residents Indicator 1    738   738  VARCHAR2
     Description: Indicates if housekeeping services are provided off-site
                  to residents.
     SAS Name:    HSEKPNG_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  HSEKPNG-SRVC-OFSITE-RSDNT-SW

   Services: Housekeeping On-Site Nonresidents Indicator 1    739   739  VARCHAR2
     Description: Indicates if housekeeping services are provided on-site
                  to nonresidents.
     SAS Name:    HSEKPNG_SRVC_ONST_NRSDNT_SW
     COBOL Name:  HSEKPNG-SRVC-ONST-NRSDNT-SW

   Services: Housekeeping On-Site Residents Indicator 1    740   740  VARCHAR2
     Description: Indicates if housekeeping services are provided on-site
                  to residents.
     SAS Name:    HSEKPNG_SRVC_ONST_RSDNT_SW
     COBOL Name:  HSEKPNG-SRVC-ONST-RSDNT-SW

   Services: Mental Health Off-Site Residents Indicator 1    747   747  VARCHAR2
     Description: Indicates if mental health services are provided off-site
                  to residents.
     SAS Name:    MENTL_HLTH_OFSITE_RSDNT_SW
     COBOL Name:  MENTL-HLTH-OFSITE-RSDNT-SW

   Services: Mental Health On-Site Nonresidents      1    748   748  VARCHAR2


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             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

   Indicator
     Description: Indicates if mental health services are provided on-site
                  to nonresidents.
     SAS Name:    MENTL_HLTH_ONST_NRSDNT_SW
     COBOL Name:  MENTL-HLTH-ONST-NRSDNT-SW

   Services: Mental Health On-Site Residents Indicator 1    749   749  VARCHAR2
     Description: Indicates if mental health services are provided on-site
                  to residents.
     SAS Name:    MENTL_HLTH_ONST_RSDNT_SW
     COBOL Name:  MENTL-HLTH-ONST-RSDNT-SW

   Services: Nursing Off-Site Residents Indicator    1    760   760  VARCHAR2
     Description: Indicates if nursing services are provided off-site to
                  residents.
     SAS Name:    NRSNG_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  NRSNG-SRVC-OFSITE-RSDNT-SW

   Services: Nursing On-Site Nonresidents Indicator  1    761   761  VARCHAR2
     Description: Indicates if nursing services are provided on-site to
                  nonresidents.
     SAS Name:    NRSNG_SRVC_ONST_NRSDNT_SW
     COBOL Name:  NRSNG-SRVC-ONST-NRSDNT-SW

   Services: Nursing On-Site Residents Indicator     1    762   762  VARCHAR2
     Description: Indicates if nursing services are provided on-site to
                  residents.
     SAS Name:    NRSNG_SRVC_ONST_RSDNT_SW
     COBOL Name:  NRSNG-SRVC-ONST-RSDNT-SW

   Services: OT Off-Site Residents Indicator         1    776   776  VARCHAR2
     Description: Indicates if occupational therapy services are provided
                  off-site to residents.
     SAS Name:    OT_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  OT-SRVC-OFSITE-RSDNT-SW

   Services: OT On-Site Nonresidents Indicator       1    777   777  VARCHAR2
     Description: Indicates if occupational therapy services are provided
                  on-site to nonresidents.
     SAS Name:    OT_SRVC_ONST_NRSDNT_SW
     COBOL Name:  OT-SRVC-ONST-NRSDNT-SW

   Services: OT On-Site Residents Indicator          1    778   778  VARCHAR2
     Description: Indicates if occupational therapy services are provided
                  on-site to residents.
     SAS Name:    OT_SRVC_ONST_RSDNT_SW
     COBOL Name:  OT-SRVC-ONST-RSDNT-SW

   Services: Pharmacy Off-Site Residents Indicator   1    789   789  VARCHAR2
     Description: Indicates if pharmacy services are provided off-site to
                  residents.
     SAS Name:    PHRMCY_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  PHRMCY-SRVC-OFSITE-RSDNT-SW

   Services: Pharmacy On-Site Nonresidents Indicator 1    790   790  VARCHAR2
     Description: Indicates if pharmacy services are provided on-site to
                  nonresidents.
     SAS Name:    PHRMCY_SRVC_ONST_NRSDNT_SW
     COBOL Name:  PHRMCY-SRVC-ONST-NRSDNT-SW

   Services: Pharmacy On-Site Residents Indicator    1    791   791  VARCHAR2
     Description: Indicates if pharmacy services are provided on-site to
                  residents.
     SAS Name:    PHRMCY_SRVC_ONST_RSDNT_SW


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             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     COBOL Name:  PHRMCY-SRVC-ONST-RSDNT-SW

   Services: Physician Extender Off-Site Residents   1    796   796  VARCHAR2
   Indicator
     Description: Indicates if physician extender services are provided
                  off-site to residents.
     SAS Name:    PHYSN_EXT_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  PHYSN-EXT-SRVC-OFSITE-RSDNT-SW

   Services: Physician Extender On-Site Nonresidents 1    797   797  VARCHAR2
   Indicator
     Description: Indicates if physician extender services are provided
                  on-site to nonresidents.
     SAS Name:    PHYSN_EXT_SRVC_ONST_NRSDNT_SW
     COBOL Name:  PHYSN-EXT-SRVC-ONST-NRSDNT-SW

   Services: Physician Extender On-Site Residents    1    798   798  VARCHAR2
   Indicator
     Description: Indicates if physician extender services are provided
                  on-site to residents.
     SAS Name:    PHYSN_EXT_SRVC_ONST_RSDNT_SW
     COBOL Name:  PHYSN-EXT-SRVC-ONST-RSDNT-SW

   Services: Physician Off-Site Residents Indicator  1    799   799  VARCHAR2
     Description: Indicates if physician services are provided off-site to
                  residents.
     SAS Name:    PHYSN_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  PHYSN-SRVC-OFSITE-RSDNT-SW

   Services: Physician On-Site Nonresidents Indicator 1    800   800  VARCHAR2
     Description: Indicates if physician services are provided on-site to
                  nonresidents.
     SAS Name:    PHYSN_SRVC_ONST_NRSDNT_SW
     COBOL Name:  PHYSN-SRVC-ONST-NRSDNT-SW

   Services: Physician On-Site Residents Indicator   1    801   801  VARCHAR2
     Description: Indicates if physician services are provided on-site to
                  residents.
     SAS Name:    PHYSN_SRVC_ONST_RSDNT_SW
     COBOL Name:  PHYSN-SRVC-ONST-RSDNT-SW

   Services: Podiatry Off-Site Residents Indicator   1    802   802  VARCHAR2
     Description: Indicates if podiatry services are provided off-site to
                  residents.
     SAS Name:    PDTRY_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  PDTRY-SRVC-OFSITE-RSDNT-SW

   Services: Podiatry On-Site Nonresidents Indicator 1    803   803  VARCHAR2
     Description: Indicates if podiatry services are provided on-site to
                  nonresidents.
     SAS Name:    PDTRY_SRVC_ONST_NRSDNT_SW
     COBOL Name:  PDTRY-SRVC-ONST-NRSDNT-SW

   Services: Podiatry On-Site Residents Indicator    1    804   804  VARCHAR2
     Description: Indicates if podiatry services are provided on-site to
                  residents.
     SAS Name:    PDTRY_SRVC_ONST_RSDNT_SW
     COBOL Name:  PDTRY-SRVC-ONST-RSDNT-SW

   Services: PT Off-Site Residents Indicator         1    814   814  VARCHAR2
     Description: Indicates if physical therapy services are provided
                  off-site to residents.
     SAS Name:    PT_OFSITE_RSDNT_SW
     COBOL Name:  PT-OFSITE-RSDNT-SW


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             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Services: PT On-Site Nonresidents Indicator       1    815   815  VARCHAR2
     Description: Indicates if physical therapy services are provided
                  on-site to nonresidents.
     SAS Name:    PT_ONST_NRSDNT_SW
     COBOL Name:  PT-ONST-NRSDNT-SW

   Services: PT On-Site Residents Indicator          1    816   816  VARCHAR2
     Description: Indicates if physical therapy services are provided
                  on-site to residents.
     SAS Name:    PT_ONST_RSDNT_SW
     COBOL Name:  PT-ONST-RSDNT-SW

   Services: Social Work Off-Site Residents Indicator 1    827   827  VARCHAR2
     Description: Indicates if social work services are provided off-site
                  to residents.
     SAS Name:    SCL_WORK_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  SCL-WORK-SRVC-OFSITE-RSDNT-SW

   Services: Social Work On-Site Nonresidents Indicator 1    828   828  VARCHAR2
     Description: Indicates if social work services are provided on-site to
                  nonresidents.
     SAS Name:    SCL_WORK_SRVC_ONST_NRSDNT_SW
     COBOL Name:  SCL-WORK-SRVC-ONST-NRSDNT-SW

   Services: Social Work On-Site Residents Indicator 1    829   829  VARCHAR2
     Description: Indicates if social work services are provided on-site to
                  residents.
     SAS Name:    SCL_WORK_SRVC_ONST_RSDNT_SW
     COBOL Name:  SCL-WORK-SRVC-ONST-RSDNT-SW

   Services: Speech Pathology Off-Site Residents     1    834   834  VARCHAR2
   Indicator
     Description: Indicates if speech/language pathology services are
                  provided off-site to residents.
     SAS Name:    SPCH_PTHLGY_OFSITE_RSDNT_SW
     COBOL Name:  SPCH-PTHLGY-OFSITE-RSDNT-SW

   Services: Speech Pathology On-Site Nonresidents   1    835   835  VARCHAR2
   Indicator
     Description: Indicates if speech/language pathology services are
                  provided on-site to nonresidents.
     SAS Name:    SPCH_PTHLGY_ONST_NRSDNT_SW
     COBOL Name:  SPCH-PTHLGY-ONST-NRSDNT-SW

   Services: Speech Pathology On-Site Residents      1    836   836  VARCHAR2
   Indicator
     Description: Indicates if speech/language pathology services are
                  provided on-site to residents.
     SAS Name:    SPCH_PTHLGY_ONST_RSDNT_SW
     COBOL Name:  SPCH-PTHLGY-ONST-RSDNT-SW

   Services: Therapeutic - Other Activities Staff -  1    839   839  VARCHAR2
   Off-Site Residents Indicator
     Description: Indicates if therapeutic services are provided off-site
                  to residents by other activities staff.
     SAS Name:    ACTVTY_OTHR_OFSITE_RSDNT_SW
     COBOL Name:  ACTVTY-OTHR-OFSITE-RSDNT-SW

   Services: Therapeutic - Other Activities Staff -  1    840   840  VARCHAR2
   On-Site Nonresidents Indicator
     Description: Indicates if therapeutic services are provided on-site to
                  nonresidents by other activities staff.
     SAS Name:    ACTVTY_OTHR_ONST_NRSDNT_SW


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             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     COBOL Name:  ACTVTY-OTHR-ONST-NRSDNT-SW

   Services: Therapeutic - Other Activities Staff -  1    841   841  VARCHAR2
   On-Site Residents Indicator
     Description: Indicates if therapeutic services are provided on-site to
                  residents by other activities staff.
     SAS Name:    ACTVTY_OTHR_ONST_RSDNT_SW
     COBOL Name:  ACTVTY-OTHR-ONST-RSDNT-SW

   Services: Therapeutic - Other Social Services Staff - 1    842   842  VARCHAR2
   Off-Site Residents Indicator
     Description: Indicates if other therapeutic social services are
                  provided off-site to residents.
     SAS Name:    SCL_SRVC_OTHR_OFSITE_RSDNT_SW
     COBOL Name:  SCL-SRVC-OTHR-OFSITE-RSDNT-SW

   Services: Therapeutic - Other Social Services Staff - 1    843   843  VARCHAR2
   On-Site Nonresidents Indicator
     Description: Indicates if other therapeutic social services are
                  provided on-site to nonresidents.
     SAS Name:    SCL_SRVC_OTHR_ONST_NRSDNT_SW
     COBOL Name:  SCL-SRVC-OTHR-ONST-NRSDNT-SW

   Services: Therapeutic - Other Social Services Staff - 1    844   844  VARCHAR2
   On-Site Residents Indicator
     Description: Indicates if other therapeutic social services are
                  provided on-site to residents.
     SAS Name:    SCL_SRVC_OTHR_ONST_RSDNT_SW
     COBOL Name:  SCL-SRVC-OTHR-ONST-RSDNT-SW

   Services: Therapeutic - Qualified Activities      1    845   845  VARCHAR2
   Professional - Off-Site Residents Indicator
     Description: Indicates if therapeutic services are provided off-site
                  to residents by qualified activities professionals.
     SAS Name:    ACTVTY_OFSITE_RSDNT_SW
     COBOL Name:  ACTVTY-OFSITE-RSDNT-SW

   Services: Therapeutic - Qualified Activities      1    846   846  VARCHAR2
   Professional - On-Site Nonresidents Indicator
     Description: Indicates if therapeutic services are provided on-site to
                  nonresidents by qualified activities professionals.
     SAS Name:    ACTVTY_ONST_NRSDNT_SW
     COBOL Name:  ACTVTY-ONST-NRSDNT-SW

   Services: Therapeutic - Qualified Activities      1    847   847  VARCHAR2
   Professional - On-Site Residents Indicator
     Description: Indicates if therapeutic services are provided on-site to
                  residents by qualified activities professionals.
     SAS Name:    ACTVTY_ONST_RSDNT_SW
     COBOL Name:  ACTVTY-ONST-RSDNT-SW

   Services: Therapeutic Recreational Specialty Off-Site 1    849   849  VARCHAR2
   Residents Indicator
     Description: Indicates if therapeutic recreation specialist services
                  are provided off-site to residents.
     SAS Name:    THRPTC_RCRTNL_OFSITE_RSDNT_SW
     COBOL Name:  THRPTC-RCRTNL-OFSITE-RSDNT-SW

   Services: Therapeutic Recreational Specialty On-Site 1    850   850  VARCHAR2
   Nonresidents Indicator
     Description: Indicates if therapeutic recreation specialist services
                  are provided on-site to nonresidents.
     SAS Name:    THRPTC_RCRTNL_ONST_NRSDNT_SW
     COBOL Name:  THRPTC-RCRTNL-ONST-NRSDNT-SW


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             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Services: Therapeutic Recreational Specialty On-Site 1    851   851  VARCHAR2
   Residents Indicator
     Description: Indicates if therapeutic recreation specialist services
                  are provided on-site to residents.
     SAS Name:    THRPTC_RCRTNL_ONST_RSDNT_SW
     COBOL Name:  THRPTC-RCRTNL-ONST-RSDNT-SW

   Services: Vocational Off-Site Residents Indicator 1    854   854  VARCHAR2
     Description: Indicates if vocational services are provided off-site to
                  residents.
     SAS Name:    VCTNL_SRVC_OFSITE_RSDNT_SW
     COBOL Name:  VCTNL-SRVC-OFSITE-RSDNT-SW

   Services: Vocational On-Site Nonresidents Indicator 1    855   855  VARCHAR2
     Description: Indicates if vocational services are provided on-site to
                  nonresidents.
     SAS Name:    VCTNL_SRVC_ONST_NRSDNT_SW
     COBOL Name:  VCTNL-SRVC-ONST-NRSDNT-SW

   Services: Vocational On-Site Residents Indicator  1    856   856  VARCHAR2
     Description: Indicates if vocational services are provided on-site to
                  residents.
     SAS Name:    VCTNL_SRVC_ONST_RSDNT_SW
     COBOL Name:  VCTNL-SRVC-ONST-RSDNT-SW

   Services: X-ray Off-Site Residents Indicator      1    857   857  VARCHAR2
     Description: Indicates if diagnostic X-ray services are provided
                  off-site to residents.
     SAS Name:    DGNSTC_XRAY_OFSITE_RSDNT_SW
     COBOL Name:  DGNSTC-XRAY-OFSITE-RSDNT-SW

   Services: X-ray On-Site Nonresidents Indicator    1    858   858  VARCHAR2
     Description: Indicates if diagnostic X-ray services are provided
                  on-site to nonresidents.
     SAS Name:    DGNSTC_XRAY_ONST_NRSDNT_SW
     COBOL Name:  DGNSTC-XRAY-ONST-NRSDNT-SW

   Services: X-ray On-Site Residents Indicator       1    859   859  VARCHAR2
     Description: Indicates if diagnostic X-ray services are provided
                  on-site to residents.
     SAS Name:    DGNSTC_XRAY_ONST_RSDNT_SW
     COBOL Name:  DGNSTC-XRAY-ONST-RSDNT-SW

   Staff Count Override Indicator                    1    861   861  CHAR
     Description: Indicates if the regional office has approved a
                  significant staff count change from the previous
                  certification.
     SAS Name:    OVRRD_STFG_SW
     COBOL Name:  OVRRD-STFG-SW

   Staff Count: Administrative Staff - Contract      8    862   869  NUMBER
     Description: Number of full-time equivalent administrative staff under
                  contract to a facility.
     SAS Name:    PROFNL_ADMIN_CNTRCT_CNT
     COBOL Name:  PROFNL-ADMIN-CNTRCT-CNT

   Staff Count: Administrative Staff - Full-Time     8    870   877  NUMBER
     Description: Number of full-time equivalent administrative staff
                  employed on a full-time basis by a facility.
     SAS Name:    PROFNL_ADMIN_FLTM_CNT
     COBOL Name:  PROFNL-ADMIN-FLTM-CNT

   Staff Count: Administrative Staff - Part-Time     8    878   885  NUMBER


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             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Number of full-time equivalent administrative staff
                  employed on a part-time basis by a facility.
     SAS Name:    PROFNL_ADMIN_PRTM_CNT
     COBOL Name:  PROFNL-ADMIN-PRTM-CNT

   Staff Count: Certified Nurse Aide - Contract      8    910   917  NUMBER
     Description: Number of full-time equivalent certified nurse aides
                  under contract to a facility.
     SAS Name:    NRS_AIDE_CNTRCT_CNT
     COBOL Name:  NRS-AIDE-CNTRCT-CNT

   Staff Count: Certified Nurse Aide - Full-Time     8    918   925  NUMBER
     Description: Number of full-time equivalent certified nurse aides
                  employed full-time by a facility.
     SAS Name:    NRS_AIDE_FLTM_CNT
     COBOL Name:  NRS-AIDE-FLTM-CNT

   Staff Count: Certified Nurse Aide - Part-Time     8    926   933  NUMBER
     Description: Number of full-time equivalent certified nurse aides
                  employed part-time by a facility.
     SAS Name:    NRS_AIDE_PRTM_CNT
     COBOL Name:  NRS-AIDE-PRTM-CNT

   Staff Count: Dentist - Contract                   8    958   965  NUMBER
     Description: Number of full-time equivalent dentists under contract to
                  a facility.
     SAS Name:    DNTST_CNTRCT_CNT
     COBOL Name:  DNTST-CNTRCT-CNT

   Staff Count: Dentist - Full-Time                  8    966   973  NUMBER
     Description: Number of full-time equivalent dentists employed full
                  time by a facility.
     SAS Name:    DNTST_FLTM_CNT
     COBOL Name:  DNTST-FLTM-CNT

   Staff Count: Dentist - Part-Time                  8    974   981  NUMBER
     Description: Number of full-time equivalent dentists employed part
                  time by a facility.
     SAS Name:    DNTST_PRTM_CNT
     COBOL Name:  DNTST-PRTM-CNT

   Staff Count: Dietitian - Contract                 8    990   997  NUMBER
     Description: Number of full-time equivalent dietitians under contract
                  to a facility.
     SAS Name:    DIETN_CNTRCT_CNT
     COBOL Name:  DIETN-CNTRCT-CNT

   Staff Count: Dietitian - Full-Time                8    998   1005 NUMBER
     Description: Number of full-time equivalent dietitians employed full
                  time by a facility.
     SAS Name:    DIETN_FLTM_CNT
     COBOL Name:  DIETN-FLTM-CNT

   Staff Count: Dietitian - Part-Time                8    1006  1013 NUMBER
     Description: Number of full-time equivalent dietitians employed part
                  time by a facility.
     SAS Name:    DIETN_PRTM_CNT
     COBOL Name:  DIETN-PRTM-CNT

   Staff Count: Food Service Worker - Contract       8    1022  1029 NUMBER
     Description: Number of full-time equivalent food service personnel
                  under contract to a facility.
     SAS Name:    FOOD_SRVC_CNTRCT_CNT
     COBOL Name:  FOOD-SRVC-CNTRCT-CNT


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 33
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Staff Count: Food Service Worker - Full-Time      8    1030  1037 NUMBER
     Description: Number of full-time equivalent food service personnel
                  employed  full-time by a facility.
     SAS Name:    FOOD_SRVC_FLTM_CNT
     COBOL Name:  FOOD-SRVC-FLTM-CNT

   Staff Count: Food Service Worker - Part-Time      8    1038  1045 NUMBER
     Description: Number of full-time equivalent food service personnel
                  employed  part-time by a facility.
     SAS Name:    FOOD_SRVC_PRTM_CNT
     COBOL Name:  FOOD-SRVC-PRTM-CNT

   Staff Count: Housekeeping - Contract              8    1070  1077 NUMBER
     Description: Number of full-time equivalent housekeeping personnel
                  under contract to a facility.
     SAS Name:    HSEKPNG_CNTRCT_CNT
     COBOL Name:  HSEKPNG-CNTRCT-CNT

   Staff Count: Housekeeping - Full-Time             8    1078  1085 NUMBER
     Description: Number of full-time equivalent housekeeping personnel
                  employed  full-time by a facility.
     SAS Name:    HSEKPNG_FLTM_CNT
     COBOL Name:  HSEKPNG-FLTM-CNT

   Staff Count: Housekeeping - Part-Time             8    1086  1093 NUMBER
     Description: Number of full-time equivalent housekeeping personnel
                  employed  part-time by a facility.
     SAS Name:    HSEKPNG_PRTM_CNT
     COBOL Name:  HSEKPNG-PRTM-CNT

   Staff Count: LPN/LVN - Contract                   8    1118  1125 NUMBER
     Description: Number of full-time equivalent licensed
                  practical/vocational nurses under contract to a facility.
     SAS Name:    LPN_LVN_CNTRCT_CNT
     COBOL Name:  LPN-LVN-CNTRCT-CNT

   Staff Count: LPN/LVN - Full-Time                  8    1126  1133 NUMBER
     Description: Number of full-time equivalent licensed
                  practical/vocational nurses employed full-time by a
                  facility.
     SAS Name:    LPN_LVN_FLTM_CNT
     COBOL Name:  LPN-LVN-FLTM-CNT

   Staff Count: LPN/LVN - Part-Time                  8    1134  1141 NUMBER
     Description: Number of full-time equivalent licensed
                  practical/vocational nurses employed part-time by a
                  facility.
     SAS Name:    LPN_LVN_PRTM_CNT
     COBOL Name:  LPN-LVN-PRTM-CNT

   Staff Count: Medical Director - Contract          8    1150  1157 NUMBER
     Description: Number of full-time equivalent medical directors under
                  contract to a facility.
     SAS Name:    MDCL_DRCTR_CNTRCT_CNT
     COBOL Name:  MDCL-DRCTR-CNTRCT-CNT

   Staff Count: Medical Director - Full-Time         8    1158  1165 NUMBER
     Description: Number of full-time equivalent medical directors employed
                  full-time by a facility.
     SAS Name:    MDCL_DRCTR_FLTM_CNT
     COBOL Name:  MDCL-DRCTR-FLTM-CNT

   Staff Count: Medical Director - Part-Time         8    1166  1173 NUMBER


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 34
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Number of full-time equivalent medical directors employed
                  part-time by a facility.
     SAS Name:    MDCL_DRCTR_PRTM_CNT
     COBOL Name:  MDCL-DRCTR-PRTM-CNT

   Staff Count: Medication Aide/Technician - Contract 8    1198  1205 NUMBER
     Description: Number of full-time equivalent medication aides/
                  technicians under contract to a facility.
     SAS Name:    MDCTN_AIDE_CNTRCT_CNT
     COBOL Name:  MDCTN-AIDE-CNTRCT-CNT

   Staff Count: Medication Aide/Technician - Full-Time 8    1206  1213 NUMBER
     Description: Number of full-time equivalent medication aides/
                  technicians employed full-time by a facility.
     SAS Name:    MDCTN_AIDE_FLTM_CNT
     COBOL Name:  MDCTN-AIDE-FLTM-CNT

   Staff Count: Medication Aide/Technician - Part-Time 8    1214  1221 NUMBER
     Description: Number of full-time equivalent medication aides/
                  technicians employed part-time by a facility.
     SAS Name:    MDCTN_AIDE_PRTM_CNT
     COBOL Name:  MDCTN-AIDE-PRTM-CNT

   Staff Count: Mental Health Services - Contract    8    1222  1229 NUMBER
     Description: Number of full-time equivalent mental health services
                  personnel under contract to a facility.
     SAS Name:    MENTL_HLTH_SRVC_CNTRCT_CNT
     COBOL Name:  MENTL-HLTH-SRVC-CNTRCT-CNT

   Staff Count: Mental Health Services - Full-Time   8    1230  1237 NUMBER
     Description: Number of full-time equivalent mental health services
                  personnel employed full-time by a facility.
     SAS Name:    MENTL_HLTH_SRVC_FLTM_CNT
     COBOL Name:  MENTL-HLTH-SRVC-FLTM-CNT

   Staff Count: Mental Health Services - Part-Time   8    1238  1245 NUMBER
     Description: Number of full-time equivalent mental health services
                  personnel employed part-time by a facility.
     SAS Name:    MENTL_HLTH_SRVC_PRTM_CNT
     COBOL Name:  MENTL-HLTH-SRVC-PRTM-CNT

   Staff Count: Nurse Aide in Training - Contract    8    1254  1261 NUMBER
     Description: Number of full-time equivalent nurse aides in training
                  under contract to a facility.
     SAS Name:    NAT_CNTRCT_CNT
     COBOL Name:  NAT-CNTRCT-CNT

   Staff Count: Nurse Aide in Training - Full-Time   8    1262  1269 NUMBER
     Description: Number of full-time equivalent nurse aides in training
                  employed full-time by a facility.
     SAS Name:    NAT_FLTM_CNT
     COBOL Name:  NAT-FLTM-CNT

   Staff Count: Nurse Aide in Training - Part-Time   8    1270  1277 NUMBER
     Description: Number of full-time equivalent nurse aides in training
                  employed part-time by a facility.
     SAS Name:    NAT_PRTM_CNT
     COBOL Name:  NAT-PRTM-CNT

   Staff Count: Nurse With Administrative Duties -   8    1286  1293 NUMBER
   Contract
     Description: Number of full-time equivalent nurses with administrative
                  duties under contract to a facility.
     SAS Name:    NRS_ADMINV_CNTRCT_CNT


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             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     COBOL Name:  NRS-ADMINV-CNTRCT-CNT

   Staff Count: Nurse With Administrative Duties -   8    1294  1301 NUMBER
   Full-Time
     Description: Number of full-time equivalent nurses with administrative
                  duties employed full-time by a facility.
     SAS Name:    NRS_ADMINV_FLTM_CNT
     COBOL Name:  NRS-ADMINV-FLTM-CNT

   Staff Count: Nurse With Administrative Duties -   8    1302  1309 NUMBER
   Part-Time
     Description: Number of full-time equivalent nurses with administrative
                  duties employed part-time by a facility.
     SAS Name:    NRS_ADMINV_PRTM_CNT
     COBOL Name:  NRS-ADMINV-PRTM-CNT

   Staff Count: OT - Arrangement                     8    1318  1325 NUMBER
     Description: Number of full-time equivalent occupational therapists
                  under arrangement to the provider
     SAS Name:    OCPTNL_THRPST_CNTRCT_CNT
     COBOL Name:  OCPTNL-THRPST-CNTRCT-CNT

   Staff Count: OT - Full-Time                       8    1326  1333 NUMBER
     Description: Number of full-time equivalent occupational therapists
                  employed full-time by a facility.
     SAS Name:    OCPTNL_THRPST_FLTM_CNT
     COBOL Name:  OCPTNL-THRPST-FLTM-CNT

   Staff Count: OT - Part-Time                       8    1334  1341 NUMBER
     Description: Number of full-time equivalent occupational therapists
                  employed part-time by a facility.
     SAS Name:    OCPTNL_THRPST_PRTM_CNT
     COBOL Name:  OCPTNL-THRPST-PRTM-CNT

   Staff Count: OT Aide - Contract                   8    1342  1349 NUMBER
     Description: Number of full-time equivalent occupational therapy aides
                  under contract to a facility.
     SAS Name:    OT_AIDE_CNTRCT_CNT
     COBOL Name:  OT-AIDE-CNTRCT-CNT

   Staff Count: OT Aide - Full-Time                  8    1350  1357 NUMBER
     Description: Number of full-time equivalent occupational therapy aides
                  employed full-time by a facility.
     SAS Name:    OT_AIDE_FLTM_CNT
     COBOL Name:  OT-AIDE-FLTM-CNT

   Staff Count: OT Aide - Part-Time                  8    1358  1365 NUMBER
     Description: Number of full-time equivalent occupational therapy aides
                  employed part-time by a facility.
     SAS Name:    OT_AIDE_PRTM_CNT
     COBOL Name:  OT-AIDE-PRTM-CNT

   Staff Count: OT Assistant - Contract              8    1366  1373 NUMBER
     Description: Number of full-time equivalent occupational therapy
                  assistants under contract to a facility.
     SAS Name:    OT_ASTNT_CNTRCT_CNT
     COBOL Name:  OT-ASTNT-CNTRCT-CNT

   Staff Count: OT Assistant - Full-Time             8    1374  1381 NUMBER
     Description: Number of full-time equivalent occupational therapy
                  assistants employed full-time by a facility.
     SAS Name:    OT_ASTNT_FLTM_CNT
     COBOL Name:  OT-ASTNT-FLTM-CNT



 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 36
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

   Staff Count: OT Assistant - Part-Time             8    1382  1389 NUMBER
     Description: Number of full-time equivalent occupational therapy
                  assistants employed part-time by a facility.
     SAS Name:    OT_ASTNT_PRTM_CNT
     COBOL Name:  OT-ASTNT-PRTM-CNT

   Staff Count: Other Activities - Contract          8    1398  1405 NUMBER
     Description: Number of full-time equivalent other activities staff
                  providing therapeutic services under contract to a
                  facility.
     SAS Name:    ACTVTY_STF_OTHR_CNTRCT_CNT
     COBOL Name:  ACTVTY-STF-OTHR-CNTRCT-CNT

   Staff Count: Other Activities - Full-Time         8    1406  1413 NUMBER
     Description: Number of full-time equivalent other activities staff
                  providing therapeutic services employed full time by a
                  facility.
     SAS Name:    ACTVTY_STF_OTHR_FLTM_CNT
     COBOL Name:  ACTVTY-STF-OTHR-FLTM-CNT

   Staff Count: Other Activities - Part-Time         8    1414  1421 NUMBER
     Description: Number of full-time equivalent other activities staff
                  providing therapeutic services employed part time by a
                  facility.
     SAS Name:    ACTVTY_STF_OTHR_PRTM_CNT
     COBOL Name:  ACTVTY-STF-OTHR-PRTM-CNT

   Staff Count: Other Physician - Contract           8    1422  1429 NUMBER
     Description: Number of full-time equivalent other physicians under
                  contract to a facility.
     SAS Name:    PHYSN_OTHR_CNTRCT_CNT
     COBOL Name:  PHYSN-OTHR-CNTRCT-CNT

   Staff Count: Other Physician - Full-Time          8    1430  1437 NUMBER
     Description: Number of full-time equivalent other physicians employed
                  full-time by a facility.
     SAS Name:    PHYSN_OTHR_FLTM_CNT
     COBOL Name:  PHYSN-OTHR-FLTM-CNT

   Staff Count: Other Physician - Part-Time          8    1438  1445 NUMBER
     Description: Number of full-time equivalent other physicians employed
                  part-time by a facility.
     SAS Name:    PHYSN_OTHR_PRTM_CNT
     COBOL Name:  PHYSN-OTHR-PRTM-CNT

   Staff Count: Other Social Services - Contract     8    1446  1453 NUMBER
     Description: Number of full-time equivalent other social services
                  staff under contract to a facility.
     SAS Name:    SCL_SRVC_OTHR_STF_CNTRCT_CNT
     COBOL Name:  SCL-SRVC-OTHR-STF-CNTRCT-CNT

   Staff Count: Other Social Services - Full-Time    8    1454  1461 NUMBER
     Description: Number of full-time equivalent other social services
                  staff employed full time by a facility.
     SAS Name:    SCL_SRVC_OTHR_STF_FLTM_CNT
     COBOL Name:  SCL-SRVC-OTHR-STF-FLTM-CNT

   Staff Count: Other Social Services - Part-Time    8    1462  1469 NUMBER
     Description: Number of full-time equivalent other social services
                  staff employed part time by a facility.
     SAS Name:    SCL_SRVC_OTHR_STF_PRTM_CNT
     COBOL Name:  SCL-SRVC-OTHR-STF-PRTM-CNT

   Staff Count: Other Staff - Contract               8    1470  1477 NUMBER


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 37
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Number of full-time equivalent staff not included in any
                  other categories under contract to the facility.
     SAS Name:    STF_OTHR_CNTRCT_CNT
     COBOL Name:  STF-OTHR-CNTRCT-CNT

   Staff Count: Other Staff - Full-Time              8    1478  1485 NUMBER
     Description: Number of full-time equivalent persons not included in
                  any other categories employed full-time by the facility.
     SAS Name:    STF_OTHR_FLTM_CNT
     COBOL Name:  STF-OTHR-FLTM-CNT

   Staff Count: Other Staff - Part-Time              8    1486  1493 NUMBER
     Description: Number of full-time equivalent persons not included in
                  any other categories employed part-time by the facility.
     SAS Name:    STF_OTHR_PRTM_CNT
     COBOL Name:  STF-OTHR-PRTM-CNT

   Staff Count: Pharmacist - Contract                8    1494  1501 NUMBER
     Description: Number of full-time equivalent pharmacists under contract
                  to a facility.
     SAS Name:    PHRMCST_CNTRCT_CNT
     COBOL Name:  PHRMCST-CNTRCT-CNT

   Staff Count: Pharmacist - Full-Time               8    1502  1509 NUMBER
     Description: Number of full-time equivalent pharmacists employed
                  full-time by a facility.
     SAS Name:    PHRMCST_FLTM_CNT
     COBOL Name:  PHRMCST-FLTM-CNT

   Staff Count: Pharmacist - Part-Time               8    1510  1517 NUMBER
     Description: Number of full-time equivalent pharmacists employed
                  part-time by a facility.
     SAS Name:    PHRMCST_PRTM_CNT
     COBOL Name:  PHRMCST-PRTM-CNT

   Staff Count: Physical Therapist - Contract        8    1518  1525 NUMBER
     Description: Number of full-time equivalent physical therapists under
                  contract to a facility.
     SAS Name:    PHYS_THRPST_CNTRCT_CNT
     COBOL Name:  PHYS-THRPST-CNTRCT-CNT

   Staff Count: Physical Therapist - Full-Time       8    1526  1533 NUMBER
     Description: Number of full-time equivalent physical therapists
                  employed full-time by a facility.
     SAS Name:    PHYS_THRPST_FLTM_CNT
     COBOL Name:  PHYS-THRPST-FLTM-CNT

   Staff Count: Physical Therapist - Part-Time       8    1534  1541 NUMBER
     Description: Number of full-time equivalent physical therapists
                  employed part-time by a facility.
     SAS Name:    PHYS_THRPST_PRTM_CNT
     COBOL Name:  PHYS-THRPST-PRTM-CNT

   Staff Count: Physician Extender - Contract        8    1566  1573 NUMBER
     Description: Number of full-time equivalent physician extenders under
                  contract to the facility.
     SAS Name:    PHYSN_EXT_CNTRCT_CNT
     COBOL Name:  PHYSN-EXT-CNTRCT-CNT

   Staff Count: Physician Extender - Full-Time       8    1574  1581 NUMBER
     Description: Number of full-time equivalent physician extenders
                  employed full-time by the facility.
     SAS Name:    PHYSN_EXT_FLTM_CNT
     COBOL Name:  PHYSN-EXT-FLTM-CNT


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 38
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Staff Count: Physician Extender - Part-Time       8    1582  1589 NUMBER
     Description: Number of full-time equivalent physician extenders
                  employed part-time by the facility.
     SAS Name:    PHYSN_EXT_PRTM_CNT
     COBOL Name:  PHYSN-EXT-PRTM-CNT

   Staff Count: Podiatrist - Contract                8    1598  1605 NUMBER
     Description: Number of full-time equivalent podiatrists under contract
                  to a facility.
     SAS Name:    PDTRST_CNTRCT_CNT
     COBOL Name:  PDTRST-CNTRCT-CNT

   Staff Count: Podiatrist - Full-Time               8    1606  1613 NUMBER
     Description: Number of full-time equivalent podiatrists employed
                  full-time by a facility.
     SAS Name:    PDTRST_FLTM_CNT
     COBOL Name:  PDTRST-FLTM-CNT

   Staff Count: Podiatrist - Part-Time               8    1614  1621 NUMBER
     Description: Number of full-time equivalent podiatrists employed
                  part-time by a facility.
     SAS Name:    PDTRST_PRTM_CNT
     COBOL Name:  PDTRST-PRTM-CNT

   Staff Count: PT Aide - Contract                   8    1654  1661 NUMBER
     Description: Number of full-time equivalent physical therapy aides
                  under contract to a facility.
     SAS Name:    PT_AIDE_CNTRCT_CNT
     COBOL Name:  PT-AIDE-CNTRCT-CNT

   Staff Count: PT Aide - Full-Time                  8    1662  1669 NUMBER
     Description: Number of full-time equivalent physical therapy aides
                  employed full-time by a facility.
     SAS Name:    PT_AIDE_FLTM_CNT
     COBOL Name:  PT-AIDE-FLTM-CNT

   Staff Count: PT Aide - Part-Time                  8    1670  1677 NUMBER
     Description: Number of full-time equivalent physical therapy aides
                  employed part-time by a facility.
     SAS Name:    PT_AIDE_PRTM_CNT
     COBOL Name:  PT-AIDE-PRTM-CNT

   Staff Count: PT Assistant - Contract              8    1678  1685 NUMBER
     Description: Number of full-time equivalent physical therapy
                  assistants under contract to a facility.
     SAS Name:    PT_ASTNT_CNTRCT_CNT
     COBOL Name:  PT-ASTNT-CNTRCT-CNT

   Staff Count: PT Assistant - Full-Time             8    1686  1693 NUMBER
     Description: Number of full-time equivalent physical therapy
                  assistants employed full-time by a facility.
     SAS Name:    PT_ASTNT_FLTM_CNT
     COBOL Name:  PT-ASTNT-FLTM-CNT

   Staff Count: PT Assistant - Part-Time             8    1694  1701 NUMBER
     Description: Number of full-time equivalent physical therapy
                  assistants employed part-time by a facility.
     SAS Name:    PT_ASTNT_PRTM_CNT
     COBOL Name:  PT-ASTNT-PRTM-CNT

   Staff Count: Qualified Activities Professional -  8    1702  1709 NUMBER
   Contract
     Description: Number of full-time equivalent qualified activities


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 39
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  professionals providing therapeutic services under
                  contract to a facility.
     SAS Name:    ACTVTY_PROFNL_CNTRCT_CNT
     COBOL Name:  ACTVTY-PROFNL-CNTRCT-CNT

   Staff Count: Qualified Activities Professional -  8    1710  1717 NUMBER
   Full-Time
     Description: Number of full-time equivalent qualified activities
                  professionals providing therapeutic services employed
                  full time by a facility.
     SAS Name:    ACTVTY_PROFNL_FLTM_CNT
     COBOL Name:  ACTVTY-PROFNL-FLTM-CNT

   Staff Count: Qualified Activities Professional -  8    1718  1725 NUMBER
   Part-Time
     Description: Number of full-time equivalent qualified activities
                  professionals providing therapeutic services employed
                  part time by a facility.
     SAS Name:    ACTVTY_PROFNL_PRTM_CNT
     COBOL Name:  ACTVTY-PROFNL-PRTM-CNT

   Staff Count: RN - Contract                        8    1758  1765 NUMBER
     Description: Number of full-time equivalent registered nurses under
                  contract to a facility.
     SAS Name:    RN_CNTRCT_CNT
     COBOL Name:  RN-CNTRCT-CNT

   Staff Count: RN - Full-Time                       8    1766  1773 NUMBER
     Description: Number of full-time equivalent registered nurses employed
                  full-time by a facility.
     SAS Name:    RN_FLTM_CNT
     COBOL Name:  RN-FLTM-CNT

   Staff Count: RN - Part-Time                       8    1774  1781 NUMBER
     Description: Number of full-time equivalent registered nurses employed
                  part-time by a facility.
     SAS Name:    RN_PRTM_CNT
     COBOL Name:  RN-PRTM-CNT

   Staff Count: RN Director of Nursing - Contract    8    1790  1797 NUMBER
     Description: Number of full-time equivalent registered nurse directors
                  of nursing under contract to a facility.
     SAS Name:    RN_DRCTR_CNTRCT_CNT
     COBOL Name:  RN-DRCTR-CNTRCT-CNT

   Staff Count: RN Director of Nursing - Full-Time   8    1798  1805 NUMBER
     Description: Number of full-time equivalent registered nurse directors
                  of nursing employed full-time by a facility.
     SAS Name:    RN_DRCTR_FLTM_CNT
     COBOL Name:  RN-DRCTR-FLTM-CNT

   Staff Count: RN Director of Nursing - Part-Time   8    1806  1813 NUMBER
     Description: Number of full-time equivalent registered nurse directors
                  of nursing employed part-time by a facility.
     SAS Name:    RN_DRCTR_PRTM_CNT
     COBOL Name:  RN-DRCTR-PRTM-CNT

   Staff Count: Social Worker - Contract             8    1822  1829 NUMBER
     Description: Number of full-time equivalent social workers under
                  contract to a facility.
     SAS Name:    SCL_WORKR_CNTRCT_CNT
     COBOL Name:  SCL-WORKR-CNTRCT-CNT

   Staff Count: Social Worker - Full-Time            8    1830  1837 NUMBER


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 40
             Nursing Facility, CATEGORY = "10" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Number of full-time equivalent social workers employed
                  full-time by a facility.
     SAS Name:    SCL_WORKR_FLTM_CNT
     COBOL Name:  SCL-WORKR-FLTM-CNT

   Staff Count: Social Worker - Part-Time            8    1838  1845 NUMBER
     Description: Number of full-time equivalent social workers employed
                  part-time by a facility.
     SAS Name:    SCL_WORKR_PRTM_CNT
     COBOL Name:  SCL-WORKR-PRTM-CNT

   Staff Count: Speech Pathologist - Contract        8    1854  1861 NUMBER
     Description: Number of full-time equivalent speech pathologists under
                  contract to a facility.
     SAS Name:    SPCH_PTHLGST_CNTRCT_CNT
     COBOL Name:  SPCH-PTHLGST-CNTRCT-CNT

   Staff Count: Speech Pathologist - Full-Time       8    1862  1869 NUMBER
     Description: Number of full-time equivalent speech pathologists
                  employed full-time by a facility.
     SAS Name:    SPCH_PTHLGST_FLTM_CNT
     COBOL Name:  SPCH-PTHLGST-FLTM-CNT

   Staff Count: Speech Pathologist - Part-Time       8    1870  1877 NUMBER
     Description: Number of full-time equivalent speech pathologists
                  employed part-time by a facility.
     SAS Name:    SPCH_PTHLGST_PRTM_CNT
     COBOL Name:  SPCH-PTHLGST-PRTM-CNT

   Staff Count: Therapeutic Recreational Specialist - 8    1910  1917 NUMBER
   Contract
     Description: Number of full-time equivalent therapeutic recreation
                  specialist staff under contract to a facility.
     SAS Name:    THRPTC_RCRTNL_CNTRCT_CNT
     COBOL Name:  THRPTC-RCRTNL-CNTRCT-CNT

   Staff Count: Therapeutic Recreational Specialist - 8    1918  1925 NUMBER
   Full-Time
     Description: Number of full-time equivalent therapeutic recreation
                  specialist staff employed full-time by a facility.
     SAS Name:    THRPTC_RCRTNL_FLTM_CNT
     COBOL Name:  THRPTC-RCRTNL-FLTM-CNT

   Staff Count: Therapeutic Recreational Specialist - 8    1926  1933 NUMBER
   Part-Time
     Description: Number of  full-time equivalent therapeutic recreation
                  specialist staff employed full-time by a facility.
     SAS Name:    THRPTC_RCRTNL_PRTM_CNT
     COBOL Name:  THRPTC-RCRTNL-PRTM-CNT

















 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 1
     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Provider Category Subtype Code                    2    1     2    VARCHAR2
     Description: Identifies the subtype of the provider, within the
                  primary category.  Used in reporting to show the
                  breakdown of provider categories, mainly for hospitals
                  and SNFs.
     SAS Name:    PRVDR_CTGRY_SBTYP_CD
     COBOL Name:  PRVDR-CTGRY-SBTYP-CD
     VALUES:      02=Title 19 Only

   Provider Category Code                            2    3     4    VARCHAR2
     Description: Identifies the type of provider participating in the
                  Medicare/Medicaid program.
     SAS Name:    PRVDR_CTGRY_CD
     COBOL Name:  PRVDR-CTGRY-CD
     VALUES:      11=Intermediate Care Facility/Individuals with Intellectual Disabilities

   CHOW Count                                        2    5     6    NUMBER
     Description: Number of times this provider has undergone a change of
                  ownership.
     SAS Name:    CHOW_CNT
     COBOL Name:  CHOW-CNT

   CHOW Date                                         8    7     14   DATE
     Description: Effective date of the most recent change of ownership for
                  this provider.
     SAS Name:    CHOW_DT
     COBOL Name:  CHOW-DT

   Address: City                                     28   15    42   VARCHAR2
     Description: City in which the provider is physically located.
     SAS Name:    CITY_NAME
     COBOL Name:  CITY-NAME

   Compliance: Acceptable POC                        1    43    43   VARCHAR2
     Description: Indicates if a provider is in compliance with program
                  requirements based on an acceptable plan for correction
                  of deficiencies.
     SAS Name:    ACPTBL_POC_SW
     COBOL Name:  ACPTBL-POC-SW

   Compliance: Status                                1    44    44   VARCHAR2
     Description: Compliance status of a provider at the time of
                  certification survey.
     SAS Name:    CMPLNC_STUS_CD
     COBOL Name:  CMPLNC-STUS-CD
     VALUES:      A=IN COMPLIANCE
                  B=NOT IN COMPLIANCE

   SSA County Code                                   3    45    47   VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the county where the provider is located.
     SAS Name:    SSA_CNTY_CD
     COBOL Name:  SSA-CNTY-CD

   Cross Ref Provider Number                         10   48    57   CHAR
     Description: Cross reference provider number
     SAS Name:    CROSS_REF_PROVIDER_NUMBER
     COBOL Name:  CROSS-REF-PROVIDER-NUMBER

   Certification Date                                8    58    65   DATE
     Description: Equal to the exit date of the initial visit of the Health
                  survey for certifications completed after July 28, 2012.


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 2
     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  For certifications prior to that date, the certification
                  date is equal to the exit date of the initial visit of
                  the Health survey or LSC survey, whichever is later.
     SAS Name:    CRTFCTN_DT
     COBOL Name:  CRTFCTN-DT

   Eligibility Indicator                             1    66    66   VARCHAR2
     Description: Indicates if a facility is eligible to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    ELGBLTY_SW
     COBOL Name:  ELGBLTY-SW

   Facility Name                                     50   67    116  VARCHAR2
     Description: Name of the provider certified to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    FAC_NAME
     COBOL Name:  FAC-NAME

   Medicare Administrative Contractor (MAC) or       5    117   121  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_CD
     COBOL Name:  INTRMDRY-CARR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 3
     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 4
     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 5
     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 6
     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 7
     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   Medicaid Vendor Number                            15   122   136  VARCHAR2
     Description: Number which may be assigned to a provider by the state
                  Medicaid agency for external control or billing purposes.
     SAS Name:    MDCD_VNDR_NUM
     COBOL Name:  MDCD-VNDR-NUM

   Original Participation Date                       8    137   144  DATE
     Description: Date a provider is first approved to provide Medicare
                  and/or Medicaid services.
     SAS Name:    ORGNL_PRTCPTN_DT
     COBOL Name:  ORGNL-PRTCPTN-DT

   Prior CHOW Date                                   8    145   152  DATE
     Description: Effective date of the previous change of ownership for
                  this provider.
     SAS Name:    CHOW_PRIOR_DT
     COBOL Name:  CHOW-PRIOR-DT

   Prior Medicare Administrative Contractor (MAC) or 5    153   157  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the previous Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_PRIOR_CD
     COBOL Name:  INTRMDRY-CARR-PRIOR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 8
     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 9
     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 10
     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 11
     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 12
     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)
                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   CCN                                               10   158   167  VARCHAR2
     Description: Six or ten position identification number that is
                  assigned to a certified provider.  This is the CMS
                  Certification Number.
     SAS Name:    PRVDR_NUM
     COBOL Name:  PRVDR-NUM

   Region Code                                       2    168   169  VARCHAR2
     Description: Indicates the CMS Regional Office responsible for the
                  certification of the provider.
     SAS Name:    RGN_CD
     COBOL Name:  RGN-CD
     VALUES:      01=Boston
                  02=New York
                  03=Philadelphia
                  04=Atlanta
                  05=Chicago
                  06=Dallas
                  07=Kansas City
                  08=Denver
                  09=San Francisco
                  10=Seattle

   Skeleton Record Indicator                         1    170   170  VARCHAR2
     Description: Indicates if the record is a skeleton record.  Only a
                  limited set of data is available for this provider; no
                  survey data exists.  Only provider categories
                  01,17,19,21and 22 can have skeleton providers.
     SAS Name:    SKLTN_REC_SW
     COBOL Name:  SKLTN-REC-SW

   State Abbreviation                                2    171   172  VARCHAR2
     Description: Two-character state abbreviation.
     SAS Name:    STATE_CD
     COBOL Name:  STATE-CD
     VALUES:      AK=ALASKA
                  AL=ALABAMA
                  AR=ARKANSAS
                  AS=AMERICAN SAMOA
                  AZ=ARIZONA
                  CA=CALIFORNIA


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     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  CN=CANADA
                  CO=COLORADO
                  CT=CONNECTICUT
                  DC=DISTRICT OF COLUMBIA
                  DE=DELAWARE
                  FL=FLORIDA
                  FN=INTERNATIONAL
                  GA=GEORGIA
                  GU=GUAM
                  HI=HAWAII
                  IA=IOWA
                  ID=IDAHO
                  IL=ILLINOIS
                  IN=INDIANA
                  KS=KANSAS
                  KY=KENTUCKY
                  LA=LOUISIANA
                  MA=MASSACHUSETTS
                  MD=MARYLAND
                  ME=MAINE
                  MI=MICHIGAN
                  MN=MINNESOTA
                  MO=MISSOURI
                  MP=SAIPAN
                  MS=MISSISSIPPI
                  MT=MONTANA
                  MX=MEXICO
                  NC=NORTH CAROLINA
                  ND=NORTH DAKOTA
                  NE=NEBRASKA
                  NH=NEW HAMPSHIRE
                  NJ=NEW JERSEY
                  NM=NEW MEXICO
                  NV=NEVADA
                  NY=NEW YORK
                  OH=OHIO
                  OK=OKLAHOMA
                  OR=OREGON
                  PA=PENNSYLVANIA
                  PR=PUERTO RICO
                  RI=RHODE ISLAND
                  SC=SOUTH CAROLINA
                  SD=SOUTH DAKOTA
                  TN=TENNESSEE
                  TX=TEXAS
                  UT=UTAH
                  VA=VIRGINIA
                  VI=VIRGIN ISLANDS
                  VT=VERMONT
                  WA=WASHINGTON
                  WI=WISCONSIN
                  WV=WEST VIRGINIA
                  WY=WYOMING

   SSA State Code                                    2    173   174  VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the state where the provider is located.
     SAS Name:    SSA_STATE_CD
     COBOL Name:  SSA-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  03=ARIZONA
                  04=ARKANSAS


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     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  05=CALIFORNIA
                  06=COLORADO
                  07=CONNECTICUT
                  08=DELAWARE
                  09=DISTRICT OF COLUMBIA
                  10=FLORIDA
                  11=GEORGIA
                  12=HAWAII
                  13=IDAHO
                  14=ILLINOIS
                  15=INDIANA
                  16=IOWA
                  17=KANSAS
                  18=KENTUCKY
                  19=LOUISIANA
                  20=MAINE
                  21=MARYLAND
                  22=MASSACHUSETTS
                  23=MICHIGAN
                  24=MINNESOTA
                  25=MISSISSIPPI
                  26=MISSOURI
                  27=MONTANA
                  28=NEBRASKA
                  29=NEVADA
                  30=NEW HAMPSHIRE
                  31=NEW JERSEY
                  32=NEW MEXICO
                  33=NEW YORK
                  34=NORTH CAROLINA
                  35=NORTH DAKOTA
                  36=OHIO
                  37=OKLAHOMA
                  38=OREGON
                  39=PENNSYLVANIA
                  40=PUERTO RICO
                  41=RHODE ISLAND
                  42=SOUTH CAROLINA
                  43=SOUTH DAKOTA
                  44=TENNESSEE
                  45=TEXAS
                  46=UTAH
                  47=VERMONT
                  48=VIRGIN ISLANDS
                  49=VIRGINIA
                  50=WASHINGTON
                  51=WEST VIRGINIA
                  52=WISCONSIN
                  53=WYOMING
                  54=AFRICA
                  56=CANADA
                  57=WEST INDIES
                  58=EUROPE
                  59=MEXICO
                  60=OCEANIA
                  61=PHILIPPINES
                  62=SOUTH AMERICA
                  63=UNITED STATES POSSESSIONS
                  64=AMERICAN SAMOA
                  65=GUAM
                  66=SAIPAN
                  99=INTERNATIONAL



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     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

   State Region Code                                 3    175   177  VARCHAR2
     Description: Identifies the region within a state where the provider
                  is located.
     SAS Name:    STATE_RGN_CD
     COBOL Name:  STATE-RGN-CD
     VALUES:      AK/001=ALASKA
                  AK/LAB=LABORATORIES
                  AK/NPH=NON-PARTICIPATING HOSPITAL
                  AL/001=ALABAMA
                  AL/LAB=LABORATORIES
                  AL/NPH=NON-PARTICIPATING HOSPITAL
                  AR/001=ARKANSAS
                  AR/LAB=LABORATORIES
                  AR/NPH=NON-PARTICIPATING HOSPITAL
                  AS/001=AMERICAN SAMOA
                  AS/LAB=LABORATORY
                  AS/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/AZ=PHOENIX
                  AZ/LAB=ARIZONA LAB
                  AZ/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/TUC=TUCSON
                  CA/001=CALIFORNIA
                  CA/BAK=BAKERSFIELD
                  CA/BER=SAN BERNARDINO
                  CA/EB=East Bay
                  CA/FR=FRESNO
                  CA/L1=L.A. WEST
                  CA/L2=L.A. NORTH
                  CA/L3=L.A. CENTRAL
                  CA/L4=L.A. EAST
                  CA/L5=SAN GABRIEL
                  CA/LA1=LA Region 1
                  CA/LA2=LA Region 2
                  CA/LA3=LA Region 3
                  CA/LA4=LA Acute/Ancillary
                  CA/LA5=LA HHA/Hospice
                  CA/LA6=LA ICF/DD/CLinics
                  CA/LAB=LABORATORIES
                  CA/M1=LAB. SOUTH
                  CA/M2=LAB. NORTH
                  CA/NPH=NON-PARTICIPATING HOSPITAL
                  CA/ORG=ORANGE
                  CA/RIV=RIVERSIDE
                  CA/S1=SACRAMENTO
                  CA/S3=CHICO
                  CA/SD=SAN DIEGO
                  CA/SF=SAN FRANCISCO
                  CA/SJ=SAN JOSE
                  CA/SR=SANTA ROSA
                  CA/VEN=VENTURA
                  CN/001=CANADA
                  CN/LAB=LABORATORY
                  CN/NPH=NON-PARTICIPATING HOSPITAL
                  CO/001=COLORADO
                  CO/LAB=LABORATORIES
                  CO/NPH=NON-PARTICIPATING HOSPITAL
                  CT/001=CONNECTICUT
                  CT/LAB=LABORATORIES
                  CT/NPH=NON-PARTICIPATING HOSPITAL
                  DC/001=DISTRICT OF COLUMBIA
                  DC/LAB=LABORATORIES
                  DC/NPH=NON-PARTICIPATING HOSPITAL
                  DE/001=DELAWARE


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     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  DE/LAB=LABORATORIES
                  DE/NPH=NON-PARTICIPATING HOSPITAL
                  FL/001=FLORIDA
                  FL/FTM=FT. MYERS
                  FL/GAI=GAINESVILLE
                  FL/JAX=JACKSONVILLE
                  FL/LAB=LABORATORIES
                  FL/LAN=LANTANA
                  FL/LAU=LAUDERHILL
                  FL/MIA=MIAMI
                  FL/NPH=NON-PARTICIPATING HOSPITAL
                  FL/ORL=ORLANDO
                  FL/PEN=PENSACOLA
                  FL/STP=ST. PETERSBURG
                  FL/TAL=TALLAHASSEE
                  FL/TAM=TAMPA
                  FM/001=FEDERATED STATES OF MICRO
                  FM/NPH=NON-PARTICIPATING HOSPITAL
                  FN/001=INTERNATIONAL
                  FN/LAB=LABORATORIES
                  FN/NPH=NON-PARTICIPATING HOSPITAL
                  GA/001=GEORGIA
                  GA/GAA=GEORGIA ALL
                  GA/GAC=GEORGIA CENTRAL
                  GA/GAE=GEORGIA EASTERN
                  GA/GAN=GEORGIA NORTH
                  GA/GAS=GEORGIA SOUTH
                  GA/GAW=GEORGIA WESTERN
                  GA/LAB=LABORATORIES
                  GA/NPH=NON-PARTICIPATING HOSPITAL
                  GU/001=GUAM
                  GU/LAB=LABORATORIES
                  GU/NPH=NON-PARTICIPATING HOSPITAL
                  HI/001=HAWAII
                  HI/LAB=LABORATORIES
                  HI/NPH=NON-PARTICIPATING HOSPITAL
                  IA/001=IOWA
                  IA/LAB=LABORATORIES
                  IA/NPH=NON-PARTICIPATING HOSPITAL
                  ID/001=IDAHO
                  ID/LAB=LABORATORIES
                  ID/NPH=NON-PARTICIPATING HOSPITAL
                  IL/001=ILLINOIS
                  IL/LAB=LABORATORIES
                  IL/NPH=NON-PARTICIPATING HOSPITAL
                  IN/001=INDIANA
                  IN/LAB=LABORATORIES
                  IN/NPH=NON-PARTICIPATING HOSPITAL
                  KS/001=KANSAS
                  KS/KCK=KANSAS CITY
                  KS/KDH=KDHE
                  KS/LAB=LABORATORIES
                  KS/LAW=LAWRENCE
                  KS/NC=NORTH CENTRAL KANSAS
                  KS/NE=NORTH EAST KANSAS
                  KS/NPH=NON-PARTICIPATING HOSPITAL
                  KS/NW=NORTH WEST KANSAS
                  KS/SC=SOUTH CENTRAL KANSAS
                  KS/SE=SOUTH EAST KANSAS
                  KS/SW=SOUTH WEST KANSAS
                  KS/WST=WEST
                  KY/2C1=HOPKINSVILLE
                  KY/2C2=LOUISVILLE


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     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  KY/2C3=LONDON
                  KY/2C4=LEXINGTON
                  KY/LAB=LABORATORIES
                  KY/NPH=NON-PARTICIPATING HOSPITAL
                  LA/001=LOUISIANA
                  LA/LA1=NEW ORLEANS
                  LA/LA2=MANDEVILLE
                  LA/LA3=LAFAYETTE
                  LA/LA4=MONROE
                  LA/LA5=SHREVEPORT
                  LA/LA6=ALEXANDRIA
                  LA/LAB=LABORATORIES
                  LA/LB1=CLIA NEW ORLEANS
                  LA/LB5=CLIA SHREVEPORT
                  LA/LB6=CLIA ALEXANDRIA
                  LA/NPH=NON-PARTICIPATING HOSPITAL
                  MA/001=MASSACHUSETTS
                  MA/LAB=LABORATORIES
                  MA/NPH=NON-PARTICIPATING HOSPITAL
                  MD/001=MARYLAND
                  MD/LAB=LABORATORIES
                  MD/NPH=NON-PARTICIPATING HOSPITAL
                  ME/001=MAINE
                  ME/LAB=LABORATORIES
                  ME/NPH=NON-PARTICIPATING HOSPITAL
                  MH/001=MARSHALL ISLANDS
                  MH/NPH=NON-PARTICIPATING HOSPITAL
                  MI/001=MICHIGAN
                  MI/LAB=LABORATORIES
                  MI/NPH=NON-PARTICIPATING HOSPITAL
                  MN/001=MINNESOTA
                  MN/LAB=LABORATORIES
                  MN/NPH=NON-PARTICIPATING HOSPITAL
                  MO/001=MISSOURI
                  MO/01=REGION01
                  MO/02=REGION02
                  MO/03=REGION 03
                  MO/04=REGION 04
                  MO/05=REGION 05
                  MO/06=REGION 06
                  MO/07=REGION 07
                  MO/1NH=REGION 1 NH
                  MO/2NH=REGION 2 NH
                  MO/3NH=REGION 3 NH
                  MO/4NH=REGION 4 NH
                  MO/5NH=REGION 5 NH
                  MO/6NH=REGION 6 NH
                  MO/7NH=REGION 7 NH
                  MO/LAB=LABORATORIES
                  MO/MO=STATEWIDE
                  MO/NPH=NON-PARTICIPATING HOSPITAL
                  MP/001=NORTHERN MARIANA ISLANDS
                  MP/LAB=LABORATORIES
                  MP/NPH=NON-PARTICIPATING HOSPITAL
                  MS/001=MISSISSIPPI
                  MS/LAB=LABORATORIES
                  MS/NPH=NON-PARTICIPATING HOSPITAL
                  MT/001=MONTANA
                  MT/LAB=LABORATORIES
                  MT/NPH=NON-PARTICIPATING HOSPITAL
                  MX/001=MEXICO
                  MX/LAB=LABORATORY
                  MX/NPH=NON-PARTICIPATING HOSPITAL


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     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  NC/001=NORTH CAROLINA
                  NC/LAB=LABORATORIES
                  NC/NCC=NORTH CAROLINA CENTRAL
                  NC/NCE=NORTH CAROLINA EAST
                  NC/NCN=NORTH CAROLINA NORTH
                  NC/NCS=NORTH CAROLINA SOUTH
                  NC/NCW=NORTH CAROLINA WEST
                  NC/NPH=NON-PARTICIPATING HOSPITAL
                  ND/001=NORTH DAKOTA
                  ND/LAB=LABORATORIES
                  ND/NPH=NON-PARTICIPATING HOSPITAL
                  NE/001=NEBRASKA
                  NE/1=NORTH CENTRAL
                  NE/2=CENTRAL
                  NE/3=NORTHEAST
                  NE/4=SOUTHEAST
                  NE/5=WESTERN
                  NE/LAB=LABORATORIES
                  NE/NPH=NON-PARTICIPATING HOSPITAL
                  NH/001=NEW HAMPSHIRE
                  NH/LAB=LABORATORIES
                  NH/NPH=NON-PARTICIPATING HOSPITAL
                  NJ/001=NEW JERSEY
                  NJ/LAB=LABORATORIES
                  NJ/NPH=NON-PARTICIPATING HOSPITAL
                  NM/001=NEW MEXICO
                  NM/LAB=LABORATORIES
                  NM/NPH=NON-PARTICIPATING HOSPITAL
                  NV/001=NEVADA
                  NV/CC=CARSON CITY
                  NV/LAB=LABORATORIES
                  NV/LV=LAS VEGAS
                  NV/NPH=NON-PARTICIPATING HOSPITAL
                  NY/001=BUFFALO
                  NY/002=ROCHESTER
                  NY/003=SYRACUSE
                  NY/004=ALBANY
                  NY/005=NEW ROCHELLE
                  NY/006=NEW YORK CITY
                  NY/007=SUFFOLK/NASSAU COUNTY
                  NY/LAB=LABORATORIES
                  NY/NPH=NON-PARTICIPATING HOSPITAL
                  OH/001=OHIO
                  OH/LAB=LABORATORIES
                  OH/NPH=NON-PARTICIPATING HOSPITAL
                  OK/001=OKLAHOMA
                  OK/LAB=LABORATORIES
                  OK/NPH=NON-PARTICIPATING HOSPITAL
                  OR/001=OFFICE #1
                  OR/002=OFFICE #2
                  OR/003=OFFICE #3
                  OR/LAB=LABORATORIES
                  OR/NPH=NON-PARTICIPATING HOSPITAL
                  PA/001=PENNSYLVANIA
                  PA/LAB=LABORATORIES
                  PA/NPH=NON-PARTICIPATING HOSPITAL
                  PR/001=PUERTO RICO
                  PR/LAB=LABORATORIES
                  PR/NPH=NON-PARTICIPATING HOSPITAL
                  PW/001=PALAU
                  PW/NPH=NON-PARTICIPATING HOSPITAL
                  RI/001=RHODE ISLAND
                  RI/LAB=LABORATORIES


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     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  RI/NPH=NON-PARTICIPATING HOSPITAL
                  SC/001=SOUTH CAROLINA
                  SC/LAB=LABORATORIES
                  SC/NPH=NON-PARTICIPATING HOSPITAL
                  SD/001=SOUTH DAKOTA
                  SD/LAB=LABORATORIES
                  SD/NPH=NON-PARTICIPATING HOSPITAL
                  TN/001=TENNESSEE
                  TN/LAB=LABORATORIES
                  TN/NPH=NON-PARTICIPATING HOSPITAL
                  TN/TNC=TENNESSEE COOKEVILLE
                  TN/TNE=TENNESSEE EASTERN
                  TN/TNM=TENNESSEE MIDDLE
                  TN/TNW=TENNESSEE WESTERN
                  TX/001=TEXAS
                  TX/L01=AMARILLO-LTC
                  TX/L02=ABILENE-LTC
                  TX/L03=ARLINGTON-LTC
                  TX/L04=TYLER-LTC
                  TX/L05=TEMPLE-LTC
                  TX/L06=HOUSTON-LTC
                  TX/L07=SAN ANTONIO-LTC
                  TX/LAB=LABORATORIES
                  TX/NPH=NON-PARTICIPATING HOSPITAL
                  TX/TX1=NLTC REG 1, 7, 9, 10
                  TX/TX2=NLTC REG 2, 3
                  TX/TX4=NLTC REG 6
                  TX/TX5=NLTC REG 4, 5
                  TX/TX6=AUSTIN
                  TX/TX8=NLTC REG 8, 11
                  UT/001=UTAH
                  UT/LAB=LABORATORIES
                  UT/NPH=NON-PARTICIPATING HOSPITAL
                  VA/001=VIRGINIA
                  VA/LAB=LABORATORIES
                  VA/NPH=NON-PARTICIPATING HOSPITAL
                  VI/001=VIRGIN ISLANDS
                  VI/LAB=LABORATORIES
                  VI/NPH=NON-PARTICIPATING HOSPITAL
                  VT/001=VERMONT
                  VT/LAB=LABORATORIES
                  VT/NPH=NON-PARTICIPATING HOSPITAL
                  WA/001=ALL OTHERS (NON-LTC FAC)
                  WA/D1=SPOKANE & YAKIMA AREAS
                  WA/D1A=District 1, Unit A
                  WA/D1B=District 1, Unit B
                  WA/D1C=District 1, Unit C
                  WA/D1D=District 1, Unit D
                  WA/D1E=District 1, Unit E
                  WA/D2=SPOKANE & SE
                  WA/D2A=District 2, Unit A
                  WA/D2B=District 2, Unit B
                  WA/D2C=District 2, Unit C
                  WA/D2D=District 2, Unit D
                  WA/D2E=District 2, Unit E
                  WA/D2F=District 2, Unit F
                  WA/D2G=District 2, Unit G
                  WA/D2H=District 2, Unit H
                  WA/D2I=District 2, Unit I
                  WA/D2J=District 2, Unit J
                  WA/D3=NW WASHINGTON
                  WA/D3A=District 3, Unit A
                  WA/D3B=District 3, Unit B


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     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  WA/D3C=District 3, Unit C
                  WA/D3D=District 3, Unit D
                  WA/D3E=District 3, Unit E
                  WA/D3F=District 3, Unit F
                  WA/D3G=District 3, Unit G
                  WA/D4A=GREATER SEATTLE AREA
                  WA/D4B=S KING COUNTY
                  WA/D5A=PIERCE CTY & PENINSULA
                  WA/D5B=PIERCE CTY & GRAYS HARBOR
                  WA/D6=OLYMPIA AREA
                  WA/LAB=LABORATORIES
                  WA/NPH=NON-PARTICIPATING HOSPITAL
                  WI/001=WISCONSIN
                  WI/LAB=LABORATORIES
                  WI/NPH=NON-PARTICIPATING HOSPITAL
                  WV/001=WEST VIRGINIA
                  WV/LAB=LABORATORIES
                  WV/NPH=NON-PARTICIPATING HOSPITAL
                  WY/001=WYOMING
                  WY/LAB=LABORATORIES
                  WY/NPH=NON-PARTICIPATING HOSPITAL

   Address: Street                                   50   178   227  VARCHAR2
     Description: Street address where the provider is located.
     SAS Name:    ST_ADR
     COBOL Name:  ST-ADR

   Telephone Number                                  10   228   237  VARCHAR2
     Description: Telephone number of the provider.
     SAS Name:    PHNE_NUM
     COBOL Name:  PHNE-NUM

   Termination Code                                  2    238   239  VARCHAR2
     Description: Indicates the current termination status for the
                  provider.
     SAS Name:    PGM_TRMNTN_CD
     COBOL Name:  PGM-TRMNTN-CD
     VALUES:      00=ACTIVE PROVIDER
                  01=VOLUNTARY-MERGER, CLOSURE
                  02=VOLUNTARY-DISSATISFACTION WITH REIMBURSEMENT
                  03=VOLUNTARY-RISK OF INVOLUNTARY TERMINATION
                  04=VOLUNTARY-OTHER REASON FOR WITHDRAWAL
                  05=INVOLUNTARY-FAILURE TO MEET HEALTH/SAFETY REQ
                  06=INVOLUNTARY-FAILURE TO MEET AGREEMENT
                  07=OTHER-PROVIDER STATUS CHANGE
                  08=NONPAYMENT OF FEES - CLIA Only
                  09=REV/UNSUCCESSFUL PARTICIPATION IN PT - CLIA Only
                  10=REV/OTHER REASON - CLIA Only
                  11=INCOMPLETE CLIA APPLICATION INFORMATION - CLIA Only
                  12=NO LONGER PERFORMING TESTS - CLIA Only
                  13=MULTIPLE TO SINGLE SITE CERTIFICATE - CLIA Only
                  14=SHARED LABORATORY - CLIA Only
                  15=FAILURE TO RENEW WAIVER PPM CERTIFICATE - CLIA Only
                  16=DUPLICATE CLIA NUMBER - CLIA Only
                  17=MAIL RETURNED NO FORWARD ADDRESS CERT ENDED - CLIA Only
                  20=NOTIFICATION BANKRUPTCY - CLIA Only
                  33=ACCREDITATION NOT CONFIRMED - CLIA Only
                  80=AWAITING STATE APPROVAL
                  99=OIG ACTION - DO NOT ACTIVATE - CLIA Only

   Termination or Expiration Date                    8    240   247  DATE
     Description: Date the provider was terminated.  For CLIA providers,
                  date the laboratory's certificate was terminated or the


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     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  expiration date of the current CLIA certificate.
     SAS Name:    TRMNTN_EXPRTN_DT
     COBOL Name:  TRMNTN-EXPRTN-DT

   Type of Action Code                               1    248   248  VARCHAR2
     Description: Identifies the reason for the certification.  Type of
                  action from the official survey record, CMS 1539 form.
     SAS Name:    CRTFCTN_ACTN_TYPE_CD
     COBOL Name:  CRTFCTN-ACTN-TYPE-CD
     VALUES:      1=INITIAL
                  2=RECERTIFICATION
                  3=TERMINATION
                  4=CHANGE OF OWNERSHIP
                  5=VALIDATION
                  8=FULL SURVEY AFTER COMPLAINT

   Ownership Type Code                               2    249   250  VARCHAR2
     Description: Indicates the ownership type of the provider.
     SAS Name:    GNRL_CNTL_TYPE_CD
     COBOL Name:  GNRL-CNTL-TYPE-CD
     VALUES:      01=PRIVATE NON PROFIT
                  02=PRIVATE PROPRIETARY
                  03=STATE
                  04=CITY/TOWN
                  05=COUNTY
                  06=CITY/COUNTY
                  07=OTHER

   Address: ZIP Code                                 5    251   255  VARCHAR2
     Description: Five-digit ZIP code for a provider's physical address.
     SAS Name:    ZIP_CD
     COBOL Name:  ZIP-CD

   FIPS State Code                                   2    256   257  VARCHAR2
     Description: FIPS State Code
     SAS Name:    FIPS_STATE_CD
     COBOL Name:  FIPS-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  04=ARIZONA
                  05=ARKANSAS
                  06=CALIFORNIA
                  08=COLORADO
                  09=CONNECTICUT
                  10=DELAWARE
                  11=DISTRICT OF COLUMBIA
                  12=FLORIDA
                  13=GEORGIA
                  15=HAWAII
                  16=IDAHO
                  17=ILLINOIS
                  18=INDIANA
                  19=IOWA
                  20=KANSAS
                  21=KENTUCKY
                  22=LOUISIANA
                  23=MAINE
                  24=MARYLAND
                  25=MASSACHUSETTS
                  26=MICHIGAN
                  27=MINNESOTA
                  28=MISSISSIPPI
                  29=MISSOURI


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     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  30=MONTANA
                  31=NEBRASKA
                  32=NEVADA
                  33=NEW HAMPSHIRE
                  34=NEW JERSEY
                  35=NEW MEXICO
                  36=NEW YORK
                  37=NORTH CAROLINA
                  38=NORTH DAKOTA
                  39=OHIO
                  40=OKLAHOMA
                  41=OREGON
                  42=PENNSYLVANIA
                  43=PUERTO RICO
                  44=RHODE ISLAND
                  45=SOUTH CAROLINA
                  46=SOUTH DAKOTA
                  47=TENNESSEE
                  48=TEXAS
                  49=UTAH
                  50=VERMONT
                  51=VIRGINIA
                  53=WASHINGTON
                  54=WEST VIRGINIA
                  55=WISCONSIN
                  56=WYOMING
                  60=AMERICAN SAMOA
                  66=GUAM
                  69=SAIPAN/MARIANA IS.
                  78=VIRGIN ISLANDS

   FIPS County Code                                  3    258   260  VARCHAR2
     Description: FIPS County Code
     SAS Name:    FIPS_CNTY_CD
     COBOL Name:  FIPS-CNTY-CD

   CBSA Urban Rural Indicator                        1    261   261  VARCHAR2
     Description: CBSA (Core Based Statistical Area) indicates whether the
                  county is defined as Urban or Rural.
     SAS Name:    CBSA_URBN_RRL_IND
     COBOL Name:  CBSA-URBN-RRL-IND

   CBSA Code                                         5    262   266  VARCHAR2
     Description: CBSA (Core Based Statistical Area) geographic entities
                  defined by the U.S. Office of Management and Budget (OMB)
                  on June 6, 2003 for use by Federal statistical agencies
                  in collecting, tabulating, and publishing Federal
                  statistics.  CBSA collectively refers to MSA.
     SAS Name:    CBSA_CD
     COBOL Name:  CBSA-CD

   Bed Count Override Indicator                      1    325   325  CHAR
     Description: Indicates if the regional office has approved a
                  significant bed count change from the previous
                  certification.
     SAS Name:    OVRRD_BED_CNT_SW
     COBOL Name:  OVRRD-BED-CNT-SW

   Bed Count: Certified                              4    326   329  NUMBER
     Description: Number of beds in Medicare and/or Medicaid certified
                  areas within a facility.
     SAS Name:    CRTFD_BED_CNT
     COBOL Name:  CRTFD-BED-CNT


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 23
     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Bed Count: Certified - Total                      4    330   333  NUMBER
     Description: Number of certified beds in an Intermediate Care Facility
                  for Individuals with Intellectual Disabilities (ICF/IID).
     SAS Name:    ICFIID_BED_CNT
     COBOL Name:  ICFIID-BED-CNT

   Bed Count: Total                                  4    373   376  NUMBER
     Description: Total number of beds in a provider, including those in
                  non-participating or non-licensed areas.
     SAS Name:    BED_CNT
     COBOL Name:  BED-CNT

   Compliance: Beds Per Room Waiver Indicator        1    444   444  CHAR
     Description: Indicates if a waiver of the beds per room requirement
                  has been recommended for a facility.
     SAS Name:    BED_PER_ROOM_WVR_SW
     COBOL Name:  BED-PER-ROOM-WVR-SW

   Compliance: LSC Waiver Indicator                  1    445   445  CHAR
     Description: Indicates if a waiver of any life safety code provision
                  has been recommended for a provider.
     SAS Name:    LSC_WVR_SW
     COBOL Name:  LSC-WVR-SW

   Compliance: Patient Room Size Waiver Indicator    1    446   446  CHAR
     Description: Indicates if a waiver of the patient room size provision
                  has been recommended for a provider.
     SAS Name:    ROOM_SIZE_WVR_SW
     COBOL Name:  ROOM-SIZE-WVR-SW

   Fiscal Year End Date (MMDD)                       4    464   467  VARCHAR2
     Description: End date, consisting of the month and day, of the
                  provider's fiscal year.
     SAS Name:    FY_END_MO_DAY_CD
     COBOL Name:  FY-END-MO-DAY-CD

   Program Participation Code                        1    640   640  CHAR
     Description: Indicates if the provider participates in Medicare,
                  Medicaid, or both programs.
     SAS Name:    PGM_PRTCPTN_CD
     COBOL Name:  PGM-PRTCPTN-CD
     VALUES:      1=MEDICARE ONLY
                  2=MEDICAID ONLY
                  3=MEDICARE AND MEDICAID

   Provider Based Facility Indicator                 1    641   641  VARCHAR2
     Description: Indicates if an Intermediate Care Facility for
                  Individuals with Intellectual Disabilities (ICF/IID)
                  facility is provider-based, a distinct part of a
                  Hospital, Skilled Nursing Facility or Nursing Facility.
                  Related CCN is found in the Provider Auxiliary Facility
                  Table.
     SAS Name:    PRVDR_BSD_FAC_SW
     COBOL Name:  PRVDR-BSD-FAC-SW

   Related Provider Number                           10   686   695  CHAR
     Description: Related provider number
     SAS Name:    RELATED_PROVIDER_NUMBER
     COBOL Name:  RELATED-PROVIDER-NUMBER

   Staff Count: Direct Care                          8    1014  1021 NUMBER
     Description: Number of full-time equivalent direct care personnel


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 24
     Intermediate Care Facility/Individuals with Intellectual Disabilities,
                      CATEGORY = "11" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  employed by an Intermediate Care Facility for Individuals
                  with Intellectual Disabilities (ICF/IID).
     SAS Name:    DRCT_CARE_PRSNEL_CNT
     COBOL Name:  DRCT-CARE-PRSNEL-CNT

   Staff Count: LPN/LVN - Employee                   8    1110  1117 NUMBER
     Description: Number of full-time equivalent licensed practical or
                  vocational nurses employed by a provider.
     SAS Name:    LPN_LVN_CNT
     COBOL Name:  LPN-LVN-CNT

   Staff Count: RN                                   8    1750  1757 NUMBER
     Description: Number of full-time equivalent registered nurses employed
                  by a provider.
     SAS Name:    RN_CNT
     COBOL Name:  RN-CNT

   Staff Count: Total - Employee                     9    1934  1942 NUMBER
     Description: Total number of full-time equivalent employees of a
                  provider.
     SAS Name:    EMPLEE_CNT
     COBOL Name:  EMPLEE-CNT











































 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 1
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Provider Category Subtype Code                    2    1     2    VARCHAR2
     Description: Identifies the subtype of the provider, within the
                  primary category.  Used in reporting to show the
                  breakdown of provider categories, mainly for hospitals
                  and SNFs.
     SAS Name:    PRVDR_CTGRY_SBTYP_CD
     COBOL Name:  PRVDR-CTGRY-SBTYP-CD
     VALUES:      01=Rural Health Clinics

   Provider Category Code                            2    3     4    VARCHAR2
     Description: Identifies the type of provider participating in the
                  Medicare/Medicaid program.
     SAS Name:    PRVDR_CTGRY_CD
     COBOL Name:  PRVDR-CTGRY-CD
     VALUES:      12=Rural Health Clinic

   CHOW Count                                        2    5     6    NUMBER
     Description: Number of times this provider has undergone a change of
                  ownership.
     SAS Name:    CHOW_CNT
     COBOL Name:  CHOW-CNT

   CHOW Date                                         8    7     14   DATE
     Description: Effective date of the most recent change of ownership for
                  this provider.
     SAS Name:    CHOW_DT
     COBOL Name:  CHOW-DT

   Address: City                                     28   15    42   VARCHAR2
     Description: City in which the provider is physically located.
     SAS Name:    CITY_NAME
     COBOL Name:  CITY-NAME

   Compliance: Acceptable POC                        1    43    43   VARCHAR2
     Description: Indicates if a provider is in compliance with program
                  requirements based on an acceptable plan for correction
                  of deficiencies.
     SAS Name:    ACPTBL_POC_SW
     COBOL Name:  ACPTBL-POC-SW

   Compliance: Status                                1    44    44   VARCHAR2
     Description: Compliance status of a provider at the time of
                  certification survey.
     SAS Name:    CMPLNC_STUS_CD
     COBOL Name:  CMPLNC-STUS-CD
     VALUES:      A=IN COMPLIANCE
                  B=NOT IN COMPLIANCE

   SSA County Code                                   3    45    47   VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the county where the provider is located.
     SAS Name:    SSA_CNTY_CD
     COBOL Name:  SSA-CNTY-CD

   Cross Ref Provider Number                         10   48    57   CHAR
     Description: Cross reference provider number
     SAS Name:    CROSS_REF_PROVIDER_NUMBER
     COBOL Name:  CROSS-REF-PROVIDER-NUMBER

   Certification Date                                8    58    65   DATE
     Description: Equal to the exit date of the initial visit of the Health
                  survey for certifications completed after July 28, 2012.
                  For certifications prior to that date, the certification


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 2
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  date is equal to the exit date of the initial visit of
                  the Health survey or LSC survey, whichever is later.
     SAS Name:    CRTFCTN_DT
     COBOL Name:  CRTFCTN-DT

   Eligibility Indicator                             1    66    66   VARCHAR2
     Description: Indicates if a facility is eligible to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    ELGBLTY_SW
     COBOL Name:  ELGBLTY-SW

   Facility Name                                     50   67    116  VARCHAR2
     Description: Name of the provider certified to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    FAC_NAME
     COBOL Name:  FAC-NAME

   Medicare Administrative Contractor (MAC) or       5    117   121  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_CD
     COBOL Name:  INTRMDRY-CARR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 3
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 4
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 5
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 6
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)
                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 7
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   Medicaid Vendor Number                            15   122   136  VARCHAR2
     Description: Number which may be assigned to a provider by the state
                  Medicaid agency for external control or billing purposes.
     SAS Name:    MDCD_VNDR_NUM
     COBOL Name:  MDCD-VNDR-NUM

   Original Participation Date                       8    137   144  DATE
     Description: Date a provider is first approved to provide Medicare
                  and/or Medicaid services.
     SAS Name:    ORGNL_PRTCPTN_DT
     COBOL Name:  ORGNL-PRTCPTN-DT

   Prior CHOW Date                                   8    145   152  DATE
     Description: Effective date of the previous change of ownership for
                  this provider.
     SAS Name:    CHOW_PRIOR_DT
     COBOL Name:  CHOW-PRIOR-DT

   Prior Medicare Administrative Contractor (MAC) or 5    153   157  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the previous Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_PRIOR_CD
     COBOL Name:  INTRMDRY-CARR-PRIOR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 8
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 9
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 10
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 11
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 12
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   CCN                                               10   158   167  VARCHAR2
     Description: Six or ten position identification number that is
                  assigned to a certified provider.  This is the CMS
                  Certification Number.
     SAS Name:    PRVDR_NUM
     COBOL Name:  PRVDR-NUM

   Region Code                                       2    168   169  VARCHAR2
     Description: Indicates the CMS Regional Office responsible for the
                  certification of the provider.
     SAS Name:    RGN_CD
     COBOL Name:  RGN-CD
     VALUES:      01=Boston
                  02=New York
                  03=Philadelphia
                  04=Atlanta
                  05=Chicago
                  06=Dallas
                  07=Kansas City
                  08=Denver
                  09=San Francisco
                  10=Seattle

   Skeleton Record Indicator                         1    170   170  VARCHAR2
     Description: Indicates if the record is a skeleton record.  Only a
                  limited set of data is available for this provider; no
                  survey data exists.  Only provider categories
                  01,17,19,21and 22 can have skeleton providers.
     SAS Name:    SKLTN_REC_SW
     COBOL Name:  SKLTN-REC-SW

   State Abbreviation                                2    171   172  VARCHAR2
     Description: Two-character state abbreviation.
     SAS Name:    STATE_CD
     COBOL Name:  STATE-CD
     VALUES:      AK=ALASKA
                  AL=ALABAMA
                  AR=ARKANSAS
                  AS=AMERICAN SAMOA
                  AZ=ARIZONA
                  CA=CALIFORNIA
                  CN=CANADA
                  CO=COLORADO
                  CT=CONNECTICUT
                  DC=DISTRICT OF COLUMBIA
                  DE=DELAWARE
                  FL=FLORIDA
                  FN=INTERNATIONAL
                  GA=GEORGIA
                  GU=GUAM
                  HI=HAWAII
                  IA=IOWA
                  ID=IDAHO


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 13
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  IL=ILLINOIS
                  IN=INDIANA
                  KS=KANSAS
                  KY=KENTUCKY
                  LA=LOUISIANA
                  MA=MASSACHUSETTS
                  MD=MARYLAND
                  ME=MAINE
                  MI=MICHIGAN
                  MN=MINNESOTA
                  MO=MISSOURI
                  MP=SAIPAN
                  MS=MISSISSIPPI
                  MT=MONTANA
                  MX=MEXICO
                  NC=NORTH CAROLINA
                  ND=NORTH DAKOTA
                  NE=NEBRASKA
                  NH=NEW HAMPSHIRE
                  NJ=NEW JERSEY
                  NM=NEW MEXICO
                  NV=NEVADA
                  NY=NEW YORK
                  OH=OHIO
                  OK=OKLAHOMA
                  OR=OREGON
                  PA=PENNSYLVANIA
                  PR=PUERTO RICO
                  RI=RHODE ISLAND
                  SC=SOUTH CAROLINA
                  SD=SOUTH DAKOTA
                  TN=TENNESSEE
                  TX=TEXAS
                  UT=UTAH
                  VA=VIRGINIA
                  VI=VIRGIN ISLANDS
                  VT=VERMONT
                  WA=WASHINGTON
                  WI=WISCONSIN
                  WV=WEST VIRGINIA
                  WY=WYOMING

   SSA State Code                                    2    173   174  VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the state where the provider is located.
     SAS Name:    SSA_STATE_CD
     COBOL Name:  SSA-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  03=ARIZONA
                  04=ARKANSAS
                  05=CALIFORNIA
                  06=COLORADO
                  07=CONNECTICUT
                  08=DELAWARE
                  09=DISTRICT OF COLUMBIA
                  10=FLORIDA
                  11=GEORGIA
                  12=HAWAII
                  13=IDAHO
                  14=ILLINOIS
                  15=INDIANA
                  16=IOWA
                  17=KANSAS


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 14
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  18=KENTUCKY
                  19=LOUISIANA
                  20=MAINE
                  21=MARYLAND
                  22=MASSACHUSETTS
                  23=MICHIGAN
                  24=MINNESOTA
                  25=MISSISSIPPI
                  26=MISSOURI
                  27=MONTANA
                  28=NEBRASKA
                  29=NEVADA
                  30=NEW HAMPSHIRE
                  31=NEW JERSEY
                  32=NEW MEXICO
                  33=NEW YORK
                  34=NORTH CAROLINA
                  35=NORTH DAKOTA
                  36=OHIO
                  37=OKLAHOMA
                  38=OREGON
                  39=PENNSYLVANIA
                  40=PUERTO RICO
                  41=RHODE ISLAND
                  42=SOUTH CAROLINA
                  43=SOUTH DAKOTA
                  44=TENNESSEE
                  45=TEXAS
                  46=UTAH
                  47=VERMONT
                  48=VIRGIN ISLANDS
                  49=VIRGINIA
                  50=WASHINGTON
                  51=WEST VIRGINIA
                  52=WISCONSIN
                  53=WYOMING
                  54=AFRICA
                  56=CANADA
                  57=WEST INDIES
                  58=EUROPE
                  59=MEXICO
                  60=OCEANIA
                  61=PHILIPPINES
                  62=SOUTH AMERICA
                  63=UNITED STATES POSSESSIONS
                  64=AMERICAN SAMOA
                  65=GUAM
                  66=SAIPAN
                  99=INTERNATIONAL

   State Region Code                                 3    175   177  VARCHAR2
     Description: Identifies the region within a state where the provider
                  is located.
     SAS Name:    STATE_RGN_CD
     COBOL Name:  STATE-RGN-CD
     VALUES:      AK/001=ALASKA
                  AK/LAB=LABORATORIES
                  AK/NPH=NON-PARTICIPATING HOSPITAL
                  AL/001=ALABAMA
                  AL/LAB=LABORATORIES
                  AL/NPH=NON-PARTICIPATING HOSPITAL
                  AR/001=ARKANSAS
                  AR/LAB=LABORATORIES
                  AR/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 15
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  AS/001=AMERICAN SAMOA
                  AS/LAB=LABORATORY
                  AS/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/AZ=PHOENIX
                  AZ/LAB=ARIZONA LAB
                  AZ/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/TUC=TUCSON
                  CA/001=CALIFORNIA
                  CA/BAK=BAKERSFIELD
                  CA/BER=SAN BERNARDINO
                  CA/EB=East Bay
                  CA/FR=FRESNO
                  CA/L1=L.A. WEST
                  CA/L2=L.A. NORTH
                  CA/L3=L.A. CENTRAL
                  CA/L4=L.A. EAST
                  CA/L5=SAN GABRIEL
                  CA/LA1=LA Region 1
                  CA/LA2=LA Region 2
                  CA/LA3=LA Region 3
                  CA/LA4=LA Acute/Ancillary
                  CA/LA5=LA HHA/Hospice
                  CA/LA6=LA ICF/DD/CLinics
                  CA/LAB=LABORATORIES
                  CA/M1=LAB. SOUTH
                  CA/M2=LAB. NORTH
                  CA/NPH=NON-PARTICIPATING HOSPITAL
                  CA/ORG=ORANGE
                  CA/RIV=RIVERSIDE
                  CA/S1=SACRAMENTO
                  CA/S3=CHICO
                  CA/SD=SAN DIEGO
                  CA/SF=SAN FRANCISCO
                  CA/SJ=SAN JOSE
                  CA/SR=SANTA ROSA
                  CA/VEN=VENTURA
                  CN/001=CANADA
                  CN/LAB=LABORATORY
                  CN/NPH=NON-PARTICIPATING HOSPITAL
                  CO/001=COLORADO
                  CO/LAB=LABORATORIES
                  CO/NPH=NON-PARTICIPATING HOSPITAL
                  CT/001=CONNECTICUT
                  CT/LAB=LABORATORIES
                  CT/NPH=NON-PARTICIPATING HOSPITAL
                  DC/001=DISTRICT OF COLUMBIA
                  DC/LAB=LABORATORIES
                  DC/NPH=NON-PARTICIPATING HOSPITAL
                  DE/001=DELAWARE
                  DE/LAB=LABORATORIES
                  DE/NPH=NON-PARTICIPATING HOSPITAL
                  FL/001=FLORIDA
                  FL/FTM=FT. MYERS
                  FL/GAI=GAINESVILLE
                  FL/JAX=JACKSONVILLE
                  FL/LAB=LABORATORIES
                  FL/LAN=LANTANA
                  FL/LAU=LAUDERHILL
                  FL/MIA=MIAMI
                  FL/NPH=NON-PARTICIPATING HOSPITAL
                  FL/ORL=ORLANDO
                  FL/PEN=PENSACOLA
                  FL/STP=ST. PETERSBURG
                  FL/TAL=TALLAHASSEE


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 16
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  FL/TAM=TAMPA
                  FM/001=FEDERATED STATES OF MICRO
                  FM/NPH=NON-PARTICIPATING HOSPITAL
                  FN/001=INTERNATIONAL
                  FN/LAB=LABORATORIES
                  FN/NPH=NON-PARTICIPATING HOSPITAL
                  GA/001=GEORGIA
                  GA/GAA=GEORGIA ALL
                  GA/GAC=GEORGIA CENTRAL
                  GA/GAE=GEORGIA EASTERN
                  GA/GAN=GEORGIA NORTH
                  GA/GAS=GEORGIA SOUTH
                  GA/GAW=GEORGIA WESTERN
                  GA/LAB=LABORATORIES
                  GA/NPH=NON-PARTICIPATING HOSPITAL
                  GU/001=GUAM
                  GU/LAB=LABORATORIES
                  GU/NPH=NON-PARTICIPATING HOSPITAL
                  HI/001=HAWAII
                  HI/LAB=LABORATORIES
                  HI/NPH=NON-PARTICIPATING HOSPITAL
                  IA/001=IOWA
                  IA/LAB=LABORATORIES
                  IA/NPH=NON-PARTICIPATING HOSPITAL
                  ID/001=IDAHO
                  ID/LAB=LABORATORIES
                  ID/NPH=NON-PARTICIPATING HOSPITAL
                  IL/001=ILLINOIS
                  IL/LAB=LABORATORIES
                  IL/NPH=NON-PARTICIPATING HOSPITAL
                  IN/001=INDIANA
                  IN/LAB=LABORATORIES
                  IN/NPH=NON-PARTICIPATING HOSPITAL
                  KS/001=KANSAS
                  KS/KCK=KANSAS CITY
                  KS/KDH=KDHE
                  KS/LAB=LABORATORIES
                  KS/LAW=LAWRENCE
                  KS/NC=NORTH CENTRAL KANSAS
                  KS/NE=NORTH EAST KANSAS
                  KS/NPH=NON-PARTICIPATING HOSPITAL
                  KS/NW=NORTH WEST KANSAS
                  KS/SC=SOUTH CENTRAL KANSAS
                  KS/SE=SOUTH EAST KANSAS
                  KS/SW=SOUTH WEST KANSAS
                  KS/WST=WEST
                  KY/2C1=HOPKINSVILLE
                  KY/2C2=LOUISVILLE
                  KY/2C3=LONDON
                  KY/2C4=LEXINGTON
                  KY/LAB=LABORATORIES
                  KY/NPH=NON-PARTICIPATING HOSPITAL
                  LA/001=LOUISIANA
                  LA/LA1=NEW ORLEANS
                  LA/LA2=MANDEVILLE
                  LA/LA3=LAFAYETTE
                  LA/LA4=MONROE
                  LA/LA5=SHREVEPORT
                  LA/LA6=ALEXANDRIA
                  LA/LAB=LABORATORIES
                  LA/LB1=CLIA NEW ORLEANS
                  LA/LB5=CLIA SHREVEPORT
                  LA/LB6=CLIA ALEXANDRIA
                  LA/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 17
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  MA/001=MASSACHUSETTS
                  MA/LAB=LABORATORIES
                  MA/NPH=NON-PARTICIPATING HOSPITAL
                  MD/001=MARYLAND
                  MD/LAB=LABORATORIES
                  MD/NPH=NON-PARTICIPATING HOSPITAL
                  ME/001=MAINE
                  ME/LAB=LABORATORIES
                  ME/NPH=NON-PARTICIPATING HOSPITAL
                  MH/001=MARSHALL ISLANDS
                  MH/NPH=NON-PARTICIPATING HOSPITAL
                  MI/001=MICHIGAN
                  MI/LAB=LABORATORIES
                  MI/NPH=NON-PARTICIPATING HOSPITAL
                  MN/001=MINNESOTA
                  MN/LAB=LABORATORIES
                  MN/NPH=NON-PARTICIPATING HOSPITAL
                  MO/001=MISSOURI
                  MO/01=REGION01
                  MO/02=REGION02
                  MO/03=REGION 03
                  MO/04=REGION 04
                  MO/05=REGION 05
                  MO/06=REGION 06
                  MO/07=REGION 07
                  MO/1NH=REGION 1 NH
                  MO/2NH=REGION 2 NH
                  MO/3NH=REGION 3 NH
                  MO/4NH=REGION 4 NH
                  MO/5NH=REGION 5 NH
                  MO/6NH=REGION 6 NH
                  MO/7NH=REGION 7 NH
                  MO/LAB=LABORATORIES
                  MO/MO=STATEWIDE
                  MO/NPH=NON-PARTICIPATING HOSPITAL
                  MP/001=NORTHERN MARIANA ISLANDS
                  MP/LAB=LABORATORIES
                  MP/NPH=NON-PARTICIPATING HOSPITAL
                  MS/001=MISSISSIPPI
                  MS/LAB=LABORATORIES
                  MS/NPH=NON-PARTICIPATING HOSPITAL
                  MT/001=MONTANA
                  MT/LAB=LABORATORIES
                  MT/NPH=NON-PARTICIPATING HOSPITAL
                  MX/001=MEXICO
                  MX/LAB=LABORATORY
                  MX/NPH=NON-PARTICIPATING HOSPITAL
                  NC/001=NORTH CAROLINA
                  NC/LAB=LABORATORIES
                  NC/NCC=NORTH CAROLINA CENTRAL
                  NC/NCE=NORTH CAROLINA EAST
                  NC/NCN=NORTH CAROLINA NORTH
                  NC/NCS=NORTH CAROLINA SOUTH
                  NC/NCW=NORTH CAROLINA WEST
                  NC/NPH=NON-PARTICIPATING HOSPITAL
                  ND/001=NORTH DAKOTA
                  ND/LAB=LABORATORIES
                  ND/NPH=NON-PARTICIPATING HOSPITAL
                  NE/001=NEBRASKA
                  NE/1=NORTH CENTRAL
                  NE/2=CENTRAL
                  NE/3=NORTHEAST
                  NE/4=SOUTHEAST
                  NE/5=WESTERN


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 18
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  NE/LAB=LABORATORIES
                  NE/NPH=NON-PARTICIPATING HOSPITAL
                  NH/001=NEW HAMPSHIRE
                  NH/LAB=LABORATORIES
                  NH/NPH=NON-PARTICIPATING HOSPITAL
                  NJ/001=NEW JERSEY
                  NJ/LAB=LABORATORIES
                  NJ/NPH=NON-PARTICIPATING HOSPITAL
                  NM/001=NEW MEXICO
                  NM/LAB=LABORATORIES
                  NM/NPH=NON-PARTICIPATING HOSPITAL
                  NV/001=NEVADA
                  NV/CC=CARSON CITY
                  NV/LAB=LABORATORIES
                  NV/LV=LAS VEGAS
                  NV/NPH=NON-PARTICIPATING HOSPITAL
                  NY/001=BUFFALO
                  NY/002=ROCHESTER
                  NY/003=SYRACUSE
                  NY/004=ALBANY
                  NY/005=NEW ROCHELLE
                  NY/006=NEW YORK CITY
                  NY/007=SUFFOLK/NASSAU COUNTY
                  NY/LAB=LABORATORIES
                  NY/NPH=NON-PARTICIPATING HOSPITAL
                  OH/001=OHIO
                  OH/LAB=LABORATORIES
                  OH/NPH=NON-PARTICIPATING HOSPITAL
                  OK/001=OKLAHOMA
                  OK/LAB=LABORATORIES
                  OK/NPH=NON-PARTICIPATING HOSPITAL
                  OR/001=OFFICE #1
                  OR/002=OFFICE #2
                  OR/003=OFFICE #3
                  OR/LAB=LABORATORIES
                  OR/NPH=NON-PARTICIPATING HOSPITAL
                  PA/001=PENNSYLVANIA
                  PA/LAB=LABORATORIES
                  PA/NPH=NON-PARTICIPATING HOSPITAL
                  PR/001=PUERTO RICO
                  PR/LAB=LABORATORIES
                  PR/NPH=NON-PARTICIPATING HOSPITAL
                  PW/001=PALAU
                  PW/NPH=NON-PARTICIPATING HOSPITAL
                  RI/001=RHODE ISLAND
                  RI/LAB=LABORATORIES
                  RI/NPH=NON-PARTICIPATING HOSPITAL
                  SC/001=SOUTH CAROLINA
                  SC/LAB=LABORATORIES
                  SC/NPH=NON-PARTICIPATING HOSPITAL
                  SD/001=SOUTH DAKOTA
                  SD/LAB=LABORATORIES
                  SD/NPH=NON-PARTICIPATING HOSPITAL
                  TN/001=TENNESSEE
                  TN/LAB=LABORATORIES
                  TN/NPH=NON-PARTICIPATING HOSPITAL
                  TN/TNC=TENNESSEE COOKEVILLE
                  TN/TNE=TENNESSEE EASTERN
                  TN/TNM=TENNESSEE MIDDLE
                  TN/TNW=TENNESSEE WESTERN
                  TX/001=TEXAS
                  TX/L01=AMARILLO-LTC
                  TX/L02=ABILENE-LTC
                  TX/L03=ARLINGTON-LTC


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 19
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  TX/L04=TYLER-LTC
                  TX/L05=TEMPLE-LTC
                  TX/L06=HOUSTON-LTC
                  TX/L07=SAN ANTONIO-LTC
                  TX/LAB=LABORATORIES
                  TX/NPH=NON-PARTICIPATING HOSPITAL
                  TX/TX1=NLTC REG 1, 7, 9, 10
                  TX/TX2=NLTC REG 2, 3
                  TX/TX4=NLTC REG 6
                  TX/TX5=NLTC REG 4, 5
                  TX/TX6=AUSTIN
                  TX/TX8=NLTC REG 8, 11
                  UT/001=UTAH
                  UT/LAB=LABORATORIES
                  UT/NPH=NON-PARTICIPATING HOSPITAL
                  VA/001=VIRGINIA
                  VA/LAB=LABORATORIES
                  VA/NPH=NON-PARTICIPATING HOSPITAL
                  VI/001=VIRGIN ISLANDS
                  VI/LAB=LABORATORIES
                  VI/NPH=NON-PARTICIPATING HOSPITAL
                  VT/001=VERMONT
                  VT/LAB=LABORATORIES
                  VT/NPH=NON-PARTICIPATING HOSPITAL
                  WA/001=ALL OTHERS (NON-LTC FAC)
                  WA/D1=SPOKANE & YAKIMA AREAS
                  WA/D1A=District 1, Unit A
                  WA/D1B=District 1, Unit B
                  WA/D1C=District 1, Unit C
                  WA/D1D=District 1, Unit D
                  WA/D1E=District 1, Unit E
                  WA/D2=SPOKANE & SE
                  WA/D2A=District 2, Unit A
                  WA/D2B=District 2, Unit B
                  WA/D2C=District 2, Unit C
                  WA/D2D=District 2, Unit D
                  WA/D2E=District 2, Unit E
                  WA/D2F=District 2, Unit F
                  WA/D2G=District 2, Unit G
                  WA/D2H=District 2, Unit H
                  WA/D2I=District 2, Unit I
                  WA/D2J=District 2, Unit J
                  WA/D3=NW WASHINGTON
                  WA/D3A=District 3, Unit A
                  WA/D3B=District 3, Unit B
                  WA/D3C=District 3, Unit C
                  WA/D3D=District 3, Unit D
                  WA/D3E=District 3, Unit E
                  WA/D3F=District 3, Unit F
                  WA/D3G=District 3, Unit G
                  WA/D4A=GREATER SEATTLE AREA
                  WA/D4B=S KING COUNTY
                  WA/D5A=PIERCE CTY & PENINSULA
                  WA/D5B=PIERCE CTY & GRAYS HARBOR
                  WA/D6=OLYMPIA AREA
                  WA/LAB=LABORATORIES
                  WA/NPH=NON-PARTICIPATING HOSPITAL
                  WI/001=WISCONSIN
                  WI/LAB=LABORATORIES
                  WI/NPH=NON-PARTICIPATING HOSPITAL
                  WV/001=WEST VIRGINIA
                  WV/LAB=LABORATORIES
                  WV/NPH=NON-PARTICIPATING HOSPITAL
                  WY/001=WYOMING


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 20
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  WY/LAB=LABORATORIES
                  WY/NPH=NON-PARTICIPATING HOSPITAL

   Address: Street                                   50   178   227  VARCHAR2
     Description: Street address where the provider is located.
     SAS Name:    ST_ADR
     COBOL Name:  ST-ADR

   Telephone Number                                  10   228   237  VARCHAR2
     Description: Telephone number of the provider.
     SAS Name:    PHNE_NUM
     COBOL Name:  PHNE-NUM

   Termination Code                                  2    238   239  VARCHAR2
     Description: Indicates the current termination status for the
                  provider.
     SAS Name:    PGM_TRMNTN_CD
     COBOL Name:  PGM-TRMNTN-CD
     VALUES:      00=ACTIVE PROVIDER
                  01=VOLUNTARY-MERGER, CLOSURE
                  02=VOLUNTARY-DISSATISFACTION WITH REIMBURSEMENT
                  03=VOLUNTARY-RISK OF INVOLUNTARY TERMINATION
                  04=VOLUNTARY-OTHER REASON FOR WITHDRAWAL
                  05=INVOLUNTARY-FAILURE TO MEET HEALTH/SAFETY REQ
                  06=INVOLUNTARY-FAILURE TO MEET AGREEMENT
                  07=OTHER-PROVIDER STATUS CHANGE
                  08=NONPAYMENT OF FEES - CLIA Only
                  09=REV/UNSUCCESSFUL PARTICIPATION IN PT - CLIA Only
                  10=REV/OTHER REASON - CLIA Only
                  11=INCOMPLETE CLIA APPLICATION INFORMATION - CLIA Only
                  12=NO LONGER PERFORMING TESTS - CLIA Only
                  13=MULTIPLE TO SINGLE SITE CERTIFICATE - CLIA Only
                  14=SHARED LABORATORY - CLIA Only
                  15=FAILURE TO RENEW WAIVER PPM CERTIFICATE - CLIA Only
                  16=DUPLICATE CLIA NUMBER - CLIA Only
                  17=MAIL RETURNED NO FORWARD ADDRESS CERT ENDED - CLIA Only
                  20=NOTIFICATION BANKRUPTCY - CLIA Only
                  33=ACCREDITATION NOT CONFIRMED - CLIA Only
                  80=AWAITING STATE APPROVAL
                  99=OIG ACTION - DO NOT ACTIVATE - CLIA Only

   Termination or Expiration Date                    8    240   247  DATE
     Description: Date the provider was terminated.  For CLIA providers,
                  date the laboratory's certificate was terminated or the
                  expiration date of the current CLIA certificate.
     SAS Name:    TRMNTN_EXPRTN_DT
     COBOL Name:  TRMNTN-EXPRTN-DT

   Type of Action Code                               1    248   248  VARCHAR2
     Description: Identifies the reason for the certification.  Type of
                  action from the official survey record, CMS 1539 form.
     SAS Name:    CRTFCTN_ACTN_TYPE_CD
     COBOL Name:  CRTFCTN-ACTN-TYPE-CD
     VALUES:      1=INITIAL
                  2=RECERTIFICATION
                  3=TERMINATION
                  4=CHANGE OF OWNERSHIP
                  5=VALIDATION
                  8=FULL SURVEY AFTER COMPLAINT

   Ownership Type Code                               2    249   250  VARCHAR2
     Description: Indicates the ownership type of the provider.
     SAS Name:    GNRL_CNTL_TYPE_CD
     COBOL Name:  GNRL-CNTL-TYPE-CD


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 21
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     VALUES:      03=STATE GOVERNMENT
                  04=LOCAL GOVERNMENT
                  05=FEDERAL GOVERNMENT
                  1A=FOR PROFIT INDIVIDUAL
                  1B=FOR PROFIT CORPORATION
                  1C=FOR PROFIT PARTNERSHIP
                  2A=NON PROFIT INDIVIDUAL
                  2B=NON PROFIT CORPORATION
                  2C=NON PROFIT PARTNERSHIP

   Address: ZIP Code                                 5    251   255  VARCHAR2
     Description: Five-digit ZIP code for a provider's physical address.
     SAS Name:    ZIP_CD
     COBOL Name:  ZIP-CD

   FIPS State Code                                   2    256   257  VARCHAR2
     Description: FIPS State Code
     SAS Name:    FIPS_STATE_CD
     COBOL Name:  FIPS-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  04=ARIZONA
                  05=ARKANSAS
                  06=CALIFORNIA
                  08=COLORADO
                  09=CONNECTICUT
                  10=DELAWARE
                  11=DISTRICT OF COLUMBIA
                  12=FLORIDA
                  13=GEORGIA
                  15=HAWAII
                  16=IDAHO
                  17=ILLINOIS
                  18=INDIANA
                  19=IOWA
                  20=KANSAS
                  21=KENTUCKY
                  22=LOUISIANA
                  23=MAINE
                  24=MARYLAND
                  25=MASSACHUSETTS
                  26=MICHIGAN
                  27=MINNESOTA
                  28=MISSISSIPPI
                  29=MISSOURI
                  30=MONTANA
                  31=NEBRASKA
                  32=NEVADA
                  33=NEW HAMPSHIRE
                  34=NEW JERSEY
                  35=NEW MEXICO
                  36=NEW YORK
                  37=NORTH CAROLINA
                  38=NORTH DAKOTA
                  39=OHIO
                  40=OKLAHOMA
                  41=OREGON
                  42=PENNSYLVANIA
                  43=PUERTO RICO
                  44=RHODE ISLAND
                  45=SOUTH CAROLINA
                  46=SOUTH DAKOTA
                  47=TENNESSEE
                  48=TEXAS


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 22
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  49=UTAH
                  50=VERMONT
                  51=VIRGINIA
                  53=WASHINGTON
                  54=WEST VIRGINIA
                  55=WISCONSIN
                  56=WYOMING
                  60=AMERICAN SAMOA
                  66=GUAM
                  69=SAIPAN/MARIANA IS.
                  78=VIRGIN ISLANDS

   FIPS County Code                                  3    258   260  VARCHAR2
     Description: FIPS County Code
     SAS Name:    FIPS_CNTY_CD
     COBOL Name:  FIPS-CNTY-CD

   CBSA Urban Rural Indicator                        1    261   261  VARCHAR2
     Description: CBSA (Core Based Statistical Area) indicates whether the
                  county is defined as Urban or Rural.
     SAS Name:    CBSA_URBN_RRL_IND
     COBOL Name:  CBSA-URBN-RRL-IND

   CBSA Code                                         5    262   266  VARCHAR2
     Description: CBSA (Core Based Statistical Area) geographic entities
                  defined by the U.S. Office of Management and Budget (OMB)
                  on June 6, 2003 for use by Federal statistical agencies
                  in collecting, tabulating, and publishing Federal
                  statistics.  CBSA collectively refers to MSA.
     SAS Name:    CBSA_CD
     COBOL Name:  CBSA-CD

  *Accreditation Type Code                           1    283   283  VARCHAR2
     Description: Indicates an accrediting organization deeming the
                  provider.  If a provider is deemed by multiple
                  accrediting organizations then the accrediting
                  organization with the earliest active deeming effective
                  date is displayed in this field.
     SAS Name:    ACRDTN_TYPE_CD
     COBOL Name:  ACRDTN-TYPE-CD
     VALUES:      0=UNACCREDITED
                  1=AAAASF
                  2=TCT

   Fiscal Year End Date (MMDD)                       4    464   467  VARCHAR2
     Description: End date, consisting of the month and day, of the
                  provider's fiscal year.
     SAS Name:    FY_END_MO_DAY_CD
     COBOL Name:  FY-END-MO-DAY-CD

   Hospital Based Indicator                          1    483   483  CHAR
     Description: Indicates if the provider is based in a hospital.
     SAS Name:    HOSP_BSD_SW
     COBOL Name:  HOSP-BSD-SW

   Parent Provider Number                            10   628   637  CHAR
     Description: Parent provider number
     SAS Name:    PARENT_PROVIDER_NUMBER
     COBOL Name:  PARENT-PROVIDER-NUMBER

   Related Provider Number                           10   686   695  CHAR
     Description: Related provider number
     SAS Name:    RELATED_PROVIDER_NUMBER
     COBOL Name:  RELATED-PROVIDER-NUMBER


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 23
            Rural Health Clinic, CATEGORY = "12" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Staff Count: Other Personnel                      8    902   909  NUMBER
     Description: Number of full-time equivalent other personnel employed
                  by a provider
     SAS Name:    PRSNEL_OTHR_CNT
     COBOL Name:  PRSNEL-OTHR-CNT

   Staff Count: Nurse Practitioner                   8    1278  1285 NUMBER
     Description: Number of full-time equivalent nurse practitioners
                  employed by a provider.
     SAS Name:    NRS_PRCTNR_CNT
     COBOL Name:  NRS-PRCTNR-CNT

   Staff Count: Physician - Employee                 8    1542  1549 NUMBER
     Description: Number of full-time equivalent physicians employed by a
                  provider.
     SAS Name:    PHYSN_CNT
     COBOL Name:  PHYSN-CNT

   Staff Count: Physician Assistant                  8    1558  1565 NUMBER
     Description: Number of full-time equivalent physician assistants
                  employed by a provider.
     SAS Name:    PHYSN_ASTNT_CNT
     COBOL Name:  PHYSN-ASTNT-CNT










































 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 1
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Provider Category Subtype Code                    2    1     2    VARCHAR2
     Description: Identifies the subtype of the provider, within the
                  primary category.  Used in reporting to show the
                  breakdown of provider categories, mainly for hospitals
                  and SNFs.
     SAS Name:    PRVDR_CTGRY_SBTYP_CD
     COBOL Name:  PRVDR-CTGRY-SBTYP-CD
     VALUES:      01=Comprehensive Outpatient

   Provider Category Code                            2    3     4    VARCHAR2
     Description: Identifies the type of provider participating in the
                  Medicare/Medicaid program.
     SAS Name:    PRVDR_CTGRY_CD
     COBOL Name:  PRVDR-CTGRY-CD
     VALUES:      14=Comprehensive Outpatient Rehab Facility

   CHOW Count                                        2    5     6    NUMBER
     Description: Number of times this provider has undergone a change of
                  ownership.
     SAS Name:    CHOW_CNT
     COBOL Name:  CHOW-CNT

   CHOW Date                                         8    7     14   DATE
     Description: Effective date of the most recent change of ownership for
                  this provider.
     SAS Name:    CHOW_DT
     COBOL Name:  CHOW-DT

   Address: City                                     28   15    42   VARCHAR2
     Description: City in which the provider is physically located.
     SAS Name:    CITY_NAME
     COBOL Name:  CITY-NAME

   Compliance: Acceptable POC                        1    43    43   VARCHAR2
     Description: Indicates if a provider is in compliance with program
                  requirements based on an acceptable plan for correction
                  of deficiencies.
     SAS Name:    ACPTBL_POC_SW
     COBOL Name:  ACPTBL-POC-SW

   Compliance: Status                                1    44    44   VARCHAR2
     Description: Compliance status of a provider at the time of
                  certification survey.
     SAS Name:    CMPLNC_STUS_CD
     COBOL Name:  CMPLNC-STUS-CD
     VALUES:      A=IN COMPLIANCE
                  B=NOT IN COMPLIANCE

   SSA County Code                                   3    45    47   VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the county where the provider is located.
     SAS Name:    SSA_CNTY_CD
     COBOL Name:  SSA-CNTY-CD

   Cross Ref Provider Number                         10   48    57   CHAR
     Description: Cross reference provider number
     SAS Name:    CROSS_REF_PROVIDER_NUMBER
     COBOL Name:  CROSS-REF-PROVIDER-NUMBER

   Certification Date                                8    58    65   DATE
     Description: Equal to the exit date of the initial visit of the Health
                  survey for certifications completed after July 28, 2012.
                  For certifications prior to that date, the certification


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 2
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  date is equal to the exit date of the initial visit of
                  the Health survey or LSC survey, whichever is later.
     SAS Name:    CRTFCTN_DT
     COBOL Name:  CRTFCTN-DT

   Eligibility Indicator                             1    66    66   VARCHAR2
     Description: Indicates if a facility is eligible to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    ELGBLTY_SW
     COBOL Name:  ELGBLTY-SW

   Facility Name                                     50   67    116  VARCHAR2
     Description: Name of the provider certified to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    FAC_NAME
     COBOL Name:  FAC-NAME

   Medicare Administrative Contractor (MAC) or       5    117   121  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_CD
     COBOL Name:  INTRMDRY-CARR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 3
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 4
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 5
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 6
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)
                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 7
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   Medicaid Vendor Number                            15   122   136  VARCHAR2
     Description: Number which may be assigned to a provider by the state
                  Medicaid agency for external control or billing purposes.
     SAS Name:    MDCD_VNDR_NUM
     COBOL Name:  MDCD-VNDR-NUM

   Original Participation Date                       8    137   144  DATE
     Description: Date a provider is first approved to provide Medicare
                  and/or Medicaid services.
     SAS Name:    ORGNL_PRTCPTN_DT
     COBOL Name:  ORGNL-PRTCPTN-DT

   Prior CHOW Date                                   8    145   152  DATE
     Description: Effective date of the previous change of ownership for
                  this provider.
     SAS Name:    CHOW_PRIOR_DT
     COBOL Name:  CHOW-PRIOR-DT

   Prior Medicare Administrative Contractor (MAC) or 5    153   157  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the previous Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_PRIOR_CD
     COBOL Name:  INTRMDRY-CARR-PRIOR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 8
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 9
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 10
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 11
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 12
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   CCN                                               10   158   167  VARCHAR2
     Description: Six or ten position identification number that is
                  assigned to a certified provider.  This is the CMS
                  Certification Number.
     SAS Name:    PRVDR_NUM
     COBOL Name:  PRVDR-NUM

   Region Code                                       2    168   169  VARCHAR2
     Description: Indicates the CMS Regional Office responsible for the
                  certification of the provider.
     SAS Name:    RGN_CD
     COBOL Name:  RGN-CD
     VALUES:      01=Boston
                  02=New York
                  03=Philadelphia
                  04=Atlanta
                  05=Chicago
                  06=Dallas
                  07=Kansas City
                  08=Denver
                  09=San Francisco
                  10=Seattle

   Skeleton Record Indicator                         1    170   170  VARCHAR2
     Description: Indicates if the record is a skeleton record.  Only a
                  limited set of data is available for this provider; no
                  survey data exists.  Only provider categories
                  01,17,19,21and 22 can have skeleton providers.
     SAS Name:    SKLTN_REC_SW
     COBOL Name:  SKLTN-REC-SW

   State Abbreviation                                2    171   172  VARCHAR2
     Description: Two-character state abbreviation.
     SAS Name:    STATE_CD
     COBOL Name:  STATE-CD
     VALUES:      AK=ALASKA
                  AL=ALABAMA
                  AR=ARKANSAS
                  AS=AMERICAN SAMOA
                  AZ=ARIZONA
                  CA=CALIFORNIA
                  CN=CANADA
                  CO=COLORADO
                  CT=CONNECTICUT
                  DC=DISTRICT OF COLUMBIA
                  DE=DELAWARE
                  FL=FLORIDA
                  FN=INTERNATIONAL
                  GA=GEORGIA
                  GU=GUAM
                  HI=HAWAII
                  IA=IOWA
                  ID=IDAHO


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 13
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  IL=ILLINOIS
                  IN=INDIANA
                  KS=KANSAS
                  KY=KENTUCKY
                  LA=LOUISIANA
                  MA=MASSACHUSETTS
                  MD=MARYLAND
                  ME=MAINE
                  MI=MICHIGAN
                  MN=MINNESOTA
                  MO=MISSOURI
                  MP=SAIPAN
                  MS=MISSISSIPPI
                  MT=MONTANA
                  MX=MEXICO
                  NC=NORTH CAROLINA
                  ND=NORTH DAKOTA
                  NE=NEBRASKA
                  NH=NEW HAMPSHIRE
                  NJ=NEW JERSEY
                  NM=NEW MEXICO
                  NV=NEVADA
                  NY=NEW YORK
                  OH=OHIO
                  OK=OKLAHOMA
                  OR=OREGON
                  PA=PENNSYLVANIA
                  PR=PUERTO RICO
                  RI=RHODE ISLAND
                  SC=SOUTH CAROLINA
                  SD=SOUTH DAKOTA
                  TN=TENNESSEE
                  TX=TEXAS
                  UT=UTAH
                  VA=VIRGINIA
                  VI=VIRGIN ISLANDS
                  VT=VERMONT
                  WA=WASHINGTON
                  WI=WISCONSIN
                  WV=WEST VIRGINIA
                  WY=WYOMING

   SSA State Code                                    2    173   174  VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the state where the provider is located.
     SAS Name:    SSA_STATE_CD
     COBOL Name:  SSA-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  03=ARIZONA
                  04=ARKANSAS
                  05=CALIFORNIA
                  06=COLORADO
                  07=CONNECTICUT
                  08=DELAWARE
                  09=DISTRICT OF COLUMBIA
                  10=FLORIDA
                  11=GEORGIA
                  12=HAWAII
                  13=IDAHO
                  14=ILLINOIS
                  15=INDIANA
                  16=IOWA
                  17=KANSAS


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 14
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  18=KENTUCKY
                  19=LOUISIANA
                  20=MAINE
                  21=MARYLAND
                  22=MASSACHUSETTS
                  23=MICHIGAN
                  24=MINNESOTA
                  25=MISSISSIPPI
                  26=MISSOURI
                  27=MONTANA
                  28=NEBRASKA
                  29=NEVADA
                  30=NEW HAMPSHIRE
                  31=NEW JERSEY
                  32=NEW MEXICO
                  33=NEW YORK
                  34=NORTH CAROLINA
                  35=NORTH DAKOTA
                  36=OHIO
                  37=OKLAHOMA
                  38=OREGON
                  39=PENNSYLVANIA
                  40=PUERTO RICO
                  41=RHODE ISLAND
                  42=SOUTH CAROLINA
                  43=SOUTH DAKOTA
                  44=TENNESSEE
                  45=TEXAS
                  46=UTAH
                  47=VERMONT
                  48=VIRGIN ISLANDS
                  49=VIRGINIA
                  50=WASHINGTON
                  51=WEST VIRGINIA
                  52=WISCONSIN
                  53=WYOMING
                  54=AFRICA
                  56=CANADA
                  57=WEST INDIES
                  58=EUROPE
                  59=MEXICO
                  60=OCEANIA
                  61=PHILIPPINES
                  62=SOUTH AMERICA
                  63=UNITED STATES POSSESSIONS
                  64=AMERICAN SAMOA
                  65=GUAM
                  66=SAIPAN
                  99=INTERNATIONAL

   State Region Code                                 3    175   177  VARCHAR2
     Description: Identifies the region within a state where the provider
                  is located.
     SAS Name:    STATE_RGN_CD
     COBOL Name:  STATE-RGN-CD
     VALUES:      AK/001=ALASKA
                  AK/LAB=LABORATORIES
                  AK/NPH=NON-PARTICIPATING HOSPITAL
                  AL/001=ALABAMA
                  AL/LAB=LABORATORIES
                  AL/NPH=NON-PARTICIPATING HOSPITAL
                  AR/001=ARKANSAS
                  AR/LAB=LABORATORIES
                  AR/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 15
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  AS/001=AMERICAN SAMOA
                  AS/LAB=LABORATORY
                  AS/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/AZ=PHOENIX
                  AZ/LAB=ARIZONA LAB
                  AZ/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/TUC=TUCSON
                  CA/001=CALIFORNIA
                  CA/BAK=BAKERSFIELD
                  CA/BER=SAN BERNARDINO
                  CA/EB=East Bay
                  CA/FR=FRESNO
                  CA/L1=L.A. WEST
                  CA/L2=L.A. NORTH
                  CA/L3=L.A. CENTRAL
                  CA/L4=L.A. EAST
                  CA/L5=SAN GABRIEL
                  CA/LA1=LA Region 1
                  CA/LA2=LA Region 2
                  CA/LA3=LA Region 3
                  CA/LA4=LA Acute/Ancillary
                  CA/LA5=LA HHA/Hospice
                  CA/LA6=LA ICF/DD/CLinics
                  CA/LAB=LABORATORIES
                  CA/M1=LAB. SOUTH
                  CA/M2=LAB. NORTH
                  CA/NPH=NON-PARTICIPATING HOSPITAL
                  CA/ORG=ORANGE
                  CA/RIV=RIVERSIDE
                  CA/S1=SACRAMENTO
                  CA/S3=CHICO
                  CA/SD=SAN DIEGO
                  CA/SF=SAN FRANCISCO
                  CA/SJ=SAN JOSE
                  CA/SR=SANTA ROSA
                  CA/VEN=VENTURA
                  CN/001=CANADA
                  CN/LAB=LABORATORY
                  CN/NPH=NON-PARTICIPATING HOSPITAL
                  CO/001=COLORADO
                  CO/LAB=LABORATORIES
                  CO/NPH=NON-PARTICIPATING HOSPITAL
                  CT/001=CONNECTICUT
                  CT/LAB=LABORATORIES
                  CT/NPH=NON-PARTICIPATING HOSPITAL
                  DC/001=DISTRICT OF COLUMBIA
                  DC/LAB=LABORATORIES
                  DC/NPH=NON-PARTICIPATING HOSPITAL
                  DE/001=DELAWARE
                  DE/LAB=LABORATORIES
                  DE/NPH=NON-PARTICIPATING HOSPITAL
                  FL/001=FLORIDA
                  FL/FTM=FT. MYERS
                  FL/GAI=GAINESVILLE
                  FL/JAX=JACKSONVILLE
                  FL/LAB=LABORATORIES
                  FL/LAN=LANTANA
                  FL/LAU=LAUDERHILL
                  FL/MIA=MIAMI
                  FL/NPH=NON-PARTICIPATING HOSPITAL
                  FL/ORL=ORLANDO
                  FL/PEN=PENSACOLA
                  FL/STP=ST. PETERSBURG
                  FL/TAL=TALLAHASSEE


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 16
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  FL/TAM=TAMPA
                  FM/001=FEDERATED STATES OF MICRO
                  FM/NPH=NON-PARTICIPATING HOSPITAL
                  FN/001=INTERNATIONAL
                  FN/LAB=LABORATORIES
                  FN/NPH=NON-PARTICIPATING HOSPITAL
                  GA/001=GEORGIA
                  GA/GAA=GEORGIA ALL
                  GA/GAC=GEORGIA CENTRAL
                  GA/GAE=GEORGIA EASTERN
                  GA/GAN=GEORGIA NORTH
                  GA/GAS=GEORGIA SOUTH
                  GA/GAW=GEORGIA WESTERN
                  GA/LAB=LABORATORIES
                  GA/NPH=NON-PARTICIPATING HOSPITAL
                  GU/001=GUAM
                  GU/LAB=LABORATORIES
                  GU/NPH=NON-PARTICIPATING HOSPITAL
                  HI/001=HAWAII
                  HI/LAB=LABORATORIES
                  HI/NPH=NON-PARTICIPATING HOSPITAL
                  IA/001=IOWA
                  IA/LAB=LABORATORIES
                  IA/NPH=NON-PARTICIPATING HOSPITAL
                  ID/001=IDAHO
                  ID/LAB=LABORATORIES
                  ID/NPH=NON-PARTICIPATING HOSPITAL
                  IL/001=ILLINOIS
                  IL/LAB=LABORATORIES
                  IL/NPH=NON-PARTICIPATING HOSPITAL
                  IN/001=INDIANA
                  IN/LAB=LABORATORIES
                  IN/NPH=NON-PARTICIPATING HOSPITAL
                  KS/001=KANSAS
                  KS/KCK=KANSAS CITY
                  KS/KDH=KDHE
                  KS/LAB=LABORATORIES
                  KS/LAW=LAWRENCE
                  KS/NC=NORTH CENTRAL KANSAS
                  KS/NE=NORTH EAST KANSAS
                  KS/NPH=NON-PARTICIPATING HOSPITAL
                  KS/NW=NORTH WEST KANSAS
                  KS/SC=SOUTH CENTRAL KANSAS
                  KS/SE=SOUTH EAST KANSAS
                  KS/SW=SOUTH WEST KANSAS
                  KS/WST=WEST
                  KY/2C1=HOPKINSVILLE
                  KY/2C2=LOUISVILLE
                  KY/2C3=LONDON
                  KY/2C4=LEXINGTON
                  KY/LAB=LABORATORIES
                  KY/NPH=NON-PARTICIPATING HOSPITAL
                  LA/001=LOUISIANA
                  LA/LA1=NEW ORLEANS
                  LA/LA2=MANDEVILLE
                  LA/LA3=LAFAYETTE
                  LA/LA4=MONROE
                  LA/LA5=SHREVEPORT
                  LA/LA6=ALEXANDRIA
                  LA/LAB=LABORATORIES
                  LA/LB1=CLIA NEW ORLEANS
                  LA/LB5=CLIA SHREVEPORT
                  LA/LB6=CLIA ALEXANDRIA
                  LA/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 17
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  MA/001=MASSACHUSETTS
                  MA/LAB=LABORATORIES
                  MA/NPH=NON-PARTICIPATING HOSPITAL
                  MD/001=MARYLAND
                  MD/LAB=LABORATORIES
                  MD/NPH=NON-PARTICIPATING HOSPITAL
                  ME/001=MAINE
                  ME/LAB=LABORATORIES
                  ME/NPH=NON-PARTICIPATING HOSPITAL
                  MH/001=MARSHALL ISLANDS
                  MH/NPH=NON-PARTICIPATING HOSPITAL
                  MI/001=MICHIGAN
                  MI/LAB=LABORATORIES
                  MI/NPH=NON-PARTICIPATING HOSPITAL
                  MN/001=MINNESOTA
                  MN/LAB=LABORATORIES
                  MN/NPH=NON-PARTICIPATING HOSPITAL
                  MO/001=MISSOURI
                  MO/01=REGION01
                  MO/02=REGION02
                  MO/03=REGION 03
                  MO/04=REGION 04
                  MO/05=REGION 05
                  MO/06=REGION 06
                  MO/07=REGION 07
                  MO/1NH=REGION 1 NH
                  MO/2NH=REGION 2 NH
                  MO/3NH=REGION 3 NH
                  MO/4NH=REGION 4 NH
                  MO/5NH=REGION 5 NH
                  MO/6NH=REGION 6 NH
                  MO/7NH=REGION 7 NH
                  MO/LAB=LABORATORIES
                  MO/MO=STATEWIDE
                  MO/NPH=NON-PARTICIPATING HOSPITAL
                  MP/001=NORTHERN MARIANA ISLANDS
                  MP/LAB=LABORATORIES
                  MP/NPH=NON-PARTICIPATING HOSPITAL
                  MS/001=MISSISSIPPI
                  MS/LAB=LABORATORIES
                  MS/NPH=NON-PARTICIPATING HOSPITAL
                  MT/001=MONTANA
                  MT/LAB=LABORATORIES
                  MT/NPH=NON-PARTICIPATING HOSPITAL
                  MX/001=MEXICO
                  MX/LAB=LABORATORY
                  MX/NPH=NON-PARTICIPATING HOSPITAL
                  NC/001=NORTH CAROLINA
                  NC/LAB=LABORATORIES
                  NC/NCC=NORTH CAROLINA CENTRAL
                  NC/NCE=NORTH CAROLINA EAST
                  NC/NCN=NORTH CAROLINA NORTH
                  NC/NCS=NORTH CAROLINA SOUTH
                  NC/NCW=NORTH CAROLINA WEST
                  NC/NPH=NON-PARTICIPATING HOSPITAL
                  ND/001=NORTH DAKOTA
                  ND/LAB=LABORATORIES
                  ND/NPH=NON-PARTICIPATING HOSPITAL
                  NE/001=NEBRASKA
                  NE/1=NORTH CENTRAL
                  NE/2=CENTRAL
                  NE/3=NORTHEAST
                  NE/4=SOUTHEAST
                  NE/5=WESTERN


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 18
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  NE/LAB=LABORATORIES
                  NE/NPH=NON-PARTICIPATING HOSPITAL
                  NH/001=NEW HAMPSHIRE
                  NH/LAB=LABORATORIES
                  NH/NPH=NON-PARTICIPATING HOSPITAL
                  NJ/001=NEW JERSEY
                  NJ/LAB=LABORATORIES
                  NJ/NPH=NON-PARTICIPATING HOSPITAL
                  NM/001=NEW MEXICO
                  NM/LAB=LABORATORIES
                  NM/NPH=NON-PARTICIPATING HOSPITAL
                  NV/001=NEVADA
                  NV/CC=CARSON CITY
                  NV/LAB=LABORATORIES
                  NV/LV=LAS VEGAS
                  NV/NPH=NON-PARTICIPATING HOSPITAL
                  NY/001=BUFFALO
                  NY/002=ROCHESTER
                  NY/003=SYRACUSE
                  NY/004=ALBANY
                  NY/005=NEW ROCHELLE
                  NY/006=NEW YORK CITY
                  NY/007=SUFFOLK/NASSAU COUNTY
                  NY/LAB=LABORATORIES
                  NY/NPH=NON-PARTICIPATING HOSPITAL
                  OH/001=OHIO
                  OH/LAB=LABORATORIES
                  OH/NPH=NON-PARTICIPATING HOSPITAL
                  OK/001=OKLAHOMA
                  OK/LAB=LABORATORIES
                  OK/NPH=NON-PARTICIPATING HOSPITAL
                  OR/001=OFFICE #1
                  OR/002=OFFICE #2
                  OR/003=OFFICE #3
                  OR/LAB=LABORATORIES
                  OR/NPH=NON-PARTICIPATING HOSPITAL
                  PA/001=PENNSYLVANIA
                  PA/LAB=LABORATORIES
                  PA/NPH=NON-PARTICIPATING HOSPITAL
                  PR/001=PUERTO RICO
                  PR/LAB=LABORATORIES
                  PR/NPH=NON-PARTICIPATING HOSPITAL
                  PW/001=PALAU
                  PW/NPH=NON-PARTICIPATING HOSPITAL
                  RI/001=RHODE ISLAND
                  RI/LAB=LABORATORIES
                  RI/NPH=NON-PARTICIPATING HOSPITAL
                  SC/001=SOUTH CAROLINA
                  SC/LAB=LABORATORIES
                  SC/NPH=NON-PARTICIPATING HOSPITAL
                  SD/001=SOUTH DAKOTA
                  SD/LAB=LABORATORIES
                  SD/NPH=NON-PARTICIPATING HOSPITAL
                  TN/001=TENNESSEE
                  TN/LAB=LABORATORIES
                  TN/NPH=NON-PARTICIPATING HOSPITAL
                  TN/TNC=TENNESSEE COOKEVILLE
                  TN/TNE=TENNESSEE EASTERN
                  TN/TNM=TENNESSEE MIDDLE
                  TN/TNW=TENNESSEE WESTERN
                  TX/001=TEXAS
                  TX/L01=AMARILLO-LTC
                  TX/L02=ABILENE-LTC
                  TX/L03=ARLINGTON-LTC


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 19
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  TX/L04=TYLER-LTC
                  TX/L05=TEMPLE-LTC
                  TX/L06=HOUSTON-LTC
                  TX/L07=SAN ANTONIO-LTC
                  TX/LAB=LABORATORIES
                  TX/NPH=NON-PARTICIPATING HOSPITAL
                  TX/TX1=NLTC REG 1, 7, 9, 10
                  TX/TX2=NLTC REG 2, 3
                  TX/TX4=NLTC REG 6
                  TX/TX5=NLTC REG 4, 5
                  TX/TX6=AUSTIN
                  TX/TX8=NLTC REG 8, 11
                  UT/001=UTAH
                  UT/LAB=LABORATORIES
                  UT/NPH=NON-PARTICIPATING HOSPITAL
                  VA/001=VIRGINIA
                  VA/LAB=LABORATORIES
                  VA/NPH=NON-PARTICIPATING HOSPITAL
                  VI/001=VIRGIN ISLANDS
                  VI/LAB=LABORATORIES
                  VI/NPH=NON-PARTICIPATING HOSPITAL
                  VT/001=VERMONT
                  VT/LAB=LABORATORIES
                  VT/NPH=NON-PARTICIPATING HOSPITAL
                  WA/001=ALL OTHERS (NON-LTC FAC)
                  WA/D1=SPOKANE & YAKIMA AREAS
                  WA/D1A=District 1, Unit A
                  WA/D1B=District 1, Unit B
                  WA/D1C=District 1, Unit C
                  WA/D1D=District 1, Unit D
                  WA/D1E=District 1, Unit E
                  WA/D2=SPOKANE & SE
                  WA/D2A=District 2, Unit A
                  WA/D2B=District 2, Unit B
                  WA/D2C=District 2, Unit C
                  WA/D2D=District 2, Unit D
                  WA/D2E=District 2, Unit E
                  WA/D2F=District 2, Unit F
                  WA/D2G=District 2, Unit G
                  WA/D2H=District 2, Unit H
                  WA/D2I=District 2, Unit I
                  WA/D2J=District 2, Unit J
                  WA/D3=NW WASHINGTON
                  WA/D3A=District 3, Unit A
                  WA/D3B=District 3, Unit B
                  WA/D3C=District 3, Unit C
                  WA/D3D=District 3, Unit D
                  WA/D3E=District 3, Unit E
                  WA/D3F=District 3, Unit F
                  WA/D3G=District 3, Unit G
                  WA/D4A=GREATER SEATTLE AREA
                  WA/D4B=S KING COUNTY
                  WA/D5A=PIERCE CTY & PENINSULA
                  WA/D5B=PIERCE CTY & GRAYS HARBOR
                  WA/D6=OLYMPIA AREA
                  WA/LAB=LABORATORIES
                  WA/NPH=NON-PARTICIPATING HOSPITAL
                  WI/001=WISCONSIN
                  WI/LAB=LABORATORIES
                  WI/NPH=NON-PARTICIPATING HOSPITAL
                  WV/001=WEST VIRGINIA
                  WV/LAB=LABORATORIES
                  WV/NPH=NON-PARTICIPATING HOSPITAL
                  WY/001=WYOMING


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 20
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  WY/LAB=LABORATORIES
                  WY/NPH=NON-PARTICIPATING HOSPITAL

   Address: Street                                   50   178   227  VARCHAR2
     Description: Street address where the provider is located.
     SAS Name:    ST_ADR
     COBOL Name:  ST-ADR

   Telephone Number                                  10   228   237  VARCHAR2
     Description: Telephone number of the provider.
     SAS Name:    PHNE_NUM
     COBOL Name:  PHNE-NUM

   Termination Code                                  2    238   239  VARCHAR2
     Description: Indicates the current termination status for the
                  provider.
     SAS Name:    PGM_TRMNTN_CD
     COBOL Name:  PGM-TRMNTN-CD
     VALUES:      00=ACTIVE PROVIDER
                  01=VOLUNTARY-MERGER, CLOSURE
                  02=VOLUNTARY-DISSATISFACTION WITH REIMBURSEMENT
                  03=VOLUNTARY-RISK OF INVOLUNTARY TERMINATION
                  04=VOLUNTARY-OTHER REASON FOR WITHDRAWAL
                  05=INVOLUNTARY-FAILURE TO MEET HEALTH/SAFETY REQ
                  06=INVOLUNTARY-FAILURE TO MEET AGREEMENT
                  07=OTHER-PROVIDER STATUS CHANGE
                  08=NONPAYMENT OF FEES - CLIA Only
                  09=REV/UNSUCCESSFUL PARTICIPATION IN PT - CLIA Only
                  10=REV/OTHER REASON - CLIA Only
                  11=INCOMPLETE CLIA APPLICATION INFORMATION - CLIA Only
                  12=NO LONGER PERFORMING TESTS - CLIA Only
                  13=MULTIPLE TO SINGLE SITE CERTIFICATE - CLIA Only
                  14=SHARED LABORATORY - CLIA Only
                  15=FAILURE TO RENEW WAIVER PPM CERTIFICATE - CLIA Only
                  16=DUPLICATE CLIA NUMBER - CLIA Only
                  17=MAIL RETURNED NO FORWARD ADDRESS CERT ENDED - CLIA Only
                  20=NOTIFICATION BANKRUPTCY - CLIA Only
                  33=ACCREDITATION NOT CONFIRMED - CLIA Only
                  80=AWAITING STATE APPROVAL
                  99=OIG ACTION - DO NOT ACTIVATE - CLIA Only

   Termination or Expiration Date                    8    240   247  DATE
     Description: Date the provider was terminated.  For CLIA providers,
                  date the laboratory's certificate was terminated or the
                  expiration date of the current CLIA certificate.
     SAS Name:    TRMNTN_EXPRTN_DT
     COBOL Name:  TRMNTN-EXPRTN-DT

   Type of Action Code                               1    248   248  VARCHAR2
     Description: Identifies the reason for the certification.  Type of
                  action from the official survey record, CMS 1539 form.
     SAS Name:    CRTFCTN_ACTN_TYPE_CD
     COBOL Name:  CRTFCTN-ACTN-TYPE-CD
     VALUES:      1=INITIAL
                  2=RECERTIFICATION
                  3=TERMINATION
                  4=CHANGE OF OWNERSHIP
                  5=VALIDATION
                  8=FULL SURVEY AFTER COMPLAINT

   Ownership Type Code                               2    249   250  VARCHAR2
     Description: Indicates the ownership type of the provider.
     SAS Name:    GNRL_CNTL_TYPE_CD
     COBOL Name:  GNRL-CNTL-TYPE-CD


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 21
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     VALUES:      01=PROPRIETARY
                  02=NON PROFIT CHURCH
                  03=NON PROFIT OTHER
                  04=GOVERNMENT

   Address: ZIP Code                                 5    251   255  VARCHAR2
     Description: Five-digit ZIP code for a provider's physical address.
     SAS Name:    ZIP_CD
     COBOL Name:  ZIP-CD

   FIPS State Code                                   2    256   257  VARCHAR2
     Description: FIPS State Code
     SAS Name:    FIPS_STATE_CD
     COBOL Name:  FIPS-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  04=ARIZONA
                  05=ARKANSAS
                  06=CALIFORNIA
                  08=COLORADO
                  09=CONNECTICUT
                  10=DELAWARE
                  11=DISTRICT OF COLUMBIA
                  12=FLORIDA
                  13=GEORGIA
                  15=HAWAII
                  16=IDAHO
                  17=ILLINOIS
                  18=INDIANA
                  19=IOWA
                  20=KANSAS
                  21=KENTUCKY
                  22=LOUISIANA
                  23=MAINE
                  24=MARYLAND
                  25=MASSACHUSETTS
                  26=MICHIGAN
                  27=MINNESOTA
                  28=MISSISSIPPI
                  29=MISSOURI
                  30=MONTANA
                  31=NEBRASKA
                  32=NEVADA
                  33=NEW HAMPSHIRE
                  34=NEW JERSEY
                  35=NEW MEXICO
                  36=NEW YORK
                  37=NORTH CAROLINA
                  38=NORTH DAKOTA
                  39=OHIO
                  40=OKLAHOMA
                  41=OREGON
                  42=PENNSYLVANIA
                  43=PUERTO RICO
                  44=RHODE ISLAND
                  45=SOUTH CAROLINA
                  46=SOUTH DAKOTA
                  47=TENNESSEE
                  48=TEXAS
                  49=UTAH
                  50=VERMONT
                  51=VIRGINIA
                  53=WASHINGTON
                  54=WEST VIRGINIA


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 22
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  55=WISCONSIN
                  56=WYOMING
                  60=AMERICAN SAMOA
                  66=GUAM
                  69=SAIPAN/MARIANA IS.
                  78=VIRGIN ISLANDS

   FIPS County Code                                  3    258   260  VARCHAR2
     Description: FIPS County Code
     SAS Name:    FIPS_CNTY_CD
     COBOL Name:  FIPS-CNTY-CD

   CBSA Urban Rural Indicator                        1    261   261  VARCHAR2
     Description: CBSA (Core Based Statistical Area) indicates whether the
                  county is defined as Urban or Rural.
     SAS Name:    CBSA_URBN_RRL_IND
     COBOL Name:  CBSA-URBN-RRL-IND

   CBSA Code                                         5    262   266  VARCHAR2
     Description: CBSA (Core Based Statistical Area) geographic entities
                  defined by the U.S. Office of Management and Budget (OMB)
                  on June 6, 2003 for use by Federal statistical agencies
                  in collecting, tabulating, and publishing Federal
                  statistics.  CBSA collectively refers to MSA.
     SAS Name:    CBSA_CD
     COBOL Name:  CBSA-CD

  *Accreditation Type Code                           1    283   283  VARCHAR2
     Description: Indicates an accrediting organization deeming the
                  provider.  If a provider is deemed by multiple
                  accrediting organizations then the accrediting
                  organization with the earliest active deeming effective
                  date is displayed in this field.
     SAS Name:    ACRDTN_TYPE_CD
     COBOL Name:  ACRDTN-TYPE-CD
     VALUES:      0=UNACCREDITED
                  1=CARF
                  2=ACCREDISOURCE

   Fiscal Year End Date (MMDD)                       4    464   467  VARCHAR2
     Description: End date, consisting of the month and day, of the
                  provider's fiscal year.
     SAS Name:    FY_END_MO_DAY_CD
     COBOL Name:  FY-END-MO-DAY-CD

   Parent Provider Number                            10   628   637  CHAR
     Description: Parent provider number
     SAS Name:    PARENT_PROVIDER_NUMBER
     COBOL Name:  PARENT-PROVIDER-NUMBER

   Participation Medicare OPT/SP Indicator           1    639   639  VARCHAR2
     Description: Indicates if this comprehensive outpatient rehabilitation
                  facility also participates in Medicare as a provider of
                  outpatient physical therapy and/or speech pathology.
     SAS Name:    MDCR_PRTCPTN_OP_PT_SPCH_SW
     COBOL Name:  MDCR-PRTCPTN-OP-PT-SPCH-SW

   Related Provider Number                           10   686   695  CHAR
     Description: Related provider number
     SAS Name:    RELATED_PROVIDER_NUMBER
     COBOL Name:  RELATED-PROVIDER-NUMBER

   Services: Nursing - Employee Indicator            1    756   756  VARCHAR2
     Description: Indicates if nursing services are provided by employees.


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  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     SAS Name:    NRSNG_SRVC_EMPLEE_SW
     COBOL Name:  NRSNG-SRVC-EMPLEE-SW

   Services: Nursing - Independent Contractor Indicator 1    757   757  VARCHAR2
     Description: Indicates if nursing services are provided by independent
                  contractors.
     SAS Name:    NRSNG_SRVC_CNTRCTR_SW
     COBOL Name:  NRSNG-SRVC-CNTRCTR-SW

   Services: Nursing - Under Arrangement Indicator   1    758   758  VARCHAR2
     Description: Indicates if nursing services are provided under
                  arrangement.
     SAS Name:    NRSNG_SRVC_ARNGMT_SW
     COBOL Name:  NRSNG-SRVC-ARNGMT-SW

   Services: Orthotic / Prosthetic - Employee Indicator 1    769   769  VARCHAR2
     Description: Indicates if orthotic prosthetic services are provided by
                  employees.
     SAS Name:    ORTHTC_PRSTHTC_EMPLEE_SW
     COBOL Name:  ORTHTC-PRSTHTC-EMPLEE-SW

   Services: Orthotic / Prosthetic - Independent     1    770   770  VARCHAR2
   Contractor Indicator
     Description: Indicates if orthotic prosthetic services are provided by
                  independent contractors.
     SAS Name:    ORTHTC_PRSTHTC_CNTRCTR_SW
     COBOL Name:  ORTHTC-PRSTHTC-CNTRCTR-SW

   Services: Orthotic / Prosthetic - Under Arrangement 1    771   771  VARCHAR2
   Indicator
     Description: Indicates if orthotic/prosthetic services are provided
                  under arrangement.
     SAS Name:    ORTHTC_PRSTHTC_ARNGMT_SW
     COBOL Name:  ORTHTC-PRSTHTC-ARNGMT-SW

   Services: OT - Employee Indicator                 1    772   772  VARCHAR2
     Description: Indicates if occupational therapy services are provided
                  by employees.
     SAS Name:    OT_EMPLEE_SW
     COBOL Name:  OT-EMPLEE-SW

   Services: OT - Independent Contractor Indicator   1    773   773  VARCHAR2
     Description: Indicates if occupational therapy services are provided
                  by independent contractors.
     SAS Name:    OT_CNTRCTR_SW
     COBOL Name:  OT-CNTRCTR-SW

   Services: OT - Under Arrangement Indicator        1    774   774  VARCHAR2
     Description: Indicates if occupational therapy services are provided
                  under arrangement.
     SAS Name:    OT_ARNGMT_SW
     COBOL Name:  OT-ARNGMT-SW

   Services: Physician - Employee Indicator          1    792   792  VARCHAR2
     Description: Indicates if physician services are provided by
                  employees.
     SAS Name:    PHYSN_EMPLEE_SW
     COBOL Name:  PHYSN-EMPLEE-SW

   Services: Physician - Independent Contractor      1    793   793  VARCHAR2
   Indicator
     Description: Indicates if physician services are provided by
                  independent contractors.
     SAS Name:    PHYSN_CNTRCTR_SW


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 24
  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     COBOL Name:  PHYSN-CNTRCTR-SW

   Services: Physician - Under Arrangement Indicator 1    794   794  VARCHAR2
     Description: Indicates if physician services are provided under
                  arrangement.
     SAS Name:    PHYSN_ARNGMT_SW
     COBOL Name:  PHYSN-ARNGMT-SW

   Services: Psychological - Employee Indicator      1    807   807  VARCHAR2
     Description: Indicates if psychological services are provided by
                  employees.
     SAS Name:    PSYCHLGCL_EMPLEE_SW
     COBOL Name:  PSYCHLGCL-EMPLEE-SW

   Services: Psychological - Independent Contractor  1    808   808  VARCHAR2
   Indicator
     Description: Indicates if psychological services are provided by
                  independent contractors.
     SAS Name:    PSYCHLGCL_CNTRCTR_SW
     COBOL Name:  PSYCHLGCL-CNTRCTR-SW

   Services: Psychological - Under Arrangement Indicator 1    809   809  VARCHAR2
     Description: Indicates if psychological services are provided under
                  arrangement.
     SAS Name:    PSYCHLGCL_ARNGMT_SW
     COBOL Name:  PSYCHLGCL-ARNGMT-SW

   Services: PT - Employee Indicator                 1    810   810  VARCHAR2
     Description: Indicates if physical therapy services are provided by
                  employees.
     SAS Name:    PT_EMPLEE_SW
     COBOL Name:  PT-EMPLEE-SW

   Services: PT - Independent Contractor Indicator   1    811   811  VARCHAR2
     Description: Indicates if physical therapy services are provided by
                  independent contractors.
     SAS Name:    PT_CNTRCTR_SW
     COBOL Name:  PT-CNTRCTR-SW

   Services: PT - Under Arrangement Indicator        1    812   812  VARCHAR2
     Description: Indicates if physical therapy services are provided under
                  arrangement.
     SAS Name:    PT_ARNGMT_SW
     COBOL Name:  PT-ARNGMT-SW

   Services: Respiratory Care - Employee Indicator   1    818   818  VARCHAR2
     Description: Indicates if respiratory care services are provided by
                  employees.
     SAS Name:    RSPRTRY_CARE_EMPLEE_SW
     COBOL Name:  RSPRTRY-CARE-EMPLEE-SW

   Services: Respiratory Care - Independent Contractor 1    819   819  VARCHAR2
   Indicator
     Description: Indicates if respiratory care services are provided by
                  independent contractors.
     SAS Name:    RSPRTRY_CARE_CNTRCTR_SW
     COBOL Name:  RSPRTRY-CARE-CNTRCTR-SW

   Services: Respiratory Care - Under Arrangement    1    820   820  VARCHAR2
   Indicator
     Description: Indicates if respiratory care services are provided under
                  arrangement.
     SAS Name:    RSPRTRY_CARE_ARNGMT_SW
     COBOL Name:  RSPRTRY-CARE-ARNGMT-SW


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  Comprehensive Outpatient Rehab Facility, CATEGORY = "14" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Services: Social - Employee Indicator             1    823   823  VARCHAR2
     Description: Indicates if social services are provided by employees.
     SAS Name:    SCL_EMPLEE_SW
     COBOL Name:  SCL-EMPLEE-SW

   Services: Social - Independent Contractor Indicator 1    824   824  VARCHAR2
     Description: Indicates if social services are provided by independent
                  contractors.
     SAS Name:    SCL_CNTRCTR_SW
     COBOL Name:  SCL-CNTRCTR-SW

   Services: Social - Under Arrangement Indicator    1    825   825  VARCHAR2
     Description: Indicates if social services are provided under
                  arrangement.
     SAS Name:    SCL_ARNGMT_SW
     COBOL Name:  SCL-ARNGMT-SW

   Services: Speech Pathology - Employee Indicator   1    830   830  VARCHAR2
     Description: Indicates if speech pathology services are provided by
                  employees.
     SAS Name:    SPCH_PTHLGY_EMPLEE_SW
     COBOL Name:  SPCH-PTHLGY-EMPLEE-SW

   Services: Speech Pathology - Independent Contractor 1    831   831  VARCHAR2
   Indicator
     Description: Indicates if speech pathology services are provided by
                  independent contractors.
     SAS Name:    SPCH_PTHLGY_CNTRCTR_SW
     COBOL Name:  SPCH-PTHLGY-CNTRCTR-SW

   Services: Speech Pathology - Under Arrangement    1    832   832  VARCHAR2
   Indicator
     Description: Indicates if speech pathology services are provided under
                  arrangement.
     SAS Name:    SPCH_PTHLGY_ARNGMT_SW
     COBOL Name:  SPCH-PTHLGY-ARNGMT-SW





























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        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Provider Category Subtype Code                    2    1     2    VARCHAR2
     Description: Identifies the subtype of the provider, within the
                  primary category.  Used in reporting to show the
                  breakdown of provider categories, mainly for hospitals
                  and SNFs.
     SAS Name:    PRVDR_CTGRY_SBTYP_CD
     COBOL Name:  PRVDR-CTGRY-SBTYP-CD
     VALUES:      01=Ambulatory Surgical Center

   Provider Category Code                            2    3     4    VARCHAR2
     Description: Identifies the type of provider participating in the
                  Medicare/Medicaid program.
     SAS Name:    PRVDR_CTGRY_CD
     COBOL Name:  PRVDR-CTGRY-CD
     VALUES:      15=Ambulatory Surgical Center

   CHOW Count                                        2    5     6    NUMBER
     Description: Number of times this provider has undergone a change of
                  ownership.
     SAS Name:    CHOW_CNT
     COBOL Name:  CHOW-CNT

   CHOW Date                                         8    7     14   DATE
     Description: Effective date of the most recent change of ownership for
                  this provider.
     SAS Name:    CHOW_DT
     COBOL Name:  CHOW-DT

   Address: City                                     28   15    42   VARCHAR2
     Description: City in which the provider is physically located.
     SAS Name:    CITY_NAME
     COBOL Name:  CITY-NAME

   Compliance: Acceptable POC                        1    43    43   VARCHAR2
     Description: Indicates if a provider is in compliance with program
                  requirements based on an acceptable plan for correction
                  of deficiencies.
     SAS Name:    ACPTBL_POC_SW
     COBOL Name:  ACPTBL-POC-SW

   Compliance: Status                                1    44    44   VARCHAR2
     Description: Compliance status of a provider at the time of
                  certification survey.
     SAS Name:    CMPLNC_STUS_CD
     COBOL Name:  CMPLNC-STUS-CD
     VALUES:      A=IN COMPLIANCE
                  B=NOT IN COMPLIANCE

   SSA County Code                                   3    45    47   VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the county where the provider is located.
     SAS Name:    SSA_CNTY_CD
     COBOL Name:  SSA-CNTY-CD

   Cross Ref Provider Number                         10   48    57   CHAR
     Description: Cross reference provider number
     SAS Name:    CROSS_REF_PROVIDER_NUMBER
     COBOL Name:  CROSS-REF-PROVIDER-NUMBER

   Certification Date                                8    58    65   DATE
     Description: Equal to the exit date of the initial visit of the Health
                  survey for certifications completed after July 28, 2012.
                  For certifications prior to that date, the certification


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 2
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  date is equal to the exit date of the initial visit of
                  the Health survey or LSC survey, whichever is later.
     SAS Name:    CRTFCTN_DT
     COBOL Name:  CRTFCTN-DT

   Eligibility Indicator                             1    66    66   VARCHAR2
     Description: Indicates if a facility is eligible to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    ELGBLTY_SW
     COBOL Name:  ELGBLTY-SW

   Facility Name                                     50   67    116  VARCHAR2
     Description: Name of the provider certified to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    FAC_NAME
     COBOL Name:  FAC-NAME

   Medicare Administrative Contractor (MAC) or       5    117   121  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_CD
     COBOL Name:  INTRMDRY-CARR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 3
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 4
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 5
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 6
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)
                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 7
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   Medicaid Vendor Number                            15   122   136  VARCHAR2
     Description: Number which may be assigned to a provider by the state
                  Medicaid agency for external control or billing purposes.
     SAS Name:    MDCD_VNDR_NUM
     COBOL Name:  MDCD-VNDR-NUM

   Original Participation Date                       8    137   144  DATE
     Description: Date a provider is first approved to provide Medicare
                  and/or Medicaid services.
     SAS Name:    ORGNL_PRTCPTN_DT
     COBOL Name:  ORGNL-PRTCPTN-DT

   Prior CHOW Date                                   8    145   152  DATE
     Description: Effective date of the previous change of ownership for
                  this provider.
     SAS Name:    CHOW_PRIOR_DT
     COBOL Name:  CHOW-PRIOR-DT

   Prior Medicare Administrative Contractor (MAC) or 5    153   157  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the previous Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_PRIOR_CD
     COBOL Name:  INTRMDRY-CARR-PRIOR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 8
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 9
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 10
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 11
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 12
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   CCN                                               10   158   167  VARCHAR2
     Description: Six or ten position identification number that is
                  assigned to a certified provider.  This is the CMS
                  Certification Number.
     SAS Name:    PRVDR_NUM
     COBOL Name:  PRVDR-NUM

   Region Code                                       2    168   169  VARCHAR2
     Description: Indicates the CMS Regional Office responsible for the
                  certification of the provider.
     SAS Name:    RGN_CD
     COBOL Name:  RGN-CD
     VALUES:      01=Boston
                  02=New York
                  03=Philadelphia
                  04=Atlanta
                  05=Chicago
                  06=Dallas
                  07=Kansas City
                  08=Denver
                  09=San Francisco
                  10=Seattle

   Skeleton Record Indicator                         1    170   170  VARCHAR2
     Description: Indicates if the record is a skeleton record.  Only a
                  limited set of data is available for this provider; no
                  survey data exists.  Only provider categories
                  01,17,19,21and 22 can have skeleton providers.
     SAS Name:    SKLTN_REC_SW
     COBOL Name:  SKLTN-REC-SW

   State Abbreviation                                2    171   172  VARCHAR2
     Description: Two-character state abbreviation.
     SAS Name:    STATE_CD
     COBOL Name:  STATE-CD
     VALUES:      AK=ALASKA
                  AL=ALABAMA
                  AR=ARKANSAS
                  AS=AMERICAN SAMOA
                  AZ=ARIZONA
                  CA=CALIFORNIA
                  CN=CANADA
                  CO=COLORADO
                  CT=CONNECTICUT
                  DC=DISTRICT OF COLUMBIA
                  DE=DELAWARE
                  FL=FLORIDA
                  FN=INTERNATIONAL
                  GA=GEORGIA
                  GU=GUAM
                  HI=HAWAII
                  IA=IOWA
                  ID=IDAHO


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 13
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  IL=ILLINOIS
                  IN=INDIANA
                  KS=KANSAS
                  KY=KENTUCKY
                  LA=LOUISIANA
                  MA=MASSACHUSETTS
                  MD=MARYLAND
                  ME=MAINE
                  MI=MICHIGAN
                  MN=MINNESOTA
                  MO=MISSOURI
                  MP=SAIPAN
                  MS=MISSISSIPPI
                  MT=MONTANA
                  MX=MEXICO
                  NC=NORTH CAROLINA
                  ND=NORTH DAKOTA
                  NE=NEBRASKA
                  NH=NEW HAMPSHIRE
                  NJ=NEW JERSEY
                  NM=NEW MEXICO
                  NV=NEVADA
                  NY=NEW YORK
                  OH=OHIO
                  OK=OKLAHOMA
                  OR=OREGON
                  PA=PENNSYLVANIA
                  PR=PUERTO RICO
                  RI=RHODE ISLAND
                  SC=SOUTH CAROLINA
                  SD=SOUTH DAKOTA
                  TN=TENNESSEE
                  TX=TEXAS
                  UT=UTAH
                  VA=VIRGINIA
                  VI=VIRGIN ISLANDS
                  VT=VERMONT
                  WA=WASHINGTON
                  WI=WISCONSIN
                  WV=WEST VIRGINIA
                  WY=WYOMING

   SSA State Code                                    2    173   174  VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the state where the provider is located.
     SAS Name:    SSA_STATE_CD
     COBOL Name:  SSA-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  03=ARIZONA
                  04=ARKANSAS
                  05=CALIFORNIA
                  06=COLORADO
                  07=CONNECTICUT
                  08=DELAWARE
                  09=DISTRICT OF COLUMBIA
                  10=FLORIDA
                  11=GEORGIA
                  12=HAWAII
                  13=IDAHO
                  14=ILLINOIS
                  15=INDIANA
                  16=IOWA
                  17=KANSAS


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 14
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  18=KENTUCKY
                  19=LOUISIANA
                  20=MAINE
                  21=MARYLAND
                  22=MASSACHUSETTS
                  23=MICHIGAN
                  24=MINNESOTA
                  25=MISSISSIPPI
                  26=MISSOURI
                  27=MONTANA
                  28=NEBRASKA
                  29=NEVADA
                  30=NEW HAMPSHIRE
                  31=NEW JERSEY
                  32=NEW MEXICO
                  33=NEW YORK
                  34=NORTH CAROLINA
                  35=NORTH DAKOTA
                  36=OHIO
                  37=OKLAHOMA
                  38=OREGON
                  39=PENNSYLVANIA
                  40=PUERTO RICO
                  41=RHODE ISLAND
                  42=SOUTH CAROLINA
                  43=SOUTH DAKOTA
                  44=TENNESSEE
                  45=TEXAS
                  46=UTAH
                  47=VERMONT
                  48=VIRGIN ISLANDS
                  49=VIRGINIA
                  50=WASHINGTON
                  51=WEST VIRGINIA
                  52=WISCONSIN
                  53=WYOMING
                  54=AFRICA
                  56=CANADA
                  57=WEST INDIES
                  58=EUROPE
                  59=MEXICO
                  60=OCEANIA
                  61=PHILIPPINES
                  62=SOUTH AMERICA
                  63=UNITED STATES POSSESSIONS
                  64=AMERICAN SAMOA
                  65=GUAM
                  66=SAIPAN
                  99=INTERNATIONAL

   State Region Code                                 3    175   177  VARCHAR2
     Description: Identifies the region within a state where the provider
                  is located.
     SAS Name:    STATE_RGN_CD
     COBOL Name:  STATE-RGN-CD
     VALUES:      AK/001=ALASKA
                  AK/LAB=LABORATORIES
                  AK/NPH=NON-PARTICIPATING HOSPITAL
                  AL/001=ALABAMA
                  AL/LAB=LABORATORIES
                  AL/NPH=NON-PARTICIPATING HOSPITAL
                  AR/001=ARKANSAS
                  AR/LAB=LABORATORIES
                  AR/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 15
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  AS/001=AMERICAN SAMOA
                  AS/LAB=LABORATORY
                  AS/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/AZ=PHOENIX
                  AZ/LAB=ARIZONA LAB
                  AZ/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/TUC=TUCSON
                  CA/001=CALIFORNIA
                  CA/BAK=BAKERSFIELD
                  CA/BER=SAN BERNARDINO
                  CA/EB=East Bay
                  CA/FR=FRESNO
                  CA/L1=L.A. WEST
                  CA/L2=L.A. NORTH
                  CA/L3=L.A. CENTRAL
                  CA/L4=L.A. EAST
                  CA/L5=SAN GABRIEL
                  CA/LA1=LA Region 1
                  CA/LA2=LA Region 2
                  CA/LA3=LA Region 3
                  CA/LA4=LA Acute/Ancillary
                  CA/LA5=LA HHA/Hospice
                  CA/LA6=LA ICF/DD/CLinics
                  CA/LAB=LABORATORIES
                  CA/M1=LAB. SOUTH
                  CA/M2=LAB. NORTH
                  CA/NPH=NON-PARTICIPATING HOSPITAL
                  CA/ORG=ORANGE
                  CA/RIV=RIVERSIDE
                  CA/S1=SACRAMENTO
                  CA/S3=CHICO
                  CA/SD=SAN DIEGO
                  CA/SF=SAN FRANCISCO
                  CA/SJ=SAN JOSE
                  CA/SR=SANTA ROSA
                  CA/VEN=VENTURA
                  CN/001=CANADA
                  CN/LAB=LABORATORY
                  CN/NPH=NON-PARTICIPATING HOSPITAL
                  CO/001=COLORADO
                  CO/LAB=LABORATORIES
                  CO/NPH=NON-PARTICIPATING HOSPITAL
                  CT/001=CONNECTICUT
                  CT/LAB=LABORATORIES
                  CT/NPH=NON-PARTICIPATING HOSPITAL
                  DC/001=DISTRICT OF COLUMBIA
                  DC/LAB=LABORATORIES
                  DC/NPH=NON-PARTICIPATING HOSPITAL
                  DE/001=DELAWARE
                  DE/LAB=LABORATORIES
                  DE/NPH=NON-PARTICIPATING HOSPITAL
                  FL/001=FLORIDA
                  FL/FTM=FT. MYERS
                  FL/GAI=GAINESVILLE
                  FL/JAX=JACKSONVILLE
                  FL/LAB=LABORATORIES
                  FL/LAN=LANTANA
                  FL/LAU=LAUDERHILL
                  FL/MIA=MIAMI
                  FL/NPH=NON-PARTICIPATING HOSPITAL
                  FL/ORL=ORLANDO
                  FL/PEN=PENSACOLA
                  FL/STP=ST. PETERSBURG
                  FL/TAL=TALLAHASSEE


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 16
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  FL/TAM=TAMPA
                  FM/001=FEDERATED STATES OF MICRO
                  FM/NPH=NON-PARTICIPATING HOSPITAL
                  FN/001=INTERNATIONAL
                  FN/LAB=LABORATORIES
                  FN/NPH=NON-PARTICIPATING HOSPITAL
                  GA/001=GEORGIA
                  GA/GAA=GEORGIA ALL
                  GA/GAC=GEORGIA CENTRAL
                  GA/GAE=GEORGIA EASTERN
                  GA/GAN=GEORGIA NORTH
                  GA/GAS=GEORGIA SOUTH
                  GA/GAW=GEORGIA WESTERN
                  GA/LAB=LABORATORIES
                  GA/NPH=NON-PARTICIPATING HOSPITAL
                  GU/001=GUAM
                  GU/LAB=LABORATORIES
                  GU/NPH=NON-PARTICIPATING HOSPITAL
                  HI/001=HAWAII
                  HI/LAB=LABORATORIES
                  HI/NPH=NON-PARTICIPATING HOSPITAL
                  IA/001=IOWA
                  IA/LAB=LABORATORIES
                  IA/NPH=NON-PARTICIPATING HOSPITAL
                  ID/001=IDAHO
                  ID/LAB=LABORATORIES
                  ID/NPH=NON-PARTICIPATING HOSPITAL
                  IL/001=ILLINOIS
                  IL/LAB=LABORATORIES
                  IL/NPH=NON-PARTICIPATING HOSPITAL
                  IN/001=INDIANA
                  IN/LAB=LABORATORIES
                  IN/NPH=NON-PARTICIPATING HOSPITAL
                  KS/001=KANSAS
                  KS/KCK=KANSAS CITY
                  KS/KDH=KDHE
                  KS/LAB=LABORATORIES
                  KS/LAW=LAWRENCE
                  KS/NC=NORTH CENTRAL KANSAS
                  KS/NE=NORTH EAST KANSAS
                  KS/NPH=NON-PARTICIPATING HOSPITAL
                  KS/NW=NORTH WEST KANSAS
                  KS/SC=SOUTH CENTRAL KANSAS
                  KS/SE=SOUTH EAST KANSAS
                  KS/SW=SOUTH WEST KANSAS
                  KS/WST=WEST
                  KY/2C1=HOPKINSVILLE
                  KY/2C2=LOUISVILLE
                  KY/2C3=LONDON
                  KY/2C4=LEXINGTON
                  KY/LAB=LABORATORIES
                  KY/NPH=NON-PARTICIPATING HOSPITAL
                  LA/001=LOUISIANA
                  LA/LA1=NEW ORLEANS
                  LA/LA2=MANDEVILLE
                  LA/LA3=LAFAYETTE
                  LA/LA4=MONROE
                  LA/LA5=SHREVEPORT
                  LA/LA6=ALEXANDRIA
                  LA/LAB=LABORATORIES
                  LA/LB1=CLIA NEW ORLEANS
                  LA/LB5=CLIA SHREVEPORT
                  LA/LB6=CLIA ALEXANDRIA
                  LA/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 17
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  MA/001=MASSACHUSETTS
                  MA/LAB=LABORATORIES
                  MA/NPH=NON-PARTICIPATING HOSPITAL
                  MD/001=MARYLAND
                  MD/LAB=LABORATORIES
                  MD/NPH=NON-PARTICIPATING HOSPITAL
                  ME/001=MAINE
                  ME/LAB=LABORATORIES
                  ME/NPH=NON-PARTICIPATING HOSPITAL
                  MH/001=MARSHALL ISLANDS
                  MH/NPH=NON-PARTICIPATING HOSPITAL
                  MI/001=MICHIGAN
                  MI/LAB=LABORATORIES
                  MI/NPH=NON-PARTICIPATING HOSPITAL
                  MN/001=MINNESOTA
                  MN/LAB=LABORATORIES
                  MN/NPH=NON-PARTICIPATING HOSPITAL
                  MO/001=MISSOURI
                  MO/01=REGION01
                  MO/02=REGION02
                  MO/03=REGION 03
                  MO/04=REGION 04
                  MO/05=REGION 05
                  MO/06=REGION 06
                  MO/07=REGION 07
                  MO/1NH=REGION 1 NH
                  MO/2NH=REGION 2 NH
                  MO/3NH=REGION 3 NH
                  MO/4NH=REGION 4 NH
                  MO/5NH=REGION 5 NH
                  MO/6NH=REGION 6 NH
                  MO/7NH=REGION 7 NH
                  MO/LAB=LABORATORIES
                  MO/MO=STATEWIDE
                  MO/NPH=NON-PARTICIPATING HOSPITAL
                  MP/001=NORTHERN MARIANA ISLANDS
                  MP/LAB=LABORATORIES
                  MP/NPH=NON-PARTICIPATING HOSPITAL
                  MS/001=MISSISSIPPI
                  MS/LAB=LABORATORIES
                  MS/NPH=NON-PARTICIPATING HOSPITAL
                  MT/001=MONTANA
                  MT/LAB=LABORATORIES
                  MT/NPH=NON-PARTICIPATING HOSPITAL
                  MX/001=MEXICO
                  MX/LAB=LABORATORY
                  MX/NPH=NON-PARTICIPATING HOSPITAL
                  NC/001=NORTH CAROLINA
                  NC/LAB=LABORATORIES
                  NC/NCC=NORTH CAROLINA CENTRAL
                  NC/NCE=NORTH CAROLINA EAST
                  NC/NCN=NORTH CAROLINA NORTH
                  NC/NCS=NORTH CAROLINA SOUTH
                  NC/NCW=NORTH CAROLINA WEST
                  NC/NPH=NON-PARTICIPATING HOSPITAL
                  ND/001=NORTH DAKOTA
                  ND/LAB=LABORATORIES
                  ND/NPH=NON-PARTICIPATING HOSPITAL
                  NE/001=NEBRASKA
                  NE/1=NORTH CENTRAL
                  NE/2=CENTRAL
                  NE/3=NORTHEAST
                  NE/4=SOUTHEAST
                  NE/5=WESTERN


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 18
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  NE/LAB=LABORATORIES
                  NE/NPH=NON-PARTICIPATING HOSPITAL
                  NH/001=NEW HAMPSHIRE
                  NH/LAB=LABORATORIES
                  NH/NPH=NON-PARTICIPATING HOSPITAL
                  NJ/001=NEW JERSEY
                  NJ/LAB=LABORATORIES
                  NJ/NPH=NON-PARTICIPATING HOSPITAL
                  NM/001=NEW MEXICO
                  NM/LAB=LABORATORIES
                  NM/NPH=NON-PARTICIPATING HOSPITAL
                  NV/001=NEVADA
                  NV/CC=CARSON CITY
                  NV/LAB=LABORATORIES
                  NV/LV=LAS VEGAS
                  NV/NPH=NON-PARTICIPATING HOSPITAL
                  NY/001=BUFFALO
                  NY/002=ROCHESTER
                  NY/003=SYRACUSE
                  NY/004=ALBANY
                  NY/005=NEW ROCHELLE
                  NY/006=NEW YORK CITY
                  NY/007=SUFFOLK/NASSAU COUNTY
                  NY/LAB=LABORATORIES
                  NY/NPH=NON-PARTICIPATING HOSPITAL
                  OH/001=OHIO
                  OH/LAB=LABORATORIES
                  OH/NPH=NON-PARTICIPATING HOSPITAL
                  OK/001=OKLAHOMA
                  OK/LAB=LABORATORIES
                  OK/NPH=NON-PARTICIPATING HOSPITAL
                  OR/001=OFFICE #1
                  OR/002=OFFICE #2
                  OR/003=OFFICE #3
                  OR/LAB=LABORATORIES
                  OR/NPH=NON-PARTICIPATING HOSPITAL
                  PA/001=PENNSYLVANIA
                  PA/LAB=LABORATORIES
                  PA/NPH=NON-PARTICIPATING HOSPITAL
                  PR/001=PUERTO RICO
                  PR/LAB=LABORATORIES
                  PR/NPH=NON-PARTICIPATING HOSPITAL
                  PW/001=PALAU
                  PW/NPH=NON-PARTICIPATING HOSPITAL
                  RI/001=RHODE ISLAND
                  RI/LAB=LABORATORIES
                  RI/NPH=NON-PARTICIPATING HOSPITAL
                  SC/001=SOUTH CAROLINA
                  SC/LAB=LABORATORIES
                  SC/NPH=NON-PARTICIPATING HOSPITAL
                  SD/001=SOUTH DAKOTA
                  SD/LAB=LABORATORIES
                  SD/NPH=NON-PARTICIPATING HOSPITAL
                  TN/001=TENNESSEE
                  TN/LAB=LABORATORIES
                  TN/NPH=NON-PARTICIPATING HOSPITAL
                  TN/TNC=TENNESSEE COOKEVILLE
                  TN/TNE=TENNESSEE EASTERN
                  TN/TNM=TENNESSEE MIDDLE
                  TN/TNW=TENNESSEE WESTERN
                  TX/001=TEXAS
                  TX/L01=AMARILLO-LTC
                  TX/L02=ABILENE-LTC
                  TX/L03=ARLINGTON-LTC


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 19
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  TX/L04=TYLER-LTC
                  TX/L05=TEMPLE-LTC
                  TX/L06=HOUSTON-LTC
                  TX/L07=SAN ANTONIO-LTC
                  TX/LAB=LABORATORIES
                  TX/NPH=NON-PARTICIPATING HOSPITAL
                  TX/TX1=NLTC REG 1, 7, 9, 10
                  TX/TX2=NLTC REG 2, 3
                  TX/TX4=NLTC REG 6
                  TX/TX5=NLTC REG 4, 5
                  TX/TX6=AUSTIN
                  TX/TX8=NLTC REG 8, 11
                  UT/001=UTAH
                  UT/LAB=LABORATORIES
                  UT/NPH=NON-PARTICIPATING HOSPITAL
                  VA/001=VIRGINIA
                  VA/LAB=LABORATORIES
                  VA/NPH=NON-PARTICIPATING HOSPITAL
                  VI/001=VIRGIN ISLANDS
                  VI/LAB=LABORATORIES
                  VI/NPH=NON-PARTICIPATING HOSPITAL
                  VT/001=VERMONT
                  VT/LAB=LABORATORIES
                  VT/NPH=NON-PARTICIPATING HOSPITAL
                  WA/001=ALL OTHERS (NON-LTC FAC)
                  WA/D1=SPOKANE & YAKIMA AREAS
                  WA/D1A=District 1, Unit A
                  WA/D1B=District 1, Unit B
                  WA/D1C=District 1, Unit C
                  WA/D1D=District 1, Unit D
                  WA/D1E=District 1, Unit E
                  WA/D2=SPOKANE & SE
                  WA/D2A=District 2, Unit A
                  WA/D2B=District 2, Unit B
                  WA/D2C=District 2, Unit C
                  WA/D2D=District 2, Unit D
                  WA/D2E=District 2, Unit E
                  WA/D2F=District 2, Unit F
                  WA/D2G=District 2, Unit G
                  WA/D2H=District 2, Unit H
                  WA/D2I=District 2, Unit I
                  WA/D2J=District 2, Unit J
                  WA/D3=NW WASHINGTON
                  WA/D3A=District 3, Unit A
                  WA/D3B=District 3, Unit B
                  WA/D3C=District 3, Unit C
                  WA/D3D=District 3, Unit D
                  WA/D3E=District 3, Unit E
                  WA/D3F=District 3, Unit F
                  WA/D3G=District 3, Unit G
                  WA/D4A=GREATER SEATTLE AREA
                  WA/D4B=S KING COUNTY
                  WA/D5A=PIERCE CTY & PENINSULA
                  WA/D5B=PIERCE CTY & GRAYS HARBOR
                  WA/D6=OLYMPIA AREA
                  WA/LAB=LABORATORIES
                  WA/NPH=NON-PARTICIPATING HOSPITAL
                  WI/001=WISCONSIN
                  WI/LAB=LABORATORIES
                  WI/NPH=NON-PARTICIPATING HOSPITAL
                  WV/001=WEST VIRGINIA
                  WV/LAB=LABORATORIES
                  WV/NPH=NON-PARTICIPATING HOSPITAL
                  WY/001=WYOMING


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 20
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  WY/LAB=LABORATORIES
                  WY/NPH=NON-PARTICIPATING HOSPITAL

   Address: Street                                   50   178   227  VARCHAR2
     Description: Street address where the provider is located.
     SAS Name:    ST_ADR
     COBOL Name:  ST-ADR

   Telephone Number                                  10   228   237  VARCHAR2
     Description: Telephone number of the provider.
     SAS Name:    PHNE_NUM
     COBOL Name:  PHNE-NUM

   Termination Code                                  2    238   239  VARCHAR2
     Description: Indicates the current termination status for the
                  provider.
     SAS Name:    PGM_TRMNTN_CD
     COBOL Name:  PGM-TRMNTN-CD
     VALUES:      00=ACTIVE PROVIDER
                  01=VOLUNTARY-MERGER, CLOSURE
                  02=VOLUNTARY-DISSATISFACTION WITH REIMBURSEMENT
                  03=VOLUNTARY-RISK OF INVOLUNTARY TERMINATION
                  04=VOLUNTARY-OTHER REASON FOR WITHDRAWAL
                  05=INVOLUNTARY-FAILURE TO MEET HEALTH/SAFETY REQ
                  06=INVOLUNTARY-FAILURE TO MEET AGREEMENT
                  07=OTHER-PROVIDER STATUS CHANGE
                  08=NONPAYMENT OF FEES - CLIA Only
                  09=REV/UNSUCCESSFUL PARTICIPATION IN PT - CLIA Only
                  10=REV/OTHER REASON - CLIA Only
                  11=INCOMPLETE CLIA APPLICATION INFORMATION - CLIA Only
                  12=NO LONGER PERFORMING TESTS - CLIA Only
                  13=MULTIPLE TO SINGLE SITE CERTIFICATE - CLIA Only
                  14=SHARED LABORATORY - CLIA Only
                  15=FAILURE TO RENEW WAIVER PPM CERTIFICATE - CLIA Only
                  16=DUPLICATE CLIA NUMBER - CLIA Only
                  17=MAIL RETURNED NO FORWARD ADDRESS CERT ENDED - CLIA Only
                  20=NOTIFICATION BANKRUPTCY - CLIA Only
                  33=ACCREDITATION NOT CONFIRMED - CLIA Only
                  80=AWAITING STATE APPROVAL
                  99=OIG ACTION - DO NOT ACTIVATE - CLIA Only

   Termination or Expiration Date                    8    240   247  DATE
     Description: Date the provider was terminated.  For CLIA providers,
                  date the laboratory's certificate was terminated or the
                  expiration date of the current CLIA certificate.
     SAS Name:    TRMNTN_EXPRTN_DT
     COBOL Name:  TRMNTN-EXPRTN-DT

   Type of Action Code                               1    248   248  VARCHAR2
     Description: Identifies the reason for the certification.  Type of
                  action from the official survey record, CMS 1539 form.
     SAS Name:    CRTFCTN_ACTN_TYPE_CD
     COBOL Name:  CRTFCTN-ACTN-TYPE-CD
     VALUES:      1=INITIAL
                  2=RECERTIFICATION
                  3=TERMINATION
                  4=CHANGE OF OWNERSHIP
                  5=VALIDATION
                  8=FULL SURVEY AFTER COMPLAINT

   Ownership Type Code                               2    249   250  VARCHAR2
     Description: Indicates the ownership type of the provider.
     SAS Name:    GNRL_CNTL_TYPE_CD
     COBOL Name:  GNRL-CNTL-TYPE-CD


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 21
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     VALUES:      01=PROPRIETARY
                  02=NON PROFIT
                  03=GOVERNMENT

   Address: ZIP Code                                 5    251   255  VARCHAR2
     Description: Five-digit ZIP code for a provider's physical address.
     SAS Name:    ZIP_CD
     COBOL Name:  ZIP-CD

   FIPS State Code                                   2    256   257  VARCHAR2
     Description: FIPS State Code
     SAS Name:    FIPS_STATE_CD
     COBOL Name:  FIPS-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  04=ARIZONA
                  05=ARKANSAS
                  06=CALIFORNIA
                  08=COLORADO
                  09=CONNECTICUT
                  10=DELAWARE
                  11=DISTRICT OF COLUMBIA
                  12=FLORIDA
                  13=GEORGIA
                  15=HAWAII
                  16=IDAHO
                  17=ILLINOIS
                  18=INDIANA
                  19=IOWA
                  20=KANSAS
                  21=KENTUCKY
                  22=LOUISIANA
                  23=MAINE
                  24=MARYLAND
                  25=MASSACHUSETTS
                  26=MICHIGAN
                  27=MINNESOTA
                  28=MISSISSIPPI
                  29=MISSOURI
                  30=MONTANA
                  31=NEBRASKA
                  32=NEVADA
                  33=NEW HAMPSHIRE
                  34=NEW JERSEY
                  35=NEW MEXICO
                  36=NEW YORK
                  37=NORTH CAROLINA
                  38=NORTH DAKOTA
                  39=OHIO
                  40=OKLAHOMA
                  41=OREGON
                  42=PENNSYLVANIA
                  43=PUERTO RICO
                  44=RHODE ISLAND
                  45=SOUTH CAROLINA
                  46=SOUTH DAKOTA
                  47=TENNESSEE
                  48=TEXAS
                  49=UTAH
                  50=VERMONT
                  51=VIRGINIA
                  53=WASHINGTON
                  54=WEST VIRGINIA
                  55=WISCONSIN


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 22
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  56=WYOMING
                  60=AMERICAN SAMOA
                  66=GUAM
                  69=SAIPAN/MARIANA IS.
                  78=VIRGIN ISLANDS

   FIPS County Code                                  3    258   260  VARCHAR2
     Description: FIPS County Code
     SAS Name:    FIPS_CNTY_CD
     COBOL Name:  FIPS-CNTY-CD

   CBSA Urban Rural Indicator                        1    261   261  VARCHAR2
     Description: CBSA (Core Based Statistical Area) indicates whether the
                  county is defined as Urban or Rural.
     SAS Name:    CBSA_URBN_RRL_IND
     COBOL Name:  CBSA-URBN-RRL-IND

   CBSA Code                                         5    262   266  VARCHAR2
     Description: CBSA (Core Based Statistical Area) geographic entities
                  defined by the U.S. Office of Management and Budget (OMB)
                  on June 6, 2003 for use by Federal statistical agencies
                  in collecting, tabulating, and publishing Federal
                  statistics.  CBSA collectively refers to MSA.
     SAS Name:    CBSA_CD
     COBOL Name:  CBSA-CD

  *Accreditation Type Code                           1    283   283  VARCHAR2
     Description: Indicates an accrediting organization deeming the
                  provider.  If a provider is deemed by multiple
                  accrediting organizations then the accrediting
                  organization with the earliest active deeming effective
                  date is displayed in this field.
     SAS Name:    ACRDTN_TYPE_CD
     COBOL Name:  ACRDTN-TYPE-CD
     VALUES:      0=UNACCREDITED
                  1=JC
                  2=AAAHC
                  3=AAAASF
                  4=AOA/HFAP
                  5=DNV
                  6=IMQ
                  7=ACHC

   Services: Laboratory Code                         1    313   313  CHAR
     Description: Indicates how laboratory services are provided.
     SAS Name:    LAB_SRVC_CD
     COBOL Name:  LAB-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION
                  4=NOT PROVIDED

   Services: Pharmacy Code                           1    314   314  CHAR
     Description: Indicates how pharmaceutical services are provided.
     SAS Name:    PHRMCY_SRVC_CD
     COBOL Name:  PHRMCY-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION
                  4=NOT PROVIDED

   Ancillary Services: Radiology Code                1    315   315  VARCHAR2


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 23
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     Description: Indicates how radiology services are provided.
     SAS Name:    RDLGY_SRVC_CD
     COBOL Name:  RDLGY-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION
                  4=NOT PROVIDED

   ASC Begin Service Date                            8    316   323  DATE
     Description: Date an ambulatory surgical center began providing health
                  care services.
     SAS Name:    ASC_BGN_SRVC_DT
     COBOL Name:  ASC-BGN-SRVC-DT

   ASC Free Standing Indicator                       1    324   324  VARCHAR2
     Description: Indicates if the ambulatory surgical center is
                  freestanding.
     SAS Name:    FREESTNDNG_ASC_SW
     COBOL Name:  FREESTNDNG-ASC-SW

   Compliance: LSC Waiver Indicator                  1    445   445  CHAR
     Description: Indicates if a waiver of any life safety code provision
                  has been recommended for a provider.
     SAS Name:    LSC_WVR_SW
     COBOL Name:  LSC-WVR-SW

   Fiscal Year End Date (MMDD)                       4    464   467  VARCHAR2
     Description: End date, consisting of the month and day, of the
                  provider's fiscal year.
     SAS Name:    FY_END_MO_DAY_CD
     COBOL Name:  FY-END-MO-DAY-CD

   Hospital Based Indicator                          1    483   483  CHAR
     Description: Indicates if the provider is based in a hospital.
     SAS Name:    HOSP_BSD_SW
     COBOL Name:  HOSP-BSD-SW

   Operating Room Count                              4    622   625  NUMBER
     Description: Number of operating rooms in an ambulatory surgical
                  center.
     SAS Name:    OPRTG_ROOM_CNT
     COBOL Name:  OPRTG-ROOM-CNT

   Related Provider Number                           10   686   695  CHAR
     Description: Related provider number
     SAS Name:    RELATED_PROVIDER_NUMBER
     COBOL Name:  RELATED-PROVIDER-NUMBER

   Surgical Specialty: Dental Indicator              1    1957  1957 VARCHAR2
     Description: Indicates if dental surgery is offered by an ambulatory
                  surgical center.
     SAS Name:    DNTL_SRGRY_SW
     COBOL Name:  DNTL-SRGRY-SW

   Surgical Specialty: Ear/Nose/Throat Indicator     1    1958  1958 VARCHAR2
     Description: Indicates if ear, nose and throat surgery is offered by
                  an ambulatory surgical center.
     SAS Name:    OTLRYNGLGY_SRGRY_SW
     COBOL Name:  OTLRYNGLGY-SRGRY-SW

   Surgical Specialty: Endoscopy Indicator           1    1959  1959 VARCHAR2
     Description: Indicates if endoscopy surgery is offered by an
                  ambulatory surgical center.


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 24
        Ambulatory Surgical Center, CATEGORY = "15" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     SAS Name:    ENDSCPY_SRGRY_SW
     COBOL Name:  ENDSCPY-SRGRY-SW

   Surgical Specialty: Obstetrics / Gynecology Indicator 1    1960  1960 VARCHAR2
     Description: Indicates if obstetrics/gynecology surgery is offered by
                  an ambulatory surgical center.
     SAS Name:    OB_GYN_SRGRY_SW
     COBOL Name:  OB-GYN-SRGRY-SW

   Surgical Specialty: Ophthalmologic Indicator      1    1961  1961 VARCHAR2
     Description: Indicates if ophthalmologic surgery is offered by an
                  ambulatory surgical center.
     SAS Name:    OPTHMLGY_SRGRY_SW
     COBOL Name:  OPTHMLGY-SRGRY-SW

   Surgical Specialty: Orthopedic Indicator          1    1962  1962 VARCHAR2
     Description: Indicates if orthopedic surgery is offered by an
                  ambulatory surgical center.
     SAS Name:    ORTHPDC_SRGRY_SW
     COBOL Name:  ORTHPDC-SRGRY-SW

   Surgical Specialty: Other Indicator               1    1963  1963 VARCHAR2
     Description: Indicates if other surgery types are performed at an
                  ambulatory surgical center.
     SAS Name:    OTHR_SRGRY_SW
     COBOL Name:  OTHR-SRGRY-SW

   Surgical Specialty: Pain Indicator                1    1964  1964 VARCHAR2
     Description: Indicates if pain surgery is offered by an ambulatory
                  surgical center.
     SAS Name:    PAIN_SRGRY_SW
     COBOL Name:  PAIN-SRGRY-SW

   Surgical Specialty: Plastic / Reconstructive      1    1965  1965 VARCHAR2
   Indicator
     Description: Indicates if plastic and reconstructive surgery is
                  offered by an ambulatory surgical center.
     SAS Name:    PLSTC_SRGRY_SW
     COBOL Name:  PLSTC-SRGRY-SW

   Surgical Specialty: Podiatry Indicator            1    1966  1966 VARCHAR2
     Description: Indicates if podiatric surgery is offered by an
                  ambulatory surgical center.
     SAS Name:    FT_SRGRY_SW
     COBOL Name:  FT-SRGRY-SW





















 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 1
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Provider Category Subtype Code                    2    1     2    VARCHAR2
     Description: Identifies the subtype of the provider, within the
                  primary category.  Used in reporting to show the
                  breakdown of provider categories, mainly for hospitals
                  and SNFs.
     SAS Name:    PRVDR_CTGRY_SBTYP_CD
     COBOL Name:  PRVDR-CTGRY-SBTYP-CD
     VALUES:      01=Hospice

   Provider Category Code                            2    3     4    VARCHAR2
     Description: Identifies the type of provider participating in the
                  Medicare/Medicaid program.
     SAS Name:    PRVDR_CTGRY_CD
     COBOL Name:  PRVDR-CTGRY-CD
     VALUES:      16=Hospice

   CHOW Count                                        2    5     6    NUMBER
     Description: Number of times this provider has undergone a change of
                  ownership.
     SAS Name:    CHOW_CNT
     COBOL Name:  CHOW-CNT

   CHOW Date                                         8    7     14   DATE
     Description: Effective date of the most recent change of ownership for
                  this provider.
     SAS Name:    CHOW_DT
     COBOL Name:  CHOW-DT

   Address: City                                     28   15    42   VARCHAR2
     Description: City in which the provider is physically located.
     SAS Name:    CITY_NAME
     COBOL Name:  CITY-NAME

   Compliance: Acceptable POC                        1    43    43   VARCHAR2
     Description: Indicates if a provider is in compliance with program
                  requirements based on an acceptable plan for correction
                  of deficiencies.
     SAS Name:    ACPTBL_POC_SW
     COBOL Name:  ACPTBL-POC-SW

   Compliance: Status                                1    44    44   VARCHAR2
     Description: Compliance status of a provider at the time of
                  certification survey.
     SAS Name:    CMPLNC_STUS_CD
     COBOL Name:  CMPLNC-STUS-CD
     VALUES:      A=IN COMPLIANCE
                  B=NOT IN COMPLIANCE

   SSA County Code                                   3    45    47   VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the county where the provider is located.
     SAS Name:    SSA_CNTY_CD
     COBOL Name:  SSA-CNTY-CD

   Cross Ref Provider Number                         10   48    57   CHAR
     Description: Cross reference provider number
     SAS Name:    CROSS_REF_PROVIDER_NUMBER
     COBOL Name:  CROSS-REF-PROVIDER-NUMBER

   Certification Date                                8    58    65   DATE
     Description: Equal to the exit date of the initial visit of the Health
                  survey for certifications completed after July 28, 2012.
                  For certifications prior to that date, the certification


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 2
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  date is equal to the exit date of the initial visit of
                  the Health survey or LSC survey, whichever is later.
     SAS Name:    CRTFCTN_DT
     COBOL Name:  CRTFCTN-DT

   Eligibility Indicator                             1    66    66   VARCHAR2
     Description: Indicates if a facility is eligible to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    ELGBLTY_SW
     COBOL Name:  ELGBLTY-SW

   Facility Name                                     50   67    116  VARCHAR2
     Description: Name of the provider certified to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    FAC_NAME
     COBOL Name:  FAC-NAME

   Medicare Administrative Contractor (MAC) or       5    117   121  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_CD
     COBOL Name:  INTRMDRY-CARR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 3
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 4
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 5
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 6
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)
                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 7
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   Medicaid Vendor Number                            15   122   136  VARCHAR2
     Description: Number which may be assigned to a provider by the state
                  Medicaid agency for external control or billing purposes.
     SAS Name:    MDCD_VNDR_NUM
     COBOL Name:  MDCD-VNDR-NUM

   Original Participation Date                       8    137   144  DATE
     Description: Date a provider is first approved to provide Medicare
                  and/or Medicaid services.
     SAS Name:    ORGNL_PRTCPTN_DT
     COBOL Name:  ORGNL-PRTCPTN-DT

   Prior CHOW Date                                   8    145   152  DATE
     Description: Effective date of the previous change of ownership for
                  this provider.
     SAS Name:    CHOW_PRIOR_DT
     COBOL Name:  CHOW-PRIOR-DT

   Prior Medicare Administrative Contractor (MAC) or 5    153   157  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the previous Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_PRIOR_CD
     COBOL Name:  INTRMDRY-CARR-PRIOR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 8
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 9
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 10
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 11
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 12
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   CCN                                               10   158   167  VARCHAR2
     Description: Six or ten position identification number that is
                  assigned to a certified provider.  This is the CMS
                  Certification Number.
     SAS Name:    PRVDR_NUM
     COBOL Name:  PRVDR-NUM

   Region Code                                       2    168   169  VARCHAR2
     Description: Indicates the CMS Regional Office responsible for the
                  certification of the provider.
     SAS Name:    RGN_CD
     COBOL Name:  RGN-CD
     VALUES:      01=Boston
                  02=New York
                  03=Philadelphia
                  04=Atlanta
                  05=Chicago
                  06=Dallas
                  07=Kansas City
                  08=Denver
                  09=San Francisco
                  10=Seattle

   Skeleton Record Indicator                         1    170   170  VARCHAR2
     Description: Indicates if the record is a skeleton record.  Only a
                  limited set of data is available for this provider; no
                  survey data exists.  Only provider categories
                  01,17,19,21and 22 can have skeleton providers.
     SAS Name:    SKLTN_REC_SW
     COBOL Name:  SKLTN-REC-SW

   State Abbreviation                                2    171   172  VARCHAR2
     Description: Two-character state abbreviation.
     SAS Name:    STATE_CD
     COBOL Name:  STATE-CD
     VALUES:      AK=ALASKA
                  AL=ALABAMA
                  AR=ARKANSAS
                  AS=AMERICAN SAMOA
                  AZ=ARIZONA
                  CA=CALIFORNIA
                  CN=CANADA
                  CO=COLORADO
                  CT=CONNECTICUT
                  DC=DISTRICT OF COLUMBIA
                  DE=DELAWARE
                  FL=FLORIDA
                  FN=INTERNATIONAL
                  GA=GEORGIA
                  GU=GUAM
                  HI=HAWAII
                  IA=IOWA
                  ID=IDAHO


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 13
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  IL=ILLINOIS
                  IN=INDIANA
                  KS=KANSAS
                  KY=KENTUCKY
                  LA=LOUISIANA
                  MA=MASSACHUSETTS
                  MD=MARYLAND
                  ME=MAINE
                  MI=MICHIGAN
                  MN=MINNESOTA
                  MO=MISSOURI
                  MP=SAIPAN
                  MS=MISSISSIPPI
                  MT=MONTANA
                  MX=MEXICO
                  NC=NORTH CAROLINA
                  ND=NORTH DAKOTA
                  NE=NEBRASKA
                  NH=NEW HAMPSHIRE
                  NJ=NEW JERSEY
                  NM=NEW MEXICO
                  NV=NEVADA
                  NY=NEW YORK
                  OH=OHIO
                  OK=OKLAHOMA
                  OR=OREGON
                  PA=PENNSYLVANIA
                  PR=PUERTO RICO
                  RI=RHODE ISLAND
                  SC=SOUTH CAROLINA
                  SD=SOUTH DAKOTA
                  TN=TENNESSEE
                  TX=TEXAS
                  UT=UTAH
                  VA=VIRGINIA
                  VI=VIRGIN ISLANDS
                  VT=VERMONT
                  WA=WASHINGTON
                  WI=WISCONSIN
                  WV=WEST VIRGINIA
                  WY=WYOMING

   SSA State Code                                    2    173   174  VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the state where the provider is located.
     SAS Name:    SSA_STATE_CD
     COBOL Name:  SSA-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  03=ARIZONA
                  04=ARKANSAS
                  05=CALIFORNIA
                  06=COLORADO
                  07=CONNECTICUT
                  08=DELAWARE
                  09=DISTRICT OF COLUMBIA
                  10=FLORIDA
                  11=GEORGIA
                  12=HAWAII
                  13=IDAHO
                  14=ILLINOIS
                  15=INDIANA
                  16=IOWA
                  17=KANSAS


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 14
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  18=KENTUCKY
                  19=LOUISIANA
                  20=MAINE
                  21=MARYLAND
                  22=MASSACHUSETTS
                  23=MICHIGAN
                  24=MINNESOTA
                  25=MISSISSIPPI
                  26=MISSOURI
                  27=MONTANA
                  28=NEBRASKA
                  29=NEVADA
                  30=NEW HAMPSHIRE
                  31=NEW JERSEY
                  32=NEW MEXICO
                  33=NEW YORK
                  34=NORTH CAROLINA
                  35=NORTH DAKOTA
                  36=OHIO
                  37=OKLAHOMA
                  38=OREGON
                  39=PENNSYLVANIA
                  40=PUERTO RICO
                  41=RHODE ISLAND
                  42=SOUTH CAROLINA
                  43=SOUTH DAKOTA
                  44=TENNESSEE
                  45=TEXAS
                  46=UTAH
                  47=VERMONT
                  48=VIRGIN ISLANDS
                  49=VIRGINIA
                  50=WASHINGTON
                  51=WEST VIRGINIA
                  52=WISCONSIN
                  53=WYOMING
                  54=AFRICA
                  56=CANADA
                  57=WEST INDIES
                  58=EUROPE
                  59=MEXICO
                  60=OCEANIA
                  61=PHILIPPINES
                  62=SOUTH AMERICA
                  63=UNITED STATES POSSESSIONS
                  64=AMERICAN SAMOA
                  65=GUAM
                  66=SAIPAN
                  99=INTERNATIONAL

   State Region Code                                 3    175   177  VARCHAR2
     Description: Identifies the region within a state where the provider
                  is located.
     SAS Name:    STATE_RGN_CD
     COBOL Name:  STATE-RGN-CD
     VALUES:      AK/001=ALASKA
                  AK/LAB=LABORATORIES
                  AK/NPH=NON-PARTICIPATING HOSPITAL
                  AL/001=ALABAMA
                  AL/LAB=LABORATORIES
                  AL/NPH=NON-PARTICIPATING HOSPITAL
                  AR/001=ARKANSAS
                  AR/LAB=LABORATORIES
                  AR/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 15
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  AS/001=AMERICAN SAMOA
                  AS/LAB=LABORATORY
                  AS/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/AZ=PHOENIX
                  AZ/LAB=ARIZONA LAB
                  AZ/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/TUC=TUCSON
                  CA/001=CALIFORNIA
                  CA/BAK=BAKERSFIELD
                  CA/BER=SAN BERNARDINO
                  CA/EB=East Bay
                  CA/FR=FRESNO
                  CA/L1=L.A. WEST
                  CA/L2=L.A. NORTH
                  CA/L3=L.A. CENTRAL
                  CA/L4=L.A. EAST
                  CA/L5=SAN GABRIEL
                  CA/LA1=LA Region 1
                  CA/LA2=LA Region 2
                  CA/LA3=LA Region 3
                  CA/LA4=LA Acute/Ancillary
                  CA/LA5=LA HHA/Hospice
                  CA/LA6=LA ICF/DD/CLinics
                  CA/LAB=LABORATORIES
                  CA/M1=LAB. SOUTH
                  CA/M2=LAB. NORTH
                  CA/NPH=NON-PARTICIPATING HOSPITAL
                  CA/ORG=ORANGE
                  CA/RIV=RIVERSIDE
                  CA/S1=SACRAMENTO
                  CA/S3=CHICO
                  CA/SD=SAN DIEGO
                  CA/SF=SAN FRANCISCO
                  CA/SJ=SAN JOSE
                  CA/SR=SANTA ROSA
                  CA/VEN=VENTURA
                  CN/001=CANADA
                  CN/LAB=LABORATORY
                  CN/NPH=NON-PARTICIPATING HOSPITAL
                  CO/001=COLORADO
                  CO/LAB=LABORATORIES
                  CO/NPH=NON-PARTICIPATING HOSPITAL
                  CT/001=CONNECTICUT
                  CT/LAB=LABORATORIES
                  CT/NPH=NON-PARTICIPATING HOSPITAL
                  DC/001=DISTRICT OF COLUMBIA
                  DC/LAB=LABORATORIES
                  DC/NPH=NON-PARTICIPATING HOSPITAL
                  DE/001=DELAWARE
                  DE/LAB=LABORATORIES
                  DE/NPH=NON-PARTICIPATING HOSPITAL
                  FL/001=FLORIDA
                  FL/FTM=FT. MYERS
                  FL/GAI=GAINESVILLE
                  FL/JAX=JACKSONVILLE
                  FL/LAB=LABORATORIES
                  FL/LAN=LANTANA
                  FL/LAU=LAUDERHILL
                  FL/MIA=MIAMI
                  FL/NPH=NON-PARTICIPATING HOSPITAL
                  FL/ORL=ORLANDO
                  FL/PEN=PENSACOLA
                  FL/STP=ST. PETERSBURG
                  FL/TAL=TALLAHASSEE


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 16
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  FL/TAM=TAMPA
                  FM/001=FEDERATED STATES OF MICRO
                  FM/NPH=NON-PARTICIPATING HOSPITAL
                  FN/001=INTERNATIONAL
                  FN/LAB=LABORATORIES
                  FN/NPH=NON-PARTICIPATING HOSPITAL
                  GA/001=GEORGIA
                  GA/GAA=GEORGIA ALL
                  GA/GAC=GEORGIA CENTRAL
                  GA/GAE=GEORGIA EASTERN
                  GA/GAN=GEORGIA NORTH
                  GA/GAS=GEORGIA SOUTH
                  GA/GAW=GEORGIA WESTERN
                  GA/LAB=LABORATORIES
                  GA/NPH=NON-PARTICIPATING HOSPITAL
                  GU/001=GUAM
                  GU/LAB=LABORATORIES
                  GU/NPH=NON-PARTICIPATING HOSPITAL
                  HI/001=HAWAII
                  HI/LAB=LABORATORIES
                  HI/NPH=NON-PARTICIPATING HOSPITAL
                  IA/001=IOWA
                  IA/LAB=LABORATORIES
                  IA/NPH=NON-PARTICIPATING HOSPITAL
                  ID/001=IDAHO
                  ID/LAB=LABORATORIES
                  ID/NPH=NON-PARTICIPATING HOSPITAL
                  IL/001=ILLINOIS
                  IL/LAB=LABORATORIES
                  IL/NPH=NON-PARTICIPATING HOSPITAL
                  IN/001=INDIANA
                  IN/LAB=LABORATORIES
                  IN/NPH=NON-PARTICIPATING HOSPITAL
                  KS/001=KANSAS
                  KS/KCK=KANSAS CITY
                  KS/KDH=KDHE
                  KS/LAB=LABORATORIES
                  KS/LAW=LAWRENCE
                  KS/NC=NORTH CENTRAL KANSAS
                  KS/NE=NORTH EAST KANSAS
                  KS/NPH=NON-PARTICIPATING HOSPITAL
                  KS/NW=NORTH WEST KANSAS
                  KS/SC=SOUTH CENTRAL KANSAS
                  KS/SE=SOUTH EAST KANSAS
                  KS/SW=SOUTH WEST KANSAS
                  KS/WST=WEST
                  KY/2C1=HOPKINSVILLE
                  KY/2C2=LOUISVILLE
                  KY/2C3=LONDON
                  KY/2C4=LEXINGTON
                  KY/LAB=LABORATORIES
                  KY/NPH=NON-PARTICIPATING HOSPITAL
                  LA/001=LOUISIANA
                  LA/LA1=NEW ORLEANS
                  LA/LA2=MANDEVILLE
                  LA/LA3=LAFAYETTE
                  LA/LA4=MONROE
                  LA/LA5=SHREVEPORT
                  LA/LA6=ALEXANDRIA
                  LA/LAB=LABORATORIES
                  LA/LB1=CLIA NEW ORLEANS
                  LA/LB5=CLIA SHREVEPORT
                  LA/LB6=CLIA ALEXANDRIA
                  LA/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 17
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  MA/001=MASSACHUSETTS
                  MA/LAB=LABORATORIES
                  MA/NPH=NON-PARTICIPATING HOSPITAL
                  MD/001=MARYLAND
                  MD/LAB=LABORATORIES
                  MD/NPH=NON-PARTICIPATING HOSPITAL
                  ME/001=MAINE
                  ME/LAB=LABORATORIES
                  ME/NPH=NON-PARTICIPATING HOSPITAL
                  MH/001=MARSHALL ISLANDS
                  MH/NPH=NON-PARTICIPATING HOSPITAL
                  MI/001=MICHIGAN
                  MI/LAB=LABORATORIES
                  MI/NPH=NON-PARTICIPATING HOSPITAL
                  MN/001=MINNESOTA
                  MN/LAB=LABORATORIES
                  MN/NPH=NON-PARTICIPATING HOSPITAL
                  MO/001=MISSOURI
                  MO/01=REGION01
                  MO/02=REGION02
                  MO/03=REGION 03
                  MO/04=REGION 04
                  MO/05=REGION 05
                  MO/06=REGION 06
                  MO/07=REGION 07
                  MO/1NH=REGION 1 NH
                  MO/2NH=REGION 2 NH
                  MO/3NH=REGION 3 NH
                  MO/4NH=REGION 4 NH
                  MO/5NH=REGION 5 NH
                  MO/6NH=REGION 6 NH
                  MO/7NH=REGION 7 NH
                  MO/LAB=LABORATORIES
                  MO/MO=STATEWIDE
                  MO/NPH=NON-PARTICIPATING HOSPITAL
                  MP/001=NORTHERN MARIANA ISLANDS
                  MP/LAB=LABORATORIES
                  MP/NPH=NON-PARTICIPATING HOSPITAL
                  MS/001=MISSISSIPPI
                  MS/LAB=LABORATORIES
                  MS/NPH=NON-PARTICIPATING HOSPITAL
                  MT/001=MONTANA
                  MT/LAB=LABORATORIES
                  MT/NPH=NON-PARTICIPATING HOSPITAL
                  MX/001=MEXICO
                  MX/LAB=LABORATORY
                  MX/NPH=NON-PARTICIPATING HOSPITAL
                  NC/001=NORTH CAROLINA
                  NC/LAB=LABORATORIES
                  NC/NCC=NORTH CAROLINA CENTRAL
                  NC/NCE=NORTH CAROLINA EAST
                  NC/NCN=NORTH CAROLINA NORTH
                  NC/NCS=NORTH CAROLINA SOUTH
                  NC/NCW=NORTH CAROLINA WEST
                  NC/NPH=NON-PARTICIPATING HOSPITAL
                  ND/001=NORTH DAKOTA
                  ND/LAB=LABORATORIES
                  ND/NPH=NON-PARTICIPATING HOSPITAL
                  NE/001=NEBRASKA
                  NE/1=NORTH CENTRAL
                  NE/2=CENTRAL
                  NE/3=NORTHEAST
                  NE/4=SOUTHEAST
                  NE/5=WESTERN


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 18
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  NE/LAB=LABORATORIES
                  NE/NPH=NON-PARTICIPATING HOSPITAL
                  NH/001=NEW HAMPSHIRE
                  NH/LAB=LABORATORIES
                  NH/NPH=NON-PARTICIPATING HOSPITAL
                  NJ/001=NEW JERSEY
                  NJ/LAB=LABORATORIES
                  NJ/NPH=NON-PARTICIPATING HOSPITAL
                  NM/001=NEW MEXICO
                  NM/LAB=LABORATORIES
                  NM/NPH=NON-PARTICIPATING HOSPITAL
                  NV/001=NEVADA
                  NV/CC=CARSON CITY
                  NV/LAB=LABORATORIES
                  NV/LV=LAS VEGAS
                  NV/NPH=NON-PARTICIPATING HOSPITAL
                  NY/001=BUFFALO
                  NY/002=ROCHESTER
                  NY/003=SYRACUSE
                  NY/004=ALBANY
                  NY/005=NEW ROCHELLE
                  NY/006=NEW YORK CITY
                  NY/007=SUFFOLK/NASSAU COUNTY
                  NY/LAB=LABORATORIES
                  NY/NPH=NON-PARTICIPATING HOSPITAL
                  OH/001=OHIO
                  OH/LAB=LABORATORIES
                  OH/NPH=NON-PARTICIPATING HOSPITAL
                  OK/001=OKLAHOMA
                  OK/LAB=LABORATORIES
                  OK/NPH=NON-PARTICIPATING HOSPITAL
                  OR/001=OFFICE #1
                  OR/002=OFFICE #2
                  OR/003=OFFICE #3
                  OR/LAB=LABORATORIES
                  OR/NPH=NON-PARTICIPATING HOSPITAL
                  PA/001=PENNSYLVANIA
                  PA/LAB=LABORATORIES
                  PA/NPH=NON-PARTICIPATING HOSPITAL
                  PR/001=PUERTO RICO
                  PR/LAB=LABORATORIES
                  PR/NPH=NON-PARTICIPATING HOSPITAL
                  PW/001=PALAU
                  PW/NPH=NON-PARTICIPATING HOSPITAL
                  RI/001=RHODE ISLAND
                  RI/LAB=LABORATORIES
                  RI/NPH=NON-PARTICIPATING HOSPITAL
                  SC/001=SOUTH CAROLINA
                  SC/LAB=LABORATORIES
                  SC/NPH=NON-PARTICIPATING HOSPITAL
                  SD/001=SOUTH DAKOTA
                  SD/LAB=LABORATORIES
                  SD/NPH=NON-PARTICIPATING HOSPITAL
                  TN/001=TENNESSEE
                  TN/LAB=LABORATORIES
                  TN/NPH=NON-PARTICIPATING HOSPITAL
                  TN/TNC=TENNESSEE COOKEVILLE
                  TN/TNE=TENNESSEE EASTERN
                  TN/TNM=TENNESSEE MIDDLE
                  TN/TNW=TENNESSEE WESTERN
                  TX/001=TEXAS
                  TX/L01=AMARILLO-LTC
                  TX/L02=ABILENE-LTC
                  TX/L03=ARLINGTON-LTC


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 19
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  TX/L04=TYLER-LTC
                  TX/L05=TEMPLE-LTC
                  TX/L06=HOUSTON-LTC
                  TX/L07=SAN ANTONIO-LTC
                  TX/LAB=LABORATORIES
                  TX/NPH=NON-PARTICIPATING HOSPITAL
                  TX/TX1=NLTC REG 1, 7, 9, 10
                  TX/TX2=NLTC REG 2, 3
                  TX/TX4=NLTC REG 6
                  TX/TX5=NLTC REG 4, 5
                  TX/TX6=AUSTIN
                  TX/TX8=NLTC REG 8, 11
                  UT/001=UTAH
                  UT/LAB=LABORATORIES
                  UT/NPH=NON-PARTICIPATING HOSPITAL
                  VA/001=VIRGINIA
                  VA/LAB=LABORATORIES
                  VA/NPH=NON-PARTICIPATING HOSPITAL
                  VI/001=VIRGIN ISLANDS
                  VI/LAB=LABORATORIES
                  VI/NPH=NON-PARTICIPATING HOSPITAL
                  VT/001=VERMONT
                  VT/LAB=LABORATORIES
                  VT/NPH=NON-PARTICIPATING HOSPITAL
                  WA/001=ALL OTHERS (NON-LTC FAC)
                  WA/D1=SPOKANE & YAKIMA AREAS
                  WA/D1A=District 1, Unit A
                  WA/D1B=District 1, Unit B
                  WA/D1C=District 1, Unit C
                  WA/D1D=District 1, Unit D
                  WA/D1E=District 1, Unit E
                  WA/D2=SPOKANE & SE
                  WA/D2A=District 2, Unit A
                  WA/D2B=District 2, Unit B
                  WA/D2C=District 2, Unit C
                  WA/D2D=District 2, Unit D
                  WA/D2E=District 2, Unit E
                  WA/D2F=District 2, Unit F
                  WA/D2G=District 2, Unit G
                  WA/D2H=District 2, Unit H
                  WA/D2I=District 2, Unit I
                  WA/D2J=District 2, Unit J
                  WA/D3=NW WASHINGTON
                  WA/D3A=District 3, Unit A
                  WA/D3B=District 3, Unit B
                  WA/D3C=District 3, Unit C
                  WA/D3D=District 3, Unit D
                  WA/D3E=District 3, Unit E
                  WA/D3F=District 3, Unit F
                  WA/D3G=District 3, Unit G
                  WA/D4A=GREATER SEATTLE AREA
                  WA/D4B=S KING COUNTY
                  WA/D5A=PIERCE CTY & PENINSULA
                  WA/D5B=PIERCE CTY & GRAYS HARBOR
                  WA/D6=OLYMPIA AREA
                  WA/LAB=LABORATORIES
                  WA/NPH=NON-PARTICIPATING HOSPITAL
                  WI/001=WISCONSIN
                  WI/LAB=LABORATORIES
                  WI/NPH=NON-PARTICIPATING HOSPITAL
                  WV/001=WEST VIRGINIA
                  WV/LAB=LABORATORIES
                  WV/NPH=NON-PARTICIPATING HOSPITAL
                  WY/001=WYOMING


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 20
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  WY/LAB=LABORATORIES
                  WY/NPH=NON-PARTICIPATING HOSPITAL

   Address: Street                                   50   178   227  VARCHAR2
     Description: Street address where the provider is located.
     SAS Name:    ST_ADR
     COBOL Name:  ST-ADR

   Telephone Number                                  10   228   237  VARCHAR2
     Description: Telephone number of the provider.
     SAS Name:    PHNE_NUM
     COBOL Name:  PHNE-NUM

   Termination Code                                  2    238   239  VARCHAR2
     Description: Indicates the current termination status for the
                  provider.
     SAS Name:    PGM_TRMNTN_CD
     COBOL Name:  PGM-TRMNTN-CD
     VALUES:      00=ACTIVE PROVIDER
                  01=VOLUNTARY-MERGER, CLOSURE
                  02=VOLUNTARY-DISSATISFACTION WITH REIMBURSEMENT
                  03=VOLUNTARY-RISK OF INVOLUNTARY TERMINATION
                  04=VOLUNTARY-OTHER REASON FOR WITHDRAWAL
                  05=INVOLUNTARY-FAILURE TO MEET HEALTH/SAFETY REQ
                  06=INVOLUNTARY-FAILURE TO MEET AGREEMENT
                  07=OTHER-PROVIDER STATUS CHANGE
                  08=NONPAYMENT OF FEES - CLIA Only
                  09=REV/UNSUCCESSFUL PARTICIPATION IN PT - CLIA Only
                  10=REV/OTHER REASON - CLIA Only
                  11=INCOMPLETE CLIA APPLICATION INFORMATION - CLIA Only
                  12=NO LONGER PERFORMING TESTS - CLIA Only
                  13=MULTIPLE TO SINGLE SITE CERTIFICATE - CLIA Only
                  14=SHARED LABORATORY - CLIA Only
                  15=FAILURE TO RENEW WAIVER PPM CERTIFICATE - CLIA Only
                  16=DUPLICATE CLIA NUMBER - CLIA Only
                  17=MAIL RETURNED NO FORWARD ADDRESS CERT ENDED - CLIA Only
                  20=NOTIFICATION BANKRUPTCY - CLIA Only
                  33=ACCREDITATION NOT CONFIRMED - CLIA Only
                  80=AWAITING STATE APPROVAL
                  99=OIG ACTION - DO NOT ACTIVATE - CLIA Only

   Termination or Expiration Date                    8    240   247  DATE
     Description: Date the provider was terminated.  For CLIA providers,
                  date the laboratory's certificate was terminated or the
                  expiration date of the current CLIA certificate.
     SAS Name:    TRMNTN_EXPRTN_DT
     COBOL Name:  TRMNTN-EXPRTN-DT

   Type of Action Code                               1    248   248  VARCHAR2
     Description: Identifies the reason for the certification.  Type of
                  action from the official survey record, CMS 1539 form.
     SAS Name:    CRTFCTN_ACTN_TYPE_CD
     COBOL Name:  CRTFCTN-ACTN-TYPE-CD
     VALUES:      1=INITIAL
                  2=RECERTIFICATION
                  3=TERMINATION
                  4=CHANGE OF OWNERSHIP
                  5=VALIDATION
                  8=FULL SURVEY AFTER COMPLAINT

   Ownership Type Code                               2    249   250  VARCHAR2
     Description: Indicates the ownership type of the provider.
     SAS Name:    GNRL_CNTL_TYPE_CD
     COBOL Name:  GNRL-CNTL-TYPE-CD


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 21
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     VALUES:      01=VOLUNTARY NON-PROFIT - CHURCH
                  02=VOLUNTARY NON-PROFIT - PRIVATE
                  03=VOLUNTARY NON-PROFIT - OTHER
                  04=PROPRIETARY - INDIVIDUAL
                  05=PROPRIETARY - PARTNERSHIP
                  06=PROPRIETARY - CORPORATION
                  07=PROPRIETARY - OTHER
                  08=GOVERNMENT - STATE
                  09=GOVERNMENT - COUNTY
                  10=GOVERNMENT - CITY
                  11=GOVERNMENT - CITY-COUNTY
                  12=COMBINATION GOVERNMENT & NONPROFIT
                  13=OTHER

   Address: ZIP Code                                 5    251   255  VARCHAR2
     Description: Five-digit ZIP code for a provider's physical address.
     SAS Name:    ZIP_CD
     COBOL Name:  ZIP-CD

   FIPS State Code                                   2    256   257  VARCHAR2
     Description: FIPS State Code
     SAS Name:    FIPS_STATE_CD
     COBOL Name:  FIPS-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  04=ARIZONA
                  05=ARKANSAS
                  06=CALIFORNIA
                  08=COLORADO
                  09=CONNECTICUT
                  10=DELAWARE
                  11=DISTRICT OF COLUMBIA
                  12=FLORIDA
                  13=GEORGIA
                  15=HAWAII
                  16=IDAHO
                  17=ILLINOIS
                  18=INDIANA
                  19=IOWA
                  20=KANSAS
                  21=KENTUCKY
                  22=LOUISIANA
                  23=MAINE
                  24=MARYLAND
                  25=MASSACHUSETTS
                  26=MICHIGAN
                  27=MINNESOTA
                  28=MISSISSIPPI
                  29=MISSOURI
                  30=MONTANA
                  31=NEBRASKA
                  32=NEVADA
                  33=NEW HAMPSHIRE
                  34=NEW JERSEY
                  35=NEW MEXICO
                  36=NEW YORK
                  37=NORTH CAROLINA
                  38=NORTH DAKOTA
                  39=OHIO
                  40=OKLAHOMA
                  41=OREGON
                  42=PENNSYLVANIA
                  43=PUERTO RICO
                  44=RHODE ISLAND


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 22
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  45=SOUTH CAROLINA
                  46=SOUTH DAKOTA
                  47=TENNESSEE
                  48=TEXAS
                  49=UTAH
                  50=VERMONT
                  51=VIRGINIA
                  53=WASHINGTON
                  54=WEST VIRGINIA
                  55=WISCONSIN
                  56=WYOMING
                  60=AMERICAN SAMOA
                  66=GUAM
                  69=SAIPAN/MARIANA IS.
                  78=VIRGIN ISLANDS

   FIPS County Code                                  3    258   260  VARCHAR2
     Description: FIPS County Code
     SAS Name:    FIPS_CNTY_CD
     COBOL Name:  FIPS-CNTY-CD

   CBSA Urban Rural Indicator                        1    261   261  VARCHAR2
     Description: CBSA (Core Based Statistical Area) indicates whether the
                  county is defined as Urban or Rural.
     SAS Name:    CBSA_URBN_RRL_IND
     COBOL Name:  CBSA-URBN-RRL-IND

   CBSA Code                                         5    262   266  VARCHAR2
     Description: CBSA (Core Based Statistical Area) geographic entities
                  defined by the U.S. Office of Management and Budget (OMB)
                  on June 6, 2003 for use by Federal statistical agencies
                  in collecting, tabulating, and publishing Federal
                  statistics.  CBSA collectively refers to MSA.
     SAS Name:    CBSA_CD
     COBOL Name:  CBSA-CD

  *Accreditation Type Code                           1    283   283  VARCHAR2
     Description: Indicates an accrediting organization deeming the
                  provider.  If a provider is deemed by multiple
                  accrediting organizations then the accrediting
                  organization with the earliest active deeming effective
                  date is displayed in this field.
     SAS Name:    ACRDTN_TYPE_CD
     COBOL Name:  ACRDTN-TYPE-CD
     VALUES:      0=UNACCREDITED
                  1=JC
                  2=CHAP
                  3=ACHC

   Category-specific Facility Type Code              2    388   389  VARCHAR2
     Description: Indicates the category-specific facility type code, for
                  certain provider categories only.
     SAS Name:    GNRL_FAC_TYPE_CD
     COBOL Name:  GNRL-FAC-TYPE-CD
     VALUES:      01=Hospital
                  02=Skilled Nursing Facility
                  03=Nursing Facility
                  04=Home Health Agency
                  05=Freestanding Hospice

   Compliance: LSC Waiver Indicator                  1    445   445  CHAR
     Description: Indicates if a waiver of any life safety code provision
                  has been recommended for a provider.
     SAS Name:    LSC_WVR_SW


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                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     COBOL Name:  LSC-WVR-SW

   Fiscal Year End Date (MMDD)                       4    464   467  VARCHAR2
     Description: End date, consisting of the month and day, of the
                  provider's fiscal year.
     SAS Name:    FY_END_MO_DAY_CD
     COBOL Name:  FY-END-MO-DAY-CD

   Related Provider Number                           10   686   695  CHAR
     Description: Related provider number
     SAS Name:    RELATED_PROVIDER_NUMBER
     COBOL Name:  RELATED-PROVIDER-NUMBER

   Services: Home Health Aide Code                   1    698   698  CHAR
     Description: Indicates how home health aide services are provided.
     SAS Name:    HH_AIDE_SRVC_CD
     COBOL Name:  HH-AIDE-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Services: Counseling Code                         1    717   717  VARCHAR2
     Description: Indicates how counseling services are provided by the
                  hospice.
     SAS Name:    CNSLNG_SRVC_CD
     COBOL Name:  CNSLNG-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Services: Homemaker Code                          1    737   737  VARCHAR2
     Description: Indicates how homemaker services are provided by the
                  hospice.
     SAS Name:    HMMKR_SRVC_CD
     COBOL Name:  HMMKR-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Services: Medical Social Code                     1    743   743  CHAR
     Description: Indicates how medical social services are provided.
     SAS Name:    MDCL_SCL_SRVC_CD
     COBOL Name:  MDCL-SCL-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Services: Medical Supplies Code                   1    744   744  VARCHAR2
     Description: Indicates how medical supply services are provided by the
                  hospice.
     SAS Name:    MDCL_SUPLY_SRVC_CD
     COBOL Name:  MDCL-SUPLY-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Services: Nursing Code                            1    759   759  CHAR
     Description: Indicates how nursing services are provided.
     SAS Name:    NRSNG_SRVC_CD


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 24
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     COBOL Name:  NRSNG-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Services: OT Code                                 1    775   775  CHAR
     Description: Indicates how occupational therapy services are provided.
     SAS Name:    OT_SRVC_CD
     COBOL Name:  OT-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Services: Other Code                              1    779   779  CHAR
     Description: Indicates how other services are provided.
     SAS Name:    OTHR_SRVC_CD
     COBOL Name:  OTHR-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Services: Physician Code                          1    795   795  VARCHAR2
     Description: Indicates how physician services are provided by the
                  hospice.
     SAS Name:    PHYSN_SRVC_CD
     COBOL Name:  PHYSN-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Services: PT Code                                 1    813   813  CHAR
     Description: Indicates how physical therapy services are provided.
     SAS Name:    PT_SRVC_CD
     COBOL Name:  PT-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Services: Short Term Inpatient Care Code          1    822   822  VARCHAR2
     Description: Indicates how short term inpatient care services are
                  provided by the hospice.
     SAS Name:    SHRT_TERM_IP_SRVC_CD
     COBOL Name:  SHRT-TERM-IP-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Services: Speech Pathology Code                   1    833   833  CHAR
     Description: Indicates how speech pathology services are provided.
     SAS Name:    SPCH_PTHLGY_SRVC_CD
     COBOL Name:  SPCH-PTHLGY-SRVC-CD
     VALUES:      0=NOT PROVIDED
                  1=PROVIDED BY STAFF
                  2=PROVIDED UNDER ARRANGEMENT
                  3=COMBINATION

   Short Term Inpatient Acute/Respite Care Code      1    860   860  VARCHAR2
     Description: Indicates the  type of short-term inpatient care provided


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 25
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  by the hospice.
     SAS Name:    ACUTE_RESP_CARE_CD
     COBOL Name:  ACUTE-RESP-CARE-CD
     VALUES:      A=SHORT TERM INPATIENT ACUTE CARE PROV'D IN HSP
                  B=SHORT TERM INPATIENT RESPITE CARE PROV IN HSP
                  C=ST INPATIENT ACUTE & RESPITE CARE PROV IN HSP

   Staff Count: Aide - Employee                      8    886   893  NUMBER
     Description: Number of full-time equivalent aides employed by the
                  hospice.
     SAS Name:    HH_AIDE_EMPLEE_CNT
     COBOL Name:  HH-AIDE-EMPLEE-CNT

   Staff Count: Aide - Volunteer                     8    894   901  NUMBER
     Description: Number of full-time equivalent aides volunteering in a
                  hospice.
     SAS Name:    HH_AIDE_VLNTR_CNT
     COBOL Name:  HH-AIDE-VLNTR-CNT

   Staff Count: Other Personnel                      8    902   909  NUMBER
     Description: Number of full-time equivalent other personnel employed
                  by a provider
     SAS Name:    PRSNEL_OTHR_CNT
     COBOL Name:  PRSNEL-OTHR-CNT

   Staff Count: Counselor - Employee                 8    934   941  NUMBER
     Description: Number of full-time equivalent counselors employed by the
                  hospice.
     SAS Name:    CNSLR_EMPLEE_CNT
     COBOL Name:  CNSLR-EMPLEE-CNT

   Staff Count: Counselor - Volunteer                8    942   949  NUMBER
     Description: Number of full-time equivalent counselors volunteering in
                  a Hospice.
     SAS Name:    CNSLR_VLNTR_CNT
     COBOL Name:  CNSLR-VLNTR-CNT

   Staff Count: Homemaker - Employee                 8    1054  1061 NUMBER
     Description: Number of full-time equivalent homemakers employed by the
                  hospice.
     SAS Name:    HMMKR_EMPLEE_CNT
     COBOL Name:  HMMKR-EMPLEE-CNT

   Staff Count: Homemaker - Volunteer                8    1062  1069 NUMBER
     Description: Number of full-time equivalent homemaker volunteering in
                  a hospice.
     SAS Name:    HMMKR_VLNTR_CNT
     COBOL Name:  HMMKR-VLNTR-CNT

   Staff Count: LPN/LVN - Employee                   8    1110  1117 NUMBER
     Description: Number of full-time equivalent licensed practical or
                  vocational nurses employed by a provider.
     SAS Name:    LPN_LVN_CNT
     COBOL Name:  LPN-LVN-CNT

   Staff Count: LPN/LVN - Volunteer                  8    1142  1149 NUMBER
     Description: Number of full-time equivalent licensed practical or
                  vocational nurses volunteering in the hospice.
     SAS Name:    LPN_LVN_VLNTR_CNT
     COBOL Name:  LPN-LVN-VLNTR-CNT

   Staff Count: Medical Social Worker - Employee     8    1174  1181 NUMBER
     Description: Number of full-time equivalent medical social workers
                  employed by a provider.


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 26
                  Hospice, CATEGORY = "16" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     SAS Name:    MDCL_SCL_WORKR_CNT
     COBOL Name:  MDCL-SCL-WORKR-CNT

   Staff Count: Medical Social Worker - Volunteer    8    1182  1189 NUMBER
     Description: Number of full-time equivalent medical social workers
                  volunteering in the hospice.
     SAS Name:    MDCL_SCL_WORKR_VLNTR_CNT
     COBOL Name:  MDCL-SCL-WORKR-VLNTR-CNT

   Staff Count: Other - Volunteer                    8    1390  1397 NUMBER
     Description: Number of full-time equivalent others volunteering in the
                  hospice.
     SAS Name:    VLNTR_OTHR_CNT
     COBOL Name:  VLNTR-OTHR-CNT

   Staff Count: Physician - Employee                 8    1542  1549 NUMBER
     Description: Number of full-time equivalent physicians employed by a
                  provider.
     SAS Name:    PHYSN_CNT
     COBOL Name:  PHYSN-CNT

   Staff Count: Physician - Volunteer                8    1550  1557 NUMBER
     Description: Number of full-time equivalent physicians volunteering in
                  a hospice.
     SAS Name:    PHYSN_VLNTR_CNT
     COBOL Name:  PHYSN-VLNTR-CNT

   Staff Count: RN                                   8    1750  1757 NUMBER
     Description: Number of full-time equivalent registered nurses employed
                  by a provider.
     SAS Name:    RN_CNT
     COBOL Name:  RN-CNT

   Staff Count: RN - Volunteer                       8    1782  1789 NUMBER
     Description: Number of full-time equivalent registered nurses
                  volunteering in a hospice.
     SAS Name:    RN_VLNTR_CNT
     COBOL Name:  RN-VLNTR-CNT

   Staff Count: Total - Employee                     9    1934  1942 NUMBER
     Description: Total number of full-time equivalent employees of a
                  provider.
     SAS Name:    EMPLEE_CNT
     COBOL Name:  EMPLEE-CNT

   Staff Count: Total - Volunteer                    9    1943  1951 NUMBER
     Description: Number of full-time equivalent volunteers in the hospice.
     SAS Name:    VLNTR_CNT
     COBOL Name:  VLNTR-CNT

















 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 1
      Organ Procurement Organization, CATEGORY = "17" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Provider Category Subtype Code                    2    1     2    VARCHAR2
     Description: Identifies the subtype of the provider, within the
                  primary category.  Used in reporting to show the
                  breakdown of provider categories, mainly for hospitals
                  and SNFs.
     SAS Name:    PRVDR_CTGRY_SBTYP_CD
     COBOL Name:  PRVDR-CTGRY-SBTYP-CD
     VALUES:      01=Organ Procurement

   Provider Category Code                            2    3     4    VARCHAR2
     Description: Identifies the type of provider participating in the
                  Medicare/Medicaid program.
     SAS Name:    PRVDR_CTGRY_CD
     COBOL Name:  PRVDR-CTGRY-CD
     VALUES:      17=Organ Procurement Organization

   CHOW Count                                        2    5     6    NUMBER
     Description: Number of times this provider has undergone a change of
                  ownership.
     SAS Name:    CHOW_CNT
     COBOL Name:  CHOW-CNT

   CHOW Date                                         8    7     14   DATE
     Description: Effective date of the most recent change of ownership for
                  this provider.
     SAS Name:    CHOW_DT
     COBOL Name:  CHOW-DT

   Address: City                                     28   15    42   VARCHAR2
     Description: City in which the provider is physically located.
     SAS Name:    CITY_NAME
     COBOL Name:  CITY-NAME

   Compliance: Acceptable POC                        1    43    43   VARCHAR2
     Description: Indicates if a provider is in compliance with program
                  requirements based on an acceptable plan for correction
                  of deficiencies.
     SAS Name:    ACPTBL_POC_SW
     COBOL Name:  ACPTBL-POC-SW

   Compliance: Status                                1    44    44   VARCHAR2
     Description: Compliance status of a provider at the time of
                  certification survey.
     SAS Name:    CMPLNC_STUS_CD
     COBOL Name:  CMPLNC-STUS-CD
     VALUES:      A=IN COMPLIANCE
                  B=NOT IN COMPLIANCE

   SSA County Code                                   3    45    47   VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the county where the provider is located.
     SAS Name:    SSA_CNTY_CD
     COBOL Name:  SSA-CNTY-CD

   Cross Ref Provider Number                         10   48    57   CHAR
     Description: Cross reference provider number
     SAS Name:    CROSS_REF_PROVIDER_NUMBER
     COBOL Name:  CROSS-REF-PROVIDER-NUMBER

   Certification Date                                8    58    65   DATE
     Description: Equal to the exit date of the initial visit of the Health
                  survey for certifications completed after July 28, 2012.
                  For certifications prior to that date, the certification


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 2
      Organ Procurement Organization, CATEGORY = "17" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  date is equal to the exit date of the initial visit of
                  the Health survey or LSC survey, whichever is later.
     SAS Name:    CRTFCTN_DT
     COBOL Name:  CRTFCTN-DT

   Eligibility Indicator                             1    66    66   VARCHAR2
     Description: Indicates if a facility is eligible to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    ELGBLTY_SW
     COBOL Name:  ELGBLTY-SW

   Facility Name                                     50   67    116  VARCHAR2
     Description: Name of the provider certified to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    FAC_NAME
     COBOL Name:  FAC-NAME

   Medicare Administrative Contractor (MAC) or       5    117   121  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_CD
     COBOL Name:  INTRMDRY-CARR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 3
      Organ Procurement Organization, CATEGORY = "17" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 4
      Organ Procurement Organization, CATEGORY = "17" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 5
      Organ Procurement Organization, CATEGORY = "17" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 6
      Organ Procurement Organization, CATEGORY = "17" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)
                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 7
      Organ Procurement Organization, CATEGORY = "17" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   Medicaid Vendor Number                            15   122   136  VARCHAR2
     Description: Number which may be assigned to a provider by the state
                  Medicaid agency for external control or billing purposes.
     SAS Name:    MDCD_VNDR_NUM
     COBOL Name:  MDCD-VNDR-NUM

   Original Participation Date                       8    137   144  DATE
     Description: Date a provider is first approved to provide Medicare
                  and/or Medicaid services.
     SAS Name:    ORGNL_PRTCPTN_DT
     COBOL Name:  ORGNL-PRTCPTN-DT

   Prior CHOW Date                                   8    145   152  DATE
     Description: Effective date of the previous change of ownership for
                  this provider.
     SAS Name:    CHOW_PRIOR_DT
     COBOL Name:  CHOW-PRIOR-DT

   Prior Medicare Administrative Contractor (MAC) or 5    153   157  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the previous Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_PRIOR_CD
     COBOL Name:  INTRMDRY-CARR-PRIOR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 8
      Organ Procurement Organization, CATEGORY = "17" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 9
      Organ Procurement Organization, CATEGORY = "17" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 10
      Organ Procurement Organization, CATEGORY = "17" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 11
      Organ Procurement Organization, CATEGORY = "17" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 12
      Organ Procurement Organization, CATEGORY = "17" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   CCN                                               10   158   167  VARCHAR2
     Description: Six or ten position identification number that is
                  assigned to a certified provider.  This is the CMS
                  Certification Number.
     SAS Name:    PRVDR_NUM
     COBOL Name:  PRVDR-NUM

   Region Code                                       2    168   169  VARCHAR2
     Description: Indicates the CMS Regional Office responsible for the
                  certification of the provider.
     SAS Name:    RGN_CD
     COBOL Name:  RGN-CD
     VALUES:      01=Boston
                  02=New York
                  03=Philadelphia
                  04=Atlanta
                  05=Chicago
                  06=Dallas
                  07=Kansas City
                  08=Denver
                  09=San Francisco
                  10=Seattle

   Skeleton Record Indicator                         1    170   170  VARCHAR2
     Description: Indicates if the record is a skeleton record.  Only a
                  limited set of data is available for this provider; no
                  survey data exists.  Only provider categories
                  01,17,19,21and 22 can have skeleton providers.
     SAS Name:    SKLTN_REC_SW
     COBOL Name:  SKLTN-REC-SW

   State Abbreviation                                2    171   172  VARCHAR2
     Description: Two-character state abbreviation.
     SAS Name:    STATE_CD
     COBOL Name:  STATE-CD
     VALUES:      AK=ALASKA
                  AL=ALABAMA
                  AR=ARKANSAS
                  AS=AMERICAN SAMOA
                  AZ=ARIZONA
                  CA=CALIFORNIA
                  CN=CANADA
                  CO=COLORADO
                  CT=CONNECTICUT
                  DC=DISTRICT OF COLUMBIA
                  DE=DELAWARE
                  FL=FLORIDA
                  FN=INTERNATIONAL
                  GA=GEORGIA
                  GU=GUAM
                  HI=HAWAII
                  IA=IOWA
                  ID=IDAHO


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 13
      Organ Procurement Organization, CATEGORY = "17" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  IL=ILLINOIS
                  IN=INDIANA
                  KS=KANSAS
                  KY=KENTUCKY
                  LA=LOUISIANA
                  MA=MASSACHUSETTS
                  MD=MARYLAND
                  ME=MAINE
                  MI=MICHIGAN
                  MN=MINNESOTA
                  MO=MISSOURI
                  MP=SAIPAN
                  MS=MISSISSIPPI
                  MT=MONTANA
                  MX=MEXICO
                  NC=NORTH CAROLINA
                  ND=NORTH DAKOTA
                  NE=NEBRASKA
                  NH=NEW HAMPSHIRE
                  NJ=NEW JERSEY
                  NM=NEW MEXICO
                  NV=NEVADA
                  NY=NEW YORK
                  OH=OHIO
                  OK=OKLAHOMA
                  OR=OREGON
                  PA=PENNSYLVANIA
                  PR=PUERTO RICO
                  RI=RHODE ISLAND
                  SC=SOUTH CAROLINA
                  SD=SOUTH DAKOTA
                  TN=TENNESSEE
                  TX=TEXAS
                  UT=UTAH
                  VA=VIRGINIA
                  VI=VIRGIN ISLANDS
                  VT=VERMONT
                  WA=WASHINGTON
                  WI=WISCONSIN
                  WV=WEST VIRGINIA
                  WY=WYOMING

   SSA State Code                                    2    173   174  VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the state where the provider is located.
     SAS Name:    SSA_STATE_CD
     COBOL Name:  SSA-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  03=ARIZONA
                  04=ARKANSAS
                  05=CALIFORNIA
                  06=COLORADO
                  07=CONNECTICUT
                  08=DELAWARE
                  09=DISTRICT OF COLUMBIA
                  10=FLORIDA
                  11=GEORGIA
                  12=HAWAII
                  13=IDAHO
                  14=ILLINOIS
                  15=INDIANA
                  16=IOWA
                  17=KANSAS


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 14
      Organ Procurement Organization, CATEGORY = "17" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  18=KENTUCKY
                  19=LOUISIANA
                  20=MAINE
                  21=MARYLAND
                  22=MASSACHUSETTS
                  23=MICHIGAN
                  24=MINNESOTA
                  25=MISSISSIPPI
                  26=MISSOURI
                  27=MONTANA
                  28=NEBRASKA
                  29=NEVADA
                  30=NEW HAMPSHIRE
                  31=NEW JERSEY
                  32=NEW MEXICO
                  33=NEW YORK
                  34=NORTH CAROLINA
                  35=NORTH DAKOTA
                  36=OHIO
                  37=OKLAHOMA
                  38=OREGON
                  39=PENNSYLVANIA
                  40=PUERTO RICO
                  41=RHODE ISLAND
                  42=SOUTH CAROLINA
                  43=SOUTH DAKOTA
                  44=TENNESSEE
                  45=TEXAS
                  46=UTAH
                  47=VERMONT
                  48=VIRGIN ISLANDS
                  49=VIRGINIA
                  50=WASHINGTON
                  51=WEST VIRGINIA
                  52=WISCONSIN
                  53=WYOMING
                  54=AFRICA
                  56=CANADA
                  57=WEST INDIES
                  58=EUROPE
                  59=MEXICO
                  60=OCEANIA
                  61=PHILIPPINES
                  62=SOUTH AMERICA
                  63=UNITED STATES POSSESSIONS
                  64=AMERICAN SAMOA
                  65=GUAM
                  66=SAIPAN
                  99=INTERNATIONAL

   State Region Code                                 3    175   177  VARCHAR2
     Description: Identifies the region within a state where the provider
                  is located.
     SAS Name:    STATE_RGN_CD
     COBOL Name:  STATE-RGN-CD
     VALUES:      AK/001=ALASKA
                  AK/LAB=LABORATORIES
                  AK/NPH=NON-PARTICIPATING HOSPITAL
                  AL/001=ALABAMA
                  AL/LAB=LABORATORIES
                  AL/NPH=NON-PARTICIPATING HOSPITAL
                  AR/001=ARKANSAS
                  AR/LAB=LABORATORIES
                  AR/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 15
      Organ Procurement Organization, CATEGORY = "17" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  AS/001=AMERICAN SAMOA
                  AS/LAB=LABORATORY
                  AS/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/AZ=PHOENIX
                  AZ/LAB=ARIZONA LAB
                  AZ/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/TUC=TUCSON
                  CA/001=CALIFORNIA
                  CA/BAK=BAKERSFIELD
                  CA/BER=SAN BERNARDINO
                  CA/EB=East Bay
                  CA/FR=FRESNO
                  CA/L1=L.A. WEST
                  CA/L2=L.A. NORTH
                  CA/L3=L.A. CENTRAL
                  CA/L4=L.A. EAST
                  CA/L5=SAN GABRIEL
                  CA/LA1=LA Region 1
                  CA/LA2=LA Region 2
                  CA/LA3=LA Region 3
                  CA/LA4=LA Acute/Ancillary
                  CA/LA5=LA HHA/Hospice
                  CA/LA6=LA ICF/DD/CLinics
                  CA/LAB=LABORATORIES
                  CA/M1=LAB. SOUTH
                  CA/M2=LAB. NORTH
                  CA/NPH=NON-PARTICIPATING HOSPITAL
                  CA/ORG=ORANGE
                  CA/RIV=RIVERSIDE
                  CA/S1=SACRAMENTO
                  CA/S3=CHICO
                  CA/SD=SAN DIEGO
                  CA/SF=SAN FRANCISCO
                  CA/SJ=SAN JOSE
                  CA/SR=SANTA ROSA
                  CA/VEN=VENTURA
                  CN/001=CANADA
                  CN/LAB=LABORATORY
                  CN/NPH=NON-PARTICIPATING HOSPITAL
                  CO/001=COLORADO
                  CO/LAB=LABORATORIES
                  CO/NPH=NON-PARTICIPATING HOSPITAL
                  CT/001=CONNECTICUT
                  CT/LAB=LABORATORIES
                  CT/NPH=NON-PARTICIPATING HOSPITAL
                  DC/001=DISTRICT OF COLUMBIA
                  DC/LAB=LABORATORIES
                  DC/NPH=NON-PARTICIPATING HOSPITAL
                  DE/001=DELAWARE
                  DE/LAB=LABORATORIES
                  DE/NPH=NON-PARTICIPATING HOSPITAL
                  FL/001=FLORIDA
                  FL/FTM=FT. MYERS
                  FL/GAI=GAINESVILLE
                  FL/JAX=JACKSONVILLE
                  FL/LAB=LABORATORIES
                  FL/LAN=LANTANA
                  FL/LAU=LAUDERHILL
                  FL/MIA=MIAMI
                  FL/NPH=NON-PARTICIPATING HOSPITAL
                  FL/ORL=ORLANDO
                  FL/PEN=PENSACOLA
                  FL/STP=ST. PETERSBURG
                  FL/TAL=TALLAHASSEE


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 16
      Organ Procurement Organization, CATEGORY = "17" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  FL/TAM=TAMPA
                  FM/001=FEDERATED STATES OF MICRO
                  FM/NPH=NON-PARTICIPATING HOSPITAL
                  FN/001=INTERNATIONAL
                  FN/LAB=LABORATORIES
                  FN/NPH=NON-PARTICIPATING HOSPITAL
                  GA/001=GEORGIA
                  GA/GAA=GEORGIA ALL
                  GA/GAC=GEORGIA CENTRAL
                  GA/GAE=GEORGIA EASTERN
                  GA/GAN=GEORGIA NORTH
                  GA/GAS=GEORGIA SOUTH
                  GA/GAW=GEORGIA WESTERN
                  GA/LAB=LABORATORIES
                  GA/NPH=NON-PARTICIPATING HOSPITAL
                  GU/001=GUAM
                  GU/LAB=LABORATORIES
                  GU/NPH=NON-PARTICIPATING HOSPITAL
                  HI/001=HAWAII
                  HI/LAB=LABORATORIES
                  HI/NPH=NON-PARTICIPATING HOSPITAL
                  IA/001=IOWA
                  IA/LAB=LABORATORIES
                  IA/NPH=NON-PARTICIPATING HOSPITAL
                  ID/001=IDAHO
                  ID/LAB=LABORATORIES
                  ID/NPH=NON-PARTICIPATING HOSPITAL
                  IL/001=ILLINOIS
                  IL/LAB=LABORATORIES
                  IL/NPH=NON-PARTICIPATING HOSPITAL
                  IN/001=INDIANA
                  IN/LAB=LABORATORIES
                  IN/NPH=NON-PARTICIPATING HOSPITAL
                  KS/001=KANSAS
                  KS/KCK=KANSAS CITY
                  KS/KDH=KDHE
                  KS/LAB=LABORATORIES
                  KS/LAW=LAWRENCE
                  KS/NC=NORTH CENTRAL KANSAS
                  KS/NE=NORTH EAST KANSAS
                  KS/NPH=NON-PARTICIPATING HOSPITAL
                  KS/NW=NORTH WEST KANSAS
                  KS/SC=SOUTH CENTRAL KANSAS
                  KS/SE=SOUTH EAST KANSAS
                  KS/SW=SOUTH WEST KANSAS
                  KS/WST=WEST
                  KY/2C1=HOPKINSVILLE
                  KY/2C2=LOUISVILLE
                  KY/2C3=LONDON
                  KY/2C4=LEXINGTON
                  KY/LAB=LABORATORIES
                  KY/NPH=NON-PARTICIPATING HOSPITAL
                  LA/001=LOUISIANA
                  LA/LA1=NEW ORLEANS
                  LA/LA2=MANDEVILLE
                  LA/LA3=LAFAYETTE
                  LA/LA4=MONROE
                  LA/LA5=SHREVEPORT
                  LA/LA6=ALEXANDRIA
                  LA/LAB=LABORATORIES
                  LA/LB1=CLIA NEW ORLEANS
                  LA/LB5=CLIA SHREVEPORT
                  LA/LB6=CLIA ALEXANDRIA
                  LA/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 17
      Organ Procurement Organization, CATEGORY = "17" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  MA/001=MASSACHUSETTS
                  MA/LAB=LABORATORIES
                  MA/NPH=NON-PARTICIPATING HOSPITAL
                  MD/001=MARYLAND
                  MD/LAB=LABORATORIES
                  MD/NPH=NON-PARTICIPATING HOSPITAL
                  ME/001=MAINE
                  ME/LAB=LABORATORIES
                  ME/NPH=NON-PARTICIPATING HOSPITAL
                  MH/001=MARSHALL ISLANDS
                  MH/NPH=NON-PARTICIPATING HOSPITAL
                  MI/001=MICHIGAN
                  MI/LAB=LABORATORIES
                  MI/NPH=NON-PARTICIPATING HOSPITAL
                  MN/001=MINNESOTA
                  MN/LAB=LABORATORIES
                  MN/NPH=NON-PARTICIPATING HOSPITAL
                  MO/001=MISSOURI
                  MO/01=REGION01
                  MO/02=REGION02
                  MO/03=REGION 03
                  MO/04=REGION 04
                  MO/05=REGION 05
                  MO/06=REGION 06
                  MO/07=REGION 07
                  MO/1NH=REGION 1 NH
                  MO/2NH=REGION 2 NH
                  MO/3NH=REGION 3 NH
                  MO/4NH=REGION 4 NH
                  MO/5NH=REGION 5 NH
                  MO/6NH=REGION 6 NH
                  MO/7NH=REGION 7 NH
                  MO/LAB=LABORATORIES
                  MO/MO=STATEWIDE
                  MO/NPH=NON-PARTICIPATING HOSPITAL
                  MP/001=NORTHERN MARIANA ISLANDS
                  MP/LAB=LABORATORIES
                  MP/NPH=NON-PARTICIPATING HOSPITAL
                  MS/001=MISSISSIPPI
                  MS/LAB=LABORATORIES
                  MS/NPH=NON-PARTICIPATING HOSPITAL
                  MT/001=MONTANA
                  MT/LAB=LABORATORIES
                  MT/NPH=NON-PARTICIPATING HOSPITAL
                  MX/001=MEXICO
                  MX/LAB=LABORATORY
                  MX/NPH=NON-PARTICIPATING HOSPITAL
                  NC/001=NORTH CAROLINA
                  NC/LAB=LABORATORIES
                  NC/NCC=NORTH CAROLINA CENTRAL
                  NC/NCE=NORTH CAROLINA EAST
                  NC/NCN=NORTH CAROLINA NORTH
                  NC/NCS=NORTH CAROLINA SOUTH
                  NC/NCW=NORTH CAROLINA WEST
                  NC/NPH=NON-PARTICIPATING HOSPITAL
                  ND/001=NORTH DAKOTA
                  ND/LAB=LABORATORIES
                  ND/NPH=NON-PARTICIPATING HOSPITAL
                  NE/001=NEBRASKA
                  NE/1=NORTH CENTRAL
                  NE/2=CENTRAL
                  NE/3=NORTHEAST
                  NE/4=SOUTHEAST
                  NE/5=WESTERN


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 18
      Organ Procurement Organization, CATEGORY = "17" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  NE/LAB=LABORATORIES
                  NE/NPH=NON-PARTICIPATING HOSPITAL
                  NH/001=NEW HAMPSHIRE
                  NH/LAB=LABORATORIES
                  NH/NPH=NON-PARTICIPATING HOSPITAL
                  NJ/001=NEW JERSEY
                  NJ/LAB=LABORATORIES
                  NJ/NPH=NON-PARTICIPATING HOSPITAL
                  NM/001=NEW MEXICO
                  NM/LAB=LABORATORIES
                  NM/NPH=NON-PARTICIPATING HOSPITAL
                  NV/001=NEVADA
                  NV/CC=CARSON CITY
                  NV/LAB=LABORATORIES
                  NV/LV=LAS VEGAS
                  NV/NPH=NON-PARTICIPATING HOSPITAL
                  NY/001=BUFFALO
                  NY/002=ROCHESTER
                  NY/003=SYRACUSE
                  NY/004=ALBANY
                  NY/005=NEW ROCHELLE
                  NY/006=NEW YORK CITY
                  NY/007=SUFFOLK/NASSAU COUNTY
                  NY/LAB=LABORATORIES
                  NY/NPH=NON-PARTICIPATING HOSPITAL
                  OH/001=OHIO
                  OH/LAB=LABORATORIES
                  OH/NPH=NON-PARTICIPATING HOSPITAL
                  OK/001=OKLAHOMA
                  OK/LAB=LABORATORIES
                  OK/NPH=NON-PARTICIPATING HOSPITAL
                  OR/001=OFFICE #1
                  OR/002=OFFICE #2
                  OR/003=OFFICE #3
                  OR/LAB=LABORATORIES
                  OR/NPH=NON-PARTICIPATING HOSPITAL
                  PA/001=PENNSYLVANIA
                  PA/LAB=LABORATORIES
                  PA/NPH=NON-PARTICIPATING HOSPITAL
                  PR/001=PUERTO RICO
                  PR/LAB=LABORATORIES
                  PR/NPH=NON-PARTICIPATING HOSPITAL
                  PW/001=PALAU
                  PW/NPH=NON-PARTICIPATING HOSPITAL
                  RI/001=RHODE ISLAND
                  RI/LAB=LABORATORIES
                  RI/NPH=NON-PARTICIPATING HOSPITAL
                  SC/001=SOUTH CAROLINA
                  SC/LAB=LABORATORIES
                  SC/NPH=NON-PARTICIPATING HOSPITAL
                  SD/001=SOUTH DAKOTA
                  SD/LAB=LABORATORIES
                  SD/NPH=NON-PARTICIPATING HOSPITAL
                  TN/001=TENNESSEE
                  TN/LAB=LABORATORIES
                  TN/NPH=NON-PARTICIPATING HOSPITAL
                  TN/TNC=TENNESSEE COOKEVILLE
                  TN/TNE=TENNESSEE EASTERN
                  TN/TNM=TENNESSEE MIDDLE
                  TN/TNW=TENNESSEE WESTERN
                  TX/001=TEXAS
                  TX/L01=AMARILLO-LTC
                  TX/L02=ABILENE-LTC
                  TX/L03=ARLINGTON-LTC


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 19
      Organ Procurement Organization, CATEGORY = "17" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  TX/L04=TYLER-LTC
                  TX/L05=TEMPLE-LTC
                  TX/L06=HOUSTON-LTC
                  TX/L07=SAN ANTONIO-LTC
                  TX/LAB=LABORATORIES
                  TX/NPH=NON-PARTICIPATING HOSPITAL
                  TX/TX1=NLTC REG 1, 7, 9, 10
                  TX/TX2=NLTC REG 2, 3
                  TX/TX4=NLTC REG 6
                  TX/TX5=NLTC REG 4, 5
                  TX/TX6=AUSTIN
                  TX/TX8=NLTC REG 8, 11
                  UT/001=UTAH
                  UT/LAB=LABORATORIES
                  UT/NPH=NON-PARTICIPATING HOSPITAL
                  VA/001=VIRGINIA
                  VA/LAB=LABORATORIES
                  VA/NPH=NON-PARTICIPATING HOSPITAL
                  VI/001=VIRGIN ISLANDS
                  VI/LAB=LABORATORIES
                  VI/NPH=NON-PARTICIPATING HOSPITAL
                  VT/001=VERMONT
                  VT/LAB=LABORATORIES
                  VT/NPH=NON-PARTICIPATING HOSPITAL
                  WA/001=ALL OTHERS (NON-LTC FAC)
                  WA/D1=SPOKANE & YAKIMA AREAS
                  WA/D1A=District 1, Unit A
                  WA/D1B=District 1, Unit B
                  WA/D1C=District 1, Unit C
                  WA/D1D=District 1, Unit D
                  WA/D1E=District 1, Unit E
                  WA/D2=SPOKANE & SE
                  WA/D2A=District 2, Unit A
                  WA/D2B=District 2, Unit B
                  WA/D2C=District 2, Unit C
                  WA/D2D=District 2, Unit D
                  WA/D2E=District 2, Unit E
                  WA/D2F=District 2, Unit F
                  WA/D2G=District 2, Unit G
                  WA/D2H=District 2, Unit H
                  WA/D2I=District 2, Unit I
                  WA/D2J=District 2, Unit J
                  WA/D3=NW WASHINGTON
                  WA/D3A=District 3, Unit A
                  WA/D3B=District 3, Unit B
                  WA/D3C=District 3, Unit C
                  WA/D3D=District 3, Unit D
                  WA/D3E=District 3, Unit E
                  WA/D3F=District 3, Unit F
                  WA/D3G=District 3, Unit G
                  WA/D4A=GREATER SEATTLE AREA
                  WA/D4B=S KING COUNTY
                  WA/D5A=PIERCE CTY & PENINSULA
                  WA/D5B=PIERCE CTY & GRAYS HARBOR
                  WA/D6=OLYMPIA AREA
                  WA/LAB=LABORATORIES
                  WA/NPH=NON-PARTICIPATING HOSPITAL
                  WI/001=WISCONSIN
                  WI/LAB=LABORATORIES
                  WI/NPH=NON-PARTICIPATING HOSPITAL
                  WV/001=WEST VIRGINIA
                  WV/LAB=LABORATORIES
                  WV/NPH=NON-PARTICIPATING HOSPITAL
                  WY/001=WYOMING


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 20
      Organ Procurement Organization, CATEGORY = "17" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  WY/LAB=LABORATORIES
                  WY/NPH=NON-PARTICIPATING HOSPITAL

   Address: Street                                   50   178   227  VARCHAR2
     Description: Street address where the provider is located.
     SAS Name:    ST_ADR
     COBOL Name:  ST-ADR

   Telephone Number                                  10   228   237  VARCHAR2
     Description: Telephone number of the provider.
     SAS Name:    PHNE_NUM
     COBOL Name:  PHNE-NUM

   Termination Code                                  2    238   239  VARCHAR2
     Description: Indicates the current termination status for the
                  provider.
     SAS Name:    PGM_TRMNTN_CD
     COBOL Name:  PGM-TRMNTN-CD
     VALUES:      00=ACTIVE PROVIDER
                  01=VOLUNTARY-MERGER, CLOSURE
                  02=VOLUNTARY-DISSATISFACTION WITH REIMBURSEMENT
                  03=VOLUNTARY-RISK OF INVOLUNTARY TERMINATION
                  04=VOLUNTARY-OTHER REASON FOR WITHDRAWAL
                  05=INVOLUNTARY-FAILURE TO MEET HEALTH/SAFETY REQ
                  06=INVOLUNTARY-FAILURE TO MEET AGREEMENT
                  07=OTHER-PROVIDER STATUS CHANGE
                  08=NONPAYMENT OF FEES - CLIA Only
                  09=REV/UNSUCCESSFUL PARTICIPATION IN PT - CLIA Only
                  10=REV/OTHER REASON - CLIA Only
                  11=INCOMPLETE CLIA APPLICATION INFORMATION - CLIA Only
                  12=NO LONGER PERFORMING TESTS - CLIA Only
                  13=MULTIPLE TO SINGLE SITE CERTIFICATE - CLIA Only
                  14=SHARED LABORATORY - CLIA Only
                  15=FAILURE TO RENEW WAIVER PPM CERTIFICATE - CLIA Only
                  16=DUPLICATE CLIA NUMBER - CLIA Only
                  17=MAIL RETURNED NO FORWARD ADDRESS CERT ENDED - CLIA Only
                  20=NOTIFICATION BANKRUPTCY - CLIA Only
                  33=ACCREDITATION NOT CONFIRMED - CLIA Only
                  80=AWAITING STATE APPROVAL
                  99=OIG ACTION - DO NOT ACTIVATE - CLIA Only

   Termination or Expiration Date                    8    240   247  DATE
     Description: Date the provider was terminated.  For CLIA providers,
                  date the laboratory's certificate was terminated or the
                  expiration date of the current CLIA certificate.
     SAS Name:    TRMNTN_EXPRTN_DT
     COBOL Name:  TRMNTN-EXPRTN-DT

   Type of Action Code                               1    248   248  VARCHAR2
     Description: Identifies the reason for the certification.  Type of
                  action from the official survey record, CMS 1539 form.
     SAS Name:    CRTFCTN_ACTN_TYPE_CD
     COBOL Name:  CRTFCTN-ACTN-TYPE-CD
     VALUES:      1=INITIAL
                  2=RECERTIFICATION
                  3=TERMINATION
                  4=CHANGE OF OWNERSHIP
                  5=VALIDATION
                  8=FULL SURVEY AFTER COMPLAINT

   Ownership Type Code                               2    249   250  VARCHAR2
     Description: Indicates the ownership type of the provider.
     SAS Name:    GNRL_CNTL_TYPE_CD
     COBOL Name:  GNRL-CNTL-TYPE-CD


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 21
      Organ Procurement Organization, CATEGORY = "17" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Address: ZIP Code                                 5    251   255  VARCHAR2
     Description: Five-digit ZIP code for a provider's physical address.
     SAS Name:    ZIP_CD
     COBOL Name:  ZIP-CD

   FIPS State Code                                   2    256   257  VARCHAR2
     Description: FIPS State Code
     SAS Name:    FIPS_STATE_CD
     COBOL Name:  FIPS-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  04=ARIZONA
                  05=ARKANSAS
                  06=CALIFORNIA
                  08=COLORADO
                  09=CONNECTICUT
                  10=DELAWARE
                  11=DISTRICT OF COLUMBIA
                  12=FLORIDA
                  13=GEORGIA
                  15=HAWAII
                  16=IDAHO
                  17=ILLINOIS
                  18=INDIANA
                  19=IOWA
                  20=KANSAS
                  21=KENTUCKY
                  22=LOUISIANA
                  23=MAINE
                  24=MARYLAND
                  25=MASSACHUSETTS
                  26=MICHIGAN
                  27=MINNESOTA
                  28=MISSISSIPPI
                  29=MISSOURI
                  30=MONTANA
                  31=NEBRASKA
                  32=NEVADA
                  33=NEW HAMPSHIRE
                  34=NEW JERSEY
                  35=NEW MEXICO
                  36=NEW YORK
                  37=NORTH CAROLINA
                  38=NORTH DAKOTA
                  39=OHIO
                  40=OKLAHOMA
                  41=OREGON
                  42=PENNSYLVANIA
                  43=PUERTO RICO
                  44=RHODE ISLAND
                  45=SOUTH CAROLINA
                  46=SOUTH DAKOTA
                  47=TENNESSEE
                  48=TEXAS
                  49=UTAH
                  50=VERMONT
                  51=VIRGINIA
                  53=WASHINGTON
                  54=WEST VIRGINIA
                  55=WISCONSIN
                  56=WYOMING
                  60=AMERICAN SAMOA
                  66=GUAM


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 22
      Organ Procurement Organization, CATEGORY = "17" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  69=SAIPAN/MARIANA IS.
                  78=VIRGIN ISLANDS

   FIPS County Code                                  3    258   260  VARCHAR2
     Description: FIPS County Code
     SAS Name:    FIPS_CNTY_CD
     COBOL Name:  FIPS-CNTY-CD

   CBSA Urban Rural Indicator                        1    261   261  VARCHAR2
     Description: CBSA (Core Based Statistical Area) indicates whether the
                  county is defined as Urban or Rural.
     SAS Name:    CBSA_URBN_RRL_IND
     COBOL Name:  CBSA-URBN-RRL-IND

   CBSA Code                                         5    262   266  VARCHAR2
     Description: CBSA (Core Based Statistical Area) geographic entities
                  defined by the U.S. Office of Management and Budget (OMB)
                  on June 6, 2003 for use by Federal statistical agencies
                  in collecting, tabulating, and publishing Federal
                  statistics.  CBSA collectively refers to MSA.
     SAS Name:    CBSA_CD
     COBOL Name:  CBSA-CD

   Fiscal Year End Date (MMDD)                       4    464   467  VARCHAR2
     Description: End date, consisting of the month and day, of the
                  provider's fiscal year.
     SAS Name:    FY_END_MO_DAY_CD
     COBOL Name:  FY-END-MO-DAY-CD






































 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 1
      Community Mental Health Center, CATEGORY = "19" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Provider Category Subtype Code                    2    1     2    VARCHAR2
     Description: Identifies the subtype of the provider, within the
                  primary category.  Used in reporting to show the
                  breakdown of provider categories, mainly for hospitals
                  and SNFs.
     SAS Name:    PRVDR_CTGRY_SBTYP_CD
     COBOL Name:  PRVDR-CTGRY-SBTYP-CD
     VALUES:      01=Community Mental Health Center

   Provider Category Code                            2    3     4    VARCHAR2
     Description: Identifies the type of provider participating in the
                  Medicare/Medicaid program.
     SAS Name:    PRVDR_CTGRY_CD
     COBOL Name:  PRVDR-CTGRY-CD
     VALUES:      19=Community Mental Health Center

   CHOW Count                                        2    5     6    NUMBER
     Description: Number of times this provider has undergone a change of
                  ownership.
     SAS Name:    CHOW_CNT
     COBOL Name:  CHOW-CNT

   CHOW Date                                         8    7     14   DATE
     Description: Effective date of the most recent change of ownership for
                  this provider.
     SAS Name:    CHOW_DT
     COBOL Name:  CHOW-DT

   Address: City                                     28   15    42   VARCHAR2
     Description: City in which the provider is physically located.
     SAS Name:    CITY_NAME
     COBOL Name:  CITY-NAME

   Compliance: Acceptable POC                        1    43    43   VARCHAR2
     Description: Indicates if a provider is in compliance with program
                  requirements based on an acceptable plan for correction
                  of deficiencies.
     SAS Name:    ACPTBL_POC_SW
     COBOL Name:  ACPTBL-POC-SW

   Compliance: Status                                1    44    44   VARCHAR2
     Description: Compliance status of a provider at the time of
                  certification survey.
     SAS Name:    CMPLNC_STUS_CD
     COBOL Name:  CMPLNC-STUS-CD
     VALUES:      A=IN COMPLIANCE
                  B=NOT IN COMPLIANCE

   SSA County Code                                   3    45    47   VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the county where the provider is located.
     SAS Name:    SSA_CNTY_CD
     COBOL Name:  SSA-CNTY-CD

   Cross Ref Provider Number                         10   48    57   CHAR
     Description: Cross reference provider number
     SAS Name:    CROSS_REF_PROVIDER_NUMBER
     COBOL Name:  CROSS-REF-PROVIDER-NUMBER

   Certification Date                                8    58    65   DATE
     Description: Equal to the exit date of the initial visit of the Health
                  survey for certifications completed after July 28, 2012.
                  For certifications prior to that date, the certification


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 2
      Community Mental Health Center, CATEGORY = "19" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  date is equal to the exit date of the initial visit of
                  the Health survey or LSC survey, whichever is later.
     SAS Name:    CRTFCTN_DT
     COBOL Name:  CRTFCTN-DT

   Eligibility Indicator                             1    66    66   VARCHAR2
     Description: Indicates if a facility is eligible to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    ELGBLTY_SW
     COBOL Name:  ELGBLTY-SW

   Facility Name                                     50   67    116  VARCHAR2
     Description: Name of the provider certified to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    FAC_NAME
     COBOL Name:  FAC-NAME

   Medicare Administrative Contractor (MAC) or       5    117   121  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_CD
     COBOL Name:  INTRMDRY-CARR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 3
      Community Mental Health Center, CATEGORY = "19" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 4
      Community Mental Health Center, CATEGORY = "19" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 5
      Community Mental Health Center, CATEGORY = "19" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 6
      Community Mental Health Center, CATEGORY = "19" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)
                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 7
      Community Mental Health Center, CATEGORY = "19" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   Medicaid Vendor Number                            15   122   136  VARCHAR2
     Description: Number which may be assigned to a provider by the state
                  Medicaid agency for external control or billing purposes.
     SAS Name:    MDCD_VNDR_NUM
     COBOL Name:  MDCD-VNDR-NUM

   Original Participation Date                       8    137   144  DATE
     Description: Date a provider is first approved to provide Medicare
                  and/or Medicaid services.
     SAS Name:    ORGNL_PRTCPTN_DT
     COBOL Name:  ORGNL-PRTCPTN-DT

   Prior CHOW Date                                   8    145   152  DATE
     Description: Effective date of the previous change of ownership for
                  this provider.
     SAS Name:    CHOW_PRIOR_DT
     COBOL Name:  CHOW-PRIOR-DT

   Prior Medicare Administrative Contractor (MAC) or 5    153   157  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the previous Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_PRIOR_CD
     COBOL Name:  INTRMDRY-CARR-PRIOR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 8
      Community Mental Health Center, CATEGORY = "19" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 9
      Community Mental Health Center, CATEGORY = "19" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 10
      Community Mental Health Center, CATEGORY = "19" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 11
      Community Mental Health Center, CATEGORY = "19" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 12
      Community Mental Health Center, CATEGORY = "19" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   CCN                                               10   158   167  VARCHAR2
     Description: Six or ten position identification number that is
                  assigned to a certified provider.  This is the CMS
                  Certification Number.
     SAS Name:    PRVDR_NUM
     COBOL Name:  PRVDR-NUM

   Region Code                                       2    168   169  VARCHAR2
     Description: Indicates the CMS Regional Office responsible for the
                  certification of the provider.
     SAS Name:    RGN_CD
     COBOL Name:  RGN-CD
     VALUES:      01=Boston
                  02=New York
                  03=Philadelphia
                  04=Atlanta
                  05=Chicago
                  06=Dallas
                  07=Kansas City
                  08=Denver
                  09=San Francisco
                  10=Seattle

   Skeleton Record Indicator                         1    170   170  VARCHAR2
     Description: Indicates if the record is a skeleton record.  Only a
                  limited set of data is available for this provider; no
                  survey data exists.  Only provider categories
                  01,17,19,21and 22 can have skeleton providers.
     SAS Name:    SKLTN_REC_SW
     COBOL Name:  SKLTN-REC-SW

   State Abbreviation                                2    171   172  VARCHAR2
     Description: Two-character state abbreviation.
     SAS Name:    STATE_CD
     COBOL Name:  STATE-CD
     VALUES:      AK=ALASKA
                  AL=ALABAMA
                  AR=ARKANSAS
                  AS=AMERICAN SAMOA
                  AZ=ARIZONA
                  CA=CALIFORNIA
                  CN=CANADA
                  CO=COLORADO
                  CT=CONNECTICUT
                  DC=DISTRICT OF COLUMBIA
                  DE=DELAWARE
                  FL=FLORIDA
                  FN=INTERNATIONAL
                  GA=GEORGIA
                  GU=GUAM
                  HI=HAWAII
                  IA=IOWA
                  ID=IDAHO


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 13
      Community Mental Health Center, CATEGORY = "19" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  IL=ILLINOIS
                  IN=INDIANA
                  KS=KANSAS
                  KY=KENTUCKY
                  LA=LOUISIANA
                  MA=MASSACHUSETTS
                  MD=MARYLAND
                  ME=MAINE
                  MI=MICHIGAN
                  MN=MINNESOTA
                  MO=MISSOURI
                  MP=SAIPAN
                  MS=MISSISSIPPI
                  MT=MONTANA
                  MX=MEXICO
                  NC=NORTH CAROLINA
                  ND=NORTH DAKOTA
                  NE=NEBRASKA
                  NH=NEW HAMPSHIRE
                  NJ=NEW JERSEY
                  NM=NEW MEXICO
                  NV=NEVADA
                  NY=NEW YORK
                  OH=OHIO
                  OK=OKLAHOMA
                  OR=OREGON
                  PA=PENNSYLVANIA
                  PR=PUERTO RICO
                  RI=RHODE ISLAND
                  SC=SOUTH CAROLINA
                  SD=SOUTH DAKOTA
                  TN=TENNESSEE
                  TX=TEXAS
                  UT=UTAH
                  VA=VIRGINIA
                  VI=VIRGIN ISLANDS
                  VT=VERMONT
                  WA=WASHINGTON
                  WI=WISCONSIN
                  WV=WEST VIRGINIA
                  WY=WYOMING

   SSA State Code                                    2    173   174  VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the state where the provider is located.
     SAS Name:    SSA_STATE_CD
     COBOL Name:  SSA-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  03=ARIZONA
                  04=ARKANSAS
                  05=CALIFORNIA
                  06=COLORADO
                  07=CONNECTICUT
                  08=DELAWARE
                  09=DISTRICT OF COLUMBIA
                  10=FLORIDA
                  11=GEORGIA
                  12=HAWAII
                  13=IDAHO
                  14=ILLINOIS
                  15=INDIANA
                  16=IOWA
                  17=KANSAS


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 14
      Community Mental Health Center, CATEGORY = "19" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  18=KENTUCKY
                  19=LOUISIANA
                  20=MAINE
                  21=MARYLAND
                  22=MASSACHUSETTS
                  23=MICHIGAN
                  24=MINNESOTA
                  25=MISSISSIPPI
                  26=MISSOURI
                  27=MONTANA
                  28=NEBRASKA
                  29=NEVADA
                  30=NEW HAMPSHIRE
                  31=NEW JERSEY
                  32=NEW MEXICO
                  33=NEW YORK
                  34=NORTH CAROLINA
                  35=NORTH DAKOTA
                  36=OHIO
                  37=OKLAHOMA
                  38=OREGON
                  39=PENNSYLVANIA
                  40=PUERTO RICO
                  41=RHODE ISLAND
                  42=SOUTH CAROLINA
                  43=SOUTH DAKOTA
                  44=TENNESSEE
                  45=TEXAS
                  46=UTAH
                  47=VERMONT
                  48=VIRGIN ISLANDS
                  49=VIRGINIA
                  50=WASHINGTON
                  51=WEST VIRGINIA
                  52=WISCONSIN
                  53=WYOMING
                  54=AFRICA
                  56=CANADA
                  57=WEST INDIES
                  58=EUROPE
                  59=MEXICO
                  60=OCEANIA
                  61=PHILIPPINES
                  62=SOUTH AMERICA
                  63=UNITED STATES POSSESSIONS
                  64=AMERICAN SAMOA
                  65=GUAM
                  66=SAIPAN
                  99=INTERNATIONAL

   State Region Code                                 3    175   177  VARCHAR2
     Description: Identifies the region within a state where the provider
                  is located.
     SAS Name:    STATE_RGN_CD
     COBOL Name:  STATE-RGN-CD
     VALUES:      AK/001=ALASKA
                  AK/LAB=LABORATORIES
                  AK/NPH=NON-PARTICIPATING HOSPITAL
                  AL/001=ALABAMA
                  AL/LAB=LABORATORIES
                  AL/NPH=NON-PARTICIPATING HOSPITAL
                  AR/001=ARKANSAS
                  AR/LAB=LABORATORIES
                  AR/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 15
      Community Mental Health Center, CATEGORY = "19" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  AS/001=AMERICAN SAMOA
                  AS/LAB=LABORATORY
                  AS/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/AZ=PHOENIX
                  AZ/LAB=ARIZONA LAB
                  AZ/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/TUC=TUCSON
                  CA/001=CALIFORNIA
                  CA/BAK=BAKERSFIELD
                  CA/BER=SAN BERNARDINO
                  CA/EB=East Bay
                  CA/FR=FRESNO
                  CA/L1=L.A. WEST
                  CA/L2=L.A. NORTH
                  CA/L3=L.A. CENTRAL
                  CA/L4=L.A. EAST
                  CA/L5=SAN GABRIEL
                  CA/LA1=LA Region 1
                  CA/LA2=LA Region 2
                  CA/LA3=LA Region 3
                  CA/LA4=LA Acute/Ancillary
                  CA/LA5=LA HHA/Hospice
                  CA/LA6=LA ICF/DD/CLinics
                  CA/LAB=LABORATORIES
                  CA/M1=LAB. SOUTH
                  CA/M2=LAB. NORTH
                  CA/NPH=NON-PARTICIPATING HOSPITAL
                  CA/ORG=ORANGE
                  CA/RIV=RIVERSIDE
                  CA/S1=SACRAMENTO
                  CA/S3=CHICO
                  CA/SD=SAN DIEGO
                  CA/SF=SAN FRANCISCO
                  CA/SJ=SAN JOSE
                  CA/SR=SANTA ROSA
                  CA/VEN=VENTURA
                  CN/001=CANADA
                  CN/LAB=LABORATORY
                  CN/NPH=NON-PARTICIPATING HOSPITAL
                  CO/001=COLORADO
                  CO/LAB=LABORATORIES
                  CO/NPH=NON-PARTICIPATING HOSPITAL
                  CT/001=CONNECTICUT
                  CT/LAB=LABORATORIES
                  CT/NPH=NON-PARTICIPATING HOSPITAL
                  DC/001=DISTRICT OF COLUMBIA
                  DC/LAB=LABORATORIES
                  DC/NPH=NON-PARTICIPATING HOSPITAL
                  DE/001=DELAWARE
                  DE/LAB=LABORATORIES
                  DE/NPH=NON-PARTICIPATING HOSPITAL
                  FL/001=FLORIDA
                  FL/FTM=FT. MYERS
                  FL/GAI=GAINESVILLE
                  FL/JAX=JACKSONVILLE
                  FL/LAB=LABORATORIES
                  FL/LAN=LANTANA
                  FL/LAU=LAUDERHILL
                  FL/MIA=MIAMI
                  FL/NPH=NON-PARTICIPATING HOSPITAL
                  FL/ORL=ORLANDO
                  FL/PEN=PENSACOLA
                  FL/STP=ST. PETERSBURG
                  FL/TAL=TALLAHASSEE


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 16
      Community Mental Health Center, CATEGORY = "19" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  FL/TAM=TAMPA
                  FM/001=FEDERATED STATES OF MICRO
                  FM/NPH=NON-PARTICIPATING HOSPITAL
                  FN/001=INTERNATIONAL
                  FN/LAB=LABORATORIES
                  FN/NPH=NON-PARTICIPATING HOSPITAL
                  GA/001=GEORGIA
                  GA/GAA=GEORGIA ALL
                  GA/GAC=GEORGIA CENTRAL
                  GA/GAE=GEORGIA EASTERN
                  GA/GAN=GEORGIA NORTH
                  GA/GAS=GEORGIA SOUTH
                  GA/GAW=GEORGIA WESTERN
                  GA/LAB=LABORATORIES
                  GA/NPH=NON-PARTICIPATING HOSPITAL
                  GU/001=GUAM
                  GU/LAB=LABORATORIES
                  GU/NPH=NON-PARTICIPATING HOSPITAL
                  HI/001=HAWAII
                  HI/LAB=LABORATORIES
                  HI/NPH=NON-PARTICIPATING HOSPITAL
                  IA/001=IOWA
                  IA/LAB=LABORATORIES
                  IA/NPH=NON-PARTICIPATING HOSPITAL
                  ID/001=IDAHO
                  ID/LAB=LABORATORIES
                  ID/NPH=NON-PARTICIPATING HOSPITAL
                  IL/001=ILLINOIS
                  IL/LAB=LABORATORIES
                  IL/NPH=NON-PARTICIPATING HOSPITAL
                  IN/001=INDIANA
                  IN/LAB=LABORATORIES
                  IN/NPH=NON-PARTICIPATING HOSPITAL
                  KS/001=KANSAS
                  KS/KCK=KANSAS CITY
                  KS/KDH=KDHE
                  KS/LAB=LABORATORIES
                  KS/LAW=LAWRENCE
                  KS/NC=NORTH CENTRAL KANSAS
                  KS/NE=NORTH EAST KANSAS
                  KS/NPH=NON-PARTICIPATING HOSPITAL
                  KS/NW=NORTH WEST KANSAS
                  KS/SC=SOUTH CENTRAL KANSAS
                  KS/SE=SOUTH EAST KANSAS
                  KS/SW=SOUTH WEST KANSAS
                  KS/WST=WEST
                  KY/2C1=HOPKINSVILLE
                  KY/2C2=LOUISVILLE
                  KY/2C3=LONDON
                  KY/2C4=LEXINGTON
                  KY/LAB=LABORATORIES
                  KY/NPH=NON-PARTICIPATING HOSPITAL
                  LA/001=LOUISIANA
                  LA/LA1=NEW ORLEANS
                  LA/LA2=MANDEVILLE
                  LA/LA3=LAFAYETTE
                  LA/LA4=MONROE
                  LA/LA5=SHREVEPORT
                  LA/LA6=ALEXANDRIA
                  LA/LAB=LABORATORIES
                  LA/LB1=CLIA NEW ORLEANS
                  LA/LB5=CLIA SHREVEPORT
                  LA/LB6=CLIA ALEXANDRIA
                  LA/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 17
      Community Mental Health Center, CATEGORY = "19" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  MA/001=MASSACHUSETTS
                  MA/LAB=LABORATORIES
                  MA/NPH=NON-PARTICIPATING HOSPITAL
                  MD/001=MARYLAND
                  MD/LAB=LABORATORIES
                  MD/NPH=NON-PARTICIPATING HOSPITAL
                  ME/001=MAINE
                  ME/LAB=LABORATORIES
                  ME/NPH=NON-PARTICIPATING HOSPITAL
                  MH/001=MARSHALL ISLANDS
                  MH/NPH=NON-PARTICIPATING HOSPITAL
                  MI/001=MICHIGAN
                  MI/LAB=LABORATORIES
                  MI/NPH=NON-PARTICIPATING HOSPITAL
                  MN/001=MINNESOTA
                  MN/LAB=LABORATORIES
                  MN/NPH=NON-PARTICIPATING HOSPITAL
                  MO/001=MISSOURI
                  MO/01=REGION01
                  MO/02=REGION02
                  MO/03=REGION 03
                  MO/04=REGION 04
                  MO/05=REGION 05
                  MO/06=REGION 06
                  MO/07=REGION 07
                  MO/1NH=REGION 1 NH
                  MO/2NH=REGION 2 NH
                  MO/3NH=REGION 3 NH
                  MO/4NH=REGION 4 NH
                  MO/5NH=REGION 5 NH
                  MO/6NH=REGION 6 NH
                  MO/7NH=REGION 7 NH
                  MO/LAB=LABORATORIES
                  MO/MO=STATEWIDE
                  MO/NPH=NON-PARTICIPATING HOSPITAL
                  MP/001=NORTHERN MARIANA ISLANDS
                  MP/LAB=LABORATORIES
                  MP/NPH=NON-PARTICIPATING HOSPITAL
                  MS/001=MISSISSIPPI
                  MS/LAB=LABORATORIES
                  MS/NPH=NON-PARTICIPATING HOSPITAL
                  MT/001=MONTANA
                  MT/LAB=LABORATORIES
                  MT/NPH=NON-PARTICIPATING HOSPITAL
                  MX/001=MEXICO
                  MX/LAB=LABORATORY
                  MX/NPH=NON-PARTICIPATING HOSPITAL
                  NC/001=NORTH CAROLINA
                  NC/LAB=LABORATORIES
                  NC/NCC=NORTH CAROLINA CENTRAL
                  NC/NCE=NORTH CAROLINA EAST
                  NC/NCN=NORTH CAROLINA NORTH
                  NC/NCS=NORTH CAROLINA SOUTH
                  NC/NCW=NORTH CAROLINA WEST
                  NC/NPH=NON-PARTICIPATING HOSPITAL
                  ND/001=NORTH DAKOTA
                  ND/LAB=LABORATORIES
                  ND/NPH=NON-PARTICIPATING HOSPITAL
                  NE/001=NEBRASKA
                  NE/1=NORTH CENTRAL
                  NE/2=CENTRAL
                  NE/3=NORTHEAST
                  NE/4=SOUTHEAST
                  NE/5=WESTERN


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      Community Mental Health Center, CATEGORY = "19" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  NE/LAB=LABORATORIES
                  NE/NPH=NON-PARTICIPATING HOSPITAL
                  NH/001=NEW HAMPSHIRE
                  NH/LAB=LABORATORIES
                  NH/NPH=NON-PARTICIPATING HOSPITAL
                  NJ/001=NEW JERSEY
                  NJ/LAB=LABORATORIES
                  NJ/NPH=NON-PARTICIPATING HOSPITAL
                  NM/001=NEW MEXICO
                  NM/LAB=LABORATORIES
                  NM/NPH=NON-PARTICIPATING HOSPITAL
                  NV/001=NEVADA
                  NV/CC=CARSON CITY
                  NV/LAB=LABORATORIES
                  NV/LV=LAS VEGAS
                  NV/NPH=NON-PARTICIPATING HOSPITAL
                  NY/001=BUFFALO
                  NY/002=ROCHESTER
                  NY/003=SYRACUSE
                  NY/004=ALBANY
                  NY/005=NEW ROCHELLE
                  NY/006=NEW YORK CITY
                  NY/007=SUFFOLK/NASSAU COUNTY
                  NY/LAB=LABORATORIES
                  NY/NPH=NON-PARTICIPATING HOSPITAL
                  OH/001=OHIO
                  OH/LAB=LABORATORIES
                  OH/NPH=NON-PARTICIPATING HOSPITAL
                  OK/001=OKLAHOMA
                  OK/LAB=LABORATORIES
                  OK/NPH=NON-PARTICIPATING HOSPITAL
                  OR/001=OFFICE #1
                  OR/002=OFFICE #2
                  OR/003=OFFICE #3
                  OR/LAB=LABORATORIES
                  OR/NPH=NON-PARTICIPATING HOSPITAL
                  PA/001=PENNSYLVANIA
                  PA/LAB=LABORATORIES
                  PA/NPH=NON-PARTICIPATING HOSPITAL
                  PR/001=PUERTO RICO
                  PR/LAB=LABORATORIES
                  PR/NPH=NON-PARTICIPATING HOSPITAL
                  PW/001=PALAU
                  PW/NPH=NON-PARTICIPATING HOSPITAL
                  RI/001=RHODE ISLAND
                  RI/LAB=LABORATORIES
                  RI/NPH=NON-PARTICIPATING HOSPITAL
                  SC/001=SOUTH CAROLINA
                  SC/LAB=LABORATORIES
                  SC/NPH=NON-PARTICIPATING HOSPITAL
                  SD/001=SOUTH DAKOTA
                  SD/LAB=LABORATORIES
                  SD/NPH=NON-PARTICIPATING HOSPITAL
                  TN/001=TENNESSEE
                  TN/LAB=LABORATORIES
                  TN/NPH=NON-PARTICIPATING HOSPITAL
                  TN/TNC=TENNESSEE COOKEVILLE
                  TN/TNE=TENNESSEE EASTERN
                  TN/TNM=TENNESSEE MIDDLE
                  TN/TNW=TENNESSEE WESTERN
                  TX/001=TEXAS
                  TX/L01=AMARILLO-LTC
                  TX/L02=ABILENE-LTC
                  TX/L03=ARLINGTON-LTC


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 19
      Community Mental Health Center, CATEGORY = "19" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  TX/L04=TYLER-LTC
                  TX/L05=TEMPLE-LTC
                  TX/L06=HOUSTON-LTC
                  TX/L07=SAN ANTONIO-LTC
                  TX/LAB=LABORATORIES
                  TX/NPH=NON-PARTICIPATING HOSPITAL
                  TX/TX1=NLTC REG 1, 7, 9, 10
                  TX/TX2=NLTC REG 2, 3
                  TX/TX4=NLTC REG 6
                  TX/TX5=NLTC REG 4, 5
                  TX/TX6=AUSTIN
                  TX/TX8=NLTC REG 8, 11
                  UT/001=UTAH
                  UT/LAB=LABORATORIES
                  UT/NPH=NON-PARTICIPATING HOSPITAL
                  VA/001=VIRGINIA
                  VA/LAB=LABORATORIES
                  VA/NPH=NON-PARTICIPATING HOSPITAL
                  VI/001=VIRGIN ISLANDS
                  VI/LAB=LABORATORIES
                  VI/NPH=NON-PARTICIPATING HOSPITAL
                  VT/001=VERMONT
                  VT/LAB=LABORATORIES
                  VT/NPH=NON-PARTICIPATING HOSPITAL
                  WA/001=ALL OTHERS (NON-LTC FAC)
                  WA/D1=SPOKANE & YAKIMA AREAS
                  WA/D1A=District 1, Unit A
                  WA/D1B=District 1, Unit B
                  WA/D1C=District 1, Unit C
                  WA/D1D=District 1, Unit D
                  WA/D1E=District 1, Unit E
                  WA/D2=SPOKANE & SE
                  WA/D2A=District 2, Unit A
                  WA/D2B=District 2, Unit B
                  WA/D2C=District 2, Unit C
                  WA/D2D=District 2, Unit D
                  WA/D2E=District 2, Unit E
                  WA/D2F=District 2, Unit F
                  WA/D2G=District 2, Unit G
                  WA/D2H=District 2, Unit H
                  WA/D2I=District 2, Unit I
                  WA/D2J=District 2, Unit J
                  WA/D3=NW WASHINGTON
                  WA/D3A=District 3, Unit A
                  WA/D3B=District 3, Unit B
                  WA/D3C=District 3, Unit C
                  WA/D3D=District 3, Unit D
                  WA/D3E=District 3, Unit E
                  WA/D3F=District 3, Unit F
                  WA/D3G=District 3, Unit G
                  WA/D4A=GREATER SEATTLE AREA
                  WA/D4B=S KING COUNTY
                  WA/D5A=PIERCE CTY & PENINSULA
                  WA/D5B=PIERCE CTY & GRAYS HARBOR
                  WA/D6=OLYMPIA AREA
                  WA/LAB=LABORATORIES
                  WA/NPH=NON-PARTICIPATING HOSPITAL
                  WI/001=WISCONSIN
                  WI/LAB=LABORATORIES
                  WI/NPH=NON-PARTICIPATING HOSPITAL
                  WV/001=WEST VIRGINIA
                  WV/LAB=LABORATORIES
                  WV/NPH=NON-PARTICIPATING HOSPITAL
                  WY/001=WYOMING


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      Community Mental Health Center, CATEGORY = "19" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  WY/LAB=LABORATORIES
                  WY/NPH=NON-PARTICIPATING HOSPITAL

   Address: Street                                   50   178   227  VARCHAR2
     Description: Street address where the provider is located.
     SAS Name:    ST_ADR
     COBOL Name:  ST-ADR

   Telephone Number                                  10   228   237  VARCHAR2
     Description: Telephone number of the provider.
     SAS Name:    PHNE_NUM
     COBOL Name:  PHNE-NUM

   Termination Code                                  2    238   239  VARCHAR2
     Description: Indicates the current termination status for the
                  provider.
     SAS Name:    PGM_TRMNTN_CD
     COBOL Name:  PGM-TRMNTN-CD
     VALUES:      00=ACTIVE PROVIDER
                  01=VOLUNTARY-MERGER, CLOSURE
                  02=VOLUNTARY-DISSATISFACTION WITH REIMBURSEMENT
                  03=VOLUNTARY-RISK OF INVOLUNTARY TERMINATION
                  04=VOLUNTARY-OTHER REASON FOR WITHDRAWAL
                  05=INVOLUNTARY-FAILURE TO MEET HEALTH/SAFETY REQ
                  06=INVOLUNTARY-FAILURE TO MEET AGREEMENT
                  07=OTHER-PROVIDER STATUS CHANGE
                  08=NONPAYMENT OF FEES - CLIA Only
                  09=REV/UNSUCCESSFUL PARTICIPATION IN PT - CLIA Only
                  10=REV/OTHER REASON - CLIA Only
                  11=INCOMPLETE CLIA APPLICATION INFORMATION - CLIA Only
                  12=NO LONGER PERFORMING TESTS - CLIA Only
                  13=MULTIPLE TO SINGLE SITE CERTIFICATE - CLIA Only
                  14=SHARED LABORATORY - CLIA Only
                  15=FAILURE TO RENEW WAIVER PPM CERTIFICATE - CLIA Only
                  16=DUPLICATE CLIA NUMBER - CLIA Only
                  17=MAIL RETURNED NO FORWARD ADDRESS CERT ENDED - CLIA Only
                  20=NOTIFICATION BANKRUPTCY - CLIA Only
                  33=ACCREDITATION NOT CONFIRMED - CLIA Only
                  80=AWAITING STATE APPROVAL
                  99=OIG ACTION - DO NOT ACTIVATE - CLIA Only

   Termination or Expiration Date                    8    240   247  DATE
     Description: Date the provider was terminated.  For CLIA providers,
                  date the laboratory's certificate was terminated or the
                  expiration date of the current CLIA certificate.
     SAS Name:    TRMNTN_EXPRTN_DT
     COBOL Name:  TRMNTN-EXPRTN-DT

   Type of Action Code                               1    248   248  VARCHAR2
     Description: Identifies the reason for the certification.  Type of
                  action from the official survey record, CMS 1539 form.
     SAS Name:    CRTFCTN_ACTN_TYPE_CD
     COBOL Name:  CRTFCTN-ACTN-TYPE-CD
     VALUES:      1=INITIAL
                  2=RECERTIFICATION
                  3=TERMINATION
                  4=CHANGE OF OWNERSHIP
                  5=VALIDATION
                  8=FULL SURVEY AFTER COMPLAINT

   Ownership Type Code                               2    249   250  VARCHAR2
     Description: Indicates the ownership type of the provider.
     SAS Name:    GNRL_CNTL_TYPE_CD
     COBOL Name:  GNRL-CNTL-TYPE-CD


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      Community Mental Health Center, CATEGORY = "19" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     VALUES:      01=PROPRIETARY
                  02=CHURCH RELATED
                  03=NONPROFIT CORPORATION
                  04=OTHER NONPROFIT
                  05=STATE
                  06=LOCAL
                  07=FEDERAL

   Address: ZIP Code                                 5    251   255  VARCHAR2
     Description: Five-digit ZIP code for a provider's physical address.
     SAS Name:    ZIP_CD
     COBOL Name:  ZIP-CD

   FIPS State Code                                   2    256   257  VARCHAR2
     Description: FIPS State Code
     SAS Name:    FIPS_STATE_CD
     COBOL Name:  FIPS-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  04=ARIZONA
                  05=ARKANSAS
                  06=CALIFORNIA
                  08=COLORADO
                  09=CONNECTICUT
                  10=DELAWARE
                  11=DISTRICT OF COLUMBIA
                  12=FLORIDA
                  13=GEORGIA
                  15=HAWAII
                  16=IDAHO
                  17=ILLINOIS
                  18=INDIANA
                  19=IOWA
                  20=KANSAS
                  21=KENTUCKY
                  22=LOUISIANA
                  23=MAINE
                  24=MARYLAND
                  25=MASSACHUSETTS
                  26=MICHIGAN
                  27=MINNESOTA
                  28=MISSISSIPPI
                  29=MISSOURI
                  30=MONTANA
                  31=NEBRASKA
                  32=NEVADA
                  33=NEW HAMPSHIRE
                  34=NEW JERSEY
                  35=NEW MEXICO
                  36=NEW YORK
                  37=NORTH CAROLINA
                  38=NORTH DAKOTA
                  39=OHIO
                  40=OKLAHOMA
                  41=OREGON
                  42=PENNSYLVANIA
                  43=PUERTO RICO
                  44=RHODE ISLAND
                  45=SOUTH CAROLINA
                  46=SOUTH DAKOTA
                  47=TENNESSEE
                  48=TEXAS
                  49=UTAH
                  50=VERMONT


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 22
      Community Mental Health Center, CATEGORY = "19" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  51=VIRGINIA
                  53=WASHINGTON
                  54=WEST VIRGINIA
                  55=WISCONSIN
                  56=WYOMING
                  60=AMERICAN SAMOA
                  66=GUAM
                  69=SAIPAN/MARIANA IS.
                  78=VIRGIN ISLANDS

   FIPS County Code                                  3    258   260  VARCHAR2
     Description: FIPS County Code
     SAS Name:    FIPS_CNTY_CD
     COBOL Name:  FIPS-CNTY-CD

   CBSA Urban Rural Indicator                        1    261   261  VARCHAR2
     Description: CBSA (Core Based Statistical Area) indicates whether the
                  county is defined as Urban or Rural.
     SAS Name:    CBSA_URBN_RRL_IND
     COBOL Name:  CBSA-URBN-RRL-IND

   CBSA Code                                         5    262   266  VARCHAR2
     Description: CBSA (Core Based Statistical Area) geographic entities
                  defined by the U.S. Office of Management and Budget (OMB)
                  on June 6, 2003 for use by Federal statistical agencies
                  in collecting, tabulating, and publishing Federal
                  statistics.  CBSA collectively refers to MSA.
     SAS Name:    CBSA_CD
     COBOL Name:  CBSA-CD

   Fiscal Year End Date (MMDD)                       4    464   467  VARCHAR2
     Description: End date, consisting of the month and day, of the
                  provider's fiscal year.
     SAS Name:    FY_END_MO_DAY_CD
     COBOL Name:  FY-END-MO-DAY-CD

   Related Provider Number                           10   686   695  CHAR
     Description: Related provider number
     SAS Name:    RELATED_PROVIDER_NUMBER
     COBOL Name:  RELATED-PROVIDER-NUMBER


























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     Federally Qualified Health Center, CATEGORY = "21" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE


   Provider Category Subtype Code                    2    1     2    VARCHAR2
     Description: Identifies the subtype of the provider, within the
                  primary category.  Used in reporting to show the
                  breakdown of provider categories, mainly for hospitals
                  and SNFs.
     SAS Name:    PRVDR_CTGRY_SBTYP_CD
     COBOL Name:  PRVDR-CTGRY-SBTYP-CD
     VALUES:      01=Federally Qualified Health Center

   Provider Category Code                            2    3     4    VARCHAR2
     Description: Identifies the type of provider participating in the
                  Medicare/Medicaid program.
     SAS Name:    PRVDR_CTGRY_CD
     COBOL Name:  PRVDR-CTGRY-CD
     VALUES:      21=Federally Qualified Health Center

   CHOW Count                                        2    5     6    NUMBER
     Description: Number of times this provider has undergone a change of
                  ownership.
     SAS Name:    CHOW_CNT
     COBOL Name:  CHOW-CNT

   CHOW Date                                         8    7     14   DATE
     Description: Effective date of the most recent change of ownership for
                  this provider.
     SAS Name:    CHOW_DT
     COBOL Name:  CHOW-DT

   Address: City                                     28   15    42   VARCHAR2
     Description: City in which the provider is physically located.
     SAS Name:    CITY_NAME
     COBOL Name:  CITY-NAME

   Compliance: Acceptable POC                        1    43    43   VARCHAR2
     Description: Indicates if a provider is in compliance with program
                  requirements based on an acceptable plan for correction
                  of deficiencies.
     SAS Name:    ACPTBL_POC_SW
     COBOL Name:  ACPTBL-POC-SW

   Compliance: Status                                1    44    44   VARCHAR2
     Description: Compliance status of a provider at the time of
                  certification survey.
     SAS Name:    CMPLNC_STUS_CD
     COBOL Name:  CMPLNC-STUS-CD
     VALUES:      A=IN COMPLIANCE
                  B=NOT IN COMPLIANCE

   SSA County Code                                   3    45    47   VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the county where the provider is located.
     SAS Name:    SSA_CNTY_CD
     COBOL Name:  SSA-CNTY-CD

   Cross Ref Provider Number                         10   48    57   CHAR
     Description: Cross reference provider number
     SAS Name:    CROSS_REF_PROVIDER_NUMBER
     COBOL Name:  CROSS-REF-PROVIDER-NUMBER

   Certification Date                                8    58    65   DATE
     Description: Equal to the exit date of the initial visit of the Health
                  survey for certifications completed after July 28, 2012.
                  For certifications prior to that date, the certification


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 2
     Federally Qualified Health Center, CATEGORY = "21" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  date is equal to the exit date of the initial visit of
                  the Health survey or LSC survey, whichever is later.
     SAS Name:    CRTFCTN_DT
     COBOL Name:  CRTFCTN-DT

   Eligibility Indicator                             1    66    66   VARCHAR2
     Description: Indicates if a facility is eligible to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    ELGBLTY_SW
     COBOL Name:  ELGBLTY-SW

   Facility Name                                     50   67    116  VARCHAR2
     Description: Name of the provider certified to participate in the
                  Medicare and/or Medicaid programs.
     SAS Name:    FAC_NAME
     COBOL Name:  FAC-NAME

   Medicare Administrative Contractor (MAC) or       5    117   121  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_CD
     COBOL Name:  INTRMDRY-CARR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A
                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 3
     Federally Qualified Health Center, CATEGORY = "21" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA
                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 4
     Federally Qualified Health Center, CATEGORY = "21" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)
                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 5
     Federally Qualified Health Center, CATEGORY = "21" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)
                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 6
     Federally Qualified Health Center, CATEGORY = "21" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)
                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 7
     Federally Qualified Health Center, CATEGORY = "21" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   Medicaid Vendor Number                            15   122   136  VARCHAR2
     Description: Number which may be assigned to a provider by the state
                  Medicaid agency for external control or billing purposes.
     SAS Name:    MDCD_VNDR_NUM
     COBOL Name:  MDCD-VNDR-NUM

   Original Participation Date                       8    137   144  DATE
     Description: Date a provider is first approved to provide Medicare
                  and/or Medicaid services.
     SAS Name:    ORGNL_PRTCPTN_DT
     COBOL Name:  ORGNL-PRTCPTN-DT

   Prior CHOW Date                                   8    145   152  DATE
     Description: Effective date of the previous change of ownership for
                  this provider.
     SAS Name:    CHOW_PRIOR_DT
     COBOL Name:  CHOW-PRIOR-DT

   Prior Medicare Administrative Contractor (MAC) or 5    153   157  VARCHAR2
   Intermediary or Carrier Code
     Description: Number assigned to the previous Medicare Administrative
                  Contractor, intermediary or carrier servicing this
                  provider.
     SAS Name:    INTRMDRY_CARR_PRIOR_CD
     COBOL Name:  INTRMDRY-CARR-PRIOR-CD
     VALUES:      00000=DUMMY FOR MEDICAID HHA
                  00010=BLUE CROSS (ALABAMA)
                  00011=CAHABA
                  00020=BLUE CROSS (ARKANSAS)
                  00040=BLUE CROSS (CALIFORNIA)
                  00060=BLUE CROSS (CONNECTICUT)
                  00070=BLUE CROSS (DELAWARE)
                  00090=BLUE CROSS (FLORIDA)
                  00101=BLUE CROSS (GEORGIA)
                  00121=HEALTH CARE SERVICE CORPORATION
                  00122=HCSC - MICHIGAN
                  00123=HCSC OF MICHIGAN
                  00130=NATIONAL GOVERNMENT SERVICES
                  00131=NATIONAL GOVERNMENT SERVICES
                  00140=BLUE CROSS (IOWA/SOUTH DAKOTA)
                  00150=BLUE CROSS (KANSAS)
                  00160=NATIONAL GOVERNMENT SERVICES
                  00180=NATIONAL GOVERNMENT SERVICES
                  00181=NATIONAL GOVERNMENT SERVICES
                  00190=BLUE CROSS (MARYLAND)
                  00200=BLUE CROSS (MASSACHUSETTS)
                  00210=BLUE CROSS (MICHIGAN)
                  00220=BLUE CROSS (MINNESOTA)
                  00230=BLUE CROSS (MISSISSIPPI)
                  00231=BLUE CROSS (LOUISIANA)
                  00233=PINNACLE
                  00241=BLUE CROSS (MISSOURI)
                  00260=BLUE CROSS (NEBRASKA)
                  00270=NATIONAL GOVERNMENT SERVICES
                  00280=BLUE CROSS (NEW JERSEY)
                  00290=BLUE CROSS (NEW MEXICO)
                  00308=NATIONAL GOVERNMENT SERVICES
                  00310=BLUE CROSS (NORTH CAROLINA)
                  00320=NORIDIAN PART A


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 8
     Federally Qualified Health Center, CATEGORY = "21" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00322=NORIDIAN PART A (AK/WA)
                  00323=NORIDIAN PART A (ID/OR)
                  00325=NORIDIAN
                  00332=NATIONAL GOVERNMENT SERVICES
                  00340=BLUE CROSS (OKLAHOMA)
                  00350=BLUE CROSS (OREGON)
                  00351=BLUE CROSS (OREGON) (IDAHO CLAIMS)
                  00362=BLUE CROSS (INDEPENDENCE)
                  00363=BLUE CROSS (WESTERN PENNSYLVANIA)
                  00366=HIGHMARK MEDICARE SERVICES
                  00370=BLUE CROSS (RHODE ISLAND)
                  00380=BLUE CROSS (SOUTH CAROLINA)
                  00390=BLUE CROSS (TENNESSEE)
                  00400=BLUE CROSS (TEXAS)
                  00410=BLUE CROSS (UTAH)
                  00423=BLUE CROSS (VIRGINIA/WEST VA)
                  00430=BLUE CROSS (WASHINGTON & ALASKA)
                  00450=NATIONAL GOVERNMENT SERVICES
                  00452=NATIONAL GOVERNMENT SERVICES
                  00453=NATIONAL GOVERNMENT SERVICES
                  00454=NATIONAL GOVERNMENT SERVICES
                  00456=NATIONAL GOVERNMENT SERVICES
                  00468=BLUE CROSS (NORTH CAROLINA FOR PR)
                  00510=BLUE SHIELD (ALABAMA)
                  00511=CAHABA
                  00512=CAHABA
                  00520=BLUE SHIELD (ARKANSAS)
                  00528=BLUE SHIELD (ARKANSAS/LOUISIANA)
                  00542=BLUE SHIELD (CALIFORNIA)
                  00550=BLUE SHIELD (COLORADO)
                  00570=BLUE SHIELD (DELAWARE)
                  00580=BLUE SHIELD (DISTRICT OF COLUMBIA)
                  00590=BLUE SHIELD (FLORIDA)
                  00621=BLUE SHIELD (ILLINOIS)
                  00630=NATIONAL GOVERNMENT SERVICES
                  00640=BLUE SHIELD (IOWA)
                  00650=BLUE SHIELD (KANSAS)
                  00655=BLUE SHIELD (KANSAS/NEBRASKA)
                  00660=NATIONAL GOVERNMENT SERVICES
                  00690=BLUE SHIELD (MARYLAND)
                  00700=BLUE SHIELD (MASSACHUSETTS)
                  00710=BLUE SHIELD (MICHIGAN)
                  00720=BLUE SHIELD (MINNESOTA)
                  00740=BLUE SHIELD (KANSAS CITY)
                  00770=BLUE SHIELD (NEW HAMPSHIRE/VERMONT)
                  00780=BLUE SHIELD (TRI-STATE)
                  00801=BLUE SHIELD (BUFFALO)
                  00803=NATIONAL GOVERNMENT SERVICES
                  00805=NATIONAL GOVERNMENT SERVICES
                  00821=NORIDIAN
                  00824=NORIDIAN GVT SERVICES (CO)
                  00826=NORIDIAN GVT SERVICES (IA)
                  00831=NORIDIAN GVT SERVICES (AK)
                  00832=NORIDIAN GVT SERVICES (AZ)
                  00833=NORIDIAN GVT SERVICES (HI)
                  00834=NORIDIAN GVT SERVICES (NV)
                  00835=NORIDIAN GVT SERVICES (OR)
                  00836=NORIDIAN GVT SERVICES (WA)
                  00860=BLUE SHIELD (PENNSYLVANIA/NEW JERSEY)
                  00865=BLUE SHIELD (PENNSYLVANIA)
                  00870=BLUE SHIELD (RHODE ISLAND)
                  00880=BLUE SHIELD (SOUTH CAROLINA)
                  00883=PALMETTO GBA PART B
                  00884=PALMETTO GBA


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 9
     Federally Qualified Health Center, CATEGORY = "21" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  00889=NORIDIAN GVT SERVICES (SD)
                  00900=BLUE SHIELD (TEXAS)
                  00901=TRAILBLAZERS HEALTH ENTERPRISES
                  00904=TRAILBLAZER
                  00910=BLUE SHIELD (UTAH)
                  00930=BLUE SHIELD (WASHINGTON)
                  00951=WISCONSIN PHYSICIANS SERVICE
                  00952=WPS - ILLINOIS
                  00953=WPS - MICHIGAN
                  00954=WI PHYSICIAN SERVICES - MN
                  00973=BLUE SHIELD (PUERTO RICO)
                  00974=BLUE SHIELD (VIRGIN ISLANDS)
                  01010=AETNA (PEORIA)
                  01020=AETNA (ALASKA)
                  01030=AETNA (ARIZONA)
                  01040=AETNA (GEORGIA)
                  01101=PALMETTO (CALIFORNIA)
                  01102=PALMETTO (CALIFORNIA (NORTH)
                  01111=Noridian (CA)
                  01112=Noridian (NF)
                  01120=AETNA (HAWAII)
                  01182=Noridian (SF)
                  01192=PALMETTO (CALIFORNIA SOUTH)
                  01201=PALMETTO (HAWAII)
                  01202=PALMETTO (HAWAII)
                  01211=Noridian (AS, GU, HI)
                  01212=Noridian (AS, GU, HI)
                  01290=AETNA (NEVADA)
                  01301=PALMETTO (NEVADA)
                  01302=PALMETTO (NEVADA)
                  01311=Noridian (NV)
                  01312=Noridian (NV)
                  01360=AETNA (NEW MEXICO)
                  01370=AETNA (OKLAHOMA)
                  01380=AETNA (OREGON)
                  01390=AETNA (WASHINGTON)
                  01901=PALMETTO GBA
                  01902=PALMETTO GBA
                  01911=Noridian (AS, GU, HI, NV)
                  02050=OCCIDENTAL (CALIFORNIA)
                  02101=Noridian AK
                  02102=Noridian AK
                  02201=Noridian ID
                  02202=Noridian ID
                  02301=Noridian OR
                  02302=Noridian OR
                  02401=Noridian WA
                  02402=Noridian WA
                  03001=NORIDIAN ADMIN SERVICES
                  03101=NORIDAN (ARIZONA)
                  03102=NORIDAN (ARIZONA)
                  03201=NORIDAN (MONTANA)
                  03202=NORIDAN (MONTANA)
                  03301=NORDIAN (NORTH DAKOTA)
                  03302=NORDIAN (NORTH DAKOTA)
                  03401=NORIDIAN (SOUTH DAKOTA)
                  03402=NORIDIAN (SOUTH DAKOTA)
                  03501=NORIDIAN (UTAH)
                  03502=NORIDIAN (UTAH)
                  03601=NORIDIAN (WYOMING)
                  03602=NORIDIAN (WYOMING)
                  04001=TRAILBLAZER
                  04101=TRAILBLAZER (COLORADO)
                  04102=TRAILBLAZER (COLORADO)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 10
     Federally Qualified Health Center, CATEGORY = "21" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  04111=NOVITAS (COLORADO)
                  04112=NOVITAS (COLORADO)
                  04201=TRAILBLAZER (NEW MEXICO)
                  04202=TRAILBLAZER (NEW MEXICO)
                  04211=NOVITAS (NEW MEXICO)
                  04212=NOVITAS (NEW MEXICO)
                  04301=TRAILBLAZER (OKLAHOMA)
                  04302=TRAILBLAZER (OKLAHOMA)
                  04311=NOVITAS (OKLAHOMA)
                  04312=NOVITAS (OKLAHOMA)
                  04401=TRAILBLAZER (TEXAS)
                  04402=TRAILBLAZER (TEXAS)
                  04411=NOVITAS (TEXAS)
                  04412=NOVITAS (TEXAS)
                  04901=MUTUAL LEGACY
                  04911=NOVITAS
                  05101=WPS (IOWA)
                  05102=WPS (IOWA)
                  05130=EQICOR (IDAHO)
                  05201=WPS (KANSAS)
                  05202=WPS (KANSAS)
                  05301=WPS (MISSOURI)
                  05302=WPS (MISSOURI WEST)
                  05392=WPS (MISSOURI EAST)
                  05401=WPS (NEBRASKA)
                  05402=WPS (NEBRASKA)
                  05440=EQICOR (TENNESSEE)
                  05535=EQICOR (NORTH CAROLINA)
                  05901=WISCONSIN PHYSICIANS SERVICE
                  06001=NGS (WI)
                  06004=National Govt Serv HHH
                  06101=NGS (IL)
                  06102=NGS (IL)
                  06201=NGS (MN)
                  06202=NGS (MN)
                  06301=NGS (WI)
                  06302=NGS (WI)
                  07101=Novitas AR
                  07102=Novitas AR
                  07201=Novitas LA
                  07202=Novitas LA
                  07301=Novitas MS
                  07302=Novitas MS
                  08101=WPS IN
                  08102=WPS IN
                  08201=WPS MI
                  08202=WPS MI
                  09101=FIRST COAST (FLORIDA)
                  09102=FIRST COAST (FLORIDA)
                  09201=FIRST COAST (PUERTO RICO/VIRGIN ISLANDS)
                  09202=FIRST COAST (PUERTO RICO)
                  09302=FIRST COAST (VIRGIN ISLANDS)
                  10071=TRAVELERS (RRB)
                  10101=CAHABA GBA (AL)
                  10102=CAHABA GBA (AL)
                  10111=PALMETTO GBA (Part A) (AL)
                  10201=CAHABA GBA (GA)
                  10202=CAHABA GBA (GA)
                  10211=PALMETTO GBA (GA)
                  10230=TRAVELERS (CONNECTICUT)
                  10240=TRAVELERS (MINNESOTA)
                  10250=TRAVELERS (MISSISSIPPI)
                  10301=CAHABA GBA (TN)
                  10302=CAHABA GBA (TN)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 11
     Federally Qualified Health Center, CATEGORY = "21" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  10311=PALMETTO GBA (TN)
                  10490=TRAVELERS (VIRGINIA)
                  10492=TRAVELERS - VIRGINIA SPECIAL PROJECT
                  11004=PALMETTO HHH C
                  11201=PALMETTO GBA (SC)
                  11202=PALMETTO GBA (SC)
                  11260=GENERAL AMERICAN
                  11301=PALMETTO GBA (VA)
                  11302=PALMETTO GBA (VA)
                  11401=PALMETTO GBA (WV)
                  11402=PALMETTO GBA (WV)
                  11501=PALMETTO GBA (NC)
                  11502=PALMETTO GBA (NC)
                  12101=Novitas DE
                  12102=Novitas DE
                  12201=Novitas DC
                  12202=Novitas DC
                  12301=Novitas MD
                  12302=Novitas MD
                  12401=Novitas NJ
                  12402=Novitas NJ
                  12501=Novitas PA
                  12502=Novitas PA
                  12901=Novitas Solutions DC, DE, MD, PA
                  12902=HIGHMARK
                  13101=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13102=NATIONAL GOVT SERVICES (CONNECTICUT)
                  13201=NATIONAL GOVT SERVICES (NEW YORK)
                  13202=NATIONAL GOVT SERVICES (NEW YORK - EMPIRE)
                  13282=NGS (UN)
                  13292=NGS (QN)
                  14004=NATIONAL HERITAGE (HHA - A)
                  14014=NGS (HHA)
                  14101=NATIONAL HERITAGE (MAINE)
                  14102=NATIONAL HERITAGE (MAINE)
                  14111=NGS (ME)
                  14112=NGS (ME)
                  14201=NATIONAL HERITAGE (MASSACHUSETTS)
                  14202=NATIONAL HERITAGE (MASSACHUSETTS)
                  14211=NGS (MA)
                  14212=NGS (MA)
                  14301=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14302=NATIONAL HERITAGE (NEW HAMPSHIRE)
                  14311=NGS (NH)
                  14312=NGS (NH)
                  14330=GROUP HEALTH INC (NEW YORK)
                  14401=NATIONAL HERITAGE (RHODE ISLAND)
                  14402=NATIONAL HERITAGE (RHODE ISLAND)
                  14411=NGS (RI)
                  14412=NGS (RI)
                  14501=NATIONAL HERITAGE (VERMONT)
                  14502=NATIONAL HERITAGE (VERMONT)
                  14511=NGS (VT)
                  14512=NGS (VT)
                  15004=CGS Administrators HHH
                  15101=CGS (KENTUCKY)
                  15102=CGS (KENTUCKY)
                  15201=CGS (OHIO)
                  15202=CGS (OHIO)
                  16360=NATIONWIDE (OHIO)
                  16510=NATIONWIDE (WEST VIRGINIA)
                  17120=HAWAII MEDICAL SERVICE ASSOCIATION
                  21200=MASSACHUSETTS/MAINE
                  31142=NATIONAL HERITAGE INSURANCE CO (MAINE)


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 12
     Federally Qualified Health Center, CATEGORY = "21" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  31143=NATIONAL HERITAGE INSURANCE CO
                  31144=NATIONAL HERITAGE INSURANCE CO
                  50333=TRAVELERS (NEW YORK)
                  51051=AETNA (PETALUMA)
                  51070=AETNA (FARMINGTON)
                  51100=AETNA (CLEARWATER)
                  51140=AETNA (PEORIA)
                  51390=AETNA (FORT WASHINGTON)
                  52280=WISCONSIN PHYSICIANS SERVICE
                  57400=COOPERATIVA (PUERTO RICO)

   CCN                                               10   158   167  VARCHAR2
     Description: Six or ten position identification number that is
                  assigned to a certified provider.  This is the CMS
                  Certification Number.
     SAS Name:    PRVDR_NUM
     COBOL Name:  PRVDR-NUM

   Region Code                                       2    168   169  VARCHAR2
     Description: Indicates the CMS Regional Office responsible for the
                  certification of the provider.
     SAS Name:    RGN_CD
     COBOL Name:  RGN-CD
     VALUES:      01=Boston
                  02=New York
                  03=Philadelphia
                  04=Atlanta
                  05=Chicago
                  06=Dallas
                  07=Kansas City
                  08=Denver
                  09=San Francisco
                  10=Seattle

   Skeleton Record Indicator                         1    170   170  VARCHAR2
     Description: Indicates if the record is a skeleton record.  Only a
                  limited set of data is available for this provider; no
                  survey data exists.  Only provider categories
                  01,17,19,21and 22 can have skeleton providers.
     SAS Name:    SKLTN_REC_SW
     COBOL Name:  SKLTN-REC-SW

   State Abbreviation                                2    171   172  VARCHAR2
     Description: Two-character state abbreviation.
     SAS Name:    STATE_CD
     COBOL Name:  STATE-CD
     VALUES:      AK=ALASKA
                  AL=ALABAMA
                  AR=ARKANSAS
                  AS=AMERICAN SAMOA
                  AZ=ARIZONA
                  CA=CALIFORNIA
                  CN=CANADA
                  CO=COLORADO
                  CT=CONNECTICUT
                  DC=DISTRICT OF COLUMBIA
                  DE=DELAWARE
                  FL=FLORIDA
                  FN=INTERNATIONAL
                  GA=GEORGIA
                  GU=GUAM
                  HI=HAWAII
                  IA=IOWA
                  ID=IDAHO


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 13
     Federally Qualified Health Center, CATEGORY = "21" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  IL=ILLINOIS
                  IN=INDIANA
                  KS=KANSAS
                  KY=KENTUCKY
                  LA=LOUISIANA
                  MA=MASSACHUSETTS
                  MD=MARYLAND
                  ME=MAINE
                  MI=MICHIGAN
                  MN=MINNESOTA
                  MO=MISSOURI
                  MP=SAIPAN
                  MS=MISSISSIPPI
                  MT=MONTANA
                  MX=MEXICO
                  NC=NORTH CAROLINA
                  ND=NORTH DAKOTA
                  NE=NEBRASKA
                  NH=NEW HAMPSHIRE
                  NJ=NEW JERSEY
                  NM=NEW MEXICO
                  NV=NEVADA
                  NY=NEW YORK
                  OH=OHIO
                  OK=OKLAHOMA
                  OR=OREGON
                  PA=PENNSYLVANIA
                  PR=PUERTO RICO
                  RI=RHODE ISLAND
                  SC=SOUTH CAROLINA
                  SD=SOUTH DAKOTA
                  TN=TENNESSEE
                  TX=TEXAS
                  UT=UTAH
                  VA=VIRGINIA
                  VI=VIRGIN ISLANDS
                  VT=VERMONT
                  WA=WASHINGTON
                  WI=WISCONSIN
                  WV=WEST VIRGINIA
                  WY=WYOMING

   SSA State Code                                    2    173   174  VARCHAR2
     Description: Social Security Administration geographic code indicating
                  the state where the provider is located.
     SAS Name:    SSA_STATE_CD
     COBOL Name:  SSA-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  03=ARIZONA
                  04=ARKANSAS
                  05=CALIFORNIA
                  06=COLORADO
                  07=CONNECTICUT
                  08=DELAWARE
                  09=DISTRICT OF COLUMBIA
                  10=FLORIDA
                  11=GEORGIA
                  12=HAWAII
                  13=IDAHO
                  14=ILLINOIS
                  15=INDIANA
                  16=IOWA
                  17=KANSAS


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 14
     Federally Qualified Health Center, CATEGORY = "21" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  18=KENTUCKY
                  19=LOUISIANA
                  20=MAINE
                  21=MARYLAND
                  22=MASSACHUSETTS
                  23=MICHIGAN
                  24=MINNESOTA
                  25=MISSISSIPPI
                  26=MISSOURI
                  27=MONTANA
                  28=NEBRASKA
                  29=NEVADA
                  30=NEW HAMPSHIRE
                  31=NEW JERSEY
                  32=NEW MEXICO
                  33=NEW YORK
                  34=NORTH CAROLINA
                  35=NORTH DAKOTA
                  36=OHIO
                  37=OKLAHOMA
                  38=OREGON
                  39=PENNSYLVANIA
                  40=PUERTO RICO
                  41=RHODE ISLAND
                  42=SOUTH CAROLINA
                  43=SOUTH DAKOTA
                  44=TENNESSEE
                  45=TEXAS
                  46=UTAH
                  47=VERMONT
                  48=VIRGIN ISLANDS
                  49=VIRGINIA
                  50=WASHINGTON
                  51=WEST VIRGINIA
                  52=WISCONSIN
                  53=WYOMING
                  54=AFRICA
                  56=CANADA
                  57=WEST INDIES
                  58=EUROPE
                  59=MEXICO
                  60=OCEANIA
                  61=PHILIPPINES
                  62=SOUTH AMERICA
                  63=UNITED STATES POSSESSIONS
                  64=AMERICAN SAMOA
                  65=GUAM
                  66=SAIPAN
                  99=INTERNATIONAL

   State Region Code                                 3    175   177  VARCHAR2
     Description: Identifies the region within a state where the provider
                  is located.
     SAS Name:    STATE_RGN_CD
     COBOL Name:  STATE-RGN-CD
     VALUES:      AK/001=ALASKA
                  AK/LAB=LABORATORIES
                  AK/NPH=NON-PARTICIPATING HOSPITAL
                  AL/001=ALABAMA
                  AL/LAB=LABORATORIES
                  AL/NPH=NON-PARTICIPATING HOSPITAL
                  AR/001=ARKANSAS
                  AR/LAB=LABORATORIES
                  AR/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 15
     Federally Qualified Health Center, CATEGORY = "21" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  AS/001=AMERICAN SAMOA
                  AS/LAB=LABORATORY
                  AS/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/AZ=PHOENIX
                  AZ/LAB=ARIZONA LAB
                  AZ/NPH=NON-PARTICIPATING HOSPITAL
                  AZ/TUC=TUCSON
                  CA/001=CALIFORNIA
                  CA/BAK=BAKERSFIELD
                  CA/BER=SAN BERNARDINO
                  CA/EB=East Bay
                  CA/FR=FRESNO
                  CA/L1=L.A. WEST
                  CA/L2=L.A. NORTH
                  CA/L3=L.A. CENTRAL
                  CA/L4=L.A. EAST
                  CA/L5=SAN GABRIEL
                  CA/LA1=LA Region 1
                  CA/LA2=LA Region 2
                  CA/LA3=LA Region 3
                  CA/LA4=LA Acute/Ancillary
                  CA/LA5=LA HHA/Hospice
                  CA/LA6=LA ICF/DD/CLinics
                  CA/LAB=LABORATORIES
                  CA/M1=LAB. SOUTH
                  CA/M2=LAB. NORTH
                  CA/NPH=NON-PARTICIPATING HOSPITAL
                  CA/ORG=ORANGE
                  CA/RIV=RIVERSIDE
                  CA/S1=SACRAMENTO
                  CA/S3=CHICO
                  CA/SD=SAN DIEGO
                  CA/SF=SAN FRANCISCO
                  CA/SJ=SAN JOSE
                  CA/SR=SANTA ROSA
                  CA/VEN=VENTURA
                  CN/001=CANADA
                  CN/LAB=LABORATORY
                  CN/NPH=NON-PARTICIPATING HOSPITAL
                  CO/001=COLORADO
                  CO/LAB=LABORATORIES
                  CO/NPH=NON-PARTICIPATING HOSPITAL
                  CT/001=CONNECTICUT
                  CT/LAB=LABORATORIES
                  CT/NPH=NON-PARTICIPATING HOSPITAL
                  DC/001=DISTRICT OF COLUMBIA
                  DC/LAB=LABORATORIES
                  DC/NPH=NON-PARTICIPATING HOSPITAL
                  DE/001=DELAWARE
                  DE/LAB=LABORATORIES
                  DE/NPH=NON-PARTICIPATING HOSPITAL
                  FL/001=FLORIDA
                  FL/FTM=FT. MYERS
                  FL/GAI=GAINESVILLE
                  FL/JAX=JACKSONVILLE
                  FL/LAB=LABORATORIES
                  FL/LAN=LANTANA
                  FL/LAU=LAUDERHILL
                  FL/MIA=MIAMI
                  FL/NPH=NON-PARTICIPATING HOSPITAL
                  FL/ORL=ORLANDO
                  FL/PEN=PENSACOLA
                  FL/STP=ST. PETERSBURG
                  FL/TAL=TALLAHASSEE


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 16
     Federally Qualified Health Center, CATEGORY = "21" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  FL/TAM=TAMPA
                  FM/001=FEDERATED STATES OF MICRO
                  FM/NPH=NON-PARTICIPATING HOSPITAL
                  FN/001=INTERNATIONAL
                  FN/LAB=LABORATORIES
                  FN/NPH=NON-PARTICIPATING HOSPITAL
                  GA/001=GEORGIA
                  GA/GAA=GEORGIA ALL
                  GA/GAC=GEORGIA CENTRAL
                  GA/GAE=GEORGIA EASTERN
                  GA/GAN=GEORGIA NORTH
                  GA/GAS=GEORGIA SOUTH
                  GA/GAW=GEORGIA WESTERN
                  GA/LAB=LABORATORIES
                  GA/NPH=NON-PARTICIPATING HOSPITAL
                  GU/001=GUAM
                  GU/LAB=LABORATORIES
                  GU/NPH=NON-PARTICIPATING HOSPITAL
                  HI/001=HAWAII
                  HI/LAB=LABORATORIES
                  HI/NPH=NON-PARTICIPATING HOSPITAL
                  IA/001=IOWA
                  IA/LAB=LABORATORIES
                  IA/NPH=NON-PARTICIPATING HOSPITAL
                  ID/001=IDAHO
                  ID/LAB=LABORATORIES
                  ID/NPH=NON-PARTICIPATING HOSPITAL
                  IL/001=ILLINOIS
                  IL/LAB=LABORATORIES
                  IL/NPH=NON-PARTICIPATING HOSPITAL
                  IN/001=INDIANA
                  IN/LAB=LABORATORIES
                  IN/NPH=NON-PARTICIPATING HOSPITAL
                  KS/001=KANSAS
                  KS/KCK=KANSAS CITY
                  KS/KDH=KDHE
                  KS/LAB=LABORATORIES
                  KS/LAW=LAWRENCE
                  KS/NC=NORTH CENTRAL KANSAS
                  KS/NE=NORTH EAST KANSAS
                  KS/NPH=NON-PARTICIPATING HOSPITAL
                  KS/NW=NORTH WEST KANSAS
                  KS/SC=SOUTH CENTRAL KANSAS
                  KS/SE=SOUTH EAST KANSAS
                  KS/SW=SOUTH WEST KANSAS
                  KS/WST=WEST
                  KY/2C1=HOPKINSVILLE
                  KY/2C2=LOUISVILLE
                  KY/2C3=LONDON
                  KY/2C4=LEXINGTON
                  KY/LAB=LABORATORIES
                  KY/NPH=NON-PARTICIPATING HOSPITAL
                  LA/001=LOUISIANA
                  LA/LA1=NEW ORLEANS
                  LA/LA2=MANDEVILLE
                  LA/LA3=LAFAYETTE
                  LA/LA4=MONROE
                  LA/LA5=SHREVEPORT
                  LA/LA6=ALEXANDRIA
                  LA/LAB=LABORATORIES
                  LA/LB1=CLIA NEW ORLEANS
                  LA/LB5=CLIA SHREVEPORT
                  LA/LB6=CLIA ALEXANDRIA
                  LA/NPH=NON-PARTICIPATING HOSPITAL


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 17
     Federally Qualified Health Center, CATEGORY = "21" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  MA/001=MASSACHUSETTS
                  MA/LAB=LABORATORIES
                  MA/NPH=NON-PARTICIPATING HOSPITAL
                  MD/001=MARYLAND
                  MD/LAB=LABORATORIES
                  MD/NPH=NON-PARTICIPATING HOSPITAL
                  ME/001=MAINE
                  ME/LAB=LABORATORIES
                  ME/NPH=NON-PARTICIPATING HOSPITAL
                  MH/001=MARSHALL ISLANDS
                  MH/NPH=NON-PARTICIPATING HOSPITAL
                  MI/001=MICHIGAN
                  MI/LAB=LABORATORIES
                  MI/NPH=NON-PARTICIPATING HOSPITAL
                  MN/001=MINNESOTA
                  MN/LAB=LABORATORIES
                  MN/NPH=NON-PARTICIPATING HOSPITAL
                  MO/001=MISSOURI
                  MO/01=REGION01
                  MO/02=REGION02
                  MO/03=REGION 03
                  MO/04=REGION 04
                  MO/05=REGION 05
                  MO/06=REGION 06
                  MO/07=REGION 07
                  MO/1NH=REGION 1 NH
                  MO/2NH=REGION 2 NH
                  MO/3NH=REGION 3 NH
                  MO/4NH=REGION 4 NH
                  MO/5NH=REGION 5 NH
                  MO/6NH=REGION 6 NH
                  MO/7NH=REGION 7 NH
                  MO/LAB=LABORATORIES
                  MO/MO=STATEWIDE
                  MO/NPH=NON-PARTICIPATING HOSPITAL
                  MP/001=NORTHERN MARIANA ISLANDS
                  MP/LAB=LABORATORIES
                  MP/NPH=NON-PARTICIPATING HOSPITAL
                  MS/001=MISSISSIPPI
                  MS/LAB=LABORATORIES
                  MS/NPH=NON-PARTICIPATING HOSPITAL
                  MT/001=MONTANA
                  MT/LAB=LABORATORIES
                  MT/NPH=NON-PARTICIPATING HOSPITAL
                  MX/001=MEXICO
                  MX/LAB=LABORATORY
                  MX/NPH=NON-PARTICIPATING HOSPITAL
                  NC/001=NORTH CAROLINA
                  NC/LAB=LABORATORIES
                  NC/NCC=NORTH CAROLINA CENTRAL
                  NC/NCE=NORTH CAROLINA EAST
                  NC/NCN=NORTH CAROLINA NORTH
                  NC/NCS=NORTH CAROLINA SOUTH
                  NC/NCW=NORTH CAROLINA WEST
                  NC/NPH=NON-PARTICIPATING HOSPITAL
                  ND/001=NORTH DAKOTA
                  ND/LAB=LABORATORIES
                  ND/NPH=NON-PARTICIPATING HOSPITAL
                  NE/001=NEBRASKA
                  NE/1=NORTH CENTRAL
                  NE/2=CENTRAL
                  NE/3=NORTHEAST
                  NE/4=SOUTHEAST
                  NE/5=WESTERN


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 18
     Federally Qualified Health Center, CATEGORY = "21" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  NE/LAB=LABORATORIES
                  NE/NPH=NON-PARTICIPATING HOSPITAL
                  NH/001=NEW HAMPSHIRE
                  NH/LAB=LABORATORIES
                  NH/NPH=NON-PARTICIPATING HOSPITAL
                  NJ/001=NEW JERSEY
                  NJ/LAB=LABORATORIES
                  NJ/NPH=NON-PARTICIPATING HOSPITAL
                  NM/001=NEW MEXICO
                  NM/LAB=LABORATORIES
                  NM/NPH=NON-PARTICIPATING HOSPITAL
                  NV/001=NEVADA
                  NV/CC=CARSON CITY
                  NV/LAB=LABORATORIES
                  NV/LV=LAS VEGAS
                  NV/NPH=NON-PARTICIPATING HOSPITAL
                  NY/001=BUFFALO
                  NY/002=ROCHESTER
                  NY/003=SYRACUSE
                  NY/004=ALBANY
                  NY/005=NEW ROCHELLE
                  NY/006=NEW YORK CITY
                  NY/007=SUFFOLK/NASSAU COUNTY
                  NY/LAB=LABORATORIES
                  NY/NPH=NON-PARTICIPATING HOSPITAL
                  OH/001=OHIO
                  OH/LAB=LABORATORIES
                  OH/NPH=NON-PARTICIPATING HOSPITAL
                  OK/001=OKLAHOMA
                  OK/LAB=LABORATORIES
                  OK/NPH=NON-PARTICIPATING HOSPITAL
                  OR/001=OFFICE #1
                  OR/002=OFFICE #2
                  OR/003=OFFICE #3
                  OR/LAB=LABORATORIES
                  OR/NPH=NON-PARTICIPATING HOSPITAL
                  PA/001=PENNSYLVANIA
                  PA/LAB=LABORATORIES
                  PA/NPH=NON-PARTICIPATING HOSPITAL
                  PR/001=PUERTO RICO
                  PR/LAB=LABORATORIES
                  PR/NPH=NON-PARTICIPATING HOSPITAL
                  PW/001=PALAU
                  PW/NPH=NON-PARTICIPATING HOSPITAL
                  RI/001=RHODE ISLAND
                  RI/LAB=LABORATORIES
                  RI/NPH=NON-PARTICIPATING HOSPITAL
                  SC/001=SOUTH CAROLINA
                  SC/LAB=LABORATORIES
                  SC/NPH=NON-PARTICIPATING HOSPITAL
                  SD/001=SOUTH DAKOTA
                  SD/LAB=LABORATORIES
                  SD/NPH=NON-PARTICIPATING HOSPITAL
                  TN/001=TENNESSEE
                  TN/LAB=LABORATORIES
                  TN/NPH=NON-PARTICIPATING HOSPITAL
                  TN/TNC=TENNESSEE COOKEVILLE
                  TN/TNE=TENNESSEE EASTERN
                  TN/TNM=TENNESSEE MIDDLE
                  TN/TNW=TENNESSEE WESTERN
                  TX/001=TEXAS
                  TX/L01=AMARILLO-LTC
                  TX/L02=ABILENE-LTC
                  TX/L03=ARLINGTON-LTC


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 19
     Federally Qualified Health Center, CATEGORY = "21" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  TX/L04=TYLER-LTC
                  TX/L05=TEMPLE-LTC
                  TX/L06=HOUSTON-LTC
                  TX/L07=SAN ANTONIO-LTC
                  TX/LAB=LABORATORIES
                  TX/NPH=NON-PARTICIPATING HOSPITAL
                  TX/TX1=NLTC REG 1, 7, 9, 10
                  TX/TX2=NLTC REG 2, 3
                  TX/TX4=NLTC REG 6
                  TX/TX5=NLTC REG 4, 5
                  TX/TX6=AUSTIN
                  TX/TX8=NLTC REG 8, 11
                  UT/001=UTAH
                  UT/LAB=LABORATORIES
                  UT/NPH=NON-PARTICIPATING HOSPITAL
                  VA/001=VIRGINIA
                  VA/LAB=LABORATORIES
                  VA/NPH=NON-PARTICIPATING HOSPITAL
                  VI/001=VIRGIN ISLANDS
                  VI/LAB=LABORATORIES
                  VI/NPH=NON-PARTICIPATING HOSPITAL
                  VT/001=VERMONT
                  VT/LAB=LABORATORIES
                  VT/NPH=NON-PARTICIPATING HOSPITAL
                  WA/001=ALL OTHERS (NON-LTC FAC)
                  WA/D1=SPOKANE & YAKIMA AREAS
                  WA/D1A=District 1, Unit A
                  WA/D1B=District 1, Unit B
                  WA/D1C=District 1, Unit C
                  WA/D1D=District 1, Unit D
                  WA/D1E=District 1, Unit E
                  WA/D2=SPOKANE & SE
                  WA/D2A=District 2, Unit A
                  WA/D2B=District 2, Unit B
                  WA/D2C=District 2, Unit C
                  WA/D2D=District 2, Unit D
                  WA/D2E=District 2, Unit E
                  WA/D2F=District 2, Unit F
                  WA/D2G=District 2, Unit G
                  WA/D2H=District 2, Unit H
                  WA/D2I=District 2, Unit I
                  WA/D2J=District 2, Unit J
                  WA/D3=NW WASHINGTON
                  WA/D3A=District 3, Unit A
                  WA/D3B=District 3, Unit B
                  WA/D3C=District 3, Unit C
                  WA/D3D=District 3, Unit D
                  WA/D3E=District 3, Unit E
                  WA/D3F=District 3, Unit F
                  WA/D3G=District 3, Unit G
                  WA/D4A=GREATER SEATTLE AREA
                  WA/D4B=S KING COUNTY
                  WA/D5A=PIERCE CTY & PENINSULA
                  WA/D5B=PIERCE CTY & GRAYS HARBOR
                  WA/D6=OLYMPIA AREA
                  WA/LAB=LABORATORIES
                  WA/NPH=NON-PARTICIPATING HOSPITAL
                  WI/001=WISCONSIN
                  WI/LAB=LABORATORIES
                  WI/NPH=NON-PARTICIPATING HOSPITAL
                  WV/001=WEST VIRGINIA
                  WV/LAB=LABORATORIES
                  WV/NPH=NON-PARTICIPATING HOSPITAL
                  WY/001=WYOMING


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 20
     Federally Qualified Health Center, CATEGORY = "21" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  WY/LAB=LABORATORIES
                  WY/NPH=NON-PARTICIPATING HOSPITAL

   Address: Street                                   50   178   227  VARCHAR2
     Description: Street address where the provider is located.
     SAS Name:    ST_ADR
     COBOL Name:  ST-ADR

   Telephone Number                                  10   228   237  VARCHAR2
     Description: Telephone number of the provider.
     SAS Name:    PHNE_NUM
     COBOL Name:  PHNE-NUM

   Termination Code                                  2    238   239  VARCHAR2
     Description: Indicates the current termination status for the
                  provider.
     SAS Name:    PGM_TRMNTN_CD
     COBOL Name:  PGM-TRMNTN-CD
     VALUES:      00=ACTIVE PROVIDER
                  01=VOLUNTARY-MERGER, CLOSURE
                  02=VOLUNTARY-DISSATISFACTION WITH REIMBURSEMENT
                  03=VOLUNTARY-RISK OF INVOLUNTARY TERMINATION
                  04=VOLUNTARY-OTHER REASON FOR WITHDRAWAL
                  05=INVOLUNTARY-FAILURE TO MEET HEALTH/SAFETY REQ
                  06=INVOLUNTARY-FAILURE TO MEET AGREEMENT
                  07=OTHER-PROVIDER STATUS CHANGE
                  08=NONPAYMENT OF FEES - CLIA Only
                  09=REV/UNSUCCESSFUL PARTICIPATION IN PT - CLIA Only
                  10=REV/OTHER REASON - CLIA Only
                  11=INCOMPLETE CLIA APPLICATION INFORMATION - CLIA Only
                  12=NO LONGER PERFORMING TESTS - CLIA Only
                  13=MULTIPLE TO SINGLE SITE CERTIFICATE - CLIA Only
                  14=SHARED LABORATORY - CLIA Only
                  15=FAILURE TO RENEW WAIVER PPM CERTIFICATE - CLIA Only
                  16=DUPLICATE CLIA NUMBER - CLIA Only
                  17=MAIL RETURNED NO FORWARD ADDRESS CERT ENDED - CLIA Only
                  20=NOTIFICATION BANKRUPTCY - CLIA Only
                  33=ACCREDITATION NOT CONFIRMED - CLIA Only
                  80=AWAITING STATE APPROVAL
                  99=OIG ACTION - DO NOT ACTIVATE - CLIA Only

   Termination or Expiration Date                    8    240   247  DATE
     Description: Date the provider was terminated.  For CLIA providers,
                  date the laboratory's certificate was terminated or the
                  expiration date of the current CLIA certificate.
     SAS Name:    TRMNTN_EXPRTN_DT
     COBOL Name:  TRMNTN-EXPRTN-DT

   Type of Action Code                               1    248   248  VARCHAR2
     Description: Identifies the reason for the certification.  Type of
                  action from the official survey record, CMS 1539 form.
     SAS Name:    CRTFCTN_ACTN_TYPE_CD
     COBOL Name:  CRTFCTN-ACTN-TYPE-CD
     VALUES:      1=INITIAL
                  2=RECERTIFICATION
                  3=TERMINATION
                  4=CHANGE OF OWNERSHIP
                  5=VALIDATION
                  8=FULL SURVEY AFTER COMPLAINT

   Ownership Type Code                               2    249   250  VARCHAR2
     Description: Indicates the ownership type of the provider.
     SAS Name:    GNRL_CNTL_TYPE_CD
     COBOL Name:  GNRL-CNTL-TYPE-CD


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 21
     Federally Qualified Health Center, CATEGORY = "21" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

     VALUES:      01=RELIGIOUS AFFILIATION
                  02=PRIVATE
                  03=OTHER
                  04=PROPRIETARY
                  05=GOVERNMENT - STATE/COUNTY
                  06=GOVERNMENT - COMBINATION GOVT & VOLUNTARY

   Address: ZIP Code                                 5    251   255  VARCHAR2
     Description: Five-digit ZIP code for a provider's physical address.
     SAS Name:    ZIP_CD
     COBOL Name:  ZIP-CD

   FIPS State Code                                   2    256   257  VARCHAR2
     Description: FIPS State Code
     SAS Name:    FIPS_STATE_CD
     COBOL Name:  FIPS-STATE-CD
     VALUES:      01=ALABAMA
                  02=ALASKA
                  04=ARIZONA
                  05=ARKANSAS
                  06=CALIFORNIA
                  08=COLORADO
                  09=CONNECTICUT
                  10=DELAWARE
                  11=DISTRICT OF COLUMBIA
                  12=FLORIDA
                  13=GEORGIA
                  15=HAWAII
                  16=IDAHO
                  17=ILLINOIS
                  18=INDIANA
                  19=IOWA
                  20=KANSAS
                  21=KENTUCKY
                  22=LOUISIANA
                  23=MAINE
                  24=MARYLAND
                  25=MASSACHUSETTS
                  26=MICHIGAN
                  27=MINNESOTA
                  28=MISSISSIPPI
                  29=MISSOURI
                  30=MONTANA
                  31=NEBRASKA
                  32=NEVADA
                  33=NEW HAMPSHIRE
                  34=NEW JERSEY
                  35=NEW MEXICO
                  36=NEW YORK
                  37=NORTH CAROLINA
                  38=NORTH DAKOTA
                  39=OHIO
                  40=OKLAHOMA
                  41=OREGON
                  42=PENNSYLVANIA
                  43=PUERTO RICO
                  44=RHODE ISLAND
                  45=SOUTH CAROLINA
                  46=SOUTH DAKOTA
                  47=TENNESSEE
                  48=TEXAS
                  49=UTAH
                  50=VERMONT
                  51=VIRGINIA


 DATE: 07/01/2021              POS RECORD LAYOUT                      PAGE: 22
     Federally Qualified Health Center, CATEGORY = "21" (SEE POSITIONS 3-4)

   SHORT DESCRIPTION                                LEN  START END    TYPE

                  53=WASHINGTON
                  54=WEST VIRGINIA
                  55=WISCONSIN
                  56=WYOMING
                  60=AMERICAN SAMOA
                  66=GUAM
                  69=SAIPAN/MARIANA IS.
                  78=VIRGIN ISLANDS

   FIPS County Code                                  3    258   260  VARCHAR2
     Description: FIPS County Code
     SAS Name:    FIPS_CNTY_CD
     COBOL Name:  FIPS-CNTY-CD

   CBSA Urban Rural Indicator                        1    261   261  VARCHAR2
     Description: CBSA (Core Based Statistical Area) indicates whether the
                  county is defined as Urban or Rural.
     SAS Name:    CBSA_URBN_RRL_IND
     COBOL Name:  CBSA-URBN-RRL-IND

   CBSA Code                                         5    262   266  VARCHAR2
     Description: CBSA (Core Based Statistical Area) geographic entities
                  defined by the U.S. Office of Management and Budget (OMB)
                  on June 6, 2003 for use by Federal statistical agencies
                  in collecting, tabulating, and publishing Federal
                  statistics.  CBSA collectively refers to MSA.
     SAS Name:    CBSA_CD
     COBOL Name:  CBSA-CD

   FQHC Approved RHC Provider Num                    10   468   477  CHAR
     Description: FQHC approved provider number
     SAS Name:    FQHC_APPROVED_RHC_PROVIDER_NUM
     COBOL Name:  FQHC-APPROVED-RHC-PROVIDER-NUM

   FQHC Federally Funded Indicator                   1    478   478  VARCHAR2
     Description: Indicates whether this facility receives federal funds.
     SAS Name:    FED_FUNDD_FQHC_SW
     COBOL Name:  FED-FUNDD-FQHC-SW

   Part of RHC Indicator                             1    638   638  VARCHAR2
     Description: Indicates if the facility is part of a Medicare approved
                  Rural Health Clinic.
     SAS Name:    FQHC_APRVD_RHC_SW
     COBOL Name:  FQHC-APRVD-RHC-SW

   Related Provider Number                           10   686   695  CHAR
     Description: Related provider number
     SAS Name:    RELATED_PROVIDER_NUMBER
     COBOL Name:  RELATED-PROVIDER-NUMBER

