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Epilepsy - Combined Medicare & Medicaid Claims, First Ever Occurrence Date
Epilepsy - Medicaid Only Claims
Epilepsy - Medicaid Only Claims, Medicare Only Claims, First Ever Occurrence Date
Epilepsy - Medicare Only Claims
Epilepsy - Medicare Only Claims, First Ever Occurrence Date
Episode beginning date.
Episode ending date.
The code categorizing groups of BICs representing similar relationships between the beneficiary and primary wage earner.
ESCO name
ESCO number
CODE INDICATING IF THE ELIGIBLE HAS INDICATED AN ETHNICITY OF HISPANIC OR LATINO.
A code indicating that the beneficiary’s ethnicity is Hispanic, Latino/a, or Spanish; most recent in the calendar and the two prior years.
Indicates the patient's self reported ethnicity.
Indicates the patient's self reported ethnicity.
Indicates the patient's self reported ethnicity.
Indicates the patient's self reported ethnicity.
Indicates the patient's self reported ethnicity.
Indicates the patient's self reported ethnicity.
Indicates the patient's self reported ethnicity.
This variable is the sum of coinsurance and deductible payments for the part B evaluation and management (E&M) services for a given year. The total Beneficiary payments are calculated as the sum of LINE_COINSRNC_AMT + LINE_BENE_PTB_DDCTBL_AMT for the relevant lines.
E & M claims are a subset of the claims in the Part B Carrier and DME data files, and a subset of physician claims. The E & M claims are defined as those with a line BETOS code (BETOS_CD) where the first digit ='M' (but is not M1A or M1B – which are categorized as physician office care in this file – see PHYS_MDCR_PMT).
This variable is the count of events for the part B evaluation and management (E&M) services for a given year. An event is defined as each line item that contains the relevant service.
E & M claims are a subset of the claims in the Part B Carrier and DME data files, and a subset of physician claims. The E & M claims are defined as those with a line BETOS code (BETOS_CD) where the first digit = 'M' (but is not M1A or M1B – which are categorized as physician office care in this file – see PHYS_MDCR_PMT).
This variable is the total Medicare payments for the part B evaluation and management (E&M) services for a given year. E & M claims are a subset of the claims in the Part B Carrier and DME data files, and a subset of physician claims.
The E & M claims are defined as those with a line BETOS code (BETOS_CD) where the first digit ='M' (but is not M1A or M1B – which are categorized as physician office care in this file – see PHYS_MDCR_PMT). The total Medicare payments are calculated as the sum of LINE_NCH_PMT_AMT where the LINE_PRCSG_IND_CD was ('A','R', or 'S') - for all relevant lines.
This variable indicates the total amount paid for evaluation and management (E&M) services by a primary payer other than Medicare for a given year. E & M claims are a subset of the claims in the Part B Carrier and DME data files, and a subset of physician claims.
The E & M claims are defined as those with a line BETOS code (BETOS_CD) where the first digit ='M' (but is not M1A or M1B – which are categorized as physician office care in this file – see PHYS_MDCR_PMT). The total Primary Payer Payments are calculated as the sum of the LINE_BENE_PRMRY_PYR_PD_AMT.
Acute Onset Mental Status Change
Is there evidence of an acute change in mental status from the patient’s/resident’s baseline?
For Enhanced Alternative plans that have indicated coverage of excluded drugs as a supplemental benefit, this variable Indicates whether the Part D plan provides coverage on this tier in the Pre-ICL phase.
For Enhanced Alternative plans that have indicated coverage of excluded drugs as a supplemental benefit, this variable Indicates whether the Part D plan provides coverage on this tier in the gap phase.
This variable indicates that the service was provided as part of an expanded access (EA) approval.
A constructed variable indicating the beneficiary’s race and ethnicity; most recent in the calendar and the two prior years.
Expression of Ideas and Wants (consider both verbal and non-verbal expression and excluding language barriers)
EXTERNAL SOCIAL SECURITY NUMBER INFORMATION SOURCE.
NOTE: IN MAX 2005, THIS VARIABLE WAS ADDED TO THE FILE.
Indicates whether the provider’s taxonomy value maps to the eye and vision service provider category; ever in the calendar year.
Months of Coverage in a Medicaid Behavioral PHP
Annual Medicaid Basis of Eligibility - last enrolled month
Monthly Medicaid Basis of Eligibility (Source = 2nd position of uniform eligibility code). January through December.
Monthly Medicare Part A and/or B Entitlement Indicator. January through December.
Months of Coverage in a Medicaid Comprehensive Managed Care PHP
Current Reason for Medicare Entitlement
Months of Coverage in a Medicaid Dental PHP
Monthly State Reported Dual Eligibility Status Code: January through December
Months full dual coverage.
Months of Coverage in a Medicaid Long Term Care (LTC) PHP
Annual Medicaid Maintenance Assistance Status - last enrolled month
Monthly Medicaid Maintenance Assistance Status (Source=1st position of uniform eligibility code). January through December.
Monthly code indicating if Medicaid enrollee is covered by Medicare. January through December.
Annual Medicaid FFS Indicator
Monthly Medicaid fee-for-service (FFS) indicator. January through December. A hierarchy is used: If any of the 4 Eligible Pre-Paid Plan (PHP) Group codes for the month equals 01 (medical or comprehensive managed care plan), 05 (LTC managed care plan), 06 (PACE), 07 (PCCM), 02 (dental), 03 (behavioral), 04(prenatal), or 08 (other managed care - only if individual lived in AL, CA, FL, or W). If none of these PHP values applies, then individual is considered FFS for the month.
Months Medicaid only with a disability (coverage).
Annual Medicaid Managed Care (Prepaid Health Plan - PHP) Indicator
Monthly Medicaid Restricted Benefits Indicator. January through December.