RIC         1  2                                        C Record Identification Code

VERSION     3  1                                        C Version Number

BASEID      4  8  $BSIDFMT                              C Unique SP Identification Number

                             463,851             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
                             463,851                   PM Prescribed medicine
                                   0                   SD Separately billing physician
                                   0                   SL Separately billing lab

CORF       14  1  $INTRFMT                              C Community or facility

                             417,977                    C Community
                              45,874                    F Facility

AMTTOT     15  9  MONYFMT                               N Total payment

                             463,851                      Amount as $$$$$$.CC

AMTCARE    24  9  MONYFMT                               N Amount paid by Medicare

                             463,851                      Amount as $$$$$$.CC

AMTCAID    33  9  MONYFMT                               N Amount paid by Medicaid

                             463,851                      Amount as $$$$$$.CC

AMTHMOP    42  9  MONYFMT                               N Amount paid by private HMO

                             463,851                      Amount as $$$$$$.CC

AMTHMOM    51  9  MONYFMT                               N Amount paid by Medicare HMO

                             463,851                      Amount as $$$$$$.CC

AMTVA      60  9  MONYFMT                               N Amount paid by Veterans Administration

                             463,851                      Amount as $$$$$$.CC

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

                             463,851                      Amount as $$$$$$.CC

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

                             463,851                      Amount as $$$$$$.CC

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

                             463,851                      Amount as $$$$$$.CC

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

                             463,851                      Amount as $$$$$$.CC

AMTDISC   105  9  MONYFMT                               N Amount of uncollected SP liability

                             463,851                      Amount as $$$$$$.CC

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

                             463,851                      Amount as $$$$$$.CC

DRUGNAME  123 30                                        C Prescribed Medicine name

PMFORM    153  2  $FORMFMT                              C Prescribed Medicine form

                              33,083                      Not ascertained
                             385,993                    1 Pill
                               2,258                   10 Patch/pad
                                 511                   11 Topical gel/jelly
                               1,387                   12 Powder
                               3,062                    2 Liquid
                               8,596                    3 Drops
                               5,599                    4 Topical ointment
                                 149                    5 Suppository
                              13,687                    6 Inhalant/aerosol spray
                                 149                    7 Shampoo, soap
                               8,304                    8 Injection
                                 299                    9 I.V.
                                 774                   91 Other

STRNUNI1  155  2  $STRNFMT                              C Unit of strength

                             105,362                      Missing
                               2,177                   -8 Don't know
                              58,792                   -9 Not ascertained
                              14,703                    1 Micrograms
                             264,304                    2 Milligrams
                                 331                    3 Grains
                               3,851                    4 Milliequivalents (MEQ)
                               1,746                    5 Grams (GM,G)
                               7,865                    6 Percent
                                 443                    7 International units
                               3,409                    8 Units
                                 868                   91 Other

STRNNUM1  157 10  STRNFMT                               N Number of units

                             105,362                    . Missing
                              68,834                   -9 Not ascertained
                               2,138                   -8 Don't know
                               9,417                    0 Zero
                             278,100                      Number of units of strength

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

                             105,362                      Missing
                             340,995                   -1 Inapplicable
                                  70                   -8 Don't know
                               1,017                    1 Micrograms
                              15,557                    2 Milligrams
                                   1                    3 Grains
                                  20                    4 Milliequivalents (MEQ)
                                  33                    5 Grams (GM,G)
                                 430                    6 Percent
                                   1                    7 International units
                                 188                    8 Units
                                 177                   91 Other

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

                             105,362                    . Missing
                                  90                   -8 Don't know
                             341,495                   -1 Inapplicable
                                  54                    0 Zero
                              16,850                      Number of units of strength

TABNUM    179  8  TABFMT                                N Number of tablets

                             269,768                    . Missing
                              46,410                   -9 Not ascertained
                                 746                   -8 Don't know
                             146,927                1-999 Number of tablets in container

SUPPNUM   187  8  SUPPFMT                               N Number of suppositories

                             269,768                    . Missing or inapplicable
                             194,083                   -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

                             269,768                    . Missing
                             182,482                   -9 Not ascertained
                                 500                   -8 Don't know
                              11,101                      Number of units in container

AMTUNIT   205  2  $AMTFMT                               C Amount unit

                             269,768                      Missing
                               1,729                   -8 Don't know
                             180,753                   -9 Not ascertained
                                 614                    1 Ounces
                               2,109                    2 Grams
                               5,198                    3 Milliliters (ML, CC)
                                  35                    4 Milliequivalents (MEQ)
                                 256                    5 Milligrams (MG, MGM)
                                 315                    6 Micrograms (MCG)
                               2,736                    7 Doses, puffs, blisters
                                 338                   91 Other

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

                              21,201                   UN Unclassified drug products
                              22,115                   02 Analgesics
                                  49                   03 Analgesic and antihist combo
                                 368                   05 Anesthetics
                                  83                   08 Anti-obesity drugs
                                  34                   09 Antidotes
                              12,664                   11 Antiarthritics
                              14,268                   14 Antiasthmatics
                               4,577                   17 Antihistamines
                                 201                   18 Antihistimine/Decongestant comb
                              10,440                   20 Antiinfectives
                               7,365                   23 Antiinfectives, miscellaneous
                               2,110                   26 Antineoplastics
                               3,484                   29 Antiparkinson drugs
                              27,968                   32 Autonomic drugs
                              16,653                   35 Blood
                              26,054                   38 Cardiac drugs
                              86,677                   41 Cardiovascular
                              16,903                   44 CNS drugs
                                 447                   47 Contraceptives
                                 871                   50 Cough and cold preparations
                                   7                   53 Diagnostic
                              24,463                   56 Diuretics
                               9,396                   59 Electrolyte, caloric, & fluid rep.
                              12,865                   62 EENT preparations
                              30,563                   65 Gastrointestinal preparations
                               8,836                   68 Hormones
                              27,208                   71 Hypoglycemics
                                 903                   72 Immunosuppresant
                                  44                   74 Misc. medical supp., devices, & other
                               4,977                   77 Muscle relaxants
                              39,446                   80 Psychotherapeutic drugs
                               5,428                   83 Sedative and hypnotic drugs
                               6,740                   86 Skin preparations
                              14,592                   89 Thyroid preparations
                                 177                   92 Biologicals
                                 112                   94 Pre-natal vitamins
                               3,542                   95 Vitamins, all others
                                   0                   97 Psychotherapeutic drugs
                                  20                   98 Herbals
                                   0                   99 Unclassified drug products

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

                                   4                      Missing
                                   0                    B Both OTC and RX
                             462,289                    F Federal or legend drug
                               1,558                    O Over-the-counter drug
                                   0                    U Unknown

ISOPCARE  240  1  $IMPFMT                               C AMTCARE payment source imputed?

                             403,466                    0 Not imputed
                              60,385                    1 Imputed

ISOPCAID  241  1  $IMPFMT                               C AMTCAID payment source imputed?

                             437,730                    0 Not imputed
                              26,121                    1 Imputed

ISOPHMOP  242  1  $IMPFMT                               C AMTHMOP payment source imputed?

                             450,774                    0 Not imputed
                              13,077                    1 Imputed

ISOPHMOM  243  1  $IMPFMT                               C AMTHMPOM payment source imputed?

                             463,851                    0 Not imputed
                                   0                    1 Imputed

ISOPVA    244  1  $IMPFMT                               C AMTVA payment source imputed?

                             454,765                    0 Not imputed
                               9,086                    1 Imputed

ISOPPRVE  245  1  $IMPFMT                               C AMTPRVE payment source imputed?

                             415,200                    0 Not imputed
                              48,651                    1 Imputed

ISOPPRVI  246  1  $IMPFMT                               C AMTPRVI payment source imputed?

                             458,692                    0 Not imputed
                               5,159                    1 Imputed

ISOPUNK   247  1  $IMPFMT                               C AMTPRVU payment source imputed?

                             463,851                    0 Not imputed
                                   0                    1 Imputed

ISOPOOP   248  1  $IMPFMT                               C AMTOOP payment source imputed?

                             363,305                    0 Not imputed
                             100,546                    1 Imputed

ISOPDISC  249  1  $IMPFMT                               C AMTDISC payment source imputed?

                             311,963                    0 Not imputed
                             151,888                    1 Imputed

ISOPOTH   250  1  $IMPFMT                               C AMTOTH payment source imputed?

                             445,322                    0 Not imputed
                              18,529                    1 Imputed

IAMTTOT   251  1  $IMPFMT                               C AMTTOT payment amount imputed?

                             418,743                    0 Not imputed
                              45,108                    1 Imputed

IAMTCARE  252  1  $IMPFMT                               C AMTCARE payment amount imputed?

                             384,972                    0 Not imputed
                              78,879                    1 Imputed

IAMTCAID  253  1  $IMPFMT                               C AMTCAID payment amount imputed?

                             427,900                    0 Not imputed
                              35,951                    1 Imputed

IAMTHMOP  254  1  $IMPFMT                               C AMTHMOP payment amount imputed?

                             426,516                    0 Not imputed
                              37,335                    1 Imputed

IAMTHMOM  255  1  $IMPFMT                               C AMTHMPOM payment amount imputed?

                             463,851                    0 Not imputed
                                   0                    1 Imputed

IAMTVA    256  1  $IMPFMT                               C AMTVA payment amount imputed?

                             450,845                    0 Not imputed
                              13,006                    1 Imputed

IAMTPRVE  257  1  $IMPFMT                               C AMTPRVE payment amount imputed?

                             398,509                    0 Not imputed
                              65,342                    1 Imputed

IAMTPRVI  258  1  $IMPFMT                               C AMTPRVI payment amount imputed?

                             457,260                    0 Not imputed
                               6,591                    1 Imputed

IAMTPRVU  259  1  $IMPFMT                               C AMTPRVU payment amount imputed?

                             463,851                    0 Not imputed
                                   0                    1 Imputed

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

                             342,231                    0 Not imputed
                             121,620                    1 Imputed

IAMTDISC  261  1  $IMPFMT                               C Imputed discount amount

                             311,776                    0 Not imputed
                             152,075                    1 Imputed

IAMTOTH   262  1  $IMPFMT                               C Imputed other amount

                             443,069                    0 Not imputed
                              20,782                    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

                             194,083                    1 Survey Reported Event
                             105,362                    2 PDE Only Event
                             164,406                    3 Survey Reported Event matched to PDE

