Search Data Variables

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

Indicates that the 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 stand alone prescription drug plan (PDP) or Medicare Advantage Prescription Drug (MA-PD) region name in which the plan benefit package provides coverage. Applies only to stand-alone PDP's and regional Medicare.

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

Name of state in which the plan benefit package (segment) provides coverage.

The charge amount (rounded to whole dollars) for semi-private room accommodations related to a beneficiary's stay.

The count of the number of semi-private room days used by the beneficiary for the stay.

This variable indicates whether a beneficiary met the condition criteria for sensory (blindness and visual) impairment as of the end of the calendar year.

This variable shows the date when the beneficiary first met the criteria for the sensory (blindness and visual) impairment indicator. The variable will be blank for beneficiaries that have never had the condition.

This variable indicates whether a beneficiary met the condition criteria for a sensory (deafness and hearing) impairment as of the end of the calendar year.

This variable shows the date when the beneficiary first met the criteria for a sensory (deafness and hearing) impairment.

The variable will be blank for beneficiaries that have never had the condition.

This code specifies whether the enrollee met the chronic condition algorithm criteria, considering both Medicare and Medicaid data, for having Sensory Blindness and Visual Impairment.

This code specifies whether the enrollee met the chronic condition algorithm criteria, considering only Medicaid data, for having Sensory Blindness and Visual Impairment. 

This code specifies whether the enrollee met the chronic condition algorithm criteria, considering only Medicare data, for having Sensory Blindness and Visual Impairment.

This variable identifies an individual line number on a claim.

This field represents the sequestration reduction amount (rounded to whole dollars).

Unit of billing that is used for billing services by the facility

Indicator denoting if this is a service location address type for the provider.

The CCW-derived service month indicates the month and year when the service was provided, based on the claim through date (CLM_THRU_DT).

This variable is the identification number for the pharmacy or physicians' office that dispensed the drug, as reported by the Part D sponsor on the PDE record submitted to CMS.

This variable indicates the type of pharmacy provider identifier that was used in the SRVC_PRVDR_ID field, as reported by the Part D sponsor on the PDE record submitted to CMS.  

On service tracking claims, the lump sum amount paid to the provider.

A code to categorize service tracking claims. A service tracking claim is used to report lump sum payments that cannot be attributed to a single enrollee.

A UNIQUE NUMBER TO IDENTIFY THE PROVIDER WHO TREATED THE RECIPIENT.

A state-assigned unique number to identify the provider who treated the recipient.

The National Provider Identifier (NPI) of the health care professional who delivers or completes a particular medical service or non-surgical procedure.

The taxonomy code for the provider who treated the recipient.

CODE INDICATING THE AREA OF SPECIALTY FOR THE SERVICING PROVIDER. THIS CODE APPLIES ONLY TO PHYSICIANS, OSTEOPATHS, DENTISTS AND OTHER LICENSED PRACTITIONERS.

This code indicates the area of specialty for the servicing provider.

The taxonomy code for the institution billing/caring for the beneficiary.

A code describing the type of provider (i.e. doctor or facility) responsible for treating a patient. This represents the attending physician if available.

Types of post-acute care facilities

This variable indicates the sex of the beneficiary.

The beneficiary’s biological sex; most recent in the calendar and the two prior years.

CODE INDICATING THE GENDER OF THE MEDICAID ELIGIBLE.

The sex of the beneficiary.

The code indicating whether the stay is a short stay, long stay, or skilled nursing facility (SNF).

Short-term Memory OK
Seems or appears to recall after 5 minutes

This variable indicates whether a beneficiary met the condition criteria for sickle cell disease as of the end of the calendar year.

This variable shows the date when the beneficiary first met the criteria for the sickle cell disease indicator. The variable will be blank for beneficiaries that have never had the condition.

This code specifies whether the enrollee met the chronic condition algorithm criteria, considering both Medicare and Medicaid data, for having  Sickle Cell Disease.

This code specifies whether the enrollee met the chronic condition algorithm criteria, considering only Medicare data, for having Sickle Cell Disease.

This code specifies whether the enrollee met the chronic condition algorithm criteria, considering only Medicaid data, for having Sickle Cell Disease.

Site ID

This variable is the sum of Medicare coinsurance and deductible payments in the skilled nursing facility (SNF) setting for the year. The total beneficiary payment is calculated as the sum of the beneficiary deductible amount and coinsurance amount (variables called NCH_BENE_IP_DDCTBL_AMT and NCH_BENE_PTA_COINSRNC_LBLTY_AM) for all SNF claims where the CLM_PMT_AMT >= 0.

This variable is the count of Medicare covered days in the skilled nursing facility (SNF) setting for the year. This variable equals the sum of the CLM_UTLZTN_DAY_CNT variables on the source claims.

This variable is the total Medicare payments in the skilled nursing facility (SNF) setting for a given year. 

The total Medicare payments for SNF are calculated as the sum of CLM_PMT_AMT for all SNF claims where the CLM_PMT_AMT >= 0.

This variable indicates the total amount paid for skilled nursing facility setting (SNF) stays by a primary payer other than Medicare. It is the sum of all the primary payer amounts (NCH_PRMRY_PYR_CLM_PD_AMT from each claim) in the SNF setting for the year.

This variable is the count of skilled nursing facility setting (SNF) stays (unique admissions, which may span more than one facility) for a given year. A SNF stay is defined as a set of one or more consecutive SNF claims where the beneficiary is only discharged on the most recent claim in the set.