Readme_PBP_Benefits_2003.txt

This zip file contains Plan Benefit Package (PBP) tab delimited text files from the HPMS 
data repository, SAS programs, and files with supporting documentation. The SAS input and
library file path names need to be changed to your working subdirectory.

The CY 2003 PBP Benefits file provides the universe of PBP data for all active contracts 
and contains all the approved benefit and financial data submitted as part of the CY 2003 
Bid Submission by Medicare Advantage and Part D organizations, including those involved in 
certain demonstration projects and cost plans. The PBP Benfits file is updated quarterly.

CY 2003 PBP Benefits Extract Contents:

Text File:                              SAS Input Statement to Use:

pbp_b1a_inpat_hosp.txt                  pbp_b1a.sas
pbp_b1b_inpat_hosp.txt                  pbp_b1b.sas
pbp_b2_snf.txt                          pbp_b2.sas
pbp_b3_corf.txt                         pbp_b3.sas
pbp_b4_emerg_urgent.txt                 pbp_b4.sas
pbp_b5_partial_hosp.txt                 pbp_b5.sas
pbp_b6_home_health.txt                  pbp_b6.sas
pbp_b7_health_prof_1.txt		pbp_b7ae.sas
pbp_b7_health_prof_2.txt		pbp_b7fi.sas
pbp_b8_clin_diag_ther.txt		pbp_b8.sas
pbp_b9_outpt_hosp.txt                   pbp_b9.sas
pbp_b10_amb_trans.txt                   pbp_b10.sas
pbp_b11_dme_prosth_orth_sup.txt         pbp_b11.sas
pbp_b12_renal_dialysis.txt		pbp_b12.sas
pbp_b13_other_services.txt		pbp_b13.sas
pbp_b14_preventive_1.txt		pbp_b14ad.sas
pbp_b14_preventive_2.txt		pbp_b14ei.sas
pbp_b15_drugs.txt			pbp_b15.sas
pbp_b16_dental.txt			pbp_b16.sas
pbp_b17_eye_exams_wear.txt              pbp_b17.sas
pbp_b18_hearing_exams_aids.txt          pbp_b18.sas
pbp_b19_pos.txt				pbp_b19.sas
pbp_section_a.txt                       pbp_Section_A.sas
pbp_section_c.txt                       pbp_Section_C.sas
pbp_section_d.txt                       pbp_Section_D.sas
pbp_section_d_opts.txt                  pbp_Section_D_opt.sas
pbp_step10b.txt			        pbp_step10b.sas
pbp_step15.txt 			        pbp_step15.sas
pbp_step16a.txt			        pbp_step16a.sas
pbp_step16b.txt			        pbp_step16b.sas
pbp_step17a.txt			        pbp_step17a.sas
pbp_step17b.txt			        pbp_step17b.sas
pbp_step18a.txt			        pbp_step18a.sas
pbp_step18b.txt			        pbp_step18b.sas
pbp_step7b.txt			        pbp_step7b.sas
pbp_step7f.txt		        	pbp_step7f.sas
PlanArea.txt 	                        planArea.sas


pbp_SectionA.txt - Contains general plan information.

pbp_b1_inpat_hosp.txt - Inpatient Hospital Acute/Psychiatric data.

pbp_b2_snf.txt - Skilled Nursing Facility data.

pbp_b3_corf.txt - Comprehensive Outpatient Rehabilitation Facility data.

pbp_b4_emerg_urgent.txt - Emergency/Urgent Care data.

pbp_b5_partial_hosp.txt - Partial Hospitalization data.

pbp_b6_home_health.txt - Home Health data.

pbp_b7_health_prof_1.txt - Contains Health Care Professional data for Primary Care Physician, Chiropractic, Occupational Therapy, Physician Specialist and Mental Health Specialist services.

pbp_b7_health_prof_2.txt -Contains Health Care Professional data for Podiatry, Other Health Care Professionals, Psychiatric and Physical/Speech Therapy services.

pbp_b8_clin_diag_ther.txt - Outpatient Clinical, Diagnostic, and Therapeutic Radiology services data.

pbp_b9_outpt_hosp.txt - Outpatient Hospital, ASC, Outpatient Substance Abuse, and Cardiac Rehabilitation data.

pbp_b10_amb_trans.txt - Ambulance/Transportation data.

pbp_b11_dme_prosth_orth_sup.txt - Durable Medical Equipment, Prosthetics/Orthotics and Medical Supplies data.

pbp_b12_renal_dialysis.txt - Renal Dialysis data.

pbp_b13_other_services.txt - Outpatient Blood, Acupuncture and "Other" services data.  The "Other" data describes benefits not included in standard PBP service categories.

pbp_b14_preventive_1.txt - Contains Preventive Services data for Health Education/Wellness, Immunizations, Routine Physicals, and Pap/Pelvic Exams.

pbp_b14_preventive_2.txt - Contains Preventive Services data for Prostate Screenings, Colorectal Screenings, Bone Mass Measurements, Mammography Screenings, and Diabetes Monitoring.

pbp_b15_drugs.txt - Outpatient Prescription Drug data.

pbp_b16_dental.txt - Preventive and Comprehensive Dental data.

pbp_b17_eye_exams_wear.txt - Eye Exams and Eye Wear data.

pbp_b18_hearing_exams_aids.txt - Hearing Exams and Hearing Aids data.

pbp_b19_pos.txt - Point of Service benefit data.

pbp_Section_C.txt - Contains plan-level data descriptions of limitations and exclusions, access to providers, and dual eligible benefits.

pbp_Section_D.txt - Contains plan-level financial data such as plan premiums, global max plan benefit/out-of-pocket limits, and global coinsurance/deductibles.

pbp_Section_D_opts.txt - Contains plan-level benefit data descriptions of optional supplemental offerings including the optional benefit premium amounts.

pbp_step10b.txt - Contains step-up transportation benefit data.

pbp_step15.txt - Contains step-up outpatient prescription data.

pbp_step16a.txt - Contains step-up preventive dental data.

pbp_step16b.txt - Contains step-up comprehensive data.

pbp_step17a.txt - Contains step-up eye exams data.

pbp_step17b.txt - Contains step-up eye wear data.

pbp_step18a.txt - Contains step-up hearing exams data.

pbp_step18b.txt - Contains step-up hearing aids data.

pbp_step7b.txt - Contains step-up chiropractic benefit data.

pbp_step7f.txt - Contains step-up podiatry benefit data.

planarea.txt - Contains Service Area data by plan (includes EGHP service areas).


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If you are importing the data into Excel, you must define certain columns as
text or you will lose any leading zero information (example, a plan id of '001'
will appear as '1' if defined as "general" or "numeric.").  The variable names
for the columns that should be delineated as text (or character in SAS 
terminology) are provided within the SAS input statements.
