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This variable is the dollar amount that the beneficiary paid for the PDE without being reimbursed by a third party.
The amount includes all copayments, coinsurance, deductible, or other patient payment amounts, and comes directly from the source PDE. This amount contributes to a beneficiary's true out-of-pocket (TrOOP) costs, but only if it is for a Part D-covered drug (i.e., spending on non-covered drugs does not count toward the TrOOP amount).
Source: PDE
This is the amount of cost sharing for the drug that was paid by the Part D low-income subsidy (LICS). This field contains plan-reported amounts per drug event; CMS uses this information to reconcile the prospective payments it makes to Part D plans for expected low-income cost sharing with the actual amounts incurred by the plans.
Source: PDE
This variable indicates whether a beneficiary met the Chronic Condition Data Warehouse (CCW) criteria for anemia as of the end of the calendar year.
This variable indicates whether a beneficiary met the Chronic Conditions Warehouse (CCW) criteria for anemia as of the end of the calendar year.
This code specifies whether the enrollee met the chronic condition algorithm criteria, considering only Medicaid data, for having Anemia.
This code specifies whether the enrollee met the chronic condition algorithm criteria, considering only Medicare data, for having Anemia.
This code specifies whether the enrollee met the chronic condition algorithm criteria, considering both Medicare and Medicaid data, for having an Anemia.
This variable indicates whether a beneficiary met the Chronic Condition Data Warehouse (CCW) criteria for anemia on July 1 of the specified reference period.
Anemia - Medicaid Only Claims, First Ever Occurrence Date
Anemia - Medicare Only Claims, First Ever Occurrence Date
This variable is the sum of coinsurance and deductible payments for part B anesthesia services (ANES) for a given year. The total Beneficiary payments are calculated as the sum of LINE_COINSRNC_AMT + LINE_BENE_PTB_DDCTBL_AMT for the relevant lines.
ANES claims are a subset of the claims, and a subset of procedures in the Part B Carrier data file. ANES claims are defined as those with a line BETOS code (BETOS_CD) where the first 2 digits = “P0” and the CARR_LINE_MTUS_CD='2'.
The charge amount (rounded to whole dollars) for anesthesia services provided during the beneficiary's stay.
This variable is the count of events for part B anesthesia services (ANES) for a given year. An event is defined as each line item that contains the relevant service.
ANES claims are a subset of the claims, and a subset of procedures in the Part B Carrier data file. ANES claims are defined as those with a line BETOS code (BETOS_CD) where the first 2 digits = “P0” and the CARR_LINE_MTUS_CD='2'.
This variable is the total Medicare payments for part B anesthesia services (ANES) for a given year. ANES claims are a subset of the claims, and a subset of procedures in the Part B Carrier data file.
ANES claims are defined as those with a line BETOS code (BETOS_CD) where the first 2 digits = “P0” and the CARR_LINE_MTUS_CD='2'. The total Medicare payments are calculated as the sum of LINE_NCH_PMT_AMT where the LINE_PRCSG_IND_CD was ('A','R', or 'S') - for all relevant lines
This variable indicates the total amount paid for anesthesia services (ANES) by a primary payer other than Medicare for a given year. ANES claims are a subset of the claims, and a subset of procedures in the Part B Carrier data file.
ANES claims are defined as those with a line BETOS code (BETOS_CD) where the first 2 digits = “P0” and the CARR_LINE_MTUS_CD='2'. The total Primary Payer Payments are calculated as the sum of the LINE_BENE_PRMRY_PYR_PD_AMT.
A flag to indicate that there are one or more record(s) in the Population Enrolled supplemental file for this managed care plan/entity (i.e., CCW_APL_LINK_KEY).
A flag to indicate that there are one or more record(s) in the Operating Authority supplemental file for this managed care plan/entity (i.e., CCW_APL_LINK_KEY).
A flag to indicate that there are one or more record(s) in the Location supplemental file for this managed care plan/entity (i.e., CCW_APL_LINK_KEY).
A flag to indicate that there are one or more record(s) in the Service Area supplemental file for this managed care plan/entity (i.e., CCW_APL_LINK_KEY) .
A flag to indicate that there is one or more record(s) in the Provider Affiliated Groups supplemental file for this provider (linking from Provider Base to Provider Affiliated Groups file via the CCW_APR_LINK_KEY).
A flag to indicate that there is/are one or more record(s) in the Provider Affiliated Program supplemental file for this provider (linking from Provider Base to Provider Affiliated Programs file via the CCW_APR_LINK_KEY).
A flag to indicate that there is one or more record(s) in the Bed Type supplemental file for this provider (linking from Provider Base to the Provider Location and Provider Bed Type files via the CCW_APR_LINK_KEY and the PRVDR_LCTN_ID).
A flag to indicate that there is one or more record(s) in the Provider Enrollment supplemental file for this provider (linking from Provider Base to Provider Enrollment file via the CCW_APR_LINK_KEY).
A flag to indicate that there is one or more record(s) in the Provider Identifiers supplemental file for this provider (linking from Provider Base to the Provider Location and Provider Identifier files via the CCW_APR_LINK_KEY and the PRVDR_LCTN_ID).
A flag to indicate that there is one or more record(s) in the Provider Location supplemental file for this provider (linking from Provider Base to Provider Location file via the CCW_APR_LINK_KEY).
A flag to indicate that there is/are one or more record(s) in the Provider License supplemental file for this provider (linking from Provider Base to the Provider Location and Provider License files via the CCW_APR_LINK_KEY and the PRVDR_LCTN_ID).
A flag to indicate that there is/are one or more record(s) in the Provider Taxonomy/Classification supplemental file for this provider (linking from Provider Base to Provider Taxonomy file via the CCW_APR_LINK_KEY).
This variable indicates whether a beneficiary met the condition criteria for anxiety disorders as of the end of the calendar year.
This variable indicates whether a beneficiary met the condition criteria for anxiety disorders as of the end of the calendar year.NOTE: The condition variable requires beneficiaries to satisfy both claims criteria (a minimum number/type of Medicare claims that have the proper diagnosis codes and occurred within a specified time period) and coverage criteria (Medicare FFS Part A and Part B coverage during the entire specified time period).NOTE1: For anxiety disorders, beneficiaries must have at least one Medicare inpatient claim or two other non-drug claims of any service type with a related code in any position during the 2-year reference period. You can find more detailed information on the criteria on the CCW website: https://www.ccwdata.org/web/guest/condition-categories
This variable shows the date when the beneficiary first met the criteria for the anxiety disorders indicator. The variable will be blank for beneficiaries that have never had the condition.
This code specifies whether the enrollee met the chronic condition algorithm criteria, considering both Medicare and Medicaid data, for having Anxiety
This code specifies whether the enrollee met the chronic condition algorithm criteria, considering only Medicaid data, for having Anxiety Disorders.
This variable indicates whether the enrollee met the chronic condition algorithm criteria, considering only Medicare data, for anxiety disorders as of the end of the calendar year.
This code specifies whether the enrollee met the chronic condition algorithm criteria, considering only Medicare data, for having Anxiety Disorders.
Anxiety Disorders - Medicaid Only Claims, First Ever Occurrence Date
Anxiety Disorders - Medicare Only Claims, First Ever Occurrence Date
“Have you experienced any bladder incontinent events (or ‘accidental leaking of urine’)
“Have you experienced any bowel incontinent events (or “accidental leaking of stool”) during the past 3 days?”
Any modifiers for the base code.
Source: Million Hearts Data Registry
Have you had pain or hurting any time during the timeframe specific to your market group?