Search Data Variables

Reason for Change in Eligibility Status — October

The reason for a change in an individual’s eligibility status; most recent in the calendar year. This variable is reported when there is a change in the individual’s eligibility status. There are separate variables for each of the 12 months during the year.

Reason for Change in Eligibility Status — September

Reason for entitlement to Medicare benefits as of CLM_THRU_DT

This variable indicates how a beneficiary qualifies for Medicare, as of the claim through date.

Reason for Service Code

Explains whether the pharmacist filled the prescription, filled part of the prescription, etc.

This is the value reported in the Reason for Service Code field of the NCPDP claim form.

Reason for Visit Diagnosis Code 1 (Encounter)

The 1st diagnosis code used to identify the patient's reason for the Home Health (HH) encounter record or Hospital Outpatient visit.

Reason for Visit Diagnosis Code 2 (Encounter)

The 2nd diagnosis code used to identify the patient's reason for the Home Health (HH) encounter record.

Reason for Visit Diagnosis Code 3 (Encounter)

The 3rd diagnosis code used to identify the patient's reason for the Home Health (HH) encounter record.

Reason for Visit Diagnosis Code I (FFS)

The 1st diagnosis code used to identify the patient's reason for the Hospital Outpatient visit.

Reason for Visit Diagnosis Code I Diagnosis Version Code (ICD-9 or ICD-10)

Effective with Version 'J', the code used to indicate if the diagnosis code is ICD-9 or ICD-10.
NOTE: With 5010, the diagnosis and procedure codes have been expanded to accommodate ICD-10, even though ICD-10 is not scheduled for iomplementation until 10/2013.

Reason for Visit Diagnosis Code II (FFS)

The 2nd diagnosis code used to identify the patient's reason for the Hospital Outpatient visit.

Reason for Visit Diagnosis Code II Diagnosis Version Code (ICD-9 or ICD-10)

Reason for Visit Diagnosis Code III (FFS)

The 3rd diagnosis code used to identify the patient's reason for the Hospital Outpatient visit.

Reason for Visit Diagnosis Code III Diagnosis Version Code (ICD-9 or ICD-10)

Reason participant opted-out of MTM program

This variable indicates the reason the participant opted-out of the Medication Therapy Management (MTM) program, if applicable.

Reason why beneficiary met the targeting criteria

This variable indicates the reason why the beneficiary met the targeting criteria for Medication Therapy Management (MTM) per CMS's Part D requirements.

Rebate Eligible Code

An indicator to identify claim lines with a National Drug Code (NDC) that is eligible for the drug rebate program.

Recalculated Z0100A

The data in this column contains the calculated Medicare Part A HIPPS code.

Recalculated Z0100B

The data in this column contains the calculated Medicare Part A RUG version code.

Recalculated Z0100C

The data in this column is an output value that is produced by the grouper and indicates whether the short-stay logic was used to calculate the RUG.

Recalculated Z0150A

The data in this column contains the calculated Medicare non-therapy Part A HIPPS code.

Recalculated Z0150B

The data in this column contains the calculated Medicare non-therapy RUG version code.

Recalculated Z0200A

The data in this column contains the calculated state Medicaid RUG case mix group code.

Recalculated Z0200B

The data in this column contains the calculated state Medicaid RUG version code.

Recalculated Z0200C

Recalculated Z0250A

The data in this column contains the second calculated state Medicaid RUG case mix group code.

Recalculated Z0250B

The data in this column contains the second calculated state Medicaid RUG version code.

Recalls “bed?”

Recalls “blue?”

Recalls “sock?”

CODE INDICATING IF AND HOW THE ELIGIBLE RECEIVED A MEDICAID SERVICE DURING THE CALENDAR YEAR AND WHETHER THOSE SERVICES WERE RECEIVED UNDER A FEE-FOR-SERVICE OR PRE-PAID PLAN.

Recipient indicator (MAX TOS 01)

INDICATOR TO SHOW IF AND HOW THE ELIGIBLE RECEIVED A MEDICAID SERVICE (UNDER FEE-FOR-SERVICE) DURING THE CALENDAR YEAR, FOR THIS TYPE OF SERVICE. THIS DATA ELEMENT IS REPORTED FOR ALL TYPES OF SERVICE, EXCEPT TOS = 20, 21, 22, AND 23.

Recipient indicator (MAX TOS 02)

Recipient indicator (MAX TOS 04)

Recipient indicator (MAX TOS 05)

Recipient indicator (MAX TOS 07)

Recipient indicator (MAX TOS 08)

Recipient indicator (MAX TOS 09)

Recipient indicator (MAX TOS 10)

Recipient indicator (MAX TOS 11)

Recipient indicator (MAX TOS 12)

Recipient indicator (MAX TOS 13)

Recipient indicator (MAX TOS 15)

Recipient indicator (MAX TOS 16)