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A flag to indicate whether the beneficiary is 5 years old or older and has serious difficulty walking or climbing stairs; ever in the calendar year.
A monthly flag to indicate whether the beneficiary is 5 years old or older and has serious difficulty walking or climbing stairs in the month. There are separate variables for each of the 12 months during the year.
A monthly flag to indicate whether the beneficiary is 5 years old or older and has serious difficulty walking or climbing stairs in the month. There are separate variables for each of the 12 months during the year.
A monthly flag to indicate whether the beneficiary is 5 years old or older and has serious difficulty walking or climbing stairs in the month. There are separate variables for each of the 12 months during the year.
A monthly flag to indicate whether the beneficiary is 5 years old or older and has serious difficulty walking or climbing stairs in the month. There are separate variables for each of the 12 months during the year.
A monthly flag to indicate whether the beneficiary is 5 years old or older and has serious difficulty walking or climbing stairs in the month. There are separate variables for each of the 12 months during the year.
A monthly flag to indicate whether the beneficiary is 5 years old or older and has serious difficulty walking or climbing stairs in the month. There are separate variables for each of the 12 months during the year.
A monthly flag to indicate whether the beneficiary is 5 years old or older and has serious difficulty walking or climbing stairs in the month. There are separate variables for each of the 12 months during the year.
A monthly flag to indicate whether the beneficiary is 5 years old or older and has serious difficulty walking or climbing stairs in the month. There are separate variables for each of the 12 months during the year.
A monthly flag to indicate whether the beneficiary is 5 years old or older and has serious difficulty walking or climbing stairs in the month. There are separate variables for each of the 12 months during the year.
A flag to indicate whether the beneficiary has another disability that is not included here; ever in the calendar year.
The date on which the recipient was discharged from a hospital or long-term care facility.
The time of discharge from a hospital or long-term care/psychiatric facility.
Were the patient’s/resident’s discrepancies regarding these medication classes addressed by involving the patient/resident or patient’s/resident’s family/formal caregiver? Anticoagulants
Were the patient’s/resident’s discrepancies regarding these medication classes addressed by involving the patient/resident or patient’s/resident’s family/formal caregiver? Antimicrobials (excluding topicals)
Were the patient’s/resident’s discrepancies regarding these medication classes addressed by involving the patient/resident or patient’s/resident’s family/formal caregiver? Antiplatelets (excluding 81 mg aspirin)
Were the patient’s/resident’s discrepancies regarding these medication classes addressed by involving the patient/resident or patient’s/resident’s family/formal caregiver? Opioids
Were the patient’s/resident’s discrepancies regarding these medication classes addressed by involving the patient/resident or patient’s/resident’s family/formal caregiver? Antipsychotics
Were the patient’s/resident’s discrepancies regarding these medication classes addressed by involving the patient/resident or patient’s/resident’s family/formal caregiver? Hypoglycemics (including insulin)
Were discrepancies regarding these medication classes communicated to the physician (or physician-designee) within 24 hours of admission/discharge/SOC/ROC? Anticoagulants
Were discrepancies regarding these medication classes communicated to the physician (or physician-designee) within 24 hours of admission/discharge/SOC/ROC? Antimicrobials (excluding topicals)
Were discrepancies regarding these medication classes communicated to the physician (or physician-designee) within 24 hours of admission/discharge/SOC/ROC? Antiplatelets (excluding 81 mg aspirin)
Were discrepancies regarding these medication classes communicated to the physician (or physician-designee) within 24 hours of admission/discharge/SOC/ROC? Antipsychotics
Were discrepancies regarding these medication classes communicated to the physician (or physician-designee) within 24 hours of admission/discharge/SOC/ROC? Hypoglycemics (including insulin)
Were discrepancies regarding these medication classes communicated to the physician (or physician-designee) within 24 hours of admission/discharge/SOC/ROC? Opioids
Were there discrepancies involving medications in these medication classes? Anticoagulants
Were there discrepancies involving medications in these medication classes? Antimicrobials (excluding topicals)
Were there discrepancies involving medications in these medication classes? Antiplatelets (excluding 81 mg aspirin)
Were there discrepancies involving medications in these medication classes? Antipsychotics
Were there discrepancies involving medications in these medication classes? Hypoglycemics (including insulin)
Were there discrepancies involving medications in these medication classes? Opioids
Number of months the beneficiary was enrolled in a Disease Management Prepaid Ambulatory Health Plan (PAHP) in the calendar year.
SOURCE: T-MSIS Annual Demographic and Eligibility TAF
This field indicates the prescriber's instruction regarding substitution of generic equivalents or order to dispense the specific prescribed medication.
Part D plans generally require pharmacies to use generics or the least expensive version of the prescribed drug.
However, there are times when a prescriber intends for the beneficiary to receive the drug exactly as it is written on the prescription (e.g., to get the brand-name version of a drug). When there are specific instructions from the prescriber, it is indicated in this variable with a value of 1 or greater.
Source: PDE
The charge to cover the cost of dispensing the prescription. Dispensing costs include overhead, supplies, and labor, etc. to fill the prescription.
The state-specific provider ID of the provider who actually dispensed the prescription medication
The National Provider ID (NPI) of the provider responsible for dispensing the prescription drug
This field indicates how the pharmacy dispensed the complete quantity of the prescription. When the pharmacy partially fills a prescription, this field indicates a partial fill.
When the full quantity is dispensed at one time, this field is blank.
Disposition at discharge (numeric)
This variable is an indicator as to whether or not the pharmacy offers some level of durable medical equipment (DME).
The National Provider Identifier (NPI) assigned to the supplier of the Part B service/DMEPOS line item.
NPIs replaced UPINs as the standard provider identifiers beginning in 2007. The UPIN is almost never populated after 2009.
The count of the total units associated with services needing unit reporting such as number of supplies, volume of oxygen or nutritional units.
This is a line item field on the DMERC claim and is used for both allowed and denied services.
Code indicating the units associated with services needing unit reporting on the line item for the DMERC service.
The 2-digit SSA state code where the durable medical equipment (DME) supplier was located; used by the Medicare Administrative Contractor (MAC) for pricing the service.
The 2-digit SSA state code where the durable medical equipment (DME) supplier was located; used by the Medicare Administrative Contractor (MAC) for pricing the service.
The amount of savings attributable to the coverage screen for this DMERC line item.
The billing number assigned to the supplier of the Part B service/DMEPOS by the National Supplier Clearinghouse, as reported on the line item for the DMERC claim.
The type of DMERC supplier.
DNC-Pain and Distress Section Notes (non-communicative)
Indicates whether the patient would like an interpreter to communicate with a doctor or health care staff?
Does the patient/resident have a designated Health Care Agent as authorized under state law to make healthcare decisions in the event that he/she is unable to make his or her own decisions AND there is legal documentation in the medical record?