RIC         1  2  $RIC                                  C Record Identification Code

                                   0                    A Administrative Data
                                   0                   DU Dental Events
                                   0                   FA Facility Events
                                   0                    H HMO Supplement
                                   0                   IA Income and Assets
                                   0                   IP Inpatient Hospital Events
                                   0                   IU Institutional Events
                                   0                    K Key Record
                                   0                   KN Knowledge and Information Needs
                                   0                   MD MDS
                                   0                   MP Medical Provider Events
                             156,546                    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

                             156,546                    1 Version 1
                                   0                    2 Version 2
                                   0                    3 Version 3
                                   0                    4 Version 4

BASEID      4  8  $BSIDFMT                              C Unique SP Identification Number

                             156,546             LOW-HIGH BASEID Count

H_DOB      12  8  $DTE8FMT                              C Date of birth

                                   1                      Missing
                             156,545                      Date as YYYYMMDD

H_DOD      20  8  $DTE8FMT                              C Date of death

                              77,897                      Missing
                              78,649                      Date as YYYYMMDD

H_DODSRC   28  2  $SRCFMT                               C Source of date of death

                              77,897                      No date of death
                                  19                   01 From Medicare bill
                                  14                   03 Clerical entry
                                   0                   05 Bill and clerical entry
                              43,737                   10 Proven Medicare Benefits record
                               5,573                   11 Proven Medicare Benefits record & bills
                              24,576                   20 Unproven Medicare Benefits record
                               4,596                   21 Unproven Mcare Benefits record & bills
                                  70                   23 Unproven Mcare Benefits rec & clerical
                                  64                   25 Unprovn Mcare Benfts rec, bill & clericl

H_SEX      30  1  $SEXFMT                               C Sex code

                                   1                      Missing
                              67,020                    1 Male
                              89,525                    2 Female

H_RACE     31  1  $RACEFMT                              C Race code

                                   1                      Missing
                                 615                    0 Unknown
                             131,557                    1 White
                              16,225                    2 Black
                               1,777                    3 Other
                               2,060                    4 Asian
                               3,694                    5 Hispanic
                                 617                    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

                                   1                      Unknown
                               5,872                    1  0-44
                              13,524                    2 45-64
                               8,795                    3 65-69
                              15,295                    4 70-74
                              22,465                    5 75-79
                              31,020                    6 80-84
                              59,574                    7 85 +

H_ENT01    36  1  $ENTFMT                               C Medicare entitlement code for Jan

                               3,842                    A Part A Medicare only
                                 384                    B Part B Medicare only
                              77,305                    C Parts A and B Medicare
                              75,015                    N No Medicare entitlement

H_ENT02    37  1  $ENTFMT                               C Medicare entitlement code for Feb

                               3,826                    A Part A Medicare only
                                 377                    B Part B Medicare only
                              76,918                    C Parts A and B Medicare
                              75,425                    N No Medicare entitlement

H_ENT03    38  1  $ENTFMT                               C Medicare entitlement code for Mar

                               3,798                    A Part A Medicare only
                                 373                    B Part B Medicare only
                              76,541                    C Parts A and B Medicare
                              75,834                    N No Medicare entitlement

H_ENT04    39  1  $ENTFMT                               C Medicare entitlement code for Apr

                               3,780                    A Part A Medicare only
                                 372                    B Part B Medicare only
                              76,143                    C Parts A and B Medicare
                              76,251                    N No Medicare entitlement

H_ENT05    40  1  $ENTFMT                               C Medicare entitlement code for May

                               3,775                    A Part A Medicare only
                                 365                    B Part B Medicare only
                              75,748                    C Parts A and B Medicare
                              76,658                    N No Medicare entitlement

H_ENT06    41  1  $ENTFMT                               C Medicare entitlement code for Jun

                               3,748                    A Part A Medicare only
                                 363                    B Part B Medicare only
                              75,371                    C Parts A and B Medicare
                              77,064                    N No Medicare entitlement

H_ENT07    42  1  $ENTFMT                               C Medicare entitlement code for Jul

                               3,631                    A Part A Medicare only
                                 353                    B Part B Medicare only
                              75,111                    C Parts A and B Medicare
                              77,451                    N No Medicare entitlement

H_ENT08    43  1  $ENTFMT                               C Medicare entitlement code for Aug

                               3,605                    A Part A Medicare only
                                 346                    B Part B Medicare only
                              74,749                    C Parts A and B Medicare
                              77,846                    N No Medicare entitlement

H_ENT09    44  1  $ENTFMT                               C Medicare entitlement code for Sep

                               3,588                    A Part A Medicare only
                                 345                    B Part B Medicare only
                              74,390                    C Parts A and B Medicare
                              78,223                    N No Medicare entitlement

H_ENT10    45  1  $ENTFMT                               C Medicare entitlement code for Oct

                               3,571                    A Part A Medicare only
                                 343                    B Part B Medicare only
                              74,034                    C Parts A and B Medicare
                              78,598                    N No Medicare entitlement

H_ENT11    46  1  $ENTFMT                               C Medicare entitlement code for Nov

                               3,558                    A Part A Medicare only
                                 340                    B Part B Medicare only
                              73,646                    C Parts A and B Medicare
                              79,002                    N No Medicare entitlement

H_ENT12    47  1  $ENTFMT                               C Medicare entitlement code for Dec

                               3,539                    A Part A Medicare only
                                 336                    B Part B Medicare only
                              73,275                    C Parts A and B Medicare
                              79,396                    N No Medicare entitlement

H_DOE      48  8  $DTE8FMT                              C Medicare entitlement start date

                               1,220                      Missing
                             155,326                      Date as YYYYMMDD

H_DOT      56  8  $DTE8FMT                              C Medicare entitlement end date

                             156,149                      Missing
                                 397                      Date as YYYYMMDD

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

                                 113                      Unknown
                             135,988                   10 Aged, no ESRD
                               2,013                   11 Aged, ESRD
                              17,786                   20 Disabled, no ESRD
                                 418                   21 Disabled, ESRD
                                 228                   31 ESRD only

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

                                  29                      Unknown
                                   1                   AD Cur pay-adj for dual entitlement
                                   0                   AF Transfer to another PSC or OIO
                                   3                   A9 Cur pay-miscellaneous adjustment
                              73,288                    C Current payment status
                                   0                   DW Deferred-Workers' Compensation
                                   0                   D2 DEF-retirement test
                                   0                   D3 DEF-D2 for primary
                                  27                   D6 DEF-recover overpayment
                                  22                   D9 DEF-miscellaneous reason
                                   2                    E Current paymt certifd to RailrdRetirBd
                                   0                    J Advanced filing-current pay
                                   0                   L2 Advanced filing-worked inside U S
                                   0                   L3 Advanced filing-insured worked in U S
                                   0                    N Not in pay status
                                   0                   PB Delayed-benefit due but not paid
                                   6                    R Cur pay-Part B reinstated
                                   0                   RN Cur pay-Part B reinstated
                                   9                    S SUSP-deferred retirement
                                  10                   SD SUSP-other
                                   7                   SF SUSP-fails to meet residence requirment
                                 329                   SH SUSP-government pension
                                   2                   SJ SUSP-alien suspension
                                   1                   SK SUSP-because of deportation
                                  12                   SP SUSP-public assistance
                                   0                   SW SUSP-Workers' Compensation
                                  11                   S0 SUSP-continuing disability investig
                                   2                   S2 SUSP-fails retirement test
                                   0                   S3 SUSP-primary account S2
                                 179                   S6 SUSP-check returned for address
                                 232                   S7 SUSP-vocational rehab refusal
                                  13                   S8 SUSP-payee not determined
                                 161                   S9 SUSP-miscellaneous reason
                                   1                   T- TERM-conv to retiremnt benefts, age 65
                                   3                   TA TERM-prior to entitlement
                                   1                   TJ TERM-prior to entlmt, not stop debit
                                   0                   TR TERM-claim withdrawn
                                   4                   T0 TERM-benefits paid by another agency
                              76,188                   T1 TERM-death of beneficiary
                                  25                   T2 TERM-death of primary
                                  37                   T3 TERM-divorce, marriage, remarriage
                                   1                   T4 TERM-dependent child attained age 18
                                   7                   T5 TERM-entitled on another account
                                  12                   T6 TERM-child no longer student, disabled
                                 178                   T8 TERM-recovery from disability
                                  27                   T9 TERM-miscellaneous
                               2,581                    U Active uninsured status (no SSA check)
                                   1                   XD Withdrawn for adjustment
                                   1                   XF Transfer to another PC or DIO
                                   0                   XR Terminated -
                               2,181                   X1 TERM-death of insured
                                  14                   X5 TERM-entitled to another benefit
                                 929                   X7 TERM of uninsured
                                   6                   X9 TERM miscellaneous
                                   3                   ZZ Erroneous entitlement

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

                               4,545                   01 Alabama
                                  27                   02 Alaska
                               3,270                   03 Arizona
                               1,166                   04 Arkansas
                              13,650                   05 California
                               3,123                   06 Colorado
                               1,833                   07 Connecticut
                                  54                   08 Delaware
                                 372                   09 Washington, DC
                              12,097                   10 Florida
                               5,077                   11 Georgia
                                  32                   12 Hawaii
                                 475                   13 Idaho
                               5,277                   14 Illinois
                               1,931                   15 Indiana
                               1,814                   16 Iowa
                               1,541                   17 Kansas
                               2,073                   18 Kentucky
                               1,526                   19 Louisiana
                                 619                   20 Maine
                               2,052                   21 Maryland
                               6,006                   22 Massachusetts
                               6,392                   23 Michigan
                               3,390                   24 Minnesota
                                 548                   25 Mississippi
                               2,892                   26 Missouri
                                  52                   27 Montana
                                 556                   28 Nebraska
                               2,438                   29 Nevada
                                  83                   30 New Hampshire
                               6,097                   31 New Jersey
                               1,965                   32 New Mexico
                              10,217                   33 New York
                               3,770                   34 North Carolina
                                 296                   35 North Dakota
                               6,704                   36 Ohio
                               1,880                   37 Oklahoma
                                 246                   38 Oregon
                               8,406                   39 Pennsylvania
                               1,958                   40 Puerto Rico
                                  40                   41 Rhode Island
                               2,785                   42 South Carolina
                                  43                   43 South Dakota
                               2,356                   44 Tennessee
                               8,835                   45 Texas
                                 145                   46 Utah
                                  52                   47 Vermont
                                   1                   48 Virgin Islands
                               3,282                   49 Virginia
                               5,215                   50 Washington
                               1,321                   51 West Virginia
                               4,137                   52 Wisconsin
                                 777                   53 Wyoming
                               1,107                      Unknown

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

                                 945                      Unknown
                             155,601                      County code

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

                                 947                      Unknown
                             155,599                      ZIP Code

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

                               8,633                   01 New England
                              24,720                   02 Middle Atlantic
                              24,441                   03 East North Central
                              10,532                   04 West North Central
                              30,810                   05 South Atlantic
                               9,522                   06 East South Central
                              13,407                   07 West South Central
                              12,245                   08 Mountain
                              19,170                   09 Pacific
                               1,960                   10 Puerto Rico
                               1,106                      Unknown

H_METRO    80  1  $METFMT                               C Metro status

                              34,525                    N Non-metro area
                                   2                    U Unknown
                             122,019                    Y Metro area

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

                             122,963                      Missing
                              33,583                      Date as YYYYMMDD

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

                             122,963                      Missing
                              33,583                      Date as YYYYMMDD

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

                             147,670                      Missing
                               8,876                      Date as YYYYMMDD

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

                             147,670                      Missing
                               8,876                      Date as YYYYMMDD

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

                             151,303                      Missing
                               5,243                      Date as YYYYMMDD

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

                             151,303                      Missing
                               5,243                      Date as YYYYMMDD

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

                             152,670                      Missing
                               3,876                      Date as YYYYMMDD

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

                             152,670                      Missing
                               3,876                      Date as YYYYMMDD

H_ESRBEG  145  8  $DTE8FMT                              C Beginning date of ESRD period

                             153,170                      Missing
                               3,376                      Date as YYYYMMDD

H_ESREND  153  8  $DTE8FMT                              C Ending date of ESRD period

                             153,620                      Missing
                               2,926                      Date as YYYYMMDD

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

                             135,849                    0 No enrollment
                              20,697                    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

                              74,795                      Unknown
                              59,670                    1 No premium subsidy
                                 174                    2 25% premium subsidy
                                 234                    3 50% premium subsidy
                                 238                    4 75% premium subsidy
                              21,435                    5 100% premium subsidy

H_PDRS01  237  1  $DRDSFMT                              C RDS Indicator for Jan

                              74,795                      Unknown
                              72,289                    N Employer not subsidized for the benefici
                               9,462                    Y Employer subsidized for the beneficiary

H_CRED01  238  1  $YES8FMT                              C Creditable Coverage for Jan

                              74,620                      Unknown
                              11,211                    1 Yes
                              70,715                    2 No

H_PDPY02  239  5                                        N Part D capitation payment for Feb

H_PDLS02  244  1  $DLISFMT                              C LIS Indicator for Feb

                              75,196                      Unknown
                              59,265                    1 No premium subsidy
                                 178                    2 25% premium subsidy
                                 233                    3 50% premium subsidy
                                 235                    4 75% premium subsidy
                              21,439                    5 100% premium subsidy

H_PDRS02  245  1  $DRDSFMT                              C RDS Indicator for Feb

                              75,196                      Unknown
                              71,937                    N Employer not subsidized for the benefici
                               9,413                    Y Employer subsidized for the beneficiary

H_CRED02  246  1  $YES8FMT                              C Creditable Coverage for Feb

                              74,620                      Unknown
                              11,218                    1 Yes
                              70,708                    2 No

H_PDPY03  247  5                                        N Part D capitation payment for Mar

H_PDLS03  252  1  $DLISFMT                              C LIS Indicator for Mar

                              75,549                      Unknown
                              58,911                    1 No premium subsidy
                                 179                    2 25% premium subsidy
                                 229                    3 50% premium subsidy
                                 234                    4 75% premium subsidy
                              21,444                    5 100% premium subsidy

H_PDRS03  253  1  $DRDSFMT                              C RDS Indicator for Mar

                              75,549                      Unknown
                              71,629                    N Employer not subsidized for the benefici
                               9,368                    Y Employer subsidized for the beneficiary

H_CRED03  254  1  $YES8FMT                              C Creditable Coverage for Mar

                              74,620                      Unknown
                              11,217                    1 Yes
                              70,709                    2 No

H_PDPY04  255  5                                        N Part D capitation payment for Apr

H_PDLS04  260  1  $DLISFMT                              C LIS Indicator for Apr

                              76,066                      Unknown
                              58,564                    1 No premium subsidy
                                 151                    2 25% premium subsidy
                                 214                    3 50% premium subsidy
                                 227                    4 75% premium subsidy
                              21,324                    5 100% premium subsidy

H_PDRS04  261  1  $DRDSFMT                              C RDS Indicator for Apr

                              76,066                      Unknown
                              71,165                    N Employer not subsidized for the benefici
                               9,315                    Y Employer subsidized for the beneficiary

H_CRED04  262  1  $YES8FMT                              C Creditable Coverage for Apr

                              74,620                      Unknown
                              11,219                    1 Yes
                              70,707                    2 No

H_PDPY05  263  5                                        N Part D capitation payment for May

H_PDLS05  268  1  $DLISFMT                              C LIS Indicator for May

                              76,466                      Unknown
                              58,223                    1 No premium subsidy
                                 153                    2 25% premium subsidy
                                 212                    3 50% premium subsidy
                                 225                    4 75% premium subsidy
                              21,267                    5 100% premium subsidy

H_PDRS05  269  1  $DRDSFMT                              C RDS Indicator for May

                              76,466                      Unknown
                              70,810                    N Employer not subsidized for the benefici
                               9,270                    Y Employer subsidized for the beneficiary

H_CRED05  270  1  $YES8FMT                              C Creditable Coverage for May

                              74,620                      Unknown
                              11,224                    1 Yes
                              70,702                    2 No

H_PDPY06  271  5                                        N Part D capitation payment for Jun

H_PDLS06  276  1  $DLISFMT                              C LIS Indicator for Jun

                              76,459                      Unknown
                              58,137                    1 No premium subsidy
                                 152                    2 25% premium subsidy
                                 212                    3 50% premium subsidy
                                 225                    4 75% premium subsidy
                              21,361                    5 100% premium subsidy

H_PDRS06  277  1  $DRDSFMT                              C RDS Indicator for Jun

                              76,459                      Unknown
                              70,847                    N Employer not subsidized for the benefici
                               9,240                    Y Employer subsidized for the beneficiary

H_CRED06  278  1  $YES8FMT                              C Creditable Coverage for Jun

                              74,620                      Unknown
                              11,229                    1 Yes
                              70,697                    2 No

H_PDPY07  279  5                                        N Part D capitation payment for Jul

H_PDLS07  284  1  $DLISFMT                              C LIS Indicator for Jul

                              76,939                      Unknown
                              57,743                    1 No premium subsidy
                                 152                    2 25% premium subsidy
                                 211                    3 50% premium subsidy
                                 219                    4 75% premium subsidy
                              21,282                    5 100% premium subsidy

H_PDRS07  285  1  $DRDSFMT                              C RDS Indicator for Jul

                              76,939                      Unknown
                              70,458                    N Employer not subsidized for the benefici
                               9,149                    Y Employer subsidized for the beneficiary

H_CRED07  286  1  $YES8FMT                              C Creditable Coverage for Jul

                              74,620                      Unknown
                              11,231                    1 Yes
                              70,695                    2 No

H_PDPY08  287  5                                        N Part D capitation payment for Aug

H_PDLS08  292  1  $DLISFMT                              C LIS Indicator for Aug

                              77,469                      Unknown
                              57,279                    1 No premium subsidy
                                 152                    2 25% premium subsidy
                                 207                    3 50% premium subsidy
                                 218                    4 75% premium subsidy
                              21,221                    5 100% premium subsidy

H_PDRS08  293  1  $DRDSFMT                              C RDS Indicator for Aug

                              77,469                      Unknown
                              69,995                    N Employer not subsidized for the benefici
                               9,082                    Y Employer subsidized for the beneficiary

H_CRED08  294  1  $YES8FMT                              C Creditable Coverage for Aug

                              74,620                      Unknown
                              11,234                    1 Yes
                              70,692                    2 No

H_PDPY09  295  5                                        N Part D capitation payment for Sep

H_PDLS09  300  1  $DLISFMT                              C LIS Indicator for Sep

                              77,999                      Unknown
                              56,826                    1 No premium subsidy
                                 152                    2 25% premium subsidy
                                 209                    3 50% premium subsidy
                                 219                    4 75% premium subsidy
                              21,141                    5 100% premium subsidy

H_PDRS09  301  1  $DRDSFMT                              C RDS Indicator for Sep

                              77,999                      Unknown
                              69,528                    N Employer not subsidized for the benefici
                               9,019                    Y Employer subsidized for the beneficiary

H_CRED09  302  1  $YES8FMT                              C Creditable Coverage for Sep

                              74,620                      Unknown
                              11,235                    1 Yes
                              70,691                    2 No

H_PDPY10  303  5                                        N Part D capitation payment for Oct

H_PDLS10  308  1  $DLISFMT                              C LIS Indicator for Oct

                              78,437                      Unknown
                              56,416                    1 No premium subsidy
                                 153                    2 25% premium subsidy
                                 208                    3 50% premium subsidy
                                 219                    4 75% premium subsidy
                              21,113                    5 100% premium subsidy

H_PDRS10  309  1  $DRDSFMT                              C RDS Indicator for Oct

                              78,437                      Unknown
                              69,140                    N Employer not subsidized for the benefici
                               8,969                    Y Employer subsidized for the beneficiary

H_CRED10  310  1  $YES8FMT                              C Creditable Coverage for Oct

                              74,620                      Unknown
                              11,237                    1 Yes
                              70,689                    2 No

H_PDPY11  311  5                                        N Part D capitation payment for Nov

H_PDLS11  316  1  $DLISFMT                              C LIS Indicator for Nov

                              78,802                      Unknown
                              56,092                    1 No premium subsidy
                                 151                    2 25% premium subsidy
                                 208                    3 50% premium subsidy
                                 215                    4 75% premium subsidy
                              21,078                    5 100% premium subsidy

H_PDRS11  317  1  $DRDSFMT                              C RDS Indicator for Nov

                              78,802                      Unknown
                              68,808                    N Employer not subsidized for the benefici
                               8,936                    Y Employer subsidized for the beneficiary

H_CRED11  318  1  $YES8FMT                              C Creditable Coverage for Nov

                              74,620                      Unknown
                              11,240                    1 Yes
                              70,686                    2 No

H_PDPY12  319  5                                        N Part D capitation payment for Dec

H_PDLS12  324  1  $DLISFMT                              C LIS Indicator for Dec

                              79,240                      Unknown
                              55,722                    1 No premium subsidy
                                 151                    2 25% premium subsidy
                                 205                    3 50% premium subsidy
                                 215                    4 75% premium subsidy
                              21,013                    5 100% premium subsidy

H_PDRS12  325  1  $DRDSFMT                              C RDS Indicator for Dec

                              79,240                      Unknown
                              68,426                    N Employer not subsidized for the benefici
                               8,880                    Y Employer subsidized for the beneficiary

H_CRED12  326  1  $YES8FMT                              C Creditable Coverage for Dec

                              74,620                      Unknown
                              11,244                    1 Yes
                              70,682                    2 No

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

                             138,126                    N No participation
                              18,420                    Y Some participation

H_MCDE01  328  1  $MCDCFMT                              C Medicaid eligibility for Jan

                                   3                    A State Part A buy-in
                               6,048                    B State Part B buy-in
                                 250                    C State Part A and B buy-in
                                 867                    D State Part A and B QMB buy-in
                                   3                    E State Part A and B SLMB buy-in
                             139,194                    N No buy-in this month
                               8,096                    Q State Part B QMB buy-in
                               2,085                    S State Part B SLMB buy-in

H_MCDE02  329  1  $MCDCFMT                              C Medicaid eligibility for Feb

                                   3                    A State Part A buy-in
                               6,026                    B State Part B buy-in
                                 246                    C State Part A and B buy-in
                                 864                    D State Part A and B QMB buy-in
                                   3                    E State Part A and B SLMB buy-in
                             139,281                    N No buy-in this month
                               8,060                    Q State Part B QMB buy-in
                               2,063                    S State Part B SLMB buy-in

H_MCDE03  330  1  $MCDCFMT                              C Medicaid eligibility for Mar

                                   1                    A State Part A buy-in
                               6,003                    B State Part B buy-in
                                 245                    C State Part A and B buy-in
                                 855                    D State Part A and B QMB buy-in
                                   3                    E State Part A and B SLMB buy-in
                             139,322                    N No buy-in this month
                               8,044                    Q State Part B QMB buy-in
                               2,073                    S State Part B SLMB buy-in

H_MCDE04  331  1  $MCDCFMT                              C Medicaid eligibility for Apr

                                   1                    A State Part A buy-in
                               5,973                    B State Part B buy-in
                                 246                    C State Part A and B buy-in
                                 853                    D State Part A and B QMB buy-in
                                   3                    E State Part A and B SLMB buy-in
                             139,389                    N No buy-in this month
                               8,011                    Q State Part B QMB buy-in
                               2,070                    S State Part B SLMB buy-in

H_MCDE05  332  1  $MCDCFMT                              C Medicaid eligibility for May

                                   0                    A State Part A buy-in
                               5,937                    B State Part B buy-in
                                 243                    C State Part A and B buy-in
                                 846                    D State Part A and B QMB buy-in
                                   3                    E State Part A and B SLMB buy-in
                             139,479                    N No buy-in this month
                               7,984                    Q State Part B QMB buy-in
                               2,054                    S State Part B SLMB buy-in

H_MCDE06  333  1  $MCDCFMT                              C Medicaid eligibility for Jun

                                   1                    A State Part A buy-in
                               5,915                    B State Part B buy-in
                                 241                    C State Part A and B buy-in
                                 835                    D State Part A and B QMB buy-in
                                   3                    E State Part A and B SLMB buy-in
                             139,556                    N No buy-in this month
                               7,944                    Q State Part B QMB buy-in
                               2,051                    S State Part B SLMB buy-in

H_MCDE07  334  1  $MCDCFMT                              C Medicaid eligibility for Jul

                                   0                    A State Part A buy-in
                               5,903                    B State Part B buy-in
                                 246                    C State Part A and B buy-in
                                 829                    D State Part A and B QMB buy-in
                                   3                    E State Part A and B SLMB buy-in
                             139,599                    N No buy-in this month
                               7,923                    Q State Part B QMB buy-in
                               2,043                    S State Part B SLMB buy-in

H_MCDE08  335  1  $MCDCFMT                              C Medicaid eligibility for Aug

                                   1                    A State Part A buy-in
                               5,872                    B State Part B buy-in
                                 244                    C State Part A and B buy-in
                                 826                    D State Part A and B QMB buy-in
                                   3                    E State Part A and B SLMB buy-in
                             139,656                    N No buy-in this month
                               7,911                    Q State Part B QMB buy-in
                               2,033                    S State Part B SLMB buy-in

H_MCDE09  336  1  $MCDCFMT                              C Medicaid eligibility for Sep

                                   0                    A State Part A buy-in
                               5,853                    B State Part B buy-in
                                 242                    C State Part A and B buy-in
                                 820                    D State Part A and B QMB buy-in
                                   3                    E State Part A and B SLMB buy-in
                             139,693                    N No buy-in this month
                               7,894                    Q State Part B QMB buy-in
                               2,041                    S State Part B SLMB buy-in

H_MCDE10  337  1  $MCDCFMT                              C Medicaid eligibility for Oct

                                   1                    A State Part A buy-in
                               5,836                    B State Part B buy-in
                                 239                    C State Part A and B buy-in
                                 816                    D State Part A and B QMB buy-in
                                   3                    E State Part A and B SLMB buy-in
                             139,729                    N No buy-in this month
                               7,875                    Q State Part B QMB buy-in
                               2,047                    S State Part B SLMB buy-in

H_MCDE11  338  1  $MCDCFMT                              C Medicaid eligibility for Nov

                                   0                    A State Part A buy-in
                               5,813                    B State Part B buy-in
                                 238                    C State Part A and B buy-in
                                 815                    D State Part A and B QMB buy-in
                                   3                    E State Part A and B SLMB buy-in
                             139,805                    N No buy-in this month
                               7,832                    Q State Part B QMB buy-in
                               2,040                    S State Part B SLMB buy-in

H_MCDE12  339  1  $MCDCFMT                              C Medicaid eligibility for Dec

                                   2                    A State Part A buy-in
                               5,712                    B State Part B buy-in
                                 233                    C State Part A and B buy-in
                                 808                    D State Part A and B QMB buy-in
                                   3                    E State Part A and B SLMB buy-in
                             140,055                    N No buy-in this month
                               7,729                    Q State Part B QMB buy-in
                               2,004                    S State Part B SLMB buy-in

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

                             139,194                    N Unknown, or no buy-in
                              17,352              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                             139,281                    N Unknown, or no buy-in
                              17,265              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                             139,322                    N Unknown, or no buy-in
                              17,224              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                             139,389                    N Unknown, or no buy-in
                              17,157              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                             139,479                    N Unknown, or no buy-in
                              17,067              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                             139,556                    N Unknown, or no buy-in
                              16,990              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                             139,599                    N Unknown, or no buy-in
                              16,947              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                             139,656                    N Unknown, or no buy-in
                              16,890              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                             139,693                    N Unknown, or no buy-in
                              16,853              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                             139,729                    N Unknown, or no buy-in
                              16,817              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                             139,805                    N Unknown, or no buy-in
                              16,741              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                             140,055                    N Unknown, or no buy-in
                              16,491              S00-S99 State Agency code
                                   0              000-999 State Agency code

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

                             153,173                    0 No utilization this type
                               3,373                    1 Some utilization this type

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

                             142,729                    0 No utilization this type
                              13,817                    1 Some utilization this type

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

                             151,330                    0 No utilization this type
                               5,216                    1 Some utilization this type

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

                             148,734                    0 No utilization this type
                               7,812                    1 Some utilization this type

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

                             114,156                    0 No utilization this type
                              42,390                    1 Some utilization this type

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

                              98,707                    0 No utilization this type
                              57,839                    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

                             142,729                      Missing
                              13,817                      Date as YYYYMMDD

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

                             142,729                      Unknown, or no discharge
                              13,817                      DRG

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

                             142,729                      Missing
                               6,101                   01 Discharged to home/self care
                                  42                   02 Discharged to other short-term hospital
                               3,233                   03 Discharged to skilled nursing facility
                                 265                   04 Discharged to intermediate care facility
                                  15                   05 Disch to another type of institution
                               2,196                   06 Discharged to home care of organized HMO
                                  83                   07 Left against medical advice/stopped care
                                   0                   08 Disch home under care of IV therapy prov
                                 816                   20 Expired (did not recover Christian Sci)
                                  15                   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)
                                   6                   43 Disch/Transferred to a Fed Hospital (10)
                                 286                   50 Hospice - home (eff. 96)
                                 414                   51 Hospice - medical facility (eff. 96)
                                 127                   61 Disch w/i facility to swing-bed SNF (99)
                                 100                   62 Disch inp rehab; inc distinct hosp (10)
                                  48                   63 Disch to long term care hospital (10)
                                  21                   64 Disch cert nursing; Mcaid, not Mcare(10)
                                  18                   65 Disch to psychiatric hosp or unit   (10)
                                  30                   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)
                                   1                      Other destination

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

                              74,876                      Beneficiary not found in duals data
                                  25                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              62,898                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 173                   00 Not enrolled in Medicare for the month
                               1,920                   01 QMB-only
                              10,013                   02 QMB & full Medicaid covrge, + Rx drugs
                               1,460                   03 SLMB-only
                                 599                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 800                   06 Qualifying individuals
                               3,511                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                 271                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_FEB  631  2  $DUALMON                              C Dual eligibity code for Feb

                              74,876                      Beneficiary not found in duals data
                                  25                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              62,186                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 586                   00 Not enrolled in Medicare for the month
                               1,981                   01 QMB-only
                              10,157                   02 QMB & full Medicaid covrge, + Rx drugs
                               1,466                   03 SLMB-only
                                 622                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 825                   06 Qualifying individuals
                               3,535                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                 287                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_MAR  633  2  $DUALMON                              C Dual eligibity code for Mar

                              74,876                      Beneficiary not found in duals data
                                  25                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              61,985                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                 995                   00 Not enrolled in Medicare for the month
                               1,994                   01 QMB-only
                              10,101                   02 QMB & full Medicaid covrge, + Rx drugs
                               1,468                   03 SLMB-only
                                 630                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 826                   06 Qualifying individuals
                               3,559                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  86                   09 Other dual eligible, no Medicaid covrage
                                   1                   99 Unknown

DUAL_APR  635  2  $DUALMON                              C Dual eligibity code for Apr

                              74,876                      Beneficiary not found in duals data
                                  25                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              61,687                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                               1,411                   00 Not enrolled in Medicare for the month
                               1,954                   01 QMB-only
                              10,032                   02 QMB & full Medicaid covrge, + Rx drugs
                               1,482                   03 SLMB-only
                                 626                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 825                   06 Qualifying individuals
                               3,546                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  82                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_MAY  637  2  $DUALMON                              C Dual eligibity code for May

                              74,876                      Beneficiary not found in duals data
                                  25                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              61,375                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                               1,818                   00 Not enrolled in Medicare for the month
                               1,933                   01 QMB-only
                               9,967                   02 QMB & full Medicaid covrge, + Rx drugs
                               1,458                   03 SLMB-only
                                 639                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 836                   06 Qualifying individuals
                               3,541                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  78                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_JUN  639  2  $DUALMON                              C Dual eligibity code for Jun

                              74,876                      Beneficiary not found in duals data
                                  25                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              61,102                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                               2,222                   00 Not enrolled in Medicare for the month
                               1,911                   01 QMB-only
                               9,928                   02 QMB & full Medicaid covrge, + Rx drugs
                               1,451                   03 SLMB-only
                                 644                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 816                   06 Qualifying individuals
                               3,492                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  79                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_JUL  641  2  $DUALMON                              C Dual eligibity code for Jul

                              74,876                      Beneficiary not found in duals data
                                  25                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              60,805                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                               2,612                   00 Not enrolled in Medicare for the month
                               1,910                   01 QMB-only
                               9,894                   02 QMB & full Medicaid covrge, + Rx drugs
                               1,444                   03 SLMB-only
                                 637                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 819                   06 Qualifying individuals
                               3,478                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  46                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_AUG  643  2  $DUALMON                              C Dual eligibity code for Aug

                              74,876                      Beneficiary not found in duals data
                                  25                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              60,363                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                               3,007                   00 Not enrolled in Medicare for the month
                               1,916                   01 QMB-only
                               9,886                   02 QMB & full Medicaid covrge, + Rx drugs
                               1,450                   03 SLMB-only
                                 664                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 809                   06 Qualifying individuals
                               3,474                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  76                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_SEP  645  2  $DUALMON                              C Dual eligibity code for Sep

                              74,876                      Beneficiary not found in duals data
                                  25                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              60,069                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                               3,384                   00 Not enrolled in Medicare for the month
                               1,911                   01 QMB-only
                               9,816                   02 QMB & full Medicaid covrge, + Rx drugs
                               1,444                   03 SLMB-only
                                 666                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 819                   06 Qualifying individuals
                               3,464                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  72                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_OCT  647  2  $DUALMON                              C Dual eligibity code for Oct

                              74,876                      Beneficiary not found in duals data
                                  25                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              59,796                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                               3,759                   00 Not enrolled in Medicare for the month
                               1,916                   01 QMB-only
                               9,754                   02 QMB & full Medicaid covrge, + Rx drugs
                               1,455                   03 SLMB-only
                                 671                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 801                   06 Qualifying individuals
                               3,462                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  31                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_NOV  649  2  $DUALMON                              C Dual eligibity code for Nov

                              74,876                      Beneficiary not found in duals data
                                  25                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              59,462                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                               4,163                   00 Not enrolled in Medicare for the month
                               1,932                   01 QMB-only
                               9,723                   02 QMB & full Medicaid covrge, + Rx drugs
                               1,453                   03 SLMB-only
                                 654                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 801                   06 Qualifying individuals
                               3,427                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  30                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_DEC  651  2  $DUALMON                              C Dual eligibity code for Dec

                              74,876                      Beneficiary not found in duals data
                                  25                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              59,152                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                               4,557                   00 Not enrolled in Medicare for the month
                               1,916                   01 QMB-only
                               9,679                   02 QMB & full Medicaid covrge, + Rx drugs
                               1,469                   03 SLMB-only
                                 664                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 789                   06 Qualifying individuals
                               3,390                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                  29                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

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

                              74,854                      Missing
                              15,437                    1 FULL-Bene elig. full Medicaid benefits
                              61,568                    2 NONDUAL-Bene not elig Medicaid benfits
                               2,581                    3 PARTIAL-Bene elig part Medicd- not QMB
                               2,106                    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

                              73,741                      Unknown
                              28,682                    N No
                              54,123                    Y Yes

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

                              73,741                      Unknown
                              28,809                    N No
                              53,996                    Y Yes

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

                              73,741                      Unknown
                              28,974                    N No
                              53,831                    Y Yes

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

                              73,741                      Unknown
                              29,265                    N No
                              53,540                    Y Yes

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

                              73,741                      Unknown
                              29,512                    N No
                              53,293                    Y Yes

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

                              73,741                      Unknown
                              29,474                    N No
                              53,331                    Y Yes

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

                              73,741                      Unknown
                              29,698                    N No
                              53,107                    Y Yes

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

                              73,741                      Unknown
                              29,992                    N No
                              52,813                    Y Yes

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

                              73,741                      Unknown
                              30,316                    N No
                              52,489                    Y Yes

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

                              73,741                      Unknown
                              30,577                    N No
                              52,228                    Y Yes

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

                              73,741                      Unknown
                              30,831                    N No
                              51,974                    Y Yes

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

                              73,741                      Unknown
                              31,126                    N No
                              51,679                    Y Yes

MAFLAG01  858  3  $MAFLAG                               C MA flag for January

                              75,025                      No Entitlement
                              59,453                  FFS Original Medicare/FFS
                              22,068                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG02  861  3  $MAFLAG                               C MA flag for February

                              75,436                      No Entitlement
                              59,119                  FFS Original Medicare/FFS
                              21,991                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG03  864  3  $MAFLAG                               C MA flag for March

                              75,845                      No Entitlement
                              58,788                  FFS Original Medicare/FFS
                              21,913                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG04  867  3  $MAFLAG                               C MA flag for April

                              76,262                      No Entitlement
                              58,435                  FFS Original Medicare/FFS
                              21,849                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG05  870  3  $MAFLAG                               C MA flag for May

                              76,669                      No Entitlement
                              58,074                  FFS Original Medicare/FFS
                              21,803                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG06  873  3  $MAFLAG                               C MA flag for June

                              77,075                      No Entitlement
                              57,743                  FFS Original Medicare/FFS
                              21,728                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG07  876  3  $MAFLAG                               C MA flag for July

                              77,462                      No Entitlement
                              57,410                  FFS Original Medicare/FFS
                              21,674                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG08  879  3  $MAFLAG                               C MA flag for August

                              77,857                      No Entitlement
                              57,087                  FFS Original Medicare/FFS
                              21,602                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG09  882  3  $MAFLAG                               C MA flag for September

                              78,234                      No Entitlement
                              56,774                  FFS Original Medicare/FFS
                              21,538                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG10  885  3  $MAFLAG                               C MA flag for October

                              78,609                      No Entitlement
                              56,491                  FFS Original Medicare/FFS
                              21,446                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG11  888  3  $MAFLAG                               C MA flag for November

                              79,013                      No Entitlement
                              56,188                  FFS Original Medicare/FFS
                              21,345                   MA MA/Other Medicare Capitated Paymnt Plans

MAFLAG12  891  3  $MAFLAG                               C MA flag for December

                              79,407                      No Entitlement
                              55,880                  FFS Original Medicare/FFS
                              21,259                   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

                              73,741                    . No additional codes/payers
                              79,641                    1 Medicare
                               1,621                    2 Employer/Large Group Health Plan
                               1,543                    3 Other Liability (Auto, WC, etc.)

PRPY2    1123  1  PRPY                                  N Primary Payer - 2nd code

                             156,313                    . No additional codes/payers
                                   0                    1 Medicare
                                  64                    2 Employer/Large Group Health Plan
                                 169                    3 Other Liability (Auto, WC, etc.)

PRPY3    1124  1  PRPY                                  N Primary Payer - 3rd code

                             156,498                    . No additional codes/payers
                                   0                    1 Medicare
                                  29                    2 Employer/Large Group Health Plan
                                  19                    3 Other Liability (Auto, WC, etc.)

