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CODE INDICATING THAT THE ELIGIBLE IS COVERED BY MEDICARE (KNOWN AS DUAL OR MEDICARE ELIGIBILITY), ACCORDING TO MEDICAID (MSIS), MEDICARE (EDB) OR BOTH FOR THE RESPECTIVE MONTH.
CODE INDICATING THAT THE ELIGIBLE IS COVERED BY MEDICARE (KNOWN AS DUAL OR MEDICARE ELIGIBILITY), ACCORDING TO MEDICAID (MSIS), MEDICARE (EDB) OR BOTH FOR THE RESPECTIVE MONTH.
CODE INDICATING THAT THE ELIGIBLE IS COVERED BY MEDICARE (KNOWN AS DUAL OR MEDICARE ELIGIBILITY), ACCORDING TO MEDICAID (MSIS), MEDICARE (EDB) OR BOTH FOR THE RESPECTIVE MONTH.
CODE INDICATING THAT THE ELIGIBLE IS COVERED BY MEDICARE (KNOWN AS DUAL OR MEDICARE ELIGIBILITY), ACCORDING TO MEDICAID (MSIS), MEDICARE (EDB) OR BOTH FOR THE RESPECTIVE MONTH.
CODE INDICATING THAT THE ELIGIBLE IS COVERED BY MEDICARE (KNOWN AS DUAL OR MEDICARE ELIGIBILITY), ACCORDING TO MEDICAID (MSIS), MEDICARE (EDB) OR BOTH FOR THE RESPECTIVE MONTH.
CODE INDICATING THAT THE ELIGIBLE IS COVERED BY MEDICARE (KNOWN AS DUAL OR MEDICARE ELIGIBILITY), ACCORDING TO MEDICAID (MSIS), MEDICARE (EDB) OR BOTH FOR THE RESPECTIVE MONTH.
CODE INDICATING THAT THE ELIGIBLE IS COVERED BY MEDICARE (KNOWN AS DUAL OR MEDICARE ELIGIBILITY), ACCORDING TO MEDICAID (MSIS), MEDICARE (EDB) OR BOTH FOR THE RESPECTIVE MONTH.
CODE INDICATING THAT THE ELIGIBLE IS COVERED BY MEDICARE (KNOWN AS DUAL OR MEDICARE ELIGIBILITY), ACCORDING TO MEDICAID (MSIS), MEDICARE (EDB) OR BOTH FOR THE RESPECTIVE MONTH.
CODE INDICATING THAT THE ELIGIBLE IS COVERED BY MEDICARE (KNOWN AS DUAL OR MEDICARE ELIGIBILITY), ACCORDING TO MEDICAID (MSIS), MEDICARE (EDB) OR BOTH FOR THE RESPECTIVE MONTH.
NOTES: IN MAX 2005, THIS VARIABLE WAS ADDED TO THE FILE. IN MAX 2006, VALUES 50-59 WERE ADDED TO THE FILE.
NOTE: IN MAX 2006, VALUES 50-59 WERE ADDED TO THE FILE.
NOTE: IN MAX 2009, VALUES 10 AND 60 WERE ADDED TO THE FILE.
Data Variable Alert:
CMS has identified an error in the 2008 MAX Personal Summary file for North Carolina. Researchers who recieved the file prior to 9/13/13 will need to apply the correction to the data. Files received after 9/13/13 will have been corrected.
Two undocumented values were discovered for the monthly dual codes (EL_MDCR_DUAL_MO_x, where x = 1-12) in North Carolina's MAX 2008 Personal Summary (PS) file. The undocumented values were "5 " (5 space) and " " (space space). CMS researched the issue and determined that the correct values should be "50" and "00", respectively. The annual dual code (EL_MDCR_DUAL_ANN) and the validation tables (which use the annual dual code) are unaffected by the error.
CMS regrets any the inconvenience this may have caused for the user community. Researchers can fix the error themselves, by recoding "5 " (5 space) to "50" (5 zero) and recoding " " (space space) to "00" (zero zero).
CODE INDICATING THAT THE ELIGIBLE IS COVERED BY MEDICARE (KNOWN AS DUAL OR MEDICARE ELIGIBILITY), ACCORDING TO MEDICAID (MSIS), MEDICARE (EDB) OR BOTH FOR THE RESPECTIVE MONTH.
CODE INDICATING THAT THE ELIGIBLE IS COVERED BY MEDICARE (KNOWN AS DUAL OR MEDICARE ELIGIBILITY), ACCORDING TO MEDICAID (MSIS), MEDICARE (EDB) OR BOTH FOR THE RESPECTIVE MONTH.
Monthly Part A and/or Part B entitlement indicator.
Monthly Part A and/or Part B entitlement indicator (April).
Monthly Part A and/or Part B entitlement indicator (August).
Monthly Part A and/or Part B entitlement indicator (December).
Monthly Part A and/or Part B entitlement indicator (February).
Monthly Part A and/or Part B entitlement indicator (January).
Monthly Part A and/or Part B entitlement indicator (July).
Monthly Part A and/or Part B entitlement indicator (June).
Monthly Part A and/or Part B entitlement indicator (March).
Monthly Part A and/or Part B entitlement indicator (May).
Monthly Part A and/or Part B entitlement indicator (November).
Monthly Part A and/or Part B entitlement indicator (October).
Monthly Part A and/or Part B entitlement indicator (September).
This variable is the total Medicare payment amount from all Hospital Outpatient (HOP) claims for the beneficiary during the year. Note that only fee-for-service (FFS) claims are included.
This variable is the total Medicare payment amount from all Part A claims for the beneficiary during the year. Note that only fee-for-service (FFS) claims are included. The Part A claims include: Inpatient, skilled nursing facility (SNF), home health agency (HHA), and hospice.
This variable is the total Medicare payment amount from all Part B non-institutional claims for the beneficiary during the year. The Part B non-institutional claims include: Carrier and durable medical equipment (DME). Note that only fee-for-service (FFS) claims are included.
This variable is the total Medicare payment amount for all Medicare fee-for-service (FFS) claims and Part D events (PDEs) for the beneficiary during the year. Note that only fee-for-service (FFS) claims for services and PDEs are included.
This variable is the number of months during the year that the beneficiary was enrolled in Medicare — and not dually eligible for full Medicare-Medicaid benefits.
The amount paid by Medicare on this claim or adjustment.
This variable is the number of months during the year that the beneficiary had both Medicare Part A and Part B coverage.
This variable is the number of months during the year that the beneficiary had Medicare Part A coverage.
This variable is the number of months during the year that the beneficiary had Medicare Part B coverage.
This variable is the unique identification for a managed care organization (MCO) enabling the entity to provide coverage to eligible Medicare beneficiaries.
The variable is the plan benefit package (PBP) number for the beneficiary’s managed care plan. CMS assigns an identifier to each PBP within a contract that a plan sponsor has with CMS.
This field represents the minimum cost sharing tier in which the product was placed in the sponsor's formulary. This identifier is also a key that links a Part D plan's cost sharing tier record to a prescription drug event record via contract ID, plan ID, and tier ID.
This variable is valid from 2006-2009. Starting in 2010, it is included in the Formulary file.
This variable is the total Medicare payment amount for each month for all Medicare fee-for-service (FFS) claims, Part D events (PDEs), and Medicare Advantage capitated payments for the beneficiary.
This variable is the total Medicare payment amount for each month for all Medicare fee-for-service (FFS) claims, Part D events (PDEs), and Medicare Advantage capitated payments for the beneficiary.
This variable is the total Medicare payment amount for each month for all Medicare fee-for-service (FFS) claims, Part D events (PDEs), and Medicare Advantage capitated payments for the beneficiary.
This variable is the total Medicare payment amount for each month for all Medicare fee-for-service (FFS) claims, Part D events (PDEs), and Medicare Advantage capitated payments for the beneficiary.
This variable is the total Medicare payment amount for each month for all Medicare fee-for-service (FFS) claims, Part D events (PDEs), and Medicare Advantage capitated payments for the beneficiary.
This variable is the total Medicare payment amount for each month for all Medicare fee-for-service (FFS) claims, Part D events (PDEs), and Medicare Advantage capitated payments for the beneficiary.
This variable is the total Medicare payment amount for each month for all Medicare fee-for-service (FFS) claims, Part D events (PDEs), and Medicare Advantage capitated payments for the beneficiary.
This variable is the total Medicare payment amount for each month for all Medicare fee-for-service (FFS) claims, Part D events (PDEs), and Medicare Advantage capitated payments for the beneficiary.
This variable is the total Medicare payment amount for each month for all Medicare fee-for-service (FFS) claims, Part D events (PDEs), and Medicare Advantage capitated payments for the beneficiary.
This variable is the total Medicare payment amount for each month for all Medicare fee-for-service (FFS) claims, Part D events (PDEs), and Medicare Advantage capitated payments for the beneficiary.
This variable is the total Medicare payment amount for each month for all Medicare fee-for-service (FFS) claims, Part D events (PDEs), and Medicare Advantage capitated payments for the beneficiary.
This variable is the total prescription drug cost amount from all Medicare Part D Events (PDEs) for the beneficiary during the year.
This variable is the total Medicare payment amount for each month for all Medicare fee-for-service (FFS) claims, Part D events (PDEs), and Medicare Advantage capitated payments for the beneficiary.
This variable is the total Medicare payment amount for all Medicare fee-for-service (FFS) claims, Part D events (PDEs), and Medicare Advantage capitated payments for the beneficiary during the year.