Variable Format    Q#/Freq            Description/Label
 
BASEID   $BSIDFMT                      Unique SP Identification Number          
                         10,834        LOW-HIGH          BASEID Count                            
 
VERSION  VERSFMT                       Version Number                           
                         10,834                       1  Version 1                               
 
SURVEYYR SVYRFMT                       Survey Year                              
                         10,834                    2016  2016                                    
 
EVNTNUM  $EVNTNUM                      Unique event identifier                  
                         10,641        001-999           Survey-reported event                   
                            193        U001-U999         Event created from survey-reported event
 
OREVTYPE $EVNTTYP                      Original reported event type             
                         10,834        DU                Dental                                  
 
CLAIMID  CLAIMID                       Claim this survey is matched to          
                         10,808                       .  Missing                                 
                             26        Range of values   Claim ID                                
 
EVBEGYY  EVYY                          Event begin year                         
                         10,834        Range of values   Year                                    
 
EVBEGMM  EVMM                          Event begin month                        
                            121                       R  Refused                                 
                         10,713        01-12             Month                                   
 
EVBEGDD  EVDD                          Event begin day                          
                              9                       D  Don't Know                              
                            889                       .  Inapplicable                            
                          2,512                       R  Refused                                 
                          7,424        01-31             Day of month                            
 
SOURCE   SRCE                          Source of event: Survey, claim, or both? 
                         10,808                       1  Survey only                             
                             26                       3  Both survey & claims                    
 
SITCODE  $SITCODE                      Community or facility setting?           
                              1        B                 Both community & facility               
                         10,795        C                 Community                               
                             21        D                 Deemed community                        
                              2        H                 Hospice                                 
                             12        I                 Inpatient                               
                              3        S                 SNF                                     
 
AMTTOT   MONYFMT                       Total payment                            
                         10,834        Range of values   Amount as $$$$$$.CC                     
 
IMPATOT  IMPFLAG                       Imputation flag:  Amt total payment      
                          6,039                       0  Not Imputed                             
                          4,795                       1  Imputed by hotdeck                      
 
AMTCOV   MONYFMT                       Portion of total pay cov by Medicare     
                         10,834        Range of values   Amount as $$$$$$.CC                     
 
AMTNCOV  MONYFMT                       Portion of total pay not cov by Medicare 
                         10,834        Range of values   Amount as $$$$$$.CC                     
 
AMTCARE  MONYFMT                       Amount paid by Medicare                  
                         10,834        Range of values   Amount as $$$$$$.CC                     
 
IMPSCARE IMPFLAG                       Imputation flag: SOP Medicare            
                         10,834                       0  Not Imputed                             
 
IMPACARE IMPFLAG                       Imputation flag: Amt Medicare            
                         10,834                       0  Not Imputed                             
 
AMTCAID  MONYFMT                       Amount paid by Medicaid                  
                         10,834        Range of values   Amount as $$$$$$.CC                     
 
IMPSCAID IMPFLAG                       Imputation flag: SOP Medicaid            
                         10,833                       0  Not Imputed                             
                              1                       1  Imputed by hotdeck                      
 
IMPACAID IMPFLAG                       Imputation flag: Amt Medicaid            
                         10,717                       0  Not Imputed                             
                            117                       1  Imputed by hotdeck                      
 
AMTMADV  MONYFMT                       Amount paid by Medicare MCO/HMO          
                         10,834        Range of values   Amount as $$$$$$.CC                     
 
IMPSMADV IMPFLAG                       Imputation flag: SOP Medicare MCO/HMO    
                         10,182                       0  Not Imputed                             
                            652                       1  Imputed by hotdeck                      
 
IMPAMADV IMPFLAG                       Imputation flag: Amt Medicare MCO/HMO    
                          9,994                       0  Not Imputed                             
                            840                       1  Imputed by hotdeck                      
 
AMTHMOP  MONYFMT                       Amount paid by Private MCO/HMO           
                         10,834        Range of values   Amount as $$$$$$.CC                     
 
IMPSHMOP IMPFLAG                       Imputation flag: SOP Private MCO/HMO     
                         10,559                       0  Not Imputed                             
                            275                       1  Imputed by hotdeck                      
 
IMPAHMOP IMPFLAG                       Imputation flag: Amt Private MCO/HMO     
                         10,435                       0  Not Imputed                             
                            399                       1  Imputed by hotdeck                      
 
AMTPRVE  MONYFMT                       Amount paid by priv ins(employer spons)  
                         10,834        Range of values   Amount as $$$$$$.CC                     
 
IMPSPRVE IMPFLAG                       Imputation flag: SOP priv ins-employer   
                         10,529                       0  Not Imputed                             
                            305                       1  Imputed by hotdeck                      
 
IMPAPRVE IMPFLAG                       Imputation flag: Amt priv ins-employer   
                          9,991                       0  Not Imputed                             
                            843                       1  Imputed by hotdeck                      
 
AMTPRVI  MONYFMT                       Amount paid by priv ins (indiv purch)    
                         10,834        Range of values   Amount as $$$$$$.CC                     
 
IMPSPRVI IMPFLAG                       Imputation flag: SOP priv ins-indiv pur  
                         10,704                       0  Not Imputed                             
                            130                       1  Imputed by hotdeck                      
 
IMPAPRVI IMPFLAG                       Imputation flag: Amt priv ins-indiv pur  
                         10,456                       0  Not Imputed                             
                            378                       1  Imputed by hotdeck                      
 
AMTPRVU  MONYFMT                       Amount paid by priv ins (unknown purch)  
                         10,834        Range of values   Amount as $$$$$$.CC                     
 
IMPSPRVU IMPFLAG                       Imputaiton flag: SOP priv ins-unknown    
                         10,834                       0  Not Imputed                             
 
IMPAPRVU IMPFLAG                       Imputation flag: Amt priv ins-unknown    
                         10,834                       0  Not Imputed                             
 
AMTOOP   MONYFMT                       Amount paid by person/family             
                         10,834        Range of values   Amount as $$$$$$.CC                     
 
IMPSOOP  IMPFLAG                       Imputation flag: SOP paid by person      
                          9,483                       0  Not Imputed                             
                          1,351                       1  Imputed by hotdeck                      
 
IMPAOOP  IMPFLAG                       Imputation flag: Amt paid by person      
                          8,068                       0  Not Imputed                             
                          2,766                       1  Imputed by hotdeck                      
 
AMTDISC  MONYFMT                       Amount of uncollected liabilities        
                         10,834        Range of values   Amount as $$$$$$.CC                     
         Notes:  Beginning in 2013 this includes sequestration reduction
 
IMPSDISC IMPFLAG                       Imputation flag: SOP of uncoll liab      
                         10,379                       0  Not Imputed                             
                            455                       1  Imputed by hotdeck                      
 
IMPADISC IMPFLAG                       Imputation flag: Amt of uncoll liab      
                         10,131                       0  Not Imputed                             
                            703                       1  Imputed by hotdeck                      
 
AMTOTH   MONYFMT                       Amt paid by other sources (includes VA)  
                         10,834        Range of values   Amount as $$$$$$.CC                     
         Notes:  Beginning in 2016, this field also includes VA payments
 
IMPSOTH  IMPFLAG                       Imputation flag: SOP other sources       
                         10,834                       0  Not Imputed                             
 
IMPAOTH  IMPFLAG                       Imputation flag: Amt other sources       
                         10,703                       0  Not Imputed                             
                            131                       1  Imputed by hotdeck                      
 
DVBRIDGE YESNODUE                      Have done during dental visit-bridge     
                             42                       D  Don't Know                              
                             60                       N  Not ascertained                         
                              4                       R  Refused                                 
                         10,503                       0  No                                      
                            225                       1  Yes                                     
 
DVCLEAN  YESNODUE                      Have done during dental visit-cleaning   
                             42                       D  Don't Know                              
                             60                       N  Not ascertained                         
                              4                       R  Refused                                 
                          5,484                       0  No                                      
                          5,244                       1  Yes                                     
 
DVCROWN  YESNODUE                      Have done during dental visit-crown      
                             42                       D  Don't Know                              
                             60                       N  Not ascertained                         
                              4                       R  Refused                                 
                          9,705                       0  No                                      
                          1,023                       1  Yes                                     
 
DVEXAM   YESNODUE                      Have done during dental visit-examin     
                             42                       D  Don't Know                              
                             60                       N  Not ascertained                         
                              4                       R  Refused                                 
                          5,966                       0  No                                      
                          4,762                       1  Yes                                     
 
DVEXTRAC YESNODUE                      Have done during dental visit-extract    
                             42                       D  Don't Know                              
                             60                       N  Not ascertained                         
                              4                       R  Refused                                 
                          9,887                       0  No                                      
                            841                       1  Yes                                     
 
DVFILLNG YESNODUE                      Have done during dental visit-filling    
                             42                       D  Don't Know                              
                             60                       N  Not ascertained                         
                              4                       R  Refused                                 
                          9,554                       0  No                                      
                          1,174                       1  Yes                                     
 
DVORTHO  YESNODUE                      Have done during dental visit-othodon    
                             42                       D  Don't Know                              
                             60                       N  Not ascertained                         
                              4                       R  Refused                                 
                         10,687                       0  No                                      
                             41                       1  Yes                                     
 
DVOTHER  YESNODUE                      Have done during dental visit-other      
                             42                       D  Don't Know                              
                             60                       N  Not ascertained                         
                              4                       R  Refused                                 
                         10,115                       0  No                                      
                            613                       1  Yes                                     
 
DVRTCNAL YESNODUE                      Have done during dental visit-root canal 
                             42                       D  Don't Know                              
                             60                       N  Not ascertained                         
                              4                       R  Refused                                 
                         10,446                       0  No                                      
                            282                       1  Yes                                     
 
DVXRAYS  YESNODUE                      Have done during dental visit-xray taken 
                             42                       D  Don't Know                              
                             60                       N  Not ascertained                         
                              4                       R  Refused                                 
                          8,111                       0  No                                      
                          2,617                       1  Yes                                     
 
DVPERIOD YESNODUE                      Have done during dental visit-periodont  
                             42                       D  Don't Know                              
                             60                       N  Not ascertained                         
                              4                       R  Refused                                 
                         10,587                       0  No                                      
                            141                       1  Yes                                     
 
DVBONDNG YESNODUE                      Have done during dental visit-bonding    
                             42                       D  Don't Know                              
                             60                       N  Not ascertained                         
                              4                       R  Refused                                 
                         10,700                       0  No                                      
                             28                       1  Yes                                     
 
DVSURG   YESNODUE                      Have done during dental visit-surgery    
                             42                       D  Don't Know                              
                             60                       N  Not ascertained                         
                              4                       R  Refused                                 
                         10,652                       0  No                                      
                             76                       1  Yes                                     
 
MCOHMO   HMO                           Event provided by an MCO/HMO?            
                          5,086                       0  Event not provided by MCO/HMO           
                          5,748                       1  Event provided by MCO/HMO               
 
