Variable    Format      Q#/Freq        Description/Label
 
BASEID      $BSIDFMT                   Unique SP Identification Number                   
                         12,623        LOW-HIGH          BASEID Count                                
 
SURVEYYR    SVYRFMT                    Survey year                                       
                         12,623                    2023  2023                                        
 
VERSION     VERSFMT                    Version Number                                    
                         12,623                       1  Version 1                                   
 
EVNTNUM     $EVNTNUM                   Unique event identifier                           
                         12,434        001-999           Survey-reported event                       
                            189        U001-U999         Event created from survey-reported event    
 
OREVTYPE    $EVNTTYP                   Original reported event type                      
                         12,623        DU                Dental                                      
 
CLAIMID     CLAIMID                    Claim this survey is matched to                   
                         12,585                       .  Missing                                     
                             38        Range of values   Claim ID                                    
 
D_BEGYY     EVYY                       Event begin year                                  
                         12,623        Range of values   Year                                        
 
D_BEGMM     EVMM                       Event begin month                                 
                            220                       D  Don't Know                                  
                              2                       R  Refused                                     
                         12,401        01-12             Month                                       
 
D_BEGDD     EVDD                       Event begin day                                   
                          3,571                       D  Don't Know                                  
                            522                       .  Inapplicable                                
                            460                       N  Not ascertained                             
                              7                       R  Refused                                     
                          8,063        01-31             Day of month                                
 
SOURCE      SRCE                       Source of event: Survey, claim, or both?          
                         12,585                       1  Survey only                                 
                             38                       3  Both survey & claims                        
 
SITCODE     $SITCODE                   Community or facility setting?                    
                         12,594        C                 Community                                   
                             10        D                 Deemed community                            
                              3        F                 Facility                                    
                              2        H                 Hospice                                     
                             12        I                 Inpatient                                   
                              2        S                 SNF                                         
 
AMTTOT      MONYFMT                    Total payment                                     
                         12,623        Range of values   Amount as $$$$$$.CC                         
 
IMPATOT     IMPFLAG                    Imputation flag:  Amt total payment               
                          5,532                       0  Not Imputed                                 
                          7,091                       1  Imputed by hotdeck                          
 
AMTCOV      MONYFMT                    Portion of total pay cov by Medicare              
                         12,623        Range of values   Amount as $$$$$$.CC                         
 
AMTNCOV     MONYFMT                    Portion of total pay not cov by Medicare          
                         12,623        Range of values   Amount as $$$$$$.CC                         
 
AMTCARE     MONYFMT                    Amount paid by Medicare FFS                       
                         12,623        Range of values   Amount as $$$$$$.CC                         
 
IMPSCARE    IMPFLAG                    Imputation flag: SOP Medicare FFS                 
                         12,623                       0  Not Imputed                                 
 
IMPACARE    IMPFLAG                    Imputation flag: Amt Medicare FFS                 
                         12,623                       0  Not Imputed                                 
 
AMTCAID     MONYFMT                    Amount paid by Medicaid                           
                         12,623        Range of values   Amount as $$$$$$.CC                         
 
IMPSCAID    IMPFLAG                    Imputation flag: SOP Medicaid                     
                         12,446                       0  Not Imputed                                 
                            177                       1  Imputed by hotdeck                          
 
IMPACAID    IMPFLAG                    Imputation flag: Amt Medicaid                     
                         12,386                       0  Not Imputed                                 
                            237                       1  Imputed by hotdeck                          
 
AMTMADV     MONYFMT                    Amount paid by Medicare MCO/HMO                   
                         12,623        Range of values   Amount as $$$$$$.CC                         
 
IMPSMADV    IMPFLAG                    Imputation flag: SOP Medicare MCO/HMO             
                         10,078                       0  Not Imputed                                 
                          2,545                       1  Imputed by hotdeck                          
 
IMPAMADV    IMPFLAG                    Imputation flag: Amt Medicare MCO/HMO             
                          9,526                       0  Not Imputed                                 
                          3,097                       1  Imputed by hotdeck                          
 
AMTHMOP     MONYFMT                    Amount paid by Private MCO/HMO                    
                         12,623        Range of values   Amount as $$$$$$.CC                         
 
IMPSHMOP    IMPFLAG                    Imputation flag: SOP Private MCO/HMO              
                         12,240                       0  Not Imputed                                 
                            383                       1  Imputed by hotdeck                          
 
IMPAHMOP    IMPFLAG                    Imputation flag: Amt Private MCO/HMO              
                         12,103                       0  Not Imputed                                 
                            520                       1  Imputed by hotdeck                          
 
AMTPRVE     MONYFMT                    Amount paid by priv ins(employer spons)           
                         12,623        Range of values   Amount as $$$$$$.CC                         
 
IMPSPRVE    IMPFLAG                    Imputation flag: SOP priv ins-employer            
                         12,518                       0  Not Imputed                                 
                            105                       1  Imputed by hotdeck                          
 
IMPAPRVE    IMPFLAG                    Imputation flag: Amt priv ins-employer            
                         12,054                       0  Not Imputed                                 
                            569                       1  Imputed by hotdeck                          
 
AMTPRVI     MONYFMT                    Amount paid by priv ins (indiv purch)             
                         12,623        Range of values   Amount as $$$$$$.CC                         
 
IMPSPRVI    IMPFLAG                    Imputation flag: SOP priv ins-indiv pur           
                         12,565                       0  Not Imputed                                 
                             58                       1  Imputed by hotdeck                          
 
IMPAPRVI    IMPFLAG                    Imputation flag: Amt priv ins-indiv pur           
                         12,361                       0  Not Imputed                                 
                            262                       1  Imputed by hotdeck                          
 
AMTPRVU     MONYFMT                    Amount paid by priv ins (unknown purch)           
                         12,623        Range of values   Amount as $$$$$$.CC                         
 
IMPSPRVU    IMPFLAG                    Imputation flag: SOP priv ins-unknown             
                         12,623                       0  Not Imputed                                 
 
IMPAPRVU    IMPFLAG                    Imputation flag: Amt priv ins-unknown             
                         12,623                       0  Not Imputed                                 
 
AMTOOP      MONYFMT                    Amount paid by person/family                      
                         12,623        Range of values   Amount as $$$$$$.CC                         
 
IMPSOOP     IMPFLAG                    Imputation flag: SOP paid by person               
                         11,621                       0  Not Imputed                                 
                          1,002                       1  Imputed by hotdeck                          
 
IMPAOOP     IMPFLAG                    Imputation flag: Amt paid by person               
                         10,842                       0  Not Imputed                                 
                          1,781                       1  Imputed by hotdeck                          
 
AMTDISC     MONYFMT                    Amount of uncollected liabilities                 
                         12,623        Range of values   Amount as $$$$$$.CC                         
         Notes:  This includes sequestration reduction
 
IMPSDISC    IMPFLAG                    Imputation flag: SOP of uncoll liab               
                         12,379                       0  Not Imputed                                 
                            244                       1  Imputed by hotdeck                          
 
IMPADISC    IMPFLAG                    Imputation flag: Amt of uncoll liab               
                         12,237                       0  Not Imputed                                 
                            386                       1  Imputed by hotdeck                          
 
AMTOTH      MONYFMT                    Amt paid by other sources (includes VA)           
                         12,623        Range of values   Amount as $$$$$$.CC                         
         Notes:  This field also includes VA payments
 
IMPSOTH     IMPFLAG                    Imputation flag: SOP other sources                
                         12,623                       0  Not Imputed                                 
 
IMPAOTH     IMPFLAG                    Imputation flag: Amt other sources                
                         12,596                       0  Not Imputed                                 
                             27                       1  Imputed by hotdeck                          
 
DVEXAM      IND1FMT                    SP had dental exam                                
                             33                       D  Don't know                                  
                            189                       .  Inapplicable/Missing                        
                             53                       N  Not ascertained                             
                              1                       R  Refused                                     
                          5,783                       0  Not indicated                               
                          6,564                       1  Indicated                                   
 
DVCLEAN     IND1FMT                    SP had cleaning                                   
                             33                       D  Don't know                                  
                            189                       .  Inapplicable/Missing                        
                             53                       N  Not ascertained                             
                              1                       R  Refused                                     
                          5,665                       0  Not indicated                               
                          6,682                       1  Indicated                                   
 
DVXRAYS     IND1FMT                    SP had dental xray                                
                             33                       D  Don't know                                  
                            189                       .  Inapplicable/Missing                        
                             53                       N  Not ascertained                             
                              1                       R  Refused                                     
                          8,742                       0  Not indicated                               
                          3,605                       1  Indicated                                   
 
DVFLURID    IND1FMT                    SP had fluoride treatment                         
                             33                       D  Don't know                                  
                            189                       .  Inapplicable/Missing                        
                             53                       N  Not ascertained                             
                              1                       R  Refused                                     
                         11,924                       0  Not indicated                               
                            423                       1  Indicated                                   
 
DVSEALNT    IND1FMT                    SP had sealant                                    
                             33                       D  Don't know                                  
                            189                       .  Inapplicable/Missing                        
                             53                       N  Not ascertained                             
                              1                       R  Refused                                     
                         12,294                       0  Not indicated                               
                             53                       1  Indicated                                   
 
DVFILLNG    IND1FMT                    SP had fillings                                   
                             33                       D  Don't know                                  
                            189                       .  Inapplicable/Missing                        
                             53                       N  Not ascertained                             
                              1                       R  Refused                                     
                         11,294                       0  Not indicated                               
                          1,053                       1  Indicated                                   
 
DVINLAYS    IND1FMT                    SP had inlays                                     
                             33                       D  Don't know                                  
                            189                       .  Inapplicable/Missing                        
                             53                       N  Not ascertained                             
                              1                       R  Refused                                     
                         12,326                       0  Not indicated                               
                             21                       1  Indicated                                   
 
DVCROWN     IND1FMT                    SP had crown                                      
                             33                       D  Don't know                                  
                            189                       .  Inapplicable/Missing                        
                             53                       N  Not ascertained                             
                              1                       R  Refused                                     
                         10,907                       0  Not indicated                               
                          1,440                       1  Indicated                                   
 
DVRTCNAL    IND1FMT                    SP had root canal                                 
                             33                       D  Don't know                                  
                            189                       .  Inapplicable/Missing                        
                             53                       N  Not ascertained                             
                              1                       R  Refused                                     
                         12,003                       0  Not indicated                               
                            344                       1  Indicated                                   
 
DVPERIOD    IND1FMT                    SP had periodontal procedure                      
                             33                       D  Don't know                                  
                            189                       .  Inapplicable/Missing                        
                             53                       N  Not ascertained                             
                              1                       R  Refused                                     
                         12,232                       0  Not indicated                               
                            115                       1  Indicated                                   
 
DVRECALL    IND1FMT                    SP had periodontal recall visit                   
                             33                       D  Don't know                                  
                            189                       .  Inapplicable/Missing                        
                             53                       N  Not ascertained                             
                              1                       R  Refused                                     
                         12,290                       0  Not indicated                               
                             57                       1  Indicated                                   
 
DVEXTRAC    IND1FMT                    SP had extraction                                 
                             33                       D  Don't know                                  
                            189                       .  Inapplicable/Missing                        
                             53                       N  Not ascertained                             
                              1                       R  Refused                                     
                         11,590                       0  Not indicated                               
                            757                       1  Indicated                                   
 
DVIMPLNT    IND1FMT                    SP had implants                                   
                             33                       D  Don't know                                  
                            189                       .  Inapplicable/Missing                        
                             53                       N  Not ascertained                             
                              1                       R  Refused                                     
                         11,962                       0  Not indicated                               
                            385                       1  Indicated                                   
 
DVABSESS    IND1FMT                    SP had abscess or infection treatment             
                             33                       D  Don't know                                  
                            189                       .  Inapplicable/Missing                        
                             53                       N  Not ascertained                             
                              1                       R  Refused                                     
                         12,287                       0  Not indicated                               
                             60                       1  Indicated                                   
 
DVSURG      IND1FMT                    SP had oral surgery                               
                             33                       D  Don't know                                  
                            189                       .  Inapplicable/Missing                        
                             53                       N  Not ascertained                             
                              1                       R  Refused                                     
                         12,291                       0  Not indicated                               
                             56                       1  Indicated                                   
 
DVBRIDGE    IND1FMT                    SP had bridges                                    
                             33                       D  Don't know                                  
                            189                       .  Inapplicable/Missing                        
                             53                       N  Not ascertained                             
                              1                       R  Refused                                     
                         12,122                       0  Not indicated                               
                            225                       1  Indicated                                   
 
DVDENTRS    IND1FMT                    SP had dentures                                   
                             33                       D  Don't know                                  
                            189                       .  Inapplicable/Missing                        
                             53                       N  Not ascertained                             
                              1                       R  Refused                                     
                         11,805                       0  Not indicated                               
                            542                       1  Indicated                                   
 
DVREPAIR    IND1FMT                    SP had bridge/denture repair                      
                             33                       D  Don't know                                  
                            189                       .  Inapplicable/Missing                        
                             53                       N  Not ascertained                             
                              1                       R  Refused                                     
                         12,150                       0  Not indicated                               
                            197                       1  Indicated                                   
 
DVORTHO     IND1FMT                    SP had orthodontia                                
                             33                       D  Don't know                                  
                            189                       .  Inapplicable/Missing                        
                             53                       N  Not ascertained                             
                              1                       R  Refused                                     
                         12,235                       0  Not indicated                               
                            112                       1  Indicated                                   
 
DVBONDNG    IND1FMT                    SP had bonding/whiten/bleach                      
                             33                       D  Don't know                                  
                            189                       .  Inapplicable/Missing                        
                             53                       N  Not ascertained                             
                              1                       R  Refused                                     
                         12,306                       0  Not indicated                               
                             41                       1  Indicated                                   
 
DVTMJ       IND1FMT                    SP had treatment for TMD/TMJ                      
                             33                       D  Don't know                                  
                            189                       .  Inapplicable/Missing                        
                             53                       N  Not ascertained                             
                              1                       R  Refused                                     
                         12,327                       0  Not indicated                               
                             20                       1  Indicated                                   
 
DVOTHER     IND1FMT                    SP had other dental service                       
                             33                       D  Don't know                                  
                            189                       .  Inapplicable/Missing                        
                             53                       N  Not ascertained                             
                              1                       R  Refused                                     
                         11,657                       0  Not indicated                               
                            690                       1  Indicated                                   
 
MCOHMO      HMO                        Event provided by an MCO/HMO?                     
                          4,657                       0  Event not provided by MCO/HMO               
                          7,966                       1  Event provided by MCO/HMO                   
 
