"Supplementary Exhibit 3B.  Beneficiaries Attributed to Your TIN for the Cost Measures (excluding MSPB) and Claims-Based Quality Outcome Measure: Hospital Admissions for Any Cause 
(MSSP ACO TINs Only)

"							"Supplementary Exhibit 3B.  Beneficiaries Attributed to Your TIN for the Cost Measures (excluding MSPB) and Claims-Based Quality Outcome Measure: Hospital Admissions for Any Cause 
(MSSP ACO TINs Only)

"							
														
														
"Supplementary Exhibit 3B provides details about each beneficiarys hospitalizations in 2014, for those beneficiaries attributed to your TIN based on the two-step attribution rule. Because your TIN participated in the Medicare Shared Savings Program in 2014, no data are available on whether the hospital admission was the result of an emergency department evaluation, an ACSC admission, or a readmission within 30 days of prior admission. Data on 30-day readmissions are available in Supplementary Exhibit 13."														
														
														
														
Attributed Beneficiaries Admitted to the Hospital				Characteristics of Hospital Admission							Discharge Disposition			
HIC	Gender	DOB	 Index	Date of Admission	"Admitting Hospital
(Name, CCN, City, State)"				"Principal Diagnosis
(Code, Description)"		Date of Discharge	"Discharge Status
(Code, Description)"		
#	F	04/01/1939	#	06/12/14	Name 	CMS Certification Number	City 	State	481	Pneumococcal Pneumonia	06/19/14	3	Disch to SNF	
-	-	-	-	-	-	-	-	-	-	-	-	-	-	
														
 Crosses indicate terms to be defined through the hover-over function.							 Crosses indicate terms to be defined through the hover-over function.							
