Variable Format    Q#/Freq            Description/Label
 
BASEID   $BSIDFMT                      Unique SP Identification Number          
                          2,887        LOW-HIGH          BASEID Count                            
 
SURVEYYR SVYRFMT                       Survey Year                              
                          2,887                    2015  2015                                    
 
VERSION  VERSFMT                       Version Number                           
                          2,887                       1  Version 1                               
 
EVNTNUM  $EVNTNUM                      Event identifier                         
                          1,834        001-999           Survey-reported event                   
                          1,044        C001-C999         Event created from claim                
                              9        U001-U999         Event created from survey-reported event
 
OREVTYPE $EVNTTYP                      Original reported event type             
                          1,044                          Missing                                 
                             39        ER                Emergency Room                          
                          1,681        IP                Inpatient                               
                             55        IU                Institutional utilization               
                             68        OP                Outpatient                              
 
CLAIMID  CLAIMID                       1st Claim this survey event matched to   
                            606                       .  Missing                                 
                          2,281        Range of values   Claim ID                                
 
EVBEGYY  EVYY                          Event begin year                         
                              5                       R  Refused                                 
                          2,882        Range of values   Year                                    
 
EVBEGMM  EVMM                          Event begin month                        
                             27                       R  Refused                                 
                          2,860        01-12             Month                                   
 
EVBEGDD  EVDD                          Event begin day                          
                              2                       .  Inapplicable                            
                            155                       R  Refused                                 
                          2,730        01-31             Day of month                            
 
EVENDYY  EVYY                          Event end year                           
                              1                       D  Don't Know                              
                             36                       .  Inapplicable                            
                              8                       R  Refused                                 
                          2,842        Range of values   Year                                    
 
EVENDMM  EVMM                          Event end month                          
                              1                       D  Don't Know                              
                             36                       .  Inapplicable                            
                             31                       R  Refused                                 
                          2,819        01-12             Month                                   
 
EVENDDD  EVDD                          Event end day                            
                              2                       D  Don't Know                              
                             36                       .  Inapplicable                            
                            132                       R  Refused                                 
                          2,717        01-31             Day of month                            
 
SOURCE   SRCE                          Source of event: survey, claim, or both? 
                            606                       1  Survey only                             
                          1,044                       2  Claims only                             
                          1,237                       3  Both survey & claims                    
 
SITCODE  $SITCODE                      Community or facility setting?           
                            602        C                 Community                               
                              2        F                 Facility                                
                             10        H                 Hospice                                 
                          2,265        I                 Inpatient                               
                              7        IH                Inpatient Hospice                       
                              1        S                 SNF                                     
 
AMTTOT   MONYFMT                       Total payment                            
                          2,887        Range of values   Amount as $$$$$$.CC                     
 
IMPATOT  IMPFLAG                       Imputation flag: total payment           
                          1,953                       0  Not Imputed                             
                            934                       1  Imputed by hotdeck                      
 
AMTCOV   MONYFMT                       Portion of total pay cov by Medicare     
                          2,887        Range of values   Amount as $$$$$$.CC                     
 
AMTNCOV  MONYFMT                       Portion of total pay not cov by Medicare 
                          2,887        Range of values   Amount as $$$$$$.CC                     
 
AMTCARE  MONYFMT                       Amount paid by Medicare                  
                          2,887        Range of values   Amount as $$$$$$.CC                     
 
IMPSCARE IMPFLAG                       Imputation flag: SOP Medicare            
                          2,887                       0  Not Imputed                             
 
IMPACARE IMPFLAG                       Imputation flag: Amt Medicare            
                          2,849                       0  Not Imputed                             
                             38                       1  Imputed by hotdeck                      
 
AMTCAID  MONYFMT                       Amount paid by Medicaid                  
                          2,887        Range of values   Amount as $$$$$$.CC                     
 
IMPSCAID IMPFLAG                       Imputation flag: SOP Medicaid            
                          2,639                       0  Not Imputed                             
                            248                       1  Imputed by hotdeck                      
 
IMPACAID IMPFLAG                       Imputation flag: Amt Medicaid            
                          2,447                       0  Not Imputed                             
                            440                       1  Imputed by hotdeck                      
 
AMTMADV  MONYFMT                       Amount paid by Medicare MCO/HMO          
                          2,887        Range of values   Amount as $$$$$$.CC                     
 
IMPSMADV IMPFLAG                       Imputation flag: SOP Medicare MCO/HMO    
                          2,492                       0  Not Imputed                             
                            395                       1  Imputed by hotdeck                      
 
IMPAMADV IMPFLAG                       Imputation flag: Amt Medicare MCO/HMO    
                          2,366                       0  Not Imputed                             
                            521                       1  Imputed by hotdeck                      
 
AMTHMOP  MONYFMT                       Amount paid by private MCO/HMO           
                          2,887        Range of values   Amount as $$$$$$.CC                     
 
IMPSHMOP IMPFLAG                       Imputation flag: SOP Priv MCO/HMO        
                          2,798                       0  Not Imputed                             
                             89                       1  Imputed by hotdeck                      
 
IMPAHMOP IMPFLAG                       Imputation flag: Amt Priv MCO/HMO        
                          2,761                       0  Not Imputed                             
                            126                       1  Imputed by hotdeck                      
 
AMTVA    MONYFMT                       Amount paid by Veterans Admin            
                          2,887        Range of values   Amount as $$$$$$.CC                     
 
IMPSVA   IMPFLAG                       Imputation flag: SOP Veterans admin      
                          2,887                       0  Not Imputed                             
 
IMPAVA   IMPFLAG                       Imputation flag: Amt Veterans admin      
                          2,887                       0  Not Imputed                             
 
AMTPRVE  MONYFMT                       Amt paid by priv ins (employer spons)    
                          2,887        Range of values   Amount as $$$$$$.CC                     
 
IMPSPRVE IMPFLAG                       Imputation flag: SOP priv ins-employer   
                          2,788                       0  Not Imputed                             
                             99                       1  Imputed by hotdeck                      
 
IMPAPRVE IMPFLAG                       Imputation flag: Amt priv ins-employer   
                          2,762                       0  Not Imputed                             
                            125                       1  Imputed by hotdeck                      
 
AMTPRVI  MONYFMT                       Amt paid by priv ins (indiv purch)       
                          2,887        Range of values   Amount as $$$$$$.CC                     
 
IMPSPRVI IMPFLAG                       Imputation flag: SOP priv ins-indiv purch
                          2,735                       0  Not Imputed                             
                            152                       1  Imputed by hotdeck                      
 
IMPAPRVI IMPFLAG                       Imputation flag: Amt priv ins-indiv purch
                          2,654                       0  Not Imputed                             
                            233                       1  Imputed by hotdeck                      
 
AMTPRVU  MONYFMT                       Amt paid by priv ins (unknown purch)     
                          2,887        Range of values   Amount as $$$$$$.CC                     
 
IMPSPRVU IMPFLAG                       Imputation flag: SOP priv ins-unknown    
                          2,822                       0  Not Imputed                             
                             65                       1  Imputed by hotdeck                      
 
IMPAPRVU IMPFLAG                       Imputation flag: Amt priv ins-unknown    
                          2,822                       0  Not Imputed                             
                             65                       1  Imputed by hotdeck                      
 
AMTOOP   MONYFMT                       Amount paid by person/family             
                          2,887        Range of values   Amount as $$$$$$.CC                     
 
IMPSOOP  IMPFLAG                       Imputation flag: SOP paid by pers/fam    
                          2,527                       0  Not Imputed                             
                            360                       1  Imputed by hotdeck                      
 
IMPAOOP  IMPFLAG                       Imputation flag: Amt paid by pers/fam    
                          2,390                       0  Not Imputed                             
                            497                       1  Imputed by hotdeck                      
 
AMTDISC  MONYFMT                       Amount of uncollected SP liability       
                          2,887        Range of values   Amount as $$$$$$.CC                     
         Notes:  Beginning in 2013 this includes sequestration reduction
 
IMPSDISC IMPFLAG                       Imputation flag: SOP of uncoll liab      
                          1,637                       0  Not Imputed                             
                          1,250                       1  Imputed by hotdeck                      
 
IMPADISC IMPFLAG                       Imputation flag: Amt of uncoll liab      
                          1,272                       0  Not Imputed                             
                          1,615                       1  Imputed by hotdeck                      
 
AMTOTH   MONYFMT                       Amount paid by other sources             
                          2,887        Range of values   Amount as $$$$$$.CC                     
 
IMPSOTH  IMPFLAG                       Imputation flag: SOP other sources       
                          2,887                       0  Not Imputed                             
 
IMPAOTH  IMPFLAG                       Imputation flag: Amt other sources       
                          2,877                       0  Not Imputed                             
                             10                       1  Imputed by hotdeck                      
 
DGNCNT   NUM3FMT                       Number of diagnosis codes on claim       
                            606                       .  Inapplicable/Missing                    
                          2,281        Range of values   Number                                  
 
PRINDIAG $DIAGFMT                      Primary ICD-9 diag code                  
                            606                          Missing                                 
                          2,281        Range of Codes    ICD Code                                
 
POAIND   POAFMT                        Present on admission indicator           
                            606                       .  Missing                                 
                             67                       0  No codes present on admission           
                          2,214                       1  At least 1 code present on admis        
 
E1DGNSCD $ECDFMT                       First E-CODE from claim                  
                          2,421                          Missing                                 
                            466        Range of Codes    E-Code                                  
 
DRG      $DRGFMT                       Diagnosis related group from claim       
                            606                          Missing                                 
                          2,281        Range of Codes    DRG                                     
 
IPPRJCNT NUM3FMT                       Number of procedure codes on claim       
                            606                       .  Inapplicable/Missing                    
                          1,048                       0  None                                    
                          1,233        Range of values   Number                                  
 
PRCDRCD1 $PRCDRFM                      First procedure codes on claim           
                          1,654                          Missing                                 
                          1,233        Range of Codes    Procedure Code                          
 
PROV     $FIDFMT                       Medicare provider number from claim      
                            606                          Missing                                 
                          2,281        Provider Number   Provider Number                         
 
STATUS   STATUS                        Beneficiary status as of claim thru date 
                            606                       .  Inapplicable/Missing                    
                            946                       1  Discharged to home/self care            
                             54                       2  Discharged to other short-term hospital 
                            493                       3  Discharged to skilled nursing facility  
                             35                       4  Discharged to intermediate care facility
                              2                       5  Disch to another type of institution    
                            435                       6  Discharged to home care of organized HMO
                             11                       7  Left against medical advice/stopped care
                             97                      20  Expired (did not recover Christian Sci) 
                              2                      30  Still patient                           
                             38                      50  Hospice - home                          
                             34                      51  Hospice - medical facility              
                             29                      61  Disch w/i facility to swing-bed SNF     
                             73                      62  Disch inp rehab; inc distinct hosp      
                             17                      63  Disch to long term care hospital        
                              1                      64  Disch cert nursing; Mcaid, not Mcare    
                              4                      65  Disch to psychiatric hosp or unit       
                              1                      66  Other destination                       
                              5                      70  Disch to other institution, no code     
                              1                      81  Disch to home/self-care: planned readmit
                              1                      86  Disch to home health: planned readmit   
                              1                      90  Disch to inp rehab fac: planned readmit 
                              1                      92  Disch to Medicaid LTCH: planned readmit 
 
UTLZNDAY NUM3FMT                       Number of covered days of care           
                            606                       .  Inapplicable/Missing                    
                             46                       0  None                                    
                          2,235        Range of values   Number                                  
 
COINDAY  NUM3FMT                       Total number of coinsurance days         
                            606                       .  Inapplicable/Missing                    
                          2,246                       0  None                                    
                             35        Range of values   Number                                  
 
LRDAYS   NUM3FMT                       Number of lifetime reserve days used     
                            606                       .  Inapplicable/Missing                    
                          2,273                       0  None                                    
                              8        Range of values   Number                                  
 
MCOHMO   HMO                           Event provided by an MCO/HMO?            
                          1,808                       0  Event not provided by MCO/HMO           
                          1,079                       1  Event provided by MCO/HMO               
 
SOWMP    SOWMP                         Survey Only with Medicare Not MA Payment 
                            346                       .  Missing                                 
                          2,475                       0  Not Srvy Only w/Medicare Pymnt (not MA) 
                             66                       1  Survey Only w/Medicare Payment (not MA) 
                 First available in 2015
 
