RIC         1  2  $RIC                                  C Record Identification Code

                                   0                    A Administrative Data
                                   0                   DU Dental Events
                                   0                   FA Facility Events
                                   0                    H HMO Supplement
                                   0                   IA Income and Assets
                                   0                   IP Inpatient Hospital Events
                                   0                   IU Institutional Events
                                   0                    K Key Record
                                   0                   KN Knowledge and Information Needs
                                   0                   MD MDS
                                   0                   MP Medical Provider Events
                                   0                    N Non-Respondent
                                   0                   OA OASIS
                                   0                   OP Outpatient Events
                                   0                   PA Patient Activation
                                   0                   PM Prescribed Medicine Events
                                   0                   PS Person Summary
                                   0                   RX Drug Coverage
                              99,441                   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

                              99,441                    1 Version 1
                                   0                    2 Version 2
                                   0                    3 Version 3
                                   0                    4 Version 4

BASEID      4  8  $BSIDFMT                              C Unique SP Identification Number

                              99,441             LOW-HIGH BASEID Count

EVNTTYPE   13  2  $EVN3TYP                              C Type of event

                              11,049                   DU Dental
                              11,049                   FA Facility
                              11,049                   HH Home health
                              11,049                   HP Hospice
                              11,049                   IP Inpatient
                              11,049                   IU Institutional utilization
                              11,049                   MP Medical provider
                              11,049                   OP Outpatient
                              11,049                   PM Prescribed medicine

AAMTTOT    15 10  MONYFMT                               N Adj. sum: total payments, all sources

                              99,441                      Amount as $$$$$$.CC

AAMTCARE   25 10  MONYFMT                               N Adj. sum: Medicare payments

                              99,441                      Amount as $$$$$$.CC

AAMTCAID   35 10  MONYFMT                               N Adj. sum: Medicaid payments

                              99,441                      Amount as $$$$$$.CC

AAMTHMOM   45 10  MONYFMT                               N Adj. sum: Medicare HMO payments

                              99,441                      Amount as $$$$$$.CC

AAMTHMOP   55 10  MONYFMT                               N Adj. sum: private HMO payments

                              99,441                      Amount as $$$$$$.CC

AAMTVA     65 10  MONYFMT                               N Adj. sum: VA payments

                              99,441                      Amount as $$$$$$.CC

AAMTPRVE   75 10  MONYFMT                               N Adj. sum: empl.-sponsored ins. payments

                              99,441                      Amount as $$$$$$.CC

AAMTPRVI   85 10  MONYFMT                               N Adj. sum: indiv-purch ins. payments

                              99,441                      Amount as $$$$$$.CC

AAMTPRVU   95 10  MONYFMT                               N Adj. sum: unknown priv ins. payments

                              99,441                      Amount as $$$$$$.CC

AAMTOOP   105 10  MONYFMT                               N Adj. sum: out-of-pocket payments

                              99,441                      Amount as $$$$$$.CC

AAMTDISC  115 10  MONYFMT                               N Adj. sum: uncollected liability

                              99,441                      Amount as $$$$$$.CC

AAMTOTH   125 10  MONYFMT                               N Adj. sum: other payments

                              99,441                      Amount as $$$$$$.CC

AEVENTS   135  4                                        N Adjusted count of events

SAMTTOT   139 10  MONYFMT                               N Unadj. sum: total payments, all sources

                              99,441                      Amount as $$$$$$.CC

SAMTCARE  149 10  MONYFMT                               N Unadj. sum: Medicare payments

                              99,441                      Amount as $$$$$$.CC

SAMTCAID  159 10  MONYFMT                               N Unadj. sum: Medicaid payments

                              99,441                      Amount as $$$$$$.CC

SAMTHMOM  169 10  MONYFMT                               N Unadj. sum: Medicare HMO payments

                              99,441                      Amount as $$$$$$.CC

SAMTHMOP  179 10  MONYFMT                               N Unadj. sum: private HMO payments

                              99,441                      Amount as $$$$$$.CC

SAMTVA    189 10  MONYFMT                               N Unadj. sum: VA payments

                              99,441                      Amount as $$$$$$.CC

SAMTPRVE  199 10  MONYFMT                               N Unadj. sum: empl.-sponsored ins payments

                              99,441                      Amount as $$$$$$.CC

SAMTPRVI  209 10  MONYFMT                               N Unadj. sum: indiv-purch ins. payments

                              99,441                      Amount as $$$$$$.CC

SAMTPRVU  219 10  MONYFMT                               N Unadj. sum: unknown priv ins. payments

                              99,441                      Amount as $$$$$$.CC

SAMTOOP   229 10  MONYFMT                               N Unadj. sum: out-of-pocket payments

                              99,441                      Amount as $$$$$$.CC

SAMTDISC  239 10  MONYFMT                               N Unadj. sum: uncollected liability

                              99,441                      Amount as $$$$$$.CC

SAMTOTH   249 10  MONYFMT                               N Unadj. sum: other payments

                              99,441                      Amount as $$$$$$.CC

SEVENTS   259  4                                        N Unadj. count of events

