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THE BEGINNING DATE OF SERVICE FOR THIS CLAIM.
Indicates whether the provider’s taxonomy value maps to the behavioral health and social service provider category; ever in the calendar year.
Behavioral Signs & Symptoms Section Notes
The amount of money the beneficiary paid towards coinsurance
The date the beneficiary paid the coinsurance amount
The amount of money the beneficiary paid towards a copayment
The date the beneficiary paid the copayment amount
The 3-digit social security administration (SSA) standard county code of a beneficiary's residence.
This is the beneficiary's date of birth.
Beneficiary date of birth.
Beneficiary date of death.
The amount of money the beneficiary paid towards an annual deductible.
The date the beneficiary paid the deductible amount.
On an inpatient, SNF or Home Health claim, the date the beneficiary was discharged / transferred from the facility, or died.
The date the beneficiary ended its association with a specific APM Entity.
Beneficiary gender
A flag to indicate that there is a record in the Disability and Need supplemental file for this person that indicates one or more Home- and Community-Based Services (HCBS) conditions.
This variable indicates if the beneficiary was identified as being cognitively impaired at the time of the CMR offer or delivery.
Indicates whether the beneficiary was identified as residing in a long-term care facility when the CMR was offered or delivered
Indicates the beneficiary is enrolled in Medicaid pending citizenship verification; most recent in the calendar year.
Indicates the beneficiary is enrolled in Medicaid pending immigration verification; most recent in the calendar year.
A flag to indicate that there is a record in the Disability and Needs supplemental file for this person that includes data on lock-in status.
A flag to indicate that there is record in the Disability and Needs supplemental file for this person that includes Long-Term Services and Supports (LTSS) data.
The last date for which the beneficiary had Medicare coverage. This field is completed only where benefits were exhausted before the discharge date and during the period covered by stay.
The number of lifetime reserve days that the beneficiary has elected to use during the period covered by the institutional claim.
Under Medicare, each beneficiary has a one-time reserve of sixty additional days of inpatient hospital coverage that can be used after 90 days of inpatient care have been provided in a single benefit period.
This count is used to subtract from the total number of lifetime reserve days that a beneficiary has available.
This variable identifies how a beneficiary qualifies for Medicare benefits as of a particular date.
This variable indicates if the beneficiary met the specified targeting criteria for Medication Therapy Management (MTM) per CMS's Part D requirements.
Beneficiary monthly alignment status.
Beneficiary monthly alignment status.
Beneficiary monthly alignment status.
Beneficiary monthly alignment status.
Beneficiary monthly alignment status.
Beneficiary monthly alignment status.
Beneficiary monthly alignment status.
Beneficiary monthly alignment status.
Beneficiary monthly alignment status.
Beneficiary monthly alignment status.
Beneficiary monthly alignment status.
Beneficiary monthly alignment status.
Beneficiary monthly assignment status.
Beneficiary monthly alignment status.
Beneficiary monthly alignment status.
This variable indicates whether the plan reassignment occurred in January of the reference year.
This variable is populated only if the beneficiary was newly reassigned for their January plan, regardless if they opted out of the re-assignment. This flag resets yearly.
A flag to indicate that there is record in the Disability and Needs supplemental file for this person with monthly values of: HCBS chronic conditions, care level status for LongTerm Services and Supports (LTSS) program, disabilities (concentrating, walking, dressing/bathing, and errands), pregnancy, enrollment in Social Security Disability Insurance (SSDI), receipt of Supplemental Security Income (SSI), SSI State supplement status, SSI status, Birth to Conception status, receipt of Temporary Assistance for Needy Families (TANF) benefits, had some form of third party liability (TPL) insurance coverage and/or had some other form of third party liability (TPL) funding besides insurance coverage.
This variable is the date the beneficiary disenrolled in the Part D Plan, if applicable
This variable is the date the Part D plan sponsor received the election form from the beneficiary.
This variable is the date that Part D coverage began for the beneficiary.
This variable contain the enrollment type code, which is used to identify the source/mechanism of the Part D enrollment.
The race of the beneficiary.
Race code of the beneficiary