RIC         1  2  $RIC                                  C Record Identification Code

                              14,874                    A Administrative Data
                                   0                    H HMO Supplement
                                   0                    K Key Record
                                   0                    N Non-Respondent
                                   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                    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                    8 Interview Description

VERSION     3  1  $VERSION                              C Version Number

                              14,874                    1 Version 1
                                   0                    2 Version 2
                                   0                    3 Version 3
                                   0                    4 Version 4

BASEID      4  8  $BSIDFMT                              C Unique SP Identification Number

                              14,874             LOW-HIGH BASEID Count

H_DOB      12  8  $DTE8FMT                              C Date of birth

                              14,874                      Date as YYYYMMDD

H_DOD      20  8  $DTE8FMT                              C Date of death

                              14,753                      Missing
                                 121                      Date as YYYYMMDD

H_DODSRC   28  2  $SRCFMT                               C Source of date of death

                              14,753                      No date of death
                                   0                   01 From Medicare bill
                                   0                   03 Clerical entry
                                   0                   05 Bill and clerical entry
                                  62                   10 Proven Medicare Benefits record
                                  10                   11 Proven Medicare Benefits record & bills
                                  41                   20 Unproven Medicare Benefits record
                                   8                   21 Unproven Mcare Benefits record & bills
                                   0                   23 Unproven Mcare Benefits rec & clerical
                                   0                   25 Unproven Mcare Benefits rec, bill & cler

H_SEX      30  1  $SEXFMT                               C Sex code

                               6,713                    1 Male
                               8,161                    2 Female

H_RACE     31  1  $RACEFMT                              C Race code

                                  71                    0 Unknown
                              12,160                    1 White
                               1,736                    2 Black
                                 207                    3 Other
                                 206                    4 Asian
                                 412                    5 Hispanic
                                  82                    6 North American Native

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

                              14,874                      Age in years

D_STRAT    35  1  $AGEFMT                               C MCBS Sample age stratum

                               1,353                    1  0-44
                               1,326                    2 45-64
                               2,484                    3 65-69
                               2,519                    4 70-74
                               2,461                    5 75-79
                               2,360                    6 80-84
                               2,371                    7 85 +

H_ENT01    36  1  $ENTFMT                               C Medicare entitlement code for Jan

                                 630                    A Part A Medicare only
                                  68                    B Part B Medicare only
                              14,174                    C Parts A and B Medicare
                                   2                    N No Medicare entitlement

H_ENT02    37  1  $ENTFMT                               C Medicare entitlement code for Feb

                                 627                    A Part A Medicare only
                                  67                    B Part B Medicare only
                              14,178                    C Parts A and B Medicare
                                   2                    N No Medicare entitlement

H_ENT03    38  1  $ENTFMT                               C Medicare entitlement code for Mar

                                 621                    A Part A Medicare only
                                  66                    B Part B Medicare only
                              14,185                    C Parts A and B Medicare
                                   2                    N No Medicare entitlement

H_ENT04    39  1  $ENTFMT                               C Medicare entitlement code for Apr

                                 616                    A Part A Medicare only
                                  66                    B Part B Medicare only
                              14,190                    C Parts A and B Medicare
                                   2                    N No Medicare entitlement

H_ENT05    40  1  $ENTFMT                               C Medicare entitlement code for May

                                 612                    A Part A Medicare only
                                  66                    B Part B Medicare only
                              14,194                    C Parts A and B Medicare
                                   2                    N No Medicare entitlement

H_ENT06    41  1  $ENTFMT                               C Medicare entitlement code for Jun

                                 604                    A Part A Medicare only
                                  66                    B Part B Medicare only
                              14,202                    C Parts A and B Medicare
                                   2                    N No Medicare entitlement

H_ENT07    42  1  $ENTFMT                               C Medicare entitlement code for Jul

                                 566                    A Part A Medicare only
                                  64                    B Part B Medicare only
                              14,242                    C Parts A and B Medicare
                                   2                    N No Medicare entitlement

H_ENT08    43  1  $ENTFMT                               C Medicare entitlement code for Aug

                                 564                    A Part A Medicare only
                                  64                    B Part B Medicare only
                              14,244                    C Parts A and B Medicare
                                   2                    N No Medicare entitlement

H_ENT09    44  1  $ENTFMT                               C Medicare entitlement code for Sep

                                 556                    A Part A Medicare only
                                  64                    B Part B Medicare only
                              14,250                    C Parts A and B Medicare
                                   4                    N No Medicare entitlement

H_ENT10    45  1  $ENTFMT                               C Medicare entitlement code for Oct

                                 554                    A Part A Medicare only
                                  64                    B Part B Medicare only
                              14,243                    C Parts A and B Medicare
                                  13                    N No Medicare entitlement

H_ENT11    46  1  $ENTFMT                               C Medicare entitlement code for Nov

                                 544                    A Part A Medicare only
                                  65                    B Part B Medicare only
                              14,238                    C Parts A and B Medicare
                                  27                    N No Medicare entitlement

H_ENT12    47  1  $ENTFMT                               C Medicare entitlement code for Dec

                                 540                    A Part A Medicare only
                                  65                    B Part B Medicare only
                              14,206                    C Parts A and B Medicare
                                  63                    N No Medicare entitlement

H_DOE      48  8  $DTE8FMT                              C Medicare entitlement start date

                                   2                      Missing
                              14,872                      Date as YYYYMMDD

H_DOT      56  8  $DTE8FMT                              C Medicare entitlement end date

                              14,848                      Missing
                                  26                      Date as YYYYMMDD

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

                                  16                      Unknown
                              12,121                   10 Aged, no ESRD
                                  70                   11 Aged, ESRD
                               2,610                   20 Disabled, no ESRD
                                  51                   21 Disabled, ESRD
                                   6                   31 ESRD only

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

                                   2                      Unknown
                                   0                   AD Cur pay-adj for dual entitlement
                                   0                   AF Transfer to another PC or dio
                                   0                   A9 Cur pay-miscellaneous adjustment
                              14,178                    C Current payment status
                                   0                   DW Deferred-Workers' Compensation
                                   0                   D2 DEF-retirement test
                                   0                   D3 DEF-D2 for primary
                                   7                   D6 DEF-recover overpayment
                                   7                   D9 DEF-miscellaneous reason
                                   0                    J Advanced filing-current pay
                                   0                   L2 Advanced filing-worked inside U S
                                   0                   L3 Advanced filing-insured worked in U S
                                   0                    N Not in pay status
                                   0                   PB Delayed-benefit due but not paid
                                   0                    R Cur pay-Part B reinstated
                                   0                   RN Cur pay-Part B reinstated
                                   0                    S SUSP-deferred retirement
                                   8                   SD SUSP-other
                                   0                   SF SUSP-fails to meet residence requirment
                                  81                   SH SUSP-government pension
                                   1                   SJ SUSP-alien suspension
                                   0                   SP SUSP-public assistance
                                   0                   SW SUSP-Workers' Compensation
                                   0                   S0 SUSP-continuing disability investig
                                   0                   S2 SUSP-fails retirement test
                                   0                   S3 SUSP-primary account S2
                                  11                   S6 SUSP-check returned for address
                                  16                   S7 SUSP-vocational rehab refusal
                                   1                   S8 SUSP-payee not determined
                                  26                   S9 SUSP-miscellaneous reason
                                   0                   TA TERM-prior to entitlement
                                   0                   TJ TERM-prior to entlmt, not stop debit
                                   0                   TR TERM-claim withdrawn
                                   0                   T0 TERM-benefits paid by another agency
                                  93                   T1 TERM-death of beneficiary
                                   0                   T2 TERM-death of primary
                                   0                   T3 TERM-divorce, marriage, remarriage
                                   0                   T4 TERM-dependent child attained age 18
                                   0                   T5 TERM-entitled on another account
                                   0                   T6 TERM-child no longer student, disabled
                                   0                   T8 TERM-recovery from disability
                                   1                   T9 TERM-miscellaneous
                                 436                    U Active uninsured status (no SSA check)
                                   0                   XF Transfer to another PC or DIO
                                   0                   XR Terminated -
                                   3                   X1 TERM-death of insured
                                   0                   X5 TERM-entitled to another benefit
                                   3                   X7 TERM of uninsured
                                   0                   X9 TERM miscellaneous
                                   0                   ZZ Erroneous entitlement

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

                                 563                   01 Alabama
                                   0                   02 Alaska
                                 260                   03 Arizona
                                 138                   04 Arkansas
                               1,052                   05 California
                                 102                   06 Colorado
                                 224                   07 Connecticut
                                   0                   08 Delaware
                                  13                   09 Washington, DC
                               1,069                   10 Florida
                                 509                   11 Georgia
                                   0                   12 Hawaii
                                   1                   13 Idaho
                                 530                   14 Illinois
                                  45                   15 Indiana
                                 119                   16 Iowa
                                 156                   17 Kansas
                                 242                   18 Kentucky
                                 174                   19 Louisiana
                                   0                   20 Maine
                                 228                   21 Maryland
                                 261                   22 Massachusetts
                                 811                   23 Michigan
                                 302                   24 Minnesota
                                   1                   25 Mississippi
                                 378                   26 Missouri
                                   0                   27 Montana
                                 131                   28 Nebraska
                                 309                   29 Nevada
                                   2                   30 New Hampshire
                                 422                   31 New Jersey
                                 328                   32 New Mexico
                                 851                   33 New York
                                 765                   34 North Carolina
                                   0                   35 North Dakota
                                 787                   36 Ohio
                                 120                   37 Oklahoma
                                   0                   38 Oregon
                                 697                   39 Pennsylvania
                                 259                   40 Puerto Rico
                                   2                   41 Rhode Island
                                 141                   42 South Carolina
                                   0                   43 South Dakota
                                 402                   44 Tennessee
                                 973                   45 Texas
                                   1                   46 Utah
                                   0                   47 Vermont
                                   0                   48 Virgin Islands
                                 194                   49 Virginia
                                 547                   50 Washington
                                 172                   51 West Virginia
                                 471                   52 Wisconsin
                                 122                   53 Wyoming

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

                              14,874                      County code

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

                              14,874                      ZIP Code

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

                                   0                   ** Unknown
                                 489                   01 New England
                               1,970                   02 Middle Atlantic
                               2,644                   03 East North Central
                               1,086                   04 West North Central
                               3,091                   05 South Atlantic
                               1,208                   06 East South Central
                               1,405                   07 West South Central
                               1,123                   08 Mountain
                               1,599                   09 Pacific
                                 259                   10 Puerto Rico

H_METRO    80  1  $METFMT                               C Metro status

                               3,795                    N Non-metro area
                                   0                    U Unknown
                              11,079                    Y Metro area

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

                              14,205                      Missing
                                 669                      Date as YYYYMMDD

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

                              14,205                      Missing
                                 669                      Date as YYYYMMDD

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

                              14,622                      Missing
                                 252                      Date as YYYYMMDD

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

                              14,622                      Missing
                                 252                      Date as YYYYMMDD

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

                              14,698                      Missing
                                 176                      Date as YYYYMMDD

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

                              14,698                      Missing
                                 176                      Date as YYYYMMDD

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

                              14,737                      Missing
                                 137                      Date as YYYYMMDD

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

                              14,737                      Missing
                                 137                      Date as YYYYMMDD

H_ESRBEG  145  8  $DTE8FMT                              C Beginning date of ESRD period

                              14,675                      Missing
                                 199                      Date as YYYYMMDD

H_ESREND  153  8  $DTE8FMT                              C Ending date of ESRD period

                              14,800                      Missing
                                  74                      Date as YYYYMMDD

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

                              10,293                    0 No enrollment
                               4,581                    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

                              10,941                    1 No premium subsidy
                                  40                    2 25% premium subsidy
                                  48                    3 50% premium subsidy
                                  40                    4 75% premium subsidy
                               3,805                    5 100% premium subsidy

H_PDRS01  237  1  $DRDSFMT                              C RDS Indicator for Jan

                              13,927                    N Employer not subsidized for the benefici
                                 947                    Y Employer subsidized for the beneficiary

H_CRED01  238  1  $YES8FMT                              C Creditable Coverage For Jan

                               2,124                    1 Yes
                              12,750                    2 No

H_PDPY02  239  5                                        N Part D capitation payment for Feb

H_PDLS02  244  1  $DLISFMT                              C LIS Indicator for Feb

                              10,924                    1 No premium subsidy
                                  39                    2 25% premium subsidy
                                  47                    3 50% premium subsidy
                                  40                    4 75% premium subsidy
                               3,824                    5 100% premium subsidy

H_PDRS02  245  1  $DRDSFMT                              C RDS Indicator for Feb

                              13,931                    N Employer not subsidized for the benefici
                                 943                    Y Employer subsidized for the beneficiary

H_CRED02  246  1  $YES8FMT                              C Creditable Coverage For Feb

                               2,124                    1 Yes
                              12,750                    2 No

H_PDPY03  247  5                                        N Part D capitation payment for Mar

H_PDLS03  252  1  $DLISFMT                              C LIS Indicator for Mar

                              10,916                    1 No premium subsidy
                                  39                    2 25% premium subsidy
                                  45                    3 50% premium subsidy
                                  39                    4 75% premium subsidy
                               3,835                    5 100% premium subsidy

H_PDRS03  253  1  $DRDSFMT                              C RDS Indicator for Mar

                              13,935                    N Employer not subsidized for the benefici
                                 939                    Y Employer subsidized for the beneficiary

H_CRED03  254  1  $YES8FMT                              C Creditable Coverage For Mar

                               2,124                    1 Yes
                              12,750                    2 No

H_PDPY04  255  5                                        N Part D capitation payment for Apr

H_PDLS04  260  1  $DLISFMT                              C LIS Indicator for Apr

                              10,911                    1 No premium subsidy
                                  36                    2 25% premium subsidy
                                  41                    3 50% premium subsidy
                                  40                    4 75% premium subsidy
                               3,846                    5 100% premium subsidy

H_PDRS04  261  1  $DRDSFMT                              C RDS Indicator for Apr

                              13,939                    N Employer not subsidized for the benefici
                                 935                    Y Employer subsidized for the beneficiary

H_CRED04  262  1  $YES8FMT                              C Creditable Coverage For Apr

                               2,124                    1 Yes
                              12,750                    2 No

H_PDPY05  263  5                                        N Part D capitation payment for May

H_PDLS05  268  1  $DLISFMT                              C LIS Indicator for May

                              10,892                    1 No premium subsidy
                                  36                    2 25% premium subsidy
                                  41                    3 50% premium subsidy
                                  40                    4 75% premium subsidy
                               3,865                    5 100% premium subsidy

H_PDRS05  269  1  $DRDSFMT                              C RDS Indicator for May

                              13,941                    N Employer not subsidized for the benefici
                                 933                    Y Employer subsidized for the beneficiary

H_CRED05  270  1  $YES8FMT                              C Creditable Coverage For May

                               2,124                    1 Yes
                              12,750                    2 No

H_PDPY06  271  5                                        N Part D capitation payment for Jun

H_PDLS06  276  1  $DLISFMT                              C LIS Indicator for Jun

                              10,875                    1 No premium subsidy
                                  36                    2 25% premium subsidy
                                  41                    3 50% premium subsidy
                                  41                    4 75% premium subsidy
                               3,881                    5 100% premium subsidy

H_PDRS06  277  1  $DRDSFMT                              C RDS Indicator for Jun

                              13,938                    N Employer not subsidized for the benefici
                                 936                    Y Employer subsidized for the beneficiary

H_CRED06  278  1  $YES8FMT                              C Creditable Coverage For Jun

                               2,124                    1 Yes
                              12,750                    2 No

H_PDPY07  279  5                                        N Part D capitation payment for Jul

H_PDLS07  284  1  $DLISFMT                              C LIS Indicator for Jul

                              10,860                    1 No premium subsidy
                                  36                    2 25% premium subsidy
                                  41                    3 50% premium subsidy
                                  42                    4 75% premium subsidy
                               3,895                    5 100% premium subsidy

H_PDRS07  285  1  $DRDSFMT                              C RDS Indicator for Jul

                              13,940                    N Employer not subsidized for the benefici
                                 934                    Y Employer subsidized for the beneficiary

H_CRED07  286  1  $YES8FMT                              C Creditable Coverage For Jul

                               2,124                    1 Yes
                              12,750                    2 No

H_PDPY08  287  5                                        N Part D capitation payment for Aug

H_PDLS08  292  1  $DLISFMT                              C LIS Indicator for Aug

                              10,844                    1 No premium subsidy
                                  35                    2 25% premium subsidy
                                  42                    3 50% premium subsidy
                                  42                    4 75% premium subsidy
                               3,911                    5 100% premium subsidy

H_PDRS08  293  1  $DRDSFMT                              C RDS Indicator for Aug

                              13,938                    N Employer not subsidized for the benefici
                                 936                    Y Employer subsidized for the beneficiary

H_CRED08  294  1  $YES8FMT                              C Creditable Coverage For Aug

                               2,124                    1 Yes
                              12,750                    2 No

H_PDPY09  295  5                                        N Part D capitation payment for Sep

H_PDLS09  300  1  $DLISFMT                              C LIS Indicator for Sep

                                   1                      Unknown
                              10,823                    1 No premium subsidy
                                  35                    2 25% premium subsidy
                                  42                    3 50% premium subsidy
                                  42                    4 75% premium subsidy
                               3,931                    5 100% premium subsidy

H_PDRS09  301  1  $DRDSFMT                              C RDS Indicator for Sep

                                   1                      Unknown
                              13,938                    N Employer not subsidized for the benefici
                                 935                    Y Employer subsidized for the beneficiary

H_CRED09  302  1  $YES8FMT                              C Creditable Coverage For Sep

                               2,124                    1 Yes
                              12,750                    2 No

H_PDPY10  303  5                                        N Part D capitation payment for Oct

H_PDLS10  308  1  $DLISFMT                              C LIS Indicator for Oct

                                   5                      Unknown
                              10,798                    1 No premium subsidy
                                  35                    2 25% premium subsidy
                                  42                    3 50% premium subsidy
                                  42                    4 75% premium subsidy
                               3,952                    5 100% premium subsidy

H_PDRS10  309  1  $DRDSFMT                              C RDS Indicator for Oct

                                   5                      Unknown
                              13,936                    N Employer not subsidized for the benefici
                                 933                    Y Employer subsidized for the beneficiary

H_CRED10  310  1  $YES8FMT                              C Creditable Coverage For Oct

                               2,124                    1 Yes
                              12,750                    2 No

H_PDPY11  311  5                                        N Part D capitation payment for Nov

H_PDLS11  316  1  $DLISFMT                              C LIS Indicator for Nov

                                  20                      Unknown
                              10,778                    1 No premium subsidy
                                  35                    2 25% premium subsidy
                                  42                    3 50% premium subsidy
                                  42                    4 75% premium subsidy
                               3,957                    5 100% premium subsidy

H_PDRS11  317  1  $DRDSFMT                              C RDS Indicator for Nov

                                  20                      Unknown
                              13,921                    N Employer not subsidized for the benefici
                                 933                    Y Employer subsidized for the beneficiary

H_CRED11  318  1  $YES8FMT                              C Creditable Coverage For Nov

                               2,124                    1 Yes
                              12,750                    2 No

H_PDPY12  319  5                                        N Part D capitation payment for Dec

H_PDLS12  324  1  $DLISFMT                              C LIS Indicator for Dec

                                  47                      Unknown
                              10,746                    1 No premium subsidy
                                  35                    2 25% premium subsidy
                                  42                    3 50% premium subsidy
                                  42                    4 75% premium subsidy
                               3,962                    5 100% premium subsidy

H_PDRS12  325  1  $DRDSFMT                              C RDS Indicator for Dec

                                  47                      Unknown
                              13,895                    N Employer not subsidized for the benefici
                                 932                    Y Employer subsidized for the beneficiary

H_CRED12  326  1  $YES8FMT                              C Creditable Coverage For Dec

                               2,124                    1 Yes
                              12,750                    2 No

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

                              11,598                    N No participation
                               3,276                    Y Some participation

H_MCDE01  328  1  $MCDCFMT                              C Medicaid eligibility for Jan

                                   0                    A State Part A buy-in
                               1,169                    B State Part B buy-in
                                  63                    C State Part A and B buy-in
                                  98                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,782                    N No buy-in this month
                               1,385                    Q State Part B QMB buy-in
                                 377                    S State Part B SLMB buy-in

H_MCDE02  329  1  $MCDCFMT                              C Medicaid eligibility for Feb

                                   0                    A State Part A buy-in
                               1,173                    B State Part B buy-in
                                  63                    C State Part A and B buy-in
                                  98                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,775                    N No buy-in this month
                               1,387                    Q State Part B QMB buy-in
                                 378                    S State Part B SLMB buy-in

H_MCDE03  330  1  $MCDCFMT                              C Medicaid eligibility for Mar

                                   0                    A State Part A buy-in
                               1,182                    B State Part B buy-in
                                  62                    C State Part A and B buy-in
                                  99                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,766                    N No buy-in this month
                               1,388                    Q State Part B QMB buy-in
                                 377                    S State Part B SLMB buy-in

H_MCDE04  331  1  $MCDCFMT                              C Medicaid eligibility for Apr

                                   0                    A State Part A buy-in
                               1,181                    B State Part B buy-in
                                  62                    C State Part A and B buy-in
                                  99                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,759                    N No buy-in this month
                               1,397                    Q State Part B QMB buy-in
                                 376                    S State Part B SLMB buy-in

H_MCDE05  332  1  $MCDCFMT                              C Medicaid eligibility for May

                                   1                    A State Part A buy-in
                               1,185                    B State Part B buy-in
                                  62                    C State Part A and B buy-in
                                  98                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,755                    N No buy-in this month
                               1,394                    Q State Part B QMB buy-in
                                 379                    S State Part B SLMB buy-in

H_MCDE06  333  1  $MCDCFMT                              C Medicaid eligibility for Jun

                                   1                    A State Part A buy-in
                               1,184                    B State Part B buy-in
                                  62                    C State Part A and B buy-in
                                  98                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,752                    N No buy-in this month
                               1,398                    Q State Part B QMB buy-in
                                 379                    S State Part B SLMB buy-in

H_MCDE07  334  1  $MCDCFMT                              C Medicaid eligibility for Jul

                                   0                    A State Part A buy-in
                               1,185                    B State Part B buy-in
                                  65                    C State Part A and B buy-in
                                  98                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,737                    N No buy-in this month
                               1,407                    Q State Part B QMB buy-in
                                 382                    S State Part B SLMB buy-in

H_MCDE08  335  1  $MCDCFMT                              C Medicaid eligibility for Aug

                                   0                    A State Part A buy-in
                               1,187                    B State Part B buy-in
                                  65                    C State Part A and B buy-in
                                  98                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,732                    N No buy-in this month
                               1,407                    Q State Part B QMB buy-in
                                 385                    S State Part B SLMB buy-in

H_MCDE09  336  1  $MCDCFMT                              C Medicaid eligibility for Sep

                                   0                    A State Part A buy-in
                               1,190                    B State Part B buy-in
                                  65                    C State Part A and B buy-in
                                  99                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,731                    N No buy-in this month
                               1,403                    Q State Part B QMB buy-in
                                 386                    S State Part B SLMB buy-in

H_MCDE10  337  1  $MCDCFMT                              C Medicaid eligibility for Oct

                                   0                    A State Part A buy-in
                               1,200                    B State Part B buy-in
                                  64                    C State Part A and B buy-in
                                  99                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,715                    N No buy-in this month
                               1,408                    Q State Part B QMB buy-in
                                 388                    S State Part B SLMB buy-in

H_MCDE11  338  1  $MCDCFMT                              C Medicaid eligibility for Nov

                                   1                    A State Part A buy-in
                               1,207                    B State Part B buy-in
                                  63                    C State Part A and B buy-in
                                  98                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,706                    N No buy-in this month
                               1,411                    Q State Part B QMB buy-in
                                 388                    S State Part B SLMB buy-in

H_MCDE12  339  1  $MCDCFMT                              C Medicaid eligibility for Dec

                                   1                    A State Part A buy-in
                               1,187                    B State Part B buy-in
                                  63                    C State Part A and B buy-in
                                  97                    D State Part A and B QMB buy-in
                                   0                    E State Part A and B SLMB buy-in
                              11,763                    N No buy-in this month
                               1,383                    Q State Part B QMB buy-in
                                 380                    S State Part B SLMB buy-in

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

                              11,782                    N Unknown, or no buy-in
                               3,092                      State Agency code

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

                              11,775                    N Unknown, or no buy-in
                               3,099                      State Agency code

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

                              11,766                    N Unknown, or no buy-in
                               3,108                      State Agency code

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

                              11,759                    N Unknown, or no buy-in
                               3,115                      State Agency code

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

                              11,755                    N Unknown, or no buy-in
                               3,119                      State Agency code

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

                              11,752                    N Unknown, or no buy-in
                               3,122                      State Agency code

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

                              11,737                    N Unknown, or no buy-in
                               3,137                      State Agency code

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

                              11,732                    N Unknown, or no buy-in
                               3,142                      State Agency code

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

                              11,731                    N Unknown, or no buy-in
                               3,143                      State Agency code

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

                              11,715                    N Unknown, or no buy-in
                               3,159                      State Agency code

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

                              11,706                    N Unknown, or no buy-in
                               3,168                      State Agency code

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

                              11,763                    N Unknown, or no buy-in
                               3,111                      State Agency code

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

                              14,653                    0 No utilization this type
                                 221                    1 Some utilization this type

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

                              12,927                    0 No utilization this type
                               1,947                    1 Some utilization this type

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

                              14,229                    0 No utilization this type
                                 645                    1 Some utilization this type

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

                              13,730                    0 No utilization this type
                               1,144                    1 Some utilization this type

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

                               7,239                    0 No utilization this type
                               7,635                    1 Some utilization this type

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

                               4,473                    0 No utilization this type
                              10,401                    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

                              12,927                      Missing
                               1,947                      Date as YYYYMMDD

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

                              12,927                      Unknown, or no discharge
                               1,947                      DRG

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

                              12,927                      Missing
                               1,055                   01 Discharged to home/self care
                                   8                   02 Discharged to other short-term hospital
                                 389                   03 Discharged to skilled nursing facility
                                  22                   04 Discharged to intermediate care facility
                                   0                   05 Disch to another type of institution
                                 375                   06 Discharged to home care of organized HMO
                                   4                   07 Left against medical advice/stopped care
                                   0                   08 Disch home under care of IV therapy prov
                                  19                   20 Expired (did not recover Christian Sci)
                                   1                   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)
                                   0                   43 Disch/Transferred to a Fed Hospital (10)
                                  24                   50 Hospice - home (eff. 96)
                                  15                   51 Hospice - medical facility (eff. 96)
                                  13                   61 Disch w/i facility to swing-bed SNF (99)
                                  11                   62 Disch inp rehab; inc distinct hosp (10)
                                   4                   63 Disch to long term care hospital (10)
                                   5                   64 Disch cert nursing; Mcaid, not Mcare(10)
                                   0                   65 Disch to psychiatric hosp or unit   (10)
                                   2                   70 Disch to other institution, no code (10)
                                   0                   71 Disch to other facility for O/P svcs(99)
                                   0                   72 Disch to this facility for O/P svcs (99)

H_INPSTY  425  2                                        N No. of inpatient stays for CY

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

H_INPCHG  430  7                                        N Inpatient charges for CY ($)

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

H_INPRMB  444  7                                        N Inpatient reimbursement for CY ($)

H_INPCDY  451  2                                        N Inpatient coinsurance days used in CY

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

H_SNFSTY  458  2                                        N Total SNF stays in CY

H_SNFDAY  460  3                                        N Total SNF covered days in CY

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

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

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

H_SNFCDY  484  3                                        N Total SNF coinsurance days in CY

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

H_HHAVST  494  5                                        N Total HHA visits in CY

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

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

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

                 Notes: Prior to 2000 this was included in H_HHARMB.
                        First available in 2000

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

                 Notes: Prior to 2000 this was included in H_HHARMB.
                        First available in 2000

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_PHYCLM  561  4                                        N Total physician claims in CY

                 Notes: Prior to 2000 this was included in H_PMTCLM.
                        First available in 2000

H_PHYLIN  565  4                                        N Total physician line items in CY

                 Notes: Prior to 2000 this was included in H_PMTLIN.
                        First available in 2000

H_PHYSCH  569  7                                        N Total physician submitted charges ($)

                 Notes: Prior to 2000 this was included in H_PMTSCH.
                        First available in 2000

H_PHYACH  576  7                                        N Total physician allowed charges ($)

                 Notes: Prior to 2000 this was included in H_PMTACH.
                        First available in 2000

H_PHYRMB  583  7                                        N Total physician reimbursement ($)

                 Notes: Prior to 2000 this was included in H_PMTRMB.
                        First available in 2000

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 2000 this was included in H_PMTCLM.
                        First available in 2000

H_DMELIN  604  4                                        N Total DME supplier line items in CY

                 Notes: Prior to 2000 this was included in H_PMTLIN.
                        First available in 2000

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

                 Notes: Prior to 2000 this was included in H_PMTSCH.
                        First available in 2000

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

                 Notes: Prior to 2000 this was included in H_PMTACH.
                        First available in 2000

H_DMERMB  622  7                                        N Total DME supplier reimbursement ($)

                 Notes: Prior to 2000 this was included in H_PMTRMB.
                        First available in 2000

DUAL_JAN  629  2  $DUALMON                              C Dual eligibity code for Jan

                                   2                      Beneficiary not found in duals data
                                   0                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              11,584                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                   0                   00 Not enrolled in Medicare for the month
                                 391                   01 QMB-only
                               1,767                   02 QMB & full Medicaid covrge, + Rx drugs
                                 298                   03 SLMB-only
                                 110                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 150                   06 Qualifying individuals
                                 566                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                   6                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_FEB  631  2  $DUALMON                              C Dual eligibity code for Feb

                                   2                      Beneficiary not found in duals data
                                   0                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              11,573                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                   0                   00 Not enrolled in Medicare for the month
                                 397                   01 QMB-only
                               1,762                   02 QMB & full Medicaid covrge, + Rx drugs
                                 297                   03 SLMB-only
                                 107                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 148                   06 Qualifying individuals
                                 582                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                   6                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_MAR  633  2  $DUALMON                              C Dual eligibity code for Mar

                                   2                      Beneficiary not found in duals data
                                   0                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              11,566                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                   0                   00 Not enrolled in Medicare for the month
                                 404                   01 QMB-only
                               1,756                   02 QMB & full Medicaid covrge, + Rx drugs
                                 292                   03 SLMB-only
                                 103                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 151                   06 Qualifying individuals
                                 595                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                   5                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_APR  635  2  $DUALMON                              C Dual eligibity code for Apr

                                   2                      Beneficiary not found in duals data
                                   0                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              11,564                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                   0                   00 Not enrolled in Medicare for the month
                                 404                   01 QMB-only
                               1,762                   02 QMB & full Medicaid covrge, + Rx drugs
                                 301                   03 SLMB-only
                                 106                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 146                   06 Qualifying individuals
                                 583                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                   6                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_MAY  637  2  $DUALMON                              C Dual eligibity code for May

                                   2                      Beneficiary not found in duals data
                                   0                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              11,543                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                   0                   00 Not enrolled in Medicare for the month
                                 407                   01 QMB-only
                               1,769                   02 QMB & full Medicaid covrge, + Rx drugs
                                 304                   03 SLMB-only
                                 106                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 145                   06 Qualifying individuals
                                 592                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                   6                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_JUN  639  2  $DUALMON                              C Dual eligibity code for Jun

                                   2                      Beneficiary not found in duals data
                                   0                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              11,536                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                   0                   00 Not enrolled in Medicare for the month
                                 409                   01 QMB-only
                               1,773                   02 QMB & full Medicaid covrge, + Rx drugs
                                 301                   03 SLMB-only
                                 104                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 147                   06 Qualifying individuals
                                 597                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                   5                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_JUL  641  2  $DUALMON                              C Dual eligibity code for Jul

                                   2                      Beneficiary not found in duals data
                                   0                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              11,516                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                   0                   00 Not enrolled in Medicare for the month
                                 408                   01 QMB-only
                               1,783                   02 QMB & full Medicaid covrge, + Rx drugs
                                 304                   03 SLMB-only
                                 101                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 155                   06 Qualifying individuals
                                 599                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                   6                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_AUG  643  2  $DUALMON                              C Dual eligibity code for Aug

                                   2                      Beneficiary not found in duals data
                                   0                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              11,515                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                   0                   00 Not enrolled in Medicare for the month
                                 398                   01 QMB-only
                               1,785                   02 QMB & full Medicaid covrge, + Rx drugs
                                 306                   03 SLMB-only
                                 102                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 154                   06 Qualifying individuals
                                 606                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                   6                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_SEP  645  2  $DUALMON                              C Dual eligibity code for Sep

                                   2                      Beneficiary not found in duals data
                                   0                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              11,511                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                   2                   00 Not enrolled in Medicare for the month
                                 406                   01 QMB-only
                               1,783                   02 QMB & full Medicaid covrge, + Rx drugs
                                 304                   03 SLMB-only
                                 106                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 148                   06 Qualifying individuals
                                 605                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                   7                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_OCT  647  2  $DUALMON                              C Dual eligibity code for Oct

                                   2                      Beneficiary not found in duals data
                                   0                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              11,493                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                  11                   00 Not enrolled in Medicare for the month
                                 406                   01 QMB-only
                               1,792                   02 QMB & full Medicaid covrge, + Rx drugs
                                 299                   03 SLMB-only
                                 111                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 149                   06 Qualifying individuals
                                 604                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                   7                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_NOV  649  2  $DUALMON                              C Dual eligibity code for Nov

                                   2                      Beneficiary not found in duals data
                                   0                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              11,473                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                  25                   00 Not enrolled in Medicare for the month
                                 409                   01 QMB-only
                               1,781                   02 QMB & full Medicaid covrge, + Rx drugs
                                 303                   03 SLMB-only
                                 112                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 148                   06 Qualifying individuals
                                 614                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                   7                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

DUAL_DEC  651  2  $DUALMON                              C Dual eligibity code for Dec

                                   2                      Beneficiary not found in duals data
                                   0                   ** Bene enrold PtA &/or PtB, no PtD enrlmnt
                              11,457                   NA Non-Medicaid
                                   0                   XX Bene enrold PtA &/or PtB, no '06-'09 PtD
                                  60                   00 Not enrolled in Medicare for the month
                                 404                   01 QMB-only
                               1,765                   02 QMB & full Medicaid covrge, + Rx drugs
                                 297                   03 SLMB-only
                                 113                   04 SLMB & full Medicaid covrge, + Rx drugs
                                   0                   05 QDWI
                                 154                   06 Qualifying individuals
                                 616                   08 Othr dual(Not QMB,SLMB,QWDI,QI)Medicd+Rx
                                   6                   09 Other dual eligible, no Medicaid covrage
                                   0                   99 Unknown

OP_MDCD   653 10  $DUALFMT                              C Medicare-Medicaid dual eligibility indic

                               2,612                      FULL
                              11,336                      NONDUAL
                                 501                      PARTIAL
                                 425                      QMB

PTCPRM1   663  8                                        N Part C Premium for Jan

PTCPRM2   671  8                                        N Part C Premium for Feb

PTCPRM3   679  8                                        N Part C Premium for Mar

PTCPRM4   687  8                                        N Part C Premium for Apr

PTCPRM5   695  8                                        N Part C Premium for May

PTCPRM6   703  8                                        N Part C Premium for Jun

PTCPRM7   711  8                                        N Part C Premium for Jul

PTCPRM8   719  8                                        N Part C Premium for Aug

PTCPRM9   727  8                                        N Part C Premium for Sep

PTCPRM10  735  8                                        N Part C Premium for Oct

PTCPRM11  743  8                                        N Part C Premium for Nov

PTCPRM12  751  8                                        N Part C Premium for Dec

PTDPRM1   759  8                                        N Part D Premium for Jan

PTDPRM2   767  8                                        N Part D Premium for Feb

PTDPRM3   775  8                                        N Part D Premium for Mar

PTDPRM4   783  8                                        N Part D Premium for Apr

PTDPRM5   791  8                                        N Part D Premium for May

PTDPRM6   799  8                                        N Part D Premium for Jun

PTDPRM7   807  8                                        N Part D Premium for Jul

PTDPRM8   815  8                                        N Part D Premium for Aug

PTDPRM9   823  8                                        N Part D Premium for Sep

PTDPRM10  831  8                                        N Part D Premium for Oct

PTDPRM11  839  8                                        N Part D Premium for Nov

PTDPRM12  847  8                                        N Part D Premium for Dec

PARTD_01  855  1  $YNO8FMT                              C Part D plan flag for Jan

                               3,990                    N No
                              10,884                    Y Yes

PARTD_02  856  1  $YNO8FMT                              C Part D plan flag for Feb

                               3,974                    N No
                              10,900                    Y Yes

PARTD_03  857  1  $YNO8FMT                              C Part D plan flag for Mar

                               3,972                    N No
                              10,902                    Y Yes

PARTD_04  858  1  $YNO8FMT                              C Part D plan flag for Apr

                               3,951                    N No
                              10,923                    Y Yes

PARTD_05  859  1  $YNO8FMT                              C Part D plan flag for May

                               3,949                    N No
                              10,925                    Y Yes

PARTD_06  860  1  $YNO8FMT                              C Part D plan flag for Jun

                               3,936                    N No
                              10,938                    Y Yes

PARTD_07  861  1  $YNO8FMT                              C Part D plan flag for Jul

                               3,905                    N No
                              10,969                    Y Yes

PARTD_08  862  1  $YNO8FMT                              C Part D plan flag for Aug

                               3,889                    N No
                              10,985                    Y Yes

PARTD_09  863  1  $YNO8FMT                              C Part D plan flag for Sep

                               3,876                    N No
                              10,998                    Y Yes

PARTD_10  864  1  $YNO8FMT                              C Part D plan flag for Oct

                               3,869                    N No
                              11,005                    Y Yes

PARTD_11  865  1  $YNO8FMT                              C Part D plan flag for Nov

                               3,872                    N No
                              11,002                    Y Yes

PARTD_12  866  1  $YNO8FMT                              C Part D plan flag for Dec

                               3,899                    N No
                              10,975                    Y Yes

MAFLAG01  867  3  $MAFLAG                               C MA flag for January

                              10,508                  FFS Fee for Service
                               4,366                   MA Medicare Advantage

MAFLAG02  870  3  $MAFLAG                               C MA flag for February

                              10,501                  FFS Fee for Service
                               4,373                   MA Medicare Advantage

MAFLAG03  873  3  $MAFLAG                               C MA flag for March

                              10,491                  FFS Fee for Service
                               4,383                   MA Medicare Advantage

MAFLAG04  876  3  $MAFLAG                               C MA flag for April

                              10,505                  FFS Fee for Service
                               4,369                   MA Medicare Advantage

MAFLAG05  879  3  $MAFLAG                               C MA flag for May

                              10,489                  FFS Fee for Service
                               4,385                   MA Medicare Advantage

MAFLAG06  882  3  $MAFLAG                               C MA flag for June

                              10,470                  FFS Fee for Service
                               4,404                   MA Medicare Advantage

MAFLAG07  885  3  $MAFLAG                               C MA flag for July

                              10,444                  FFS Fee for Service
                               4,430                   MA Medicare Advantage

MAFLAG08  888  3  $MAFLAG                               C MA flag for August

                              10,436                  FFS Fee for Service
                               4,438                   MA Medicare Advantage

MAFLAG09  891  3  $MAFLAG                               C MA flag for September

                              10,417                  FFS Fee for Service
                               4,457                   MA Medicare Advantage

MAFLAG10  894  3  $MAFLAG                               C MA flag for October

                              10,413                  FFS Fee for Service
                               4,461                   MA Medicare Advantage

MAFLAG11  897  3  $MAFLAG                               C MA flag for November

                              10,410                  FFS Fee for Service
                               4,464                   MA Medicare Advantage

MAFLAG12  900  3  $MAFLAG                               C MA flag for December

                              10,409                  FFS Fee for Service
                               4,465                   MA Medicare Advantage

ACOFLAG   903  1  $ACOFMT                               C Accountable Care Org.(ACO)

                              13,429                    0 Not assigned to an ACO
                               1,445                    8 Shared Savings Program ACO

