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
                                   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
                              11,299                    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

                              11,299                    1 Version 1
                                   0                    2 Version 2
                                   0                    3 Version 3
                                   0                    4 Version 4

BASEID      4  8  $BSIDFMT                              C Unique SP Identification Number

                              11,299             LOW-HIGH BASEID Count

D_CARE1    12  1  $MEDCOVG                              C Medicare coverage - Jan

                                 355                    0 No entitlement
                                 452                    1 Part A only
                                  48                    2 Part B only
                              10,444                    3 Both A and B

D_CAID1    13  1  $SRC2FMT                              C Source of Medicaid coverage status - Jan

                               8,516                    0 No entitlement
                                 352                    1 Survey data only
                                 278                    2 CMS administrative data only
                               2,153                    3 Both survey and administrative data

D_PHI1     14  1  $PHIAFMT                              C Private health insurance coverage - Jan

                               6,286                    0 No entitlement
                               2,698                    1 Employer-sponsored insurance (ESI)
                               1,860                    2 Self-purchased
                                 310                    3 Both ESI and self-purchased
                                 119                    4 Facility respondent, type unknown
                                  24                    5 Both ESI and unknown (facil)
                                   1                    6 Both self-purchased and unknown (facil)
                                   1                    7 ESI, self-purchased and unknown (facil)

D_PMC1     15  1  $YESCFMT                              C Private Managed Care coverage-Jan

                               1,115                    1 Yes
                              10,184                    2 No

D_MA1      16  1  $MAFMT                                C Medicare Advantage Data Source-Jan

                               7,478                    0 No Coverage
                                 598                    1 Survey Only
                                 338                    2 Admin Only
                               2,885                    3 Both Survey & Admin

D_PDP1     17  1  $MAFMT                                C Part D Data Source-Jan

                               3,473                    0 No Coverage
                                 382                    1 Survey Only
                               3,387                    2 Admin Only
                               4,057                    3 Both Survey & Admin

D_OTH1     18  1  $OTHFMT                               C Number of other plans - Jan

                              10,949                    0 No other plans
                                 329                    1 1 other plan
                                  21                    2 2 other plans
                                   0                    3 3 other plans
                                   0                    4 4 other plans
                                   0                    5 5 other plans
                                   0                    6 6 other plans

D_CARE2    19  1  $MEDCOVG                              C Medicare coverage - Feb

                                 356                    0 No entitlement
                                 458                    1 Part A only
                                  48                    2 Part B only
                              10,437                    3 Both A and B

D_CAID2    20  1  $SRC2FMT                              C Source of Medicaid coverage status - Feb

                               8,520                    0 No entitlement
                                 300                    1 Survey data only
                                 285                    2 CMS administrative data only
                               2,194                    3 Both survey and administrative data

D_PHI2     21  1  $PHIAFMT                              C Private health insurance coverage - Feb

                               6,272                    0 No entitlement
                               2,698                    1 Employer-sponsored insurance (ESI)
                               1,866                    2 Self-purchased
                                 315                    3 Both ESI and self-purchased
                                 118                    4 Facility respondent, type unknown
                                  24                    5 Both ESI and unknown (facil)
                                   3                    6 Both self-purchased and unknown (facil)
                                   3                    7 ESI, self-purchased and unknown (facil)

D_PMC2     22  1  $YESCFMT                              C Private Managed Care coverage-Feb

                               1,122                    1 Yes
                              10,177                    2 No

D_MA2      23  1  $MAFMT                                C Medicare Advantage Data Source-Feb

                               7,482                    0 No Coverage
                                 593                    1 Survey Only
                                 329                    2 Admin Only
                               2,895                    3 Both Survey & Admin

D_PDP2     24  1  $MAFMT                                C Part D Data Source-Feb

                               3,479                    0 No Coverage
                                 369                    1 Survey Only
                               3,382                    2 Admin Only
                               4,069                    3 Both Survey & Admin

D_OTH2     25  1  $OTHFMT                               C Number of other plans - Feb

                              10,947                    0 No other plans
                                 334                    1 1 other plan
                                  18                    2 2 other plans
                                   0                    3 3 other plans
                                   0                    4 4 other plans
                                   0                    5 5 other plans
                                   0                    6 6 other plans

D_CARE3    26  1  $MEDCOVG                              C Medicare coverage - Mar

                                 369                    0 No entitlement
                                 459                    1 Part A only
                                  48                    2 Part B only
                              10,423                    3 Both A and B

D_CAID3    27  1  $SRC2FMT                              C Source of Medicaid coverage status - Mar

                               8,545                    0 No entitlement
                                 293                    1 Survey data only
                                 283                    2 CMS administrative data only
                               2,178                    3 Both survey and administrative data

D_PHI3     28  1  $PHIAFMT                              C Private health insurance coverage - Mar

                               6,270                    0 No entitlement
                               2,700                    1 Employer-sponsored insurance (ESI)
                               1,850                    2 Self-purchased
                                 321                    3 Both ESI and self-purchased
                                 124                    4 Facility respondent, type unknown
                                  30                    5 Both ESI and unknown (facil)
                                   4                    6 Both self-purchased and unknown (facil)
                                   0                    7 ESI, self-purchased and unknown (facil)

D_PMC3     29  1  $YESCFMT                              C Private Managed Care coverage-Mar

                               1,113                    1 Yes
                              10,186                    2 No

D_MA3      30  1  $MAFMT                                C Medicare Advantage Data Source-Mar

                               7,498                    0 No Coverage
                                 580                    1 Survey Only
                                 318                    2 Admin Only
                               2,903                    3 Both Survey & Admin

D_PDP3     31  1  $MAFMT                                C Part D Data Source-Mar

                               3,488                    0 No Coverage
                                 366                    1 Survey Only
                               3,377                    2 Admin Only
                               4,068                    3 Both Survey & Admin

D_OTH3     32  1  $OTHFMT                               C Number of other plans - Mar

                              10,952                    0 No other plans
                                 329                    1 1 other plan
                                  18                    2 2 other plans
                                   0                    3 3 other plans
                                   0                    4 4 other plans
                                   0                    5 5 other plans
                                   0                    6 6 other plans

D_CARE4    33  1  $MEDCOVG                              C Medicare coverage - Apr

                                 394                    0 No entitlement
                                 463                    1 Part A only
                                  48                    2 Part B only
                              10,394                    3 Both A and B

D_CAID4    34  1  $SRC2FMT                              C Source of Medicaid coverage status - Apr

                               8,564                    0 No entitlement
                                 286                    1 Survey data only
                                 281                    2 CMS administrative data only
                               2,168                    3 Both survey and administrative data

D_PHI4     35  1  $PHIAFMT                              C Private health insurance coverage - Apr

                               6,280                    0 No entitlement
                               2,687                    1 Employer-sponsored insurance (ESI)
                               1,848                    2 Self-purchased
                                 325                    3 Both ESI and self-purchased
                                 127                    4 Facility respondent, type unknown
                                  29                    5 Both ESI and unknown (facil)
                                   3                    6 Both self-purchased and unknown (facil)
                                   0                    7 ESI, self-purchased and unknown (facil)

D_PMC4     36  1  $YESCFMT                              C Private Managed Care coverage-Apr

                               1,103                    1 Yes
                              10,196                    2 No

D_MA4      37  1  $MAFMT                                C Medicare Advantage Data Source-Apr

                               7,526                    0 No Coverage
                                 553                    1 Survey Only
                                 322                    2 Admin Only
                               2,898                    3 Both Survey & Admin

D_PDP4     38  1  $MAFMT                                C Part D Data Source-Apr

                               3,525                    0 No Coverage
                                 352                    1 Survey Only
                               3,372                    2 Admin Only
                               4,050                    3 Both Survey & Admin

D_OTH4     39  1  $OTHFMT                               C Number of other plans - Apr

                              10,952                    0 No other plans
                                 336                    1 1 other plan
                                  11                    2 2 other plans
                                   0                    3 3 other plans
                                   0                    4 4 other plans
                                   0                    5 5 other plans
                                   0                    6 6 other plans

D_CARE5    40  1  $MEDCOVG                              C Medicare coverage - May

                                 413                    0 No entitlement
                                 469                    1 Part A only
                                  50                    2 Part B only
                              10,367                    3 Both A and B

D_CAID5    41  1  $SRC2FMT                              C Source of Medicaid coverage status - May

                               8,566                    0 No entitlement
                                 293                    1 Survey data only
                                 281                    2 CMS administrative data only
                               2,159                    3 Both survey and administrative data

D_PHI5     42  1  $PHIAFMT                              C Private health insurance coverage - May

                               6,276                    0 No entitlement
                               2,670                    1 Employer-sponsored insurance (ESI)
                               1,851                    2 Self-purchased
                                 337                    3 Both ESI and self-purchased
                                 127                    4 Facility respondent, type unknown
                                  32                    5 Both ESI and unknown (facil)
                                   5                    6 Both self-purchased and unknown (facil)
                                   1                    7 ESI, self-purchased and unknown (facil)

D_PMC5     43  1  $YESCFMT                              C Private Managed Care coverage-May

                               1,100                    1 Yes
                              10,199                    2 No

D_MA5      44  1  $MAFMT                                C Medicare Advantage Data Source-May

                               7,531                    0 No Coverage
                                 547                    1 Survey Only
                                 313                    2 Admin Only
                               2,908                    3 Both Survey & Admin

D_PDP5     45  1  $MAFMT                                C Part D Data Source-May

                               3,543                    0 No Coverage
                                 346                    1 Survey Only
                               3,334                    2 Admin Only
                               4,076                    3 Both Survey & Admin

D_OTH5     46  1  $OTHFMT                               C Number of other plans - May

                              10,947                    0 No other plans
                                 331                    1 1 other plan
                                  21                    2 2 other plans
                                   0                    3 3 other plans
                                   0                    4 4 other plans
                                   0                    5 5 other plans
                                   0                    6 6 other plans

D_CARE6    47  1  $MEDCOVG                              C Medicare coverage - Jun

                                 412                    0 No entitlement
                                 476                    1 Part A only
                                  48                    2 Part B only
                              10,363                    3 Both A and B

D_CAID6    48  1  $SRC2FMT                              C Source of Medicaid coverage status - Jun

                               8,562                    0 No entitlement
                                 283                    1 Survey data only
                                 288                    2 CMS administrative data only
                               2,166                    3 Both survey and administrative data

D_PHI6     49  1  $PHIAFMT                              C Private health insurance coverage - Jun

                               6,278                    0 No entitlement
                               2,658                    1 Employer-sponsored insurance (ESI)
                               1,833                    2 Self-purchased
                                 350                    3 Both ESI and self-purchased
                                 144                    4 Facility respondent, type unknown
                                  31                    5 Both ESI and unknown (facil)
                                   5                    6 Both self-purchased and unknown (facil)
                                   0                    7 ESI, self-purchased and unknown (facil)

D_PMC6     50  1  $YESCFMT                              C Private Managed Care coverage-Jun

                               1,102                    1 Yes
                              10,197                    2 No

D_MA6      51  1  $MAFMT                                C Medicare Advantage Data Source-Jun

                               7,546                    0 No Coverage
                                 539                    1 Survey Only
                                 307                    2 Admin Only
                               2,907                    3 Both Survey & Admin

D_PDP6     52  1  $MAFMT                                C Part D Data Source-Jun

                               3,522                    0 No Coverage
                                 345                    1 Survey Only
                               3,356                    2 Admin Only
                               4,076                    3 Both Survey & Admin

D_OTH6     53  1  $OTHFMT                               C Number of other plans - Jun

                              10,944                    0 No other plans
                                 329                    1 1 other plan
                                  25                    2 2 other plans
                                   0                    3 3 other plans
                                   1                    4 4 other plans
                                   0                    5 5 other plans
                                   0                    6 6 other plans

D_CARE7    54  1  $MEDCOVG                              C Medicare coverage - Jul

                                 419                    0 No entitlement
                                 456                    1 Part A only
                                  48                    2 Part B only
                              10,376                    3 Both A and B

D_CAID7    55  1  $SRC2FMT                              C Source of Medicaid coverage status - Jul

                               8,578                    0 No entitlement
                                 278                    1 Survey data only
                                 273                    2 CMS administrative data only
                               2,170                    3 Both survey and administrative data

D_PHI7     56  1  $PHIAFMT                              C Private health insurance coverage - Jul

                               6,279                    0 No entitlement
                               2,646                    1 Employer-sponsored insurance (ESI)
                               1,826                    2 Self-purchased
                                 354                    3 Both ESI and self-purchased
                                 156                    4 Facility respondent, type unknown
                                  33                    5 Both ESI and unknown (facil)
                                   5                    6 Both self-purchased and unknown (facil)
                                   0                    7 ESI, self-purchased and unknown (facil)

D_PMC7     57  1  $YESCFMT                              C Private Managed Care coverage-Jul

                               1,097                    1 Yes
                              10,202                    2 No

D_MA7      58  1  $MAFMT                                C Medicare Advantage Data Source-Jul

                               7,553                    0 No Coverage
                                 525                    1 Survey Only
                                 290                    2 Admin Only
                               2,931                    3 Both Survey & Admin

D_PDP7     59  1  $MAFMT                                C Part D Data Source-Jul

                               3,527                    0 No Coverage
                                 331                    1 Survey Only
                               3,351                    2 Admin Only
                               4,090                    3 Both Survey & Admin

D_OTH7     60  1  $OTHFMT                               C Number of other plans - Jul

                              10,943                    0 No other plans
                                 334                    1 1 other plan
                                  20                    2 2 other plans
                                   2                    3 3 other plans
                                   0                    4 4 other plans
                                   0                    5 5 other plans
                                   0                    6 6 other plans

D_CARE8    61  1  $MEDCOVG                              C Medicare coverage - Aug

                                 445                    0 No entitlement
                                 455                    1 Part A only
                                  46                    2 Part B only
                              10,353                    3 Both A and B

D_CAID8    62  1  $SRC2FMT                              C Source of Medicaid coverage status - Aug

                               8,597                    0 No entitlement
                                 272                    1 Survey data only
                                 281                    2 CMS administrative data only
                               2,149                    3 Both survey and administrative data

D_PHI8     63  1  $PHIAFMT                              C Private health insurance coverage - Aug

                               6,303                    0 No entitlement
                               2,623                    1 Employer-sponsored insurance (ESI)
                               1,826                    2 Self-purchased
                                 353                    3 Both ESI and self-purchased
                                 157                    4 Facility respondent, type unknown
                                  34                    5 Both ESI and unknown (facil)
                                   2                    6 Both self-purchased and unknown (facil)
                                   1                    7 ESI, self-purchased and unknown (facil)

D_PMC8     64  1  $YESCFMT                              C Private Managed Care coverage-Aug

                               1,089                    1 Yes
                              10,210                    2 No

D_MA8      65  1  $MAFMT                                C Medicare Advantage Data Source-Aug

                               7,569                    0 No Coverage
                                 515                    1 Survey Only
                                 289                    2 Admin Only
                               2,926                    3 Both Survey & Admin

D_PDP8     66  1  $MAFMT                                C Part D Data Source-Aug

                               3,554                    0 No Coverage
                                 316                    1 Survey Only
                               3,332                    2 Admin Only
                               4,097                    3 Both Survey & Admin

D_OTH8     67  1  $OTHFMT                               C Number of other plans - Aug

                              10,954                    0 No other plans
                                 330                    1 1 other plan
                                  15                    2 2 other plans
                                   0                    3 3 other plans
                                   0                    4 4 other plans
                                   0                    5 5 other plans
                                   0                    6 6 other plans

D_CARE9    68  1  $MEDCOVG                              C Medicare coverage - Sep

                                 458                    0 No entitlement
                                 451                    1 Part A only
                                  46                    2 Part B only
                              10,344                    3 Both A and B

D_CAID9    69  1  $SRC2FMT                              C Source of Medicaid coverage status - Sep

                               8,605                    0 No entitlement
                                 269                    1 Survey data only
                                 290                    2 CMS administrative data only
                               2,135                    3 Both survey and administrative data

D_PHI9     70  1  $PHIAFMT                              C Private health insurance coverage - Sep

                               6,333                    0 No entitlement
                               2,601                    1 Employer-sponsored insurance (ESI)
                               1,816                    2 Self-purchased
                                 350                    3 Both ESI and self-purchased
                                 158                    4 Facility respondent, type unknown
                                  35                    5 Both ESI and unknown (facil)
                                   5                    6 Both self-purchased and unknown (facil)
                                   1                    7 ESI, self-purchased and unknown (facil)

D_PMC9     71  1  $YESCFMT                              C Private Managed Care coverage-Sep

                               1,087                    1 Yes
                              10,212                    2 No

D_MA9      72  1  $MAFMT                                C Medicare Advantage Data Source-Sep

                               7,561                    0 No Coverage
                                 516                    1 Survey Only
                                 294                    2 Admin Only
                               2,928                    3 Both Survey & Admin

D_PDP9     73  1  $MAFMT                                C Part D Data Source-Sep

                               3,569                    0 No Coverage
                                 322                    1 Survey Only
                               3,295                    2 Admin Only
                               4,113                    3 Both Survey & Admin

D_OTH9     74  1  $OTHFMT                               C Number of other plans - Sep

                              10,957                    0 No other plans
                                 324                    1 1 other plan
                                  16                    2 2 other plans
                                   2                    3 3 other plans
                                   0                    4 4 other plans
                                   0                    5 5 other plans
                                   0                    6 6 other plans

D_CARE10   75  1  $MEDCOVG                              C Medicare coverage - Oct

                                 467                    0 No entitlement
                                 458                    1 Part A only
                                  47                    2 Part B only
                              10,327                    3 Both A and B

D_CAID10   76  1  $SRC2FMT                              C Source of Medicaid coverage status - Oct

                               8,598                    0 No entitlement
                                 265                    1 Survey data only
                                 302                    2 CMS administrative data only
                               2,134                    3 Both survey and administrative data

D_PHI10    77  1  $PHIAFMT                              C Private health insurance coverage - Oct

                               6,343                    0 No entitlement
                               2,594                    1 Employer-sponsored insurance (ESI)
                               1,811                    2 Self-purchased
                                 350                    3 Both ESI and self-purchased
                                 162                    4 Facility respondent, type unknown
                                  37                    5 Both ESI and unknown (facil)
                                   2                    6 Both self-purchased and unknown (facil)
                                   0                    7 ESI, self-purchased and unknown (facil)

D_PMC10    78  1  $YESCFMT                              C Private Managed Care coverage-Oct

                               1,087                    1 Yes
                              10,212                    2 No

D_MA10     79  1  $MAFMT                                C Medicare Advantage Data Source-Oct

                               7,535                    0 No Coverage
                                 538                    1 Survey Only
                                 301                    2 Admin Only
                               2,925                    3 Both Survey & Admin

D_PDP10    80  1  $MAFMT                                C Part D Data Source-Oct

                               3,531                    0 No Coverage
                                 370                    1 Survey Only
                               3,250                    2 Admin Only
                               4,148                    3 Both Survey & Admin

D_OTH10    81  1  $OTHFMT                               C Number of other plans - Oct

                              10,966                    0 No other plans
                                 305                    1 1 other plan
                                  28                    2 2 other plans
                                   0                    3 3 other plans
                                   0                    4 4 other plans
                                   0                    5 5 other plans
                                   0                    6 6 other plans

D_CARE11   82  1  $MEDCOVG                              C Medicare coverage - Nov

                                 484                    0 No entitlement
                                 455                    1 Part A only
                                  46                    2 Part B only
                              10,314                    3 Both A and B

D_CAID11   83  1  $SRC2FMT                              C Source of Medicaid coverage status - Nov

                               8,604                    0 No entitlement
                                 272                    1 Survey data only
                                 315                    2 CMS administrative data only
                               2,108                    3 Both survey and administrative data

D_PHI11    84  1  $PHIAFMT                              C Private health insurance coverage - Nov

                               6,408                    0 No entitlement
                               2,566                    1 Employer-sponsored insurance (ESI)
                               1,792                    2 Self-purchased
                                 354                    3 Both ESI and self-purchased
                                 143                    4 Facility respondent, type unknown
                                  36                    5 Both ESI and unknown (facil)
                                   0                    6 Both self-purchased and unknown (facil)
                                   0                    7 ESI, self-purchased and unknown (facil)

D_PMC11    85  1  $YESCFMT                              C Private Managed Care coverage-Nov

                               1,077                    1 Yes
                              10,222                    2 No

D_MA11     86  1  $MAFMT                                C Medicare Advantage Data Source-Nov

                               7,528                    0 No Coverage
                                 542                    1 Survey Only
                                 327                    2 Admin Only
                               2,902                    3 Both Survey & Admin

D_PDP11    87  1  $MAFMT                                C Part D Data Source-Nov

                               3,512                    0 No Coverage
                                 394                    1 Survey Only
                               3,265                    2 Admin Only
                               4,128                    3 Both Survey & Admin

D_OTH11    88  1  $OTHFMT                               C Number of other plans - Nov

                              10,974                    0 No other plans
                                 306                    1 1 other plan
                                  17                    2 2 other plans
                                   1                    3 3 other plans
                                   1                    4 4 other plans
                                   0                    5 5 other plans
                                   0                    6 6 other plans

D_CARE12   89  1  $MEDCOVG                              C Medicare coverage - Dec

                                 499                    0 No entitlement
                                 462                    1 Part A only
                                  46                    2 Part B only
                              10,292                    3 Both A and B

D_CAID12   90  1  $SRC2FMT                              C Source of Medicaid coverage status - Dec

                               8,613                    0 No entitlement
                                 258                    1 Survey data only
                                 342                    2 CMS administrative data only
                               2,086                    3 Both survey and administrative data

D_PHI12    91  1  $PHIAFMT                              C Private health insurance coverage - Dec

                               6,552                    0 No entitlement
                               2,555                    1 Employer-sponsored insurance (ESI)
                               1,762                    2 Self-purchased
                                 344                    3 Both ESI and self-purchased
                                  70                    4 Facility respondent, type unknown
                                  15                    5 Both ESI and unknown (facil)
                                   1                    6 Both self-purchased and unknown (facil)
                                   0                    7 ESI, self-purchased and unknown (facil)

D_PMC12    92  1  $YESCFMT                              C Private Managed Care coverage-Dec

                               1,059                    1 Yes
                              10,240                    2 No

D_MA12     93  1  $MAFMT                                C Medicare Advantage Data Source-Dec

                               7,541                    0 No Coverage
                                 534                    1 Survey Only
                                 351                    2 Admin Only
                               2,873                    3 Both Survey & Admin

D_PDP12    94  1  $MAFMT                                C Part D Data Source-Dec

                               3,533                    0 No Coverage
                                 395                    1 Survey Only
                               3,299                    2 Admin Only
                               4,072                    3 Both Survey & Admin

D_OTH12    95  1  $OTHFMT                               C Number of other plans - Dec

                              10,985                    0 No other plans
                                 296                    1 1 other plan
                                  16                    2 2 other plans
                                   0                    3 3 other plans
                                   2                    4 4 other plans
                                   0                    5 5 other plans
                                   0                    6 6 other plans

D_CARE     96  1  $MEDCOVG                              C Annual Medicare coverage

                                   0                    0 No entitlement
                                 448                    1 Part A only
                                  50                    2 Part B only
                              10,801                    3 Both A and B

D_CAID     97  1  $SRC2FMT                              C Source of annual Medicaid coverage

                               8,318                    0 No entitlement
                                 255                    1 Survey data only
                                 312                    2 CMS administrative data only
                               2,414                    3 Both survey and administrative data

D_PHI      98  1  $PHIAFMT                              C Annual private health insurance coverage

                               6,021                    0 No entitlement
                               2,675                    1 Employer-sponsored insurance (ESI)
                               1,911                    2 Self-purchased
                                 424                    3 Both ESI and self-purchased
                                 161                    4 Facility respondent, type unknown
                                  57                    5 Both ESI and unknown (facil)
                                  41                    6 Both self-purchased and unknown (facil)
                                   9                    7 ESI, self-purchased and unknown (facil)

D_PMC      99  1  $YESCFMT                              C Annual Private Managed Care coverage

                               1,208                    1 Yes
                              10,091                    2 No

D_MA      100  1  $MAFMT                                C Annual Medicare Advantage Data Source

                               7,217                    0 No Coverage
                                 670                    1 Survey Only
                                 299                    2 Admin Only
                               3,113                    3 Both Survey & Admin

D_PDP     101  1  $MAFMT                                C Annual Part D Data Source

                               3,081                    0 No Coverage
                                 460                    1 Survey Only
                               3,102                    2 Admin Only
                               4,656                    3 Both Survey & Admin

D_OTH     102  1  $OTHFMT                               C Number of other plans for the year

                              10,874                    0 No other plans
                                 308                    1 1 other plan
                                  81                    2 2 other plans
                                  26                    3 3 other plans
                                   7                    4 4 other plans
                                   2                    5 5 other plans
                                   1                    6 6 other plans

TOT_PREM  103  8  PREM_F                                N Total health insurance premiums

                               3,753                    . Inapplicable
                               1,421                0-100 $100 or less
                               1,150           100.01-500 $101-$500
                                 989          500.01-1000 $501-$1000
                                 674         1000.01-1500 $1001-$1500
                                 791         1500.01-2000 $1501-$2000
                                 624         2000.01-2500 $2001-$2500
                                 412         2500.01-3000 $2501-$3000
                                 252         3000.01-3500 $3001-$3500
                                 254         3500.01-4000 $3501-$4000
                                 135         4000.01-4500 $4001-$4500
                                 131         4500.01-5000 $4501-$5000
                                 713        5000.01-99999 Over $5000

                  Note: See Notes for derivation

DRUGCAID  111  2  YES1FMT                               N Medicaid prescription drug coverage

                              10,307                    . Inapplicable
                                  16                   -9 Not ascertained
                                  89                   -8 Don't know
                                 736                    1 Yes
                                 151                    2 No

                 Notes: Applies only if D_CAID is greater than zero.
                        First available in 1999

S_TYPPL1  119  2  PLANFMT                               N Type of plan - Plan #1

                               5,328                    . Inapplicable
                               2,430                    1 Employer-sponsored insurance (ESI)
                               1,975                    2 Self-purchased
                                 150                    3 Private unknown
                               1,040                    4 Private Managed Care
                                 376                    5 Other Public Plan

S_BEGPL1  121  8  DTE8FMT                               N Date coverage began - plan #1

                               5,328                    . Inapplicable
                               5,971                      Date as YYYYMMDD

S_ENDPL1  129  8  DTE8FMT                               N Date coverage ended - plan #1

                               5,328                    . Inapplicable
                               5,971                      Date as YYYYMMDD

S_PHREL1  137  2  RELFMT                                N Policy holder relationship - Plan #1

                               7,041                    . Inapplicable
                                   0                   -5 Never ask again
                               3,453                    1 Sample person
                                 767                    2 Spouse
                                   2                    3 Son
                                   2                    4 Daughter
                                   0                    5 Brother
                                   1                    6 Sister
                                  11                    7 Father
                                  14                    8 Mother
                                   0                    9 Son-in-law
                                   0                   10 Daughter-in-law
                                   0                   11 Grandson
                                   0                   12 Granddaughter
                                   0                   13 Nephew
                                   0                   14 Niece
                                   5                   50 Partner/roommate
                                   2                   51 Friend/neighbor
                                   0                   52 Boarder
                                   0                   53 Nurse/nurses aide
                                   0                   54 Legal/financial officer
                                   0                   55 Guardian
                                   0                   91 Other relative
                                   1                   92 Other non-relative

S_COVNM1  139  2  COVGFMT                               N # of family members covered by Plan #1

                               6,307                    . Inapplicable
                                  19                   -8 Don't know
                               4,973                      Number reported covered

S_COVRX1  141  2  YES2FMT                               N Does Plan #1 cover prescribed medicines?

                               5,505                    . Inapplicable
                               3,077                    1 Yes
                                 125                    2 Possibly
                               2,592                    3 No

S_COVNH1  143  2  YES1FMT                               N Does Plan #1 cover stay in nursing home?

                               6,307                    . Inapplicable
                               1,230                   -8 Don't know
                               1,009                    1 Yes
                               2,753                    2 No

S_PAYSP1  145  2  PAYSPFMT                              N MIP pay any/all cost for Plan #1

                               6,307                    . Inapplicable
                                 132                   -8 Don't know
                                   3                   -7 Refused
                               4,094                    1 Yes
                                 763                    2 No
                                   0                    3 Yes, but don't know how much

S_ANAMT1  147  8  PREM_F                                N Premium MIP pays for Plan #1-Annualized

                               6,447                    . Inapplicable
                                 942                   -8 Don't know
                                   7                   -7 Refused
                                 829                0-100 $100 or less
                                 372           100.01-500 $101-$500
                                 228          500.01-1000 $501-$1000
                                 370         1000.01-1500 $1001-$1500
                                 450         1500.01-2000 $1501-$2000
                                 599         2000.01-2500 $2001-$2500
                                 400         2500.01-3000 $2501-$3000
                                 189         3000.01-3500 $3001-$3500
                                 120         3500.01-4000 $3501-$4000
                                  70         4000.01-4500 $4001-$4500
                                  69         4500.01-5000 $4501-$5000
                                 207        5000.01-99999 Over $5000

S_HMOPL1  155  2  YES1FMT                               N Is Plan #1 an HMO

                               6,536                    . Inapplicable
                               1,040                    1 Yes
                               3,723                    2 No

S_OBTNP1  162  2  MIPFMT                                N How did MIP get Plan #1

                               6,307                    . Inapplicable
                                  75                   -8 Don't know
                                   1                   -7 Refused
                               1,889                    1 Directly
                                 490                    2 Main insured person's current employer
                               1,888                    3 Main insured person's prior employer
                                  94                    4 Union
                                  18                    5 Family business
                                 183                    6 AARP
                                 258                    7 Deceased spouse's employer
                                  26                    8 Deceased spouse's union
                                  16                    9 Fraternal/professional organization
                                  54                   91 Other

S_TRI1    164  2  YES1FMT                               N Is Plan #1 TRICARE?

                              10,846                    . Inapplicable
                                   5                   -8 Don't know
                                 433                    1 Yes
                                  15                    2 No

S_INS1    166  2  INSPLFMT                              N Insurance coverage Plan #1

                               5,788                    . Inapplicable
                                   0                    0 Other government program
                               4,696                    1 General insurance
                                 415                    2 Dental only
                                  31                    3 Vision only
                                  51                    4 LTC
                                 288                    5 Rx only
                                   6                    6 Dental/Vision
                                  12                    7 Life insurance
                                  12                    8 Cancer/dread disease
                                   0                    9 Military/Other

S_RX1     168  2  RXPLFMT                               N Drug coverage Plan #1

                               5,788                    . Inapplicable
                               2,911                    1 Plan covers prescription drugs
                               2,562                    2 Plan does not cover prescription drugs
                                  38                    3 Drug discount card

S_TYPPL2  170  2  PLANFMT                               N Type of plan - Plan #2

                               8,337                    . Inapplicable
                               1,273                    1 Employer-sponsored insurance (ESI)
                               1,052                    2 Self-purchased
                                  33                    3 Private unknown
                                 470                    4 Private Managed Care
                                 134                    5 Other Public Plan

S_BEGPL2  172  8  DTE8FMT                               N Date coverage began - plan #2

                               8,337                    . Inapplicable
                               2,962                      Date as YYYYMMDD

S_ENDPL2  180  8  DTE8FMT                               N Date coverage ended - plan #2

                               8,337                    . Inapplicable
                               2,962                      Date as YYYYMMDD

S_PHREL2  188  2  RELFMT                                N Policy holder relationship - Plan #2

                               8,980                    . Inapplicable
                                   0                   -5 Never ask again
                               1,851                    1 Sample person
                                 436                    2 Spouse
                                   1                    3 Son
                                   2                    4 Daughter
                                   0                    5 Brother
                                   0                    6 Sister
                                   9                    7 Father
                                  11                    8 Mother
                                   0                    9 Son-in-law
                                   0                   10 Daughter-in-law
                                   0                   11 Grandson
                                   0                   12 Granddaughter
                                   0                   13 Nephew
                                   0                   14 Niece
                                   5                   50 Partner/roommate
                                   2                   51 Friend/neighbor
                                   0                   52 Boarder
                                   0                   53 Nurse/nurses aide
                                   0                   54 Legal/financial officer
                                   0                   55 Guardian
                                   0                   91 Other relative
                                   2                   92 Other non-relative

S_COVNM2  190  2  COVGFMT                               N # of family members covered by Plan #2

                               8,521                    . Inapplicable
                                  12                   -8 Don't know
                               2,766                      Number reported covered

S_COVRX2  192  2  YES2FMT                               N Does Plan #2 cover prescribed medicines?

                               8,370                    . Inapplicable
                                 896                    1 Yes
                                 377                    2 Possibly
                               1,656                    3 No

S_COVNH2  194  2  YES1FMT                               N Does Plan #2 cover stay in nursing home?

                               8,521                    . Inapplicable
                                 508                   -8 Don't know
                                 506                    1 Yes
                               1,764                    2 No

S_PAYSP2  196  2  PAYSPFMT                              N MIP pay any/all cost for Plan #2

                               8,521                    . Inapplicable
                                  81                   -8 Don't know
                                   2                   -7 Refused
                               2,191                    1 Yes
                                 504                    2 No
                                   0                    3 Yes, but don't know how much

S_ANAMT2  198  8  PREM_F                                N Premium MIP pays for Plan #2-Annualized

                               8,609                    . Inapplicable
                                 563                   -8 Don't know
                                   4                   -7 Refused
                                 584                0-100 $100 or less
                                 359           100.01-500 $101-$500
                                 191          500.01-1000 $501-$1000
                                 175         1000.01-1500 $1001-$1500
                                 173         1500.01-2000 $1501-$2000
                                 253         2000.01-2500 $2001-$2500
                                 158         2500.01-3000 $2501-$3000
                                  65         3000.01-3500 $3001-$3500
                                  54         3500.01-4000 $3501-$4000
                                  31         4000.01-4500 $4001-$4500
                                  24         4500.01-5000 $4501-$5000
                                  56        5000.01-99999 Over $5000

S_HMOPL2  206  2  YES1FMT                               N Is Plan #2 an HMO

                               8,656                    . Inapplicable
                                 470                    1 Yes
                               2,173                    2 No

S_OBTNP2  213  2  MIPFMT                                N How did MIP get Plan #2

                               8,521                    . Inapplicable
                                  43                   -8 Don't know
                                   1                   -7 Refused
                               1,011                    1 Directly
                                 298                    2 Main insured person's current employer
                               1,087                    3 Main insured person's prior employer
                                  58                    4 Union
                                  10                    5 Family business
                                  84                    6 AARP
                                 136                    7 Deceased spouse's employer
                                   9                    8 Deceased spouse's union
                                   7                    9 Fraternal/professional organization
                                  34                   91 Other

S_TRI2    215  2  YES1FMT                               N Is Plan #2 TRICARE?

                              11,282                    . Inapplicable
                                   2                   -8 Don't know
                                  12                    1 Yes
                                   3                    2 No

S_INS2    217  2  INSPLFMT                              N Insurance coverage Plan #2

                               8,648                    . Inapplicable
                                   0                    0 Other government program
                               1,673                    1 General insurance
                                 642                    2 Dental only
                                  76                    3 Vision only
                                 100                    4 LTC
                                 132                    5 Rx only
                                   9                    6 Dental/Vision
                                   8                    7 Life insurance
                                  11                    8 Cancer/dread disease
                                   0                    9 Military/Other

S_RX2     219  2  RXPLFMT                               N Drug coverage Plan #2

                               8,648                    . Inapplicable
                                 899                    1 Plan covers prescription drugs
                               1,728                    2 Plan does not cover prescription drugs
                                  24                    3 Drug discount card

S_TYPPL3  221  2  PLANFMT                               N Type of plan - Plan #3

                               9,607                    . Inapplicable
                                 790                    1 Employer-sponsored insurance (ESI)
                                 570                    2 Self-purchased
                                  31                    3 Private unknown
                                 253                    4 Private Managed Care
                                  48                    5 Other Public Plan

S_BEGPL3  223  8  DTE8FMT                               N Date coverage began - plan #3

                               9,607                    . Inapplicable
                               1,692                      Date as YYYYMMDD

S_ENDPL3  231  8  DTE8FMT                               N Date coverage ended - plan #3

                               9,607                    . Inapplicable
                               1,692                      Date as YYYYMMDD

S_PHREL3  239  2  RELFMT                                N Policy holder relationship - Plan #3

                               9,913                    . Inapplicable
                                   0                   -5 Never ask again
                               1,095                    1 Sample person
                                 271                    2 Spouse
                                   2                    3 Son
                                   1                    4 Daughter
                                   0                    5 Brother
                                   0                    6 Sister
                                   6                    7 Father
                                   6                    8 Mother
                                   0                    9 Son-in-law
                                   0                   10 Daughter-in-law
                                   0                   11 Grandson
                                   0                   12 Granddaughter
                                   0                   13 Nephew
                                   0                   14 Niece
                                   3                   50 Partner/roommate
                                   2                   51 Friend/neighbor
                                   0                   52 Boarder
                                   0                   53 Nurse/nurses aide
                                   0                   54 Legal/financial officer
                                   0                   55 Guardian
                                   0                   91 Other relative
                                   0                   92 Other non-relative

S_COVNM3  241  2  COVGFMT                               N # of family members covered by Plan #3

                               9,687                    . Inapplicable
                                  10                   -8 Don't know
                               1,602                      Number reported covered

S_COVRX3  243  2  YES2FMT                               N Does Plan #3 cover prescribed medicines?

                               9,638                    . Inapplicable
                                 550                    1 Yes
                                 212                    2 Possibly
                                 899                    3 No

S_COVNH3  245  2  YES1FMT                               N Does Plan #3 cover stay in nursing home?

                               9,687                    . Inapplicable
                                 271                   -8 Don't know
                                 277                    1 Yes
                               1,064                    2 No

S_PAYSP3  247  2  PAYSPFMT                              N MIP pay any/all cost for Plan #3

                               9,687                    . Inapplicable
                                  58                   -8 Don't know
                                   1                   -7 Refused
                               1,238                    1 Yes
                                 315                    2 No
                                   0                    3 Yes, but don't know how much

S_ANAMT3  249  8  PREM_F                                N Premium MIP pays for Plan #3-Annualized

                               9,753                    . Inapplicable
                                 364                   -8 Don't know
                                   3                   -7 Refused
                                 378                0-100 $100 or less
                                 215           100.01-500 $101-$500
                                 102          500.01-1000 $501-$1000
                                  81         1000.01-1500 $1001-$1500
                                  77         1500.01-2000 $1501-$2000
                                 118         2000.01-2500 $2001-$2500
                                  79         2500.01-3000 $2501-$3000
                                  35         3000.01-3500 $3001-$3500
                                  26         3500.01-4000 $3501-$4000
                                  19         4000.01-4500 $4001-$4500
                                  11         4500.01-5000 $4501-$5000
                                  38        5000.01-99999 Over $5000

S_HMOPL3  257  2  YES1FMT                               N Is Plan #3 an HMO

                               9,771                    . Inapplicable
                                 253                    1 Yes
                               1,275                    2 No

S_OBTNP3  264  2  MIPFMT                                N How did MIP get Plan #3

                               9,687                    . Inapplicable
                                  32                   -8 Don't know
                                 519                    1 Directly
                                 187                    2 Main insured person's current employer
                                 691                    3 Main insured person's prior employer
                                  33                    4 Union
                                   3                    5 Family business
                                  49                    6 AARP
                                  73                    7 Deceased spouse's employer
                                   3                    8 Deceased spouse's union
                                   3                    9 Fraternal/professional organization
                                  19                   91 Other

S_TRI3    266  2  YES1FMT                               N Is Plan #3 TRICARE?

                              11,298                    . Inapplicable
                                   0                    1 Yes
                                   1                    2 No

S_INS3    268  2  INSPLFMT                              N Insurance coverage Plan #3

                               9,825                    . Inapplicable
                                   0                    0 Other government program
                                 827                    1 General insurance
                                 407                    2 Dental only
                                  91                    3 Vision only
                                  73                    4 LTC
                                  59                    5 Rx only
                                   5                    6 Dental/Vision
                                   5                    7 Life insurance
                                   7                    8 Cancer/dread disease
                                   0                    9 Military/Other

S_RX3     270  2  RXPLFMT                               N Drug coverage Plan #3

                               9,825                    . Inapplicable
                                 423                    1 Plan covers prescription drugs
                               1,042                    2 Plan does not cover prescription drugs
                                   9                    3 Drug discount card

S_TYPPL4  272  2  PLANFMT                               N Type of plan - Plan #4

                              10,485                    . Inapplicable
                                 429                    1 Employer-sponsored insurance (ESI)
                                 239                    2 Self-purchased
                                   6                    3 Private unknown
                                 124                    4 Private Managed Care
                                  16                    5 Other Public Plan

S_BEGPL4  274  8  DTE8FMT                               N Date coverage began - plan #4

                              10,485                    . Inapplicable
                                 814                      Date as YYYYMMDD

S_ENDPL4  282  8  DTE8FMT                               N Date coverage ended - plan #4

                              10,485                    . Inapplicable
                                 814                      Date as YYYYMMDD

S_PHREL4  290  2  RELFMT                                N Policy holder relationship - Plan #4

                              10,644                    . Inapplicable
                                   0                   -5 Never ask again
                                 505                    1 Sample person
                                 142                    2 Spouse
                                   1                    3 Son
                                   0                    4 Daughter
                                   0                    5 Brother
                                   0                    6 Sister
                                   3                    7 Father
                                   2                    8 Mother
                                   0                    9 Son-in-law
                                   0                   10 Daughter-in-law
                                   0                   11 Grandson
                                   0                   12 Granddaughter
                                   0                   13 Nephew
                                   0                   14 Niece
                                   2                   50 Partner/roommate
                                   0                   51 Friend/neighbor
                                   0                   52 Boarder
                                   0                   53 Nurse/nurses aide
                                   0                   54 Legal/financial officer
                                   0                   55 Guardian
                                   0                   91 Other relative
                                   0                   92 Other non-relative

S_COVNM4  292  2  COVGFMT                               N # of family members covered by Plan #4

                              10,512                    . Inapplicable
                                   6                   -8 Don't know
                                 781                      Number reported covered

S_COVRX4  294  2  YES2FMT                               N Does Plan #4 cover prescribed medicines?

                              10,491                    . Inapplicable
                                 209                    1 Yes
                                 119                    2 Possibly
                                 480                    3 No

S_COVNH4  296  2  YES1FMT                               N Does Plan #4 cover stay in nursing home?

                              10,512                    . Inapplicable
                                  99                   -8 Don't know
                                 121                    1 Yes
                                 567                    2 No

S_PAYSP4  298  2  PAYSPFMT                              N MIP pay any/all cost for Plan #4

                              10,512                    . Inapplicable
                                  38                   -8 Don't know
                                 576                    1 Yes
                                 173                    2 No
                                   0                    3 Yes, but don't know how much

S_ANAMT4  300  8  PREM_F                                N Premium MIP pays for Plan #4-Annualized

                              10,552                    . Inapplicable
                                 188                   -8 Don't know
                                 217                0-100 $100 or less
                                 113           100.01-500 $101-$500
                                  58          500.01-1000 $501-$1000
                                  36         1000.01-1500 $1001-$1500
                                  26         1500.01-2000 $1501-$2000
                                  40         2000.01-2500 $2001-$2500
                                  28         2500.01-3000 $2501-$3000
                                   7         3000.01-3500 $3001-$3500
                                  11         3500.01-4000 $3501-$4000
                                   6         4000.01-4500 $4001-$4500
                                   3         4500.01-5000 $4501-$5000
                                  14        5000.01-99999 Over $5000

S_HMOPL4  308  2  YES1FMT                               N Is Plan #4 an HMO

                              10,561                    . Inapplicable
                                 124                    1 Yes
                                 614                    2 No

S_OBTNP4  315  2  MIPFMT                                N How did MIP get Plan #4

                              10,512                    . Inapplicable
                                  15                   -8 Don't know
                                 227                    1 Directly
                                 107                    2 Main insured person's current employer
                                 358                    3 Main insured person's prior employer
                                  14                    4 Union
                                   2                    5 Family business
                                  19                    6 AARP
                                  38                    7 Deceased spouse's employer
                                   0                    8 Deceased spouse's union
                                   0                    9 Fraternal/professional organization
                                   7                   91 Other

S_TRI4    317  2  YES1FMT                               N Is Plan #4 TRICARE?

                              11,294                    . Inapplicable
                                   1                   -8 Don't know
                                   2                    1 Yes
                                   2                    2 No

S_INS4    319  2  INSPLFMT                              N Insurance coverage Plan #4

                              10,586                    . Inapplicable
                                   0                    0 Other government program
                                 296                    1 General insurance
                                 248                    2 Dental only
                                  64                    3 Vision only
                                  48                    4 LTC
                                  43                    5 Rx only
                                   5                    6 Dental/Vision
                                   4                    7 Life insurance
                                   5                    8 Cancer/dread disease
                                   0                    9 Military/Other

S_RX4     321  2  RXPLFMT                               N Drug coverage Plan #4

                              10,586                    . Inapplicable
                                 167                    1 Plan covers prescription drugs
                                 544                    2 Plan does not cover prescription drugs
                                   2                    3 Drug discount card

S_TYPPL5  323  2  PLANFMT                               N Type of plan - Plan #5

                              10,908                    . Inapplicable
                                 232                    1 Employer-sponsored insurance (ESI)
                                  98                    2 Self-purchased
                                   7                    3 Private unknown
                                  45                    4 Private Managed Care
                                   9                    5 Other Public Plan

S_BEGPL5  325  8  DTE8FMT                               N Date coverage began - plan #5

                              10,908                    . Inapplicable
                                 391                      Date as YYYYMMDD

S_ENDPL5  333  8  DTE8FMT                               N Date coverage ended - plan #5

                              10,908                    . Inapplicable
                                 391                      Date as YYYYMMDD

S_PHREL5  341  2  RELFMT                                N Policy holder relationship - Plan #5

                              10,986                    . Inapplicable
                                   0                   -5 Never ask again
                                 250                    1 Sample person
                                  62                    2 Spouse
                                   0                    3 Son
                                   0                    4 Daughter
                                   0                    5 Brother
                                   0                    6 Sister
                                   0                    7 Father
                                   0                    8 Mother
                                   0                    9 Son-in-law
                                   0                   10 Daughter-in-law
                                   0                   11 Grandson
                                   0                   12 Granddaughter
                                   0                   13 Nephew
                                   0                   14 Niece
                                   1                   50 Partner/roommate
                                   0                   51 Friend/neighbor
                                   0                   52 Boarder
                                   0                   53 Nurse/nurses aide
                                   0                   54 Legal/financial officer
                                   0                   55 Guardian
                                   0                   91 Other relative
                                   0                   92 Other non-relative

S_COVNM5  343  2  COVGFMT                               N # of family members covered by Plan #5

                              10,926                    . Inapplicable
                                   1                   -8 Don't know
                                 372                      Number reported covered

S_COVRX5  345  2  YES2FMT                               N Does Plan #5 cover prescribed medicines?

                              10,915                    . Inapplicable
                                 101                    1 Yes
                                  75                    2 Possibly
                                 208                    3 No

S_COVNH5  347  2  YES1FMT                               N Does Plan #5 cover stay in nursing home?

                              10,926                    . Inapplicable
                                  52                   -8 Don't know
                                  59                    1 Yes
                                 262                    2 No

S_PAYSP5  349  2  PAYSPFMT                              N MIP pay any/all cost for Plan #5

                              10,926                    . Inapplicable
                                  18                   -8 Don't know
                                 271                    1 Yes
                                  84                    2 No
                                   0                    3 Yes, but don't know how much

S_ANAMT5  351  8  PREM_F                                N Premium MIP pays for Plan #5-Annualized

                              10,945                    . Inapplicable
                                  96                   -8 Don't know
                                 111                0-100 $100 or less
                                  50           100.01-500 $101-$500
                                  30          500.01-1000 $501-$1000
                                  17         1000.01-1500 $1001-$1500
                                  11         1500.01-2000 $1501-$2000
                                  11         2000.01-2500 $2001-$2500
                                  15         2500.01-3000 $2501-$3000
                                   3         3000.01-3500 $3001-$3500
                                   5         3500.01-4000 $3501-$4000
                                   2         4000.01-4500 $4001-$4500
                                   1         4500.01-5000 $4501-$5000
                                   2        5000.01-99999 Over $5000

S_HMOPL5  359  2  YES1FMT                               N Is Plan #5 an HMO

                              10,954                    . Inapplicable
                                  45                    1 Yes
                                 300                    2 No

S_OBTNP5  366  2  MIPFMT                                N How did MIP get Plan #5

                              10,926                    . Inapplicable
                                   6                   -8 Don't know
                                 101                    1 Directly
                                  54                    2 Main insured person's current employer
                                 179                    3 Main insured person's prior employer
                                   7                    4 Union
                                   0                    5 Family business
                                   3                    6 AARP
                                  20                    7 Deceased spouse's employer
                                   0                    8 Deceased spouse's union
                                   2                    9 Fraternal/professional organization
                                   1                   91 Other

S_TRI5    368  2  YES1FMT                               N Is Plan #5 TRICARE?

                              11,297                    . Inapplicable
                                   1                   -8 Don't know
                                   1                    1 Yes
                                   0                    2 No

S_INS5    370  2  INSPLFMT                              N Insurance coverage Plan #5

                              10,980                    . Inapplicable
                                   0                    0 Other government program
                                 120                    1 General insurance
                                 103                    2 Dental only
                                  44                    3 Vision only
                                  29                    4 LTC
                                  19                    5 Rx only
                                   2                    6 Dental/Vision
                                   1                    7 Life insurance
                                   1                    8 Cancer/dread disease
                                   0                    9 Military/Other

S_RX5     372  2  RXPLFMT                               N Drug coverage Plan #5

                              10,980                    . Inapplicable
                                  59                    1 Plan covers prescription drugs
                                 258                    2 Plan does not cover prescription drugs
                                   2                    3 Drug discount card

