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Ischemic Heart Disease - Medicare Only Claims, First Ever Occurrence Date
This variable is the sum of coinsurance and deductible payments for imaging services (IMG) 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.
Claims for imaging procedures are a subset of the claims, and a subset of procedures in the Part B Carrier and DME data files. These imaging claims are defined as those with a line BETOS code (BETOS_CD) where the first digit = I (except for 'I1E', or 'I1F' – which are considered Part B drugs).
This variable is the count of events for imaging services (IMG) for a given year. An event is defined as each line item that contains the relevant service. Claims for imaging procedures are a subset of the claims, and a subset of procedures in the Part B Carrier and DME data files.
These imaging claims are defined as those with a line BETOS code (BETOS_CD) where the first digit =I (except for 'I1E', or 'I1F' – which are considered Part B drugs).
This variable is the total Medicare payments for imaging services (IMG) for a given year. Claims for imaging procedures are a subset of the claims, and a subset of procedures in the Part B Carrier and DME data files.
These imaging claims are defined as those with a line BETOS code (BETOS_CD) where the first digit =I (except for 'I1E', or 'I1F' – which are considered Part B drugs).
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 imaging services (IMG) by a primary payer other than Medicare for a given year. This variable is the total Medicare payments for imaging services (IMG) for a given year. Claims for imaging procedures are a subset of the claims, and a subset of procedures in the Part B Carrier and DME data files.
These imaging claims are defined as those with a line BETOS code (BETOS_CD) where the first digit =I (except for 'I1E', or 'I1F' – which are considered Part B drugs). The total Primary Payer Payments are calculated as the sum of the LINE_BENE_PRMRY_PYR_PD_AMT.
The immigration status of the beneficiary; most recent in the calendar year.
The date the five-year bar for a beneficiary ends; most recent in the calendar and the two prior years.
This variable is an indicator as to whether or not the pharmacy offers some level immunizations on-site.
This field identifies the type of immunization provided in order to track additional detail not currently contained in CPT codes.
A code indicating the family income level; most recent in the calendar and the two prior years.
For Enhanced Alternative plans that cover excluded drugs as a supplemental benefit, this variable Indicates whether the Part D plan provides coverage on this tier during the coverage gap phase.
For Enhanced Alternative plans that cover excluded drugs as a supplemental benefit, this variable Indicates whether the Part D plan provides coverage on this tier during the Pre-initial coverage limit (ICL) phase.
This variable indicates whether any excluded drugs are part of the Part D plan's supplemental coverage (e.g., benzodiazepines, barbiturates).
Indicates whether the plan benefit package is a stand-alone Prescription Drug Plan (PDP) that offers a basic benefit with a premium below the regional benchmark or de minimis amount. A beneficiary with a full (100%) low-income premium subsidy (LIPS) would pay no premium for this plan.
This variable indicates whether the Part D plan offers a free first fill (i.e. $0 copayment) to the beneficiary for any drugs.
This variable indicates whether the plan offers reduced cost sharing in the Initial Coverage Limit (ICL) phase by offering an ICL that is higher than the year's predefined standard ICL amount.
This variable indicates whether the plan offers reduced Part D cost-sharing as part of its supplemental Part D benefit.
This variable indicates whether the plan offers reduced cost sharing in the deductible phase of the Part D benefit.
Indicates Whether Part D Plan Offers Reduced Post Out-of-Pocket (OOP) Threshold Cost-Sharing Amounts
This variable indicates whether the plan offers reduced cost sharing in the post out-of-pocket threshold (catastrophic) phase of the Part D benefit.
This variable indicates whether the plan offers reduced cost sharing applies to the pre-Initial Coverage Limit (ICL) phase of the Part D benefit.
This variable indicates whether the Plan is Medicare Part C, Part D or both. All Part C and D Plans are included in the file.
This variable indicates whether the Plan for the Current Year (2015) is Medicare Part C, Part D or both. All Part C and D Plans are included in the file.
This variable indicates whether the Plan for the Current Year (2016) is Medicare Part C, Part D or both. All Part C and D Plans are included in the file.
This variable indicates whether the Plan for the Current Year (2017) is Medicare Part C, Part D or both. All Part C and D Plans are included in the file.
Indicates whether the formulary tier has extra coverage in the during the coverage gap phase.
For Part D plans with some cost sharing in the coverage gap phase (i.e., those where the variable GAP_TIER = Y [yes]), this variable indicates whether or not the cost sharing applies to a partial list of drugs. If only a limited number of drugs on the tier are covered during the coverage gap phase then the value will be 'Y'. If all drugs on the tier are covered during the gap then the value will be 'N'.
Was there an indication noted for all medications in these medication classes on the most recent medication list? Anticoagulants
Was there an indication noted for all medications in these medication classes on the most recent medication list? Antimicrobials (excluding topicals)
Was there an indication noted for all medications in these medication classes on the most recent medication list? Antiplatelets (excluding 81 mg aspirin)
Was there an indication noted for all medications in these medication classes on the most recent medication list? Antipsychotics
Was there an indication noted for all medications in these medication classes on the most recent medication list? Hypoglycemics (including insulin)
Was there an indication noted for all medications in these medication classes on the most recent medication list? Opioids
Indication of completion of beneficiary record in the registry (Y or N).
Indication of patient's attribution to the practice (Y or N).
Indication of patient's eligibility
The field denotes whether the insured party is covered under another insurance plan other than Medicare or Medicaid.
A flag to indicate that the claim is for a person and not a service tracking claim or a non-person claim.
A flag to indicate whether the beneficiary was ever enrolled in a Section 1115A demonstration during the month. There are separate variables for each of the 12 months. 1115A is a CMS Center for Medicare & Medicaid Innovation (CMMI) demonstration.
A flag to indicate whether the beneficiary was ever enrolled in a Section 1115A demonstration during the month. There are separate variables for each of the 12 months. 1115A is a CMS Center for Medicare & Medicaid Innovation (CMMI) demonstration.
A flag to indicate whether the beneficiary was ever enrolled in a Section 1115A demonstration during the month. There are separate variables for each of the 12 months. 1115A is a CMS Center for Medicare & Medicaid Innovation (CMMI) demonstration.
A flag to indicate whether the beneficiary was ever enrolled in a Section 1115A demonstration during the month. There are separate variables for each of the 12 months. 1115A is a CMS Center for Medicare & Medicaid Innovation (CMMI) demonstration.
A flag to indicate whether the beneficiary was ever enrolled in a Section 1115A demonstration during the month. There are separate variables for each of the 12 months. 1115A is a CMS Center for Medicare & Medicaid Innovation (CMMI) demonstration.
A flag to indicate whether the beneficiary was ever enrolled in a Section 1115A demonstration during the month. There are separate variables for each of the 12 months. 1115A is a CMS Center for Medicare & Medicaid Innovation (CMMI) demonstration.
A flag to indicate whether the beneficiary was ever enrolled in a Section 1115A demonstration during the month. There are separate variables for each of the 12 months. 1115A is a CMS Center for Medicare & Medicaid Innovation (CMMI) demonstration.
A flag to indicate whether the beneficiary was ever enrolled in a Section 1115A demonstration during the month. There are separate variables for each of the 12 months. 1115A is a CMS Center for Medicare & Medicaid Innovation (CMMI) demonstration.
A flag to indicate whether the beneficiary was ever enrolled in a Section 1115A demonstration during the month. There are separate variables for each of the 12 months. 1115A is a CMS Center for Medicare & Medicaid Innovation (CMMI) demonstration.
A flag to indicate whether the beneficiary was ever enrolled in a Section 1115A demonstration during the month. There are separate variables for each of the 12 months. 1115A is a CMS Center for Medicare & Medicaid Innovation (CMMI) demonstration.