Variable Format    Q#/Freq            Description/Label
 
BASEID   $BSIDFMT                      Unique SP Identification Number          
                        290,674        LOW-HIGH          BASEID Count                            
 
SURVEYYR SVYRFMT                       Survey Year                              
                        290,674                    2015  2015                                    
 
VERSION  VERSFMT                       Version Number                           
                        290,674                       1  Version 1                               
 
EVNTNUM  $EVNTNUM                      Unique event identifier                  
                          2,085                          Missing                                 
                        145,405        001-999           Survey-reported event                   
                        141,949        C001-C999         Event created from claim                
                          1,235        U001-U999         Event created from survey-reported event
 
EVNTTYPE $EVNTTYP                      Event type                               
                        148,979        MP                Medical provider                        
                         39,757        OM                Other medical expense                   
                         59,375        SD                Separately billing physician            
                         42,563        SL                Separately billing lab                  
 
OREVTYPE $EVNTTYP                      Original reported event type             
                        144,034                          Missing                                 
                            849        ER                Emergency Room                          
                          1,031        IP                Inpatient                               
                        100,772        MP                Medical provider                        
                         22,861        OM                Other medical expense                   
                          3,430        OP                Outpatient                              
                         13,964        SD                Separately billing physician            
                          3,733        SL                Separately billing lab                  
 
CLAIMID  CLAIMID                       Claim this survey event matched to       
                         82,275                       .  Missing                                 
                        208,399        Range of values   Claim ID                                
 
CLAIMTYP $CLAIMTP                      Claim type that event matched to         
                         80,190                          Inapplicable/Missing                    
                         14,334        D                 DME claim                               
                        194,065        P                 Physician claim                         
                          2,085        R                 PDE claim                               
 
EVBEGYY  EVENTYY                       Event begin year                         
                             34                       D  Don't know                              
                          8,461                       .  Inapplicable/Missing                    
                             10                       N  Not ascertained                         
                            205                       R  Refused                                 
                        281,964        Range of values   Year                                    
 
EVBEGMM  EVENTMM                       Event begin month                        
                            175                       D  Don't know                              
                          8,458                       .  Inapplicable/Missing                    
                              9                       N  Not ascertained                         
                          1,877                       R  Refused                                 
                        280,155        01-12             Month                                   
 
EVBEGDD  EVENTDD                       Event begin day                          
                          1,482                       D  Don't know                              
                         19,805                       .  Inapplicable/Missing                    
                             12                       N  Not ascertained                         
                         20,773                       R  Refused                                 
                        248,602        01-31             Day of month                            
 
SOURCE   $SOURCE                       Source of event: survey, claim, or both  
                         80,190        1                 Survey only                             
                        144,034        2                 Claims only                             
                         66,450        3                 Both survey & claims                    
 
SITCODE  $CODEFMT                      Community or facility setting            
                            283        B                 Both                                    
                        228,657        C                 Community                               
                          2,484        D                 Deemed Community                        
                         20,622        F                 Facility                                
                            278        G                 Deemed facility                         
                          1,750        H                 Hospice                                 
                         30,669        I                 Inpatient                               
                             46        IH                Inpatient Hospice                       
                          5,885        S                 SNF                                     
 
AMTTOT   MONYFMT                       Total payment                            
                        290,674        Range of values   Amount as $$$$$$.CC                     
 
IMPATOT  IMPFLAG                       Imputation flag:  total payment          
                        183,697                       0  Not Imputed                             
                        106,977                       1  Imputed by hotdeck                      
 
AMTCOV   MONYFMT                       Portion of total pay cov by Medicare     
                        290,674        Range of values   Amount as $$$$$$.CC                     
 
AMTNCOV  MONYFMT                       Portion of total pay not cov by Medicare 
                        290,674        Range of values   Amount as $$$$$$.CC                     
 
AMTCARE  MONYFMT                       Amount paid by Medicare                  
                        290,674        Range of values   Amount as $$$$$$.CC                     
 
IMPSCARE IMPFLAG                       Imputation flag: SOP Medicare            
                        290,674                       0  Not Imputed                             
 
IMPACARE IMPFLAG                       Imputation flag: amt Medicare            
                        281,767                       0  Not Imputed                             
                          8,907                       1  Imputed by hotdeck                      
 
AMTCAID  MONYFMT                       Amount paid by Medicaid                  
                        290,674        Range of values   Amount as $$$$$$.CC                     
 
IMPSCAID IMPFLAG                       Imputation flag: SOP Medicaid            
                        264,288                       0  Not Imputed                             
                         26,386                       1  Imputed by hotdeck                      
 
IMPACAID IMPFLAG                       Imputation flag: amt Medicaid            
                        244,779                       0  Not Imputed                             
                         45,895                       1  Imputed by hotdeck                      
 
AMTMADV  MONYFMT                       Amount paid by Medicare MCO/HMO          
                        290,674        Range of values   Amount as $$$$$$.CC                     
 
IMPSMADV IMPFLAG                       Imputation flag: SOP Medicare MCO/HMO    
                        268,823                       0  Not Imputed                             
                         21,851                       1  Imputed by hotdeck                      
 
IMPAMADV IMPFLAG                       Imputation flag: amt Medicare MCO/HMO    
                        262,115                       0  Not Imputed                             
                         28,559                       1  Imputed by hotdeck                      
 
AMTHMOP  MONYFMT                       Amount paid by Private MCO/HMO           
                        290,674        Range of values   Amount as $$$$$$.CC                     
 
IMPSHMOP IMPFLAG                       Imputation flag: SOP Private MCO/HMO     
                        280,909                       0  Not Imputed                             
                          9,765                       1  Imputed by hotdeck                      
 
IMPAHMOP IMPFLAG                       Imputation flag: amt Private MCO/HMO     
                        278,086                       0  Not Imputed                             
                         12,588                       1  Imputed by hotdeck                      
 
AMTVA    MONYFMT                       Amount paid by Veterans Admin.           
                        290,674        Range of values   Amount as $$$$$$.CC                     
 
IMPSVA   IMPFLAG                       Imputation flag: SOP Veterans Admin.     
                        290,668                       0  Not Imputed                             
                              6                       1  Imputed by hotdeck                      
 
IMPAVA   IMPFLAG                       Imputation flag: amt Veterans Admin.     
                        290,537                       0  Not Imputed                             
                            137                       1  Imputed by hotdeck                      
 
AMTPRVE  MONYFMT                       Amount paid by Priv ins (Employer Spon)  
                        290,674        Range of values   Amount as $$$$$$.CC                     
 
IMPSPRVE IMPFLAG                       Imputation flag: SOP Priv ins-Employer   
                        274,064                       0  Not Imputed                             
                         16,610                       1  Imputed by hotdeck                      
 
IMPAPRVE IMPFLAG                       Imputation flag: amt Priv ins-Employer   
                        271,937                       0  Not Imputed                             
                         18,737                       1  Imputed by hotdeck                      
 
AMTPRVI  MONYFMT                       Amount paid by Priv ins (Indiv Purch)    
                        290,674        Range of values   Amount as $$$$$$.CC                     
 
IMPSPRVI IMPFLAG                       Imputation flag: SOP PPriv ins-Indiv Pur 
                        264,309                       0  Not Imputed                             
                         26,365                       1  Imputed by hotdeck                      
 
IMPAPRVI IMPFLAG                       Imputation flag: amt Priv ins-Indiv Pur  
                        257,883                       0  Not Imputed                             
                         32,791                       1  Imputed by hotdeck                      
 
AMTPRVU  MONYFMT                       Amount paid by Priv ins (Unknown Purch)  
                        290,674        Range of values   Amount as $$$$$$.CC                     
 
IMPSPRVU IMPFLAG                       Imputation flag: SOP Priv ins-Unknown    
                        286,607                       0  Not Imputed                             
                          4,067                       1  Imputed by hotdeck                      
 
IMPAPRVU IMPFLAG                       Imputation flag: amt Priv ins-Unknown    
                        286,607                       0  Not Imputed                             
                          4,067                       1  Imputed by hotdeck                      
 
AMTOOP   MONYFMT                       Amount paid by person/family             
                        290,674        Range of values   Amount as $$$$$$.CC                     
 
IMPSOOP  IMPFLAG                       Imputation flag: SOP paid by person      
                        228,623                       0  Not Imputed                             
                         62,051                       1  Imputed by hotdeck                      
 
IMPAOOP  IMPFLAG                       Imputation flag: amt paid by person      
                        200,810                       0  Not Imputed                             
                         89,864                       1  Imputed by hotdeck                      
 
AMTDISC  MONYFMT                       Amount of uncollected liabilities        
                        290,674        Range of values   Amount as $$$$$$.CC                     
         Notes:  Beginning in 2013 this includes sequestration reduction
 
IMPSDISC IMPFLAG                       Imputation flag: SOP of uncoll liab      
                        147,691                       0  Not Imputed                             
                        142,983                       1  Imputed by hotdeck                      
 
IMPADISC IMPFLAG                       Imputation flag: amt of uncoll liab      
                        113,509                       0  Not Imputed                             
                        177,165                       1  Imputed by hotdeck                      
 
AMTOTH   MONYFMT                       Amount paid by other sources             
                        290,674        Range of values   Amount as $$$$$$.CC                     
 
IMPSOTH  IMPFLAG                       Imputation flag: SOP other sources       
                        290,397                       0  Not Imputed                             
                            277                       1  Imputed by hotdeck                      
 
IMPAOTH  IMPFLAG                       Imputation flag: amt other sources       
                        288,362                       0  Not Imputed                             
                          2,312                       1  Imputed by hotdeck                      
 
PAMTMED  MONYFMT                       Total amount paid for medical services   
                         80,205                       .  Inapplicable/Missing                    
                        210,469        Range of values   Amount as $$$$$$.CC                     
 
PAMTSURG MONYFMT                       Total amount paid for surgical services  
                         80,205                       .  Inapplicable/Missing                    
                        210,469        Range of values   Amount as $$$$$$.CC                     
 
PAMTLABX MONYFMT                       Total amount paid for lab/x-ray          
                         80,205                       .  Inapplicable/Missing                    
                        210,469        Range of values   Amount as $$$$$$.CC                     
 
PAMTOM   MONYFMT                       Total amount paid for oth med services   
                         80,205                       .  Inapplicable/Missing                    
                        210,469        Range of values   Amount as $$$$$$.CC                     
 
PAMTPM   MONYFMT                       Total amount paid for pres. medicines    
                         80,205                       .  Inapplicable/Missing                    
                        210,469        Range of values   Amount as $$$$$$.CC                     
 
PROVSPEC PROVSPEC                      Medical provider speciality              
                             34                       D  Don't know                              
                        178,108                       .  Inapplicable/Missing                    
                             50                       N  Not ascertained                         
                            379                       1  Dentist or dental provider              
                         72,499                       2  Medical doctor                          
                            681                       3  Audiologist                             
                          5,930                       4  Chiropractor                            
                            202                       5  Clinical Social Worker                  
                             62                       6  Dietician or nutritionist               
                             21                       7  Hearing therapist                       
                          1,506                       8  Home health/health aide                 
                              1                      10  Hospice worker                          
                            144                      11  I.V. Therapist                          
                          1,178                      12  Nurse (RN)                              
                          1,632                      13  Nurse Practitioner                      
                             50                      14  Nurse's aide                            
                            572                      15  Occupational Therapist (OT)             
                          2,295                      16  Optometrist                             
                            616                      17  Osteopath (DO)                          
                             68                      18  Paramedic                               
                          9,906                      19  Physical Therapist (PT)                 
                          1,163                      20  Physician's Assistant                   
                          2,735                      21  Podiatrist (foot doctor)                
                          1,451                      22  Psychologist                            
                             49                      23  Respiratory Therapist                   
                            407                      24  Social/case worker                      
                            409                      25  Speech Therapist                        
                            562                      26  Therapist (mental health)               
                            796                      27  X-Ray Technician                        
                            148                      28  Licensed Practical Nurse (LPN)          
                            583                      29  Acupuncturist                           
                             17                      30  Homeopath                               
                          1,098                      31  Massage therapist                       
                             93                      32  Naturopath                              
                            206                      33  Licensed Professional Counselor (LPC)   
                          1,289                      34  Lab Technician                          
                              1                      35  Dental Hygienist                        
                              1                      37  Dental/Oral Surgeon                     
                          3,732                      91  Other medical provider                  
 
OMETYPE  OMETYPE                       Type of OM event                         
                        254,297                       .  Inapplicable/Missing                    
                          2,508                       1  Eyeglasses                              
                            671                       2  Hearing or speech device                
                          2,599                       3  Orthopedic                              
                          7,239                       4  Diabetic                                
                          4,985                       5  Ambulance                               
                            126                       6  Prosthesis                              
                            529                       7  Alteration                              
                          4,510                       8  Oxygen                                  
                             64                       9  Kidney dialysis                         
                         13,146                      10  Other                                   
 
ORTHTYPE ORTHTYPE                      Type of orthopedic item                  
                        288,075                       .  Inapplicable/Missing                    
                              1                       N  Not ascertained                         
                            723                       1  Braces or supports                      
                            270                       2  Cane                                    
                            334                       3  Corrective shoes or inserts             
                             33                       4  Crutches                                
                            456                       5  Walker                                  
                            319                       6  Wheelchair                              
                            313                       7  Stockings                               
                            150                      91  Other                                   
 
ALTRTYPE ALTRTYPE                      Type of alteration                       
                        290,145                       .  Inapplicable/Missing                    
                             19                       1  Elevator or incline chair               
                            128                       2  Handrails (other than tub)              
                             92                       3  Ramps                                   
                             93                       4  Tub handrails                           
                             32                       5  Tub seat                                
                             19                       6  Any car alteration                      
                            146                      91  Other                                   
 
OTHRTYPE OTHRTYPE                      Type of other OME                        
                        277,528                       .  Inapplicable/Missing                    
                             18                       N  Not ascertained                         
                            203                       1  Portable or raised toilet               
                             79                       2  Portable tub seat                       
                             73                       3  Special chair or cushion                
                            461                       4  Hospital bed                            
                            540                       5  Ostomy supplies                         
                          7,420                       6  Depends (diapers)                       
                            773                       7  Bandages, dressings, tape supplies      
                            621                       8  Pulmonary equipment                     
                            208                       9  Blood pressure equipment                
                          2,750                      91  Other                                   
 
MCOHMO   HMO                           Event provided by MCO/HMO                
                        188,741                       0  Event not provided by MCO/HMO           
                         99,848                       1  Event provided by MCO/HMO               
                          2,085                       3  Event provided by PDP/MAPD              
 
SOWMP    SOWMP                         Survey Only with Medicare Not MA Payment 
                         30,943                       .  Missing                                 
                        247,680                       0  Not Srvy Only w/Medicare Pymnt (not MA) 
                         12,051                       1  Survey Only w/Medicare Payment (not MA) 
                 First available in 2015
 
