cms-gov/www.cms.gov/files/document/py-2018-and-onwards-csv-sample-file-physician-owner/investor.csv

1	APPLICABLE_MANUFACTURER_OR_APPLICABLE_GPO_NAME	APPLICABLE_MANUFACTURER_OR_APPLICABLE_GPO_ID	CONSOLIDATED_REPORT_INDICATOR	RESUBMISSION_FILE_INDICATOR	OWNERSHIP_INVESTMENT_PHYSICIAN_S_FIRST_NAME	OWNERSHIP_INVESTMENT_PHYSICIAN_S_MIDDLE_NAME	OWNERSHIP_INVESTMENT_PHYSICIAN_S_LAST_NAME	OWNERSHIP_INVESTMENT_PHYSICIAN_S_NAME_SUFFIX	OWNERSHIP_INVESTMENT_PHYSICIAN_S_BUSINESS_STREET_ADDRESS_LINE_1	OWNERSHIP_INVESTMENT_PHYSICIAN_S_BUSINESS_STREET_ADDRESS_LINE_2	OWNERSHIP_INVESTMENT_PHYSICIAN_S_CITY	OWNERSHIP_INVESTMENT_PHYSICIAN_S_STATE	OWNERSHIP_INVESTMENT_PHYSICIAN_S_ZIP_CODE	OWNERSHIP_INVESTMENT_PHYSICIAN__S_COUNTRY	OWNERSHIP_INVESTMENT_PHYSICIAN__PROVINCE	OWNERSHIP_INVESTMENT_PHYSICIAN_S_POSTAL_CODE	OWNERSHIP_INVESTMENT_PHYSICIAN_S_EMAIL_ADDRESS	OWNERSHIP_INVESTMENT_PHYSICIAN_S_PRIMARY_TYPE	OWNERSHIP_INVESTMENT_PHYSICIAN_S_OR_TEACHING_HOSPITAL_NPI	OWNERSHIP_INVESTMENT_PHYSICIAN_S_SPECIALTY	OWNERSHIP_INVESTMENT_PHYSICIAN_S_LICENSE_STATE_AND_LICENSE_NUMBER_1	OWNERSHIP_INVESTMENT_PHYSICIAN_S_LICENSE_STATE_AND_LICENSE_NUMBER_2	OWNERSHIP_INVESTMENT_PHYSICIAN_S_LICENSE_STATE_AND_LICENSE_NUMBER_3	OWNERSHIP_INVESTMENT_PHYSICIAN_S_LICENSE_STATE_AND_LICENSE_NUMBER_4	OWNERSHIP_INVESTMENT_PHYSICIAN_S_LICENSE_STATE_AND_LICENSE_NUMBER_5	APPLICABLE_MANUFACTURER_OR_APPLICABLE_GPO_REPORTING_OWNERSHIP_NAME	APPLICABLE_MANUFACTURER_OR_APPLICABLE_GPOREPORTING_OWNERSHIP_REGISTRATION_ID	HOME_SYSTEM_PAYMENT_ID	RESUBMITTED_PAYMENT_RECORD_ID	PREVIOUSLY_DELETED_INDICATOR	PREVIOUSLY_DELETED_PAYMENT_RECORD_ID	INTEREST_HELD_BY_PHYSICIAN_OR_AN_IMMEDIATE_FAMILY_MEMBER	DOLLAR_AMOUNT_INVESTED	VALUE_OF_INTEREST	TERMS_OF_INTEREST
2	JKLMN Manufacturer	101110101	N	N	Jerry	M	Ellis	Jr	680 Main St		Baltimore	MD	28055	US			jerry.ellis@theGenralhospital.com	2	1213341213	207Q00000X	MD-6576523					AM 1	101110101	1212121314		N		1	6894.22	668.22	This is a test for verifying the terms and conditions