Variable Format    Q#/Freq            Description/Label
 
BASEID   $BSIDFMT                      Unique SP Identification Number          
                         12,240        LOW-HIGH          BASEID Count                            
 
SURVEYYR SVYRFMT                       Survey Year                              
                         12,240                    2015  2015                                    
 
VERSION  VERSFMT                       Version Number                           
                         12,240                       1  Version 1                               
 
EVNTNUM  $EVNTNUM                      Unique event identifier                  
                         12,074        001-999           Survey-reported event                   
                            166        U001-U999         Event created from survey-reported event
 
OREVTYPE $EVNTTYP                      Original reported event type             
                         12,240        DU                Dental                                  
 
CLAIMID  CLAIMID                       Claim this survey is matched to          
                         12,202                       .  Missing                                 
                             38        Range of values   Claim ID                                
 
EVBEGYY  EVYY                          Event begin year                         
                             37                       R  Refused                                 
                         12,203        Range of values   Year                                    
 
EVBEGMM  EVMM                          Event begin month                        
                              2                       D  Don't Know                              
                              1                       N  Not ascertained                         
                            317                       R  Refused                                 
                         11,920        01-12             Month                                   
 
EVBEGDD  EVDD                          Event begin day                          
                              9                       D  Don't Know                              
                            996                       .  Inapplicable                            
                              1                       N  Not ascertained                         
                          3,323                       R  Refused                                 
                          7,911        01-31             Day of month                            
 
SOURCE   SRCE                          Source of event: Survey, claim, or both? 
                         12,202                       1  Survey only                             
                             38                       3  Both survey & claims                    
 
SITCODE  $SITCODE                      Community or facility setting?           
                              3        B                 Both community & facility               
                         12,197        C                 Community                               
                             11        D                 Deemed community                        
                              3        F                 Facility                                
                             14        H                 Hospice                                 
                             10        I                 Inpatient                               
                              2        S                 SNF                                     
 
AMTTOT   MONYFMT                       Total payment                            
                         12,240        Range of values   Amount as $$$$$$.CC                     
 
IMPATOT  IMPFLAG                       Imputation flag:  Amt total payment      
                          6,694                       0  Not Imputed                             
                          5,546                       1  Imputed by hotdeck                      
 
AMTCOV   MONYFMT                       Portion of total pay cov by Medicare     
                         12,240        Range of values   Amount as $$$$$$.CC                     
 
AMTNCOV  MONYFMT                       Portion of total pay not cov by Medicare 
                         12,240        Range of values   Amount as $$$$$$.CC                     
 
AMTCARE  MONYFMT                       Amount paid by Medicare                  
                         12,240        Range of values   Amount as $$$$$$.CC                     
 
IMPSCARE IMPFLAG                       Imputation flag: SOP Medicare            
                         12,240                       0  Not Imputed                             
 
IMPACARE IMPFLAG                       Imputation flag: Amt Medicare            
                         12,240                       0  Not Imputed                             
 
AMTCAID  MONYFMT                       Amount paid by Medicaid                  
                         12,240        Range of values   Amount as $$$$$$.CC                     
 
IMPSCAID IMPFLAG                       Imputation flag: SOP Medicaid            
                         12,236                       0  Not Imputed                             
                              4                       1  Imputed by hotdeck                      
 
IMPACAID IMPFLAG                       Imputation flag: Amt Medicaid            
                         11,992                       0  Not Imputed                             
                            248                       1  Imputed by hotdeck                      
 
AMTMADV  MONYFMT                       Amount paid by Medicare MCO/HMO          
                         12,240        Range of values   Amount as $$$$$$.CC                     
 
IMPSMADV IMPFLAG                       Imputation flag: SOP Medicare MCO/HMO    
                         11,437                       0  Not Imputed                             
                            803                       1  Imputed by hotdeck                      
 
IMPAMADV IMPFLAG                       Imputation flag: Amt Medicare MCO/HMO    
                         11,236                       0  Not Imputed                             
                          1,004                       1  Imputed by hotdeck                      
 
AMTHMOP  MONYFMT                       Amount paid by Private MCO/HMO           
                         12,240        Range of values   Amount as $$$$$$.CC                     
 
IMPSHMOP IMPFLAG                       Imputation flag: SOP Private MCO/HMO     
                         11,926                       0  Not Imputed                             
                            314                       1  Imputed by hotdeck                      
 
IMPAHMOP IMPFLAG                       Imputation flag: Amt Private MCO/HMO     
                         11,760                       0  Not Imputed                             
                            480                       1  Imputed by hotdeck                      
 
AMTVA    MONYFMT                       Amount paid by Veterans adm              
                         12,240        Range of values   Amount as $$$$$$.CC                     
 
IMPSVA   IMPFLAG                       Imputation flag: SOP Veterans adm        
                         12,240                       0  Not Imputed                             
 
IMPAVA   IMPFLAG                       Imputation flag: Amt Veterans adm        
                         12,216                       0  Not Imputed                             
                             24                       1  Imputed by hotdeck                      
 
AMTPRVE  MONYFMT                       Amount paid by priv ins(employer spons)  
                         12,240        Range of values   Amount as $$$$$$.CC                     
 
IMPSPRVE IMPFLAG                       Imputation flag: SOP priv ins-employer   
                         11,942                       0  Not Imputed                             
                            298                       1  Imputed by hotdeck                      
 
IMPAPRVE IMPFLAG                       Imputation flag: Amt priv ins-employer   
                         11,853                       0  Not Imputed                             
                            387                       1  Imputed by hotdeck                      
 
AMTPRVI  MONYFMT                       Amount paid by priv ins (indiv purch)    
                         12,240        Range of values   Amount as $$$$$$.CC                     
 
IMPSPRVI IMPFLAG                       Imputation flag: SOP priv ins-indiv pur  
                         12,050                       0  Not Imputed                             
                            190                       1  Imputed by hotdeck                      
 
IMPAPRVI IMPFLAG                       Imputation flag: Amt priv ins-indiv pur  
                         11,786                       0  Not Imputed                             
                            454                       1  Imputed by hotdeck                      
 
AMTPRVU  MONYFMT                       Amount paid by priv ins (unknown purch)  
                         12,240        Range of values   Amount as $$$$$$.CC                     
 
IMPSPRVU IMPFLAG                       Imputaiton flag: SOP priv ins-unknown    
                         12,240                       0  Not Imputed                             
 
IMPAPRVU IMPFLAG                       Imputation flag: Amt priv ins-unknown    
                         12,240                       0  Not Imputed                             
 
AMTOOP   MONYFMT                       Amount paid by person/family             
                         12,240        Range of values   Amount as $$$$$$.CC                     
 
IMPSOOP  IMPFLAG                       Imputation flag: SOP paid by person      
                         10,526                       0  Not Imputed                             
                          1,714                       1  Imputed by hotdeck                      
 
IMPAOOP  IMPFLAG                       Imputation flag: Amt paid by person      
                          8,832                       0  Not Imputed                             
                          3,408                       1  Imputed by hotdeck                      
 
AMTDISC  MONYFMT                       Amount of uncollected liabilities        
                         12,240        Range of values   Amount as $$$$$$.CC                     
         Notes:  Beginning in 2013 this includes sequestration reduction
 
IMPSDISC IMPFLAG                       Imputation flag: SOP of uncoll liab      
                         11,375                       0  Not Imputed                             
                            865                       1  Imputed by hotdeck                      
 
IMPADISC IMPFLAG                       Imputation flag: Amt of uncoll liab      
                         11,151                       0  Not Imputed                             
                          1,089                       1  Imputed by hotdeck                      
 
AMTOTH   MONYFMT                       Amount paid by other sources             
                         12,240        Range of values   Amount as $$$$$$.CC                     
 
IMPSOTH  IMPFLAG                       Imputation flag: SOP other sources       
                         12,239                       0  Not Imputed                             
                              1                       1  Imputed by hotdeck                      
 
IMPAOTH  IMPFLAG                       Imputation flag: Amt other sources       
                         12,062                       0  Not Imputed                             
                            178                       1  Imputed by hotdeck                      
 
DVBRIDGE YESNODUE                      Have done during dental visit-bridge     
                             53                       D  Don't Know                              
                          5,273                       .  Inapplicable                            
                              3                       R  Refused                                 
                          6,787                       0  No                                      
                            124                       1  Yes                                     
 
DVCLEAN  YESNODUE                      Have done during dental visit-cleaning   
                             53                       D  Don't Know                              
                          5,273                       .  Inapplicable                            
                              3                       R  Refused                                 
                          3,415                       0  No                                      
                          3,496                       1  Yes                                     
 
DVCROWN  YESNODUE                      Have done during dental visit-crown      
                             53                       D  Don't Know                              
                          5,273                       .  Inapplicable                            
                              3                       R  Refused                                 
                          6,310                       0  No                                      
                            601                       1  Yes                                     
 
DVEXAM   YESNODUE                      Have done during dental visit-examin     
                             53                       D  Don't Know                              
                          5,273                       .  Inapplicable                            
                              3                       R  Refused                                 
                          3,896                       0  No                                      
                          3,015                       1  Yes                                     
 
DVEXTRAC YESNODUE                      Have done during dental visit-extract    
                             53                       D  Don't Know                              
                          5,273                       .  Inapplicable                            
                              3                       R  Refused                                 
                          6,368                       0  No                                      
                            543                       1  Yes                                     
 
DVFILLNG YESNODUE                      Have done during dental visit-filling    
                             53                       D  Don't Know                              
                          5,273                       .  Inapplicable                            
                              3                       R  Refused                                 
                          6,099                       0  No                                      
                            812                       1  Yes                                     
 
DVORTHO  YESNODUE                      Have done during dental visit-othodon    
                             53                       D  Don't Know                              
                          5,273                       .  Inapplicable                            
                              3                       R  Refused                                 
                          6,893                       0  No                                      
                             18                       1  Yes                                     
 
DVOTHER  YESNODUE                      Have done during dental visit-other      
                             53                       D  Don't Know                              
                          5,273                       .  Inapplicable                            
                              3                       R  Refused                                 
                          6,564                       0  No                                      
                            347                       1  Yes                                     
 
DVRTCNAL YESNODUE                      Have done during dental visit-root canal 
                             53                       D  Don't Know                              
                          5,273                       .  Inapplicable                            
                              3                       R  Refused                                 
                          6,733                       0  No                                      
                            178                       1  Yes                                     
 
DVXRAYS  YESNODUE                      Have done during dental visit-xray taken 
                             53                       D  Don't Know                              
                          5,273                       .  Inapplicable                            
                              3                       R  Refused                                 
                          5,349                       0  No                                      
                          1,562                       1  Yes                                     
 
DVPERIOD YESNODUE                      Have done during dental visit-periodont  
                             53                       D  Don't Know                              
                          5,273                       .  Inapplicable                            
                              3                       R  Refused                                 
                          6,839                       0  No                                      
                             72                       1  Yes                                     
 
DVBONDNG YESNODUE                      Have done during dental visit-bonding    
                             53                       D  Don't Know                              
                          5,273                       .  Inapplicable                            
                              3                       R  Refused                                 
                          6,884                       0  No                                      
                             27                       1  Yes                                     
 
DVSURG   YESNODUE                      Have done during dental visit-surgery    
                             53                       D  Don't Know                              
                          5,273                       .  Inapplicable                            
                              3                       R  Refused                                 
                          6,862                       0  No                                      
                             49                       1  Yes                                     
 
MCOHMO   HMO                           Event provided by an MCO/HMO?            
                          5,883                       0  Event not provided by MCO/HMO           
                          6,357                       1  Event provided by MCO/HMO               
 
