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This field identifies the payment for disproportionate share hospitals (DSH). It represents the uncompensated care amount of the payment.
The amount related to the condition identified in the claim value code (variable called CLM_VAL_CD) which was used by the intermediary to process the institutional claim.
The code indicating a monetary condition which was used on an institutional claim.
The code indicating a monetary condition which was used by the intermediary to process an institutional claim.
The associated monetary value is in the claim value amount field (CLM_VAL_AMT).
This field is the code used to identify a reason a hospital is excluded from the Hospital Value Based Purchasing (HVBP) program.
This field represents the Hospital Value Based Purchasing (HVBP) Amount.
This could be an additional payment on the claim or a reduction, depending on the hospital's performance score.
Under the Hospital Value Based Purchasing (HVBP) program, an adjustment is made to the base operating DRG amount for certain Inpatient Prospective Payment System (IPPS) hospitals - based on their Total Performance Score (TPS).
A beneficiary may be both voluntarily aligned to the ACO and assigned through claims-based assignment and may have a flag designating they were assigned through both methods.
The charge amount (rounded to whole dollars) for clinic visits (e.g., visits to chronic pain or dental centers or to clinics providing psychiatric, OB-GYN, pediatric services) related to the beneficiary's stay.
CLINICAL FORMULATION ID REPRESENTS THE CLINICAL FORMULATION, WHICH IS THE COMBINATION OF ACTIVE INGREDIENTS, DOSAGE FORM AND STRENGTH. [P.1597]. A GCN_SEQNO CAN BE LINKED TO MANY PACKAGED DRUG PRODUCTS, BUT A PACKAGED DRUG PRODUCT CAN HAVE ONLY ONE GCN_SEQNO.NOTE: IN MAX 2007, THIS VARIABLE WAS ADDED TO THE FILE.
The identification number assigned to the clinical laboratory providing services for the line item on the carrier claim (non-DMERC).
The number used to identify all items and line item services provided to a beneficiary during their participation in a clinical trial.
This code is used to identify that the care improvement model 2 is being used for payments.
The data in this column contains the calculated Medicare Set Code used for the Part A RUG.
The data in this column contains the calculated Medicare non-therapy Set Code.
The data in this column contains the calculated state Medicaid RUG Set Code.
The data in this column contains the second calculated state Medicaid RUG Set Code.
The data in this column contains the calculated Medicare CMI value returned for the Part A RUG.
The data in this column contains the calculated Medicare non-therapy CMI value.
The data in this column contains the calculated state Medicaid CMI text.
The data in this column contains the second calculated state Medicaid CMI text.
CMS Certification Number (formerly OSCAR Number) included as an organization associated with an ACO participant TIN during the period of performance (based on information in PECOS). Limited to CCNs associated with ACO participant TINs used in financial reconciliation.
CMS Certification Number; the hospital provider number used to verify Medicare/Medicaid certification
Source: AHCAH facility-submitted data
Values: Ex – 030036, 220110
The CMS Certification Number (CCN) of a participating institutional provider (when applicable and available).
CMS Certification Number assigned by CMS for all facilities.
Submitting State FIPS Code grouped into the 10 CMS Regions.
A code indicating the category of service for the paid claim. The category of service is the line item from the CMS-21 form that states use to report their expenditures and request federal financial participation.
A code indicating the category of service for the paid claim. The category of service is the line item from the CMS-64 form that states use to report their expenditures and request federal financial participation.
This code indicates if the claim was matched with Title XIX or Title XXI, ACA, or funding under other legislation
Final, prospective risk score based on the applicable risk adjustment model for the most recently available MA payment year, renormalized so that the mean national assignable FFS risk score equals 1.0. Populated based on the beneficiary's last eligible month and =. if Final_assign =1.
Final, prospective risk score based on the applicable risk adjustment model for the most recently available MA payment year, renormalized so that the mean national assignable FFS risk score equals 1.0. Populated based on the beneficiary's last eligible month and =. if Final_assign =1.
Final, prospective risk score based on the applicable risk adjustment model for the most recently available MA payment year, renormalized so that the mean national assignable FFS risk score equals 1.0. Populated based on the beneficiary's last eligible month and =. if Final_assign =1.
Final, prospective risk score based on the applicable risk adjustment model for the most recently available MA payment year, renormalized so that the mean national assignable FFS risk score equals 1.0. Populated based on the beneficiary's last eligible month and =. if Final_assign =1.
The code used to identify the status of the patient as of the CLM_THRU_DT.
The code indicating the day of the week on which the beneficiary was admitted to a facility.
For pharmacies that indicated they offer some level of durable medical equipment (DME) (reference variable called DME_SRVC_IND), this variable identifies the type of DME services offered.
Source: NCDPD DataQ™
For pharmacies that indicated they offer e-prescribing (reference variable called EPRSCRB_SRVC_IND), this variable identifies the type of e-prescribing transactions offered.
Source: NCDPD DataQ™
For pharmacies that indicated they offer some level of 340 B service (reference variable called STATUS_340B_IND), this variable identifies the level of 340B services offered.
Source: NCDPD DataQ™
For pharmacies that indicated they offer some level of immunizations (reference variable called IMMUNIZATIONS_IND), this variable identifies the level of immunization services offered.
Source: NCDPD DataQ™
For pharmacies that indicated they offer some level of walk-in clinic services (reference variable called WALKIN_CLINIC_IND), this variable identifies the level of walk-in clinic services offered.
Source: NCDPD DataQ™
The code indicating whether a group health organization (GHO; also known as a managed care organization) has paid the provider for the claim(s).
An indicator specifying whether the claim is a crossover claim where a portion is paid by Medicare.
A code to indicate the source of non-federal share funds
Code used to document the service. The ACC/AHA risk calculation used clinical information submitted by the practice to ascertain CVD risk. The risk factors are documented for each patient. There is one record in the file for each patient and each risk factor that was assessed on a given date (i.e., the ACTIVITY_DATE).
Source: Million Hearts Data Registry
Cognition II Section Notes
This variable indicates whether a beneficiary met the Chronic Condition Data Warehouse (CCW) criteria for colorectal cancer as of the end of the calendar year.
This variable indicates whether a beneficiary met the Chronic Conditions Warehouse (CCW) criteria for colorectal cancer as of the end of the calendar year.
This code specifies whether the enrollee met the chronic condition algorithm criteria, considering both Medicare and Medicaid data, for having Colorectal Cancer.
This code specifies whether the enrollee met the chronic condition algorithm criteria, considering only Medicaid data, for having Colorectal Cancer.
This code specifies whether the enrollee met the chronic condition algorithm criteria, considering only Medicare data, for having Colorectal Cancer.