RIC         1  2  $RIC                                  C Record Identification Code

                              10,901                    A Administrative Data
                                   0                   DU Dental Events
                                   0                   FA Facility Events
                                   0                    H HMO Supplement
                                   0                   IA Income and Assets
                                   0                   IP Inpatient Hospital Events
                                   0                   IU Institutional Events
                                   0                    K Key Record
                                   0                   KN Knowledge and Information Needs
                                   0                   MD MDS
                                   0                   MP Medical Provider Events
                                   0                    N Non-Respondent
                                   0                   OA OASIS
                                   0                   OP Outpatient Events
                                   0                   PA Patient Activation
                                   0                   PM Prescribed Medicine Events
                                   0                   PS Person Summary
                                   0                   RX Drug Coverage
                                   0                   SS Service Summary
                                   0                    X Cross Sectional Weights
                                   0                   XE Ever Enrolled Weights
                                   0                   X2 2 year Weights
                                   0                   X3 3 year Weights
                                   0                   X4 4 year Weights
                                   0                    1 Survey Identification (Demographic)
                                   0                   10 MDS/OAS Timeline
                                   0                    2 Health Status/Functioning (Community)
                                   0                   2F Health Status/Functioning (Facility)
                                   0                   2H Health Status/Functioning (Helper)
                                   0                   2P Health Status/Functioning (Prevention)
                                   0                    3 Access to Care
                                   0                    4 Health Insurance
                                   0                    5 Enumeration
                                   0                    6 Facility Residence History
                                   0                    7 Facility Characteristics
                                   0                   7S SNF Characteristics
                                   0                    8 Interview Description
                                   0                    9 Residence Timeline

VERSION     3  1  $VERSION                              C Version Number

                                   0                    1 Version 1
                                   0                    2 Version 2
                                   0                    3 Version 3
                              10,901                    4 Version 4

BASEID      4  8  $BSIDFMT                              C Unique SP Identification Number

                              10,901             LOW-HIGH BASEID Count

H_DOB      12  8  $DTE8FMT                              C Date of birth

                              10,901                      Date as YYYYMMDD

H_DOD      20  8  $DTE8FMT                              C Date of death

                              10,374                      Missing
                                 527                      Date as YYYYMMDD

H_DODSRC   28  2  $SRCFMT                               C Source of date of death

                              10,374                      No date of death
                                   0                   01 From Medicare bill
                                   0                   03 Clerical entry
                                   0                   05 Bill and clerical entry
                                 296                   10 Proven Medicare Benefits record
                                  25                   11 Proven Medicare Benefits record & bills
                                 182                   20 Unproven Medicare Benefits record
                                  24                   21 Unproven Mcare Benefits record & bills
                                   0                   23 Unproven Mcare Benefits rec & clerical
                                   0                   25 Unprovn Mcare Benfts rec, bill & clericl

H_SEX      30  1  $SEXFMT                               C Sex code

                               4,954                    1 Male
                               5,947                    2 Female

H_RACE     31  1  $RACEFMT                              C Race code

                                  19                    0 Unknown
                               9,021                    1 White
                               1,229                    2 Black
                                 125                    3 Other
                                 142                    4 Asian
                                 313                    5 Hispanic
                                  52                    6 North American Native

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

D_STRAT    35  1  $AGEFMT                               C MCBS Sample age stratum

                                 957                    1  0-44
                                 988                    2 45-64
                               1,973                    3 65-69
                               1,738                    4 70-74
                               1,653                    5 75-79
                               1,703                    6 80-84
                               1,889                    7 85 +

H_ENT01    36  1  $ENTFMT                               C Medicare entitlement code for Jan

                                 404                    A Part A Medicare only
                                  52                    B Part B Medicare only
                              10,094                    C Parts A and B Medicare
                                 351                    N No Medicare entitlement

H_ENT02    37  1  $ENTFMT                               C Medicare entitlement code for Feb

                                 404                    A Part A Medicare only
                                  52                    B Part B Medicare only
                              10,077                    C Parts A and B Medicare
                                 368                    N No Medicare entitlement

H_ENT03    38  1  $ENTFMT                               C Medicare entitlement code for Mar

                                 408                    A Part A Medicare only
                                  52                    B Part B Medicare only
                              10,057                    C Parts A and B Medicare
                                 384                    N No Medicare entitlement

H_ENT04    39  1  $ENTFMT                               C Medicare entitlement code for Apr

                                 410                    A Part A Medicare only
                                  51                    B Part B Medicare only
                              10,019                    C Parts A and B Medicare
                                 421                    N No Medicare entitlement

H_ENT05    40  1  $ENTFMT                               C Medicare entitlement code for May

                                 418                    A Part A Medicare only
                                  48                    B Part B Medicare only
                              10,008                    C Parts A and B Medicare
                                 427                    N No Medicare entitlement

H_ENT06    41  1  $ENTFMT                               C Medicare entitlement code for Jun

                                 420                    A Part A Medicare only
                                  48                    B Part B Medicare only
                              10,000                    C Parts A and B Medicare
                                 433                    N No Medicare entitlement

H_ENT07    42  1  $ENTFMT                               C Medicare entitlement code for Jul

                                 413                    A Part A Medicare only
                                  47                    B Part B Medicare only
                               9,999                    C Parts A and B Medicare
                                 442                    N No Medicare entitlement

H_ENT08    43  1  $ENTFMT                               C Medicare entitlement code for Aug

                                 418                    A Part A Medicare only
                                  47                    B Part B Medicare only
                               9,978                    C Parts A and B Medicare
                                 458                    N No Medicare entitlement

H_ENT09    44  1  $ENTFMT                               C Medicare entitlement code for Sep

                                 425                    A Part A Medicare only
                                  47                    B Part B Medicare only
                               9,965                    C Parts A and B Medicare
                                 464                    N No Medicare entitlement

H_ENT10    45  1  $ENTFMT                               C Medicare entitlement code for Oct

                                 431                    A Part A Medicare only
                                  46                    B Part B Medicare only
                               9,958                    C Parts A and B Medicare
                                 466                    N No Medicare entitlement

H_ENT11    46  1  $ENTFMT                               C Medicare entitlement code for Nov

                                 429                    A Part A Medicare only
                                  46                    B Part B Medicare only
                               9,951                    C Parts A and B Medicare
                                 475                    N No Medicare entitlement

H_ENT12    47  1  $ENTFMT                               C Medicare entitlement code for Dec

                                 430                    A Part A Medicare only
                                  45                    B Part B Medicare only
                               9,927                    C Parts A and B Medicare
                                 499                    N No Medicare entitlement

H_DOE      48  8  $DTE8FMT                              C Medicare entitlement start date

                              10,901                      Date as YYYYMMDD

H_DOT      56  8  $DTE8FMT                              C Medicare entitlement end date

                              10,862                      Missing
                                  39                      Date as YYYYMMDD

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

                                  12                      Unknown
                               8,895                   10 Aged, no ESRD
                                  60                   11 Aged, ESRD
                               1,897                   20 Disabled, no ESRD
                                  26                   21 Disabled, ESRD
                                  11                   31 ESRD only

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

                                  14                      Unknown
                                   0                   AD Cur pay-adj for dual entitlement
                                   0                   AF Transfer to another PC or dio
                                   0                   A9 Cur pay-miscellaneous adjustment
                               9,909                    C Current payment status
                                   0                   DW Deferred-Workers' Compensation
                                   2                   D2 DEF-retirement test
                                   0                   D3 DEF-D2 for primary
                                   6                   D6 DEF-recover overpayment
                                   4                   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
                                   2                    S SUSP-deferred retirement
                                   7                   SD SUSP-other
                                   0                   SF SUSP-fails to meet residence requirment
                                  51                   SH SUSP-government pension
                                   0                   SP SUSP-public assistance
                                   0                   SW SUSP-Workers' Compensation
                                   1                   S0 SUSP-continuing disability investig
                                   0                   S2 SUSP-fails retirement test
                                   0                   S3 SUSP-primary account S2
                                   9                   S6 SUSP-check returned for address
                                  11                   S7 SUSP-vocational rehab refusal
                                   0                   S8 SUSP-payee not determined
                                  20                   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
                                 505                   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
                                   1                   T8 TERM-recovery from disability
                                   0                   T9 TERM-miscellaneous
                                 338                    U Active uninsured status (no SSA check)
                                   0                   XF Transfer to another PC or DIO
                                   0                   XR Terminated -
                                  11                   X1 TERM-death of insured
                                   0                   X5 TERM-entitled to another benefit
                                   9                   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

                                 414                   01 Alabama
                                   0                   02 Alaska
                                 191                   03 Arizona
                                 111                   04 Arkansas
                                 750                   05 California
                                  92                   06 Colorado
                                 127                   07 Connecticut
                                   2                   08 Delaware
                                   9                   09 Washington, DC
                                 780                   10 Florida
                                 367                   11 Georgia
                                   0                   12 Hawaii
                                   0                   13 Idaho
                                 342                   14 Illinois
                                  30                   15 Indiana
                                 100                   16 Iowa
                                 105                   17 Kansas
                                 196                   18 Kentucky
                                 114                   19 Louisiana
                                   0                   20 Maine
                                 178                   21 Maryland
                                 181                   22 Massachusetts
                                 575                   23 Michigan
                                 215                   24 Minnesota
                                   2                   25 Mississippi
                                 280                   26 Missouri
                                   0                   27 Montana
                                  92                   28 Nebraska
                                 190                   29 Nevada
                                   1                   30 New Hampshire
                                 304                   31 New Jersey
                                 251                   32 New Mexico
                                 625                   33 New York
                                 541                   34 North Carolina
                                   0                   35 North Dakota
                                 563                   36 Ohio
                                 119                   37 Oklahoma
                                   0                   38 Oregon
                                 553                   39 Pennsylvania
                                 197                   40 Puerto Rico
                                   1                   41 Rhode Island
                                 104                   42 South Carolina
                                   1                   43 South Dakota
                                 321                   44 Tennessee
                                 750                   45 Texas
                                   2                   46 Utah
                                   1                   47 Vermont
                                   0                   48 Virgin Islands
                                 153                   49 Virginia
                                 414                   50 Washington
                                 127                   51 West Virginia
                                 322                   52 Wisconsin
                                  97                   53 Wyoming
                                  11                      Unknown

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

                                  11                      Unknown
                              10,890                      County code

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

                                  11                      Unknown
                              10,890                      ZIP Code

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

                                 311                   01 New England
                               1,482                   02 Middle Atlantic
                               1,832                   03 East North Central
                                 793                   04 West North Central
                               2,261                   05 South Atlantic
                                 933                   06 East South Central
                               1,094                   07 West South Central
                                 823                   08 Mountain
                               1,164                   09 Pacific
                                 197                   10 Puerto Rico
                                  11                      Unknown

H_METRO    80  1  $METFMT                               C Metro status

                               2,848                    N Non-metro area
                                   0                    U Unknown
                               8,053                    Y Metro area

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

                              10,022                      Missing
                                 879                      Date as YYYYMMDD

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

                              10,022                      Missing
                                 879                      Date as YYYYMMDD

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

                              10,620                      Missing
                                 281                      Date as YYYYMMDD

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

                              10,620                      Missing
                                 281                      Date as YYYYMMDD

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

                              10,725                      Missing
                                 176                      Date as YYYYMMDD

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

                              10,725                      Missing
                                 176                      Date as YYYYMMDD

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

                              10,770                      Missing
                                 131                      Date as YYYYMMDD

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

                              10,770                      Missing
                                 131                      Date as YYYYMMDD

H_ESRBEG  145  8  $DTE8FMT                              C Beginning date of ESRD period

                              10,731                      Missing
                                 170                      Date as YYYYMMDD

H_ESREND  153  8  $DTE8FMT                              C Ending date of ESRD period

                              10,812                      Missing
                                  89                      Date as YYYYMMDD

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

                               8,098                    0 No enrollment
                               2,803                    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_PLPY01  171  5                                        N Medicare capitation payment for Jan

H_PLPY02  176  5                                        N Medicare capitation payment for Feb

H_PLPY03  181  5                                        N Medicare capitation payment for Mar

H_PLPY04  186  5                                        N Medicare capitation payment for Apr

H_PLPY05  191  5                                        N Medicare capitation payment for May

H_PLPY06  196  5                                        N Medicare capitation payment for Jun

H_PLPY07  201  5                                        N Medicare capitation payment for Jul

H_PLPY08  206  5                                        N Medicare capitation payment for Aug

H_PLPY09  211  5                                        N Medicare capitation payment for Sep

H_PLPY10  216  5                                        N Medicare capitation payment for Oct

H_PLPY11  221  5                                        N Medicare capitation payment for Nov

H_PLPY12  226  5                                        N Medicare capitation payment for Dec

H_PDPY01  231  5                                        N Part D capitation payment for Jan

H_PDLS01  236  1  $DLISFMT                              C LIS Indicator for Jan

                                 355                      Unknown
                               7,727                    1 No premium subsidy
                                  30                    2 25% premium subsidy
                                  28                    3 50% premium subsidy
                                  33                    4 75% premium subsidy
                               2,728                    5 100% premium subsidy

H_PDRS01  237  1  $DRDSFMT                              C RDS Indicator for Jan

                                 355                      Unknown
                               9,070                    N Employer not subsidized for the benefici
                               1,476                    Y Employer subsidized for the beneficiary

H_CRED01  238  1  $YES8FMT                              C Creditable Coverage for Jan

                                   4                      Unknown
                               1,560                    1 Yes
                               9,337                    2 No

H_PDPY02  239  5                                        N Part D capitation payment for Feb

H_PDLS02  244  1  $DLISFMT                              C LIS Indicator for Feb

                                 361                      Unknown
                               7,713                    1 No premium subsidy
                                  31                    2 25% premium subsidy
                                  27                    3 50% premium subsidy
                                  33                    4 75% premium subsidy
                               2,736                    5 100% premium subsidy

H_PDRS02  245  1  $DRDSFMT                              C RDS Indicator for Feb

                                 361                      Unknown
                               9,064                    N Employer not subsidized for the benefici
                               1,476                    Y Employer subsidized for the beneficiary

H_CRED02  246  1  $YES8FMT                              C Creditable Coverage for Feb

                                   4                      Unknown
                               1,562                    1 Yes
                               9,335                    2 No

H_PDPY03  247  5                                        N Part D capitation payment for Mar

H_PDLS03  252  1  $DLISFMT                              C LIS Indicator for Mar

                                 370                      Unknown
                               7,699                    1 No premium subsidy
                                  32                    2 25% premium subsidy
                                  28                    3 50% premium subsidy
                                  34                    4 75% premium subsidy
                               2,738                    5 100% premium subsidy

H_PDRS03  253  1  $DRDSFMT                              C RDS Indicator for Mar

                                 370                      Unknown
                               9,059                    N Employer not subsidized for the benefici
                               1,472                    Y Employer subsidized for the beneficiary

H_CRED03  254  1  $YES8FMT                              C Creditable Coverage for Mar

                                   4                      Unknown
                               1,560                    1 Yes
                               9,337                    2 No

H_PDPY04  255  5                                        N Part D capitation payment for Apr

H_PDLS04  260  1  $DLISFMT                              C LIS Indicator for Apr

                                 395                      Unknown
                               7,688                    1 No premium subsidy
                                  31                    2 25% premium subsidy
                                  25                    3 50% premium subsidy
                                  32                    4 75% premium subsidy
                               2,730                    5 100% premium subsidy

H_PDRS04  261  1  $DRDSFMT                              C RDS Indicator for Apr

                                 395                      Unknown
                               9,040                    N Employer not subsidized for the benefici
                               1,466                    Y Employer subsidized for the beneficiary

H_CRED04  262  1  $YES8FMT                              C Creditable Coverage for Apr

                                   4                      Unknown
                               1,559                    1 Yes
                               9,338                    2 No

H_PDPY05  263  5                                        N Part D capitation payment for May

H_PDLS05  268  1  $DLISFMT                              C LIS Indicator for May

                                 419                      Unknown
                               7,659                    1 No premium subsidy
                                  30                    2 25% premium subsidy
                                  25                    3 50% premium subsidy
                                  32                    4 75% premium subsidy
                               2,736                    5 100% premium subsidy

H_PDRS05  269  1  $DRDSFMT                              C RDS Indicator for May

                                 419                      Unknown
                               9,025                    N Employer not subsidized for the benefici
                               1,457                    Y Employer subsidized for the beneficiary

H_CRED05  270  1  $YES8FMT                              C Creditable Coverage for May

                                   4                      Unknown
                               1,559                    1 Yes
                               9,338                    2 No

H_PDPY06  271  5                                        N Part D capitation payment for Jun

H_PDLS06  276  1  $DLISFMT                              C LIS Indicator for Jun

                                 428                      Unknown
                               7,645                    1 No premium subsidy
                                  29                    2 25% premium subsidy
                                  26                    3 50% premium subsidy
                                  34                    4 75% premium subsidy
                               2,739                    5 100% premium subsidy

H_PDRS06  277  1  $DRDSFMT                              C RDS Indicator for Jun

                                 428                      Unknown
                               9,013                    N Employer not subsidized for the benefici
                               1,460                    Y Employer subsidized for the beneficiary

H_CRED06  278  1  $YES8FMT                              C Creditable Coverage for Jun

                                   4                      Unknown
                               1,565                    1 Yes
                               9,332                    2 No

H_PDPY07  279  5                                        N Part D capitation payment for Jul

H_PDLS07  284  1  $DLISFMT                              C LIS Indicator for Jul

                                 425                      Unknown
                               7,635                    1 No premium subsidy
                                  29                    2 25% premium subsidy
                                  27                    3 50% premium subsidy
                                  34                    4 75% premium subsidy
                               2,751                    5 100% premium subsidy

H_PDRS07  285  1  $DRDSFMT                              C RDS Indicator for Jul

                                 425                      Unknown
                               9,033                    N Employer not subsidized for the benefici
                               1,443                    Y Employer subsidized for the beneficiary

H_CRED07  286  1  $YES8FMT                              C Creditable Coverage for Jul

                                   4                      Unknown
                               1,564                    1 Yes
                               9,333                    2 No

H_PDPY08  287  5                                        N Part D capitation payment for Aug

H_PDLS08  292  1  $DLISFMT                              C LIS Indicator for Aug

                                 438                      Unknown
                               7,624                    1 No premium subsidy
                                  29                    2 25% premium subsidy
                                  26                    3 50% premium subsidy
                                  33                    4 75% premium subsidy
                               2,751                    5 100% premium subsidy

H_PDRS08  293  1  $DRDSFMT                              C RDS Indicator for Aug

                                 438                      Unknown
                               9,022                    N Employer not subsidized for the benefici
                               1,441                    Y Employer subsidized for the beneficiary

H_CRED08  294  1  $YES8FMT                              C Creditable Coverage for Aug

                                   4                      Unknown
                               1,562                    1 Yes
                               9,335                    2 No

H_PDPY09  295  5                                        N Part D capitation payment for Sep

H_PDLS09  300  1  $DLISFMT                              C LIS Indicator for Sep

                                 445                      Unknown
                               7,613                    1 No premium subsidy
                                  30                    2 25% premium subsidy
                                  26                    3 50% premium subsidy
                                  32                    4 75% premium subsidy
                               2,755                    5 100% premium subsidy

H_PDRS09  301  1  $DRDSFMT                              C RDS Indicator for Sep

                                 445                      Unknown
                               9,023                    N Employer not subsidized for the benefici
                               1,433                    Y Employer subsidized for the beneficiary

H_CRED09  302  1  $YES8FMT                              C Creditable Coverage for Sep

                                   4                      Unknown
                               1,566                    1 Yes
                               9,331                    2 No

H_PDPY10  303  5                                        N Part D capitation payment for Oct

H_PDLS10  308  1  $DLISFMT                              C LIS Indicator for Oct

                                 452                      Unknown
                               7,604                    1 No premium subsidy
                                  30                    2 25% premium subsidy
                                  26                    3 50% premium subsidy
                                  32                    4 75% premium subsidy
                               2,757                    5 100% premium subsidy

H_PDRS10  309  1  $DRDSFMT                              C RDS Indicator for Oct

                                 452                      Unknown
                               9,034                    N Employer not subsidized for the benefici
                               1,415                    Y Employer subsidized for the beneficiary

H_CRED10  310  1  $YES8FMT                              C Creditable Coverage for Oct

                                   4                      Unknown
                               1,567                    1 Yes
                               9,330                    2 No

H_PDPY11  311  5                                        N Part D capitation payment for Nov

H_PDLS11  316  1  $DLISFMT                              C LIS Indicator for Nov

                                 462                      Unknown
                               7,594                    1 No premium subsidy
                                  30                    2 25% premium subsidy
                                  23                    3 50% premium subsidy
                                  32                    4 75% premium subsidy
                               2,760                    5 100% premium subsidy

H_PDRS11  317  1  $DRDSFMT                              C RDS Indicator for Nov

                                 462                      Unknown
                               9,030                    N Employer not subsidized for the benefici
                               1,409                    Y Employer subsidized for the beneficiary

H_CRED11  318  1  $YES8FMT                              C Creditable Coverage for Nov

                                   4                      Unknown
                               1,566                    1 Yes
                               9,331                    2 No

H_PDPY12  319  5                                        N Part D capitation payment for Dec

H_PDLS12  324  1  $DLISFMT                              C LIS Indicator for Dec

                                 482                      Unknown
                               7,576                    1 No premium subsidy
                                  30                    2 25% premium subsidy
                                  24                    3 50% premium subsidy
                                  31                    4 75% premium subsidy
                               2,758                    5 100% premium subsidy

H_PDRS12  325  1  $DRDSFMT                              C RDS Indicator for Dec

                                 482                      Unknown
                               9,011                    N Employer not subsidized for the benefici
                               1,408                    Y Employer subsidized for the beneficiary

H_CRED12  326  1  $YES8FMT                              C Creditable Coverage for Dec

                                   4                      Unknown
                               1,567                    1 Yes
                               9,330                    2 No

H_MCSW    327  1  $SWFMT                                C Some Medicaid eligibility for the year

                               8,499                    N No participation
                               2,402                    Y Some participation

H_MCDE01  328  1  $MCDCFMT                              C Medicaid eligibility for Jan

                                   0                    A State Part A buy-in
                                 846                    B State Part B buy-in
                                  34                    C State Part A and B buy-in
                                  70                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                               8,687                    N No buy-in this month
                                 977                    Q State Part B QMB buy-in
                                 287                    S State Part B SLMB buy-in

H_MCDE02  329  1  $MCDCFMT                              C Medicaid eligibility for Feb

                                   0                    A State Part A buy-in
                                 845                    B State Part B buy-in
                                  33                    C State Part A and B buy-in
                                  71                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                               8,685                    N No buy-in this month
                                 980                    Q State Part B QMB buy-in
                                 287                    S State Part B SLMB buy-in

H_MCDE03  330  1  $MCDCFMT                              C Medicaid eligibility for Mar

                                   0                    A State Part A buy-in
                                 842                    B State Part B buy-in
                                  33                    C State Part A and B buy-in
                                  71                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                               8,693                    N No buy-in this month
                                 975                    Q State Part B QMB buy-in
                                 287                    S State Part B SLMB buy-in

H_MCDE04  331  1  $MCDCFMT                              C Medicaid eligibility for Apr

                                   0                    A State Part A buy-in
                                 841                    B State Part B buy-in
                                  33                    C State Part A and B buy-in
                                  71                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                               8,693                    N No buy-in this month
                                 975                    Q State Part B QMB buy-in
                                 288                    S State Part B SLMB buy-in

H_MCDE05  332  1  $MCDCFMT                              C Medicaid eligibility for May

                                   0                    A State Part A buy-in
                                 839                    B State Part B buy-in
                                  35                    C State Part A and B buy-in
                                  71                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                               8,692                    N No buy-in this month
                                 977                    Q State Part B QMB buy-in
                                 287                    S State Part B SLMB buy-in

H_MCDE06  333  1  $MCDCFMT                              C Medicaid eligibility for Jun

                                   0                    A State Part A buy-in
                                 836                    B State Part B buy-in
                                  35                    C State Part A and B buy-in
                                  71                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                               8,698                    N No buy-in this month
                                 972                    Q State Part B QMB buy-in
                                 289                    S State Part B SLMB buy-in

H_MCDE07  334  1  $MCDCFMT                              C Medicaid eligibility for Jul

                                   0                    A State Part A buy-in
                                 846                    B State Part B buy-in
                                  35                    C State Part A and B buy-in
                                  72                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                               8,690                    N No buy-in this month
                                 973                    Q State Part B QMB buy-in
                                 285                    S State Part B SLMB buy-in

H_MCDE08  335  1  $MCDCFMT                              C Medicaid eligibility for Aug

                                   0                    A State Part A buy-in
                                 839                    B State Part B buy-in
                                  36                    C State Part A and B buy-in
                                  71                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                               8,697                    N No buy-in this month
                                 974                    Q State Part B QMB buy-in
                                 284                    S State Part B SLMB buy-in

H_MCDE09  336  1  $MCDCFMT                              C Medicaid eligibility for Sep

                                   0                    A State Part A buy-in
                                 838                    B State Part B buy-in
                                  36                    C State Part A and B buy-in
                                  71                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                               8,708                    N No buy-in this month
                                 966                    Q State Part B QMB buy-in
                                 282                    S State Part B SLMB buy-in

H_MCDE10  337  1  $MCDCFMT                              C Medicaid eligibility for Oct

                                   0                    A State Part A buy-in
                                 841                    B State Part B buy-in
                                  37                    C State Part A and B buy-in
                                  70                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                               8,708                    N No buy-in this month
                                 963                    Q State Part B QMB buy-in
                                 282                    S State Part B SLMB buy-in

H_MCDE11  338  1  $MCDCFMT                              C Medicaid eligibility for Nov

                                   0                    A State Part A buy-in
                                 843                    B State Part B buy-in
                                  38                    C State Part A and B buy-in
                                  69                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                               8,712                    N No buy-in this month
                                 958                    Q State Part B QMB buy-in
                                 281                    S State Part B SLMB buy-in

H_MCDE12  339  1  $MCDCFMT                              C Medicaid eligibility for Dec

                                   1                    A State Part A buy-in
                                 823                    B State Part B buy-in
                                  37                    C State Part A and B buy-in
                                  68                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                               8,755                    N No buy-in this month
                                 943                    Q State Part B QMB buy-in
                                 274                    S State Part B SLMB buy-in

H_MACY01  340  3  $MACYFMT                              C Buy-in agency for Jan

                               8,687                    N Unknown, or no buy-in
                               2,214              S00-S99 State Agency code
                                   0              000-999 State Agency code

H_MACY02  343  3  $MACYFMT                              C Buy-in agency for Feb

                               8,685                    N Unknown, or no buy-in
                               2,216              S00-S99 State Agency code
                                   0              000-999 State Agency code

H_MACY03  346  3  $MACYFMT                              C Buy-in agency for Mar

                               8,693                    N Unknown, or no buy-in
                               2,208              S00-S99 State Agency code
                                   0              000-999 State Agency code

H_MACY04  349  3  $MACYFMT                              C Buy-in agency for Apr

                               8,693                    N Unknown, or no buy-in
                               2,208              S00-S99 State Agency code
                                   0              000-999 State Agency code

H_MACY05  352  3  $MACYFMT                              C Buy-in agency for May

                               8,692                    N Unknown, or no buy-in
                               2,209              S00-S99 State Agency code
                                   0              000-999 State Agency code

H_MACY06  355  3  $MACYFMT                              C Buy-in agency for Jun

                               8,698                    N Unknown, or no buy-in
                               2,203              S00-S99 State Agency code
                                   0              000-999 State Agency code

H_MACY07  358  3  $MACYFMT                              C Buy-in agency for Jul

                               8,690                    N Unknown, or no buy-in
                               2,211              S00-S99 State Agency code
                                   0              000-999 State Agency code

H_MACY08  361  3  $MACYFMT                              C Buy-in agency for Aug

                               8,697                    N Unknown, or no buy-in
                               2,204              S00-S99 State Agency code
                                   0              000-999 State Agency code

H_MACY09  364  3  $MACYFMT                              C Buy-in agency for Sep

                               8,708                    N Unknown, or no buy-in
                               2,193              S00-S99 State Agency code
                                   0              000-999 State Agency code

H_MACY10  367  3  $MACYFMT                              C Buy-in agency for Oct

                               8,708                    N Unknown, or no buy-in
                               2,193              S00-S99 State Agency code
                                   0              000-999 State Agency code

H_MACY11  370  3  $MACYFMT                              C Buy-in agency for Nov

                               8,712                    N Unknown, or no buy-in
                               2,189              S00-S99 State Agency code
                                   0              000-999 State Agency code

H_MACY12  373  3  $MACYFMT                              C Buy-in agency for Dec

                               8,755                    N Unknown, or no buy-in
                               2,146              S00-S99 State Agency code
                                   0              000-999 State Agency code

H_HOSSW   376  1  $UTLFMT                               C One or more hospice bills in CY

                              10,582                    0 No utilization this type
                                 319                    1 Some utilization this type

H_INPSW   377  1  $UTLFMT                               C One or more inpatient discharges in CY

                               9,236                    0 No utilization this type
                               1,665                    1 Some utilization this type

H_SNFSW   378  1  $UTLFMT                               C One or more SNF admissions in CY

                              10,374                    0 No utilization this type
                                 527                    1 Some utilization this type

H_HHASW   379  1  $UTLFMT                               C 1 = one or more HHA visits in CY

                              10,028                    0 No utilization this type
                                 873                    1 Some utilization this type

H_OUTSW   380  1  $UTLFMT                               C One or more outpatient visits in CY

                               5,196                    0 No utilization this type
                               5,705                    1 Some utilization this type

H_PBSW    381  1  $UTLFMT                               C One or more Part B claims in CY

                               3,098                    0 No utilization this type
                               7,803                    1 Some utilization this type

H_PTARMB  382  7                                        N Total Part A reimbursement in CY ($)

H_PTBRMB  389  7                                        N Total Part B reimbursement in CY ($)

H_PTAPRM  396  8                                        N Total Pt. A premium SP paid in CY ($.CC)

H_PTBPRM  404  8                                        N Total Pt. B premium SP paid in CY ($.CC)

H_LATDCH  412  8  $DTE8FMT                              C Discharge date of latest inpatient stay

                               9,236                      Missing
                               1,665                      Date as YYYYMMDD

H_LATDRG  420  3  $DRGFMT                               C DRG code for latest inpatient stay

                               9,236                      Unknown, or no discharge
                               1,665                      DRG

H_DISDES  423  2  $STATUS                               C Discharge dest for latest inpatient stay

                               9,236                      Missing
                                 827                   01 Discharged to home/self care
                                   7                   02 Discharged to other short-term hospital
                                 351                   03 Discharged to skilled nursing facility
                                  24                   04 Discharged to intermediate care facility
                                   2                   05 Disch to another type of institution
                                 246                   06 Discharged to home care of organized HMO
                                  12                   07 Left against medical advice/stopped care
                                   0                   08 Disch home under care of IV therapy prov
                                 100                   20 Expired (did not recover Christian Sci)
                                   2                   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)
                                   1                   43 Disch/Transferred to a Fed Hospital (10)
                                  34                   50 Hospice - home (eff. 96)
                                  36                   51 Hospice - medical facility (eff. 96)
                                  11                   61 Disch w/i facility to swing-bed SNF (99)
                                   4                   62 Disch inp rehab; inc distinct hosp (10)
                                   4                   63 Disch to long term care hospital (10)
                                   2                   64 Disch cert nursing; Mcaid, not Mcare(10)
                                   2                   65 Disch to psychiatric hosp or unit   (10)
                                   0                   70 Disch to other institution, no code (10)
                                   0                   71 Disch to other facility for O/P svcs(99)
                                   0                   72 Disch to this facility for O/P svcs (99)

H_INPSTY  425  2                                        N No. of inpatient stays for CY

H_INPDAY  427  3                                        N No. of inpatient covered days for CY

H_INPCHG  430  7                                        N Inpatient charges for CY ($)

H_INPCCH  437  7                                        N Inpatient covered charges for CY ($)

H_INPRMB  444  7                                        N Inpatient reimbursement for CY ($)

H_INPCDY  451  2                                        N Inpatient coinsurance days used in CY

H_INPCAM  453  5                                        N Total inpatient coinsurance amt CY ($)

H_SNFSTY  458  2                                        N Total SNF stays in CY

H_SNFDAY  460  3                                        N Total SNF covered days in CY

H_SNFCHG  463  7                                        N Total SNF charges in CY  ($)

H_SNFCCH  470  7                                        N Total SNF covered charges in CY ($)

H_SNFRMB  477  7                                        N Total SNF reimbursement in CY ($)

H_SNFCDY  484  3                                        N Total SNF coinsurance days in CY

H_SNFCAM  487  7                                        N Total SNF coinsurance amount in CY ($)

H_HHAVST  494  5                                        N Total HHA visits in CY

H_HHACCH  499  7                                        N Total HHA covered charges in CY ($)

H_HHACHO  506  7                                        N Total HHA other covered charges CY ($)

H_HHRMBA  513  7                                        N Total HHA reimbursement in CY ($), Pt. A

                 Notes: Prior to 1998 this was included in H_HHARMB.
                        First available in 1998

H_HHRMBB  520  7                                        N Total HHA reimbursement in CY ($), Pt. B

                 Notes: Prior to 1998 this was included in H_HHARMB.
                        First available in 1998

H_HSDAYS  527  3                                        N Total covered hospice days in CY

H_HSTCHG  530  7                                        N Total hospice charges CY ($)

H_HSREIM  537  7                                        N Total hospice reimbursement in CY ($)

H_OUTBIL  544  3                                        N Total outpatient bills in CY

H_OUTCHG  547  7                                        N Total outpatient covered charges CY ($)

H_OUTRMB  554  7                                        N Total outpatient reimbursement CY ($)

H_PMTCLM  561  4                                        N Total physician/supplier claims in CY

H_PMTLIN  565  4                                        N Total phys./supplier line items in CY

H_PMTSCH  569  7                                        N Total submitted phys/supplier charge ($)

H_PMTACH  576  7                                        N Total allowed phys/supplier charges ($)

H_PMTRMB  583  7                                        N Total phys/supplier reimbursement ($)

H_PMTVST  590  3                                        N Total office visits in CY

H_PMTCHO  593  7                                        N Total office visit charges in CY ($)

H_DMECLM  600  4                                        N Total DME supplier claims in CY

                 Notes: Prior to 1998 this was included in H_PMTCLM.
                        First available in 1998

H_DMELIN  604  4                                        N Total DME supplier line items in CY

                 Notes: Prior to 1998 this was included in H_PMTLIN.
                        First available in 1998

H_DMESCH  608  7                                        N Total DME supplier submitted charges ($)

                 Notes: Prior to 1998 this was included in H_PMTSCH.
                        First available in 1998

H_DMEACH  615  7                                        N Total DME supplier allowed charges ($)

                 Notes: Prior to 1998 this was included in H_PMTACH.
                        First available in 1998

H_DMERMB  622  7                                        N Total DME supplier reimbursement ($)

                 Notes: Prior to 1998 this was included in H_PMTRMB.
                        First available in 1998

DUAL_JAN  629  2  $DUALMON                              C Dual eligibity code for Jan

                                   3                      Beneficiary not found in duals data
                                   4                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,136                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 351                   00 Not enrolled in Medicare for the month
                                 260                   01 QMB-only
                               1,245                   02 QMB & full Medicaid covrge, + Rx drugs
                                 221                   03 SLMB-only
                                  91                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 112                   06 Qualifying individuals
                                 441                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  37                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_FEB  631  2  $DUALMON                              C Dual eligibity code for Feb

                                   3                      Beneficiary not found in duals data
                                   4                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,111                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 368                   00 Not enrolled in Medicare for the month
                                 264                   01 QMB-only
                               1,238                   02 QMB & full Medicaid covrge, + Rx drugs
                                 224                   03 SLMB-only
                                  89                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 116                   06 Qualifying individuals
                                 447                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  37                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_MAR  633  2  $DUALMON                              C Dual eligibity code for Mar

                                   3                      Beneficiary not found in duals data
                                   4                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,110                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 384                   00 Not enrolled in Medicare for the month
                                 264                   01 QMB-only
                               1,229                   02 QMB & full Medicaid covrge, + Rx drugs
                                 226                   03 SLMB-only
                                  91                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 110                   06 Qualifying individuals
                                 443                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  37                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_APR  635  2  $DUALMON                              C Dual eligibity code for Apr

                                   3                      Beneficiary not found in duals data
                                   4                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,080                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 421                   00 Not enrolled in Medicare for the month
                                 264                   01 QMB-only
                               1,236                   02 QMB & full Medicaid covrge, + Rx drugs
                                 228                   03 SLMB-only
                                  81                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 109                   06 Qualifying individuals
                                 438                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  37                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_MAY  637  2  $DUALMON                              C Dual eligibity code for May

                                   3                      Beneficiary not found in duals data
                                   4                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,065                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 427                   00 Not enrolled in Medicare for the month
                                 267                   01 QMB-only
                               1,236                   02 QMB & full Medicaid covrge, + Rx drugs
                                 232                   03 SLMB-only
                                  81                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 112                   06 Qualifying individuals
                                 434                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  40                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_JUN  639  2  $DUALMON                              C Dual eligibity code for Jun

                                   3                      Beneficiary not found in duals data
                                   4                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,059                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 433                   00 Not enrolled in Medicare for the month
                                 266                   01 QMB-only
                               1,237                   02 QMB & full Medicaid covrge, + Rx drugs
                                 226                   03 SLMB-only
                                  85                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 109                   06 Qualifying individuals
                                 440                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  39                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_JUL  641  2  $DUALMON                              C Dual eligibity code for Jul

                                   3                      Beneficiary not found in duals data
                                   4                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,037                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 443                   00 Not enrolled in Medicare for the month
                                 268                   01 QMB-only
                               1,234                   02 QMB & full Medicaid covrge, + Rx drugs
                                 225                   03 SLMB-only
                                  82                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 115                   06 Qualifying individuals
                                 449                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  41                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_AUG  643  2  $DUALMON                              C Dual eligibity code for Aug

                                   3                      Beneficiary not found in duals data
                                   4                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,038                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 459                   00 Not enrolled in Medicare for the month
                                 269                   01 QMB-only
                               1,231                   02 QMB & full Medicaid covrge, + Rx drugs
                                 221                   03 SLMB-only
                                  85                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 111                   06 Qualifying individuals
                                 442                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  38                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_SEP  645  2  $DUALMON                              C Dual eligibity code for Sep

                                   3                      Beneficiary not found in duals data
                                   4                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,044                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 465                   00 Not enrolled in Medicare for the month
                                 268                   01 QMB-only
                               1,231                   02 QMB & full Medicaid covrge, + Rx drugs
                                 223                   03 SLMB-only
                                  82                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 110                   06 Qualifying individuals
                                 437                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  34                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_OCT  647  2  $DUALMON                              C Dual eligibity code for Oct

                                   3                      Beneficiary not found in duals data
                                   4                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,027                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 467                   00 Not enrolled in Medicare for the month
                                 265                   01 QMB-only
                               1,231                   02 QMB & full Medicaid covrge, + Rx drugs
                                 224                   03 SLMB-only
                                  83                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 114                   06 Qualifying individuals
                                 448                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  35                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_NOV  649  2  $DUALMON                              C Dual eligibity code for Nov

                                   3                      Beneficiary not found in duals data
                                   4                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,052                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 476                   00 Not enrolled in Medicare for the month
                                 261                   01 QMB-only
                               1,212                   02 QMB & full Medicaid covrge, + Rx drugs
                                 220                   03 SLMB-only
                                  81                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 114                   06 Qualifying individuals
                                 446                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  32                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_DEC  651  2  $DUALMON                              C Dual eligibity code for Dec

                                   3                      Beneficiary not found in duals data
                                   4                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,022                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 500                   00 Not enrolled in Medicare for the month
                                 270                   01 QMB-only
                               1,201                   02 QMB & full Medicaid covrge, + Rx drugs
                                 220                   03 SLMB-only
                                  84                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 121                   06 Qualifying individuals
                                 442                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  34                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

OP_MDCD   653  1  $DUALFMT                              C Medicare-Medicaid dual eligibility indic

                               1,957                    1 FULL-Bene elig. full Medicaid benefits
                               8,270                    2 NONDUAL-Bene not elig Medicaid benfits
                                 382                    3 PARTIAL-Bene elig part Medicd- not QMB
                                 292                    4 QMB ONLY-Bene elig for part Medicd-QMB

PTCPRM1   654  8                                        N Part C Premium for Jan

PTCPRM2   662  8                                        N Part C Premium for Feb

PTCPRM3   670  8                                        N Part C Premium for Mar

PTCPRM4   678  8                                        N Part C Premium for Apr

PTCPRM5   686  8                                        N Part C Premium for May

PTCPRM6   694  8                                        N Part C Premium for Jun

PTCPRM7   702  8                                        N Part C Premium for Jul

PTCPRM8   710  8                                        N Part C Premium for Aug

PTCPRM9   718  8                                        N Part C Premium for Sep

PTCPRM10  726  8                                        N Part C Premium for Oct

PTCPRM11  734  8                                        N Part C Premium for Nov

PTCPRM12  742  8                                        N Part C Premium for Dec

PTDPRM1   750  8                                        N Part D Premium for Jan

PTDPRM2   758  8                                        N Part D Premium for Feb

PTDPRM3   766  8                                        N Part D Premium for Mar

PTDPRM4   774  8                                        N Part D Premium for Apr

PTDPRM5   782  8                                        N Part D Premium for May

PTDPRM6   790  8                                        N Part D Premium for Jun

PTDPRM7   798  8                                        N Part D Premium for Jul

PTDPRM8   806  8                                        N Part D Premium for Aug

PTDPRM9   814  8                                        N Part D Premium for Sep

PTDPRM10  822  8                                        N Part D Premium for Oct

PTDPRM11  830  8                                        N Part D Premium for Nov

PTDPRM12  838  8                                        N Part D Premium for Dec

PARTD_01  846  1  $YNO8FMT                              C Part D plan flag for Jan

                               4,066                    N No
                               6,835                    Y Yes

PARTD_02  847  1  $YNO8FMT                              C Part D plan flag for Feb

                               4,065                    N No
                               6,836                    Y Yes

PARTD_03  848  1  $YNO8FMT                              C Part D plan flag for Mar

                               4,073                    N No
                               6,828                    Y Yes

PARTD_04  849  1  $YNO8FMT                              C Part D plan flag for Apr

                               4,094                    N No
                               6,807                    Y Yes

PARTD_05  850  1  $YNO8FMT                              C Part D plan flag for May

                               4,103                    N No
                               6,798                    Y Yes

PARTD_06  851  1  $YNO8FMT                              C Part D plan flag for Jun

                               4,121                    N No
                               6,780                    Y Yes

PARTD_07  852  1  $YNO8FMT                              C Part D plan flag for Jul

                               4,097                    N No
                               6,804                    Y Yes

PARTD_08  853  1  $YNO8FMT                              C Part D plan flag for Aug

                               4,105                    N No
                               6,796                    Y Yes

PARTD_09  854  1  $YNO8FMT                              C Part D plan flag for Sep

                               4,102                    N No
                               6,799                    Y Yes

PARTD_10  855  1  $YNO8FMT                              C Part D plan flag for Oct

                               4,109                    N No
                               6,792                    Y Yes

PARTD_11  856  1  $YNO8FMT                              C Part D plan flag for Nov

                               4,119                    N No
                               6,782                    Y Yes

PARTD_12  857  1  $YNO8FMT                              C Part D plan flag for Dec

                               4,135                    N No
                               6,766                    Y Yes

MAFLAG01  858  3  $MAFLAG                               C MA flag for January

                                 351                      No Entitlement
                               7,692                  FFS Original Medicare/FFS
                               2,858                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG02  861  3  $MAFLAG                               C MA flag for February

                                 368                      No Entitlement
                               7,675                  FFS Original Medicare/FFS
                               2,858                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG03  864  3  $MAFLAG                               C MA flag for March

                                 384                      No Entitlement
                               7,655                  FFS Original Medicare/FFS
                               2,862                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG04  867  3  $MAFLAG                               C MA flag for April

                                 421                      No Entitlement
                               7,620                  FFS Original Medicare/FFS
                               2,860                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG05  870  3  $MAFLAG                               C MA flag for May

                                 427                      No Entitlement
                               7,616                  FFS Original Medicare/FFS
                               2,858                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG06  873  3  $MAFLAG                               C MA flag for June

                                 433                      No Entitlement
                               7,608                  FFS Original Medicare/FFS
                               2,860                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG07  876  3  $MAFLAG                               C MA flag for July

                                 442                      No Entitlement
                               7,586                  FFS Original Medicare/FFS
                               2,873                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG08  879  3  $MAFLAG                               C MA flag for August

                                 458                      No Entitlement
                               7,572                  FFS Original Medicare/FFS
                               2,871                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG09  882  3  $MAFLAG                               C MA flag for September

                                 464                      No Entitlement
                               7,563                  FFS Original Medicare/FFS
                               2,874                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG10  885  3  $MAFLAG                               C MA flag for October

                                 466                      No Entitlement
                               7,568                  FFS Original Medicare/FFS
                               2,867                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG11  888  3  $MAFLAG                               C MA flag for November

                                 475                      No Entitlement
                               7,560                  FFS Original Medicare/FFS
                               2,866                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG12  891  3  $MAFLAG                               C MA flag for December

                                 499                      No Entitlement
                               7,539                  FFS Original Medicare/FFS
                               2,863                   MA MA/Other Medicare Capitated Paymnt Plans

