Variable Format    Q#/Freq            Description/Label
 
BASEID   $BSIDFMT                      Unique SP Identification Number          
                         56,125        LOW-HIGH          BASEID Count                            
 
SURVEYYR SVYRFMT                       Survey Year                              
                         56,125                    2015  2015                                    
 
VERSION  VERSFMT                       Version Number                           
                         56,125                       1  Version 1                               
 
EVNTNUM  $EVNTNUM                      Unique event identifier                  
                         31,620        001-999           Survey-reported event                   
                         24,312        C001-C999         Event created from claim                
                            193        U001-U999         Event created from survey-reported event
 
OREVTYPE $EVNTTYP                      Original reported event type             
                         24,312                          Missing                                 
                          2,312        ER                Emergency Room                          
                            817        IP                Inpatient                               
                         14,415        MP                Medical provider                        
                            246        OM                Other medical expense                   
                         12,110        OP                Outpatient                              
                            947        SD                Separately billing physician            
                            966        SL                Separately billing lab                  
 
CLAIMID  CLAIMID                       Claim this survey is matched to          
                         14,827                       .  Missing                                 
                         41,298        Range of values   Claim ID                                
 
FROMDT   MMDDYYn8                      From date on claim                       
                         14,844                       .  Inapplicable                            
                         41,281        MMDDYYYY          Date as MMDDYYYY                        
 
THRUDT   MMDDYYn8                      Thru date on claim                       
                         14,844                       .  Inapplicable                            
                         41,281        MMDDYYYY          Date as MMDDYYYY                        
 
EVBEGYY  EVYY                          Event begin year                         
                             84                       .  Inapplicable                            
                         56,041        Range of values   Year                                    
 
EVBEGMM  EVMM                          Event begin month                        
                              3                       D  Don't Know                              
                             84                       .  Inapplicable                            
                            519                       R  Refused                                 
                         55,519        01-12             Month                                   
 
EVBEGDD  EVDD                          Event begin day                          
                             30                       D  Don't Know                              
                          6,299                       .  Inapplicable                            
                          7,386                       R  Refused                                 
                         42,410        01-31             Day of month                            
 
SOURCE   SRCE                          Source of event: Survey, claim, or both? 
                         14,827                       1  Survey only                             
                         24,312                       2  Claims only                             
                         16,986                       3  Both survey & claims                    
 
SITCODE  $SITCODE                      Community or facility setting?           
                              5        B                 Both community & facility               
                         50,245        C                 Community                               
                            544        D                 Deemed community                        
                          4,226        F                 Facility                                
                             27        G                 Deemed facility                         
                            243        H                 Hospice                                 
                            363        I                 Inpatient                               
                            472        S                 SNF                                     
 
AMTTOT   MONYFMT                       Total payment                            
                         56,125        Range of values   Amount as $$$$$$.CC                     
 
IMPATOT  IMPFLAG                       Imputation flag:  Amt total payment      
                         32,321                       0  Not Imputed                             
                         23,804                       1  Imputed by hotdeck                      
 
AMTCOV   MONYFMT                       Portion of total pay cov by Medicare     
                         56,125        Range of values   Amount as $$$$$$.CC                     
 
AMTNCOV  MONYFMT                       Portion of total pay not cov by Medicare 
                         56,125        Range of values   Amount as $$$$$$.CC                     
 
AMTCARE  MONYFMT                       Amount paid by Medicare                  
                         56,125        Range of values   Amount as $$$$$$.CC                     
 
IMPSCARE IMPFLAG                       Imputation flag: SOP Medicare            
                         56,125                       0  Not Imputed                             
 
IMPACARE IMPFLAG                       Imputation flag: Amt Medicare            
                         53,975                       0  Not Imputed                             
                          2,150                       1  Imputed by hotdeck                      
 
AMTCAID  MONYFMT                       Amount paid by Medicaid                  
                         56,125        Range of values   Amount as $$$$$$.CC                     
 
IMPSCAID IMPFLAG                       Imputation flag: SOP Medicaid            
                         51,588                       0  Not Imputed                             
                          4,537                       1  Imputed by hotdeck                      
 
IMPACAID IMPFLAG                       Imputation flag: Amt Medicaid            
                         48,019                       0  Not Imputed                             
                          8,106                       1  Imputed by hotdeck                      
 
AMTMADV  MONYFMT                       Amount paid by Medicare MCO/HMO          
                         56,125        Range of values   Amount as $$$$$$.CC                     
 
IMPSMADV IMPFLAG                       Imputation flag: SOP Medicare MCO/HMO    
                         51,181                       0  Not Imputed                             
                          4,944                       1  Imputed by hotdeck                      
 
IMPAMADV IMPFLAG                       Imputation flag: Amt Medicare MCO/HMO    
                         49,496                       0  Not Imputed                             
                          6,629                       1  Imputed by hotdeck                      
 
AMTHMOP  MONYFMT                       Amount paid by Private MCO/HMO           
                         56,125        Range of values   Amount as $$$$$$.CC                     
 
IMPSHMOP IMPFLAG                       Imputation flag: SOP Private MCO/HMO     
                         54,378                       0  Not Imputed                             
                          1,747                       1  Imputed by hotdeck                      
 
IMPAHMOP IMPFLAG                       Imputation flag: Amt Private MCO/HMO     
                         53,735                       0  Not Imputed                             
                          2,390                       1  Imputed by hotdeck                      
 
AMTVA    MONYFMT                       Amount paid by Veterans adm              
                         56,125        Range of values   Amount as $$$$$$.CC                     
 
IMPSVA   IMPFLAG                       Imputation flag: SOP Veterans adm        
                         56,119                       0  Not Imputed                             
                              6                       1  Imputed by hotdeck                      
 
IMPAVA   IMPFLAG                       Imputation flag: Amt Veterans adm        
                         56,053                       0  Not Imputed                             
                             72                       1  Imputed by hotdeck                      
 
AMTPRVE  MONYFMT                       Amount paid by priv ins(employer spons)  
                         56,125        Range of values   Amount as $$$$$$.CC                     
 
IMPSPRVE IMPFLAG                       Imputation flag: SOP priv ins-employer   
                         54,412                       0  Not Imputed                             
                          1,713                       1  Imputed by hotdeck                      
 
IMPAPRVE IMPFLAG                       Imputation flag: Amt priv ins-employer   
                         53,974                       0  Not Imputed                             
                          2,151                       1  Imputed by hotdeck                      
 
AMTPRVI  MONYFMT                       Amount paid by priv ins (indiv purch)    
                         56,125        Range of values   Amount as $$$$$$.CC                     
 
IMPSPRVI IMPFLAG                       Imputation flag: SOP priv ins-indiv pur  
                         52,103                       0  Not Imputed                             
                          4,022                       1  Imputed by hotdeck                      
 
IMPAPRVI IMPFLAG                       Imputation flag: Amt priv ins-indiv pur  
                         50,557                       0  Not Imputed                             
                          5,568                       1  Imputed by hotdeck                      
 
AMTPRVU  MONYFMT                       Amount paid by priv ins (unknown purch)  
                         56,125        Range of values   Amount as $$$$$$.CC                     
 
IMPSPRVU IMPFLAG                       Imputaiton flag: SOP priv ins-unknown    
                         55,555                       0  Not Imputed                             
                            570                       1  Imputed by hotdeck                      
 
IMPAPRVU IMPFLAG                       Imputation flag: Amt priv ins-unknown    
                         55,555                       0  Not Imputed                             
                            570                       1  Imputed by hotdeck                      
 
AMTOOP   MONYFMT                       Amount paid by person/family             
                         56,125        Range of values   Amount as $$$$$$.CC                     
 
IMPSOOP  IMPFLAG                       Imputation flag: SOP paid by person      
                         46,695                       0  Not Imputed                             
                          9,430                       1  Imputed by hotdeck                      
 
IMPAOOP  IMPFLAG                       Imputation flag: Amt paid by person      
                         43,932                       0  Not Imputed                             
                         12,193                       1  Imputed by hotdeck                      
 
AMTDISC  MONYFMT                       Amount of uncollected liabilities        
                         56,125        Range of values   Amount as $$$$$$.CC                     
         Notes:  Beginning in 2013 this includes sequestration reduction
 
IMPSDISC IMPFLAG                       Imputation flag: SOP of uncoll liab      
                         31,872                       0  Not Imputed                             
                         24,253                       1  Imputed by hotdeck                      
 
IMPADISC IMPFLAG                       Imputation flag: Amt of uncoll liab      
                         22,471                       0  Not Imputed                             
                         33,654                       1  Imputed by hotdeck                      
 
AMTOTH   MONYFMT                       Amount paid by other sources             
                         56,125        Range of values   Amount as $$$$$$.CC                     
 
IMPSOTH  IMPFLAG                       Imputation flag: SOP other sources       
                         56,098                       0  Not Imputed                             
                             27                       1  Imputed by hotdeck                      
 
IMPAOTH  IMPFLAG                       Imputation flag: Amt other sources       
                         55,145                       0  Not Imputed                             
                            980                       1  Imputed by hotdeck                      
 
DGNCNT                                 Unique diagnosis codes for event         
                         14,844                       .  Inapplicable/Missing                    
                         41,281        LOW-HIGH          Range of Values                         
 
PRINDIAG $DIAGFMT                      Primary ICD diagnosis code from claim    
                         14,844                          Missing                                 
                         41,281        Range of Codes    ICD Code                                
 
E1DGNSCD $ECDFMT                       First e-code from claim                  
                         54,841                          Missing                                 
                          1,284        Range of Codes    E-Code                                  
 
MCOHMO   HMO                           Event provided by an MCO/HMO?            
                         36,885                       0  Event not provided by MCO/HMO           
                         19,240                       1  Event provided by MCO/HMO               
 
SOWMP    SOWMP                         Survey Only with Medicare Not MA Payment 
                          4,552                       .  Missing                                 
                         48,762                       0  Not Srvy Only w/Medicare Pymnt (not MA) 
                          2,811                       1  Survey Only w/Medicare Payment (not MA) 
                 First available in 2015
 
