Search Data Variables

This variable is the dollar amount of the monthly Part D low-income total premium subsidy (LIPS) for beneficiaries at the 50% subsidized level.

This variable is the dollar amount of the monthly Part D low-income total premium subsidy (LIPS) for beneficiaries at the 75% subsidized level.

This variable is the number of months in the reference year that the beneficiary was determined to be eligible for a Part D premium low-income subsidy (LIS).

This variable is the dollar amount of the Part D low-income subsidy (LIS) where the subsidy level is 100%.

This variable is the dollar amount of the Part D low-income subsidy (LIS) where the subsidy level is 25%.

This variable is the dollar amount of the Part D low-income subsidy (LIS) where the subsidy level is 50%.

This variable is the dollar amount of the Part D low-income subsidy (LIS) where the subsidy level is 75%.

This variable is the dollar amount that the Part D plan covered for all covered drugs for a given year. The variable is calculated as the sum of the plan payments for covered PDEs (CVRD_D_PLAN_PD_AMT) and the low income cost sharing subsidy amount (LICS_AMT) during the year.

Plan reported value indicating the Part D Model type applied to the PDE.

This variable is the type of organization sponsoring the Part D plan.

This variable Indicates that the beneficiary had one or more Part D enrollment transactions that span the reference year where the Enrollment Type Code indicates auto-assignment or re-assignment (Enrollment Type Code of A or H) regardless of whether they opted-out of the plan they were assigned to.

This variable is the unique plan benefit package (PBP) number for the Part D plan sponsor's contract. CMS assigns an identifier to each PBP within a contract that a Part D plan sponsor has with CMS. This field is a key that links of Part D sponsor's contract and plan identifiers.

This variable indicates whether or not the Part D plan pays for Over-the-Counter medications (OTCs) under its Utilization Management (UM) Program.

This variable is the dollar amount of Part D deductible charged by the plan.

This variable is the coinsurance percentage beneficiaries are charged by the plan for enhanced alternative plans that offer cost sharing during the deductible phase.

Year of Part D plan enrollment. The data files are partitioned into calendar year files.

This variable is the dollar amount of Part D Initial Coverage Limit (ICL) applied by the Part D plan. If no ICL is applied this field is blank.

Indicates whether the plan benefit package is a stand-alone Prescription Drug Plan (PDP) that offers a basic benefit with a premium below the regional benchmark or de minimis amount. A beneficiary with a full (100%) low-income premium subsidy would pay no premium for this plan.

This variable indicates whether the plan choice was in the current or previous year. For beneficiaries where the variable CHOOSER = “Y”, this variable indicates whether the beneficiary made their Part D plan self-selection in the current year or the previous year.

This variable indicates that the beneficiary had one or more Part D enrollment transactions that span the reference year where the Enrollment Type Code indicates that the beneficiary made the plan selection (Enrollment Type Code of B or L).

This variable describes the type of Part D payment reinsurance demonstration, for plan benefit packages that are offered as such.

This variable indicates if the beneficiary was enrolled in an employer-sponsored prescription drug plan that qualified for Part D’s retiree drug subsidy (RDS) for a given month (April).

This variable indicates if the beneficiary was enrolled in an employer-sponsored prescription drug plan that qualified for Part D’s retiree drug subsidy (RDS) for a given month (August).

This variable indicates if the beneficiary was enrolled in an employer-sponsored prescription drug plan that qualified for Part D’s retiree drug subsidy (RDS) for a given month (December).

This variable indicates if the beneficiary was enrolled in an employer-sponsored prescription drug plan that qualified for Part D’s retiree drug subsidy (RDS) for a given month (February).

This variable indicates if the beneficiary was enrolled in an employer-sponsored prescription drug plan that qualified for Part D’s retiree drug subsidy (RDS) for a given month (January).

This variable indicates if the beneficiary was enrolled in an employer-sponsored prescription drug plan that qualified for Part D’s retiree drug subsidy (RDS) for a given month (July).

This variable indicates if the beneficiary was enrolled in an employer-sponsored prescription drug plan that qualified for Part D’s retiree drug subsidy (RDS) for a given month (June).

This variable indicates if the beneficiary was enrolled in an employer-sponsored prescription drug plan that qualified for Part D’s retiree drug subsidy (RDS) for a given month (March).

This variable indicates if the beneficiary was enrolled in an employer-sponsored prescription drug plan that qualified for Part D’s retiree drug subsidy (RDS) for a given month (May).

This variable indicates if the beneficiary was enrolled in an employer-sponsored prescription drug plan that qualified for Part D’s retiree drug subsidy (RDS) for a given month (November).

This variable indicates if the beneficiary was enrolled in an employer-sponsored prescription drug plan that qualified for Part D’s retiree drug subsidy (RDS) for a given month (October).

This variable indicates if the beneficiary was enrolled in an employer-sponsored prescription drug plan that qualified for Part D’s retiree drug subsidy (RDS) for a given month (September).

Name of county in which the Part D plan benefit package (segment) provides coverage.

Indicates that the Part D plan benefit package (segment) covers only a portion of the county.

This variable is the stand alone prescription drug plan (PDP) or Medicare Advantage Prescription Drug Plan (MA-PD) region code in which the plan benefit package provides coverage. Applies only to stand-alone PDPs and regional Medicare Advantage Prescription Drug plans.

This variable is the standard 5-digit Social Security Administration  (SSA) state and county code in which the Part D plan benefit package (segment) provides coverage.

This variable describes the type of special needs Part D plan (SNP) for applicable plan benefit packages.

Part D prescribing events (PDE) consist of highly variable days supply of the medication. This derived variable creates a standard 30 days supply of a filled Part D prescription, and counts this as a “fill”. The Part D fill count does not indicate the number of different drugs the person is using, only the total months covered by a medication (e.g., if a patient is receiving a full year supply of a medication, whether this occurs in one transaction or 12 monthly transactions, the fill count = 12; if the patient is taking three such medications, the fill count=36).

This variable is the dollar amount of the Part D Premium Enhanced (supplemental) Rate. This amount is net of any Part A/B rebates applied to "buy down" the drug premium for Medicare Advantage plans.

This variable is the dollar amount of the Part D Total Premium (basic + supplemental) Rate (Net of Rebates).

The Part D Total Premium is the sum of the Basic and Supplemental Premiums (variables called PLAN_BASIC_PREMIUM_NET_REBATE and PLAN_SUPP_PREMIUM_NET_REBATE). This amount is net of any Part A/B rebates applied to "buy down" the drug premium for Medicare Advantage plans; for some plans the total premium may be lower than the sum of the basic and supplemental premiums due to negative basic or supplemental premiums.

This variable is the gross drug cost (TOT_RX_CST_AMT) of all Part D drugs for a given year. This value includes the ingredient cost, dispensing fee, sales tax (if applicable), and vaccine administration fee (if any, 2010+ only).

Whether the patient has paired IRR assessment with a facility staff

This variable is the number of months during the year that the beneficiary was dually eligible for partial Medicare-Medicaid benefits

For Part D plans with some cost sharing in the gap (gap_tier = Yes), this variable indicates whether or not the the cost sharing applies to a partial list of drugs. If only a limited number of drugs on the tier are covered through the gap then the value will be 'Y'. If all drugs on the tier are covered through the gap then the value will be 'N'.

Indicates whether the OCM participant reported data on this episode to the OCM registry.

Participant-reported cancer type.