Variable Format    Q#/Freq            Description/Label
 
BASEID   $BSIDFMT                      Unique SP Identification Number          
                         12,488        LOW-HIGH          BASEID Count                            
 
SURVEYYR SVYRFMT                       Survey year                              
                         12,488                    2021  2021                                    
 
VERSION  VERSFMT                       Version Number                           
                         12,488                       1  Version 1                               
 
EVNTNUM  $EVNTNUM                      Unique event identifier                  
                         12,359        001-999           Survey-reported event                   
                            129        U001-U999         Event created from survey-reported event
 
OREVTYPE $EVNTTYP                      Original reported event type             
                         12,488        DU                Dental                                  
 
CLAIMID  CLAIMID                       Claim this survey is matched to          
                         12,463                       .  Missing                                 
                             25        Range of values   Claim ID                                
 
D_BEGYY  EVYY                          Event begin year                         
                         12,488        Range of values   Year                                    
 
D_BEGMM  EVMM                          Event begin month                        
                            231                       D  Don't Know                              
                              1                       N  Not ascertained                         
                         12,256        01-12             Month                                   
 
D_BEGDD  EVDD                          Event begin day                          
                          3,535                       D  Don't Know                              
                            948                       .  Inapplicable                            
                             48                       N  Not ascertained                         
                             29                       R  Refused                                 
                          7,928        01-31             Day of month                            
 
SOURCE   SRCE                          Source of event: Survey, claim, or both? 
                         12,463                       1  Survey only                             
                             25                       3  Both survey & claims                    
 
SITCODE  $SITCODE                      Community or facility setting?           
                              2        B                 Both community & facility               
                         12,462        C                 Community                               
                             11        D                 Deemed community                        
                              2        F                 Facility                                
                              5        H                 Hospice                                 
                              5        I                 Inpatient                               
                              1        S                 SNF                                     
 
AMTTOT   MONYFMT                       Total payment                            
                         12,488        Range of values   Amount as $$$$$$.CC                     
 
IMPATOT  IMPFLAG                       Imputation flag:  Amt total payment      
                          5,735                       0  Not Imputed                             
                          6,753                       1  Imputed by hotdeck                      
 
AMTCOV   MONYFMT                       Portion of total pay cov by Medicare     
                         12,488        Range of values   Amount as $$$$$$.CC                     
 
AMTNCOV  MONYFMT                       Portion of total pay not cov by Medicare 
                         12,488        Range of values   Amount as $$$$$$.CC                     
 
AMTCARE  MONYFMT                       Amount paid by Medicare FFS              
                         12,488        Range of values   Amount as $$$$$$.CC                     
 
IMPSCARE IMPFLAG                       Imputation flag: SOP Medicare FFS        
                         12,488                       0  Not Imputed                             
 
IMPACARE IMPFLAG                       Imputation flag: Amt Medicare FFS        
                         12,488                       0  Not Imputed                             
 
AMTCAID  MONYFMT                       Amount paid by Medicaid                  
                         12,488        Range of values   Amount as $$$$$$.CC                     
 
IMPSCAID IMPFLAG                       Imputation flag: SOP Medicaid            
                         12,266                       0  Not Imputed                             
                            222                       1  Imputed by hotdeck                      
 
IMPACAID IMPFLAG                       Imputation flag: Amt Medicaid            
                         12,212                       0  Not Imputed                             
                            276                       1  Imputed by hotdeck                      
 
AMTMADV  MONYFMT                       Amount paid by Medicare MCO/HMO          
                         12,488        Range of values   Amount as $$$$$$.CC                     
 
IMPSMADV IMPFLAG                       Imputation flag: SOP Medicare MCO/HMO    
                         10,247                       0  Not Imputed                             
                          2,241                       1  Imputed by hotdeck                      
 
IMPAMADV IMPFLAG                       Imputation flag: Amt Medicare MCO/HMO    
                          9,871                       0  Not Imputed                             
                          2,617                       1  Imputed by hotdeck                      
 
AMTHMOP  MONYFMT                       Amount paid by Private MCO/HMO           
                         12,488        Range of values   Amount as $$$$$$.CC                     
 
IMPSHMOP IMPFLAG                       Imputation flag: SOP Private MCO/HMO     
                         12,113                       0  Not Imputed                             
                            375                       1  Imputed by hotdeck                      
 
IMPAHMOP IMPFLAG                       Imputation flag: Amt Private MCO/HMO     
                         11,985                       0  Not Imputed                             
                            503                       1  Imputed by hotdeck                      
 
AMTPRVE  MONYFMT                       Amount paid by priv ins(employer spons)  
                         12,488        Range of values   Amount as $$$$$$.CC                     
 
IMPSPRVE IMPFLAG                       Imputation flag: SOP priv ins-employer   
                         12,366                       0  Not Imputed                             
                            122                       1  Imputed by hotdeck                      
 
IMPAPRVE IMPFLAG                       Imputation flag: Amt priv ins-employer   
                         11,799                       0  Not Imputed                             
                            689                       1  Imputed by hotdeck                      
 
AMTPRVI  MONYFMT                       Amount paid by priv ins (indiv purch)    
                         12,488        Range of values   Amount as $$$$$$.CC                     
 
IMPSPRVI IMPFLAG                       Imputation flag: SOP priv ins-indiv pur  
                         12,434                       0  Not Imputed                             
                             54                       1  Imputed by hotdeck                      
 
IMPAPRVI IMPFLAG                       Imputation flag: Amt priv ins-indiv pur  
                         12,176                       0  Not Imputed                             
                            312                       1  Imputed by hotdeck                      
 
AMTPRVU  MONYFMT                       Amount paid by priv ins (unknown purch)  
                         12,488        Range of values   Amount as $$$$$$.CC                     
 
IMPSPRVU IMPFLAG                       Imputaiton flag: SOP priv ins-unknown    
                         12,488                       0  Not Imputed                             
 
IMPAPRVU IMPFLAG                       Imputation flag: Amt priv ins-unknown    
                         12,488                       0  Not Imputed                             
 
AMTOOP   MONYFMT                       Amount paid by person/family             
                         12,488        Range of values   Amount as $$$$$$.CC                     
 
IMPSOOP  IMPFLAG                       Imputation flag: SOP paid by person      
                         11,154                       0  Not Imputed                             
                          1,334                       1  Imputed by hotdeck                      
 
IMPAOOP  IMPFLAG                       Imputation flag: Amt paid by person      
                         10,291                       0  Not Imputed                             
                          2,197                       1  Imputed by hotdeck                      
 
AMTDISC  MONYFMT                       Amount of uncollected liabilities        
                         12,488        Range of values   Amount as $$$$$$.CC                     
         Notes:  Beginning in 2013 this includes sequestration reduction
 
IMPSDISC IMPFLAG                       Imputation flag: SOP of uncoll liab      
                         12,199                       0  Not Imputed                             
                            289                       1  Imputed by hotdeck                      
 
IMPADISC IMPFLAG                       Imputation flag: Amt of uncoll liab      
                         12,108                       0  Not Imputed                             
                            380                       1  Imputed by hotdeck                      
 
AMTOTH   MONYFMT                       Amt paid by other sources (includes VA)  
                         12,488        Range of values   Amount as $$$$$$.CC                     
         Notes:  Beginning in 2016, this field also includes VA payments
 
IMPSOTH  IMPFLAG                       Imputation flag: SOP other sources       
                         12,484                       0  Not Imputed                             
                              4                       1  Imputed by hotdeck                      
 
IMPAOTH  IMPFLAG                       Imputation flag: Amt other sources       
                         12,393                       0  Not Imputed                             
                             95                       1  Imputed by hotdeck                      
 
DVEXAM   IND1FMT                       SP had dental exam                       
                             41                       D  Don't know                              
                            129                       .  Inapplicable/Missing                    
                             54                       N  Not ascertained                         
                              3                       R  Refused                                 
                          5,831                       0  Not indicated                           
                          6,430                       1  Indicated                               
 
DVCLEAN  IND1FMT                       SP had cleaning                          
                             41                       D  Don't know                              
                            129                       .  Inapplicable/Missing                    
                             54                       N  Not ascertained                         
                              3                       R  Refused                                 
                          5,848                       0  Not indicated                           
                          6,413                       1  Indicated                               
 
DVXRAYS  IND1FMT                       SP had dental xray                       
                             41                       D  Don't know                              
                            129                       .  Inapplicable/Missing                    
                             54                       N  Not ascertained                         
                              3                       R  Refused                                 
                          8,694                       0  Not indicated                           
                          3,567                       1  Indicated                               
 
DVFLURID IND1FMT                       SP had fluoride treatment                
                             41                       D  Don't know                              
                            129                       .  Inapplicable/Missing                    
                             54                       N  Not ascertained                         
                              3                       R  Refused                                 
                         11,935                       0  Not indicated                           
                            326                       1  Indicated                               
 
DVSEALNT IND1FMT                       SP had sealant                           
                             41                       D  Don't know                              
                            129                       .  Inapplicable/Missing                    
                             54                       N  Not ascertained                         
                              3                       R  Refused                                 
                         12,233                       0  Not indicated                           
                             28                       1  Indicated                               
 
DVFILLNG IND1FMT                       SP had fillings                          
                             41                       D  Don't know                              
                            129                       .  Inapplicable/Missing                    
                             54                       N  Not ascertained                         
                              3                       R  Refused                                 
                         11,233                       0  Not indicated                           
                          1,028                       1  Indicated                               
 
DVINLAYS IND1FMT                       SP had inlays                            
                             41                       D  Don't know                              
                            129                       .  Inapplicable/Missing                    
                             54                       N  Not ascertained                         
                              3                       R  Refused                                 
                         12,239                       0  Not indicated                           
                             22                       1  Indicated                               
 
DVCROWN  IND1FMT                       SP had crown                             
                             41                       D  Don't know                              
                            129                       .  Inapplicable/Missing                    
                             54                       N  Not ascertained                         
                              3                       R  Refused                                 
                         10,921                       0  Not indicated                           
                          1,340                       1  Indicated                               
 
DVRTCNAL IND1FMT                       SP had root canal                        
                             41                       D  Don't know                              
                            129                       .  Inapplicable/Missing                    
                             54                       N  Not ascertained                         
                              3                       R  Refused                                 
                         11,955                       0  Not indicated                           
                            306                       1  Indicated                               
 
DVPERIOD IND1FMT                       SP had periodontal procedure             
                             41                       D  Don't know                              
                            129                       .  Inapplicable/Missing                    
                             54                       N  Not ascertained                         
                              3                       R  Refused                                 
                         12,166                       0  Not indicated                           
                             95                       1  Indicated                               
 
DVRECALL IND1FMT                       SP had periodontal recall visit          
                             41                       D  Don't know                              
                            129                       .  Inapplicable/Missing                    
                             54                       N  Not ascertained                         
                              3                       R  Refused                                 
                         12,153                       0  Not indicated                           
                            108                       1  Indicated                               
 
DVEXTRAC IND1FMT                       SP had extraction                        
                             41                       D  Don't know                              
                            129                       .  Inapplicable/Missing                    
                             54                       N  Not ascertained                         
                              3                       R  Refused                                 
                         11,444                       0  Not indicated                           
                            817                       1  Indicated                               
 
DVIMPLNT IND1FMT                       SP had implants                          
                             41                       D  Don't know                              
                            129                       .  Inapplicable/Missing                    
                             54                       N  Not ascertained                         
                              3                       R  Refused                                 
                         11,840                       0  Not indicated                           
                            421                       1  Indicated                               
 
DVABSESS IND1FMT                       SP had abscess or infection treatment    
                             41                       D  Don't know                              
                            129                       .  Inapplicable/Missing                    
                             54                       N  Not ascertained                         
                              3                       R  Refused                                 
                         12,162                       0  Not indicated                           
                             99                       1  Indicated                               
 
DVSURG   IND1FMT                       SP had oral surgery                      
                             41                       D  Don't know                              
                            129                       .  Inapplicable/Missing                    
                             54                       N  Not ascertained                         
                              3                       R  Refused                                 
                         12,197                       0  Not indicated                           
                             64                       1  Indicated                               
 
DVBRIDGE IND1FMT                       SP had bridges                           
                             41                       D  Don't know                              
                            129                       .  Inapplicable/Missing                    
                             54                       N  Not ascertained                         
                              3                       R  Refused                                 
                         12,067                       0  Not indicated                           
                            194                       1  Indicated                               
 
DVDENTRS IND1FMT                       SP had dentures                          
                             41                       D  Don't know                              
                            129                       .  Inapplicable/Missing                    
                             54                       N  Not ascertained                         
                              3                       R  Refused                                 
                         11,736                       0  Not indicated                           
                            525                       1  Indicated                               
 
DVREPAIR IND1FMT                       SP had bridge/denture repair             
                             41                       D  Don't know                              
                            129                       .  Inapplicable/Missing                    
                             54                       N  Not ascertained                         
                              3                       R  Refused                                 
                         11,950                       0  Not indicated                           
                            311                       1  Indicated                               
 
DVORTHO  IND1FMT                       SP had orthodontia                       
                             41                       D  Don't know                              
                            129                       .  Inapplicable/Missing                    
                             54                       N  Not ascertained                         
                              3                       R  Refused                                 
                         12,198                       0  Not indicated                           
                             63                       1  Indicated                               
 
DVBONDNG IND1FMT                       SP had bonding/whiten/bleach             
                             41                       D  Don't know                              
                            129                       .  Inapplicable/Missing                    
                             54                       N  Not ascertained                         
                              3                       R  Refused                                 
                         12,218                       0  Not indicated                           
                             43                       1  Indicated                               
 
DVTMJ    IND1FMT                       SP had treatment for TMD/TMJ             
                             41                       D  Don't know                              
                            129                       .  Inapplicable/Missing                    
                             54                       N  Not ascertained                         
                              3                       R  Refused                                 
                         12,246                       0  Not indicated                           
                             15                       1  Indicated                               
 
DVOTHER  IND1FMT                       SP had other dental service              
                             41                       D  Don't know                              
                            129                       .  Inapplicable/Missing                    
                             54                       N  Not ascertained                         
                              3                       R  Refused                                 
                         11,704                       0  Not indicated                           
                            557                       1  Indicated                               
 
MCOHMO   HMO                           Event provided by an MCO/HMO?            
                          5,102                       0  Event not provided by MCO/HMO           
                          7,386                       1  Event provided by MCO/HMO               
 
