RIC         1  2                                        C Record Identification Code

VERSION     3  1                                        C Version Number

BASEID      4  8  $BSIDFMT                              C Unique SP Identification Number

                              15,806             LOW-HIGH BASEID Count

H_DOB      12  8  $DTE8FMT                              C Date of birth

                              15,806                      Date as YYYYMMDD

H_DOD      20  8  $DTE8FMT                              C Date of death

                              15,674                      Missing
                                 132                      Date as YYYYMMDD

H_DODSRC   28  2  $SRCFMT                               C Source of date of death

                              15,674                      No date of death
                                   0                   01 From Medicare bill
                                   0                   03 Clerical entry
                                   0                   05 Bill and clerical entry
                                  71                   10 Proven Medicare Benefits record
                                   8                   11 Proven Medicare Benefits record & bills
                                  44                   20 Unproven Medicare Benefits record
                                   9                   21 Unproven Mcare Benefits record & bills
                                   0                   23 Unproven Mcare Benefits rec & clerical
                                   0                   25 Unproven Mcare Benefits rec, bill & cler

H_SEX      30  1  $SEXFMT                               C Sex code

                               7,004                    1 Male
                               8,802                    2 Female

H_RACE     31  1  $RACEFMT                              C Race code

                                  20                    0 Unknown
                              13,340                    1 White
                               1,629                    2 Black
                                 181                    3 Other
                                 194                    4 Asian
                                 362                    5 Hispanic
                                  80                    6 North American Native

H_AGE      32  3  AGEFMT                                N SP age based on CMS date of birth

                              15,806                      Age in years

D_STRAT    35  1  $AGEFMT                               C MCBS Sample age stratum

                               1,416                    1  0-44
                               1,381                    2 45-64
                               2,620                    3 65-69
                               2,720                    4 70-74
                               2,568                    5 75-79
                               2,565                    6 80-84
                               2,536                    7 85 +

H_ENT01    36  1  $ENTFMT                               C Medicare entitlement code for Jan

                                 667                    A Part A Medicare only
                                  86                    B Part B Medicare only
                              15,053                    C Parts A and B Medicare
                                   0                    N No Medicare entitlement

H_ENT02    37  1  $ENTFMT                               C Medicare entitlement code for Feb

                                 663                    A Part A Medicare only
                                  86                    B Part B Medicare only
                              15,057                    C Parts A and B Medicare
                                   0                    N No Medicare entitlement

H_ENT03    38  1  $ENTFMT                               C Medicare entitlement code for Mar

                                 659                    A Part A Medicare only
                                  85                    B Part B Medicare only
                              15,062                    C Parts A and B Medicare
                                   0                    N No Medicare entitlement

H_ENT04    39  1  $ENTFMT                               C Medicare entitlement code for Apr

                                 650                    A Part A Medicare only
                                  84                    B Part B Medicare only
                              15,072                    C Parts A and B Medicare
                                   0                    N No Medicare entitlement

H_ENT05    40  1  $ENTFMT                               C Medicare entitlement code for May

                                 647                    A Part A Medicare only
                                  83                    B Part B Medicare only
                              15,076                    C Parts A and B Medicare
                                   0                    N No Medicare entitlement

H_ENT06    41  1  $ENTFMT                               C Medicare entitlement code for Jun

                                 646                    A Part A Medicare only
                                  81                    B Part B Medicare only
                              15,078                    C Parts A and B Medicare
                                   1                    N No Medicare entitlement

H_ENT07    42  1  $ENTFMT                               C Medicare entitlement code for Jul

                                 612                    A Part A Medicare only
                                  79                    B Part B Medicare only
                              15,113                    C Parts A and B Medicare
                                   2                    N No Medicare entitlement

H_ENT08    43  1  $ENTFMT                               C Medicare entitlement code for Aug

                                 609                    A Part A Medicare only
                                  80                    B Part B Medicare only
                              15,116                    C Parts A and B Medicare
                                   1                    N No Medicare entitlement

H_ENT09    44  1  $ENTFMT                               C Medicare entitlement code for Sep

                                 601                    A Part A Medicare only
                                  80                    B Part B Medicare only
                              15,121                    C Parts A and B Medicare
                                   4                    N No Medicare entitlement

H_ENT10    45  1  $ENTFMT                               C Medicare entitlement code for Oct

                                 592                    A Part A Medicare only
                                  81                    B Part B Medicare only
                              15,121                    C Parts A and B Medicare
                                  12                    N No Medicare entitlement

H_ENT11    46  1  $ENTFMT                               C Medicare entitlement code for Nov

                                 592                    A Part A Medicare only
                                  80                    B Part B Medicare only
                              15,104                    C Parts A and B Medicare
                                  30                    N No Medicare entitlement

H_ENT12    47  1  $ENTFMT                               C Medicare entitlement code for Dec

                                 594                    A Part A Medicare only
                                  79                    B Part B Medicare only
                              15,045                    C Parts A and B Medicare
                                  88                    N No Medicare entitlement

H_DOE      48  8  $DTE8FMT                              C Medicare entitlement start date

                              15,806                      Date as YYYYMMDD

H_DOT      56  8  $DTE8FMT                              C Medicare entitlement end date

                              15,792                      Missing
                                  14                      Date as YYYYMMDD

H_MEDSTA   64  2  $MSCFMT                               C Medicare status code as of 12/31

                                  15                      Unknown
                              12,896                   10 Aged, no ESRD
                                  52                   11 Aged, ESRD
                               2,784                   20 Disabled, no ESRD
                                  44                   21 Disabled, ESRD
                                  15                   31 ESRD only

H_LAF      66  2  $LAFFMT                               C Status of SSA check (LAF) as of 12/31

                                   1                      Unknown
                                   0                   AD Cur pay-adj for dual entitlement
                                   0                   AF Transfer to another PC or dio
                                   0                   A9 Cur pay-miscellaneous adjustment
                              15,144                    C Current payment status
                                   0                   DW Deferred-Workers' Compensation
                                   0                   D2 DEF-retirement test
                                   0                   D3 DEF-D2 for primary
                                   7                   D6 DEF-recover overpayment
                                   3                   D9 DEF-miscellaneous reason
                                   0                    J Advanced filing-current pay
                                   0                   L2 Advanced filing-worked inside U S
                                   0                   L3 Advanced filing-insured worked in U S
                                   0                    N Not in pay status
                                   0                   PB Delayed-benefit due but not paid
                                   0                    R Cur pay-Part B reinstated
                                   0                   RN Cur pay-Part B reinstated
                                   1                    S SUSP-deferred retirement
                                   1                   SD SUSP-other
                                   0                   SF SUSP-fails to meet residence requirment
                                  67                   SH SUSP-government pension
                                   0                   SP SUSP-public assistance
                                   0                   SW SUSP-Workers' Compensation
                                   0                   S0 SUSP-continuing disability investig
                                   0                   S2 SUSP-fails retirement test
                                   0                   S3 SUSP-primary account S2
                                   6                   S6 SUSP-check returned for address
                                  30                   S7 SUSP-vocational rehab refusal
                                   2                   S8 SUSP-payee not determined
                                  15                   S9 SUSP-miscellaneous reason
                                   0                   TA TERM-prior to entitlement
                                   0                   TJ TERM-prior to entlmt, not stop debit
                                   0                   TR TERM-claim withdrawn
                                   0                   T0 TERM-benefits paid by another agency
                                 112                   T1 TERM-death of beneficiary
                                   0                   T2 TERM-death of primary
                                   0                   T3 TERM-divorce, marriage, remarriage
                                   0                   T4 TERM-dependent child attained age 18
                                   0                   T5 TERM-entitled on another account
                                   0                   T6 TERM-child no longer student, disabled
                                   1                   T8 TERM-recovery from disability
                                   0                   T9 TERM-miscellaneous
                                 411                    U Active uninsured status (no SSA check)
                                   0                   XF Transfer to another PC or DIO
                                   0                   XR Terminated -
                                   3                   X1 TERM-death of insured
                                   0                   X5 TERM-entitled to another benefit
                                   2                   X7 TERM of uninsured
                                   0                   X9 TERM miscellaneous
                                   0                   ZZ Erroneous entitlement

H_RESST    68  2  $STFMT                                C SSA State code of residence as of 12/31

                                 573                   01 Alabama
                                   0                   02 Alaska
                                 293                   03 Arizona
                                 158                   04 Arkansas
                               1,093                   05 California
                                 121                   06 Colorado
                                 212                   07 Connecticut
                                   4                   08 Delaware
                                  19                   09 Washington, DC
                               1,229                   10 Florida
                                 509                   11 Georgia
                                   0                   12 Hawaii
                                   1                   13 Idaho
                                 499                   14 Illinois
                                  50                   15 Indiana
                                 144                   16 Iowa
                                 163                   17 Kansas
                                 295                   18 Kentucky
                                 161                   19 Louisiana
                                   0                   20 Maine
                                 220                   21 Maryland
                                 295                   22 Massachusetts
                                 859                   23 Michigan
                                 251                   24 Minnesota
                                   1                   25 Mississippi
                                 412                   26 Missouri
                                   0                   27 Montana
                                 143                   28 Nebraska
                                 332                   29 Nevada
                                   6                   30 New Hampshire
                                 454                   31 New Jersey
                                 289                   32 New Mexico
                               1,058                   33 New York
                                 773                   34 North Carolina
                                   0                   35 North Dakota
                                 771                   36 Ohio
                                 144                   37 Oklahoma
                                   3                   38 Oregon
                                 850                   39 Pennsylvania
                                 276                   40 Puerto Rico
                                   0                   41 Rhode Island
                                 134                   42 South Carolina
                                   0                   43 South Dakota
                                 441                   44 Tennessee
                               1,006                   45 Texas
                                   0                   46 Utah
                                   0                   47 Vermont
                                   0                   48 Virgin Islands
                                 174                   49 Virginia
                                 606                   50 Washington
                                 214                   51 West Virginia
                                 426                   52 Wisconsin
                                 143                   53 Wyoming
                                   1                      Unknown

H_RESCTY   70  3  $CTYFMT                               C SSA county code of residence as of 12/31

                              15,806                      County code

H_ZIP      73  5  $ZIPFMT                               C Postal zip code of residence as of 12/31

                              15,806                      ZIP Code

H_CENSUS   78  2  $CENFMT                               C Census Region of residence as of 12/31

                                  14                      Missing
                                   1                   ** Unknown
                                 509                   01 New England
                               2,362                   02 Middle Atlantic
                               2,604                   03 East North Central
                               1,113                   04 West North Central
                               3,269                   05 South Atlantic
                               1,309                   06 East South Central
                               1,469                   07 West South Central
                               1,179                   08 Mountain
                               1,701                   09 Pacific
                                 276                   10 Puerto Rico

H_METRO    80  1  $METFMT                               C Metro status

                               4,084                    N Non-metro area
                                  14                    U Unknown
                              11,708                    Y Metro area

H_HSBEG1   81  8  $DTE8FMT                              C Beginning date of latest hospice period

                              15,416                      Missing
                                 390                      Date as YYYYMMDD

H_HSEND1   89  8  $DTE8FMT                              C Ending date of latest hospice period

                              15,416                      Missing
                                 390                      Date as YYYYMMDD

H_HSBEG2   97  8  $DTE8FMT                              C Beginning date of 2nd hospice period

                              15,641                      Missing
                                 165                      Date as YYYYMMDD

H_HSEND2  105  8  $DTE8FMT                              C Ending date of 2nd hospice period

                              15,641                      Missing
                                 165                      Date as YYYYMMDD

H_HSBEG3  113  8  $DTE8FMT                              C Beginning date of 3rd hospice period

                              15,696                      Missing
                                 110                      Date as YYYYMMDD

H_HSEND3  121  8  $DTE8FMT                              C Ending date of 3rd hospice period

                              15,696                      Missing
                                 110                      Date as YYYYMMDD

H_HSBEG4  129  8  $DTE8FMT                              C Beginning date of 4th hospice period

                              15,724                      Missing
                                  82                      Date as YYYYMMDD

H_HSEND4  137  8  $DTE8FMT                              C Ending date of 4th hospice period

                              15,724                      Missing
                                  82                      Date as YYYYMMDD

H_ESRBEG  145  8  $DTE8FMT                              C Beginning date of ESRD period

                              15,630                      Missing
                                 176                      Date as YYYYMMDD

H_ESREND  153  8  $DTE8FMT                              C Ending date of ESRD period

                              15,744                      Missing
                                  62                      Date as YYYYMMDD

H_GHPSW   161  1  $GHPSW                                C Some group health participation in year

                              12,725                    0 No enrollment
                               3,081                    1 Some enrollment

H_PNUM    162  3                                        N Number of GHPs in bene area

H_MANUM   165  3                                        N Number of MA plans in bene area

H_PFSNUM  168  3                                        N Number of PFFS plans in bene area

H_PLTP01  171  2  $PLNFMT                               C GHP plan type for Jan

                              13,303                      No enrollment
                                  15                   01 Health care prepayment plan
                                  71                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,397                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  20                   16 Employer PDP
                                   0                   17 Pace Demo plan
                                   0                   18 HCPP

H_PLPY01  173  5                                        N Medicare capitation payment for Jan

H_PLTP02  178  2  $PLNFMT                               C GHP plan type for Feb

                              13,132                      No enrollment
                                  15                   01 Health care prepayment plan
                                  73                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,551                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  35                   16 Employer PDP
                                   0                   17 Pace Demo plan
                                   0                   18 HCPP

H_PLPY02  180  5                                        N Medicare capitation payment for Feb

H_PLTP03  185  2  $PLNFMT                               C GHP plan type for Mar

                              13,116                      No enrollment
                                  15                   01 Health care prepayment plan
                                  73                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,567                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  35                   16 Employer PDP
                                   0                   17 Pace Demo plan
                                   0                   18 HCPP

H_PLPY03  187  5                                        N Medicare capitation payment for Mar

H_PLTP04  192  2  $PLNFMT                               C GHP plan type for Apr

                              13,034                      No enrollment
                                  15                   01 Health care prepayment plan
                                  72                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,649                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  36                   16 Employer PDP
                                   0                   17 Pace Demo plan
                                   0                   18 HCPP

H_PLPY04  194  5                                        N Medicare capitation payment for Apr

H_PLTP05  199  2  $PLNFMT                               C GHP plan type for May

                              12,992                      No enrollment
                                  15                   01 Health care prepayment plan
                                  72                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,691                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  36                   16 Employer PDP
                                   0                   17 Pace Demo plan
                                   0                   18 HCPP

H_PLPY05  201  5                                        N Medicare capitation payment for May

H_PLTP06  206  2  $PLNFMT                               C GHP plan type for Jun

                              12,966                      No enrollment
                                  15                   01 Health care prepayment plan
                                  72                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,717                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  36                   16 Employer PDP
                                   0                   17 Pace Demo plan
                                   0                   18 HCPP

H_PLPY06  208  5                                        N Medicare capitation payment for Jun

H_PLTP07  213  2  $PLNFMT                               C GHP plan type for Jul

                              12,931                      No enrollment
                                  15                   01 Health care prepayment plan
                                  72                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,752                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  36                   16 Employer PDP
                                   0                   17 Pace Demo plan
                                   0                   18 HCPP

H_PLPY07  215  5                                        N Medicare capitation payment for Jul

H_PLTP08  220  2  $PLNFMT                               C GHP plan type for Aug

                              12,899                      No enrollment
                                  15                   01 Health care prepayment plan
                                  72                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,784                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  36                   16 Employer PDP
                                   0                   17 Pace Demo plan
                                   0                   18 HCPP

H_PLPY08  222  5                                        N Medicare capitation payment for Aug

H_PLTP09  227  2  $PLNFMT                               C GHP plan type for Sep

                              12,889                      No enrollment
                                  15                   01 Health care prepayment plan
                                  72                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,794                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  36                   16 Employer PDP
                                   0                   17 Pace Demo plan
                                   0                   18 HCPP

H_PLPY09  229  5                                        N Medicare capitation payment for Sep

H_PLTP10  234  2  $PLNFMT                               C GHP plan type for Oct

                              12,884                      No enrollment
                                  15                   01 Health care prepayment plan
                                  72                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,799                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  36                   16 Employer PDP
                                   0                   17 Pace Demo plan
                                   0                   18 HCPP

H_PLPY10  236  5                                        N Medicare capitation payment for Oct

H_PLTP11  241  2  $PLNFMT                               C GHP plan type for Nov

                              12,886                      No enrollment
                                  15                   01 Health care prepayment plan
                                  72                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,797                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  36                   16 Employer PDP
                                   0                   17 Pace Demo plan
                                   0                   18 HCPP

H_PLPY11  243  5                                        N Medicare capitation payment for Nov

H_PLTP12  248  2  $PLNFMT                               C GHP plan type for Dec

                              12,882                      No enrollment
                                  15                   01 Health care prepayment plan
                                  74                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,799                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  36                   16 Employer PDP
                                   0                   17 Pace Demo plan
                                   0                   18 HCPP

H_PLPY12  250  5                                        N Medicare capitation payment for Dec

H_PDTP01  255  1  $DPLNFMT                              C Part D plan type for Jan

                                   2                      Unknown
                               6,621                    0 No Part D enrollment
                               2,594                    1 MA-PD plan
                               6,589                    2 PDP

H_PDPY01  256  5                                        N Part D capitation payment for Jan

H_PDLS01  261  1  $DLISFMT                              C LIS Indicator for Jan

                                   6                      Unknown
                              11,746                    1 No premium subsidy
                                  36                    2 25% premium subsidy
                                  54                    3 50% premium subsidy
                                  54                    4 75% premium subsidy
                               3,910                    5 100% premium subsidy

H_PDRS01  262  1  $DRDSFMT                              C RDS Indicator for Jan

                                   6                      Unknown
                              13,300                    N Employer not subsidized for the benefici
                               2,500                    Y Employer subsidized for the beneficiary

H_CRED01  263  1  $YES8FMT                              C Creditable Coverage For Jan

                                   2                      Unknown
                               3,419                    1 Yes
                              12,385                    2 No

H_PDTP02  264  1  $DPLNFMT                              C Part D plan type for Feb

                                   2                      Unknown
                               6,606                    0 No Part D enrollment
                               2,603                    1 MA-PD plan
                               6,595                    2 PDP

H_PDPY02  265  5                                        N Part D capitation payment for Feb

H_PDLS02  270  1  $DLISFMT                              C LIS Indicator for Feb

                                   6                      Unknown
                              11,735                    1 No premium subsidy
                                  37                    2 25% premium subsidy
                                  48                    3 50% premium subsidy
                                  56                    4 75% premium subsidy
                               3,924                    5 100% premium subsidy

H_PDRS02  271  1  $DRDSFMT                              C RDS Indicator for Feb

                                   6                      Unknown
                              13,300                    N Employer not subsidized for the benefici
                               2,500                    Y Employer subsidized for the beneficiary

H_CRED02  272  1  $YES8FMT                              C Creditable Coverage For Feb

                                   2                      Unknown
                               3,419                    1 Yes
                              12,385                    2 No

H_PDTP03  273  1  $DPLNFMT                              C Part D plan type for Mar

                                   2                      Unknown
                               6,586                    0 No Part D enrollment
                               2,641                    1 MA-PD plan
                               6,577                    2 PDP

H_PDPY03  274  5                                        N Part D capitation payment for Mar

H_PDLS03  279  1  $DLISFMT                              C LIS Indicator for Mar

                                   6                      Unknown
                              11,723                    1 No premium subsidy
                                  35                    2 25% premium subsidy
                                  49                    3 50% premium subsidy
                                  53                    4 75% premium subsidy
                               3,940                    5 100% premium subsidy

H_PDRS03  280  1  $DRDSFMT                              C RDS Indicator for Mar

                                   6                      Unknown
                              13,300                    N Employer not subsidized for the benefici
                               2,500                    Y Employer subsidized for the beneficiary

H_CRED03  281  1  $YES8FMT                              C Creditable Coverage For Mar

                                   2                      Unknown
                               3,419                    1 Yes
                              12,385                    2 No

H_PDTP04  282  1  $DPLNFMT                              C Part D plan type for Apr

                                   2                      Unknown
                               6,570                    0 No Part D enrollment
                               2,674                    1 MA-PD plan
                               6,560                    2 PDP

H_PDPY04  283  5                                        N Part D capitation payment for Apr

H_PDLS04  288  1  $DLISFMT                              C LIS Indicator for Apr

                                   6                      Unknown
                              11,708                    1 No premium subsidy
                                  35                    2 25% premium subsidy
                                  50                    3 50% premium subsidy
                                  51                    4 75% premium subsidy
                               3,956                    5 100% premium subsidy

H_PDRS04  289  1  $DRDSFMT                              C RDS Indicator for Apr

                                   6                      Unknown
                              13,300                    N Employer not subsidized for the benefici
                               2,500                    Y Employer subsidized for the beneficiary

H_CRED04  290  1  $YES8FMT                              C Creditable Coverage For Apr

                                   2                      Unknown
                               3,419                    1 Yes
                              12,385                    2 No

H_PDTP05  291  1  $DPLNFMT                              C Part D plan type for May

                                   2                      Unknown
                               6,605                    0 No Part D enrollment
                               2,678                    1 MA-PD plan
                               6,521                    2 PDP

H_PDPY05  292  5                                        N Part D capitation payment for May

H_PDLS05  297  1  $DLISFMT                              C LIS Indicator for May

                                  26                      Unknown
                              11,648                    1 No premium subsidy
                                  36                    2 25% premium subsidy
                                  47                    3 50% premium subsidy
                                  51                    4 75% premium subsidy
                               3,998                    5 100% premium subsidy

H_PDRS05  298  1  $DRDSFMT                              C RDS Indicator for May

                                  26                      Unknown
                              13,235                    N Employer not subsidized for the benefici
                               2,545                    Y Employer subsidized for the beneficiary

H_CRED05  299  1  $YES8FMT                              C Creditable Coverage For May

                                   2                      Unknown
                               3,418                    1 Yes
                              12,386                    2 No

H_PDTP06  300  1  $DPLNFMT                              C Part D plan type for Jun

                                   2                      Unknown
                               6,596                    0 No Part D enrollment
                               2,680                    1 MA-PD plan
                               6,528                    2 PDP

H_PDPY06  301  5                                        N Part D capitation payment for Jun

H_PDLS06  306  1  $DLISFMT                              C LIS Indicator for Jun

                                  27                      Unknown
                              11,626                    1 No premium subsidy
                                  37                    2 25% premium subsidy
                                  47                    3 50% premium subsidy
                                  53                    4 75% premium subsidy
                               4,016                    5 100% premium subsidy

H_PDRS06  307  1  $DRDSFMT                              C RDS Indicator for Jun

                                  27                      Unknown
                              13,234                    N Employer not subsidized for the benefici
                               2,545                    Y Employer subsidized for the beneficiary

H_CRED06  308  1  $YES8FMT                              C Creditable Coverage For Jun

                                   2                      Unknown
                               3,418                    1 Yes
                              12,386                    2 No

H_PDTP07  309  1  $DPLNFMT                              C Part D plan type for Jul

                                   2                      Unknown
                               6,545                    0 No Part D enrollment
                               2,712                    1 MA-PD plan
                               6,547                    2 PDP

H_PDPY07  310  5                                        N Part D capitation payment for Jul

H_PDLS07  315  1  $DLISFMT                              C LIS Indicator for Jul

                                  31                      Unknown
                              11,602                    1 No premium subsidy
                                  37                    2 25% premium subsidy
                                  48                    3 50% premium subsidy
                                  52                    4 75% premium subsidy
                               4,036                    5 100% premium subsidy

H_PDRS07  316  1  $DRDSFMT                              C RDS Indicator for Jul

                                  31                      Unknown
                              13,243                    N Employer not subsidized for the benefici
                               2,532                    Y Employer subsidized for the beneficiary

H_CRED07  317  1  $YES8FMT                              C Creditable Coverage For Jul

                                   2                      Unknown
                               3,419                    1 Yes
                              12,385                    2 No

H_PDTP08  318  1  $DPLNFMT                              C Part D plan type for Aug

                                   2                      Unknown
                               6,527                    0 No Part D enrollment
                               2,724                    1 MA-PD plan
                               6,553                    2 PDP

H_PDPY08  319  5                                        N Part D capitation payment for Aug

H_PDLS08  324  1  $DLISFMT                              C LIS Indicator for Aug

                                  30                      Unknown
                              11,580                    1 No premium subsidy
                                  36                    2 25% premium subsidy
                                  48                    3 50% premium subsidy
                                  50                    4 75% premium subsidy
                               4,062                    5 100% premium subsidy

H_PDRS08  325  1  $DRDSFMT                              C RDS Indicator for Aug

                                  30                      Unknown
                              13,244                    N Employer not subsidized for the benefici
                               2,532                    Y Employer subsidized for the beneficiary

H_CRED08  326  1  $YES8FMT                              C Creditable Coverage For Aug

                                   2                      Unknown
                               3,419                    1 Yes
                              12,385                    2 No

H_PDTP09  327  1  $DPLNFMT                              C Part D plan type for Sep

                                   2                      Unknown
                               6,510                    0 No Part D enrollment
                               2,726                    1 MA-PD plan
                               6,568                    2 PDP

H_PDPY09  328  5                                        N Part D capitation payment for Sep

H_PDLS09  333  1  $DLISFMT                              C LIS Indicator for Sep

                                  33                      Unknown
                              11,567                    1 No premium subsidy
                                  36                    2 25% premium subsidy
                                  48                    3 50% premium subsidy
                                  50                    4 75% premium subsidy
                               4,072                    5 100% premium subsidy

H_PDRS09  334  1  $DRDSFMT                              C RDS Indicator for Sep

                                  33                      Unknown
                              13,241                    N Employer not subsidized for the benefici
                               2,532                    Y Employer subsidized for the beneficiary

H_CRED09  335  1  $YES8FMT                              C Creditable Coverage For Sep

                                   2                      Unknown
                               3,419                    1 Yes
                              12,385                    2 No

H_PDTP10  336  1  $DPLNFMT                              C Part D plan type for Oct

                                   2                      Unknown
                               6,494                    0 No Part D enrollment
                               2,737                    1 MA-PD plan
                               6,573                    2 PDP

H_PDPY10  337  5                                        N Part D capitation payment for Oct

H_PDLS10  342  1  $DLISFMT                              C LIS Indicator for Oct

                                  40                      Unknown
                              11,551                    1 No premium subsidy
                                  37                    2 25% premium subsidy
                                  49                    3 50% premium subsidy
                                  49                    4 75% premium subsidy
                               4,080                    5 100% premium subsidy

H_PDRS10  343  1  $DRDSFMT                              C RDS Indicator for Oct

                                  40                      Unknown
                              13,234                    N Employer not subsidized for the benefici
                               2,532                    Y Employer subsidized for the beneficiary

H_CRED10  344  1  $YES8FMT                              C Creditable Coverage For Oct

                                   2                      Unknown
                               3,417                    1 Yes
                              12,387                    2 No

H_PDTP11  345  1  $DPLNFMT                              C Part D plan type for Nov

                                   2                      Unknown
                               6,496                    0 No Part D enrollment
                               2,746                    1 MA-PD plan
                               6,562                    2 PDP

H_PDPY11  346  5                                        N Part D capitation payment for Nov

H_PDLS11  351  1  $DLISFMT                              C LIS Indicator for Nov

                                  58                      Unknown
                              11,531                    1 No premium subsidy
                                  37                    2 25% premium subsidy
                                  50                    3 50% premium subsidy
                                  49                    4 75% premium subsidy
                               4,081                    5 100% premium subsidy

H_PDRS11  352  1  $DRDSFMT                              C RDS Indicator for Nov

                                  58                      Unknown
                              13,216                    N Employer not subsidized for the benefici
                               2,532                    Y Employer subsidized for the beneficiary

H_CRED11  353  1  $YES8FMT                              C Creditable Coverage For Nov

                                   2                      Unknown
                               3,413                    1 Yes
                              12,391                    2 No

H_PDTP12  354  1  $DPLNFMT                              C Part D plan type for Dec

                                   2                      Unknown
                               6,593                    0 No Part D enrollment
                               2,719                    1 MA-PD plan
                               6,492                    2 PDP

H_PDPY12  355  5                                        N Part D capitation payment for Dec

H_PDLS12  360  1  $DLISFMT                              C LIS Indicator for Dec

                                 127                      Unknown
                              11,469                    1 No premium subsidy
                                  37                    2 25% premium subsidy
                                  51                    3 50% premium subsidy
                                  49                    4 75% premium subsidy
                               4,073                    5 100% premium subsidy

H_PDRS12  361  1  $DRDSFMT                              C RDS Indicator for Dec

                                 127                      Unknown
                              13,393                    N Employer not subsidized for the benefici
                               2,286                    Y Employer subsidized for the beneficiary

H_CRED12  362  1  $YES8FMT                              C Creditable Coverage For Dec

                                   2                      Unknown
                               3,403                    1 Yes
                              12,401                    2 No

H_MCSW    363  1  $SWFMT                                C Some Medicaid eligibility for the year

                              12,503                    N No participation
                               3,303                    Y Some participation

H_MCDE01  364  1  $MCDCFMT                              C Medicaid eligibility for Jan

                                   0                    A State Part A buy-in
                               1,240                    B State Part B buy-in
                                  63                    C State Part A and B buy-in
                                 107                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              12,704                    N No buy-in this month
                               1,322                    Q State Part B QMB buy-in
                                 370                    S State Part B SLMB buy-in

H_MCDE02  365  1  $MCDCFMT                              C Medicaid eligibility for Feb

                                   0                    A State Part A buy-in
                               1,244                    B State Part B buy-in
                                  63                    C State Part A and B buy-in
                                 107                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              12,687                    N No buy-in this month
                               1,332                    Q State Part B QMB buy-in
                                 373                    S State Part B SLMB buy-in

H_MCDE03  366  1  $MCDCFMT                              C Medicaid eligibility for Mar

                                   0                    A State Part A buy-in
                               1,248                    B State Part B buy-in
                                  63                    C State Part A and B buy-in
                                 108                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              12,684                    N No buy-in this month
                               1,333                    Q State Part B QMB buy-in
                                 370                    S State Part B SLMB buy-in

H_MCDE04  367  1  $MCDCFMT                              C Medicaid eligibility for Apr

                                   0                    A State Part A buy-in
                               1,251                    B State Part B buy-in
                                  64                    C State Part A and B buy-in
                                 108                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              12,676                    N No buy-in this month
                               1,335                    Q State Part B QMB buy-in
                                 372                    S State Part B SLMB buy-in

H_MCDE05  368  1  $MCDCFMT                              C Medicaid eligibility for May

                                   0                    A State Part A buy-in
                               1,261                    B State Part B buy-in
                                  64                    C State Part A and B buy-in
                                 109                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              12,660                    N No buy-in this month
                               1,336                    Q State Part B QMB buy-in
                                 376                    S State Part B SLMB buy-in

H_MCDE06  369  1  $MCDCFMT                              C Medicaid eligibility for Jun

                                   0                    A State Part A buy-in
                               1,263                    B State Part B buy-in
                                  64                    C State Part A and B buy-in
                                 109                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              12,664                    N No buy-in this month
                               1,327                    Q State Part B QMB buy-in
                                 379                    S State Part B SLMB buy-in

H_MCDE07  370  1  $MCDCFMT                              C Medicaid eligibility for Jul

                                   0                    A State Part A buy-in
                               1,270                    B State Part B buy-in
                                  64                    C State Part A and B buy-in
                                 108                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              12,653                    N No buy-in this month
                               1,331                    Q State Part B QMB buy-in
                                 380                    S State Part B SLMB buy-in

H_MCDE08  371  1  $MCDCFMT                              C Medicaid eligibility for Aug

                                   0                    A State Part A buy-in
                               1,278                    B State Part B buy-in
                                  64                    C State Part A and B buy-in
                                 108                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              12,643                    N No buy-in this month
                               1,332                    Q State Part B QMB buy-in
                                 381                    S State Part B SLMB buy-in

H_MCDE09  372  1  $MCDCFMT                              C Medicaid eligibility for Sep

                                   0                    A State Part A buy-in
                               1,281                    B State Part B buy-in
                                  64                    C State Part A and B buy-in
                                 108                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              12,629                    N No buy-in this month
                               1,337                    Q State Part B QMB buy-in
                                 387                    S State Part B SLMB buy-in

H_MCDE10  373  1  $MCDCFMT                              C Medicaid eligibility for Oct

                                   0                    A State Part A buy-in
                               1,286                    B State Part B buy-in
                                  64                    C State Part A and B buy-in
                                 108                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              12,619                    N No buy-in this month
                               1,341                    Q State Part B QMB buy-in
                                 388                    S State Part B SLMB buy-in

H_MCDE11  374  1  $MCDCFMT                              C Medicaid eligibility for Nov

                                   0                    A State Part A buy-in
                               1,285                    B State Part B buy-in
                                  64                    C State Part A and B buy-in
                                 108                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              12,626                    N No buy-in this month
                               1,337                    Q State Part B QMB buy-in
                                 386                    S State Part B SLMB buy-in

H_MCDE12  375  1  $MCDCFMT                              C Medicaid eligibility for Dec

                                   0                    A State Part A buy-in
                               1,271                    B State Part B buy-in
                                  63                    C State Part A and B buy-in
                                 108                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              12,669                    N No buy-in this month
                               1,323                    Q State Part B QMB buy-in
                                 372                    S State Part B SLMB buy-in

H_MACY01  376  3  $MACYFMT                              C Buy-in agency for Jan

                              12,704                    N Unknown, or no buy-in
                               3,102                      State Agency code

H_MACY02  379  3  $MACYFMT                              C Buy-in agency for Feb

                              12,687                    N Unknown, or no buy-in
                               3,119                      State Agency code

H_MACY03  382  3  $MACYFMT                              C Buy-in agency for Mar

                              12,684                    N Unknown, or no buy-in
                               3,122                      State Agency code

H_MACY04  385  3  $MACYFMT                              C Buy-in agency for Apr

                              12,676                    N Unknown, or no buy-in
                               3,130                      State Agency code

H_MACY05  388  3  $MACYFMT                              C Buy-in agency for May

                              12,660                    N Unknown, or no buy-in
                               3,146                      State Agency code

H_MACY06  391  3  $MACYFMT                              C Buy-in agency for Jun

                              12,664                    N Unknown, or no buy-in
                               3,142                      State Agency code

H_MACY07  394  3  $MACYFMT                              C Buy-in agency for Jul

                              12,653                    N Unknown, or no buy-in
                               3,153                      State Agency code

H_MACY08  397  3  $MACYFMT                              C Buy-in agency for Aug

                              12,643                    N Unknown, or no buy-in
                               3,163                      State Agency code

H_MACY09  400  3  $MACYFMT                              C Buy-in agency for Sep

                              12,629                    N Unknown, or no buy-in
                               3,177                      State Agency code

H_MACY10  403  3  $MACYFMT                              C Buy-in agency for Oct

                              12,619                    N Unknown, or no buy-in
                               3,187                      State Agency code

H_MACY11  406  3  $MACYFMT                              C Buy-in agency for Nov

                              12,626                    N Unknown, or no buy-in
                               3,180                      State Agency code

H_MACY12  409  3  $MACYFMT                              C Buy-in agency for Dec

                              12,669                    N Unknown, or no buy-in
                               3,137                      State Agency code

H_HOSSW   412  1  $UTLFMT                               C One or more hospice bills in CY

                              15,630                    0 No utilization this type
                                 176                    1 Some utilization this type

H_INPSW   413  1  $UTLFMT                               C One or more inpatient discharges in CY

                              13,146                    0 No utilization this type
                               2,660                    1 Some utilization this type

H_SNFSW   414  1  $UTLFMT                               C One or more SNF admissions in CY

                              15,126                    0 No utilization this type
                                 680                    1 Some utilization this type

H_HHASW   415  1  $UTLFMT                               C 1 = one or more HHA visits in CY

                              14,629                    0 No utilization this type
                               1,177                    1 Some utilization this type

H_OUTSW   416  1  $UTLFMT                               C One or more outpatient visits in CY

                               6,840                    0 No utilization this type
                               8,966                    1 Some utilization this type

H_PBSW    417  1  $UTLFMT                               C One or more Part B claims in CY

                               3,468                    0 No utilization this type
                              12,338                    1 Some utilization this type

H_PTARMB  418  7                                        N Total Part A reimbursement in CY ($)

H_PTBRMB  425  7                                        N Total Part B reimbursement in CY ($)

H_PTAPRM  432  8                                        N Total Pt. A premium SP paid in CY ($.CC)

H_PTBPRM  440  8                                        N Total Pt. B premium SP paid in CY ($.CC)

H_LATDCH  448  8  $DTE8FMT                              C Discharge date of latest inpatient stay

                              13,146                      Missing
                               2,660                      Date as YYYYMMDD

H_LATDRG  456  3  $DRGFMT                               C DRG code for latest inpatient stay

                              13,146                      Unknown, or no discharge
                               2,660                      DRG

H_DISDES  459  2  $STATUS                               C Discharge dest for latest inpatient stay

                              13,146                      Missing
                               1,573                   01 Discharged to home/self care
                                  11                   02 Discharged to other short-term hospital
                                 505                   03 Discharged to skilled nursing facility
                                  32                   04 Discharged to intermediate care facility
                                  15                   05 Disch to another type of institution
                                 402                   06 Discharged to home care of organized HMO
                                  17                   07 Left against medical advice/stopped care
                                   0                   08 Disch home under care of IV therapy prov
                                  26                   20 Expired (did not recover Christian Sci)
                                   3                   30 Still patient
                                   0                   40 Expired at home (hospice claims only)
                                   0                   41 Expired in hospital, SNF, ICF or hospice
                                   0                   42 Expired in unknown place (hospice only)
                                  20                   50 Hospice - home (eff. 96)
                                  10                   51 Hospice - medical facility (eff. 96)
                                  26                   61 Disch w/i facility to swing-bed SNF (99)
                                   0                   71 Disch to other facility for O/P svcs(99)
                                   0                   72 Disch to this facility for O/P svcs (99)
                                  20                      Other destination

H_INPSTY  461  2                                        N No. of inpatient stays for CY

H_INPDAY  463  3                                        N No. of inpatient covered days for CY

H_INPCHG  466  7                                        N Inpatient charges for CY ($)

H_INPCCH  473  7                                        N Inpatient covered charges for CY ($)

H_INPRMB  480  7                                        N Inpatient reimbursement for CY ($)

H_INPCDY  487  2                                        N Inpatient coinsurance days used in CY

H_INPCAM  489  5                                        N Total inpatient coinsurance amt CY ($)

H_SNFSTY  494  2                                        N Total SNF stays in CY

H_SNFDAY  496  3                                        N Total SNF covered days in CY

H_SNFCHG  499  7                                        N Total SNF charges in CY  ($)

H_SNFCCH  506  7                                        N Total SNF covered charges in CY ($)

H_SNFRMB  513  7                                        N Total SNF reimbursement in CY ($)

H_SNFCDY  520  3                                        N Total SNF coinsurance days in CY

H_SNFCAM  523  7                                        N Total SNF coinsurance amount in CY ($)

H_HHAVST  530  5                                        N Total HHA visits in CY

H_HHACCH  535  7                                        N Total HHA covered charges in CY ($)

H_HHACHO  542  7                                        N Total HHA other covered charges CY ($)

H_HHRMBA  549  7                                        N Total HHA reimbursement in CY ($), Pt. A

                 Notes: Prior to 2000 this was included in H_HHARMB.
                        First available in 2000

H_HHRMBB  556  7                                        N Total HHA reimbursement in CY ($), Pt. B

                 Notes: Prior to 2000 this was included in H_HHARMB.
                        First available in 2000

H_HSDAYS  563  3                                        N Total covered hospice days in CY

H_HSTCHG  566  7                                        N Total hospice charges CY ($)

H_HSREIM  573  7                                        N Total hospice reimbursement in CY ($)

H_OUTBIL  580  3                                        N Total outpatient bills in CY

H_OUTCHG  583  7                                        N Total outpatient covered charges CY ($)

H_OUTRMB  590  7                                        N Total outpatient reimbursement CY ($)

H_PHYCLM  597  4                                        N Total physician claims in CY

                 Notes: Prior to 2000 this was included in H_PMTCLM.
                        First available in 2000

H_PHYLIN  601  4                                        N Total physician line items in CY

                 Notes: Prior to 2000 this was included in H_PMTLIN.
                        First available in 2000

H_PHYSCH  605  7                                        N Total physician submitted charges ($)

                 Notes: Prior to 2000 this was included in H_PMTSCH.
                        First available in 2000

H_PHYACH  612  7                                        N Total physician allowed charges ($)

                 Notes: Prior to 2000 this was included in H_PMTACH.
                        First available in 2000

H_PHYRMB  619  7                                        N Total physician reimbursement ($)

                 Notes: Prior to 2000 this was included in H_PMTRMB.
                        First available in 2000

H_PMTVST  626  3                                        N Total office visits in CY

H_PMTCHO  629  7                                        N Total office visit charges in CY ($)

H_DMECLM  636  4                                        N Total DME supplier claims in CY

                 Notes: Prior to 2000 this was included in H_PMTCLM.
                        First available in 2000

H_DMELIN  640  4                                        N Total DME supplier line items in CY

                 Notes: Prior to 2000 this was included in H_PMTLIN.
                        First available in 2000

H_DMESCH  644  7                                        N Total DME supplier submitted charges ($)

                 Notes: Prior to 2000 this was included in H_PMTSCH.
                        First available in 2000

H_DMEACH  651  7                                        N Total DME supplier allowed charges ($)

                 Notes: Prior to 2000 this was included in H_PMTACH.
                        First available in 2000

H_DMERMB  658  7                                        N Total DME supplier reimbursement ($)

                 Notes: Prior to 2000 this was included in H_PMTRMB.
                        First available in 2000

