RIC         1  2  $RIC                                  C Record Identification Code

                              11,299                    A Administrative Data
                                   0                   DU Dental Events
                                   0                   FA Facility Events
                                   0                    H HMO Supplement
                                   0                   IA Income and Assets
                                   0                   IP Inpatient Hospital Events
                                   0                   IU Institutional Events
                                   0                    K Key Record
                                   0                   KN Knowledge and Information Needs
                                   0                   MD MDS
                                   0                   MP Medical Provider Events
                                   0                    N Non-Respondent
                                   0                   OA OASIS
                                   0                   OP Outpatient Events
                                   0                   PA Patient Activation
                                   0                   PM Prescribed Medicine Events
                                   0                   PS Person Summary
                                   0                   RX Drug Coverage
                                   0                   SS Service Summary
                                   0                    X Cross Sectional Weights
                                   0                   XE Ever Enrolled Weights
                                   0                   X2 2 year Weights
                                   0                   X3 3 year Weights
                                   0                   X4 4 year Weights
                                   0                    1 Survey Identification (Demographic)
                                   0                   10 MDS/OAS Timeline
                                   0                    2 Health Status/Functioning (Community)
                                   0                   2F Health Status/Functioning (Facility)
                                   0                   2H Health Status/Functioning (Helper)
                                   0                   2P Health Status/Functioning (Prevention)
                                   0                    3 Access to Care
                                   0                    4 Health Insurance
                                   0                    5 Enumeration
                                   0                    6 Facility Residence History
                                   0                    7 Facility Characteristics
                                   0                   7S SNF Characteristics
                                   0                    8 Interview Description
                                   0                    9 Residence Timeline

VERSION     3  1  $VERSION                              C Version Number

                              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

H_DOB      12  8  $DTE8FMT                              C Date of birth

                              11,299                      Date as YYYYMMDD

H_DOD      20  8  $DTE8FMT                              C Date of death

                              10,775                      Missing
                                 524                      Date as YYYYMMDD

H_DODSRC   28  2  $SRCFMT                               C Source of date of death

                              10,775                      No date of death
                                   0                   01 From Medicare bill
                                   0                   03 Clerical entry
                                   0                   05 Bill and clerical entry
                                 289                   10 Proven Medicare Benefits record
                                  36                   11 Proven Medicare Benefits record & bills
                                 168                   20 Unproven Medicare Benefits record
                                  29                   21 Unproven Mcare Benefits record & bills
                                   2                   23 Unproven Mcare Benefits rec & clerical
                                   0                   25 Unprovn Mcare Benfts rec, bill & clericl

H_SEX      30  1  $SEXFMT                               C Sex code

                               5,140                    1 Male
                               6,159                    2 Female

H_RACE     31  1  $RACEFMT                              C Race code

                                  45                    0 Unknown
                               9,328                    1 White
                               1,262                    2 Black
                                 139                    3 Other
                                 146                    4 Asian
                                 323                    5 Hispanic
                                  56                    6 North American Native

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

D_STRAT    35  1  $AGEFMT                               C MCBS Sample age stratum

                                 989                    1  0-44
                               1,009                    2 45-64
                               2,027                    3 65-69
                               1,895                    4 70-74
                               1,698                    5 75-79
                               1,763                    6 80-84
                               1,918                    7 85 +

H_ENT01    36  1  $ENTFMT                               C Medicare entitlement code for Jan

                                 452                    A Part A Medicare only
                                  48                    B Part B Medicare only
                              10,444                    C Parts A and B Medicare
                                 355                    N No Medicare entitlement

H_ENT02    37  1  $ENTFMT                               C Medicare entitlement code for Feb

                                 458                    A Part A Medicare only
                                  48                    B Part B Medicare only
                              10,437                    C Parts A and B Medicare
                                 356                    N No Medicare entitlement

H_ENT03    38  1  $ENTFMT                               C Medicare entitlement code for Mar

                                 459                    A Part A Medicare only
                                  48                    B Part B Medicare only
                              10,423                    C Parts A and B Medicare
                                 369                    N No Medicare entitlement

H_ENT04    39  1  $ENTFMT                               C Medicare entitlement code for Apr

                                 463                    A Part A Medicare only
                                  48                    B Part B Medicare only
                              10,394                    C Parts A and B Medicare
                                 394                    N No Medicare entitlement

H_ENT05    40  1  $ENTFMT                               C Medicare entitlement code for May

                                 469                    A Part A Medicare only
                                  50                    B Part B Medicare only
                              10,367                    C Parts A and B Medicare
                                 413                    N No Medicare entitlement

H_ENT06    41  1  $ENTFMT                               C Medicare entitlement code for Jun

                                 476                    A Part A Medicare only
                                  48                    B Part B Medicare only
                              10,363                    C Parts A and B Medicare
                                 412                    N No Medicare entitlement

H_ENT07    42  1  $ENTFMT                               C Medicare entitlement code for Jul

                                 456                    A Part A Medicare only
                                  48                    B Part B Medicare only
                              10,376                    C Parts A and B Medicare
                                 419                    N No Medicare entitlement

H_ENT08    43  1  $ENTFMT                               C Medicare entitlement code for Aug

                                 455                    A Part A Medicare only
                                  46                    B Part B Medicare only
                              10,353                    C Parts A and B Medicare
                                 445                    N No Medicare entitlement

H_ENT09    44  1  $ENTFMT                               C Medicare entitlement code for Sep

                                 451                    A Part A Medicare only
                                  46                    B Part B Medicare only
                              10,344                    C Parts A and B Medicare
                                 458                    N No Medicare entitlement

H_ENT10    45  1  $ENTFMT                               C Medicare entitlement code for Oct

                                 458                    A Part A Medicare only
                                  47                    B Part B Medicare only
                              10,327                    C Parts A and B Medicare
                                 467                    N No Medicare entitlement

H_ENT11    46  1  $ENTFMT                               C Medicare entitlement code for Nov

                                 455                    A Part A Medicare only
                                  46                    B Part B Medicare only
                              10,314                    C Parts A and B Medicare
                                 484                    N No Medicare entitlement

H_ENT12    47  1  $ENTFMT                               C Medicare entitlement code for Dec

                                 462                    A Part A Medicare only
                                  46                    B Part B Medicare only
                              10,292                    C Parts A and B Medicare
                                 499                    N No Medicare entitlement

H_DOE      48  8  $DTE8FMT                              C Medicare entitlement start date

                              11,299                      Date as YYYYMMDD

H_DOT      56  8  $DTE8FMT                              C Medicare entitlement end date

                              11,250                      Missing
                                  49                      Date as YYYYMMDD

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

                                  15                      Unknown
                               9,230                   10 Aged, no ESRD
                                  66                   11 Aged, ESRD
                               1,947                   20 Disabled, no ESRD
                                  34                   21 Disabled, ESRD
                                   7                   31 ESRD only

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

                                  18                      Unknown
                                   0                   AD Cur pay-adj for dual entitlement
                                   0                   AF Transfer to another PSC or OIO
                                   0                   A9 Cur pay-miscellaneous adjustment
                              10,272                    C Current payment status
                                   0                   DW Deferred-Workers' Compensation
                                   1                   D2 DEF-retirement test
                                   0                   D3 DEF-D2 for primary
                                   3                   D6 DEF-recover overpayment
                                   3                   D9 DEF-miscellaneous reason
                                   2                    J Advanced filing-current pay
                                   0                   L2 Advanced filing-worked inside U S
                                   0                   L3 Advanced filing-insured worked in U S
                                   0                    N Not in pay status
                                   0                   PB Delayed-benefit due but not paid
                                   0                    R Cur pay-Part B reinstated
                                   0                   RN Cur pay-Part B reinstated
                                   0                    S SUSP-deferred retirement
                                   7                   SD SUSP-other
                                   0                   SF SUSP-fails to meet residence requirment
                                  55                   SH SUSP-government pension
                                   1                   SJ SUSP-alien suspension
                                   0                   SP SUSP-public assistance
                                   0                   SW SUSP-Workers' Compensation
                                   1                   S0 SUSP-continuing disability investig
                                   1                   S2 SUSP-fails retirement test
                                   0                   S3 SUSP-primary account S2
                                   4                   S6 SUSP-check returned for address
                                  18                   S7 SUSP-vocational rehab refusal
                                   0                   S8 SUSP-payee not determined
                                  22                   S9 SUSP-miscellaneous reason
                                   0                   TA TERM-prior to entitlement
                                   0                   TJ TERM-prior to entlmt, not stop debit
                                   0                   TR TERM-claim withdrawn
                                   0                   T0 TERM-benefits paid by another agency
                                 491                   T1 TERM-death of beneficiary
                                   0                   T2 TERM-death of primary
                                   0                   T3 TERM-divorce, marriage, remarriage
                                   0                   T4 TERM-dependent child attained age 18
                                   0                   T5 TERM-entitled on another account
                                   0                   T6 TERM-child no longer student, disabled
                                   5                   T8 TERM-recovery from disability
                                   0                   T9 TERM-miscellaneous
                                 367                    U Active uninsured status (no SSA check)
                                   0                   XF Transfer to another PC or DIO
                                   0                   XR Terminated -
                                  14                   X1 TERM-death of insured
                                   0                   X5 TERM-entitled to another benefit
                                  14                   X7 TERM of uninsured
                                   0                   X9 TERM miscellaneous
                                   0                   ZZ Erroneous entitlement

H_RESST    68  2  $STFMT                                C SSA State code of residence as of 12/31

                                 410                   01 Alabama
                                   0                   02 Alaska
                                 203                   03 Arizona
                                 115                   04 Arkansas
                                 801                   05 California
                                  81                   06 Colorado
                                 131                   07 Connecticut
                                   1                   08 Delaware
                                  10                   09 Washington, DC
                                 814                   10 Florida
                                 374                   11 Georgia
                                   0                   12 Hawaii
                                   0                   13 Idaho
                                 372                   14 Illinois
                                  33                   15 Indiana
                                 103                   16 Iowa
                                 104                   17 Kansas
                                 186                   18 Kentucky
                                 136                   19 Louisiana
                                   0                   20 Maine
                                 182                   21 Maryland
                                 196                   22 Massachusetts
                                 586                   23 Michigan
                                 242                   24 Minnesota
                                   0                   25 Mississippi
                                 286                   26 Missouri
                                   0                   27 Montana
                                  94                   28 Nebraska
                                 228                   29 Nevada
                                   3                   30 New Hampshire
                                 288                   31 New Jersey
                                 274                   32 New Mexico
                                 620                   33 New York
                                 555                   34 North Carolina
                                   0                   35 North Dakota
                                 595                   36 Ohio
                                 105                   37 Oklahoma
                                   1                   38 Oregon
                                 558                   39 Pennsylvania
                                 203                   40 Puerto Rico
                                   1                   41 Rhode Island
                                 112                   42 South Carolina
                                   0                   43 South Dakota
                                 323                   44 Tennessee
                                 789                   45 Texas
                                   0                   46 Utah
                                   0                   47 Vermont
                                   0                   48 Virgin Islands
                                 159                   49 Virginia
                                 414                   50 Washington
                                 141                   51 West Virginia
                                 347                   52 Wisconsin
                                 109                   53 Wyoming
                                  14                      Unknown

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

                                  14                      Unknown
                              11,285                      County code

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

                                  14                      Unknown
                              11,285                      ZIP Code

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

                                 331                   01 New England
                               1,466                   02 Middle Atlantic
                               1,933                   03 East North Central
                                 829                   04 West North Central
                               2,348                   05 South Atlantic
                                 919                   06 East South Central
                               1,145                   07 West South Central
                                 895                   08 Mountain
                               1,216                   09 Pacific
                                 203                   10 Puerto Rico
                                  14                      Unknown

H_METRO    80  1  $METFMT                               C Metro status

                               3,001                    N Non-metro area
                                   0                    U Unknown
                               8,298                    Y Metro area

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

                              10,370                      Missing
                                 929                      Date as YYYYMMDD

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

                              10,370                      Missing
                                 929                      Date as YYYYMMDD

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

                              10,996                      Missing
                                 303                      Date as YYYYMMDD

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

                              10,996                      Missing
                                 303                      Date as YYYYMMDD

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

                              11,096                      Missing
                                 203                      Date as YYYYMMDD

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

                              11,096                      Missing
                                 203                      Date as YYYYMMDD

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

                              11,144                      Missing
                                 155                      Date as YYYYMMDD

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

                              11,144                      Missing
                                 155                      Date as YYYYMMDD

H_ESRBEG  145  8  $DTE8FMT                              C Beginning date of ESRD period

                              11,121                      Missing
                                 178                      Date as YYYYMMDD

H_ESREND  153  8  $DTE8FMT                              C Ending date of ESRD period

                              11,212                      Missing
                                  87                      Date as YYYYMMDD

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

                               8,152                    0 No enrollment
                               3,147                    1 Some enrollment

H_PNUM    162  3                                        N Number of GHPs in bene area

H_MANUM   165  3                                        N Number of MA plans in bene area

H_PFSNUM  168  3                                        N Number of PFFS plans in bene area

H_PLPY01  171  5                                        N Medicare capitation payment for Jan

H_PLPY02  176  5                                        N Medicare capitation payment for Feb

H_PLPY03  181  5                                        N Medicare capitation payment for Mar

H_PLPY04  186  5                                        N Medicare capitation payment for Apr

H_PLPY05  191  5                                        N Medicare capitation payment for May

H_PLPY06  196  5                                        N Medicare capitation payment for Jun

H_PLPY07  201  5                                        N Medicare capitation payment for Jul

H_PLPY08  206  5                                        N Medicare capitation payment for Aug

H_PLPY09  211  5                                        N Medicare capitation payment for Sep

H_PLPY10  216  5                                        N Medicare capitation payment for Oct

H_PLPY11  221  5                                        N Medicare capitation payment for Nov

H_PLPY12  226  5                                        N Medicare capitation payment for Dec

H_PDPY01  231  5                                        N Part D capitation payment for Jan

H_PDLS01  236  1  $DLISFMT                              C LIS Indicator for Jan

                                 359                      Unknown
                               7,995                    1 No premium subsidy
                                  29                    2 25% premium subsidy
                                  30                    3 50% premium subsidy
                                  31                    4 75% premium subsidy
                               2,855                    5 100% premium subsidy

H_PDRS01  237  1  $DRDSFMT                              C RDS Indicator for Jan

                                 359                      Unknown
                               9,691                    N Employer not subsidized for the benefici
                               1,249                    Y Employer subsidized for the beneficiary

H_CRED01  238  1  $YES8FMT                              C Creditable Coverage for Jan

                                   6                      Unknown
                               1,449                    1 Yes
                               9,844                    2 No

H_PDPY02  239  5                                        N Part D capitation payment for Feb

H_PDLS02  244  1  $DLISFMT                              C LIS Indicator for Feb

                                 347                      Unknown
                               7,999                    1 No premium subsidy
                                  29                    2 25% premium subsidy
                                  29                    3 50% premium subsidy
                                  31                    4 75% premium subsidy
                               2,864                    5 100% premium subsidy

H_PDRS02  245  1  $DRDSFMT                              C RDS Indicator for Feb

                                 347                      Unknown
                               9,701                    N Employer not subsidized for the benefici
                               1,251                    Y Employer subsidized for the beneficiary

H_CRED02  246  1  $YES8FMT                              C Creditable Coverage for Feb

                                   6                      Unknown
                               1,458                    1 Yes
                               9,835                    2 No

H_PDPY03  247  5                                        N Part D capitation payment for Mar

H_PDLS03  252  1  $DLISFMT                              C LIS Indicator for Mar

                                 349                      Unknown
                               8,001                    1 No premium subsidy
                                  29                    2 25% premium subsidy
                                  30                    3 50% premium subsidy
                                  31                    4 75% premium subsidy
                               2,859                    5 100% premium subsidy

H_PDRS03  253  1  $DRDSFMT                              C RDS Indicator for Mar

                                 349                      Unknown
                               9,703                    N Employer not subsidized for the benefici
                               1,247                    Y Employer subsidized for the beneficiary

H_CRED03  254  1  $YES8FMT                              C Creditable Coverage for Mar

                                   6                      Unknown
                               1,465                    1 Yes
                               9,828                    2 No

H_PDPY04  255  5                                        N Part D capitation payment for Apr

H_PDLS04  260  1  $DLISFMT                              C LIS Indicator for Apr

                                 374                      Unknown
                               7,985                    1 No premium subsidy
                                  25                    2 25% premium subsidy
                                  29                    3 50% premium subsidy
                                  29                    4 75% premium subsidy
                               2,857                    5 100% premium subsidy

H_PDRS04  261  1  $DRDSFMT                              C RDS Indicator for Apr

                                 374                      Unknown
                               9,678                    N Employer not subsidized for the benefici
                               1,247                    Y Employer subsidized for the beneficiary

H_CRED04  262  1  $YES8FMT                              C Creditable Coverage for Apr

                                   6                      Unknown
                               1,469                    1 Yes
                               9,824                    2 No

H_PDPY05  263  5                                        N Part D capitation payment for May

H_PDLS05  268  1  $DLISFMT                              C LIS Indicator for May

                                 393                      Unknown
                               7,973                    1 No premium subsidy
                                  25                    2 25% premium subsidy
                                  28                    3 50% premium subsidy
                                  29                    4 75% premium subsidy
                               2,851                    5 100% premium subsidy

H_PDRS05  269  1  $DRDSFMT                              C RDS Indicator for May

                                 393                      Unknown
                               9,658                    N Employer not subsidized for the benefici
                               1,248                    Y Employer subsidized for the beneficiary

H_CRED05  270  1  $YES8FMT                              C Creditable Coverage for May

                                   6                      Unknown
                               1,474                    1 Yes
                               9,819                    2 No

H_PDPY06  271  5                                        N Part D capitation payment for Jun

H_PDLS06  276  1  $DLISFMT                              C LIS Indicator for Jun

                                 361                      Unknown
                               7,987                    1 No premium subsidy
                                  24                    2 25% premium subsidy
                                  28                    3 50% premium subsidy
                                  29                    4 75% premium subsidy
                               2,870                    5 100% premium subsidy

H_PDRS06  277  1  $DRDSFMT                              C RDS Indicator for Jun

                                 361                      Unknown
                               9,691                    N Employer not subsidized for the benefici
                               1,247                    Y Employer subsidized for the beneficiary

H_CRED06  278  1  $YES8FMT                              C Creditable Coverage for Jun

                                   6                      Unknown
                               1,480                    1 Yes
                               9,813                    2 No

H_PDPY07  279  5                                        N Part D capitation payment for Jul

H_PDLS07  284  1  $DLISFMT                              C LIS Indicator for Jul

                                 374                      Unknown
                               7,975                    1 No premium subsidy
                                  24                    2 25% premium subsidy
                                  29                    3 50% premium subsidy
                                  29                    4 75% premium subsidy
                               2,868                    5 100% premium subsidy

H_PDRS07  285  1  $DRDSFMT                              C RDS Indicator for Jul

                                 374                      Unknown
                               9,690                    N Employer not subsidized for the benefici
                               1,235                    Y Employer subsidized for the beneficiary

H_CRED07  286  1  $YES8FMT                              C Creditable Coverage for Jul

                                   6                      Unknown
                               1,486                    1 Yes
                               9,807                    2 No

H_PDPY08  287  5                                        N Part D capitation payment for Aug

H_PDLS08  292  1  $DLISFMT                              C LIS Indicator for Aug

                                 405                      Unknown
                               7,961                    1 No premium subsidy
                                  25                    2 25% premium subsidy
                                  29                    3 50% premium subsidy
                                  29                    4 75% premium subsidy
                               2,850                    5 100% premium subsidy

H_PDRS08  293  1  $DRDSFMT                              C RDS Indicator for Aug

                                 405                      Unknown
                               9,668                    N Employer not subsidized for the benefici
                               1,226                    Y Employer subsidized for the beneficiary

H_CRED08  294  1  $YES8FMT                              C Creditable Coverage for Aug

                                   6                      Unknown
                               1,488                    1 Yes
                               9,805                    2 No

H_PDPY09  295  5                                        N Part D capitation payment for Sep

H_PDLS09  300  1  $DLISFMT                              C LIS Indicator for Sep

                                 441                      Unknown
                               7,932                    1 No premium subsidy
                                  25                    2 25% premium subsidy
                                  29                    3 50% premium subsidy
                                  30                    4 75% premium subsidy
                               2,842                    5 100% premium subsidy

H_PDRS09  301  1  $DRDSFMT                              C RDS Indicator for Sep

                                 441                      Unknown
                               9,635                    N Employer not subsidized for the benefici
                               1,223                    Y Employer subsidized for the beneficiary

H_CRED09  302  1  $YES8FMT                              C Creditable Coverage for Sep

                                   6                      Unknown
                               1,496                    1 Yes
                               9,797                    2 No

H_PDPY10  303  5                                        N Part D capitation payment for Oct

H_PDLS10  308  1  $DLISFMT                              C LIS Indicator for Oct

                                 458                      Unknown
                               7,914                    1 No premium subsidy
                                  25                    2 25% premium subsidy
                                  27                    3 50% premium subsidy
                                  30                    4 75% premium subsidy
                               2,845                    5 100% premium subsidy

H_PDRS10  309  1  $DRDSFMT                              C RDS Indicator for Oct

                                 458                      Unknown
                               9,623                    N Employer not subsidized for the benefici
                               1,218                    Y Employer subsidized for the beneficiary

H_CRED10  310  1  $YES8FMT                              C Creditable Coverage for Oct

                                   6                      Unknown
                               1,504                    1 Yes
                               9,789                    2 No

H_PDPY11  311  5                                        N Part D capitation payment for Nov

H_PDLS11  316  1  $DLISFMT                              C LIS Indicator for Nov

                                 475                      Unknown
                               7,900                    1 No premium subsidy
                                  26                    2 25% premium subsidy
                                  27                    3 50% premium subsidy
                                  31                    4 75% premium subsidy
                               2,840                    5 100% premium subsidy

H_PDRS11  317  1  $DRDSFMT                              C RDS Indicator for Nov

                                 475                      Unknown
                               9,611                    N Employer not subsidized for the benefici
                               1,213                    Y Employer subsidized for the beneficiary

H_CRED11  318  1  $YES8FMT                              C Creditable Coverage for Nov

                                   6                      Unknown
                               1,508                    1 Yes
                               9,785                    2 No

H_PDPY12  319  5                                        N Part D capitation payment for Dec

H_PDLS12  324  1  $DLISFMT                              C LIS Indicator for Dec

                                 487                      Unknown
                               7,884                    1 No premium subsidy
                                  26                    2 25% premium subsidy
                                  27                    3 50% premium subsidy
                                  30                    4 75% premium subsidy
                               2,845                    5 100% premium subsidy

H_PDRS12  325  1  $DRDSFMT                              C RDS Indicator for Dec

                                 487                      Unknown
                               9,601                    N Employer not subsidized for the benefici
                               1,211                    Y Employer subsidized for the beneficiary

H_CRED12  326  1  $YES8FMT                              C Creditable Coverage for Dec

                                   6                      Unknown
                               1,515                    1 Yes
                               9,778                    2 No

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

                               8,815                    N No participation
                               2,484                    Y Some participation

H_MCDE01  328  1  $MCDCFMT                              C Medicaid eligibility for Jan

                                   0                    A State Part A buy-in
                                 890                    B State Part B buy-in
                                  44                    C State Part A and B buy-in
                                  78                    D State Part A and B QMB buy-in
                                   1                    E State Part A and B SLMB buy-in
                               8,988                    N No buy-in this month
                               1,005                    Q State Part B QMB buy-in
                                 293                    S State Part B SLMB buy-in

H_MCDE02  329  1  $MCDCFMT                              C Medicaid eligibility for Feb

                                   0                    A State Part A buy-in
                                 889                    B State Part B buy-in
                                  44                    C State Part A and B buy-in
                                  79                    D State Part A and B QMB buy-in
                                   1                    E State Part A and B SLMB buy-in
                               8,997                    N No buy-in this month
                                 999                    Q State Part B QMB buy-in
                                 290                    S State Part B SLMB buy-in

H_MCDE03  330  1  $MCDCFMT                              C Medicaid eligibility for Mar

                                   0                    A State Part A buy-in
                                 888                    B State Part B buy-in
                                  44                    C State Part A and B buy-in
                                  79                    D State Part A and B QMB buy-in
                                   1                    E State Part A and B SLMB buy-in
                               9,008                    N No buy-in this month
                                 995                    Q State Part B QMB buy-in
                                 284                    S State Part B SLMB buy-in

H_MCDE04  331  1  $MCDCFMT                              C Medicaid eligibility for Apr

                                   0                    A State Part A buy-in
                                 880                    B State Part B buy-in
                                  44                    C State Part A and B buy-in
                                  79                    D State Part A and B QMB buy-in
                                   1                    E State Part A and B SLMB buy-in
                               9,015                    N No buy-in this month
                                 995                    Q State Part B QMB buy-in
                                 285                    S State Part B SLMB buy-in

H_MCDE05  332  1  $MCDCFMT                              C Medicaid eligibility for May

                                   0                    A State Part A buy-in
                                 874                    B State Part B buy-in
                                  44                    C State Part A and B buy-in
                                  78                    D State Part A and B QMB buy-in
                                   1                    E State Part A and B SLMB buy-in
                               9,022                    N No buy-in this month
                                 994                    Q State Part B QMB buy-in
                                 286                    S State Part B SLMB buy-in

H_MCDE06  333  1  $MCDCFMT                              C Medicaid eligibility for Jun

                                   0                    A State Part A buy-in
                                 883                    B State Part B buy-in
                                  43                    C State Part A and B buy-in
                                  77                    D State Part A and B QMB buy-in
                                   1                    E State Part A and B SLMB buy-in
                               9,017                    N No buy-in this month
                                 993                    Q State Part B QMB buy-in
                                 285                    S State Part B SLMB buy-in

H_MCDE07  334  1  $MCDCFMT                              C Medicaid eligibility for Jul

                                   0                    A State Part A buy-in
                                 876                    B State Part B buy-in
                                  43                    C State Part A and B buy-in
                                  77                    D State Part A and B QMB buy-in
                                   1                    E State Part A and B SLMB buy-in
                               9,021                    N No buy-in this month
                                 996                    Q State Part B QMB buy-in
                                 285                    S State Part B SLMB buy-in

H_MCDE08  335  1  $MCDCFMT                              C Medicaid eligibility for Aug

                                   0                    A State Part A buy-in
                                 875                    B State Part B buy-in
                                  43                    C State Part A and B buy-in
                                  77                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                               9,034                    N No buy-in this month
                                 984                    Q State Part B QMB buy-in
                                 286                    S State Part B SLMB buy-in

H_MCDE09  336  1  $MCDCFMT                              C Medicaid eligibility for Sep

                                   0                    A State Part A buy-in
                                 883                    B State Part B buy-in
                                  42                    C State Part A and B buy-in
                                  77                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                               9,029                    N No buy-in this month
                                 985                    Q State Part B QMB buy-in
                                 283                    S State Part B SLMB buy-in

H_MCDE10  337  1  $MCDCFMT                              C Medicaid eligibility for Oct

                                   0                    A State Part A buy-in
                                 888                    B State Part B buy-in
                                  41                    C State Part A and B buy-in
                                  76                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                               9,023                    N No buy-in this month
                                 985                    Q State Part B QMB buy-in
                                 286                    S State Part B SLMB buy-in

H_MCDE11  338  1  $MCDCFMT                              C Medicaid eligibility for Nov

                                   0                    A State Part A buy-in
                                 883                    B State Part B buy-in
                                  41                    C State Part A and B buy-in
                                  76                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                               9,024                    N No buy-in this month
                                 990                    Q State Part B QMB buy-in
                                 285                    S State Part B SLMB buy-in

H_MCDE12  339  1  $MCDCFMT                              C Medicaid eligibility for Dec

                                   0                    A State Part A buy-in
                                 857                    B State Part B buy-in
                                  41                    C State Part A and B buy-in
                                  76                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                               9,063                    N No buy-in this month
                                 979                    Q State Part B QMB buy-in
                                 283                    S State Part B SLMB buy-in

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

                               8,988                    N Unknown, or no buy-in
                               2,311              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                               8,997                    N Unknown, or no buy-in
                               2,302              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                               9,008                    N Unknown, or no buy-in
                               2,291              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                               9,015                    N Unknown, or no buy-in
                               2,284              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                               9,022                    N Unknown, or no buy-in
                               2,277              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                               9,017                    N Unknown, or no buy-in
                               2,282              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                               9,021                    N Unknown, or no buy-in
                               2,278              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                               9,034                    N Unknown, or no buy-in
                               2,265              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                               9,029                    N Unknown, or no buy-in
                               2,270              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                               9,023                    N Unknown, or no buy-in
                               2,276              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                               9,024                    N Unknown, or no buy-in
                               2,275              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                               9,063                    N Unknown, or no buy-in
                               2,236              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                              10,959                    0 No utilization this type
                                 340                    1 Some utilization this type

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

                               9,657                    0 No utilization this type
                               1,642                    1 Some utilization this type

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

                              10,751                    0 No utilization this type
                                 548                    1 Some utilization this type

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

                              10,475                    0 No utilization this type
                                 824                    1 Some utilization this type

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

                               5,591                    0 No utilization this type
                               5,708                    1 Some utilization this type

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

                               3,471                    0 No utilization this type
                               7,828                    1 Some utilization this type

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

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

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

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

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

                               9,657                      Missing
                               1,642                      Date as YYYYMMDD

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

                               9,657                      Unknown, or no discharge
                               1,642                      DRG

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

                               9,657                      Missing
                                 807                   01 Discharged to home/self care
                                   4                   02 Discharged to other short-term hospital
                                 338                   03 Discharged to skilled nursing facility
                                  39                   04 Discharged to intermediate care facility
                                   1                   05 Disch to another type of institution
                                 243                   06 Discharged to home care of organized HMO
                                  10                   07 Left against medical advice/stopped care
                                   0                   08 Disch home under care of IV therapy prov
                                  93                   20 Expired (did not recover Christian Sci)
                                   2                   30 Still patient
                                   0                   40 Expired at home (hospice claims only)
                                   0                   41 Expired in hospital, SNF, ICF or hospice
                                   0                   42 Expired in unknown place (hospice only)
                                   2                   43 Disch/Transferred to a Fed Hospital (10)
                                  29                   50 Hospice - home (eff. 96)
                                  39                   51 Hospice - medical facility (eff. 96)
                                  14                   61 Disch w/i facility to swing-bed SNF (99)
                                  12                   62 Disch inp rehab; inc distinct hosp (10)
                                   7                   63 Disch to long term care hospital (10)
                                   2                   64 Disch cert nursing; Mcaid, not Mcare(10)
                                   0                   65 Disch to psychiatric hosp or unit   (10)
                                   0                   70 Disch to other institution, no code (10)
                                   0                   71 Disch to other facility for O/P svcs(99)
                                   0                   72 Disch to this facility for O/P svcs (99)

H_INPSTY  425  2                                        N No. of inpatient stays for CY

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

H_INPCHG  430  7                                        N Inpatient charges for CY ($)

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

H_INPRMB  444  7                                        N Inpatient reimbursement for CY ($)

H_INPCDY  451  2                                        N Inpatient coinsurance days used in CY

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

H_SNFSTY  458  2                                        N Total SNF stays in CY

H_SNFDAY  460  3                                        N Total SNF covered days in CY

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

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

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

H_SNFCDY  484  3                                        N Total SNF coinsurance days in CY

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

H_HHAVST  494  5                                        N Total HHA visits in CY

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

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

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

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

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

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

H_HSDAYS  527  3                                        N Total covered hospice days in CY

H_HSTCHG  530  7                                        N Total hospice charges CY ($)

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

H_OUTBIL  544  3                                        N Total outpatient bills in CY

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

H_OUTRMB  554  7                                        N Total outpatient reimbursement CY ($)

H_PMTCLM  561  4                                        N Total physician/supplier claims in CY

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

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

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

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

H_PMTVST  590  3                                        N Total office visits in CY

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

H_DMECLM  600  4                                        N Total DME supplier claims in CY

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

H_DMELIN  604  4                                        N Total DME supplier line items in CY

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

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

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

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

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

H_DMERMB  622  7                                        N Total DME supplier reimbursement ($)

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

DUAL_JAN  629  2  $DUALMON                              C Dual eligibity code for Jan

                                   3                      Beneficiary not found in duals data
                                   6                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,478                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 350                   00 Not enrolled in Medicare for the month
                                 255                   01 QMB-only
                               1,295                   02 QMB & full Medicaid covrge, + Rx drugs
                                 215                   03 SLMB-only
                                  90                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 108                   06 Qualifying individuals
                                 468                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  31                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_FEB  631  2  $DUALMON                              C Dual eligibity code for Feb

                                   3                      Beneficiary not found in duals data
                                   6                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,429                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 351                   00 Not enrolled in Medicare for the month
                                 260                   01 QMB-only
                               1,330                   02 QMB & full Medicaid covrge, + Rx drugs
                                 219                   03 SLMB-only
                                  92                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 110                   06 Qualifying individuals
                                 468                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  31                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_MAR  633  2  $DUALMON                              C Dual eligibity code for Mar

                                   3                      Beneficiary not found in duals data
                                   6                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,458                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 364                   00 Not enrolled in Medicare for the month
                                 260                   01 QMB-only
                               1,324                   02 QMB & full Medicaid covrge, + Rx drugs
                                 216                   03 SLMB-only
                                  88                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 107                   06 Qualifying individuals
                                 466                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                   7                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_APR  635  2  $DUALMON                              C Dual eligibity code for Apr

                                   3                      Beneficiary not found in duals data
                                   6                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,445                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 389                   00 Not enrolled in Medicare for the month
                                 254                   01 QMB-only
                               1,324                   02 QMB & full Medicaid covrge, + Rx drugs
                                 226                   03 SLMB-only
                                  89                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 103                   06 Qualifying individuals
                                 453                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                   7                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_MAY  637  2  $DUALMON                              C Dual eligibity code for May

                                   3                      Beneficiary not found in duals data
                                   6                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,435                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 408                   00 Not enrolled in Medicare for the month
                                 256                   01 QMB-only
                               1,307                   02 QMB & full Medicaid covrge, + Rx drugs
                                 228                   03 SLMB-only
                                  90                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 101                   06 Qualifying individuals
                                 458                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                   7                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_JUN  639  2  $DUALMON                              C Dual eligibity code for Jun

                                   3                      Beneficiary not found in duals data
                                   6                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,419                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 410                   00 Not enrolled in Medicare for the month
                                 258                   01 QMB-only
                               1,309                   02 QMB & full Medicaid covrge, + Rx drugs
                                 231                   03 SLMB-only
                                  89                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 101                   06 Qualifying individuals
                                 466                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                   7                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_JUL  641  2  $DUALMON                              C Dual eligibity code for Jul

                                   3                      Beneficiary not found in duals data
                                   6                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,426                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 417                   00 Not enrolled in Medicare for the month
                                 256                   01 QMB-only
                               1,312                   02 QMB & full Medicaid covrge, + Rx drugs
                                 228                   03 SLMB-only
                                  92                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                  99                   06 Qualifying individuals
                                 456                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                   4                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_AUG  643  2  $DUALMON                              C Dual eligibity code for Aug

                                   3                      Beneficiary not found in duals data
                                   6                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,409                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 443                   00 Not enrolled in Medicare for the month
                                 247                   01 QMB-only
                               1,311                   02 QMB & full Medicaid covrge, + Rx drugs
                                 225                   03 SLMB-only
                                  90                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 105                   06 Qualifying individuals
                                 452                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                   8                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_SEP  645  2  $DUALMON                              C Dual eligibity code for Sep

                                   3                      Beneficiary not found in duals data
                                   6                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,400                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 457                   00 Not enrolled in Medicare for the month
                                 248                   01 QMB-only
                               1,314                   02 QMB & full Medicaid covrge, + Rx drugs
                                 220                   03 SLMB-only
                                  89                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 105                   06 Qualifying individuals
                                 449                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                   8                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_OCT  647  2  $DUALMON                              C Dual eligibity code for Oct

                                   3                      Beneficiary not found in duals data
                                   6                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,382                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 467                   00 Not enrolled in Medicare for the month
                                 245                   01 QMB-only
                               1,314                   02 QMB & full Medicaid covrge, + Rx drugs
                                 223                   03 SLMB-only
                                  91                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 109                   06 Qualifying individuals
                                 454                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                   5                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_NOV  649  2  $DUALMON                              C Dual eligibity code for Nov

                                   3                      Beneficiary not found in duals data
                                   6                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,378                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 484                   00 Not enrolled in Medicare for the month
                                 251                   01 QMB-only
                               1,312                   02 QMB & full Medicaid covrge, + Rx drugs
                                 224                   03 SLMB-only
                                  88                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 105                   06 Qualifying individuals
                                 443                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                   5                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_DEC  651  2  $DUALMON                              C Dual eligibity code for Dec

                                   3                      Beneficiary not found in duals data
                                   6                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                               8,358                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 499                   00 Not enrolled in Medicare for the month
                                 258                   01 QMB-only
                               1,304                   02 QMB & full Medicaid covrge, + Rx drugs
                                 227                   03 SLMB-only
                                  86                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 101                   06 Qualifying individuals
                                 452                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                   5                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

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

                               2,061                    1 FULL-Bene elig. full Medicaid benefits
                               8,573                    2 NONDUAL-Bene not elig Medicaid benfits
                                 376                    3 PARTIAL-Bene elig part Medicd- not QMB
                                 289                    4 QMB ONLY-Bene elig for part Medicd-QMB

PTCPRM1   654  8                                        N Part C Premium for Jan

PTCPRM2   662  8                                        N Part C Premium for Feb

PTCPRM3   670  8                                        N Part C Premium for Mar

PTCPRM4   678  8                                        N Part C Premium for Apr

PTCPRM5   686  8                                        N Part C Premium for May

PTCPRM6   694  8                                        N Part C Premium for Jun

PTCPRM7   702  8                                        N Part C Premium for Jul

PTCPRM8   710  8                                        N Part C Premium for Aug

PTCPRM9   718  8                                        N Part C Premium for Sep

PTCPRM10  726  8                                        N Part C Premium for Oct

PTCPRM11  734  8                                        N Part C Premium for Nov

PTCPRM12  742  8                                        N Part C Premium for Dec

PTDPRM1   750  8                                        N Part D Premium for Jan

PTDPRM2   758  8                                        N Part D Premium for Feb

PTDPRM3   766  8                                        N Part D Premium for Mar

PTDPRM4   774  8                                        N Part D Premium for Apr

PTDPRM5   782  8                                        N Part D Premium for May

PTDPRM6   790  8                                        N Part D Premium for Jun

PTDPRM7   798  8                                        N Part D Premium for Jul

PTDPRM8   806  8                                        N Part D Premium for Aug

PTDPRM9   814  8                                        N Part D Premium for Sep

PTDPRM10  822  8                                        N Part D Premium for Oct

PTDPRM11  830  8                                        N Part D Premium for Nov

PTDPRM12  838  8                                        N Part D Premium for Dec

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

                               3,855                    N No
                               7,444                    Y Yes

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

                               3,848                    N No
                               7,451                    Y Yes

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

                               3,854                    N No
                               7,445                    Y Yes

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

                               3,877                    N No
                               7,422                    Y Yes

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

                               3,889                    N No
                               7,410                    Y Yes

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

                               3,867                    N No
                               7,432                    Y Yes

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

                               3,858                    N No
                               7,441                    Y Yes

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

                               3,870                    N No
                               7,429                    Y Yes

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

                               3,891                    N No
                               7,408                    Y Yes

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

                               3,901                    N No
                               7,398                    Y Yes

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

                               3,906                    N No
                               7,393                    Y Yes

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

                               3,928                    N No
                               7,371                    Y Yes

MAFLAG01  858  3  $MAFLAG                               C MA flag for January

                                 355                      No Entitlement
                               7,721                  FFS Original Medicare/FFS
                               3,223                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG02  861  3  $MAFLAG                               C MA flag for February

                                 356                      No Entitlement
                               7,719                  FFS Original Medicare/FFS
                               3,224                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG03  864  3  $MAFLAG                               C MA flag for March

                                 369                      No Entitlement
                               7,709                  FFS Original Medicare/FFS
                               3,221                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG04  867  3  $MAFLAG                               C MA flag for April

                                 394                      No Entitlement
                               7,685                  FFS Original Medicare/FFS
                               3,220                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG05  870  3  $MAFLAG                               C MA flag for May

                                 413                      No Entitlement
                               7,665                  FFS Original Medicare/FFS
                               3,221                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG06  873  3  $MAFLAG                               C MA flag for June

                                 412                      No Entitlement
                               7,673                  FFS Original Medicare/FFS
                               3,214                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG07  876  3  $MAFLAG                               C MA flag for July

                                 419                      No Entitlement
                               7,659                  FFS Original Medicare/FFS
                               3,221                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG08  879  3  $MAFLAG                               C MA flag for August

                                 445                      No Entitlement
                               7,639                  FFS Original Medicare/FFS
                               3,215                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG09  882  3  $MAFLAG                               C MA flag for September

                                 458                      No Entitlement
                               7,619                  FFS Original Medicare/FFS
                               3,222                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG10  885  3  $MAFLAG                               C MA flag for October

                                 467                      No Entitlement
                               7,606                  FFS Original Medicare/FFS
                               3,226                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG11  888  3  $MAFLAG                               C MA flag for November

                                 484                      No Entitlement
                               7,586                  FFS Original Medicare/FFS
                               3,229                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG12  891  3  $MAFLAG                               C MA flag for December

                                 499                      No Entitlement
                               7,576                  FFS Original Medicare/FFS
                               3,224                   MA MA/Other Medicare Capitated Paymnt Plans

PTDPBP01  894  3                                        C PtD Plan Benefit Packge Jan

PTDPBP02  897  3                                        C PtD Plan Benefit Packge Feb

PTDPBP03  900  3                                        C PtD Plan Benefit Packge Mar

PTDPBP04  903  3                                        C PtD Plan Benefit Packge Apr

PTDPBP05  906  3                                        C PtD Plan Benefit Packge May

PTDPBP06  909  3                                        C PtD Plan Benefit Packge Jun

PTDPBP07  912  3                                        C PtD Plan Benefit Packge Jul

PTDPBP08  915  3                                        C PtD Plan Benefit Packge Aug

PTDPBP09  918  3                                        C PtD Plan Benefit Packge Sep

PTDPBP10  921  3                                        C PtD Plan Benefit Packge Oct

PTDPBP11  924  3                                        C PtD Plan Benefit Packge Nov

PTDPBP12  927  3                                        C PtD Plan Benefit Packge Dec

PTDSGM01  930  3                                        C Part D Segment ID - Jan

PTDSGM02  933  3                                        C Part D Segment ID - Feb

PTDSGM03  936  3                                        C Part D Segment ID - Mar

PTDSGM04  939  3                                        C Part D Segment ID - Apr

PTDSGM05  942  3                                        C Part D Segment ID - May

PTDSGM06  945  3                                        C Part D Segment ID - Jun

PTDSGM07  948  3                                        C Part D Segment ID - Jul

PTDSGM08  951  3                                        C Part D Segment ID - Aug

PTDSGM09  954  3                                        C Part D Segment ID - Sep

PTDSGM10  957  3                                        C Part D Segment ID - Oct

PTDSGM11  960  3                                        C Part D Segment ID - Nov

PTDSGM12  963  3                                        C Part D Segment ID - Dec

PTDCRT01  966  5                                        C Part D Contract ID - Jan

PTDCRT02  971  5                                        C Part D Contract ID - Feb

PTDCRT03  976  5                                        C Part D Contract ID - Mar

PTDCRT04  981  5                                        C Part D Contract ID - Apr

PTDCRT05  986  5                                        C Part D Contract ID - May

PTDCRT06  991  5                                        C Part D Contract ID - Jun

PTDCRT07  996  5                                        C Part D Contract ID - Jul

PTDCRT08 1001  5                                        C Part D Contract ID - Aug

PTDCRT09 1006  5                                        C Part D Contract ID - Sep

PTDCRT10 1011  5                                        C Part D Contract ID - Oct

PTDCRT11 1016  5                                        C Part D Contract ID - Nov

PTDCRT12 1021  5                                        C Part D Contract ID - Dec

PTDDED01 1026  8                                        N Part D Deductible - Jan

PTDDED02 1034  8                                        N Part D Deductible - Feb

PTDDED03 1042  8                                        N Part D Deductible - Mar

PTDDED04 1050  8                                        N Part D Deductible - Apr

PTDDED05 1058  8                                        N Part D Deductible - May

PTDDED06 1066  8                                        N Part D Deductible - Jun

PTDDED07 1074  8                                        N Part D Deductible - Jul

PTDDED08 1082  8                                        N Part D Deductible - Aug

PTDDED09 1090  8                                        N Part D Deductible - Sep

PTDDED10 1098  8                                        N Part D Deductible - Oct

PTDDED11 1106  8                                        N Part D Deductible - Nov

PTDDED12 1114  8                                        N Part D Deductible - Dec

PRPY1    1122  1  PRPY                                  N Primary Payer

                              10,733                    1 Medicare
                                 328                    2 Employer/Large Group Health Plan
                                 238                    3 Other Liability (Auto, WC, etc.)

PRPY2    1123  1  PRPY                                  N Primary Payer - 2nd code

                              11,264                    . No additional codes/payers
                                   0                    1 Medicare
                                   6                    2 Employer/Large Group Health Plan
                                  29                    3 Other Liability (Auto, WC, etc.)

