RIC         1  2                                        C Record Identification Code

VERSION     3  1                                        C Version Number

BASEID      4  8  $BSIDFMT                              C Unique SP Identification Number

                              14,547             LOW-HIGH BASEID Count

H_DOB      12  8  $DTE8FMT                              C Date of birth

                              14,547                      Date as YYYYMMDD

H_DOD      20  8  $DTE8FMT                              C Date of death

                              14,444                      Missing
                                 103                      Date as YYYYMMDD

H_DODSRC   28  2  $SRCFMT                               C Source of date of death

                              14,444                      No date of death
                                   1                   01 From Medicare bill
                                   0                   03 Clerical entry
                                   0                   05 Bill and clerical entry
                                  52                   10 Proven Medicare Benefits record
                                  10                   11 Proven Medicare Benefits record & bills
                                  33                   20 Unproven Medicare Benefits record
                                   7                   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

                               6,501                    1 Male
                               8,046                    2 Female

H_RACE     31  1  $RACEFMT                              C Race code

                                  14                    0 Unknown
                              12,264                    1 White
                               1,510                    2 Black
                                 159                    3 Other
                                 168                    4 Asian
                                 357                    5 Hispanic
                                  75                    6 North American Native

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

                              14,547                      Age in years

D_STRAT    35  1  $AGEFMT                               C MCBS Sample age stratum

                               1,272                    1  0-44
                               1,258                    2 45-64
                               2,303                    3 65-69
                               2,592                    4 70-74
                               2,351                    5 75-79
                               2,404                    6 80-84
                               2,367                    7 85 +

H_ENT01    36  1  $ENTFMT                               C Medicare entitlement code for Jan

                                 617                    A Part A Medicare only
                                  81                    B Part B Medicare only
                              13,849                    C Parts A and B Medicare
                                   0                    N No Medicare entitlement

H_ENT02    37  1  $ENTFMT                               C Medicare entitlement code for Feb

                                 603                    A Part A Medicare only
                                  81                    B Part B Medicare only
                              13,863                    C Parts A and B Medicare
                                   0                    N No Medicare entitlement

H_ENT03    38  1  $ENTFMT                               C Medicare entitlement code for Mar

                                 595                    A Part A Medicare only
                                  81                    B Part B Medicare only
                              13,871                    C Parts A and B Medicare
                                   0                    N No Medicare entitlement

H_ENT04    39  1  $ENTFMT                               C Medicare entitlement code for Apr

                                 592                    A Part A Medicare only
                                  81                    B Part B Medicare only
                              13,874                    C Parts A and B Medicare
                                   0                    N No Medicare entitlement

H_ENT05    40  1  $ENTFMT                               C Medicare entitlement code for May

                                 586                    A Part A Medicare only
                                  81                    B Part B Medicare only
                              13,880                    C Parts A and B Medicare
                                   0                    N No Medicare entitlement

H_ENT06    41  1  $ENTFMT                               C Medicare entitlement code for Jun

                                 579                    A Part A Medicare only
                                  80                    B Part B Medicare only
                              13,888                    C Parts A and B Medicare
                                   0                    N No Medicare entitlement

H_ENT07    42  1  $ENTFMT                               C Medicare entitlement code for Jul

                                 557                    A Part A Medicare only
                                  78                    B Part B Medicare only
                              13,911                    C Parts A and B Medicare
                                   1                    N No Medicare entitlement

H_ENT08    43  1  $ENTFMT                               C Medicare entitlement code for Aug

                                 550                    A Part A Medicare only
                                  78                    B Part B Medicare only
                              13,917                    C Parts A and B Medicare
                                   2                    N No Medicare entitlement

H_ENT09    44  1  $ENTFMT                               C Medicare entitlement code for Sep

                                 542                    A Part A Medicare only
                                  79                    B Part B Medicare only
                              13,921                    C Parts A and B Medicare
                                   5                    N No Medicare entitlement

H_ENT10    45  1  $ENTFMT                               C Medicare entitlement code for Oct

                                 532                    A Part A Medicare only
                                  78                    B Part B Medicare only
                              13,924                    C Parts A and B Medicare
                                  13                    N No Medicare entitlement

H_ENT11    46  1  $ENTFMT                               C Medicare entitlement code for Nov

                                 528                    A Part A Medicare only
                                  78                    B Part B Medicare only
                              13,913                    C Parts A and B Medicare
                                  28                    N No Medicare entitlement

H_ENT12    47  1  $ENTFMT                               C Medicare entitlement code for Dec

                                 524                    A Part A Medicare only
                                  78                    B Part B Medicare only
                              13,889                    C Parts A and B Medicare
                                  56                    N No Medicare entitlement

H_DOE      48  8  $DTE8FMT                              C Medicare entitlement start date

                              14,547                      Date as YYYYMMDD

H_DOT      56  8  $DTE8FMT                              C Medicare entitlement end date

                              14,532                      Missing
                                  15                      Date as YYYYMMDD

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

                                  13                      Unknown
                              11,846                   10 Aged, no ESRD
                                  63                   11 Aged, ESRD
                               2,570                   20 Disabled, no ESRD
                                  46                   21 Disabled, ESRD
                                   9                   31 ESRD only

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

                                   2                      Unknown
                                   0                   AD Cur pay-adj for dual entitlement
                                   0                   AF Transfer to another PC or dio
                                   0                   A9 Cur pay-miscellaneous adjustment
                              13,971                    C Current payment status
                                   0                   DW Deferred-Workers' Compensation
                                   0                   D2 DEF-retirement test
                                   0                   D3 DEF-D2 for primary
                                   2                   D6 DEF-recover overpayment
                                   6                   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
                                   3                    S SUSP-deferred retirement
                                   3                   SD SUSP-other
                                   0                   SF SUSP-fails to meet residence requirment
                                  68                   SH SUSP-government pension
                                   0                   SP SUSP-public assistance
                                   0                   SW SUSP-Workers' Compensation
                                   3                   S0 SUSP-continuing disability investig
                                   0                   S2 SUSP-fails retirement test
                                   0                   S3 SUSP-primary account S2
                                  10                   S6 SUSP-check returned for address
                                  26                   S7 SUSP-vocational rehab refusal
                                   2                   S8 SUSP-payee not determined
                                  12                   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
                                  71                   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
                                   1                   T6 TERM-child no longer student, disabled
                                   0                   T8 TERM-recovery from disability
                                   0                   T9 TERM-miscellaneous
                                 363                    U Active uninsured status (no SSA check)
                                   0                   XF Transfer to another PC or DIO
                                   0                   XR Terminated -
                                   2                   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

                                 531                   01 Alabama
                                   0                   02 Alaska
                                 257                   03 Arizona
                                 155                   04 Arkansas
                                 978                   05 California
                                 121                   06 Colorado
                                 202                   07 Connecticut
                                   3                   08 Delaware
                                  17                   09 Washington, DC
                               1,079                   10 Florida
                                 488                   11 Georgia
                                   0                   12 Hawaii
                                   0                   13 Idaho
                                 448                   14 Illinois
                                  42                   15 Indiana
                                 127                   16 Iowa
                                 152                   17 Kansas
                                 275                   18 Kentucky
                                 143                   19 Louisiana
                                   0                   20 Maine
                                 219                   21 Maryland
                                 262                   22 Massachusetts
                                 781                   23 Michigan
                                 243                   24 Minnesota
                                   0                   25 Mississippi
                                 375                   26 Missouri
                                   0                   27 Montana
                                 132                   28 Nebraska
                                 285                   29 Nevada
                                   2                   30 New Hampshire
                                 443                   31 New Jersey
                                 261                   32 New Mexico
                                 975                   33 New York
                                 723                   34 North Carolina
                                   0                   35 North Dakota
                                 717                   36 Ohio
                                 150                   37 Oklahoma
                                   0                   38 Oregon
                                 759                   39 Pennsylvania
                                 262                   40 Puerto Rico
                                   0                   41 Rhode Island
                                 115                   42 South Carolina
                                   0                   43 South Dakota
                                 402                   44 Tennessee
                                 924                   45 Texas
                                   1                   46 Utah
                                   0                   47 Vermont
                                   0                   48 Virgin Islands
                                 166                   49 Virginia
                                 570                   50 Washington
                                 214                   51 West Virginia
                                 417                   52 Wisconsin
                                 131                   53 Wyoming

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

                              14,547                      County code

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

                              14,547                      ZIP Code

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

                                   0                   ** Unknown
                                 466                   01 New England
                               2,177                   02 Middle Atlantic
                               2,405                   03 East North Central
                               1,029                   04 West North Central
                               3,024                   05 South Atlantic
                               1,208                   06 East South Central
                               1,372                   07 West South Central
                               1,056                   08 Mountain
                               1,548                   09 Pacific
                                 262                   10 Puerto Rico

H_METRO    80  1  $METFMT                               C Metro status

                               3,757                    N Non-metro area
                                   0                    U Unknown
                              10,790                    Y Metro area

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

                              14,180                      Missing
                                 367                      Date as YYYYMMDD

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

                              14,180                      Missing
                                 367                      Date as YYYYMMDD

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

                              14,398                      Missing
                                 149                      Date as YYYYMMDD

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

                              14,398                      Missing
                                 149                      Date as YYYYMMDD

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

                              14,437                      Missing
                                 110                      Date as YYYYMMDD

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

                              14,437                      Missing
                                 110                      Date as YYYYMMDD

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

                              14,462                      Missing
                                  85                      Date as YYYYMMDD

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

                              14,462                      Missing
                                  85                      Date as YYYYMMDD

H_ESRBEG  145  8  $DTE8FMT                              C Beginning date of ESRD period

                              14,373                      Missing
                                 174                      Date as YYYYMMDD

H_ESREND  153  8  $DTE8FMT                              C Ending date of ESRD period

                              14,489                      Missing
                                  58                      Date as YYYYMMDD

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

                              11,366                    0 No enrollment
                               3,181                    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

                              11,824                      No enrollment
                                  17                   01 Health care prepayment plan
                                  64                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,605                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  37                   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

                              11,700                      No enrollment
                                  17                   01 Health care prepayment plan
                                  68                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,725                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  37                   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

                              11,660                      No enrollment
                                  17                   01 Health care prepayment plan
                                  68                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,766                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  36                   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

                              11,632                      No enrollment
                                  17                   01 Health care prepayment plan
                                  67                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,795                   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

                              11,578                      No enrollment
                                  17                   01 Health care prepayment plan
                                  69                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,846                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  37                   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

                              11,561                      No enrollment
                                  17                   01 Health care prepayment plan
                                  69                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,863                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  37                   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

                              11,554                      No enrollment
                                  17                   01 Health care prepayment plan
                                  69                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,870                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  37                   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

                              11,548                      No enrollment
                                  17                   01 Health care prepayment plan
                                  69                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,876                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  37                   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

                              11,555                      No enrollment
                                  17                   01 Health care prepayment plan
                                  69                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,869                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  37                   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

                              11,539                      No enrollment
                                  17                   01 Health care prepayment plan
                                  69                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,884                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  38                   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

                              11,532                      No enrollment
                                  17                   01 Health care prepayment plan
                                  69                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,891                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  38                   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

                              11,537                      No enrollment
                                  17                   01 Health care prepayment plan
                                  69                   02 Cost HMO
                                   0                   05 Old Risk HMO
                               2,886                   06 Risk HMO
                                   0                   12 Demo Risk HMO
                                  38                   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

                               5,784                    0 No Part D enrollment
                               2,707                    1 MA-PD plan
                               6,056                    2 PDP

H_PDPY01  256  5                                        N Part D capitation payment for Jan

H_PDLS01  261  1  $DLISFMT                              C LIS Indicator for Jan

                              10,890                    1 No premium subsidy
                                  34                    2 25% premium subsidy
                                  39                    3 50% premium subsidy
                                  51                    4 75% premium subsidy
                               3,533                    5 100% premium subsidy

H_PDRS01  262  1  $DRDSFMT                              C RDS Indicator for Jan

                              12,373                    N Employer not subsidized for the benefici
                               2,174                    Y Employer subsidized for the beneficiary

H_CRED01  263  1  $YES8FMT                              C Creditable Coverage For Jan

                               2,810                    1 Yes
                              11,737                    2 No

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

                               5,755                    0 No Part D enrollment
                               2,734                    1 MA-PD plan
                               6,058                    2 PDP

H_PDPY02  265  5                                        N Part D capitation payment for Feb

H_PDLS02  270  1  $DLISFMT                              C LIS Indicator for Feb

                              10,875                    1 No premium subsidy
                                  34                    2 25% premium subsidy
                                  39                    3 50% premium subsidy
                                  50                    4 75% premium subsidy
                               3,549                    5 100% premium subsidy

H_PDRS02  271  1  $DRDSFMT                              C RDS Indicator for Feb

                              12,366                    N Employer not subsidized for the benefici
                               2,181                    Y Employer subsidized for the beneficiary

H_CRED02  272  1  $YES8FMT                              C Creditable Coverage For Feb

                               2,810                    1 Yes
                              11,737                    2 No

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

                               5,730                    0 No Part D enrollment
                               2,751                    1 MA-PD plan
                               6,066                    2 PDP

H_PDPY03  274  5                                        N Part D capitation payment for Mar

H_PDLS03  279  1  $DLISFMT                              C LIS Indicator for Mar

                              10,852                    1 No premium subsidy
                                  34                    2 25% premium subsidy
                                  39                    3 50% premium subsidy
                                  50                    4 75% premium subsidy
                               3,572                    5 100% premium subsidy

H_PDRS03  280  1  $DRDSFMT                              C RDS Indicator for Mar

                              12,356                    N Employer not subsidized for the benefici
                               2,191                    Y Employer subsidized for the beneficiary

H_CRED03  281  1  $YES8FMT                              C Creditable Coverage For Mar

                               2,810                    1 Yes
                              11,737                    2 No

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

                               5,716                    0 No Part D enrollment
                               2,772                    1 MA-PD plan
                               6,059                    2 PDP

H_PDPY04  283  5                                        N Part D capitation payment for Apr

H_PDLS04  288  1  $DLISFMT                              C LIS Indicator for Apr

                                   7                      Unknown
                              10,844                    1 No premium subsidy
                                  34                    2 25% premium subsidy
                                  41                    3 50% premium subsidy
                                  47                    4 75% premium subsidy
                               3,574                    5 100% premium subsidy

H_PDRS04  289  1  $DRDSFMT                              C RDS Indicator for Apr

                                   7                      Unknown
                              12,339                    N Employer not subsidized for the benefici
                               2,201                    Y Employer subsidized for the beneficiary

H_CRED04  290  1  $YES8FMT                              C Creditable Coverage For Apr

                               2,808                    1 Yes
                              11,739                    2 No

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

                               5,700                    0 No Part D enrollment
                               2,796                    1 MA-PD plan
                               6,051                    2 PDP

H_PDPY05  292  5                                        N Part D capitation payment for May

H_PDLS05  297  1  $DLISFMT                              C LIS Indicator for May

                                   7                      Unknown
                              10,829                    1 No premium subsidy
                                  34                    2 25% premium subsidy
                                  41                    3 50% premium subsidy
                                  46                    4 75% premium subsidy
                               3,590                    5 100% premium subsidy

H_PDRS05  298  1  $DRDSFMT                              C RDS Indicator for May

                                   7                      Unknown
                              12,341                    N Employer not subsidized for the benefici
                               2,199                    Y Employer subsidized for the beneficiary

H_CRED05  299  1  $YES8FMT                              C Creditable Coverage For May

                               2,808                    1 Yes
                              11,739                    2 No

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

                               5,700                    0 No Part D enrollment
                               2,799                    1 MA-PD plan
                               6,048                    2 PDP

H_PDPY06  301  5                                        N Part D capitation payment for Jun

H_PDLS06  306  1  $DLISFMT                              C LIS Indicator for Jun

                                   7                      Unknown
                              10,809                    1 No premium subsidy
                                  34                    2 25% premium subsidy
                                  43                    3 50% premium subsidy
                                  47                    4 75% premium subsidy
                               3,607                    5 100% premium subsidy

H_PDRS06  307  1  $DRDSFMT                              C RDS Indicator for Jun

                                   7                      Unknown
                              12,332                    N Employer not subsidized for the benefici
                               2,208                    Y Employer subsidized for the beneficiary

H_CRED06  308  1  $YES8FMT                              C Creditable Coverage For Jun

                               2,808                    1 Yes
                              11,739                    2 No

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

                               5,671                    0 No Part D enrollment
                               2,809                    1 MA-PD plan
                               6,067                    2 PDP

H_PDPY07  310  5                                        N Part D capitation payment for Jul

H_PDLS07  315  1  $DLISFMT                              C LIS Indicator for Jul

                                   8                      Unknown
                              10,785                    1 No premium subsidy
                                  33                    2 25% premium subsidy
                                  43                    3 50% premium subsidy
                                  48                    4 75% premium subsidy
                               3,630                    5 100% premium subsidy

H_PDRS07  316  1  $DRDSFMT                              C RDS Indicator for Jul

                                   8                      Unknown
                              12,343                    N Employer not subsidized for the benefici
                               2,196                    Y Employer subsidized for the beneficiary

H_CRED07  317  1  $YES8FMT                              C Creditable Coverage For Jul

                               2,808                    1 Yes
                              11,739                    2 No

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

                               5,654                    0 No Part D enrollment
                               2,822                    1 MA-PD plan
                               6,071                    2 PDP

H_PDPY08  319  5                                        N Part D capitation payment for Aug

H_PDLS08  324  1  $DLISFMT                              C LIS Indicator for Aug

                                   9                      Unknown
                              10,766                    1 No premium subsidy
                                  33                    2 25% premium subsidy
                                  43                    3 50% premium subsidy
                                  50                    4 75% premium subsidy
                               3,646                    5 100% premium subsidy

H_PDRS08  325  1  $DRDSFMT                              C RDS Indicator for Aug

                                   9                      Unknown
                              12,331                    N Employer not subsidized for the benefici
                               2,207                    Y Employer subsidized for the beneficiary

H_CRED08  326  1  $YES8FMT                              C Creditable Coverage For Aug

                               2,808                    1 Yes
                              11,739                    2 No

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

                               5,650                    0 No Part D enrollment
                               2,827                    1 MA-PD plan
                               6,070                    2 PDP

H_PDPY09  328  5                                        N Part D capitation payment for Sep

H_PDLS09  333  1  $DLISFMT                              C LIS Indicator for Sep

                                  11                      Unknown
                              10,754                    1 No premium subsidy
                                  32                    2 25% premium subsidy
                                  43                    3 50% premium subsidy
                                  50                    4 75% premium subsidy
                               3,657                    5 100% premium subsidy

H_PDRS09  334  1  $DRDSFMT                              C RDS Indicator for Sep

                                  11                      Unknown
                              12,336                    N Employer not subsidized for the benefici
                               2,200                    Y Employer subsidized for the beneficiary

H_CRED09  335  1  $YES8FMT                              C Creditable Coverage For Sep

                               2,806                    1 Yes
                              11,741                    2 No

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

                               5,638                    0 No Part D enrollment
                               2,843                    1 MA-PD plan
                               6,066                    2 PDP

H_PDPY10  337  5                                        N Part D capitation payment for Oct

H_PDLS10  342  1  $DLISFMT                              C LIS Indicator for Oct

                                  20                      Unknown
                              10,726                    1 No premium subsidy
                                  33                    2 25% premium subsidy
                                  44                    3 50% premium subsidy
                                  49                    4 75% premium subsidy
                               3,675                    5 100% premium subsidy

H_PDRS10  343  1  $DRDSFMT                              C RDS Indicator for Oct

                                  20                      Unknown
                              12,336                    N Employer not subsidized for the benefici
                               2,191                    Y Employer subsidized for the beneficiary

H_CRED10  344  1  $YES8FMT                              C Creditable Coverage For Oct

                               2,804                    1 Yes
                              11,743                    2 No

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

                               5,640                    0 No Part D enrollment
                               2,838                    1 MA-PD plan
                               6,069                    2 PDP

H_PDPY11  346  5                                        N Part D capitation payment for Nov

H_PDLS11  351  1  $DLISFMT                              C LIS Indicator for Nov

                                  35                      Unknown
                              10,696                    1 No premium subsidy
                                  34                    2 25% premium subsidy
                                  44                    3 50% premium subsidy
                                  49                    4 75% premium subsidy
                               3,689                    5 100% premium subsidy

H_PDRS11  352  1  $DRDSFMT                              C RDS Indicator for Nov

                                  35                      Unknown
                              12,321                    N Employer not subsidized for the benefici
                               2,191                    Y Employer subsidized for the beneficiary

H_CRED11  353  1  $YES8FMT                              C Creditable Coverage For Nov

                               2,804                    1 Yes
                              11,743                    2 No

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

                               5,671                    0 No Part D enrollment
                               2,824                    1 MA-PD plan
                               6,052                    2 PDP

H_PDPY12  355  5                                        N Part D capitation payment for Dec

H_PDLS12  360  1  $DLISFMT                              C LIS Indicator for Dec

                                  63                      Unknown
                              10,657                    1 No premium subsidy
                                  35                    2 25% premium subsidy
                                  44                    3 50% premium subsidy
                                  50                    4 75% premium subsidy
                               3,698                    5 100% premium subsidy

H_PDRS12  361  1  $DRDSFMT                              C RDS Indicator for Dec

                                  63                      Unknown
                              12,296                    N Employer not subsidized for the benefici
                               2,188                    Y Employer subsidized for the beneficiary

H_CRED12  362  1  $YES8FMT                              C Creditable Coverage For Dec

                               2,799                    1 Yes
                              11,748                    2 No

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

                              11,547                    N No participation
                               3,000                    Y Some participation

H_MCDE01  364  1  $MCDCFMT                              C Medicaid eligibility for Jan

                                   0                    A State Part A buy-in
                               1,069                    B State Part B buy-in
                                  46                    C State Part A and B buy-in
                                  86                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,758                    N No buy-in this month
                               1,255                    Q State Part B QMB buy-in
                                 333                    S State Part B SLMB buy-in

H_MCDE02  365  1  $MCDCFMT                              C Medicaid eligibility for Feb

                                   0                    A State Part A buy-in
                               1,072                    B State Part B buy-in
                                  46                    C State Part A and B buy-in
                                  86                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,739                    N No buy-in this month
                               1,265                    Q State Part B QMB buy-in
                                 339                    S State Part B SLMB buy-in

H_MCDE03  366  1  $MCDCFMT                              C Medicaid eligibility for Mar

                                   0                    A State Part A buy-in
                               1,080                    B State Part B buy-in
                                  46                    C State Part A and B buy-in
                                  86                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,724                    N No buy-in this month
                               1,273                    Q State Part B QMB buy-in
                                 338                    S State Part B SLMB buy-in

H_MCDE04  367  1  $MCDCFMT                              C Medicaid eligibility for Apr

                                   0                    A State Part A buy-in
                               1,082                    B State Part B buy-in
                                  46                    C State Part A and B buy-in
                                  86                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,706                    N No buy-in this month
                               1,273                    Q State Part B QMB buy-in
                                 354                    S State Part B SLMB buy-in

H_MCDE05  368  1  $MCDCFMT                              C Medicaid eligibility for May

                                   0                    A State Part A buy-in
                               1,081                    B State Part B buy-in
                                  46                    C State Part A and B buy-in
                                  86                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,707                    N No buy-in this month
                               1,277                    Q State Part B QMB buy-in
                                 350                    S State Part B SLMB buy-in

H_MCDE06  369  1  $MCDCFMT                              C Medicaid eligibility for Jun

                                   0                    A State Part A buy-in
                               1,089                    B State Part B buy-in
                                  47                    C State Part A and B buy-in
                                  86                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,705                    N No buy-in this month
                               1,276                    Q State Part B QMB buy-in
                                 344                    S State Part B SLMB buy-in

H_MCDE07  370  1  $MCDCFMT                              C Medicaid eligibility for Jul

                                   0                    A State Part A buy-in
                               1,098                    B State Part B buy-in
                                  47                    C State Part A and B buy-in
                                  87                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,685                    N No buy-in this month
                               1,282                    Q State Part B QMB buy-in
                                 348                    S State Part B SLMB buy-in

H_MCDE08  371  1  $MCDCFMT                              C Medicaid eligibility for Aug

                                   0                    A State Part A buy-in
                               1,103                    B State Part B buy-in
                                  47                    C State Part A and B buy-in
                                  87                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,672                    N No buy-in this month
                               1,291                    Q State Part B QMB buy-in
                                 347                    S State Part B SLMB buy-in

H_MCDE09  372  1  $MCDCFMT                              C Medicaid eligibility for Sep

                                   0                    A State Part A buy-in
                               1,104                    B State Part B buy-in
                                  47                    C State Part A and B buy-in
                                  87                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,670                    N No buy-in this month
                               1,291                    Q State Part B QMB buy-in
                                 348                    S State Part B SLMB buy-in

H_MCDE10  373  1  $MCDCFMT                              C Medicaid eligibility for Oct

                                   0                    A State Part A buy-in
                               1,104                    B State Part B buy-in
                                  48                    C State Part A and B buy-in
                                  87                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,661                    N No buy-in this month
                               1,294                    Q State Part B QMB buy-in
                                 353                    S State Part B SLMB buy-in

H_MCDE11  374  1  $MCDCFMT                              C Medicaid eligibility for Nov

                                   0                    A State Part A buy-in
                               1,102                    B State Part B buy-in
                                  48                    C State Part A and B buy-in
                                  87                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,657                    N No buy-in this month
                               1,295                    Q State Part B QMB buy-in
                                 358                    S State Part B SLMB buy-in

H_MCDE12  375  1  $MCDCFMT                              C Medicaid eligibility for Dec

                                   0                    A State Part A buy-in
                               1,076                    B State Part B buy-in
                                  48                    C State Part A and B buy-in
                                  87                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,702                    N No buy-in this month
                               1,277                    Q State Part B QMB buy-in
                                 357                    S State Part B SLMB buy-in

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

                              11,758                    N Unknown, or no buy-in
                               2,789                      State Agency code

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

                              11,739                    N Unknown, or no buy-in
                               2,808                      State Agency code

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

                              11,724                    N Unknown, or no buy-in
                               2,823                      State Agency code

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

                              11,706                    N Unknown, or no buy-in
                               2,841                      State Agency code

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

                              11,707                    N Unknown, or no buy-in
                               2,840                      State Agency code

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

                              11,705                    N Unknown, or no buy-in
                               2,842                      State Agency code

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

                              11,685                    N Unknown, or no buy-in
                               2,862                      State Agency code

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

                              11,672                    N Unknown, or no buy-in
                               2,875                      State Agency code

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

                              11,670                    N Unknown, or no buy-in
                               2,877                      State Agency code

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

                              11,661                    N Unknown, or no buy-in
                               2,886                      State Agency code

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

                              11,657                    N Unknown, or no buy-in
                               2,890                      State Agency code

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

                              11,702                    N Unknown, or no buy-in
                               2,845                      State Agency code

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

                              14,403                    0 No utilization this type
                                 144                    1 Some utilization this type

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

                              12,236                    0 No utilization this type
                               2,311                    1 Some utilization this type

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

                              13,978                    0 No utilization this type
                                 569                    1 Some utilization this type

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

                              13,454                    0 No utilization this type
                               1,093                    1 Some utilization this type

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

                               6,525                    0 No utilization this type
                               8,022                    1 Some utilization this type

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

                               3,554                    0 No utilization this type
                              10,993                    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

                              12,236                      Missing
                               2,311                      Date as YYYYMMDD

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

                              12,236                      Unknown, or no discharge
                               2,311                      DRG

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

                              12,236                      Missing
                               1,372                   01 Discharged to home/self care
                                   8                   02 Discharged to other short-term hospital
                                 377                   03 Discharged to skilled nursing facility
                                  33                   04 Discharged to intermediate care facility
                                   5                   05 Disch to another type of institution
                                 397                   06 Discharged to home care of organized HMO
                                   7                   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)
                                   4                   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)
                                   5                   51 Hospice - medical facility (eff. 96)
                                  25                   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)
                                  32                      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

