RIC         1  2                                        C Record Identification Code

VERSION     3  1                                        C Version Number

BASEID      4  8  $BSIDFMT                              C Unique SP Identification Number

                             495,023             LOW-HIGH BASEID Count

TYPE       12  2  $EVNTTYP                              C Event type-Prescribed Medicine

                                   0                   DU Dental
                                   0                   ER Emergency Room
                                   0                   IP Inpatient
                                   0                   IU Institutional utilization
                                   0                   MP Medical provider
                                   0                   OM Other medical expense
                                   0                   OP Outpatient
                             495,023                   PM Prescribed medicine
                                   0                   SD Separately billing physician
                                   0                   SL Separately billing lab

CORF       14  1  $INTRFMT                              C Community or facility

                             438,836                    C Community
                              56,187                    F Facility

AMTTOT     15  9  MONYFMT                               N Total payment

                             495,023                      Amount as $$$$$$.CC

AMTCARE    24  9  MONYFMT                               N Amount paid by Medicare

                             495,023                      Amount as $$$$$$.CC

AMTCAID    33  9  MONYFMT                               N Amount paid by Medicaid

                             495,023                      Amount as $$$$$$.CC

AMTHMOP    42  9  MONYFMT                               N Amount paid by private HMO

                             495,023                      Amount as $$$$$$.CC

AMTHMOM    51  9  MONYFMT                               N Amount paid by Medicare HMO

                             495,023                      Amount as $$$$$$.CC

AMTVA      60  9  MONYFMT                               N Amount paid by Veterans Administration

                             495,023                      Amount as $$$$$$.CC

AMTPRVE    69  9  MONYFMT                               N Amt paid by employer-sponsored priv ins

                             495,023                      Amount as $$$$$$.CC

AMTPRVI    78  9  MONYFMT                               N Amt paid by individually-purch priv ins

                             495,023                      Amount as $$$$$$.CC

AMTPRVU    87  9  MONYFMT                               N Amt paid by priv ins (unknown purchased)

                             495,023                      Amount as $$$$$$.CC

AMTOOP     96  9  MONYFMT                               N Amount paid out-of-pocket (OOP)

                             495,023                      Amount as $$$$$$.CC

AMTDISC   105  9  MONYFMT                               N Amount of uncollected SP liability

                             495,023                      Amount as $$$$$$.CC

AMTOTH    114  9  MONYFMT                               N Amount paid by other payor(s)

                             495,023                      Amount as $$$$$$.CC

DRUGNAME  123 30                                        C Prescribed Medicine name

PMFORM    153  2  $FORMFMT                              C Prescribed Medicine form

                              21,329                      Not ascertained
                             423,529                    1 Pill
                               2,481                   10 Patch/pad
                                 377                   11 Topical gel/jelly
                               1,629                   12 Powder
                               3,908                    2 Liquid
                               9,782                    3 Drops
                               6,127                    4 Topical ointment
                                 183                    5 Suppository
                              15,384                    6 Inhalant/aerosol spray
                                 172                    7 Shampoo, soap
                               8,800                    8 Injection
                                 384                    9 I.V.
                                 938                   91 Other

STRNUNI1  155  2  $STRNFMT                              C Unit of strength

                             109,638                      Missing
                              11,599                   -8 Don't know
                              35,668                   -9 Not ascertained
                              14,756                    1 Micrograms
                             302,812                    2 Milligrams
                                 424                    3 Grains
                               4,999                    4 Milliequivalents (MEQ)
                               1,734                    5 Grams (GM,G)
                               8,927                    6 Percent
                                 705                    7 International units
                               3,352                    8 Units
                                 409                   91 Other

STRNNUM1  157 10  STRNFMT                               N Number of units

                             109,638                    . Missing
                              56,195                   -9 Not ascertained
                                 764                   -8 Don't know
                              12,545                    0 Zero
                             315,881                      Number of units of strength

STRNUNI2  167  2  $STRNFMT                              C Unit of strength/2nd combination

                             109,638                      Missing
                             360,732                   -1 Inapplicable
                                 539                   -8 Don't know
                               1,013                    1 Micrograms
                              22,343                    2 Milligrams
                                  15                    3 Grains
                                  29                    4 Milliequivalents (MEQ)
                                  38                    5 Grams (GM,G)
                                 263                    6 Percent
                                  34                    7 International units
                                 298                    8 Units
                                  81                   91 Other

STRNNUM2  169 10  STRNFMT                               N Number of units/2nd combination

                             109,638                    . Missing
                                  15                   -8 Don't know
                             361,534                   -1 Inapplicable
                                  73                    0 Zero
                              23,763                      Number of units of strength

TABNUM    179  8  TABFMT                                N Number of tablets

                             289,377                    . Missing
                              37,605                   -9 Not ascertained
                                 691                   -8 Don't know
                             167,350                1-999 Number of tablets in container

SUPPNUM   187  8  SUPPFMT                               N Number of suppositories

                             289,377                    . Missing or inapplicable
                             205,646                   -9 Not ascertained
                                   0                 1-98 Number of suppositories in container
                                   0                   99 99 or more suppositories in container

AMTNUM    195 10  AMTFMT                                N Amount of prescr. medicine in container

                             289,377                    . Missing
                             193,630                   -9 Not ascertained
                                 101                   -8 Don't know
                              11,915                      Number of units in container

AMTUNIT   205  2  $AMTFMT                               C Amount unit

                             289,377                      Missing
                               4,516                   -8 Don't know
                             189,114                   -9 Not ascertained
                                 484                    1 Ounces
                               2,416                    2 Grams
                               6,015                    3 Milliliters (ML, CC)
                                  47                    4 Milliequivalents (MEQ)
                                 215                    5 Milligrams (MG, MGM)
                                 265                    6 Micrograms (MCG)
                               2,216                    7 Doses, puffs, blisters
                                 358                   91 Other

THERCC    237  2  $THERFMT                              C F.D.B. generic therapeutic class

                              24,791                   UN Unclassified drug products
                              23,726                   02 Analgesics
                                  33                   03 Analgesic and antihist combo
                                 451                   05 Anesthetics
                                  79                   08 Anti-obesity drugs
                                   8                   09 Antidotes
                              13,184                   11 Antiarthritics
                              13,427                   14 Antiasthmatics
                               6,527                   17 Antihistamines
                                 462                   18 Antihistimine/Decongestant comb
                              11,124                   20 Antiinfectives
                               7,642                   23 Antiinfectives, miscellaneous
                               2,287                   26 Antineoplastics
                               3,989                   29 Antiparkinson drugs
                              30,142                   32 Autonomic drugs
                              16,654                   35 Blood
                              29,581                   38 Cardiac drugs
                              89,126                   41 Cardiovascular
                              16,682                   44 CNS drugs
                                 363                   47 Contraceptives
                               1,045                   50 Cough and cold preparations
                                  41                   53 Diagnostic
                              28,346                   56 Diuretics
                              10,443                   59 Electrolyte, caloric, & fluid rep.
                              13,835                   62 EENT preparations
                              31,707                   65 Gastrointestinal preparations
                               9,895                   68 Hormones
                              28,883                   71 Hypoglycemics
                               1,079                   72 Immunosuppresant
                                  10                   74 Misc. medical supp., devices, & other
                               4,618                   77 Muscle relaxants
                              43,935                   80 Psychotherapeutic drugs
                               5,063                   83 Sedative and hypnotic drugs
                               7,071                   86 Skin preparations
                              15,374                   89 Thyroid preparations
                                 146                   92 Biologicals
                                 156                   94 Pre-natal vitamins
                               3,097                   95 Vitamins, all others
                                   0                   97 Psychotherapeutic drugs
                                   1                   98 Herbals
                                   0                   99 Unclassified drug products

OTCLEG    239  1  $OTCFMT                               C Over-the-counter/legend indicator

                                 120                      Missing
                                   0                    B Both OTC and RX
                             493,116                    F Federal or legend drug
                               1,787                    O Over-the-counter drug
                                   0                    U Unknown

ISOPCARE  240  1  $IMPFMT                               C AMTCARE payment source imputed?

                             441,302                    0 Not imputed
                              53,721                    1 Imputed

ISOPCAID  241  1  $IMPFMT                               C AMTCAID payment source imputed?

                             472,767                    0 Not imputed
                              22,256                    1 Imputed

ISOPHMOP  242  1  $IMPFMT                               C AMTHMOP payment source imputed?

                             480,217                    0 Not imputed
                              14,806                    1 Imputed

ISOPHMOM  243  1  $IMPFMT                               C AMTHMPOM payment source imputed?

                             495,023                    0 Not imputed
                                   0                    1 Imputed

ISOPVA    244  1  $IMPFMT                               C AMTVA payment source imputed?

                             486,211                    0 Not imputed
                               8,812                    1 Imputed

ISOPPRVE  245  1  $IMPFMT                               C AMTPRVE payment source imputed?

                             436,649                    0 Not imputed
                              58,374                    1 Imputed

ISOPPRVI  246  1  $IMPFMT                               C AMTPRVI payment source imputed?

                             488,451                    0 Not imputed
                               6,572                    1 Imputed

ISOPUNK   247  1  $IMPFMT                               C AMTPRVU payment source imputed?

                             495,023                    0 Not imputed
                                   0                    1 Imputed

ISOPOOP   248  1  $IMPFMT                               C AMTOOP payment source imputed?

                             394,893                    0 Not imputed
                             100,130                    1 Imputed

ISOPDISC  249  1  $IMPFMT                               C AMTDISC payment source imputed?

                             332,526                    0 Not imputed
                             162,497                    1 Imputed

ISOPOTH   250  1  $IMPFMT                               C AMTOTH payment source imputed?

                             483,744                    0 Not imputed
                              11,279                    1 Imputed

IAMTTOT   251  1  $IMPFMT                               C AMTTOT payment amount imputed?

                             458,198                    0 Not imputed
                              36,825                    1 Imputed

IAMTCARE  252  1  $IMPFMT                               C AMTCARE payment amount imputed?

                             392,182                    0 Not imputed
                             102,841                    1 Imputed

IAMTCAID  253  1  $IMPFMT                               C AMTCAID payment amount imputed?

                             465,932                    0 Not imputed
                              29,091                    1 Imputed

IAMTHMOP  254  1  $IMPFMT                               C AMTHMOP payment amount imputed?

                             415,389                    0 Not imputed
                              79,634                    1 Imputed

IAMTHMOM  255  1  $IMPFMT                               C AMTHMPOM payment amount imputed?

                             495,023                    0 Not imputed
                                   0                    1 Imputed

IAMTVA    256  1  $IMPFMT                               C AMTVA payment amount imputed?

                             481,609                    0 Not imputed
                              13,414                    1 Imputed

IAMTPRVE  257  1  $IMPFMT                               C AMTPRVE payment amount imputed?

                             414,853                    0 Not imputed
                              80,170                    1 Imputed

IAMTPRVI  258  1  $IMPFMT                               C AMTPRVI payment amount imputed?

                             487,004                    0 Not imputed
                               8,019                    1 Imputed

IAMTPRVU  259  1  $IMPFMT                               C AMTPRVU payment amount imputed?

                             495,023                    0 Not imputed
                                   0                    1 Imputed

IAMTOOP   260  1  $IMPFMT                               C Imputed out-of-pocket amount

                             379,199                    0 Not imputed
                             115,824                    1 Imputed

IAMTDISC  261  1  $IMPFMT                               C Imputed discount amount

                             332,135                    0 Not imputed
                             162,888                    1 Imputed

IAMTOTH   262  1  $IMPFMT                               C Imputed other amount

                             481,690                    0 Not imputed
                              13,333                    1 Imputed

PMEID     263 16                                        C RICPME event ID

FDB_BN    279 30                                        C First Databank brand name

FDB_GNN   309 30                                        C First Databank generic name

FDB_STR   339 10                                        C First Databank strength

FDB_RTE   349 40                                        C First Databank Route

SERV_DT   389  8                                        C Service Date

NDC_CD    397 19                                        C NDC Code

QNTY      416  8                                        N Quantity

DAYSUPP   424  3                                        N Days Supplied

PDEFLAG   427  1  MATCH                                 N PDE Match Indicator

                             205,646                    1 Survey Reported Event
                             109,638                    2 PDE Only Event
                             179,739                    3 Survey Reported Event matched to PDE

