RIC         1  2  $RIC                                  C Record Identification Code

                                   0                    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
                             487,302                   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

                             487,302                    1 Version 1
                                   0                    2 Version 2
                                   0                    3 Version 3
                                   0                    4 Version 4

BASEID      4  8  $BSIDFMT                              C Unique SP Identification Number

                             487,302             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
                             487,302                   PM Prescribed medicine
                                   0                   SD Separately billing physician
                                   0                   SL Separately billing lab

CORF       14  1  $INTRFMT                              C Community or facility

                             431,698                    C Community
                              55,604                    F Facility

AMTTOT     15  9  MONYFMT                               N Total payment

                             487,302                      Amount as $$$$$$.CC

AMTCARE    24  9  MONYFMT                               N Amount paid by Medicare

                             487,302                      Amount as $$$$$$.CC

AMTCAID    33  9  MONYFMT                               N Amount paid by Medicaid

                             487,302                      Amount as $$$$$$.CC

AMTHMOP    42  9  MONYFMT                               N Amount paid by private HMO

                             487,302                      Amount as $$$$$$.CC

AMTHMOM    51  9  MONYFMT                               N Amount paid by Medicare HMO

                             487,302                      Amount as $$$$$$.CC

AMTVA      60  9  MONYFMT                               N Amount paid by Veterans Administration

                             487,302                      Amount as $$$$$$.CC

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

                             487,302                      Amount as $$$$$$.CC

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

                             487,302                      Amount as $$$$$$.CC

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

                             487,302                      Amount as $$$$$$.CC

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

                             487,302                      Amount as $$$$$$.CC

AMTDISC   105  9  MONYFMT                               N Amount of uncollected SP liability

                             487,302                      Amount as $$$$$$.CC

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

                             487,302                      Amount as $$$$$$.CC

DRUGNAME  123 30                                        C Prescribed Medicine name

PMFORM    153  2  $FORMFMT                              C Prescribed Medicine form

                              24,394                      Not ascertained
                             403,109                    1 Pill
                               2,335                   10 Patch/pad
                               1,028                   11 Topical gel/jelly
                               1,951                   12 Powder
                               4,831                    2 Liquid
                              10,483                    3 Drops
                              11,720                    4 Topical ointment
                                 190                    5 Suppository
                              15,158                    6 Inhalant/aerosol spray
                                 627                    7 Shampoo, soap
                              10,028                    8 Injection
                                 582                    9 I.V.
                                 866                   91 Other

STRNUNI1  155  2  $STRNFMT                              C Unit of strength

                             117,914                      Missing
                               2,775                   -8 Don't know
                              45,262                   -9 Not ascertained
                              19,840                    1 Micrograms
                             278,763                    2 Milligrams
                                 232                    3 Grains
                               3,636                    4 Milliequivalents (MEQ)
                               1,809                    5 Grams (GM,G)
                              11,627                    6 Percent
                                 568                    7 International units
                               4,625                    8 Units
                                 251                   91 Other

STRNNUM1  157 10  STRNFMT                               N Number of units

                             117,914                    . Missing
                              59,668                   -9 Not ascertained
                                 987                   -8 Don't know
                               9,679                    0 Zero
                             299,054                      Number of units of strength

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

                             117,914                      Missing
                             346,701                   -1 Inapplicable
                                  90                   -8 Don't know
                               2,093                    1 Micrograms
                              19,602                    2 Milligrams
                                   2                    3 Grains
                                  33                    4 Milliequivalents (MEQ)
                                   1                    5 Grams (GM,G)
                                 639                    6 Percent
                                  28                    7 International units
                                 145                    8 Units
                                  54                   91 Other

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

                             117,914                    . Missing
                                  70                   -8 Don't know
                             347,430                   -1 Inapplicable
                                 172                    0 Zero
                              21,716                      Number of units of strength

TABNUM    179  8  TABFMT                                N Number of tablets

                             304,978                    . Missing
                              39,232                   -9 Not ascertained
                                 631                   -8 Don't know
                             142,461                1-999 Number of tablets in container

SUPPNUM   187  8  SUPPFMT                               N Number of suppositories

                             304,978                    . Missing or inapplicable
                             182,324                   -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

                             304,978                    . Missing
                             168,908                   -9 Not ascertained
                                 401                   -8 Don't know
                              13,015                      Number of units in container

AMTUNIT   205  2  $AMTFMT                               C Amount unit

                             304,978                      Missing
                               1,439                   -8 Don't know
                             167,468                   -9 Not ascertained
                                 570                    1 Ounces
                               2,735                    2 Grams
                               6,589                    3 Milliliters (ML, CC)
                                  15                    4 Milliequivalents (MEQ)
                                 200                    5 Milligrams (MG, MGM)
                                 239                    6 Micrograms (MCG)
                               2,766                    7 Doses, puffs, blisters
                                 303                   91 Other

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

                              18,849                   UN Unclassified drug products
                              24,964                   02 Analgesics
                                   4                   03 Analgesic and antihist combo
                               1,039                   05 Anesthetics
                                 100                   08 Anti-obesity drugs
                                  41                   09 Antidotes
                              12,329                   11 Antiarthritics
                              16,000                   14 Antiasthmatics
                               5,343                   17 Antihistamines
                                  55                   18 Antihistimine/Decongestant comb
                              20,066                   19 Antibiotics
                                   4                   20 Antiinfectives
                                   0                   21 Antivirals
                                   0                   22 Antifungals
                               7,629                   23 Antiinfectives, miscellaneous
                               2,195                   26 Antineoplastics
                               4,678                   29 Antiparkinson drugs
                               4,562                   32 Autonomic drugs
                               7,204                   35 Blood
                               8,386                   36 Anticoagulants
                              25,635                   38 Cardiac drugs
                             110,261                   41 Cardiovascular
                              20,026                   44 CNS drugs
                                 530                   47 Contraceptives
                                 952                   50 Cough and cold preparations
                                   1                   53 Diagnostic
                              23,523                   56 Diuretics
                               8,666                   59 Electrolyte, caloric, & fluid rep.
                              13,023                   62 EENT preparations
                              32,448                   65 Gastrointestinal preparations
                               7,676                   68 Hormones
                              27,872                   71 Hypoglycemics
                               1,011                   72 Immunosuppresant
                                  35                   74 Misc. medical supp., devices, & other
                               4,952                   77 Muscle relaxants
                              42,588                   80 Psychotherapeutic drugs
                               5,518                   83 Sedative and hypnotic drugs
                               9,060                   86 Skin preparations
                              15,605                   89 Thyroid preparations
                                 480                   92 Biologicals
                                 103                   94 Pre-natal vitamins
                               3,741                   95 Vitamins, all others
                                 146                   97 Smoking Deterrents
                                   2                   98 Herbals
                                   0                   99 Unclassified drug products

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

                                   0                    B Both OTC and RX
                             485,914                    F Federal or legend drug
                               1,388                    O Over-the-counter drug
                                   0                    U Unknown

ISOPCARE  240  1  $IMPFMT                               C AMTCARE payment source imputed?

                             441,775                    0 Not imputed
                              45,527                    1 Imputed

ISOPCAID  241  1  $IMPFMT                               C AMTCAID payment source imputed?

                             463,225                    0 Not imputed
                              24,077                    1 Imputed

ISOPHMOP  242  1  $IMPFMT                               C AMTHMOP payment source imputed?

                             476,138                    0 Not imputed
                              11,164                    1 Imputed

ISOPHMOM  243  1  $IMPFMT                               C AMTHMPOM payment source imputed?

                             487,302                    0 Not imputed
                                   0                    1 Imputed

ISOPVA    244  1  $IMPFMT                               C AMTVA payment source imputed?

                             483,681                    0 Not imputed
                               3,621                    1 Imputed

ISOPPRVE  245  1  $IMPFMT                               C AMTPRVE payment source imputed?

                             454,851                    0 Not imputed
                              32,451                    1 Imputed

ISOPPRVI  246  1  $IMPFMT                               C AMTPRVI payment source imputed?

                             481,380                    0 Not imputed
                               5,922                    1 Imputed

ISOPUNK   247  1  $IMPFMT                               C AMTPRVU payment source imputed?

                             487,302                    0 Not imputed
                                   0                    1 Imputed

ISOPOOP   248  1  $IMPFMT                               C AMTOOP payment source imputed?

                             443,992                    0 Not imputed
                              43,310                    1 Imputed

ISOPDISC  249  1  $IMPFMT                               C AMTDISC payment source imputed?

                             354,396                    0 Not imputed
                             132,906                    1 Imputed

ISOPOTH   250  1  $IMPFMT                               C AMTOTH payment source imputed?

                             474,688                    0 Not imputed
                              12,614                    1 Imputed

IAMTTOT   251  1  $IMPFMT                               C AMTTOT payment amount imputed?

                             450,807                    0 Not imputed
                              36,495                    1 Imputed

IAMTCARE  252  1  $IMPFMT                               C AMTCARE payment amount imputed?

                             421,185                    0 Not imputed
                              66,117                    1 Imputed

IAMTCAID  253  1  $IMPFMT                               C AMTCAID payment amount imputed?

                             456,642                    0 Not imputed
                              30,660                    1 Imputed

IAMTHMOP  254  1  $IMPFMT                               C AMTHMOP payment amount imputed?

                             472,560                    0 Not imputed
                              14,742                    1 Imputed

IAMTHMOM  255  1  $IMPFMT                               C AMTHMPOM payment amount imputed?

                             487,302                    0 Not imputed
                                   0                    1 Imputed

IAMTVA    256  1  $IMPFMT                               C AMTVA payment amount imputed?

                             476,152                    0 Not imputed
                              11,150                    1 Imputed

IAMTPRVE  257  1  $IMPFMT                               C AMTPRVE payment amount imputed?

                             434,132                    0 Not imputed
                              53,170                    1 Imputed

IAMTPRVI  258  1  $IMPFMT                               C AMTPRVI payment amount imputed?

                             479,031                    0 Not imputed
                               8,271                    1 Imputed

IAMTPRVU  259  1  $IMPFMT                               C AMTPRVU payment amount imputed?

                             487,302                    0 Not imputed
                                   0                    1 Imputed

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

                             383,249                    0 Not imputed
                             104,053                    1 Imputed

IAMTDISC  261  1  $IMPFMT                               C Imputed discount amount

                             353,675                    0 Not imputed
                             133,627                    1 Imputed

IAMTOTH   262  1  $IMPFMT                               C Imputed other amount

                             459,687                    0 Not imputed
                              27,615                    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

                             182,324                    1 Survey Reported Event
                             117,914                    2 PDE Only Event
                             187,064                    3 Survey Reported Event matched to PDE

