Variable Format    Q#/Freq            Description/Label
 
BASEID   $BSIDFMT                      Unique SP Identification Number          
                          1,540        LOW-HIGH          BASEID Count                            
 
SURVEYYR SVYRFMT                       Survey Year                              
                          1,540                    2021  2021                                    
 
VERSION  VERSFMT                       Version Number                           
                          1,540                       1  Version 1                               
 
EVNTNUM  $EVNTNUM                      Unique event identifier                  
                          1,007        001-999           Survey-reported event                   
                            526        C001-C999         Event created from claim                
                              7        U001-U999         Event created from survey-reported event
 
OREVTYPE $EVNTTYP                      Original reported event type             
                            526                          Missing                                 
                             18        ER                Emergency Room                          
                            908        IP                Inpatient                               
                             15        IU                Institutional utilization               
                             73        OP                Outpatient                              
 
CLAIMID  CLAIMID                       1st Claim this survey event matched to   
                            467                       .  Missing                                 
                          1,073        Range of values   Claim ID                                
 
D_BEGYY  EVYY                          Event begin year                         
                          1,540        Range of values   Year                                    
 
D_BEGMM  EVMM                          Event begin month                        
                             14                       D  Don't Know                              
                          1,526        01-12             Month                                   
 
D_BEGDD  EVDD                          Event begin day                          
                            104                       D  Don't Know                              
                             18                       .  Inapplicable                            
                          1,418        01-31             Day of month                            
 
D_ENDYY  EVYY                          Event end year                           
                              2                       D  Don't Know                              
                             43                       .  Inapplicable                            
                              4                       N  Not ascertained                         
                          1,491        Range of values   Year                                    
 
D_ENDMM  EVMM                          Event end month                          
                             12                       D  Don't Know                              
                             43                       .  Inapplicable                            
                              4                       N  Not ascertained                         
                          1,481        01-12             Month                                   
 
D_ENDDD  EVDD                          Event end day                            
                             97                       D  Don't Know                              
                             43                       .  Inapplicable                            
                              4                       N  Not ascertained                         
                          1,396        01-31             Day of month                            
 
SOURCE   SRCE                          Source of event: survey, claim, or both? 
                            467                       1  Survey only                             
                            526                       2  Claims only                             
                            547                       3  Both survey & claims                    
 
SITCODE  $SITCODE                      Community or facility setting?           
                            468        C                 Community                               
                              1        D                 Deemed community                        
                             12        H                 Hospice                                 
                          1,059        I                 Inpatient                               
 
AMTTOT   MONYFMT                       Total payment                            
                          1,540        Range of values   Amount as $$$$$$.CC                     
 
IMPATOT  IMPFLAG                       Imputation flag: total payment           
                          1,009                       0  Not Imputed                             
                            531                       1  Imputed by hotdeck                      
 
AMTCOV   MONYFMT                       Portion of total pay cov by Medicare     
                              1                       .  Inapplicable/Missing                    
                          1,539        Range of values   Amount as $$$$$$.CC                     
 
AMTNCOV  MONYFMT                       Portion of total pay not cov by Medicare 
                              1                       .  Inapplicable/Missing                    
                          1,539        Range of values   Amount as $$$$$$.CC                     
 
AMTCARE  MONYFMT                       Amount paid by Medicare FFS              
                          1,540        Range of values   Amount as $$$$$$.CC                     
 
IMPSCARE IMPFLAG                       Imputation flag: SOP Medicare FFS        
                          1,540                       0  Not Imputed                             
 
IMPACARE IMPFLAG                       Imputation flag: Amt Medicare FFS        
                          1,522                       0  Not Imputed                             
                             18                       1  Imputed by hotdeck                      
 
AMTCAID  MONYFMT                       Amount paid by Medicaid                  
                          1,540        Range of values   Amount as $$$$$$.CC                     
 
IMPSCAID IMPFLAG                       Imputation flag: SOP Medicaid            
                          1,449                       0  Not Imputed                             
                             91                       1  Imputed by hotdeck                      
 
IMPACAID IMPFLAG                       Imputation flag: Amt Medicaid            
                          1,361                       0  Not Imputed                             
                            179                       1  Imputed by hotdeck                      
 
AMTMADV  MONYFMT                       Amount paid by Medicare MCO/HMO          
                          1,540        Range of values   Amount as $$$$$$.CC                     
 
IMPSMADV IMPFLAG                       Imputation flag: SOP Medicare MCO/HMO    
                          1,291                       0  Not Imputed                             
                            249                       1  Imputed by hotdeck                      
 
IMPAMADV IMPFLAG                       Imputation flag: Amt Medicare MCO/HMO    
                          1,225                       0  Not Imputed                             
                            315                       1  Imputed by hotdeck                      
 
AMTHMOP  MONYFMT                       Amount paid by private MCO/HMO           
                          1,540        Range of values   Amount as $$$$$$.CC                     
 
IMPSHMOP IMPFLAG                       Imputation flag: SOP Priv MCO/HMO        
                          1,497                       0  Not Imputed                             
                             43                       1  Imputed by hotdeck                      
 
IMPAHMOP IMPFLAG                       Imputation flag: Amt Priv MCO/HMO        
                          1,481                       0  Not Imputed                             
                             59                       1  Imputed by hotdeck                      
 
AMTPRVE  MONYFMT                       Amt paid by priv ins (employer spons)    
                          1,540        Range of values   Amount as $$$$$$.CC                     
 
IMPSPRVE IMPFLAG                       Imputation flag: SOP priv ins-employer   
                          1,506                       0  Not Imputed                             
                             34                       1  Imputed by hotdeck                      
 
IMPAPRVE IMPFLAG                       Imputation flag: Amt priv ins-employer   
                          1,477                       0  Not Imputed                             
                             63                       1  Imputed by hotdeck                      
 
AMTPRVI  MONYFMT                       Amt paid by priv ins (indiv purch)       
                          1,540        Range of values   Amount as $$$$$$.CC                     
 
IMPSPRVI IMPFLAG                       Imputation flag: SOP priv ins-indiv purch
                          1,475                       0  Not Imputed                             
                             65                       1  Imputed by hotdeck                      
 
IMPAPRVI IMPFLAG                       Imputation flag: Amt priv ins-indiv purch
                          1,435                       0  Not Imputed                             
                            105                       1  Imputed by hotdeck                      
 
AMTPRVU  MONYFMT                       Amt paid by priv ins (unknown purch)     
                          1,540        Range of values   Amount as $$$$$$.CC                     
 
IMPSPRVU IMPFLAG                       Imputation flag: SOP priv ins-unknown    
                          1,529                       0  Not Imputed                             
                             11                       1  Imputed by hotdeck                      
 
IMPAPRVU IMPFLAG                       Imputation flag: Amt priv ins-unknown    
                          1,529                       0  Not Imputed                             
                             11                       1  Imputed by hotdeck                      
 
AMTOOP   MONYFMT                       Amount paid by person/family             
                          1,540        Range of values   Amount as $$$$$$.CC                     
 
IMPSOOP  IMPFLAG                       Imputation flag: SOP paid by pers/fam    
                          1,227                       0  Not Imputed                             
                            313                       1  Imputed by hotdeck                      
 
IMPAOOP  IMPFLAG                       Imputation flag: Amt paid by pers/fam    
                          1,141                       0  Not Imputed                             
                            399                       1  Imputed by hotdeck                      
 
AMTDISC  MONYFMT                       Amount of uncollected SP liability       
                          1,540        Range of values   Amount as $$$$$$.CC                     
         Notes:  Beginning in 2013 this includes sequestration reduction
 
IMPSDISC IMPFLAG                       Imputation flag: SOP of uncoll liab      
                          1,467                       0  Not Imputed                             
                             73                       1  Imputed by hotdeck                      
 
IMPADISC IMPFLAG                       Imputation flag: Amt of uncoll liab      
                          1,462                       0  Not Imputed                             
                             78                       1  Imputed by hotdeck                      
 
AMTOTH   MONYFMT                       Amt paid by other sources (includes VA)  
                          1,540        Range of values   Amount as $$$$$$.CC                     
         Notes:  Beginning in 2016, this field also includes VA payments
 
IMPSOTH  IMPFLAG                       Imputation flag: SOP other sources       
                          1,539                       0  Not Imputed                             
                              1                       1  Imputed by hotdeck                      
 
IMPAOTH  IMPFLAG                       Imputation flag: Amt other sources       
                          1,527                       0  Not Imputed                             
                             13                       1  Imputed by hotdeck                      
 
DGNCNT   NUM3FMT                       Number of diagnosis codes on claim       
                            467                       .  Inapplicable/Missing                    
                          1,073        Range of values   Number                                  
 
PRINDIAG $DIAGFMT                      Primary ICD-10 diag code                 
                            467                          Missing                                 
                          1,073        Range of Codes    ICD Code                                
 
POAIND   POAFMT                        Present on admission indicator           
                            467                       .  Missing                                 
                             30                       0  No codes present on admission           
                          1,043                       1  At least 1 code present on admis        
 
E1DGNSCD $ECDFMT                       First E-CODE from claim                  
                          1,340                          Missing                                 
                            200        Range of Codes    E-Code                                  
 
DRG      $DRGFMT                       Diagnosis related group from claim       
                            467                          Missing                                 
                          1,073        Range of Codes    DRG                                     
 
IPPRJCNT NUM3FMT                       Number of procedure codes on claim       
                            467                       .  Inapplicable/Missing                    
                            482                       0  None                                    
                            591        Range of values   Number                                  
 
PRCDRCD1 $PRCDRFM                      First procedure codes on claim           
                            949                          Missing                                 
                            591        Range of Codes    Procedure Code                          
 
PROV     $FIDFMT                       Medicare provider number from claim      
                            467                          Missing                                 
                          1,073        Provider ID       Provider Number                         
 
STATUS   STATUS                        Beneficiary status as of claim thru date 
                            467                       .  Inapplicable/Missing                    
                            415                       1  Discharged to home/self care            
                             22                       2  Discharged to other short-term hospital 
                            209                       3  Discharged to skilled nursing facility  
                             24                       4  Discharged to intermediate care facility
                            238                       6  Discharged to home care of organized HMO
                             10                       7  Left against medical advice/stopped care
                             50                      20  Expired (did not recover Christian Sci) 
                              2                      43  Disch/Transferred to a Fed Hospital     
                             20                      50  Hospice - home                          
                             16                      51  Hospice - medical facility              
                              4                      61  Disch w/i facility to swing-bed SNF     
                             42                      62  Disch inp rehab; inc distinct hosp      
                             13                      63  Disch to long term care hospital        
                              4                      64  Disch cert nursing; Mcaid, not Mcare    
                              2                      65  Disch to psychiatric hosp or unit       
                              1                      66  Other destination                       
                              1                      70  Disch to other institution, no code     
 
UTLZNDAY NUM3FMT                       Number of covered days of care           
                            467                       .  Inapplicable/Missing                    
                             34                       0  None                                    
                          1,039        Range of values   Number                                  
 
MCOHMO   HMO                           Event provided by an MCO/HMO?            
                          1,039                       0  Event not provided by MCO/HMO           
                            501                       1  Event provided by MCO/HMO               
 
SOWMP    SOWMP                         Survey Only with Medicare Not MA Payment 
                            197                       .  Missing                                 
                          1,324                       0  Not Srvy Only w/Medicare Pymnt (not MA) 
                             19                       1  Survey Only w/Medicare Payment (not MA) 
 
