Search Data Variables

Recipient indicator (MAX TOS 34)

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 35)

Recipient indicator (MAX TOS 36)

Recipient indicator (MAX TOS 37)

Recipient indicator (MAX TOS 38)

Recipient indicator (MAX TOS 39)

Recipient indicator (MAX TOS 51)

Recipient indicator (MAX TOS 52)

Recipient indicator (MAX TOS 53)

Recipient indicator (MAX TOS 54)

Recipient indicator (Unknown)

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

NOTE: IN MAX 2010, USER NOTE WAS UPDATED TO CLARIFY THAT IN MAX ALL NON-ENCOUNTER CLAIMS WITH MEDICAID PAYMENT AMOUNT LESS THAN OR EQUALTO ZERO ARE DELETED.

Were recommended physician (or physician-designee) actions regarding discrepancies for these medication classes carried out within 24 hours after the physician responded? Anticoagulants

Were recommended physician (or physician-designee) actions regarding discrepancies for these medication classes carried out within 24 hours after the physician responded? Antimicrobials (excluding topicals)

Were recommended physician (or physician-designee) actions regarding discrepancies for these medication classes carried out within 24 hours after the physician responded? Antipsychotics

Were recommended physician (or physician-designee) actions regarding discrepancies for these medication classes carried out within 24 hours after the physician responded? Opioids

Reconciled Rx list communicated to: none? (i1g_4)

Was the reconciled medication list (for all medications) communicated to any of the following? Check all that apply.

Reconciled Rx list communicated to: patient/caregiver? (i1g_1)

Was the reconciled medication list (for all medications) communicated to any of the following? Check all that apply. Patient/resident or patient’s/resident’s family/formal caregiver

Reconciled Rx list communicated to: pharmacy? (i1g_3)

Was the reconciled medication list (for all medications) communicated to any of the following? Check all that apply.

Reconciled Rx list communicated to: prescribers? (i1g_2)

Was the reconciled medication list (for all medications) communicated to any of the following? Check all that apply. Prescribers and the care team responsible for the patient’s/resident’s care following admission/ discharge/ SOC/ ROC

Record Reference Year

This field indicates the reference year of the enrollment data.

Record Type

This is a calculated field based on the combination of the AA8A PRIRFA and AA8B SPC RFA fields.

Reduction in patient liability due to payments by other payers (PLRO)

This is the amount of any payment by other third-party payers that reduces the beneficiary’s liability for the PDE but does not count towards Part D’s true out-of-pocket (TrOOP) requirement. Examples include payments by group health plans, worker's compensation, and governmental programs like the Veterans Administration and TRICARE.

Reference Year (Base)

This field indicates the reference year of the enrollment data.

Reference Year (MBSF)

This field indicates the reference year of the enrollment data.

Reference Year (MMLEADS)

This variable represents the year of the data file

Reference Year (TAF)

This variable represents the year of the data file

Reference Yr

This variable represents the year of the data file.

Referring Provider Identification Number

A unique identification number assigned to a provider which identifies the physician or other provider who referred the patient.

For physicians, this must be the individual’s ID number, not a group identification number.

Referring Provider NPI

The National Provider Identifier (NPI) assigned to a provider which identifies the physician or other provider who referred the patient.

Referring Provider Specialty Code

This code indicates the area of specialty of the referring provider.

Referring Provider Taxonomy Code

The taxonomy code for the provider who referred the beneficiary for treatment.

Referring Provider Type Code

A code describing the type of provider (i.e. doctor) who referred the patient.

Indicates whether the provider’s taxonomy value maps to the nursing service-related category; ever in the calendar year.

Relationship Code

This variable is the code that identifies whether the Contract and Plan ID that was active in the reference year was new, or related to a Contract and Plan ID in the previous year.

Relationship Description

This variable is the description of the relationship between the Part D Contract and Plan ID that was active in the reference year - an any associated Contract and Plan ID(s) in the previous year.

Remittance Number

The Remittance Advice Number is a sequential number that identifies the current Remittance Advice (RA) produced for a provider. The number is incremented by one each time a new RA is generated. The first five (5) positions are Julian date YYDDD format. The RA is the detailed explanation of the reason for the payment amount. The RA number is not the check number.

Rendering Physician NPI (Encounter)

This variable is the National Provider Identifier (NPI) for the physician who rendered the services on the record.

Rendering Physician NPI (FFS)

This variable is the National Provider Identifier (NPI) for the physician who rendered the services.

NPIs replaced UPINs as the standard provider identifiers beginning in 2007. The UPIN is almost never populated after 2009.

Rendering Physician Specialty Code

The code used to identify the CMS specilty code of the rendering physician/practitioner. (Revenue Center file)

Rendering Provider Secondary Specialty Code 1

CMS secondary specialty code(s) for the rendering (aka performing) provider on the non-institutional claim.

Applies to the PRF_PHYSN_NPI on the carrier line file. These rendering provider specialty codes are in addition to the Line CMS Provider Specialty Code (PRVDR_SPCLTY).

Rendering Provider Secondary Specialty Code 2

CMS secondary specialty code(s) for the rendering (aka performing) provider on the non-institutional claim.

Applies to the PRF_PHYSN_NPI on the carrier line file. These rendering provider specialty codes are in addition to the Line CMS Provider Specialty Code (PRVDR_SPCLTY).

Rendering Provider Secondary Specialty Code 3

CMS secondary specialty code(s) for the rendering (aka performing) provider on the non-institutional claim.

Applies to the PRF_PHYSN_NPI on the carrier line file. These rendering provider specialty codes are in addition to the Line CMS Provider Specialty Code (PRVDR_SPCLTY).

Rendering Provider Taxonomy Code

Rendering provider taxonomy code. Applies to the PRF_PHYSN_NPI on the carrier line file. A taxonomy code is a unique 10-character code that assigns a provider's classification and specialization. Providers use this code when applying for a National Provider Identifier (NPI).

Repetition of three words

Indicates patient's ability to repeat back three words given to them after first attempt.

Research Triangle Institute (RTI) Race Code

Beneficiary race code (modified using RTI algorithm). Enhanced race/ethnicity designation based on first and last name algorithms.

Resident Age

This column contains the system calculated resident age number.

Resident Change Timestamp

This is a timestamp indicating when the resident identifying information was changed. It is used to distinguish which version of the resident identifying information was in effect during a particular time period.