HRS MAX Research Files: Geographic Version
This Data Dictionary defines the data elements in our Center's Medicaid Analytic Extract (MAX) research files as well as provides summary statistics about file contents.
File Type | Description | Years |
---|---|---|
MAX Summary File | The Medicaid Analytic Extract (MAX) Summary File contains summary payment information aggregated from the IP, LT, OT, and RX claim files. The MAX Annual, Quarterly, and Monthly Summary Files contain demographic and enrollment information about each beneficiary enrolled within a calendar year. Some of the information contained in this file includes the beneficiary unique identifier, state and county codes, zipcode, date of birth, date of death, sex, race, and age. | 1999-2012 |
Inpatient Services (IP) | The MAX hospital inpatient (IP) file provides information on inpatient hospital stays for each recipient. Interim claim records are combined into a hospital stay record if they have the same 'MSIS Identification Number', the same 'Billing Provider Identification Number' and are for contiguous or overlapping periods of time. The IP file does not have final action claims, and claims are defined to be contiguous if the 'Ending Date of Service' on a previous claim is the same day or the day before the 'Service Beginning Date' for the next claim. Contiguous claims are combined if the 'Patient Status Code' = 30 (still a patient) or = 99 (unknown). However, contiguous claims are not combined into the same stay if the 'Patient Status Code' indicates that the patient was discharged and was admitted again on the same day (or the next day). | 1999-2012 |
Long-Term Care Services (LT) | The MAX long-term care (LT) services record provides information on services provided in long-term care institutions for each recipient. These services include nursing facility services, intermediate care facility services for individuals with intellectual disablities, psychiatric hospitals, and independent (free-standing) psychiatric wings of acute care hospitals. The records in this file are typically weekly or monthly long-term care claims. These records represent all medicaid-covered services for the eligible. However, they may not include all long-termcare services or complete information on medicaid-covered services when the eligible has other health insurance coverage (e.g. medicare and/or private coverage). | 1999-2012 |
Other Services (OT) | The MAX other services (OT) record contains information on services other than those provided by an inpatient hospital, long-term care facility or pharmacy. As a result, this file contains all other service records, including Healthcare Common Procedure Code System (HCPCS) or other state-specific codes. | 1999-2012 |
Drug Record (RX) | The MAX drug record contains information on drugs and other pharmacy services for each recipient. Such information includes records containing national drug codes (NDCs), which encompass codes for prescription and over-the-counter drugs as well as durable medical equipment (DME) and supplies. Please note that any service provided by a pharmacy or services that contain a national drug code (NDC) are reported in the MAX drug file. For this reason, DMG and supplies billed by pharmacy providers (and containing NDCs) are included in the MAX RX file. In contrast, DME and supplies billed by other types of providers (and containing HCPCs or other state-specific procedure codes) are included in the MAX other services file. Please also note that injectable items, which patients may receive from other types of providers (e.g., physicians and clinics), are identified using procedure (service) codes. | 1999-2012 |
Personal Summary (PS) | The Personal Summary (PS) File contains one record for every individual enrolled for at least one day during the year. The file contains demographic data (e.g. date of birth, gender, race), basis of eligibility, maintenance assistance status, and monthly enrollment status. | 1999-2012 |
Dataset Detail Summary
Dataset | Year | # Observations | # Of Vars | File Size (Bytes) | # Unique Beneficiaries |
---|---|---|---|---|---|
HRS_MAX_ASF_1999_2012 | 1999 - 2012 | 53,718 | 261 | 5,246,976 | 3,837 |
HRS_MAX_MSF_1999_2012 | 1999 - 2012 | 644,616 | 262 | 52,535,296 | 3,837 |
HRS_MAX_QSF_1999_2012 | 1999 - 2012 | 214,872 | 262 | 18,743,296 | 3,837 |
HRS_MAX_IP_1999 | 1999 | 304 | 127 | 262,144 | 1,377 |
HRS_MAX_IP_2000 | 2000 | 392 | 127 | 262,144 | 1,504 |
HRS_MAX_IP_2001 | 2001 | 494 | 127 | 327,680 | 1,657 |
HRS_MAX_IP_2002 | 2002 | 566 | 127 | 327,680 | 1,923 |
HRS_MAX_IP_2003 | 2003 | 671 | 127 | 327,680 | 2,186 |
HRS_MAX_IP_2004 | 2004 | 516 | 127 | 327,680 | 2,193 |
HRS_MAX_IP_2005 | 2005 | 581 | 134 | 327,680 | 2,176 |
HRS_MAX_IP_2006 | 2006 | 458 | 134 | 327,680 | 2,106 |
HRS_MAX_IP_2007 | 2007 | 455 | 134 | 327,680 | 2,050 |
HRS_MAX_IP_2008 | 2008 | 542 | 134 | 327,680 | 2,041 |
HRS_MAX_IP_2009 | 2009 | 484 | 134 | 327,680 | 1,975 |
HRS_MAX_IP_2010 | 2010 | 447 | 134 | 327,680 | 1,899 |
HRS_MAX_IP_2011 | 2011 | 517 | 134 | 327,680 | 1,818 |
HRS_MAX_IP_2012 | 2012 | 444 | 134 | 327,680 | 1,713 |
HRS_MAX_LT_1999 | 1999 | 1,196 | 43 | 327,680 | 1,377 |
HRS_MAX_LT_2000 | 2000 | 2,296 | 43 | 458,752 | 1,504 |
HRS_MAX_LT_2001 | 2001 | 2,981 | 43 | 524,288 | 1,657 |
HRS_MAX_LT_2002 | 2002 | 4,005 | 43 | 655,360 | 1,923 |
HRS_MAX_LT_2003 | 2003 | 5,187 | 43 | 851,968 | 2,186 |
HRS_MAX_LT_2004 | 2004 | 5,212 | 43 | 851,968 | 2,193 |
HRS_MAX_LT_2005 | 2005 | 7,282 | 50 | 1,114,112 | 2,176 |
HRS_MAX_LT_2006 | 2006 | 6,140 | 50 | 983,040 | 2,106 |
HRS_MAX_LT_2007 | 2007 | 6,156 | 50 | 983,040 | 2,050 |
HRS_MAX_LT_2008 | 2008 | 5,868 | 50 | 917,504 | 2,041 |
HRS_MAX_LT_2009 | 2009 | 5,663 | 50 | 917,504 | 1,975 |
HRS_MAX_LT_2010 | 2010 | 4,648 | 50 | 786,432 | 1,899 |
HRS_MAX_LT_2011 | 2011 | 3,827 | 50 | 655,360 | 1,818 |
HRS_MAX_LT_2012 | 2012 | 3,261 | 50 | 589,824 | 1,713 |
HRS_MAX_OT_1999 | 1999 | 57,311 | 40 | 7,733,248 | 1,377 |
HRS_MAX_OT_2000 | 2000 | 68,540 | 40 | 9,240,576 | 1,504 |
HRS_MAX_OT_2001 | 2001 | 77,564 | 40 | 10,354,688 | 1,657 |
HRS_MAX_OT_2002 | 2002 | 91,580 | 40 | 12,255,232 | 1,923 |
HRS_MAX_OT_2003 | 2003 | 103,650 | 40 | 13,828,096 | 2,186 |
HRS_MAX_OT_2004 | 2004 | 101,687 | 40 | 13,565,952 | 2,193 |
HRS_MAX_OT_2005 | 2005 | 102,869 | 48 | 14,024,704 | 2,176 |
HRS_MAX_OT_2006 | 2006 | 96,716 | 48 | 13,172,736 | 2,106 |
HRS_MAX_OT_2007 | 2007 | 105,618 | 48 | 14,417,920 | 2,050 |
HRS_MAX_OT_2008 | 2008 | 112,293 | 48 | 15,335,424 | 2,041 |
HRS_MAX_OT_2009 | 2009 | 119,373 | 48 | 16,580,608 | 1,975 |
HRS_MAX_OT_2010 | 2010 | 119,629 | 49 | 16,777,216 | 1,899 |
HRS_MAX_OT_2011 | 2011 | 116,088 | 49 | 16,384,000 | 1,818 |
HRS_MAX_OT_2012 | 2012 | 108,429 | 49 | 15,269,888 | 1,713 |
HRS_MAX_PS_1999 | 1999 | 1,377 | 227 | 851,968 | 1,377 |
HRS_MAX_PS_2000 | 2000 | 1,504 | 227 | 851,968 | 1,504 |
HRS_MAX_PS_2001 | 2001 | 1,658 | 227 | 917,504 | 1,657 |
HRS_MAX_PS_2002 | 2002 | 1,923 | 227 | 1,048,576 | 1,923 |
HRS_MAX_PS_2003 | 2003 | 2,186 | 227 | 1,179,648 | 2,186 |
HRS_MAX_PS_2004 | 2004 | 2,193 | 227 | 1,179,648 | 2,193 |
HRS_MAX_PS_2005 | 2005 | 2,176 | 326 | 1,245,184 | 2,176 |
HRS_MAX_PS_2006 | 2006 | 2,106 | 326 | 1,245,184 | 2,106 |
HRS_MAX_PS_2007 | 2007 | 2,050 | 326 | 1,179,648 | 2,050 |
HRS_MAX_PS_2008 | 2008 | 2,041 | 326 | 1,179,648 | 2,041 |
HRS_MAX_PS_2009 | 2009 | 1,975 | 326 | 1,179,648 | 1,975 |
HRS_MAX_PS_2010 | 2010 | 1,899 | 327 | 1,114,112 | 1,899 |
HRS_MAX_PS_2011 | 2011 | 1,818 | 327 | 1,114,112 | 1,818 |
HRS_MAX_PS_2012 | 2012 | 1,713 | 327 | 1,048,576 | 1,713 |
HRS_MAX_RX_1999 | 1999 | 41,376 | 44 | 7,208,960 | 1,377 |
HRS_MAX_RX_2000 | 2000 | 48,972 | 44 | 8,519,680 | 1,504 |
HRS_MAX_RX_2001 | 2001 | 57,215 | 44 | 9,961,472 | 1,657 |
HRS_MAX_RX_2002 | 2002 | 67,509 | 44 | 11,730,944 | 1,923 |
HRS_MAX_RX_2003 | 2003 | 82,138 | 44 | 14,221,312 | 2,186 |
HRS_MAX_RX_2004 | 2004 | 88,273 | 44 | 15,400,960 | 2,193 |
HRS_MAX_RX_2005 | 2005 | 88,263 | 50 | 15,269,888 | 2,176 |
HRS_MAX_RX_2006 | 2006 | 25,500 | 50 | 4,718,592 | 2,106 |
HRS_MAX_RX_2007 | 2007 | 23,625 | 48 | 3,866,624 | 2,050 |
HRS_MAX_RX_2008 | 2008 | 24,826 | 48 | 4,063,232 | 2,041 |
HRS_MAX_RX_2009 | 2009 | 25,617 | 48 | 4,259,840 | 1,975 |
HRS_MAX_RX_2010 | 2010 | 28,549 | 48 | 4,653,056 | 1,899 |
HRS_MAX_RX_2011 | 2011 | 25,700 | 48 | 4,259,840 | 1,818 |
HRS_MAX_RX_2012 | 2012 | 25,691 | 48 | 4,259,840 | 1,713 |
Variable List - MAX Summary File
Variable Name | Label |
---|---|
BID_MDCD | Beneficiary Identifier |
YEAR | Indicator of year |
MDCD_LTSS | Long-Term Services and Supports (LTSS) flag; i) Institutional Only; ii) Institutional and Home and Community-Based Services (HCBS); iii) HCBS Waiver, no Institutional; iv) HCBS State Plan Only, no HCBS Waiver and no Institutional; presence of LTSS defined in Appendix 8 |
MDCD_SPMI_STATUS | Severe and Persistent Mental Illness (SPMI) flag, 0 = SPMI not present, 1 = SPMI present; presence of SPMI defined in Appendix 4 |
MDCD_FFS_AMT | Total Medicaid payments on all Fee-for-Service (FFS) payments (MAX TYPE-OF-SERVICE not equal to 20, 21, 22) |
MDCD_HMO_AMT | Total Medicaid spending on all Capitated Payments to Health Maintenance Organization (HMO/HIO) or Pace Plans (MAX TYPE-OF-SERVICE = 20) |
MDCD_HMO_AMT_HCBS | Total Medicaid spending on all Capitated Payments to HMO, HIO or Pace Plans (MAX TYPE-OF-SERVICE = 20) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) |
MDCD_PHP_AMT | Total Medicaid spending on all Capitated Payments to Physicians Health Plan (PHPs) (MAX TYPE-OF-SERVICE = 21) |
MDCD_PHP_AMT_HCBS | Total Medicaid spending on all Capitated Payments to PHPs (MAX TYPE-OF-SERVICE = 21) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) |
MDCD_PCCM_AMT | Total Medicaid spending on all Capitated Payments for Primary Care Case Management (PCCMs) (MAX TYPE-OF-SERVICE = 22) |
MDCD_PCCM_AMT_HCBS | Total Medicaid spending on all Capitated Payments for PCCMs (MAX TYPE-OF-SERVICE = 22) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) |
MDCD_IP_AMT | Total Medicaid spending on all Inpatient services (MAX TYPE-OF-SERVICE = 1) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_IP_ADMITS_FFS | Total number of Inpatient admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 1) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_IP_DAYS_FFS | Total Inpatient days (MAX TYPE-OF-SERVICE = 1) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_IP_ADMITS_ALL | Total number of Inpatient admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 1) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_IP_DAYS_ALL | Total Inpatient days (MAX TYPE-OF-SERVICE = 1) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_IP_AMT_HCBS | Total Medicaid spending on all Inpatient Services (MAX TYPE-OF-SERVICE = 1) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_IP_ADMITS_HCBS_FFS | Total number of Inpatient admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 1) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_IP_DAYS_HCBS_FFS | Total Inpatient days (MAX TYPE-OF-SERVICE = 1) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_IP_ADMITS_HCBS_ALL | Total number of Inpatient admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 1) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_IP_DAYS_HCBS_ALL | Total Inpatient days (MAX TYPE-OF-SERVICE = 1) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_IP_ER_ADMITS_FFS | Total number of Inpatient Emergency Room (ER) admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 1 and with at least one claim where UB-REV-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_IP_ER_DAYS_FFS | Total Inpatient ER days (MAX TYPE-OF-SERVICE = 1 and with at least one claim where UB-REV-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_IP_ER_ADMITS_ALL | Total number of Inpatient ER admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 1 and with at least one claim where UB-REV-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_IP_ER_DAYS_ALL | Total Inpatient ER days (MAX TYPE-OF-SERVICE = 1 and with at least one claim where UB-REV-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_IP_ER_ADMITS_HCBS_FFS | Total number of Inpatient ER admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 1 and with at least one claim where UB-REV-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_IP_ER_DAYS_HCBS_FFS | Total Inpatient ER days (MAX TYPE-OF-SERVICE = 1 and with at least one claim where UB-REV-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_IP_ER_ADMITS_HCBS_ALL | Total number of Inpatient ER admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 1 and with at least one claim where UB-REV-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_IP_ER_DAYS_HCBS_ALL | Total Inpatient ER days (MAX TYPE-OF-SERVICE = 1 and with at least one claim where UB-REV-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_MHS_AMT | Total Medicaid spending on all Mental Hospital Services (MAX TYPE-OF-SERVICE = 2) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_MHS_ADMITS_FFS | Total number of Mental Hospital Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 2) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_MHS_DAYS_FFS | Total Mental Hospital days (MAX TYPE-OF-SERVICE = 2) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_MHS_ADMITS_ALL | Total number of Mental Hospital Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 2) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_MHS_DAYS_ALL | Total Mental Hospital days (MAX TYPE-OF-SERVICE = 2) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_MHS_AMT_HCBS | Total Medicaid spending on all Mental Hospital Services (MAX TYPE-OF-SERVICE = 2) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_MHS_ADMITS_HCBS_FFS | Total number of Mental Hospital Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 2) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_MHS_DAYS_HCBS_FFS | Total Mental Hospital days (MAX TYPE-OF-SERVICE = 2) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_MHS_ADMITS_HCBS_ALL | Total number of Mental Hospital Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 2) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_MHS_DAYS_HCBS_ALL | Total Mental Hospital days (MAX TYPE-OF-SERVICE = 2) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_IPF_AMT | Total Medicaid spending on all Inpatient Psychiatric Facility (IPF) Services (MAX TYPE-OF-SERVICE = 4) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_IPF_ADMITS_FFS | Total number of IPF Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 4) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_IPF_DAYS_FFS | Total IPF days (MAX TYPE-OF-SERVICE = 4) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_IPF_ADMITS_ALL | Total number of IPF Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 4) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_IPF_DAYS_ALL | Total IPF days (MAX TYPE-OF-SERVICE = 4) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_IPF_AMT_HCBS | Total Medicaid spending on all IPF Services (MAX TYPE-OF-SERVICE = 4) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_IPF_ADMITS_HCBS_FFS | Total number of IPF Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 4) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_IPF_DAYS_HCBS_FFS | Total IPF days (MAX TYPE-OF-SERVICE = 4) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_IPF_ADMITS_HCBS_ALL | Total number of IPF Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 4) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_IPF_DAYS_HCBS_ALL | Total IPF days (MAX TYPE-OF-SERVICE = 4) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_ICF_AMT | Total Medicaid spending on all Intermediate Care Facilities (ICF) Services (MAX TYPE-OF-SERVICE = 5) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_ICF_ADMITS_FFS | Total number of ICF Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 5) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_ICF_DAYS_FFS | Total ICF days (MAX TYPE-OF-SERVICE = 5) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_ICF_ADMITS_ALL | Total number of ICF Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 5) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_ICF_DAYS_ALL | Total ICF days (MAX TYPE-OF-SERVICE = 5) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_ICF_AMT_HCBS | Total Medicaid spending on all ICF Services (MAX TYPE-OF-SERVICE = 5) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_ICF_ADMITS_HCBS_FFS | Total number of ICF Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 5) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_ICF_DAYS_HCBS_FFS | Total ICF days (MAX TYPE-OF-SERVICE = 5) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_ICF_ADMITS_HCBS_ALL | Total number of ICF Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 5) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_ICF_DAYS_HCBS_ALL | Total ICF days (MAX TYPE-OF-SERVICE = 5) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_NF_AMT | Total Medicaid spending on all Nursing Facility Services (MAX TYPE-OF-SERVICE = 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_NF_ADMITS_FFS | Total number of Nursing Facility Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_NF_DAYS_FFS | Total Nursing Facility days (MAX TYPE-OF-SERVICE = 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_NF_ADMITS_ALL | Total number of Nursing Facility Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_NF_DAYS_ALL | Total Nursing Facility days (MAX TYPE-OF-SERVICE = 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_NF_AMT_HCBS | Total Medicaid spending on all Nursing Facility Services (MAX TYPE-OF-SERVICE = 7) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_NF_ADMITS_HCBS_FFS | Total number of Nursing Facility Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 7) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_NF_DAYS_HCBS_FFS | Total Nursing Facility days (MAX TYPE-OF-SERVICE = 7) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_NF_ADMITS_HCBS_ALL | Total number of Nursing Facility Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 7) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_NF_DAYS_HCBS_ALL | Total Nursing Facility days (MAX TYPE-OF-SERVICE = 7) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_PHYS_AMT | Total Medicaid spending on all Physician Services (MAX TYPE-OF-SERVICE = 8) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_PHYS_EVENTS_FFS | Total number of Physician visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 8) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_PHYS_EVENTS_ALL | Total number of Physician visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 8) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_PHYS_AMT_HCBS | Total Medicaid spending on all Physician Services (MAX TYPE-OF-SERVICE = 8) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_PHYS_EVENTS_HCBS_FFS | Total number of Physician visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 8) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_PHYS_EVENTS_HCBS_ALL | Total number of Physician visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 8) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_DN_AMT | Total Medicaid spending on all Dental Services (MAX TYPE-OF-SERVICE = 9) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_DN_EVENTS_FFS | Total number of Dental visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 9) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_DN_EVENTS_ALL | Total number of Dental visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 9) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_DN_AMT_HCBS | Total Medicaid spending on all Dental Services (MAX TYPE-OF-SERVICE = 9) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_DN_EVENTS_HCBS_FFS | Total number of Dental visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 9) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_DN_EVENTS_HCBS_ALL | Total number of Dental visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 9) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_OPR_AMT | Total Medicaid spending on all Other Practitioners Services (MAX TYPE-OF-SERVICE = 10) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_OPR_EVENTS_FFS | Total number of Other Practitioner visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 10) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_OPR_EVENTS_ALL | Total number of Other Practitioner visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 10) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_OPR_AMT_HCBS | Total Medicaid spending on all Other Practitioners Services (MAX TYPE-OF-SERVICE = 10) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_OPR_EVENTS_HCBS_FFS | Total number of Other Practitioner visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 10) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_OPR_EVENTS_HCBS_ALL | Total number of Other Practitioner visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 10) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_OPH_AMT | Total Medicaid spending on all Outpatient Hospital Services (MAX TYPE-OF-SERVICE = 11) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_OPH_EVENTS_FFS | Total number of visits to Outpatient Hospitals (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 11) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_OPH_EVENTS_ALL | Total number of visits to Outpatient Hospitals (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 11) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_OPH_AMT_HCBS | Total Medicaid spending on all Outpatient Hospital Services (MAX TYPE-OF-SERVICE = 11) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_OPH_EVENTS_HCBS_FFS | Total number of visits to Outpatient Hospitals (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 11) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_OPH_EVENTS_HCBS_ALL | Total number of visits to Outpatient Hospitals (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 11) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_OPH_ER_ADMITS_FFS | Total number of Outpatient Hospital ER admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 11 and with at least one claim where UB-92-REVENUE-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_OPH_ER_DAYS_FFS | Total Outpatient Hospital ER days (MAX TYPE-OF-SERVICE = 11 and with at least one claim where UB-92-REVENUE-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_OPH_ER_ADMITS_ALL | Total number of Outpatient Hospital ER admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 11 and with at least one claim where UB-92-REVENUE-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_OPH_ER_DAYS_ALL | Total Outpatient Hospital ER days (MAX TYPE-OF-SERVICE = 11 and with at least one claim where UB-92-REVENUE-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_OPH_ER_ADMITS_HCBS_FFS | Total number of Outpatient Hospital ER admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 11 and with at least one claim where UB-92-REVENUE-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_OPH_ER_DAYS_HCBS_FFS | Total Outpatient Hospital ER days (MAX TYPE-OF-SERVICE = 11 and with at least one claim where UB-92-REVENUE-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_OPH_ER_ADMITS_HCBS_ALL | Total number of Outpatient Hospital ER admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 11 and with at least one claim where UB-92-REVENUE-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_OPH_ER_DAYS_HCBS_ALL | Total Outpatient Hospital ER days (MAX TYPE-OF-SERVICE = 11 and with at least one claim where UB-92-REVENUE-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_CLIN_AMT | Total Medicaid spending on all Clinic Services (MAX TYPE-OF-SERVICE = 12) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_CLIN_EVENTS_FFS | Total number of Clinic visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 12) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_CLIN_EVENTS_ALL | Total number of Clinic visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 12) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_CLIN_AMT_HCBS | Total Medicaid spending on all Clinic Services (MAX TYPE-OF-SERVICE = 12) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_CLIN_EVENTS_HCBS_FFS | Total number of Clinic visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 12) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_CLIN_EVENTS_HCBS_ALL | Total number of Clinic visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 12) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_HH_AMT | Total Medicaid spending on all Home Health Services (MAX TYPE-OF-SERVICE = 13) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_HH_ADMITS_FFS | Total number of Home Health admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 13) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_HH_DAYS_FFS | Total Home Health Services days (MAX TYPE-OF-SERVICE = 13) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_HH_ADMITS_ALL | Total number of Home Health admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 13) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_HH_DAYS_ALL | Total Home Health Services days (MAX TYPE-OF-SERVICE = 13) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_HH_AMT_HCBS | Total Medicaid spending on all Home Health Services (MAX TYPE-OF-SERVICE = 13) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_HH_ADMITS_HCBS_FFS | Total number of Home Health admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 13) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_HH_DAYS_HCBS_FFS | Total Home Health Services days (MAX TYPE-OF-SERVICE = 13) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_HH_ADMITS_HCBS_ALL | Total number of Home Health admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 13) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_HH_DAYS_HCBS_ALL | Total Home Health Services days (MAX TYPE-OF-SERVICE = 13) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_LX_AMT | Total Medicaid spending on all Lab and X-Ray Services (MAX TYPE-OF-SERVICE = 15) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_LX_EVENTS_FFS | Total number of Lab and X-Ray visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 15) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_LX_EVENTS_ALL | Total number of Lab and X-Ray visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 15) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_LX_AMT_HCBS | Total Medicaid spending on all Lab and X-Ray Services (MAX TYPE-OF-SERVICE = 15) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_LX_EVENTS_HCBS_FFS | Total number of Lab and X-Ray visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 15) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_LX_EVENTS_HCBS_ALL | Total number of Lab and X-Ray visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 15) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_RX_AMT | Total Medicaid spending on all prescribed drugs (MAX TYPE-OF-SERVICE = 16) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_RX_EVENTS_FFS | Total number of prescription drug claims (MAX TYPE-OF-SERVICE = 16) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_RX_EVENTS_ALL | Total number of prescription drug claims (MAX TYPE-OF-SERVICE = 16) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_RX_AMT_HCBS | Total Medicaid spending on all Prescribed Drugs (MAX TYPE-OF-SERVICE = 16) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_RX_EVENTS_HCBS_FFS | Total number of prescription drug claims (MAX TYPE-OF-SERVICE = 16) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_RX_EVENTS_HCBS_ALL | Total number of prescription drug claims (MAX TYPE-OF-SERVICE = 16) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_OS_AMT | Total Medicaid spending on all Other Services (MAX TYPE-OF-SERVICE = 19) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_OS_AMT_HCBS | Total Medicaid spending on all Other Services (MAX TYPE-OF-SERVICE = 19) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_ST_AMT | Total Medicaid spending on all Sterilizations (MAX TYPE-OF-SERVICE = 24) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_ST_ADMITS_FFS | Total number of admissions for Sterilizations (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 24) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_ST_DAYS_FFS | Total Sterilization days (MAX TYPE-OF-SERVICE = 24) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_ST_ADMITS_ALL | Total number of admissions for Sterilizations (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 24) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_ST_DAYS_ALL | Total Sterilization days (MAX TYPE-OF-SERVICE = 24) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_ST_AMT_HCBS | Total Medicaid spending on all Sterilizations (MAX TYPE-OF-SERVICE = 24) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_ST_ADMITS_HCBS_FFS | Total number of admissions for Sterilizations (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 24) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_ST_DAYS_HCBS_FFS | Total Sterilization days (MAX TYPE-OF-SERVICE = 24) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_ST_ADMITS_HCBS_ALL | Total number of admissions for Sterilizations (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 24) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_ST_DAYS_HCBS_ALL | Total Sterilization days (MAX TYPE-OF-SERVICE = 24) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_AB_AMT | Total Medicaid spending on all Abortions (MAX TYPE-OF-SERVICE = 25) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_AB_ADMITS_FFS | Total number of admissions for Abortions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 25) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_AB_DAYS_FFS | Total Abortion days (MAX TYPE-OF-SERVICE = 25) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_AB_ADMITS_ALL | Total number of admissions for Abortions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 25) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_AB_DAYS_ALL | Total Abortion days (MAX TYPE-OF-SERVICE = 25) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_AB_AMT_HCBS | Total Medicaid spending on all Abortions (MAX TYPE-OF-SERVICE = 25) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_AB_ADMITS_HCBS_FFS | Total number of admissions for Abortions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 25) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_AB_DAYS_HCBS_FFS | Total Abortion days (MAX TYPE-OF-SERVICE = 25) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_AB_ADMITS_HCBS_ALL | Total number of admissions for Abortions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 25) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_AB_DAYS_HCBS_ALL | Total Abortion days (MAX TYPE-OF-SERVICE = 25) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_TS_AMT | Total Medicaid spending on all Transportation Services (MAX TYPE-OF-SERVICE = 26) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_TS_EVENTS_FFS | Total number of Transportation Services (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 26) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_TS_EVENTS_ALL | Total number of Transportation Services (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 26) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_TS_AMT_HCBS | Total Medicaid spending on all Transportation Services (MAX TYPE-OF-SERVICE = 26) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_TS_EVENTS_HCBS_FFS | Total number of Transportation Services (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 26) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_TS_EVENTS_HCBS_ALL | Total number of Transportation Services (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 26) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_PCS_AMT | Total Medicaid spending on all Personal Care Services (MAX TYPE-OF-SERVICE = 30) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_PCS_ADMITS_FFS | Total number of admissions for Personal Care Services (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 30) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_PCS_DAYS_FFS | Total Personal Care Services days (MAX TYPE-OF-SERVICE = 30) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_PCS_ADMITS_ALL | Total number of admissions for Personal Care Services (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 30) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_PCS_DAYS_ALL | Total Personal Care Services days (MAX TYPE-OF-SERVICE = 30) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_PCS_AMT_HCBS | Total Medicaid spending on all Personal Care Services (MAX TYPE-OF-SERVICE = 30) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_PCS_ADMITS_HCBS_FFS | Total number of admissions for Personal Care Services (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 30) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_PCS_DAYS_HCBS_FFS | Total Personal Care Services days (MAX TYPE-OF-SERVICE = 30) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_PCS_ADMITS_HCBS_ALL | Total number of admissions for Personal Care Services (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 30) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_PCS_DAYS_HCBS_ALL | Total Personal Care Services days (MAX TYPE-OF-SERVICE = 30) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_TC_AMT | Total Medicaid spending on all Targeted Case Management Services (MAX TYPE-OF-SERVICE = 31) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_TC_ADMITS_FFS | Total number of admissions for Targeted Case Management Services (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 31) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_TC_DAYS_FFS | Total Targeted Case Management days (MAX TYPE-OF-SERVICE = 31) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_TC_ADMITS_ALL | Total number of admissions for Targeted Case Management Services (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 31) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_TC_DAYS_ALL | Total Targeted Case Management days (MAX TYPE-OF-SERVICE = 31) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_TC_AMT_HCBS | Total Medicaid spending on all Targeted Case Management Services (MAX TYPE-OF-SERVICE = 31) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_TC_ADMITS_HCBS_FFS | Total number of admissions for Targeted Case Management Services (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 31) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_TC_DAYS_HCBS_FFS | Total Targeted Case Management days (MAX TYPE-OF-SERVICE = 31) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_TC_ADMITS_HCBS_ALL | Total number of admissions for Targeted Case Management Services (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 31) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_TC_DAYS_HCBS_ALL | Total Targeted Case Management days (MAX TYPE-OF-SERVICE = 31) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_RS_AMT | Total Medicaid spending on all Rehabilitation Services (MAX TYPE-OF-SERVICE = 33) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_RS_EVENTS_FFS | Total number of Rehabilitation Services visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 33) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_RS_EVENTS_ALL | Total number of Rehabilitation Services visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 33) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_RS_AMT_HCBS | Total Medicaid spending on all Rehabilitation Services (MAX TYPE-OF-SERVICE = 33) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_RS_EVENTS_HCBS_FFS | Total number of Rehabilitation Services visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 33) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_RS_EVENTS_HCBS_ALL | Total number of Rehabilitation Services visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 33) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_SH_AMT | Total Medicaid spending on all Physical Therapist (PT), Other (OT), Speech, Hearing Language Services (MAX TYPE-OF-SERVICE = 34) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_SH_EVENTS_FFS | Total number of PT, OT, Speech, Hearing Language visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 34) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_SH_EVENTS_ALL | Total number of PT, OT, Speech, Hearing Language visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 34) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_SH_AMT_HCBS | Total Medicaid spending on all PT, OT, Speech, Hearing Language Services (MAX TYPE-OF-SERVICE = 34) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_SH_EVENTS_HCBS_FFS | Total number of PT, OT, Speech, Hearing Language visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 34) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_SH_EVENTS_HCBS_ALL | Total number of PT, OT, Speech, Hearing Language visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 34) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_HS_AMT | Total Medicaid spending on all Hospice Services (MAX TYPE-OF-SERVICE = 35) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_HS_ADMITS_FFS | Total number of Hospice admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 35) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_HS_DAYS_FFS | Total number of Hospice days (MAX TYPE-OF-SERVICE = 35) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_HS_ADMITS_ALL | Total number of Hospice admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 35) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_HS_DAYS_ALL | Total number of Hospice days (MAX TYPE-OF-SERVICE = 35) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_HS_AMT_HCBS | Total Medicaid spending on all Hospice Services (MAX TYPE-OF-SERVICE = 35) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_HS_ADMITS_HCBS_FFS | Total number of Hospice admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 35) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_HS_DAYS_HCBS_FFS | Total number of Hospice days (MAX TYPE-OF-SERVICE = 35) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_HS_ADMITS_HCBS_ALL | Total number of Hospice admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 35) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_HS_DAYS_HCBS_ALL | Total number of Hospice days (MAX TYPE-OF-SERVICE = 35) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_NMS_AMT | Total Medicaid spending on all Nurse Midwife Services (MAX TYPE-OF-SERVICE = 36) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_NMS_EVENTS_FFS | Total number of Nurse Midwife visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 36) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_NMS_EVENTS_ALL | Total number of Nurse Midwife visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 36) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_NMS_AMT_HCBS | Total Medicaid spending on all Nurse Midwife Services (MAX TYPE-OF-SERVICE = 36) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_NMS_EVENTS_HCBS_FFS | Total number of Nurse Midwife visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 36) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_NMS_EVENTS_HCBS_ALL | Total number of Nurse Midwife visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 36) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_NPS_AMT | Total Medicaid spending on all Nurse Practitioner Services (MAX TYPE-OF-SERVICE = 37) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_NPS_EVENTS_FFS | Total number of Nurse Practitioner visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 37) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_NPS_EVENTS_ALL | Total number of Nurse Practitioner visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 37) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_NPS_AMT_HCBS | Total Medicaid spending on all Nurse Practitioner Services (MAX TYPE-OF-SERVICE = 37) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_NPS_EVENTS_HCBS_FFS | Total number of Nurse Practitioner visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 37) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_NPS_EVENTS_HCBS_ALL | Total number of Nurse Practitioner visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 37) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_PDN_AMT | Total Medicaid spending on all Private Duty Nursing Services (MAX TYPE-OF-SERVICE = 38) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_PDN_ADMITS_FFS | Total number of Private Duty Nursing admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 38) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_PDN_DAYS_FFS | Total Private Duty Nursing days (MAX TYPE-OF-SERVICE = 38) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_PDN_ADMITS_ALL | Total number of Private Duty Nursing admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 38) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_PDN_DAYS_ALL | Total Private Duty Nursing days (MAX TYPE-OF-SERVICE = 38) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_PDN_AMT_HCBS | Total Medicaid spending on all Private Duty Nursing Services (MAX TYPE-OF-SERVICE = 38) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_PDN_ADMITS_HCBS_FFS | Total number of Private Duty Nursing admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 38) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_PDN_DAYS_HCBS_FFS | Total Private Duty Nursing days (MAX TYPE-OF-SERVICE = 38) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_PDN_ADMITS_HCBS_ALL | Total number of Private Duty Nursing admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 38) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_PDN_DAYS_HCBS_ALL | Total Private Duty Nursing days (MAX TYPE-OF-SERVICE = 38) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_RNHC_AMT | Total Medicaid spending on all Religious Non-Medical Health Care Institutions Services (MAX TYPE-OF-SERVICE = 39) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_RNHC_EVENTS_FFS | Total number of Religious Non-Medical Health Care Institutions Services visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 39) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_RNHC_EVENTS_ALL | Total number of Religious Non-Medical Health Care Institutions Services visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 39) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_RNHC_AMT_HCBS | Total Medicaid spending on all Religious Non-Medical Health Care Institutions Services (MAX TYPE-OF-SERVICE = 39) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_RNHC_EVENTS_HCBS_FFS | Total number of Religious Non-Medical Health Care Institutions Services visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 39) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_RNHC_EVENTS_HCBS_ALL | Total number of Religious Non-Medical Health Care Institutions Services visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 39) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_US_AMT | Total Medicaid spending on all missing, invalid, or unknown services (MAX TYPE-OF-SERVICE = 99+) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_US_AMT_HCBS | Total Medicaid spending on all missing, invalid, or unknown services (MAX TYPE-OF-SERVICE = 99+) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_DMES_AMT | Total Medicaid spending on all Durable Medical Equipment and Supplies (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 51) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_DMES_EVENTS_FFS | Total number of Durable Medical Equipment and Supplies events (count of provider-day encounters when MAX TYPE-OF-SERVICE = 51) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_DMES_EVENTS_ALL | Total number of Durable Medical Equipment and Supplies events (count of provider-day encounters when MAX TYPE-OF-SERVICE = 51) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_DMES_AMT_HCBS | Total Medicaid spending on all Durable Medical Equipment and Supplies (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 51) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_DMES_EVENTS_HCBS_FFS | Total number of Durable Medical Equipment and Supplies events (count of provider-day encounters when MAX TYPE-OF-SERVICE = 51) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_DMES_EVENTS_HCBS_ALL | Total number of Durable Medical Equipment and Supplies events (count of provider-day encounters when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 51) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_RC_AMT | Total Medicaid spending on all Residential Care Services (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 52) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_RC_ADMITS_FFS | Total number of Residential Care admissions (an admission is the first day in a series of contiguous claims where at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 52) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_RC_DAYS_FFS | Total Residential Care days (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 52) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_RC_ADMITS_ALL | Total number of Residential Care admissions (an admission is the first day in a series of contiguous claims where at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 52) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_RC_DAYS_ALL | Total Residential Care days (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 52) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_RC_AMT_HCBS | Total Medicaid spending on all Residential Care Services (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 52) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_RC_ADMITS_HCBS_FFS | Total number of Residential Care admissions (an admission is the first day in a series of contiguous claims where at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 52) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_RC_DAYS_HCBS_FFS | Total Residential Care days (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 52) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_RC_ADMITS_HCBS_ALL | Total number of Residential Care admissions (an admission is the first day in a series of contiguous claims where at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 52) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_RC_DAYS_HCBS_ALL | Total Residential Care days (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 52) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_PS_AMT | Total Medicaid spending on all Psychiatric Services (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 53) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_PS_EVENTS_FFS | Total number of Psychiatric Services visits (count of provider-day encounters when MAX TYPE-OF-SERVICE = 53) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_PS_EVENTS_ALL | Total number of Psychiatric Services visits (count of provider-day encounters when MAX TYPE-OF-SERVICE = 53) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_PS_AMT_HCBS | Total Medicaid spending on all Psychiatric Services (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 53) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_PS_EVENTS_HCBS_FFS | Total number of Psychiatric Services visits (count of provider-day encounters when MAX TYPE-OF-SERVICE = 53) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_PS_EVENTS_HCBS_ALL | Total number of Psychiatric Services visits (count of provider-day encounters when MAX TYPE-OF-SERVICE = 53) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_ADC_AMT | Total Medicaid spending on all Adult Day Care Services (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 54) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_ADC_ADMITS_FFS | Total number of Adult Day Care admissions (an admission is the first day in a series of contiguous claims where at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 54) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_ADC_DAYS_FFS | Total Adult Day Care days (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 54) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_ADC_ADMITS_ALL | Total number of Adult Day Care admissions (an admission is the first day in a series of contiguous claims where at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 54) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_ADC_DAYS_ALL | Total Adult Day Care days (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 54) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_ADC_AMT_HCBS | Total Medicaid spending on all Adult Day Care Services (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 54) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_ADC_ADMITS_HCBS_FFS | Total number of Adult Day Care admissions (an admission is the first day in a series of contiguous claims where at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 54) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_ADC_DAYS_HCBS_FFS | Total Adult Day Care days (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 54) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5) |
MDCD_ADC_ADMITS_HCBS_ALL | Total number of Adult Day Care admissions (an admission is the first day in a series of contiguous claims where at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 54) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
MDCD_ADC_DAYS_HCBS_ALL | Total Adult Day Care days (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 54) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5) |
Variable List - Inpatient Services (IP)
Variable Name | Type | Length | Label |
---|---|---|---|
ADJUSTMENT_CODE | NUM | 1 | ADJUSTMENT CODE |
MSIS_IDENTIFICATION_NUMBER | CHAR | 20 | (Encrypted) MSIS IDENTIFICATION NUMBER |
STATE | CHAR | 2 | STATE ABBREVIATION CODE |
BIRTH_DATE | NUM | 8 | BIRTH DATE |
SEX | CHAR | 1 | SEX CODE |
RACE_ETHNICITY | CHAR | 1 | RACE/ETHNICITY CODE |
RACE_ETHNICITY_WHITE | CHAR | 1 | RACE - WHITE |
RACE_ETHNICITY_BLACK | CHAR | 1 | RACE - BLACK/AFRICAN AMERICAN |
RACE_ETHNICITY_NATIVE | CHAR | 1 | RACE - AMERICAN INDIAN/ALASKA NATIVE |
RACE_ETHNICITY_ASIAN | CHAR | 1 | RACE - ASIAN |
RACE_ETHNICITY_HAWAI | CHAR | 1 | RACE - NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER |
RACE_ETHNICITY_LATIN | CHAR | 1 | ETHNICITY - HISPANIC OR LATINO |
STATE_SPECIFIC_ELIG_MOST_RECENT | CHAR | 6 | STATE-SPECIFIC ELIGIBILITY CODE - MOST RECENT |
STATE_SPECIFIC_ELIG_MO_OF_SVC | CHAR | 6 | STATE-SPECIFIC ELIGIBILITY CODE - FOR MONTH OF SERVICE |
MAX_UNI_ELIG_CODE_MOST_RECENT | CHAR | 2 | MAX UNIFORM ELIGIBILITY CODE - MOST RECENT |
MAX_UNI_ELIG_CODE_MO_OF_SVC | CHAR | 2 | MAX UNIFORM ELIGIBILITY CODE - FOR MONTH OF SERVICE |
MISSING_ELIG_DATA | CHAR | 1 | MISSING ELIGIBILITY DATA |
CROSSOVER_CODE_FROM_CLAIMS_ONLY | NUM | 1 | MEDICARE DUAL CODE - CLAIM-BASED |
CROSSOVER_CODE_ANNUAL_NEW_VALUES | CHAR | 2 | MEDICARE DUAL CODE - ANNUAL |
MSIS_TYPE_OF_SERVICE | NUM | 2 | MSIS TYPE OF SERVICE CODE |
MSIS_TYPE_OF_PROGRAM | NUM | 1 | MSIS TYPE OF PROGRAM CODE |
SMRF_TYPE_OF_SERVICE | NUM | 2 | MAX TYPE OF SERVICE CODE |
BILLING_PROVIDER_IDENTIF_NUMBER | CHAR | 12 | (Blanked) BILLING PROVIDER IDENTIFICATION NUMBER |
NPI | CHAR | 12 | (Blanked) NATIONAL PROVIDER IDENTIFIER |
PROVIDER_TAXONOMY | CHAR | 12 | PROVIDER TAXONOMY |
TYPE_OF_CLAIM | CHAR | 1 | TYPE OF CLAIM CODE |
MANAGED_CARE_TYPE_OF_PLAN_CODE | NUM | 2 | MANAGED CARE TYPE OF PLAN CODE |
MANAGED_CARE_PLAN_IDENTIF_CODE | CHAR | 12 | (Blanked) MANAGED CARE PLAN IDENTIFICATION NUMBER |
MEDICAID_PAYMENT_AMOUNT | NUM* | 8 | MEDICAID PAYMENT AMOUNT |
THIRD_PARTY_PAYMENT_AMOUNT | NUM* | 8 | THIRD PARTY PAYMENT AMOUNT |
PAYMENT_ADJUDICATION_DATE | NUM | 8 | PAYMENT DATE |
CHARGE_AMOUNT | NUM* | 8 | CHARGE AMOUNT |
PREPAID_PLAN_VALUE | NUM* | 8 | PREPAID PLAN SERVICE VALUE |
MEDICARE_COINSURANCE_PAYMENT_AMT | NUM* | 8 | MEDICARE COINSURANCE PAYMENT AMOUNT |
MEDICARE_DEDUCTIBLE_PAYMENT_AMT | NUM* | 8 | MEDICARE DEDUCTIBLE PAYMENT AMOUNT |
ADMISSION_DATE | NUM | 8 | ADMISSION DATE |
BEGINNING_DATE_OF_SERVICE | NUM | 8 | SERVICE BEGINNING DATE |
ENDING_DATE_OF_SERVICE | NUM | 8 | ENDING DATE OF SERVICE |
DIAGNOSIS_CODE_1 | CHAR | 7 | PRINCIPAL DIAGNOSIS CODE |
DIAGNOSIS_CODE_2 | CHAR | 7 | DIAGNOSIS CODE - 2 |
PRINCIPLE_PROCEDURE_DATE | NUM | 8 | PRINCIPAL PROCEDURE DATE |
PROCEDURE_CODING_SYSTEM_1 | CHAR | 2 | PROCEDURE CODING SYSTEM CODE - PRINCIPAL |
PROCEDURE_CODE_1 | CHAR | 8 | PROCEDURE CODE - PRINCIPAL |
PROCEDURE_CODING_SYSTEM_2 | CHAR | 2 | PROCEDURE CODING SYSTEM CODE - 2 |
PROCEDURE_CODE_2 | CHAR | 8 | PROCEDURE CODE - 2 |
DELIVERY_CODE | NUM | 1 | DELIVERY CODE |
MEDICAID_COVERED_INPATIENT_DAYS | NUM* | 3 | MEDICAID-COVERED INPATIENT DAYS |
PATIENT_STATUS_ | NUM | 2 | PATIENT STATUS CODE |
DIAGNOSIS_RELATED_GROUP_INDICATR | CHAR | 4 | DIAGNOSIS RELATED GROUP INDICATOR |
DIAGNOSIS_RELATED_GROUP | NUM | 4 | DIAGNOSIS RELATED GROUP |
UB_92_REVENUE_CODE_01 | NUM | 4 | UB-92 REVENUE CODE - FIRST REVENUE CODE |
UB_92_REVENUE_CODE_CHARGE_01 | NUM* | 8 | UB-92 REVENUE CODE CHARGE - FIRST REVENUE CODE |
UB_92_REVENUE_CODE_UNITS_01 | NUM | 7 | UB-92 REVENUE CODE UNITS - FIRST REVENUE CODE |
Variable List - Long-Term Care Services (LT)
Variable Name | Type | Length | Label |
---|---|---|---|
ADJUSTMENT_CODE | NUM | 1 | ADJUSTMENT CODE |
MSIS_IDENTIFICATION_NUMBER | CHAR | 20 | (Encrypted) MSIS IDENTIFICATION NUMBER |
STATE | CHAR | 2 | STATE ABBREVIATION CODE |
BIRTH_DATE | NUM | 8 | BIRTH DATE |
SEX | CHAR | 1 | SEX CODE |
RACE_ETHNICITY | CHAR | 1 | RACE/ETHNICITY CODE |
RACE_ETHNICITY_WHITE | CHAR | 1 | RACE - WHITE |
RACE_ETHNICITY_BLACK | CHAR | 1 | RACE - BLACK/AFRICAN AMERICAN |
RACE_ETHNICITY_NATIVE | CHAR | 1 | RACE - AMERICAN INDIAN/ALASKA NATIVE |
RACE_ETHNICITY_ASIAN | CHAR | 1 | RACE - ASIAN |
RACE_ETHNICITY_HAWAI | CHAR | 1 | RACE - NATIVE HAWAIIAN/ OTHER PACIFIC ISLANDER |
RACE_ETHNICITY_LATIN | CHAR | 1 | ETHNICITY - HISPANIC OR LATINO |
STATE_SPECIFIC_ELIG_MOST_RECENT | CHAR | 6 | STATE-SPECIFIC ELIGIBILITY CODE - MOST RECENT |
STATE_SPECIFIC_ELIG_MO_OF_SVC | CHAR | 6 | STATE-SPECIFIC ELIGIBILITY CODE - FOR MONTH OF SERVICE |
MAX_UNI_ELIG_CODE_MOST_RECENT | CHAR | 2 | MAX UNIFORM ELIGIBILITY CODE - MOST RECENT |
MAX_UNI_ELIG_CODE_MO_OF_SVC | CHAR | 2 | MAX UNIFORM ELIGIBILITY CODE - FOR MONTH OF SERVICE |
MISSING_ELIG_DATA | CHAR | 1 | MISSING ELIGIBILITY DATA |
CROSSOVER_CODE_FROM_CLAIMS_ONLY | NUM | 1 | MEDICARE DUAL CODE - CLAIM-BASED |
CROSSOVER_CODE_ANNUAL_NEW_VALUES | CHAR | 2 | MEDICARE DUAL CODE - ANNUAL |
MSIS_TYPE_OF_SERVICE | NUM | 2 | MSIS TYPE OF SERVICE CODE |
MSIS_TYPE_OF_PROGRAM | NUM | 1 | MSIS TYPE OF PROGRAM CODE |
SMRF_TYPE_OF_SERVICE | NUM | 2 | MAX TYPE OF SERVICE CODE |
BILLING_PROVIDER_IDENTIF_NUMBER | CHAR | 12 | (Blanked) BILLING PROVIDER IDENTIFICATION NUMBER |
NPI | CHAR | 12 | (Blanked) NATIONAL PROVIDER IDENTIFIER |
PROVIDER_TAXONOMY | CHAR | 12 | PROVIDER TAXONOMY |
TYPE_OF_CLAIM | CHAR | 1 | TYPE OF CLAIM CODE |
MANAGED_CARE_TYPE_OF_PLAN_CODE | NUM | 2 | MANAGED CARE TYPE OF PLAN CODE |
MANAGED_CARE_PLAN_IDENTIF_CODE | CHAR | 12 | (Blanked) MANAGED CARE PLAN IDENTIFICATION NUMBER |
MEDICAID_PAYMENT_AMOUNT | NUM* | 8 | MEDICAID PAYMENT AMOUNT |
THIRD_PARTY_PAYMENT_AMOUNT | NUM* | 8 | THIRD PARTY PAYMENT AMOUNT |
PAYMENT_ADJUDICATION_DATE | NUM | 8 | PAYMENT DATE |
CHARGE_AMOUNT | NUM* | 8 | CHARGE AMOUNT |
PREPAID_PLAN_VALUE | NUM* | 8 | PREPAID PLAN SERVICE VALUE |
MEDICARE_COINSURANCE_PAYMENT_AMT | NUM* | 8 | MEDICARE COINSURANCE PAYMENT AMOUNT |
MEDICARE_DEDUCTIBLE_PAYMENT_AMT | NUM* | 8 | MEDICARE DEDUCTIBLE PAYMENT AMOUNT |
ADMISSION_DATE | NUM | 8 | INSTITUTIONAL LONG-TERM CARE ADMISSION DATE |
BEGINNING_DATE_OF_SERVICE | NUM | 8 | SERVICE BEGINNING DATE |
ENDING_DATE_OF_SERVICE | NUM | 8 | ENDING DATE OF SERVICE |
DIAGNOSIS_CODE_1 | CHAR | 7 | DIAGNOSIS CODE - FIRST DIAGNOSIS |
MENTAL_HOSPITAL_FOR_AGED_DAYS | NUM* | 3 | MENTAL HOSPITAL FOR THE AGED DAY COUNT |
INPATIENT_PSYCHIATRIC_DAYS | NUM* | 3 | INPATIENT PSYCHIATRIC FACILITY (AGE < 21) DAY COUNT |
ICF_MR_DAYS | NUM* | 3 | INTERMEDIATE CARE FACILITY FOR INDIVIDUALS WITH INTELLECTUAL DISABLITIES DAY COUNT |
NURSING_FACILITY_DAYS | NUM* | 3 | NURSING FACILITY DAY COUNT |
LEAVE_DAYS | NUM* | 3 | LONG-TERM CARE LEAVE DAY COUNT |
PATIENT_STATUS | NUM | 2 | PATIENT STATUS CODE |
PATIENT_LIABILITY_AMOUNT | NUM* | 8 | PATIENT LIABILITY AMOUNT |
Variable List - Other Services (OT)
Variable Name | Type | Length | Label |
---|---|---|---|
ADJUSTMENT_CODE | NUM | 1 | ADJUSTMENT CODE |
MSIS_IDENTIFICATION_NUMBER | CHAR | 20 | (Encrypted) MSIS IDENTIFICATION NUMBER |
STATE | CHAR | 2 | STATE ABBREVIATION CODE |
BIRTH_DATE | NUM | 8 | BIRTH DATE |
SEX | CHAR | 1 | SEX CODE |
RACE_ETHNICITY | CHAR | 1 | RACE/ETHNICITY CODE |
RACE_ETHNICITY_WHITE | CHAR | 1 | RACE - WHITE |
RACE_ETHNICITY_BLACK | CHAR | 1 | RACE - BLACK/AFRICAN AMERICAN |
RACE_ETHNICITY_NATIVE | CHAR | 1 | RACE - AMERICAN INDIAN/ALASKAN NATIVE |
RACE_ETHNICITY_ASIAN | CHAR | 1 | RACE - ASIAN |
RACE_ETHNICITY_HAWAI | CHAR | 1 | RACE - NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER |
RACE_ETHNICITY_LATIN | CHAR | 1 | ETHNICITY - HISPANIC OR LATINO |
STATE_SPECIFIC_ELIG_MOST_RECENT | CHAR | 6 | STATE-SPECIFIC ELIGIBILITY CODE - MOST RECENT |
STATE_SPECIFIC_ELIG_MO_OF_SVC | CHAR | 6 | STATE-SPECIFIC ELIGIBILITY CODE - FOR MONTH OF SERVICE |
MAX_UNI_ELIG_CODE_MOST_RECENT | CHAR | 2 | MAX UNIFORM ELIGIBILITY CODE - MOST RECENT |
MAX_UNI_ELIG_CODE_MO_OF_SVC | CHAR | 2 | MAX UNIFORM ELIGIBILITY CODE - FOR MONTH OF SERVICE |
MISSING_ELIG_DATA | CHAR | 1 | MISSING ELIGIBILITY DATA |
CROSSOVER_CODE_FROM_CLAIMS_ONLY | NUM | 1 | MEDICARE DUAL CODE - CLAIM-BASED |
CROSSOVER_CODE_ANNUAL_NEW_VALUES | CHAR | 2 | MEDICARE DUAL CODE - ANNUAL |
MSIS_TYPE_OF_SERVICE | NUM | 2 | MSIS TYPE OF SERVICE CODE |
MSIS_TYPE_OF_PROGRAM | NUM | 1 | MSIS TYPE OF PROGRAM CODE |
SMRF_TYPE_OF_SERVICE | NUM | 2 | MAX TYPE OF SERVICE CODE |
COM_BASED_LTC_FLAG | CHAR | 2 | COMMUNITY-BASED LONG-TERM CARE (CLTC) FLAG |
HCBS_TAXONOMY_WAIVERS | CHAR | 5 | HOME AND COMMUNITY-BASED SERVICES (HCBS) TAXONOMY CODE FOR WAIVERS |
BILLING_PROVIDER_IDENTIF_NUMBER | CHAR | 12 | (Blanked) BILLING PROVIDER IDENTIFICATION NUMBER |
NPI | CHAR | 12 | (Blanked) NATIONAL PROVIDER IDENTIFIER |
PROVIDER_TAXONOMY | CHAR | 12 | PROVIDER TAXONOMY |
TYPE_OF_CLAIM | CHAR | 1 | TYPE OF CLAIM CODE |
MANAGED_CARE_TYPE_OF_PLAN_CODE | NUM | 2 | MANAGED CARE TYPE OF PLAN CODE |
MANAGED_CARE_PLAN_IDENTIF_CODE | CHAR | 12 | (Blanked) MANAGED CARE PLAN IDENTIFICATION NUMBER |
MEDICAID_PAYMENT_AMOUNT | NUM* | 8 | MEDICAID PAYMENT AMOUNT |
THIRD_PARTY_PAYMENT_AMOUNT | NUM* | 8 | THIRD PARTY PAYMENT AMOUNT |
PAYMENT_ADJUDICATION_DATE | NUM | 8 | PAYMENT DATE |
CHARGE_AMOUNT | NUM* | 8 | CHARGE AMOUNT |
PREPAID_PLAN_VALUE | NUM* | 8 | PREPAID PLAN SERVICE VALUE |
MEDICARE_COINSURANCE_PAYMENT_AMT | NUM* | 8 | MEDICARE COINSURANCE PAYMENT AMOUNT |
MEDICARE_DEDUCTIBLE_PAYMENT_AMT | NUM* | 8 | MEDICARE DEDUCTIBLE PAYMENT AMOUNT |
BEGINNING_DATE_OF_SERVICE | NUM | 8 | SERVICE BEGINNING DATE |
ENDING_DATE_OF_SERVICE | NUM | 8 | ENDING DATE OF SERVICE |
PROCEDURE_CODING_SYSTEM | CHAR | 2 | PROCEDURE CODING SYSTEM CODE |
PROCEDURE_CODE | CHAR | 8 | PROCEDURE (SERVICE) CODE |
PROCEDURE_CODE_MODIFIER | CHAR | 2 | PROCEDURE (SERVICE) MODIFIER CODE |
DIAGNOSIS_CODE_1 | CHAR | 7 | DIAGNOSIS CODE-1 |
DIAGNOSIS_CODE_2 | CHAR | 7 | DIAGNOSIS CODE-2 |
QUANTITY_OF_SERVICE | NUM | 5 | QUANTITY OF SERVICE |
SERVICING_PROVIDER_IDENT_NUMBER | CHAR | 12 | SERVICING PROVIDER IDENTIFICATION NUMBER |
SERVICING_PROVIDER_SPECIALTY_CD | CHAR | 4 | SERVICING PROVIDER SPECIALTY CODE |
PLACE_OF_SERVICE | NUM | 2 | PLACE OF SERVICE CODE |
UB_92_REVENUE_CODE | NUM | 4 | UB-92 REVENUE CODE |
Variable List - Drug Record (RX)
Variable Name | Type | Length | Label |
---|---|---|---|
ADJUSTMENT_CODE | NUM | 1 | ADJUSTMENT CODE |
MSIS_IDENTIFICATION_NUMBER | CHAR | 20 | (Encrypted) MSIS IDENTIFICATION NUMBER |
STATE | CHAR | 2 | STATE ABBREVIATION CODE |
MEDICARE_HIC_NUMBER | CHAR | 12 | MEDICARE HEALTH INSURANCE CLAIM (HIC) NUMBER - FROM MSIS |
BIRTH_DATE | NUM | 8 | BIRTH DATE |
SEX | CHAR | 1 | SEX CODE |
RACE_ETHNICITY | CHAR | 1 | RACE/ETHNICITY CODE |
RACE_ETHNICITY_WHITE | CHAR | 1 | RACE - WHITE |
RACE_ETHNICITY_BLACK | CHAR | 1 | RACE - BLACK/AFRICAN AMERICAN |
RACE_ETHNICITY_NATIVE | CHAR | 1 | RACE - AMERICAN INDIAN/ALASKA NATIVE |
RACE_ETHNICITY_ASIAN | CHAR | 1 | RACE - ASIAN |
RACE_ETHNICITY_HAWAI | CHAR | 1 | RACE - NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER |
RACE_ETHNICITY_LATIN | CHAR | 1 | ETHNICITY - HISPANIC OR LATINO |
STATE_SPECIFIC_ELIG_MOST_RECENT | CHAR | 6 | STATE-SPECIFIC ELIGIBILITY CODE - MOST RECENT |
STATE_SPECIFIC_ELIG_MO_OF_SVC | CHAR | 6 | STATE-SPECIFIC ELIGIBILITY CODE - FOR MONTH OF SERVICE |
MAX_UNI_ELIG_CODE_MOST_RECENT | CHAR | 2 | MAX UNIFORM ELIGIBILITY CODE - MOST RECENT |
MAX_UNI_ELIG_CODE_MO_OF_SVC | CHAR | 2 | MAX UNIFORM ELIGIBILITY CODE - FOR MONTH OF SERVICE |
MISSING_ELIG_DATA | CHAR | 1 | MISSING ELIGIBILITY DATA |
CROSSOVER_CODE_ANNUAL_NEW_VALUES | CHAR | 2 | MEDICARE DUAL CODE - ANNUAL |
MSIS_TYPE_OF_SERVICE | NUM | 2 | MSIS TYPE OF SERVICE CODE |
MSIS_TYPE_OF_PROGRAM | NUM | 1 | MSIS TYPE OF PROGRAM CODE |
SMRF_TYPE_OF_SERVICE | NUM | 2 | MAX TYPE OF SERVICE CODE |
BILLING_PROVIDER_IDENTIF_NUMBER | CHAR | 12 | (Blanked) BILLING PROVIDER IDENTIFICATION NUMBER |
NPI | CHAR | 12 | (Blanked) NATIONAL PROVIDER IDENTIFIER |
PROVIDER_TAXONOMY | CHAR | 12 | PROVIDER TAXONOMY |
TYPE_OF_CLAIM | CHAR | 1 | TYPE OF CLAIM CODE |
MANAGED_CARE_TYPE_OF_PLAN_CODE | NUM | 2 | MANAGED CARE TYPE OF PLAN CODE |
MANAGED_CARE_PLAN_IDENTIF_CODE | CHAR | 12 | (Blanked) MANAGED CARE PLAN IDENTIFICATION NUMBER |
MEDICAID_PAYMENT_AMOUNT | NUM* | 8 | MEDICAID PAYMENT AMOUNT |
THIRD_PARTY_PAYMENT_AMOUNT | NUM* | 8 | THIRD PARTY PAYMENT AMOUNT |
PAYMENT_ADJUDICATION_DATE | NUM | 8 | PAYMENT DATE |
CHARGE_AMOUNT | NUM* | 8 | CHARGE AMOUNT |
PREPAID_PLAN_VALUE | NUM* | 8 | PREPAID PLAN SERVICE VALUE |
PRESCRIBING_PHYSICIAN_ID_NUMBER | CHAR | 12 | PRESCRIBING PHYSICIAN IDENTIFICATION NUMBER |
PRESCRIBED_DATE | NUM | 8 | PRESCRIBED DATE |
PRESCRIPTION_FILL_DATE | NUM | 8 | PRESCRIPTION FILLED DATE |
NEW_OR_REFILL_INDICATOR | NUM | 2 | NEW OR REFILL INDICATOR |
NATIONAL_DRUG_CODE | CHAR | 12 | NATIONAL DRUG CODE (NDC) |
QUANTITY_OF_SERVICE | NUM | 5 | QUANTITY OF SERVICE |
DAYS_SUPPLY | NUM | 3 | DAYS SUPPLY |
NDC_FORMAT | CHAR | 1 | NATIONAL DRUG CODE FORMAT INDICATOR |
DRUG_CLASS | CHAR | 1 | DRUG CLASS |
MULTI_SOURCE_CODE | CHAR | 1 | MULTI-SOURCE CODE |
HICL | CHAR | 6 | INGREDIENT LIST IDENTIFIER |
THERAPEUTIC_CLASS_SPECIFIC | CHAR | 3 | HIERARCHICAL SPECIFIC THERAPEUTIC CLASS CODE |
THERAPEUTIC_CLASS_GENERIC | CHAR | 2 | THERAPEUTIC CLASS CODE, GENERIC |
AMERICAN_HOSPITAL_FORMULARY_CODE | CHAR | 6 | CLINICAL FORMULATION ID |
MEDISPAN_CODE | GROUP | 107 | FIRST DATA BANK/MEDISPAN GROUP (PROPRIETARY - ACCESS LIMITED TO LICENSE HOLDERS) |
OVER_THE_COUNTER_INDICATOR | CHAR | 1 | OVER-THE-COUNTER INDICATOR CODE |
Variable List - Personal Summary (PS)
Variable Name | Type | Length | Label |
---|---|---|---|
MSIS_IDENTIFICATION_NUMBER | CHAR | 20 | (Encrypted) MSIS IDENTIFICATION NUMBER |
STATE | CHAR | 2 | (Blanked) STATE ABBREVIATION CODE |
YEAR | NUM | 4 | MAX YEAR DATE |
DATE_OF_BIRTH | NUM | 8 | BIRTH DATE |
AGE_GROUP | NUM | 1 | AGE GROUP CODE |
SEX | CHAR | 1 | SEX CODE |
RACE_ETHNICITY_FROM_MEDICAID | CHAR | 1 | RACE/ETHNICITY CODE |
RACE_ETHNICITY_WHITE | CHAR | 1 | RACE - WHITE |
RACE_ETHNICITY_BLACK | CHAR | 1 | RACE - BLACK/AFRICAN AMERICAN |
RACE_ETHNICITY_NATIVE | CHAR | 1 | RACE - AMERICAN INDIAN/ALASKAN NATIVE |
RACE_ETHNICITY_ASIAN | CHAR | 1 | RACE - ASIAN |
RACE_ETHNICITY_HAWAI | CHAR | 1 | RACE - NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER |
RACE_ETHNICITY_LATIN | CHAR | 1 | ETHNICITY - HISPANIC OR LATINO |
RACE_ETHNICITY_FROM_EDB | CHAR | 1 | MEDICARE RACE/ETHNICITY CODE |
MEDICARE_LANGUAGE_CODE_FROM_EDB | CHAR | 1 | MEDICARE LANGUAGE CODE |
SEX_RACE | NUM | 1 | SEX-RACE CODE |
DATE_OF_DEATH_FROM_MEDICAID | NUM | 8 | MEDICAID DEATH DATE |
DATE_OF_DEATH_FROM_MEDICARE_EDB | NUM | 8 | MEDICARE DEATH DATE |
DAY_OF_DEATH_VERIFIED_FROM_EDB | CHAR | 1 | MEDICARE DEATH DAY SWITCH |
DAY_OF_DEATH_FROM_SSA | NUM | 8 | DATE OF DEATH (FROM SSA DEATH MASTER FILE) |
COUNTY_OF_RESIDENCE | CHAR | 3 | (Blanked) RESIDENCE COUNTY CODE |
ZIP_CODE_OF_RESIDENCE | NUM | 5 | (Blanked) RESIDENCE ZIP CODE |
STATE_SPECIFIC_ELIGIBLITY | CHAR | 6 | (Blanked) STATE-SPECIFIC ELIGIBILITY CODE - MOST RECENT |
SMRF_ELIGIBILITY | CHAR | 2 | MAX UNIFORM ELIGIBILITY CODE - MOST RECENT |
MISSING_ELIGIBILITY_DATA | CHAR | 1 | MISSING MEDICAID ELIGIBILITY DATA SWITCH |
ELIGIBLE_MONTHS | NUM | 2 | MONTHS OF ELIGIBILITY |
PRIVATE_INSURANCE_MONTHS | NUM | 2 | PRIVATE INSURANCE MONTHS COUNT |
CROSSOVER_CODE_NEW_VALUES_ANNUAL | CHAR | 2 | MEDICARE DUAL CODE - ANNUAL |
MEDICARE_BENEFICIARY_MONTHS | NUM | 2 | MEDICARE BENEFICIARY MONTHS COUNT |
OREC | NUM | 1 | MEDICARE ORIGINAL ENTITLEMENT REASON CODE |
CROSSOVER_MO_01 | CHAR | 2 | MEDICARE DUAL CODE - FIRST MONTH |
STATE_SPECIFIC_ELIGIBILITY_MO_01 | CHAR | 6 | (Blanked) STATE-SPECIFIC ELIGIBILITY CODE - FIRST MONTH |
SMRF_UNIFORM_ELIGIBILITY_MO_01 | CHAR | 2 | MAX UNIFORM ELIGIBILITY CODE - FIRST MONTH |
PRIVATE_HEALTH_INSURANCE_MO_01 | NUM | 1 | PRIVATE INSURANCE CODE - FIRST MONTH |
MEDICARE_BENEFICIARY_MO_01 | NUM | 1 | MEDICARE BENEFICIARY CODE - FIRST MONTH |
EL_PPH_PLN_MO_CNT_CMCP | NUM | 2 | PRE-PAID PLAN TYPE-1 CODE - FIRST MONTH |
EL_PPH_PLN_MO_CNT_DMCP | CHAR | 12 | (Blanked) PRE-PAID PLAN IDENTIFIER-1 - FIRST MONTH |
EL_PPH_PLN_MO_CNT_BMCP | NUM | 2 | PRE-PAID PLAN TYPE-2 CODE - FIRST MONTH |
EL_PPH_PLN_MO_CNT_PDMC | CHAR | 12 | (Blanked) PRE-PAID PLAN IDENTIFIER-2 - FIRST MONTH |
EL_PPH_PLN_MO_CNT_LTCM | NUM | 2 | PRE-PAID PLAN TYPE-3 CODE - FIRST MONTH |
EL_PPH_PLN_MO_CNT_AICE | CHAR | 12 | (Blanked) PRE-PAID PLAN IDENTIFIER-3 - FIRST MONTH |
EL_PPH_PLN_MO_CNT_PCCM | NUM | 2 | PRE-PAID PLAN TYPE-4 CODE - FIRST MONTH |
PREPAID_PLAN_TYPE_1_MO_01 | NUM | 2 | PRE-PAID PLAN MONTHS COUNT - FIRST PLAN TYPE |
PREPAID_PLAN_IDENTIFIER_4_MO_01 | CHAR | 12 | (Blanked) PRE-PAID PLAN IDENTIFIER-4 - FIRST MONTH |
MANAGED_CARE_COMBINATIONS_MO_01 | NUM | 2 | MEDICAID MANAGED CARE COMBINATIONS - FIRST MONTH |
DAYS_OF_ELIGIBILITY_MO_01 | NUM | 2 | DAYS OF ELIGIBILITY - FIRST MONTH |
TANF_CASH_ELIGIBILITY_MO_01 | NUM | 1 | TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF) CASH FLAG - FIRST MONTH |
RESTRICTED_BENEFITS_MO_01 | CHAR | 1 | RESTRICTED BENEFITS FLAG - FIRST MONTH |
SCHIP_ELIGIBILITY_MO_01 | NUM | 1 | CHILD HEALTH INSURANCE PROGRAM (CHIP) CODE - FIRST MONTH |
MAX_WAIVER_TYPE_CODE_1_01 | CHAR | 1 | MAX WAIVER TYPE CODE - 1 - FIRST MONTH |
WAIVER_ID_1_01 | CHAR | 2 | WAIVER ID - 1 - FIRST MONTH |
MAX_WAIVER_TYPE_CODE_2_01 | CHAR | 1 | MAX WAIVER TYPE CODE - 2 - FIRST MONTH |
WAIVER_ID_2_01 | CHAR | 2 | WAIVER ID - 2 - FIRST MONTH |
MAX_WAIVER_TYPE_CODE_3_01 | CHAR | 1 | MAX WAIVER TYPE CODE - 3 - FIRST MONTH |
WAIVER_ID_3_01 | CHAR | 2 | WAIVER ID - 3 - FIRST MONTH |
MAX_1915C_WAIVER_TYPE_LTST | CHAR | 1 | ANNUAL 1915(C) MAX WAIVER TYPE - MOST RECENT |
RECIPIENT_INDICATOR | CHAR | 1 | RECIPIENT INDICATOR |
IP_DISCHARGES | NUM* | 3 | TOTAL INPATIENT DISCHARGE COUNT |
IP_STAYS | NUM* | 3 | TOTAL INPATIENT STAY COUNT |
LENGTH_OF_STAY_FOR_DISCHARGES | NUM* | 3 | TOTAL INPATIENT LENGTH OF STAY (LOS), IN DAYS (FOR DISCHARGES) |
LENGTH_OF_STAY_FOR_STAYS | NUM* | 3 | TOTAL INPATIENT LENGTH OF STAY (LOS), IN DAYS (FOR STAYS) |
COVERED_DAYS_FOR_DISCHARGES | NUM* | 3 | TOTAL INPATIENT COVERED DAY COUNT (FOR DISCHARGES) |
COVERED_DAYS_FOR_STAYS | NUM* | 3 | TOTAL INPATIENT COVERED DAY COUNT (FOR STAYS) |
MENTAL_HOSPITAL_COVERED_DAYS | NUM* | 3 | LONG-TERM CARE MENTAL HOSPITAL FOR THE AGED COVERED DAY COUNT |
INPATIENT_PSYCH_COVERED_DAYS | NUM* | 3 | LONG-TERM CARE INPATIENT PSYCHIATRIC FACILITY (AGE < 21) COVERED DAY COUNT |
ICF_MR_COVERED_DAYS | NUM* | 3 | INTERMEDIATE CARE FACILITY FOR INDIVIDUALS WITH INTELLECTUAL DISABLITIES - ICF-IID COVERED DAY COUNT |
NURSING_FACILITY_COVERED_DAYS | NUM* | 3 | NURSING FACILITY - NF - COVERED DAY COUNT |
TOTAL_LT_COVERED_DAYS | NUM* | 3 | LONG-TERM CARE COVERED DAY COUNT |
TOTAL_RECORD_COUNT | NUM* | 5 | TOTAL MEDICAID RECORD COUNT |
FEE_FOR_SERVICE_CLAIM_COUNT | NUM* | 5 | TOTAL MEDICAID FEE-FOR-SERVICE CLAIM COUNT |
PREMIUM_PAYMENT_CLAIM_COUNT | NUM* | 5 | TOTAL MEDICAID PRE-PAID PLAN PREMIUM PAYMENT RECORD COUNT |
ENCOUNTER_RECORD_COUNT | NUM* | 5 | TOTAL MEDICAID ENCOUNTER RECORD COUNT |
TOTAL_MEDICAID_PAYMENT_AMOUNT | NUM* | 8 | TOTAL MEDICAID PAYMENT AMOUNT |
FEE_FOR_SERVICE_MEDICAID_PMT_AMT | NUM* | 8 | TOTAL MEDICAID FEE-FOR-SERVICE PAYMENT AMOUNT |
PREMIUM_PAYMENT_MEDICAID_PMT_AMT | NUM* | 8 | TOTAL MEDICAID PRE-PAID PLAN PREMIUM PAYMENT AMOUNT |
CHARGE_AMOUNT | NUM* | 8 | TOTAL MEDICAID CHARGE AMOUNT |
THIRD_PARTY_PAYMENT_AMOUNT | NUM* | 8 | TOTAL THIRD PARTY PAYMENT AMOUNT |
INPATIENT_HOSPITAL_RECORDS_PT_2 | NUM | 3 | INPATIENT HOSPITAL RECORDS - FIRST TYPE OF PROGRAM |
INPATIENT_HOSPITAL_PAYMENTS_PT_2 | NUM* | 8 | INPATIENT HOSPITAL PAYMENTS - FIRST TYPE OF PROGRAM |
LONG_TERM_CARE_RECORDS_PT_2 | NUM | 3 | INSTITUTIONAL LONG-TERM CARE RECORDS - FIRST TYPE OF PROGRAM |
LONG_TERM_CARE_PAYMENTS_PT_2 | NUM* | 8 | INSTITUTIONAL LONG-TERM CARE PAYMENTS - FIRST TYPE OF PROGRAM |
OTHER_SERVICE_RECORDS_PT_2 | NUM | 3 | OTHER SERVICE RECORDS - FIRST TYPE OF PROGRAM |
OTHER_SERVICE_PAYMENTS_PT_2 | NUM* | 8 | OTHER SERVICE PAYMENTS - FIRST TYPE OF PROGRAM |
PRESCRIPTION_DRUG_RECORDS_PT_2 | NUM | 3 | PRESCRIPTION DRUG RECORDS - FIRST TYPE OF PROGRAM |
PRESCRIPTION_DRUG_PAYMENTS_PT_2 | NUM* | 8 | PRESCRIPTION DRUG PAYMENTS - FIRST TYPE OF PROGRAM |
TOTAL_RECORDS_PT_2 | NUM | 3 | TOTAL RECORDS - FIRST TYPE OF PROGRAM |
TOTAL_PAYMENTS_PT_2 | NUM* | 8 | TOTAL PAYMENTS - FIRST TYPE OF PROGRAM |
DELIVERY_CODE | NUM | 1 | DELIVERY CODE |
RECIPIENT_INDICATOR_TOS_01 | CHAR | 1 | RECIPIENT INDICATOR - FIRST MAX TOS |
CLAIM_COUNT_TOS_01 | NUM* | 5 | FEE-FOR-SERVICE CLAIM COUNT - FIRST MAX TOS |
MEDICAID_PAYMENT_AMOUNT_TOS_01 | NUM* | 8 | FEE-FOR-SERVICE MEDICAID PAYMENT AMOUNT - FIRST MAX TOS |
CHARGE_AMOUNT_TOS_01 | NUM* | 8 | FEE-FOR-SERVICE CHARGE AMOUNT - FIRST MAX TOS |
THIRD_PARTY_PAYMENT_AMT_TOS_01 | NUM* | 8 | FEE-FOR-SERVICE THIRD PARTY PAYMENT AMOUNT - FIRST MAX TOS |
ENCOUNTER_RECORD_COUNT_TOS_01 | NUM | 5 | ENCOUNTER RECORD COUNT - FIRST MAX TOS |
CLTC_FFS_PYMT_AMT_11 | NUM* | 8 | MEDICAID PAYMENT AMOUNT - FIRST TYPE OF CLTC |
HCBS_FFS_PYMT_AMT_01 | NUM* | 8 | MEDICAID PAYMENT AMOUNT - FIRST TYPE OF HCBS TAXONOMY |
PREMIUM_PAYMENT_INDICATOR_TOS_20 | NUM* | 1 | PREMIUM PAYMENT INDICATOR - FIRST TYPE OF PREMIUM |
PREMIUM_PAYMENT_RECORDS_TOS_20 | NUM* | 5 | PREMIUM PAYMENT RECORD COUNT - FIRST TYPE OF PREMIUM |
MEDICAID_PREMIUM_PAYMENTS_TOS_20 | NUM* | 8 | MEDICAID PREMIUM PAYMENT AMOUNT - FIRST TYPE OF PREMIUM |
ENCTR_REC_CNT_HCBS | NUM | 5 | ENCOUNTER RECORD COUNT - HCBS |
' |
Home Variable List - MAX Summary File .. BID_MDCD Description: Beneficiary Identifier. Home Variable List - MAX Summary File .. YEAR Description: Indicator of year. Home Variable List - MAX Summary File .. MDCD_LTSS Description: Long-Term Services and Supports (LTSS) flag; i) Institutional Only; ii) Institutional and Home and Community-Based Services (HCBS); iii) HCBS Waiver, no Institutional; iv) HCBS State Plan Only, no HCBS Waiver and no Institutional; presence of LTSS defined in Appendix 8. Home Variable List - MAX Summary File .. MDCD_SPMI_STATUS Description: Severe and Persistent Mental Illness (SPMI) flag, 0 = SPMI not present, 1 = SPMI present; presence of SPMI defined in Appendix 4. Home Variable List - MAX Summary File .. MDCD_FFS_AMT Description: Total Medicaid payments on all Fee-for-Service (FFS) payments (MAX TYPE-OF-SERVICE not equal to 20, 21, 22). Home Variable List - MAX Summary File .. MDCD_HMO_AMT Description: Total Medicaid spending on all Capitated Payments to Health Maintenance Organization (HMO/HIO) or Pace Plans (MAX TYPE-OF-SERVICE = 20). Home Variable List - MAX Summary File .. MDCD_HMO_AMT_HCBS Description: Total Medicaid spending on all Capitated Payments to HMO, HIO or Pace Plans (MAX TYPE-OF-SERVICE = 20) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7). Home Variable List - MAX Summary File .. MDCD_PHP_AMT Description: Total Medicaid spending on all Capitated Payments to Physicians Health Plan (PHPs) (MAX TYPE-OF-SERVICE = 21). Home Variable List - MAX Summary File .. MDCD_PHP_AMT_HCBS Description: Total Medicaid spending on all Capitated Payments to PHPs (MAX TYPE-OF-SERVICE = 21) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7). Home Variable List - MAX Summary File .. MDCD_PCCM_AMT Description: Total Medicaid spending on all Capitated Payments for Primary Care Case Management (PCCMs) (MAX TYPE-OF-SERVICE = 22). Home Variable List - MAX Summary File .. MDCD_PCCM_AMT_HCBS Description: Total Medicaid spending on all Capitated Payments for PCCMs (MAX TYPE-OF-SERVICE = 22) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7). Home Variable List - MAX Summary File .. MDCD_IP_AMT Description: Total Medicaid spending on all Inpatient services (MAX TYPE-OF-SERVICE = 1) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_IP_ADMITS_FFS Description: Total number of Inpatient admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 1) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_IP_DAYS_FFS Description: Total Inpatient days (MAX TYPE-OF-SERVICE = 1) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_IP_ADMITS_ALL Description: Total number of Inpatient admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 1) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_IP_DAYS_ALL Description: Total Inpatient days (MAX TYPE-OF-SERVICE = 1) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_IP_AMT_HCBS Description: Total Medicaid spending on all Inpatient Services (MAX TYPE-OF-SERVICE = 1) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_IP_ADMITS_HCBS_FFS Description: Total number of Inpatient admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 1) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_IP_DAYS_HCBS_FFS Description: Total Inpatient days (MAX TYPE-OF-SERVICE = 1) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_IP_ADMITS_HCBS_ALL Description: Total number of Inpatient admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 1) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_IP_DAYS_HCBS_ALL Description: Total Inpatient days (MAX TYPE-OF-SERVICE = 1) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_IP_ER_ADMITS_FFS Description: Total number of Inpatient Emergency Room (ER) admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 1 and with at least one claim where UB-REV-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_IP_ER_DAYS_FFS Description: Total Inpatient ER days (MAX TYPE-OF-SERVICE = 1 and with at least one claim where UB-REV-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_IP_ER_ADMITS_ALL Description: Total number of Inpatient ER admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 1 and with at least one claim where UB-REV-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_IP_ER_DAYS_ALL Description: Total Inpatient ER days (MAX TYPE-OF-SERVICE = 1 and with at least one claim where UB-REV-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_IP_ER_ADMITS_HCBS_FFS Description: Total number of Inpatient ER admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 1 and with at least one claim where UB-REV-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_IP_ER_DAYS_HCBS_FFS Description: Total Inpatient ER days (MAX TYPE-OF-SERVICE = 1 and with at least one claim where UB-REV-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_IP_ER_ADMITS_HCBS_ALL Description: Total number of Inpatient ER admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 1 and with at least one claim where UB-REV-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_IP_ER_DAYS_HCBS_ALL Description: Total Inpatient ER days (MAX TYPE-OF-SERVICE = 1 and with at least one claim where UB-REV-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_MHS_AMT Description: Total Medicaid spending on all Mental Hospital Services (MAX TYPE-OF-SERVICE = 2) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_MHS_ADMITS_FFS Description: Total number of Mental Hospital Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 2) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_MHS_DAYS_FFS Description: Total Mental Hospital days (MAX TYPE-OF-SERVICE = 2) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_MHS_ADMITS_ALL Description: Total number of Mental Hospital Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 2) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_MHS_DAYS_ALL Description: Total Mental Hospital days (MAX TYPE-OF-SERVICE = 2) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_MHS_AMT_HCBS Description: Total Medicaid spending on all Mental Hospital Services (MAX TYPE-OF-SERVICE = 2) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_MHS_ADMITS_HCBS_FFS Description: Total number of Mental Hospital Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 2) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_MHS_DAYS_HCBS_FFS Description: Total Mental Hospital days (MAX TYPE-OF-SERVICE = 2) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_MHS_ADMITS_HCBS_ALL Description: Total number of Mental Hospital Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 2) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_MHS_DAYS_HCBS_ALL Description: Total Mental Hospital days (MAX TYPE-OF-SERVICE = 2) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_IPF_AMT Description: Total Medicaid spending on all Inpatient Psychiatric Facility (IPF) Services (MAX TYPE-OF-SERVICE = 4) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_IPF_ADMITS_FFS Description: Total number of IPF Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 4) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_IPF_DAYS_FFS Description: Total IPF days (MAX TYPE-OF-SERVICE = 4) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_IPF_ADMITS_ALL Description: Total number of IPF Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 4) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_IPF_DAYS_ALL Description: Total IPF days (MAX TYPE-OF-SERVICE = 4) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_IPF_AMT_HCBS Description: Total Medicaid spending on all IPF Services (MAX TYPE-OF-SERVICE = 4) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_IPF_ADMITS_HCBS_FFS Description: Total number of IPF Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 4) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_IPF_DAYS_HCBS_FFS Description: Total IPF days (MAX TYPE-OF-SERVICE = 4) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_IPF_ADMITS_HCBS_ALL Description: Total number of IPF Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 4) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_IPF_DAYS_HCBS_ALL Description: Total IPF days (MAX TYPE-OF-SERVICE = 4) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_ICF_AMT Description: Total Medicaid spending on all Intermediate Care Facilities (ICF) Services (MAX TYPE-OF-SERVICE = 5) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_ICF_ADMITS_FFS Description: Total number of ICF Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 5) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_ICF_DAYS_FFS Description: Total ICF days (MAX TYPE-OF-SERVICE = 5) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_ICF_ADMITS_ALL Description: Total number of ICF Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 5) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_ICF_DAYS_ALL Description: Total ICF days (MAX TYPE-OF-SERVICE = 5) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_ICF_AMT_HCBS Description: Total Medicaid spending on all ICF Services (MAX TYPE-OF-SERVICE = 5) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_ICF_ADMITS_HCBS_FFS Description: Total number of ICF Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 5) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_ICF_DAYS_HCBS_FFS Description: Total ICF days (MAX TYPE-OF-SERVICE = 5) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_ICF_ADMITS_HCBS_ALL Description: Total number of ICF Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 5) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_ICF_DAYS_HCBS_ALL Description: Total ICF days (MAX TYPE-OF-SERVICE = 5) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_NF_AMT Description: Total Medicaid spending on all Nursing Facility Services (MAX TYPE-OF-SERVICE = 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_NF_ADMITS_FFS Description: Total number of Nursing Facility Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_NF_DAYS_FFS Description: Total Nursing Facility days (MAX TYPE-OF-SERVICE = 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_NF_ADMITS_ALL Description: Total number of Nursing Facility Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_NF_DAYS_ALL Description: Total Nursing Facility days (MAX TYPE-OF-SERVICE = 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_NF_AMT_HCBS Description: Total Medicaid spending on all Nursing Facility Services (MAX TYPE-OF-SERVICE = 7) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_NF_ADMITS_HCBS_FFS Description: Total number of Nursing Facility Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 7) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_NF_DAYS_HCBS_FFS Description: Total Nursing Facility days (MAX TYPE-OF-SERVICE = 7) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_NF_ADMITS_HCBS_ALL Description: Total number of Nursing Facility Services admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 7) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_NF_DAYS_HCBS_ALL Description: Total Nursing Facility days (MAX TYPE-OF-SERVICE = 7) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_PHYS_AMT Description: Total Medicaid spending on all Physician Services (MAX TYPE-OF-SERVICE = 8) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_PHYS_EVENTS_FFS Description: Total number of Physician visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 8) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_PHYS_EVENTS_ALL Description: Total number of Physician visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 8) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_PHYS_AMT_HCBS Description: Total Medicaid spending on all Physician Services (MAX TYPE-OF-SERVICE = 8) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_PHYS_EVENTS_HCBS_FFS Description: Total number of Physician visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 8) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_PHYS_EVENTS_HCBS_ALL Description: Total number of Physician visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 8) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_DN_AMT Description: Total Medicaid spending on all Dental Services (MAX TYPE-OF-SERVICE = 9) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_DN_EVENTS_FFS Description: Total number of Dental visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 9) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_DN_EVENTS_ALL Description: Total number of Dental visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 9) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_DN_AMT_HCBS Description: Total Medicaid spending on all Dental Services (MAX TYPE-OF-SERVICE = 9) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_DN_EVENTS_HCBS_FFS Description: Total number of Dental visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 9) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_DN_EVENTS_HCBS_ALL Description: Total number of Dental visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 9) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_OPR_AMT Description: Total Medicaid spending on all Other Practitioners Services (MAX TYPE-OF-SERVICE = 10) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_OPR_EVENTS_FFS Description: Total number of Other Practitioner visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 10) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_OPR_EVENTS_ALL Description: Total number of Other Practitioner visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 10) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_OPR_AMT_HCBS Description: Total Medicaid spending on all Other Practitioners Services (MAX TYPE-OF-SERVICE = 10) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_OPR_EVENTS_HCBS_FFS Description: Total number of Other Practitioner visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 10) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_OPR_EVENTS_HCBS_ALL Description: Total number of Other Practitioner visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 10) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_OPH_AMT Description: Total Medicaid spending on all Outpatient Hospital Services (MAX TYPE-OF-SERVICE = 11) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_OPH_EVENTS_FFS Description: Total number of visits to Outpatient Hospitals (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 11) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_OPH_EVENTS_ALL Description: Total number of visits to Outpatient Hospitals (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 11) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_OPH_AMT_HCBS Description: Total Medicaid spending on all Outpatient Hospital Services (MAX TYPE-OF-SERVICE = 11) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_OPH_EVENTS_HCBS_FFS Description: Total number of visits to Outpatient Hospitals (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 11) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_OPH_EVENTS_HCBS_ALL Description: Total number of visits to Outpatient Hospitals (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 11) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_OPH_ER_ADMITS_FFS Description: Total number of Outpatient Hospital ER admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 11 and with at least one claim where UB-92-REVENUE-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_OPH_ER_DAYS_FFS Description: Total Outpatient Hospital ER days (MAX TYPE-OF-SERVICE = 11 and with at least one claim where UB-92-REVENUE-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_OPH_ER_ADMITS_ALL Description: Total number of Outpatient Hospital ER admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 11 and with at least one claim where UB-92-REVENUE-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_OPH_ER_DAYS_ALL Description: Total Outpatient Hospital ER days (MAX TYPE-OF-SERVICE = 11 and with at least one claim where UB-92-REVENUE-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_OPH_ER_ADMITS_HCBS_FFS Description: Total number of Outpatient Hospital ER admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 11 and with at least one claim where UB-92-REVENUE-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_OPH_ER_DAYS_HCBS_FFS Description: Total Outpatient Hospital ER days (MAX TYPE-OF-SERVICE = 11 and with at least one claim where UB-92-REVENUE-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_OPH_ER_ADMITS_HCBS_ALL Description: Total number of Outpatient Hospital ER admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 11 and with at least one claim where UB-92-REVENUE-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_OPH_ER_DAYS_HCBS_ALL Description: Total Outpatient Hospital ER days (MAX TYPE-OF-SERVICE = 11 and with at least one claim where UB-92-REVENUE-CODE of 0450, 0451, 0452, 0456, 0459, or 0981) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_CLIN_AMT Description: Total Medicaid spending on all Clinic Services (MAX TYPE-OF-SERVICE = 12) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_CLIN_EVENTS_FFS Description: Total number of Clinic visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 12) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_CLIN_EVENTS_ALL Description: Total number of Clinic visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 12) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_CLIN_AMT_HCBS Description: Total Medicaid spending on all Clinic Services (MAX TYPE-OF-SERVICE = 12) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_CLIN_EVENTS_HCBS_FFS Description: Total number of Clinic visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 12) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_CLIN_EVENTS_HCBS_ALL Description: Total number of Clinic visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 12) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_HH_AMT Description: Total Medicaid spending on all Home Health Services (MAX TYPE-OF-SERVICE = 13) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_HH_ADMITS_FFS Description: Total number of Home Health admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 13) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_HH_DAYS_FFS Description: Total Home Health Services days (MAX TYPE-OF-SERVICE = 13) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_HH_ADMITS_ALL Description: Total number of Home Health admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 13) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_HH_DAYS_ALL Description: Total Home Health Services days (MAX TYPE-OF-SERVICE = 13) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_HH_AMT_HCBS Description: Total Medicaid spending on all Home Health Services (MAX TYPE-OF-SERVICE = 13) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_HH_ADMITS_HCBS_FFS Description: Total number of Home Health admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 13) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_HH_DAYS_HCBS_FFS Description: Total Home Health Services days (MAX TYPE-OF-SERVICE = 13) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_HH_ADMITS_HCBS_ALL Description: Total number of Home Health admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 13) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_HH_DAYS_HCBS_ALL Description: Total Home Health Services days (MAX TYPE-OF-SERVICE = 13) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_LX_AMT Description: Total Medicaid spending on all Lab and X-Ray Services (MAX TYPE-OF-SERVICE = 15) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_LX_EVENTS_FFS Description: Total number of Lab and X-Ray visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 15) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_LX_EVENTS_ALL Description: Total number of Lab and X-Ray visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 15) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_LX_AMT_HCBS Description: Total Medicaid spending on all Lab and X-Ray Services (MAX TYPE-OF-SERVICE = 15) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_LX_EVENTS_HCBS_FFS Description: Total number of Lab and X-Ray visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 15) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_LX_EVENTS_HCBS_ALL Description: Total number of Lab and X-Ray visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 15) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_RX_AMT Description: Total Medicaid spending on all prescribed drugs (MAX TYPE-OF-SERVICE = 16) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_RX_EVENTS_FFS Description: Total number of prescription drug claims (MAX TYPE-OF-SERVICE = 16) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_RX_EVENTS_ALL Description: Total number of prescription drug claims (MAX TYPE-OF-SERVICE = 16) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_RX_AMT_HCBS Description: Total Medicaid spending on all Prescribed Drugs (MAX TYPE-OF-SERVICE = 16) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_RX_EVENTS_HCBS_FFS Description: Total number of prescription drug claims (MAX TYPE-OF-SERVICE = 16) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_RX_EVENTS_HCBS_ALL Description: Total number of prescription drug claims (MAX TYPE-OF-SERVICE = 16) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_OS_AMT Description: Total Medicaid spending on all Other Services (MAX TYPE-OF-SERVICE = 19) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_OS_AMT_HCBS Description: Total Medicaid spending on all Other Services (MAX TYPE-OF-SERVICE = 19) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_ST_AMT Description: Total Medicaid spending on all Sterilizations (MAX TYPE-OF-SERVICE = 24) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_ST_ADMITS_FFS Description: Total number of admissions for Sterilizations (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 24) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_ST_DAYS_FFS Description: Total Sterilization days (MAX TYPE-OF-SERVICE = 24) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_ST_ADMITS_ALL Description: Total number of admissions for Sterilizations (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 24) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_ST_DAYS_ALL Description: Total Sterilization days (MAX TYPE-OF-SERVICE = 24) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_ST_AMT_HCBS Description: Total Medicaid spending on all Sterilizations (MAX TYPE-OF-SERVICE = 24) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_ST_ADMITS_HCBS_FFS Description: Total number of admissions for Sterilizations (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 24) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_ST_DAYS_HCBS_FFS Description: Total Sterilization days (MAX TYPE-OF-SERVICE = 24) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_ST_ADMITS_HCBS_ALL Description: Total number of admissions for Sterilizations (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 24) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_ST_DAYS_HCBS_ALL Description: Total Sterilization days (MAX TYPE-OF-SERVICE = 24) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_AB_AMT Description: Total Medicaid spending on all Abortions (MAX TYPE-OF-SERVICE = 25) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_AB_ADMITS_FFS Description: Total number of admissions for Abortions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 25) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_AB_DAYS_FFS Description: Total Abortion days (MAX TYPE-OF-SERVICE = 25) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_AB_ADMITS_ALL Description: Total number of admissions for Abortions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 25) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_AB_DAYS_ALL Description: Total Abortion days (MAX TYPE-OF-SERVICE = 25) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_AB_AMT_HCBS Description: Total Medicaid spending on all Abortions (MAX TYPE-OF-SERVICE = 25) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_AB_ADMITS_HCBS_FFS Description: Total number of admissions for Abortions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 25) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_AB_DAYS_HCBS_FFS Description: Total Abortion days (MAX TYPE-OF-SERVICE = 25) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_AB_ADMITS_HCBS_ALL Description: Total number of admissions for Abortions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 25) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_AB_DAYS_HCBS_ALL Description: Total Abortion days (MAX TYPE-OF-SERVICE = 25) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_TS_AMT Description: Total Medicaid spending on all Transportation Services (MAX TYPE-OF-SERVICE = 26) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_TS_EVENTS_FFS Description: Total number of Transportation Services (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 26) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_TS_EVENTS_ALL Description: Total number of Transportation Services (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 26) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_TS_AMT_HCBS Description: Total Medicaid spending on all Transportation Services (MAX TYPE-OF-SERVICE = 26) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_TS_EVENTS_HCBS_FFS Description: Total number of Transportation Services (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 26) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_TS_EVENTS_HCBS_ALL Description: Total number of Transportation Services (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 26) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_PCS_AMT Description: Total Medicaid spending on all Personal Care Services (MAX TYPE-OF-SERVICE = 30) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_PCS_ADMITS_FFS Description: Total number of admissions for Personal Care Services (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 30) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_PCS_DAYS_FFS Description: Total Personal Care Services days (MAX TYPE-OF-SERVICE = 30) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_PCS_ADMITS_ALL Description: Total number of admissions for Personal Care Services (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 30) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_PCS_DAYS_ALL Description: Total Personal Care Services days (MAX TYPE-OF-SERVICE = 30) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_PCS_AMT_HCBS Description: Total Medicaid spending on all Personal Care Services (MAX TYPE-OF-SERVICE = 30) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_PCS_ADMITS_HCBS_FFS Description: Total number of admissions for Personal Care Services (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 30) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_PCS_DAYS_HCBS_FFS Description: Total Personal Care Services days (MAX TYPE-OF-SERVICE = 30) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_PCS_ADMITS_HCBS_ALL Description: Total number of admissions for Personal Care Services (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 30) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_PCS_DAYS_HCBS_ALL Description: Total Personal Care Services days (MAX TYPE-OF-SERVICE = 30) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_TC_AMT Description: Total Medicaid spending on all Targeted Case Management Services (MAX TYPE-OF-SERVICE = 31) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_TC_ADMITS_FFS Description: Total number of admissions for Targeted Case Management Services (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 31) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_TC_DAYS_FFS Description: Total Targeted Case Management days (MAX TYPE-OF-SERVICE = 31) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_TC_ADMITS_ALL Description: Total number of admissions for Targeted Case Management Services (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 31) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_TC_DAYS_ALL Description: Total Targeted Case Management days (MAX TYPE-OF-SERVICE = 31) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_TC_AMT_HCBS Description: Total Medicaid spending on all Targeted Case Management Services (MAX TYPE-OF-SERVICE = 31) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_TC_ADMITS_HCBS_FFS Description: Total number of admissions for Targeted Case Management Services (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 31) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_TC_DAYS_HCBS_FFS Description: Total Targeted Case Management days (MAX TYPE-OF-SERVICE = 31) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_TC_ADMITS_HCBS_ALL Description: Total number of admissions for Targeted Case Management Services (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 31) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_TC_DAYS_HCBS_ALL Description: Total Targeted Case Management days (MAX TYPE-OF-SERVICE = 31) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_RS_AMT Description: Total Medicaid spending on all Rehabilitation Services (MAX TYPE-OF-SERVICE = 33) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_RS_EVENTS_FFS Description: Total number of Rehabilitation Services visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 33) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_RS_EVENTS_ALL Description: Total number of Rehabilitation Services visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 33) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_RS_AMT_HCBS Description: Total Medicaid spending on all Rehabilitation Services (MAX TYPE-OF-SERVICE = 33) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_RS_EVENTS_HCBS_FFS Description: Total number of Rehabilitation Services visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 33) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_RS_EVENTS_HCBS_ALL Description: Total number of Rehabilitation Services visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 33) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_SH_AMT Description: Total Medicaid spending on all Physical Therapist (PT), Other (OT), Speech, Hearing Language Services (MAX TYPE-OF-SERVICE = 34) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_SH_EVENTS_FFS Description: Total number of PT, OT, Speech, Hearing Language visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 34) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_SH_EVENTS_ALL Description: Total number of PT, OT, Speech, Hearing Language visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 34) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_SH_AMT_HCBS Description: Total Medicaid spending on all PT, OT, Speech, Hearing Language Services (MAX TYPE-OF-SERVICE = 34) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_SH_EVENTS_HCBS_FFS Description: Total number of PT, OT, Speech, Hearing Language visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 34) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_SH_EVENTS_HCBS_ALL Description: Total number of PT, OT, Speech, Hearing Language visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 34) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_HS_AMT Description: Total Medicaid spending on all Hospice Services (MAX TYPE-OF-SERVICE = 35) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_HS_ADMITS_FFS Description: Total number of Hospice admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 35) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_HS_DAYS_FFS Description: Total number of Hospice days (MAX TYPE-OF-SERVICE = 35) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_HS_ADMITS_ALL Description: Total number of Hospice admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 35) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_HS_DAYS_ALL Description: Total number of Hospice days (MAX TYPE-OF-SERVICE = 35) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_HS_AMT_HCBS Description: Total Medicaid spending on all Hospice Services (MAX TYPE-OF-SERVICE = 35) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_HS_ADMITS_HCBS_FFS Description: Total number of Hospice admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 35) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_HS_DAYS_HCBS_FFS Description: Total number of Hospice days (MAX TYPE-OF-SERVICE = 35) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_HS_ADMITS_HCBS_ALL Description: Total number of Hospice admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 35) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_HS_DAYS_HCBS_ALL Description: Total number of Hospice days (MAX TYPE-OF-SERVICE = 35) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_NMS_AMT Description: Total Medicaid spending on all Nurse Midwife Services (MAX TYPE-OF-SERVICE = 36) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_NMS_EVENTS_FFS Description: Total number of Nurse Midwife visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 36) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_NMS_EVENTS_ALL Description: Total number of Nurse Midwife visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 36) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_NMS_AMT_HCBS Description: Total Medicaid spending on all Nurse Midwife Services (MAX TYPE-OF-SERVICE = 36) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_NMS_EVENTS_HCBS_FFS Description: Total number of Nurse Midwife visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 36) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_NMS_EVENTS_HCBS_ALL Description: Total number of Nurse Midwife visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 36) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_NPS_AMT Description: Total Medicaid spending on all Nurse Practitioner Services (MAX TYPE-OF-SERVICE = 37) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_NPS_EVENTS_FFS Description: Total number of Nurse Practitioner visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 37) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_NPS_EVENTS_ALL Description: Total number of Nurse Practitioner visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 37) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_NPS_AMT_HCBS Description: Total Medicaid spending on all Nurse Practitioner Services (MAX TYPE-OF-SERVICE = 37) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_NPS_EVENTS_HCBS_FFS Description: Total number of Nurse Practitioner visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 37) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_NPS_EVENTS_HCBS_ALL Description: Total number of Nurse Practitioner visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 37) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_PDN_AMT Description: Total Medicaid spending on all Private Duty Nursing Services (MAX TYPE-OF-SERVICE = 38) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_PDN_ADMITS_FFS Description: Total number of Private Duty Nursing admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 38) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_PDN_DAYS_FFS Description: Total Private Duty Nursing days (MAX TYPE-OF-SERVICE = 38) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_PDN_ADMITS_ALL Description: Total number of Private Duty Nursing admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 38) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_PDN_DAYS_ALL Description: Total Private Duty Nursing days (MAX TYPE-OF-SERVICE = 38) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_PDN_AMT_HCBS Description: Total Medicaid spending on all Private Duty Nursing Services (MAX TYPE-OF-SERVICE = 38) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_PDN_ADMITS_HCBS_FFS Description: Total number of Private Duty Nursing admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 38) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_PDN_DAYS_HCBS_FFS Description: Total Private Duty Nursing days (MAX TYPE-OF-SERVICE = 38) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_PDN_ADMITS_HCBS_ALL Description: Total number of Private Duty Nursing admissions (an admission is the first day in a series of contiguous claims where MAX TYPE-OF-SERVICE = 38) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_PDN_DAYS_HCBS_ALL Description: Total Private Duty Nursing days (MAX TYPE-OF-SERVICE = 38) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_RNHC_AMT Description: Total Medicaid spending on all Religious Non-Medical Health Care Institutions Services (MAX TYPE-OF-SERVICE = 39) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_RNHC_EVENTS_FFS Description: Total number of Religious Non-Medical Health Care Institutions Services visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 39) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_RNHC_EVENTS_ALL Description: Total number of Religious Non-Medical Health Care Institutions Services visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 39) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_RNHC_AMT_HCBS Description: Total Medicaid spending on all Religious Non-Medical Health Care Institutions Services (MAX TYPE-OF-SERVICE = 39) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_RNHC_EVENTS_HCBS_FFS Description: Total number of Religious Non-Medical Health Care Institutions Services visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 39) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_RNHC_EVENTS_HCBS_ALL Description: Total number of Religious Non-Medical Health Care Institutions Services visits (count of provider-day encounters with an MAX TYPE-OF-SERVICE = 39) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_US_AMT Description: Total Medicaid spending on all missing, invalid, or unknown services (MAX TYPE-OF-SERVICE = 99+) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_US_AMT_HCBS Description: Total Medicaid spending on all missing, invalid, or unknown services (MAX TYPE-OF-SERVICE = 99+) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_DMES_AMT Description: Total Medicaid spending on all Durable Medical Equipment and Supplies (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 51) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_DMES_EVENTS_FFS Description: Total number of Durable Medical Equipment and Supplies events (count of provider-day encounters when MAX TYPE-OF-SERVICE = 51) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_DMES_EVENTS_ALL Description: Total number of Durable Medical Equipment and Supplies events (count of provider-day encounters when MAX TYPE-OF-SERVICE = 51) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_DMES_AMT_HCBS Description: Total Medicaid spending on all Durable Medical Equipment and Supplies (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 51) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_DMES_EVENTS_HCBS_FFS Description: Total number of Durable Medical Equipment and Supplies events (count of provider-day encounters when MAX TYPE-OF-SERVICE = 51) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_DMES_EVENTS_HCBS_ALL Description: Total number of Durable Medical Equipment and Supplies events (count of provider-day encounters when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 51) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_RC_AMT Description: Total Medicaid spending on all Residential Care Services (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 52) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_RC_ADMITS_FFS Description: Total number of Residential Care admissions (an admission is the first day in a series of contiguous claims where at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 52) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_RC_DAYS_FFS Description: Total Residential Care days (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 52) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_RC_ADMITS_ALL Description: Total number of Residential Care admissions (an admission is the first day in a series of contiguous claims where at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 52) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_RC_DAYS_ALL Description: Total Residential Care days (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 52) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_RC_AMT_HCBS Description: Total Medicaid spending on all Residential Care Services (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 52) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_RC_ADMITS_HCBS_FFS Description: Total number of Residential Care admissions (an admission is the first day in a series of contiguous claims where at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 52) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_RC_DAYS_HCBS_FFS Description: Total Residential Care days (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 52) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_RC_ADMITS_HCBS_ALL Description: Total number of Residential Care admissions (an admission is the first day in a series of contiguous claims where at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 52) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_RC_DAYS_HCBS_ALL Description: Total Residential Care days (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 52) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_PS_AMT Description: Total Medicaid spending on all Psychiatric Services (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 53) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_PS_EVENTS_FFS Description: Total number of Psychiatric Services visits (count of provider-day encounters when MAX TYPE-OF-SERVICE = 53) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_PS_EVENTS_ALL Description: Total number of Psychiatric Services visits (count of provider-day encounters when MAX TYPE-OF-SERVICE = 53) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_PS_AMT_HCBS Description: Total Medicaid spending on all Psychiatric Services (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 53) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_PS_EVENTS_HCBS_FFS Description: Total number of Psychiatric Services visits (count of provider-day encounters when MAX TYPE-OF-SERVICE = 53) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_PS_EVENTS_HCBS_ALL Description: Total number of Psychiatric Services visits (count of provider-day encounters when MAX TYPE-OF-SERVICE = 53) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_ADC_AMT Description: Total Medicaid spending on all Adult Day Care Services (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 54) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_ADC_ADMITS_FFS Description: Total number of Adult Day Care admissions (an admission is the first day in a series of contiguous claims where at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 54) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_ADC_DAYS_FFS Description: Total Adult Day Care days (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 54) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_ADC_ADMITS_ALL Description: Total number of Adult Day Care admissions (an admission is the first day in a series of contiguous claims where at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 54) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_ADC_DAYS_ALL Description: Total Adult Day Care days (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 54) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_ADC_AMT_HCBS Description: Total Medicaid spending on all Adult Day Care Services (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 54) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_ADC_ADMITS_HCBS_FFS Description: Total number of Adult Day Care admissions (an admission is the first day in a series of contiguous claims where at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 54) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_ADC_DAYS_HCBS_FFS Description: Total Adult Day Care days (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 54) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS claims (TYPE-OF-CLAIM = 1, 5). Home Variable List - MAX Summary File .. MDCD_ADC_ADMITS_HCBS_ALL Description: Total number of Adult Day Care admissions (an admission is the first day in a series of contiguous claims where at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 54) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5). Home Variable List - MAX Summary File .. MDCD_ADC_DAYS_HCBS_ALL Description: Total Adult Day Care days (when at least one claim in the claim group has a MAX TYPE-OF-SERVICE = 54) when enrolled in an HCBS Program (MSIS PROGRAM-TYPE = 6, 7) for all FFS and encounter claims (TYPE-OF-CLAIM = 1, 3, 5).
Home Variable List - MAX - IP 1. ADJUSTMENT_CODE Type: NUM Length: 1 Label: ADJUSTMENT CODE DESCRIPTION: CODE INDICATING IF THE CLAIMS FOR THIS SERVICE WERE ONLY ORIGINAL SUBMISSIONS, INCLUDED ADJUSTEMENTS OF ANY TYPE OR IF ONE OR MORE ORIGINAL SUBMISSIONS WAS MISSING. Values: 0 = NO ADJUSTMENT OF CLAIMS WAS REQUIRED, SINCE ALL CLAIMS FOR THIS RECORD WERE ORIGINAL CLAIMS (ALL CLAIMS FOR THIS RECORD HAD VALUE = 0 IN THE MSIS DATA ELEMENT 'ADJUSTMENT- INDICATOR'). IN THIS CASE, ORIGINAL CLAIMS WERE COMBINED FOR THIS RECORD. 1 = THIS RECORD REPRESENTS A CLAIMS SET WHERE IT WAS POSSIBLE TO CORRECTLY COMPLETE THE ADJUSTMENT PROCESS, BY COMBINING ORIGINAL AND ADJUSTMENT CLAIMS FOR THIS RECORD. THIS MEANS THAT THERE WAS AT LEAST ONE ORIGINAL CLAIM AND AT LEAST ONE ADJUSTMENT CLAIM IN THE SET OF CLAIMS FOR THIS RECORD (AT LEAST ONE CLAIM FOR THIS RECORD HAD VALUE = 0 IN THE MSIS DATA ELEMENT 'ADJUSTMENT-INDICATOR' AND AT LEAST ONE CLAIM FOR THIS RECORD HAD A VALUE OTHER THAN 0 IN THE MSIS DATA ELEMENT 'ADJUSTMENT-INDICATOR'). 2 = THIS RECORD REPRESENTS A CLAIMS SET WHERE IT WAS NOT POSSIBLE TO CORRECTLY COMPLETE THE ADJUSTMENT PROCESS (NONE OF THE CLAIMS FOR THIS RECORD HAD A VALUE = 0 IN THE MSIS DATA ELEMENT 'ADJUSTMENT-INDICATOR'). Home Variable List - MAX - IP 3. MSIS_IDENTIFICATION_NUMBER Type: CHAR Length: 20 Label: (Encrypted) MSIS IDENTIFICATION NUMBER Encrypted. Values: Encrypted Home Variable List - MAX - IP 4. STATE Type: CHAR Length: 2 Label: STATE ABBREVIATION CODE DESCRIPTION: U.S. POSTAL SERVICE 2-CHARACTER ABBREVIATION FOR THE STATE MEDICAID AGENCY SUBMITTING THE DATA. Values: CODES: AL = ALABAMA AK = ALASKA AZ = ARIZONA AR = ARKANSAS CA = CALIFORNIA CO = COLORADO CT = CONNECTICUT DE = DELAWARE DC = DISTRICT OF COLUMBIA FL = FLORIDA GA = GEORGIA GU = GUAM/AMERICAN SAMOA HI = HAWAII ID = IDAHO IL = ILLINOIS IN = INDIANA IA = IOWA KS = KANSAS KY = KENTUCKY LA = LOUISIANA ME = MAINE MD = MARYLAND MA = MASSACHUSETTS MI = MICHIGAN MN = MINNESOTA MS = MISSISSIPPI MO = MISSOURI MT = MONTANA NE = NEBRASKA NV = NEVADA NH = NEW HAMPSHIRE NJ = NEW JERSEY NM = NEW MEXICO NY = NEW YORK NC = NORTH CAROLINA ND = NORTH DAKOTA OH = OHIO OK = OKLAHOMA OR = OREGON PA = PENNSYLVANIA PR = PUERTO RICO RI = RHODE ISLAND SC = SOUTH CAROLINA SD = SOUTH DAKOTA TN = TENNESSEE TX = TEXAS UT = UTAH VT = VERMONT VI = VIRGIN ISLANDS VA = VIRGINIA WA = WASHINGTON WV = WEST VIRGINIA WI = WISCONSIN WY = WYOMING Home Variable List - MAX - IP 7. BIRTH_DATE Type: NUM Length: 8 Label: BIRTH DATE DESCRIPTION: BIRTH DATE OF THE MEDICAID ELIGIBLE. EDIT-RULES: YYYYMMDD. Home Variable List - MAX - IP 8. SEX Type: CHAR Length: 1 Label: SEX CODE DESCRIPTION: CODE INDICATING THE GENDER OF THE MEDICAID ELIGIBLE. Values: CODES: F = FEMALE M = MALE U = UNKNOWN/ERROR USER NOTE: THESE CODES ARE 1 (FEMALE), 2 (MALE) AND 9 (UNKNOWN) IN THE 1996-98 MSIS DATA. Home Variable List - MAX - IP 9. RACE_ETHNICITY Type: CHAR Length: 1 Label: RACE/ETHNICITY CODE DESCRIPTION: CODE INDICATING THE RACE/ETHNICITY OF THE MEDICAID ELIGIBLE. Values: CODES: 1 = WHITE, NOT OF HISPANIC ORIGIN (CHANGED TO "WHITE" BEGINNING 10/98) 2 = BLACK, NOT OF HISPANIC ORIGIN (CHANGED TO "BLACK OR AFRICAN AMERICAN" BEGINNING 10/98) 3 = AMERICAN INDIAN OR ALASKA NATIVE 4 = ASIAN OR PACIFIC ISLANDER (CHANGED TO "ASIAN" BEGINNING 10/98) 5 = HISPANIC (CHANGED TO "HISPANIC OR LATINO - NO RACE INFORMATION AVAILABLE" BEGINNING 10/98) 6 = NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER (NEW CODE BEGINNING 10/98) 7 = HISPANIC OR LATINO AND ONE OR MORE RACES (NEW CODE BEGINNING 10/98) 8 = MORE THAN ONE RACE (HISPANIC OR LATINO NOT INDICATED) (NEW CODE BEGINNING 10/98) 9 = UNKNOWN USER NOTE: SINCE SPECIFICATIONS FOR CODE VALUES = 7 AND 8 WERE NOT ISSUED UNTIL MAY 2000, THESE CODE VALUES MAY NOT APPEAR. THE METHODS OF COLLECTING INFORMATION ON RACE AND ETHNICITY DIFFER SUBSTANTIALLY ACROSS STATES AND TIME PERIODS. Home Variable List - MAX - IP 10. RACE_ETHNICITY_WHITE Type: CHAR Length: 1 Label: RACE - WHITE DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF WHITE. Values: CODES: 0 = NON-WHITE OR RACE UNKNOWN 1 = WHITE Home Variable List - MAX - IP 11. RACE_ETHNICITY_BLACK Type: CHAR Length: 1 Label: RACE - BLACK/AFRICAN AMERICAN DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF BLACK OR AFRICAN AMERICAN. Values: CODES: 0 = NON-BLACK/AFRICAN AMERICAN OR RACE UNKNOWN 1 = BLACK OR AFRICAN AMERICAN Home Variable List - MAX - IP 12. RACE_ETHNICITY_NATIVE Type: CHAR Length: 1 Label: RACE - AMERICAN INDIAN/ALASKA NATIVE DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF AMERICAN INDIAN/ALASKA NATIVE. Values: CODES: 0 = NON-AMERICAN INDIAN/ALASKA NATIVE OR RACE UNKNOWN 1 = AMERICAN INDIAN/ALASKA NATIVE Home Variable List - MAX - IP 13. RACE_ETHNICITY_ASIAN Type: CHAR Length: 1 Label: RACE - ASIAN DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF ASIAN. Values: CODES: 0 = NON-ASIAN OR RACE UNKNOWN 1 = ASIAN Home Variable List - MAX - IP 14. RACE_ETHNICITY_HAWAI Type: CHAR Length: 1 Label: RACE - NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER. Values: CODES: 0 = NON-NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER OR RACE UNKNOWN 1 = NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER Home Variable List - MAX - IP 15. RACE_ETHNICITY_LATIN Type: CHAR Length: 1 Label: ETHNICITY - HISPANIC OR LATINO DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED AN ETHNICITY OF HISPANIC OR LATINO. Values: CODES: 0 = NON-HISPANIC OR LATINO 1 = HISPANIC OR LATINO 9 = ETHNICITY UNKNOWN Home Variable List - MAX - IP 16. STATE_SPECIFIC_ELIG_MOST_RECENT Type: CHAR Length: 6 Label: STATE-SPECIFIC ELIGIBILITY CODE - MOST RECENT DESCRIPTION: STATE-SPECIFIC ELIGIBILITY CODE CLASSIFICATION UNDER WHICH THE MEDICAID ELIGIBLE IS COVERED - MOST RECENT OBSERVATION. USER NOTES: THESE SOURCE CODES ARE GENERALLY NOT APPLICABLE FOR MOST. Home Variable List - MAX - IP 17. STATE_SPECIFIC_ELIG_MO_OF_SVC Type: CHAR Length: 6 Label: STATE-SPECIFIC ELIGIBILITY CODE - FOR MONTH OF SERVICE DESCRIPTION: STATE-SPECIFIC ELIGIBILITY CODE CLASSIFICATION UNDER WHICH THE MEDICAID ELIGIBLE IS COVERED - FOR THE MONTH OF SERVICE. USER NOTES: THESE SOURCE CODES ARE GENERALLY NOT APPLICABLE FOR MOS. Home Variable List - MAX - IP 18. MAX_UNI_ELIG_CODE_MOST_RECENT Type: CHAR Length: 2 Label: MAX UNIFORM ELIGIBILITY CODE - MOST RECENT DESCRIPTION: MEDICAID ANALYTIC EXTRACTS (MAX) UNIFORM ELIGIBILITY CODE FOR THE MEDICAID ELIGIBLE - MOST RECENT OBSERVATION. Values: CODES: 00 = NOT ELIGIBLE 11 = AGED, CASH 12 = BLIND/DISABLED, CASH 14 = CHILD (NOT CHILD OF UNEMPLOYED ADULT, NOT FOSTER CARE CHILD), ELIGIBLE UNDER SECTION 1931 OF THE ACT 15 = ADULT (NOT BASED ON UNEMPLOYMENT STATUS), ELIGIBLE UNDER SECTION 1931 OF THE ACT 16 = CHILD OF UNEMPLOYED ADULT, ELIGIBLE UNDER SECTION 1931 OF THE ACT 17 = UNEMPLOYED ADULT, ELIGIBLE UNDER SECTION 1931 OF THE ACT 21 = AGED, MEDICALLY NEEDY 22 = BLIND/DISABLED, MEDICALLY NEEDY 24 = CHILD, MEDICALLY NEEDY (FORMERLY AFDC CHILD, MEDICALLY NEEDY) 25 = ADULT, MEDICALLY NEEDY (FORMERLY AFDC ADULT, MEDICALLY NEEDY) 31 = AGED, POVERTY 32 = BLIND/DISABLED, POVERTY 34 = CHILD, POVERTY (INCLUDES MEDICAID EXPANSION CHIP CHILDREN) 35 = ADULT, POVERTY 3A = INDIVIDUAL COVERED UNDER THE BREAST AND CERVICAL CANCER PREVENTION ACT OF 2000, POVERTY 41 = OTHER AGED 42 = OTHER BLIND/DISABLED 44 = OTHER CHILD 45 = OTHER ADULT 48 = FOSTER CARE CHILD 51 = AGED, SECTION 1115 DEMONSTRATION EXPANSION 52 = BLIND/DISABLED, SECTION 1115 DEMONSTRATION EXPANSION 54 = CHILD, SECTION 1115 DEMONSTRATION EXPANSION 55 = ADULT, SECTION 1115 DEMONSTRATION EXPANSION 99 = UNKNOWN ELIGIBILITY USER NOTE: MSIS 'MAINTENANCE-ASSISTANCE-STATUS' (MAS) IS IN POSITION #1 AND 'BASIS-OF-ELIGIBILITY' (BOE) IS IN POSITION #2. CODING IS THE SAME AS IN 1996-98 MAX FILES, EXCEPT THAT VALUES 51-55 ARE ADDED FOR 1999 AND VALUE 3A IS ADDED FOR 2000. THERE MAY BE SMALL NUMBERS OF RECORDS WITH INCONSISTENT VALUES BECAUSE MSIS HAS NO MAS/BOE CONSISTENCY CHECKS. PRIOR TO THE END OF THE AID TO FAMILIES WITH DEPENDENT CHILDREN (AFDC) PROGRAM, GROUPS 14-17 WERE AFDC CASH RECIPIENTS. Home Variable List - MAX - IP 19. MAX_UNI_ELIG_CODE_MO_OF_SVC Type: CHAR Length: 2 Label: MAX UNIFORM ELIGIBILITY CODE - FOR MONTH OF SERVICE DESCRIPTION: CODE INDICATING THE MEDICAID ANALYTIC EXTRACT (MAX) UNIFORM ELIGIBILITY STATUS FOR THE MEDICAID ELIGIBLE - FOR THE MONTH OF SERVICE. Values: CODES: 00 = NOT ELIGIBLE 11 = AGED, CASH 12 = BLIND/DISABLED, CASH 14 = CHILD (NOT CHILD OF UNEMPLOYED ADULT, NOT FOSTER CARE CHILD), ELIGIBLE UNDER SECTION 1931 OF THE ACT 15 = ADULT (NOT BASED ON UNEMPLOYMENT STATUS), ELIGIBLE UNDER SECTION 1931 OF THE ACT 16 = CHILD OF UNEMPLOYED ADULT, ELIGIBLE UNDER SECTION 1931 OF THE ACT 17 = UNEMPLOYED ADULT, ELIGIBLE UNDER SECTION 1931 OF THE ACT 21 = AGED, MEDICALLY NEEDY 22 = BLIND/DISABLED, MEDICALLY NEEDY 24 = CHILD, MEDICALLY NEEDY (FORMERLY AFDC CHILD, MEDICALLY NEEDY) 25 = ADULT, MEDICALLY NEEDY (FORMERLY AFDC ADULT, MEDICALLY NEEDY) 31 = AGED, POVERTY 32 = BLIND/DISABLED, POVERTY 34 = CHILD, POVERTY (INCLUDES MEDICAID EXPANSION CHIP CHILDREN) 35 = ADULT, POVERTY 3A = INDIVIDUAL COVERED UNDER THE BREAST AND CERVICAL CANCER PREVENTION ACT OF 2000, POVERTY 41 = OTHER AGED 42 = OTHER BLIND/DISABLED 44 = OTHER CHILD 45 = OTHER ADULT 48 = FOSTER CARE CHILD 51 = AGED, SECTION 1115 DEMONSTRATION EXPANSION 52 = BLIND/DISABLED, SECTION 1115 DEMONSTRATION EXPANSION 54 = CHILD, SECTION 1115 DEMONSTRATION EXPANSION 55 = ADULT, SECTION 1115 DEMONSTRATION EXPANSION 99 = UNKNOWN ELIGIBILITY USER NOTE: MSIS 'MAINTENANCE-ASSISTANCE-STATUS' (MAS) IS POSITION #1 AND 'BASIS-OF-ELIGIBILITY' (BOE) IS IN POSITION #2. CODING IS THE SAME AS IN 1996-98 MAX FILES, EXCEPT THAT VALUES 51-55 ARE ADDED FOR 1999 AND VALUE 3A IS ADDED FOR 2000. THERE MAY BE SMALL NUMBERS OF RECORDS WITH INCONSISTENT VALUES BECAUSE MSIS HAS NO MAS/BOE CONSISTENCY CHECKS. PRIOR TO THE END OF THE AID TO FAMILIES WITH DEPENDENT CHILDREN (AFDC) PROGRAM, GROUPS 14-17 WERE AFDC CASH RECIPIENTS. Home Variable List - MAX - IP 20. MISSING_ELIG_DATA Type: CHAR Length: 1 Label: MISSING ELIGIBILITY DATA DESCRIPTION: CODE INDICATING A PERSON FOR WHOM NO MONTHS OF ENROLLMENT IN MEDICAID WERE FOUND. Values: CODES: BLANK = MEDICAID ENROLLMENT MONTHS WERE FOUND. 1 = NEITHER MEDICAID ENROLLMENT MONTHS NOR S-CHIP (CHIP CODE = 3) ENROLLMENT MONTHS WERE FOUND. 2 = S-CHIP ENROLLMENT MONTHS (CHIP CODE = 3) WERE FOUND, BUT NO MEDICAID ENROLLMENT MONTHS WERE FOUND. USER NOTES: MONTHS OF MEDICAID ENROLLMENT ARE DEFINED AS MONTHS WITH MSIS MASBOE VALUES 11-17, 21-25, 31-35, 3A, 41-45, 48 OR 51-55. CHILDREN WITH S-CHIP ONLY ENROLLMENT (CHIP CODE = 3) ARE INCLUDED BECAUSE THEY DO NOT HAVE ANY MONTHS OF MEDICAID ENROLLMENT. Home Variable List - MAX - IP 21. CROSSOVER_CODE_FROM_CLAIMS_ONLY Type: NUM Length: 1 Label: MEDICARE DUAL CODE - CLAIM-BASED DESCRIPTION: CODE INDICATING THAT THE ELIGIBLE WAS COVERED BY MEDICARE WHEN THIS SERVICE WAS RENDERED. Values: CODES: 0 = NO MEDICARE DEDUCTIBLE OR COINSURANCE PAID BY MEDICAID ON THIS SERVICE 1 = MEDICARE DEDUCTIBLE OR COINSURANCE PAID BY MEDICAID ON THIS SERVICE Home Variable List - MAX - IP 22. CROSSOVER_CODE_ANNUAL_NEW_VALUES Type: CHAR Length: 2 Label: MEDICARE DUAL CODE - ANNUAL DESCRIPTION: CODE INDICATING THAT THE ELIGIBLE IS COVERED BY MEDICARE (KNOWN AS DUAL OR MEDICARE ELIGIBILITY), ACCORDING TO MEDICAID (MSIS), MEDICARE (EDB) OR BOTH IN THE CALENDAR YEAR. Values: CODES: 00 = IN MSIS, ELIGIBLE IS NOT A MEDICARE BENEFICIARY 01 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QMB ONLY 02 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QMB AND FULL MEDICAID COVERAGE 03 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-SLMB ONLY 04 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-SLMB AND FULL MEDICAID COVERAGE 05 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QDWI 06 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QUALIFYING INDIVIDUALS (1) 07 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QUALIFYING INDIVIDUALS (2) 08 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-OTHER DUAL ELIGIBLES 09 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-DUAL ELIGIBILITY CATEGORY UNKNOWN 10 = IN MSIS, S-CHIP ELIGIBLE IS ENTITLED TO MEDICARE 50 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODES 01-09 DO NOT APPLY 51 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 01 APPLIES 52 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 02 APPLIES 53 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 03 APPLIES 54 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 04 APPLIES 55 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 05 APPLIES 56 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 06 APPLIES 57 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 07 APPLIES 58 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 08 APPLIES 59 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 09 APPLIES 60 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE S-CHIP ELIGIBLE AND CODE 10 APPLIES 99 = IN MSIS, ELIGIBLE'S MEDICARE STATUS IS UNKNOWN USER NOTE: THE ANNUAL DUAL CODE IS EQUAL TO THE LATEST (MOST RECENT) QUARTERLY DUAL CODE > '00' (BEGINNING WITH THE LAST QUARTER AND MOVING BACKWARDS IN TIME QUARTER BY QUARTER). IF NONE OF THE QUARTERS HAVE DUAL CODE > '00', THE ANNUAL DUAL CODE IS SET TO '00'. IF THE PERSON IS ELIGIBLE FOR MEDICAID AND ENROLLED IN THE EDB IN AT LEAST ONE MONTH OF THE YEAR, A '5' IS MOVED TO THE FIRST POSITION (I.E. VALUES 50-59). IF THE PERSON HAS CLAIMS BUT NO ELIGIBILITY RECORD, THE ANNUAL DUAL CODE IS SET TO '99'. Home Variable List - MAX - IP 23. MSIS_TYPE_OF_SERVICE Type: NUM Length: 2 Label: MSIS TYPE OF SERVICE CODE DESCRIPTION: CODE INDICATING THE MEDICAID STATISTICAL INFORMATION SYSTEM (MSIS) TYPE OF SERVICE. EXPECTED MSIS TYPES OF SERVICE FOR THIS FILE ARE: 01 = INPATIENT HOSPITAL 24 = STERILIZATIONS 25 = ABOR. Home Variable List - MAX - IP 24. MSIS_TYPE_OF_PROGRAM Type: NUM Length: 1 Label: MSIS TYPE OF PROGRAM CODE DESCRIPTION: CODE INDICATING THE SPECIAL MEDICAID PROGRAM UNDER WHICH THE SERVICE WAS PROVIDED. Values: CODES: 0 = NO SPECIAL PROGRAM 1 = EARLY PERIODIC SCREENING DIAGNOSIS AND TREATMENT (EPSDT) 2 = FAMILY PLANNING 3 = RURAL HEALTH CLINIC 4 = FEDERALLY QUALIFIED HEALTH CENTERS (FQHCs) 5 = INDIAN HEALTH SERVICES 6 = HOME AND COMMUNITY-BASED CARE FOR DISABLED ELDERLY AND INDIVIDUALS AGE 65 AND OLDER 7 = HOME AND COMMUNITY-BASED CARE WAIVER SERVICES 9 = UNKNOWN USER NOTE: UNDER EPSDT REQUIREMENTS, STATES MUST PROVIDE HEALTH SCREENING, VISION, HEARING AND DENTAL SERVICES TO CHILDREN UNDER THE AGE OF 21. THESE SERVICES MUST BE PROVIDED AT INTERVALS TO MEET RECOGNIZED STANDARDS OF MEDICAL AND DENTAL PRACTICE AND OTHER INTERVALS TO DETERMINE IF PHYSICAL OR MENTAL ILLNESSES OR CONDITIONS EXIST. STATES MUST ALSO PROVIDE ANY SERVICE NEEDED TO TREAT AN ILLNESS OR CONDITION IDENTIFIED BY A SCREEN (TO THE EXTENT THAT A SERVICE IS PERMITTED UNDER MEDICAID LAW), REGARDLESS OF WHETHER THE SERVICE IS OTHERWISE INCLUDED UNDER THE STATE MEDICAID PLAN. ALTHOUGH EPSDT MAY BE VIEWED AS A PROGRAM BY SOME, IT CAN BE MORE ACCURATELY DESCRIBED AS A GROUP OF SERVICES, WITH A STRONG EMPHASIS ON PREVENTIVE CARE. HOWEVER, THERE IS NO STANDARD DEFINITION OF EPSDT SERVICES AND THERE ARE NO STANDARD REPORTING REQUIREMENTS FOR EPSDT SERVICES IN MEDICAID DATA SYSTEMS. THEREFORE, THERE IS SUBSTANTIAL VARIATION IN REPORTING FOR EPSDT ACROSS STATES. FOR THESE REASONS, USE OF TYPE OF PROGRAM = 1 (EPSDT) IS UNRELIABLE FOR CROSS-STATE COMPARISONS OR DEVELOPMENT OF NATIONAL STATISTICS. EXTREME CAUTION SHOULD BE EXERCISED IN ATTRIBUTING MEANING TO THIS CODE VALUE. Home Variable List - MAX - IP 25. SMRF_TYPE_OF_SERVICE Type: NUM Length: 2 Label: MAX TYPE OF SERVICE CODE DESCRIPTION: CODE INDICATING THE MEDICAID ANALYTIC EXTRACT (MAX) TYPE OF SERVICE FOR THIS RECORD. EXPECTED MAX TYPES OF SERVICE FOR THIS FILE ARE: 01 = INPATIENT HOSPITAL 24 = STERILIZATIONS 25 = ABOR. Home Variable List - MAX - IP 26. BILLING_PROVIDER_IDENTIF_NUMBER Type: CHAR Length: 12 Label: (Blanked) BILLING PROVIDER IDENTIFICATION NUMBER Blanked. Values: Blanked Home Variable List - MAX - IP 27. NPI Type: CHAR Length: 12 Label: (Blanked) NATIONAL PROVIDER IDENTIFIER Blanked. Values: Blanked Home Variable List - MAX - IP 28. PROVIDER_TAXONOMY Type: CHAR Length: 12 Label: PROVIDER TAXONOMY DESCRIPTION: A NATIONAL HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)-COMPLIANT CODE THAT DESCRIBES THE PROVIDER SPECIALTY OR INSTITUTION TYPE OF THE INSTITUTION BILLING/CARIN. Home Variable List - MAX - IP 29. TYPE_OF_CLAIM Type: CHAR Length: 1 Label: TYPE OF CLAIM CODE DESCRIPTION: CODE INDICATING THE TYPE OF CLAIM. Values: CODES: 1 = A CURRENT FEE-FOR-SERVICE CLAIM FOR MEDICAL SERVICES. 2 = CAPITATED PAYMENT. 3 = ENCOUNTER (A.K.A. 'DUMMY') RECORD THAT SIMULATES A BILL FOR A SERVICE RENDERED TO A PATIENT COVERED UNDER SOME FORM OF CAPITATION PLAN. 4 = A 'SERVICE TRACKING CLAIM' THAT DOCUMENTS SERVICES RECEIVED BY AN INDIVIDUAL PATIENT, WHEN THE STATE ACCEPTS A LUMP SUM BILL FROM A PROVIDER THAT COVERED SIMILAR SERVICES DELIVERED TO MORE THAN ONE PATIENT, SUCH AS GROUP SCREENING FOR EARLY PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT (EPSDT). 5 = SUPPLEMENTAL PAYMENT (ABOVE CAPITATION FEE OR ABOVE NEGOTIATED RATE) (E.G. FEDERALLY QUALIFIED HEALTH CENTER (FQHC) ADDITIONAL REIMBURSEMENT). 9 = UNKNOWN. A = S-CHIP CLAIM: A CURRENT FEE-FOR-SERVICE CLAIM FOR MEDICAL SERVICES. B = S-CHIP CLAIM: CAPITATED PAYMENT. C = S-CHIP CLAIM: ENCOUNTER (A.K.A. 'DUMMY') RECORD THAT SIMULATES A BILL FOR A SERVICE RENDERED TO A PATIENT COVERED UNDER SOME FORM OF CAPITATION PLAN. D = S-CHIP CLAIM: A 'SERVICE TRACKING CLAIM' THAT DOCUMENTS SERVICES RECEIVED BY AN INDIVIDUAL PATIENT, WHEN THE STATE ACCEPTS A LUMP SUM BILL FROM A PROVIDER THAT COVERED SIMILAR SERVICES DELIVERED TO MORE THAN ONE PATIENT, SUCH AS GROUP SCREENING FOR EPSDT. E = S-CHIP CLAIM: SUPPLEMENTAL PAYMENT (ABOVE CAPITATION FEE OR ABOVE NEGOTIATED RATE) (E.G. FQHC ADDITIONAL REIMBURSEMENT). USER NOTE: VOIDED CLAIMS ARE NOT RETAINED IN MAX AS $0 PAID CLAIMS. Home Variable List - MAX - IP 31. MANAGED_CARE_TYPE_OF_PLAN_CODE Type: NUM Length: 2 Label: MANAGED CARE TYPE OF PLAN CODE DESCRIPTION: CODE INDICATING THE TYPE OF MANAGED CARE PLAN, IF ANY, UNDER WHICH THE NON-FEE-FOR-SERVICE ENCOUNTER WAS PROVIDED. Values: CODES: 00 = INDIVIDUAL WAS NOT ELIGIBLE FOR MEDICAID THIS MONTH. 01 = ELIGIBLE IS ENROLLED IN A MEDICAL OR COMPREHENSIVE MANAGED CARE PLAN THIS MONTH (E.G. HMO). 02 = ELIGIBLE IS ENROLLED IN A DENTAL MANAGED CARE PLAN THIS MONTH. 03 = ELIGIBLE IS ENROLLED IN A BEHAVIORAL MANAGED CARE PLAN THIS MONTH. 04 = ELIGIBLE IS ENROLLED IN A PRENATAL/DELIVERY MANAGED CARE PLAN THIS MONTH. 05 = ELIGIBLE IS ENROLLED IN A LONG-TERM CARE MANAGED CARE PLAN THIS MONTH. 06 = ELIGIBLE IS ENROLLED IN A PROGRAM FOR ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) THIS MONTH. 07 = ELIGIBLE IS ENROLLED IN A PRIMARY CARE CASE MANAGEMENT MANAGED CARE PLAN THIS MONTH. 08 = ELIGIBLE IS ENROLLED IN AN OTHER MANAGED CARE PLAN THIS MONTH. 77 = THIS RECORD IS AN ENCOUNTER RECORD, BUT THERE WAS NO MATCH BETWEEN THE 'MANAGED CARE PLAN IDENTIFICATION NUMBER' AND THE PLAN IDENTIFIERS IN THE ELIGIBILTY RECORD FOR THIS PERSON. 88 = NOT APPLICABLE, THIS RECORD IS NOT AN ENCOUNTER RECORD OR THIS RECORD’S PLAN ID IS 8-FILLED. 99 = ELIGIBLE'S MANAGED CARE PLAN STATUS IS UNKNOWN. USER NOTE: THIS DATA ELEMENT IS 8-FILLED FOR NON-ENCOUNTER RECORDS. IN MAX 1999-2008, THIS DATA ELEMENT WAS 6, 7, 8 OR 9-FILLED FOR ALL RECORDS. IN MAX 2010, VALUE 66 WAS DELETED. IN MAX 2010, WE REVISED THE ALGORITHM TO LOOK FOR THE CLAIM’S PLAN ID IN ALL FOUR PLANS IN ALL 12 MONTHS OF ELIGIBILITY RATHER THAN LOOK ONLY IN THE SERVICE END MONTH. Home Variable List - MAX - IP 32. MANAGED_CARE_PLAN_IDENTIF_CODE Type: CHAR Length: 12 Label: (Blanked) MANAGED CARE PLAN IDENTIFICATION NUMBER Blanked. Values: Blanked Home Variable List - MAX - IP 33. MEDICAID_PAYMENT_AMOUNT Type: NUM* Length: 8 Label: MEDICAID PAYMENT AMOUNT DESCRIPTION: TOTAL AMOUNT OF MONEY PAID BY MEDICAID FOR THIS SERVICE. (SAS USERS: ZONED DECIMAL - ZD8) USER NOTES: THIS PAYMENT AMOUNT IS = $0 FOR ENCOUNTER RECORDS. IN MSIS, STATES ARE INSTRUCTED TO. Home Variable List - MAX - IP 34. THIRD_PARTY_PAYMENT_AMOUNT Type: NUM* Length: 8 Label: THIRD PARTY PAYMENT AMOUNT DESCRIPTION: TOTAL AMOUNT OF MONEY PAID BY A THIRD PARTY (I.E. ALL SOURCES OTHER THAN MEDICAID, MEDICARE AND THE ELIGIBLE'S PERSONAL FUNDS) FOR THIS SERVICE. (SAS USERS: ZONED DECIMAL - ZD8) USER NOTE. Home Variable List - MAX - IP 35. PAYMENT_ADJUDICATION_DATE Type: NUM Length: 8 Label: PAYMENT DATE DESCRIPTION: DATE ON WHICH THE CLAIM OR ENCOUNTER RECORD WAS ADJUDICATED BY THE STATE. EDIT-RULES: YYYYMMDD USER NOTE: FOR FEE-FOR-SERVICE CLAIMS THIS IS THE DATE THE CLAIM WAS ADJUDICATED FOR PAYMENT. Home Variable List - MAX - IP 36. CHARGE_AMOUNT Type: NUM* Length: 8 Label: CHARGE AMOUNT DESCRIPTION: TOTAL AMOUNT OF CHARGES SUBMITTED BY THE PROVIDER FOR THIS SERVICE. (SAS USERS: ZONED DECIMAL - ZD8) USER NOTE: THIS PAYMENT AMOUNT IS = $0 FOR ENCOUNTER RECORDS. IN MSIS, FOR TYPE OF CLA. Home Variable List - MAX - IP 37. PREPAID_PLAN_VALUE Type: NUM* Length: 8 Label: PREPAID PLAN SERVICE VALUE DESCRIPTION: DOLLAR VALUE PLACED ON THE SERVICE BY THE PROVIDER. (SAS USERS: ZONED DECIMAL - ZD8) USER NOTES: THIS PAYMENT AMOUNT IS > $0 ONLY FOR ENCOUNTER RECORDS. WHILE THIS PAYMENT AMOUNT COULD HA. Home Variable List - MAX - IP 38. MEDICARE_COINSURANCE_PAYMENT_AMT Type: NUM* Length: 8 Label: MEDICARE COINSURANCE PAYMENT AMOUNT DESCRIPTION: THE AMOUNT PAID BY MEDICAID FOR THIS SERVICE, TOWARD THE RECIPIENT'S MEDICARE COINSURANCE LIABILITY. (SAS USERS: ZONED DECIMAL - ZD8). Home Variable List - MAX - IP 39. MEDICARE_DEDUCTIBLE_PAYMENT_AMT Type: NUM* Length: 8 Label: MEDICARE DEDUCTIBLE PAYMENT AMOUNT DESCRIPTION: THE AMOUNT PAID BY MEDICAID, FOR THIS SERVICE, TOWARD THE RECIPIENT'S MEDICARE DEDUCTIBLE LIABILITY. (SAS USERS: ZONED DECIMAL - ZD8) USER NOTE: THIS DATA ELEMENT IS NOT APPLICABLE. Home Variable List - MAX - IP 40. ADMISSION_DATE Type: NUM Length: 8 Label: ADMISSION DATE DESCRIPTION: DATE WHICH THE RECIPIENT WAS ADMITTED FOR THIS INPATIENT STAY. EDIT-RULES: YYYYMMDD. Home Variable List - MAX - IP 41. BEGINNING_DATE_OF_SERVICE Type: NUM Length: 8 Label: SERVICE BEGINNING DATE DESCRIPTION: BEGINNING DATE OF SERVICE FOR THIS CLAIM. EDIT-RULES: YYYYMMDD USER NOTE: THIS DATE MAY OR MAY NOT BE THE ADMISSION DATE. Home Variable List - MAX - IP 42. ENDING_DATE_OF_SERVICE Type: NUM Length: 8 Label: ENDING DATE OF SERVICE DESCRIPTION: THE DATE RECORDED HERE IS THE LATEST DATE OF SERVICE FOR ANY CLAIM RELATED TO THIS HOSPITAL STAY. THIS DATE MAY OR MAY NOT BE THE DISCHARGE DATE. EDIT-RULES: YYYYMMDD USER NOTES: THIS DAT. Home Variable List - MAX - IP 43. DIAGNOSIS_CODE_1 Type: CHAR Length: 7 Label: PRINCIPAL DIAGNOSIS CODE DESCRIPTION: PRINCIPAL DIAGNOSIS CODE FOR THIS RECORD. EDIT-RULES: LEFT JUSTIFIED, NO DECIMAL POINT USER NOTE: USERS SHOULD EXERCISE CAUTION SINCE THIS DATA ELEMENT REMAINS AS IT WAS REP. Values: CODES: 0 = ICD-10 9 = ICD-9 BLANK = MISSING Home Variable List - MAX - IP 44. DIAGNOSIS_CODE_2 Type: CHAR Length: 7 Label: DIAGNOSIS CODE - 2 DESCRIPTION: SECOND DIAGNOSIS CODE FOR THIS RECORD. EDIT-RULES: LEFT JUSTIFIED, NO DECIMAL POINT. USER NOTE: USERS SHOULD EXERCISE CAUTION SINCE THIS DATA ELEMENT REMAINS AS IT WAS REPOR. Values: CODES: 0 = ICD-10 9 = ICD-9 BLANK = MISSING Home Variable List - MAX - IP 52. PRINCIPLE_PROCEDURE_DATE Type: NUM Length: 8 Label: PRINCIPAL PROCEDURE DATE DESCRIPTION: DATE ON WHICH THE PRINCIPAL PROCEDURE, IF ANY, WAS PERFORMED. EDIT-RULES: YYYYMMDD. Values: CODES: 0 = ICD-10 9 = ICD-9 BLANK = MISSING Home Variable List - MAX - IP 53. PROCEDURE_CODING_SYSTEM_1 Type: CHAR Length: 2 Label: PROCEDURE CODING SYSTEM CODE - PRINCIPAL DESCRIPTION: CODE SPECIFYING THE PROCEDURE CODING SYSTEM USED FOR THE PRINCIPAL PROCEDURE. Home Variable List - MAX - IP 54. PROCEDURE_CODE_1 Type: CHAR Length: 8 Label: PROCEDURE CODE - PRINCIPAL DESCRIPTION: PRINCIPAL PROCEDURE PERFORMED FOR DEFINITIVE TREATMENT (RATHER THAN DIAGNOSTIC OR EXPLORATORY PURPOSES). IT IS RELATED TO EITHER THE DIAGNOSIS OR TO COMPLICATIONS. SEE 'PROCEDU. Values: CODES: 01 = CPT-4 (HCPCS LEVEL 1) 02 = ICD-9-CM 06 = HCPCS (HCPCS LEVELS 2 AND 3) 07 = ICD-10 (FUTURE USE) 10-87 = OTHER SYSTEMS 88 = NOT APPLICABLE 99 = UNKNOWN USER NOTES: THIS DATA ELEMENT SHOULD BE USED WITH 'PRINCIPAL PROCEDURE CODE'. USERS SHOULD MAKE SURE THE CODE VALUE IN THIS DATA ELEMENT ACCURATELY REFLECTS THE CODING SCHEME IN USE. THE FOLLOWING CODE VALUES ARE OBSOLETE: 03 = CRVS 74, 04 = CRVS 69, AND 05 = CRVS 64. Home Variable List - MAX - IP 55. PROCEDURE_CODING_SYSTEM_2 Type: CHAR Length: 2 Label: PROCEDURE CODING SYSTEM CODE - 2 DESCRIPTION: CODE SPECIFYING THE PROCEDURE CODING SYSTEM USED FOR THE PROCEDURE. Home Variable List - MAX - IP 56. PROCEDURE_CODE_2 Type: CHAR Length: 8 Label: PROCEDURE CODE - 2 DESCRIPTION: PROCEDURE PERFORMED FOR DEFINITIVE TREATMENT (RATHER THAN DIAGNOSTIC OR EXPLORATORY PURPOSES). IT IS RELATED TO EITHER THE DIAGNOSIS OR TO COMPLICATIONS. SEE 'PROCEDURE CODING. Values: CODES: 01 = CPT-4 (HCPCS LEVEL 1) 02 = ICD-9-CM 06 = HCPCS (HCPCS LEVELS 2 AND 3) 07 = ICD-10 (FUTURE USE) 10-87 = OTHER SYSTEMS 88 = NOT APPLICABLE 99 = UNKNOWN USER NOTES: THIS DATA ELEMENT SHOULD BE USED WITH 'PROCEDURE CODE - ADDITIONAL PROCEDURES'. USERS SHOULD MAKE SURE THE CODE VALUE IN THIS DATA ELEMENT ACCURATELY REFLECTS THE CODING SCHEME IN USE. THE FOLLOWING CODE VALUES ARE OBSOLETE: 03 = CRVS 74, 04 = CRVS 69, AND 05 = CRVS 64. Home Variable List - MAX - IP 65. DELIVERY_CODE Type: NUM Length: 1 Label: DELIVERY CODE DESCRIPTION: CODE INDICATING WHETHER THIS IS A DELIVERY CLAIM. Values: CODES: 0 = NOT A DELIVERY CLAIM 1 = MATERNAL DELIVERY CLAIM 2 = NEWBORN DELIVERY CLAIM ON THE IP CLAIM, THE DELIVERY INDICATOR IDENTIFIES WHETHER THE CLAIM IS FOR A MATERNAL DELIVERY OR A NEWBORN DELIVERY. THERE ARE 2 STEPS TO THIS PROCESS: STEP 1. THE DELIVERY INDICATOR IS ADDED TO EACH IP CLAIM. THE VALUES ARE: 0 = NOT A DELIVERY CLAIM 1 = MATERNAL DELIVERY CLAIM (LIVE AND STILL BIRTH) IF THE CLAIM HAS ONE OF THESE DIAGNOSIS CODES (AFTER REMOVING THE DECIMAL POINT): 650, 6400-6769 (WITH A 5TH DIGIT OF 1 OR 2), AND V271-V279, AND THE PERSON'S AGE IS GREATER THAN 9 YEARS OLD (THE PERSON'S AGE IS CONFIRMED IN STEP 2). 2 = NEWBORN DELIVERY CLAIM IF THE CLAIM HAS ONE OF THESE DIAGNOSIS CODES (AFTER REMOVING THE DECIMAL POINT): V30, V31-V39 (PLUS A 4TH DIGIT OF 0 OR 1 AND ANY VALUE IN THE 5TH POSITION) STEP 2. THE DELIVERY INDICATOR IS UPDATED, BASED ON THE PERSON'S AGE ON THE PS RECORD EACH CLAIM IS MERGED TO THE PS RECORD TO GET THE PERSON'S AGE. IF THE DELIVERY INDICATOR ON THE CLAIM = 1 (MATERNAL DELIVERY) BUT THE PERSON IS UNDER AGE 10, THE DELIVERY INDICATOR ON THE CLAIM IS RECODED TO ZERO (NOT A DELIVERY CLAIM). USER NOTES: SOME INPATIENT HOSPITAL DELIVERY CLAIMS ARE ONLY FOR THE MOTHER, SOME ARE ONLY FOR THE NEWBORN, AND SOME ARE COMBINED MOTHER/NEWBORN CLAIMS. INPATIENT HOSPITAL PROCEDURE CODES WERE NOT USED TO IDENTIFY DELIVERIES BECAUSE THEY ARE NOT AS RELIABLE AS DIAGNOSIS CODES. A SMALL PERCENTAGE OF MEDICAID DELIVERIES OCCUR IN PLACES OF SERVICE OTHER THAN THE INPATIENT HOSPITAL. COUNTS OF DELIVERIES MAY OVERCOUNT THE ACTUAL NUMBER OF DELIVERIES BECAUSE THERE MAY BE MORE THAN ONE CLAIM FOR THE SAME MATERNAL DELIVERY (E.G. CLAIMS FOR FALSE LABOR AND/OR CLAIMS FOR DELIVERY-RELATED COMPLICATIONS, WHICH DID NOT RESULT IN A DELIVERY, ARE CODED INCORRECTLY AS A DELIVERY). COUNTS OF NEWBORN DELIVERIES MAY UNDERCOUNT THE ACTUAL NUMBER OF MEDICAID NEWBORNS, BECAUSE THE STATES MAY BE REPORTING NEWBORN DELIVERIES ONLY FOR PROCESSING PURPOSES. IN MAX 1999-2005 THE DELIVERY INDICATOR ON THE PS FILE INCORRECTLY INCLUDED BOTH MOTHERS AND NEWBORNS INSTEAD OF JUST MOTHERS. STARTING WITH MAX 2006 IT INCLUDES ONLY MATERNAL DELIVERIES. THE DELIVERY INDICATOR ON THE IP FILE CAN BE USED TO PROPERLY IDENTIFY EITHER MATERNAL AND/OR NEWBORN DELIVERIES DURING 1999-2005. IN MAX 2006 A FEW MORE DIAGNOSIS CODES WERE ADDED TO THE LIST OF NEWBORN DIAGNOSIS CODES. Home Variable List - MAX - IP 66. MEDICAID_COVERED_INPATIENT_DAYS Type: NUM* Length: 3 Label: MEDICAID-COVERED INPATIENT DAYS DESCRIPTION: NUMBER OF INPATIENT DAYS COVERED BY MEDICAID ON THIS INPATIENT STAY, INCLUDING NEWBORN DAYS. (SAS USERS: ZONED DECIMAL - ZD3) USER NOTE: IF THE CLAIM IS A MEDICARE CROSSOVER CLAI. Values: CODES: 0 = NOT A DELIVERY CLAIM 1 = MATERNAL DELIVERY CLAIM 2 = NEWBORN DELIVERY CLAIM ON THE IP CLAIM, THE DELIVERY INDICATOR IDENTIFIES WHETHER THE CLAIM IS FOR A MATERNAL DELIVERY OR A NEWBORN DELIVERY. THERE ARE 2 STEPS TO THIS PROCESS: STEP 1. THE DELIVERY INDICATOR IS ADDED TO EACH IP CLAIM. THE VALUES ARE: 0 = NOT A DELIVERY CLAIM 1 = MATERNAL DELIVERY CLAIM (LIVE AND STILL BIRTH) IF THE CLAIM HAS ONE OF THESE DIAGNOSIS CODES (AFTER REMOVING THE DECIMAL POINT): 650, 6400-6769 (WITH A 5TH DIGIT OF 1 OR 2), AND V271-V279, AND THE PERSON'S AGE IS GREATER THAN 9 YEARS OLD (THE PERSON'S AGE IS CONFIRMED IN STEP 2). 2 = NEWBORN DELIVERY CLAIM IF THE CLAIM HAS ONE OF THESE DIAGNOSIS CODES (AFTER REMOVING THE DECIMAL POINT): V30, V31-V39 (PLUS A 4TH DIGIT OF 0 OR 1 AND ANY VALUE IN THE 5TH POSITION) STEP 2. THE DELIVERY INDICATOR IS UPDATED, BASED ON THE PERSON'S AGE ON THE PS RECORD EACH CLAIM IS MERGED TO THE PS RECORD TO GET THE PERSON'S AGE. IF THE DELIVERY INDICATOR ON THE CLAIM = 1 (MATERNAL DELIVERY) BUT THE PERSON IS UNDER AGE 10, THE DELIVERY INDICATOR ON THE CLAIM IS RECODED TO ZERO (NOT A DELIVERY CLAIM). USER NOTES: SOME INPATIENT HOSPITAL DELIVERY CLAIMS ARE ONLY FOR THE MOTHER, SOME ARE ONLY FOR THE NEWBORN, AND SOME ARE COMBINED MOTHER/NEWBORN CLAIMS. INPATIENT HOSPITAL PROCEDURE CODES WERE NOT USED TO IDENTIFY DELIVERIES BECAUSE THEY ARE NOT AS RELIABLE AS DIAGNOSIS CODES. A SMALL PERCENTAGE OF MEDICAID DELIVERIES OCCUR IN PLACES OF SERVICE OTHER THAN THE INPATIENT HOSPITAL. COUNTS OF DELIVERIES MAY OVERCOUNT THE ACTUAL NUMBER OF DELIVERIES BECAUSE THERE MAY BE MORE THAN ONE CLAIM FOR THE SAME MATERNAL DELIVERY (E.G. CLAIMS FOR FALSE LABOR AND/OR CLAIMS FOR DELIVERY-RELATED COMPLICATIONS, WHICH DID NOT RESULT IN A DELIVERY, ARE CODED INCORRECTLY AS A DELIVERY). COUNTS OF NEWBORN DELIVERIES MAY UNDERCOUNT THE ACTUAL NUMBER OF MEDICAID NEWBORNS, BECAUSE THE STATES MAY BE REPORTING NEWBORN DELIVERIES ONLY FOR PROCESSING PURPOSES. IN MAX 1999-2005 THE DELIVERY INDICATOR ON THE PS FILE INCORRECTLY INCLUDED BOTH MOTHERS AND NEWBORNS INSTEAD OF JUST MOTHERS. STARTING WITH MAX 2006 IT INCLUDES ONLY MATERNAL DELIVERIES. THE DELIVERY INDICATOR ON THE IP FILE CAN BE USED TO PROPERLY IDENTIFY EITHER MATERNAL AND/OR NEWBORN DELIVERIES DURING 1999-2005. IN MAX 2006 A FEW MORE DIAGNOSIS CODES WERE ADDED TO THE LIST OF NEWBORN DIAGNOSIS CODES. Home Variable List - MAX - IP 67. PATIENT_STATUS_ Type: NUM Length: 2 Label: PATIENT STATUS CODE DESCRIPTION: CODE INDICATING THE PATIENT'S DISCHARGE STATUS. Values: CODES: 01 = DISCHARGED TO HOME OR SELF CARE (ROUTINE DISCHARGE) 02 = DISCHARGED/TRANSFERRED TO ANOTHER SHORT-TERM HOSPITAL 03 = DISCHARGED/TRANSFERRED TO A NURSING FACILITY 04 = DISCHARGED/TRANSFERRED TO AN INTERMEDIATE CARE FACILITY 05 = DISCHARGED/TRANSFERRED TO ANOTHER TYPE OF INSTITUTION (INCLUDING DISTINCT PARTS) OR REFERRED FOR OUTPATIENT SERVICES TO ANOTHER INSTITUTION 06 = DISCHARGED/TRANSFERRED TO HOME UNDER CARE OF ORGANIZED HOME HEALTH SERVICE ORGANIZATION 07 = LEFT AGAINST MEDICAL ADVICE OR DISCONTINUED CARE 08 = DISCHARGED/TRANSFERRED TO HOME UNDER CARE OF A HOME IV DRUG THERAPY PROVIDER 09 = ADMITTED AS AN INPATIENT TO THIS HOSPITAL 20 = EXPIRED 30 = STILL A PATIENT 40 = EXPIRED AT HOME (HOSPICE CLAIMS ONLY) 41 = EXPIRED IN A MEDICAL FACILITY SUCH AS A HOSPITAL, NF OR FREE-STANDING HOSPICE (HOSPICE CLAIMS ONLY) 42 = EXPIRED - PLACE UNKNOWN (HOSPICE CLAIMS ONLY) 43 = DISCHARGED/TRANSFERRED TO A FEDERAL HOSPITAL 50 = HOSPICE - HOME 51 = HOSPICE - MEDICAL FACILITY 61 = DISCHARGED TO A HOSPITAL-BASED MEDICARE APPROVED SWING BED 62 = DISCHARGED/TRANSFERRED TO ANOTHER REHAB FACILITY/REHAB UNIT OF A HOSPITAL 63 = DISCHARGED/TRANSFERRED TO A LONG-TERM CARE HOSPITAL 65 = DISCHARGED/TRANSFERRED TO A PSYCH HOSPITAL/PSYCH UNIT OF A HOSPITAL 66 = DISCHARGED TO CRITICAL ACCESS HOSPITAL 71 = DISCHARGED/TRANSFERRED TO ANOTHER INSTITUTION FOR OUTPATIENT SERVICES 72 = DISCHARGED/TRANSFERRED TO THIS INSTITUTION FOR OUTPATIENT SERVICES 99 = UNKNOWN USER NOTE: THE DATA ELEMENT WAS PREVIOUSLY KNOWN AS DISCHARGE STATUS. NOTE: IN MAX 2009, VALUES 43, 61, 62, 63, 65, 66, 71 AND 72 WERE ADDED TO THE FILE. 02 = DISCHARGED/TRANSFERRED TO ANOTHER SHORT-TERM HOSPITAL 03 = DISCHARGED/TRANSFERRED TO A NURSING FACILITY 04 = DISCHARGED/TRANSFERRED TO AN INTERMEDIATE CARE FACILITY 05 = DISCHARGED/TRANSFERRED TO ANOTHER TYPE OF INSTITUTION (INCLUDING DISTINCT PARTS) OR REFERRED FOR OUTPATIENT SERVICES TO ANOTHER INSTITUTION 06 = DISCHARGED/TRANSFERRED TO HOME UNDER CARE OF ORGANIZED HOME HEALTH SERVICE ORGANIZATION 07 = LEFT AGAINST MEDICAL ADVICE OR DISCONTINUED CARE 08 = DISCHARGED/TRANSFERRED TO HOME UNDER CARE OF A HOME IV DRUG THERAPY PROVIDER 09 = ADMITTED AS AN INPATIENT TO THIS HOSPITAL 20 = EXPIRED 30 = STILL A PATIENT 40 = EXPIRED AT HOME (HOSPICE CLAIMS ONLY) 41 = EXPIRED IN A MEDICAL FACILITY SUCH AS A HOSPITAL, NF OR FREE-STANDING HOSPICE (HOSPICE CLAIMS ONLY) 42 = EXPIRED - PLACE UNKNOWN (HOSPICE CLAIMS ONLY) 43 = DISCHARGED/TRANSFERRED TO A FEDERAL HOSPITAL 50 = HOSPICE - HOME 51 = HOSPICE - MEDICAL FACILITY 61 = DISCHARGED TO A HOSPITAL-BASED MEDICARE APPROVED SWING BED 62 = DISCHARGED/TRANSFERRED TO ANOTHER REHAB FACILITY/REHAB UNIT OF A HOSPITAL 63 = DISCHARGED/TRANSFERRED TO A LONG-TERM CARE HOSPITAL 65 = DISCHARGED/TRANSFERRED TO A PSYCH HOSPITAL/PSYCH UNIT OF A HOSPITAL 66 = DISCHARGED TO CRITICAL ACCESS HOSPITAL 71 = DISCHARGED/TRANSFERRED TO ANOTHER INSTITUTION FOR OUTPATIENT SERVICES 72 = DISCHARGED/TRANSFERRED TO THIS INSTITUTION FOR OUTPATIENT SERVICES 99 = UNKNOWN USER NOTE: THE DATA ELEMENT WAS PREVIOUSLY KNOWN AS DISCHARGE STATUS. NOTE: IN MAX 2009, VALUES 43, 61, 62, 63, 65, 66, 71 AND 72 WERE ADDED TO THE FILE. Home Variable List - MAX - IP 68. DIAGNOSIS_RELATED_GROUP_INDICATR Type: CHAR Length: 4 Label: DIAGNOSIS RELATED GROUP INDICATOR DESCRIPTION: IDENTIFIES THE GROUPING ALGORITHM USED TO ASSIGN DIAGNOSIS RELATED GROUP (DRG) VALUES. Values: CODES: 8888 = NO DRG SYSTEM WAS USED 9999 = UNKNOWN OTHERWISE, THE FOLLWING CODES ARE USED TO FILL THE FIELD: IN THE LEFT-MOST 2 POSITIONS: PP = WHERE "PP" IS US POSTAL CODE FOR THE STATE, IF THE DRG VALUES ARE FROM A SYSTEM DEVELOPED BY THE STATE. HG = IF THE DRG VALUES ARE FROM THE CMS SYSTEM. XX = IF THE DRG VALUES ARE FROM ANOTHER SYSTEM. IN THE RIGHT-MOST 2 POSITIONS: NN = WHERE "NN" IS THE DRG VERSION THAT WAS USED (VALUE 01-98). 99 = VERSION IS UNKNOWN. USER NOTE: FOR EXAMPLE "HG15" WOULD REPRESENT CMS DRG, VERSION 15. Home Variable List - MAX - IP 69. DIAGNOSIS_RELATED_GROUP Type: NUM Length: 4 Label: DIAGNOSIS RELATED GROUP DESCRIPTION: DIAGNOSIS RELATED GROUP (DRG) CODE FOR THIS INPATIENT RECORD. USER NOTE: IF DRGs ARE NOT USED, THIS DATA ELEMENT IS 8-FILLED. IF DRGs ARE USED BUT THE DRG VALUE IS UNKNOWN, THIS DATA ELEM. Home Variable List - MAX - IP 70. UB_92_REVENUE_CODE_01 Type: NUM Length: 4 Label: UB-92 REVENUE CODE - FIRST REVENUE CODE DESCRIPTION: CODE WHICH IDENTIFIES A SPECIFIC ACCOMMODATION, ANCILLARY SERVICE OR BILLING CALCULATION. FOR AN INPATIENT HOSPITAL STAY, REVENUE CODES 0100 - 0249 DESCRIBE ROOM AND B. Home Variable List - MAX - IP 71. UB_92_REVENUE_CODE_CHARGE_01 Type: NUM* Length: 8 Label: UB-92 REVENUE CODE CHARGE - FIRST REVENUE CODE DESCRIPTION: THE TOTAL CHARGE FOR THE RELATED UB-92 REVENUE CODE. TOTAL CHARGES INCLUDE BOTH COVERED AND NON-COVERED CHARGES (AS DEFINED BY THE UB-92 BILLING MANUAL, FORM LOCATOR 47). (SAS USERS: ZONE. Home Variable List - MAX - IP 72. UB_92_REVENUE_CODE_UNITS_01 Type: NUM Length: 7 Label: UB-92 REVENUE CODE UNITS - FIRST REVENUE CODE DESCRIPTION: UNITS ASSOCIATED WITH THE RELATED UB-92 REVENUE CODE. THIS DATA ELEMENT IS A QUANTITATIVE MEASURE OF SERVICES RENDERED FOR THE RELATED UB-92 REVENUE CODE. EXAMPLES.
Home Variable List - MAX - LT 1. ADJUSTMENT_CODE Type: NUM Length: 1 Label: ADJUSTMENT CODE DESCRIPTION: CODE INDICATING IF THE CLAIMS FOR THIS SERVICE WERE ONLY ORIGINAL SUBMISSIONS, INCLUDED ADJUSTMENTS OF ANY TYPE OR IF ONE OR MORE ORIGINAL SUBMISSIONS WAS MISSING. Values: 0 = NO ADJUSTMENT OF CLAIMS WAS REQUIRED, SINCE ALL CLAIMS FOR THIS RECORD WERE ORIGINAL CLAIMS (ALL CLAIMS FOR THIS RECORD HAD VALUE = 0 IN THE MSIS DATA ELEMENT 'ADJUSTMENT- INDICATOR'). IN THIS CASE, ORIGINAL CLAIMS WERE COMBINED FOR THIS RECORD. 1 = THIS RECORD REPRESENTS A CLAIMS SET WHERE IT WAS POSSIBLE TO CORRECTLY COMPLETE THE ADJUSTMENT PROCESS, BY COMBINING ORIGINAL AND ADJUSTMENT CLAIMS FOR THIS RECORD. THIS MEANS THAT THERE WAS AT LEAST ONE ORIGINAL CLAIM AND AT LEAST ONE ADJUSTMENT CLAIM IN THE SET OF CLAIMS FOR THIS RECORD (AT LEAST ONE CLAIM FOR THIS RECORD HAD VALUE = 0 IN THE MSIS DATA ELEMENT 'ADJUSTMENT-INDICATOR' AND AT LEAST ONE CLAIM FOR THIS RECORD HAD A VALUE OTHER THAN 0 IN THE MSIS DATA ELEMENT 'ADJUSTMENT-INDICATOR'). 2 = THIS RECORD REPRESENTS A CLAIMS SET WHERE IT WAS NOT POSSIBLE TO CORRECTLY COMPLETE THE ADJUSTMENT PROCESS (NONE OF THE CLAIMS FOR THIS RECORD HAD A VALUE = 0 IN THE MSIS DATA ELEMENT 'ADJUSTMENT-INDICATOR'). Home Variable List - MAX - LT 3. MSIS_IDENTIFICATION_NUMBER Type: CHAR Length: 20 Label: (Encrypted) MSIS IDENTIFICATION NUMBER Encrypted. Values: Encrypted Home Variable List - MAX - LT 4. STATE Type: CHAR Length: 2 Label: STATE ABBREVIATION CODE DESCRIPTION: U. S. POSTAL SERVICE 2-CHARACTER ABBREVIATION FOR THE STATE MEDICAID AGENCY SUBMITTING THE DATA. Values: CODES: AL = ALABAMA AK = ALASKA AZ = ARIZONA AR = ARKANSAS CA = CALIFORNIA CO = COLORADO CT = CONNECTICUT DE = DELAWARE DC = DISTRICT OF COLUMBIA FL = FLORIDA GA = GEORGIA GU = GUAM/AMERICAN SAMOA HI = HAWAII ID = IDAHO IL = ILLINOIS IN = INDIANA IA = IOWA KS = KANSAS KY = KENTUCKY LA = LOUISIANA ME = MAINE MD = MARYLAND MA = MASSACHUSETTS MI = MICHIGAN MN = MINNESOTA MS = MISSISSIPPI MO = MISSOURI MT = MONTANA NE = NEBRASKA NV = NEVADA NH = NEW HAMPSHIRE NJ = NEW JERSEY NM = NEW MEXICO NY = NEW YORK NC = NORTH CAROLINA ND = NORTH DAKOTA OH = OHIO OK = OKLAHOMA OR = OREGON PA = PENNSYLVANIA PR = PUERTO RICO RI = RHODE ISLAND SC = SOUTH CAROLINA SD = SOUTH DAKOTA TN = TENNESSEE TX = TEXAS UT = UTAH VT = VERMONT VI = VIRGIN ISLANDS VA = VIRGINIA WA = WASHINGTON WV = WEST VIRGINIA WI = WISCONSIN WY = WYOMING Home Variable List - MAX - LT 7. BIRTH_DATE Type: NUM Length: 8 Label: BIRTH DATE DESCRIPTION: BIRTH DATE OF THE MEDICAID ELIGIBLE. EDIT-RULES: YYYYMMDD. Home Variable List - MAX - LT 8. SEX Type: CHAR Length: 1 Label: SEX CODE DESCRIPTION: CODE INDICATING THE GENDER OF THE MEDICAID ELIGIBLE. Values: CODES: F = FEMALE M = MALE U = UNKNOWN/ERROR USER NOTE: THESE CODES ARE 1 (FEMALE), 2 (MALE) AND 9 (UNKNOWN) IN THE 1996-98 MSIS DATA. Home Variable List - MAX - LT 9. RACE_ETHNICITY Type: CHAR Length: 1 Label: RACE/ETHNICITY CODE DESCRIPTION: CODE INDICATING THE RACE/ETHNICITY OF THE MEDICAID ELIGIBLE. Values: CODES: 1 = WHITE, NOT OF HISPANIC ORIGIN (CHANGED TO "WHITE" BEGINNING 10/98) 2 = BLACK, NOT OF HISPANIC ORIGIN (CHANGED TO "BLACK OR AFRICAN AMERICAN" BEGINNING 10/98) 3 = AMERICAN INDIAN OR ALASKA NATIVE 4 = ASIAN OR PACIFIC ISLANDER (CHANGED TO "ASIAN" BEGINNING 10/98) 5 = HISPANIC (CHANGED TO "HISPANIC OR LATINO - NO RACE INFORMATION AVAILABLE" BEGINNING 10/98) 6 = NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER (NEW CODE BEGINNING 10/98) 7 = HISPANIC OR LATINO AND ONE OR MORE RACES (NEW CODE BEGINNING 10/98) 8 = MORE THAN ONE RACE (HISPANIC OR LATINO NOT INDICATED) (NEW CODE BEGINNING 10/98) 9 = UNKNOWN USER NOTE: SINCE SPECIFICATIONS FOR CODE VALUES = 7 AND 8 WERE NOT ISSUED UNTIL MAY 2000, THESE CODE VALUES MAY NOT APPEAR. THE METHODS OF COLLECTING INFORMATION ON RACE AND ETHNICITY DIFFER SUBSTANTIALLY ACROSS STATES AND TIME PERIODS. Home Variable List - MAX - LT 10. RACE_ETHNICITY_WHITE Type: CHAR Length: 1 Label: RACE - WHITE DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF WHITE. Values: CODES: 0 = NON-WHITE OR RACE UNKNOWN 1 = WHITE Home Variable List - MAX - LT 11. RACE_ETHNICITY_BLACK Type: CHAR Length: 1 Label: RACE - BLACK/AFRICAN AMERICAN DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF BLACK OR AFRICAN AMERICAN. Values: CODES: 0 = NON-BLACK/AFRICAN AMERICAN OR RACE UNKNOWN 1 = BLACK OR AFRICAN AMERICAN Home Variable List - MAX - LT 12. RACE_ETHNICITY_NATIVE Type: CHAR Length: 1 Label: RACE - AMERICAN INDIAN/ALASKA NATIVE DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF AMERICAN INDIAN/ALASKA NATIVE. Values: CODES: 0 = NON-AMERICAN INDIAN/ALASKA NATIVE OR RACE UNKNOWN 1 = AMERICAN INDIAN/ALASKA NATIVE Home Variable List - MAX - LT 13. RACE_ETHNICITY_ASIAN Type: CHAR Length: 1 Label: RACE - ASIAN DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF ASIAN. Values: CODES: 0 = NON-ASIAN OR RACE UNKNOWN 1 = ASIAN Home Variable List - MAX - LT 14. RACE_ETHNICITY_HAWAI Type: CHAR Length: 1 Label: RACE - NATIVE HAWAIIAN/ OTHER PACIFIC ISLANDER DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER. Values: CODES: 0 = NON-NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER OR RACE UNKNOWN 1 = NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER Home Variable List - MAX - LT 15. RACE_ETHNICITY_LATIN Type: CHAR Length: 1 Label: ETHNICITY - HISPANIC OR LATINO DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED AN ETHNICITY OF HISPANIC OR LATINO. Values: CODES: 0 = NON-HISPANIC OR LATINO 1 = HISPANIC OR LATINO 9 = ETHNICITY UNKNOWN Home Variable List - MAX - LT 16. STATE_SPECIFIC_ELIG_MOST_RECENT Type: CHAR Length: 6 Label: STATE-SPECIFIC ELIGIBILITY CODE - MOST RECENT DESCRIPTION: STATE-SPECIFIC ELIGIBILITY CODE CLASSIFICATION UNDER WHICH THE MEDICAID ELIGIBLE IS COVERED - MOST RECENT OBSERVATION. USER NOTES: THESE SOURCE CODES ARE GENERALLY NOT APPLICABLE FOR MOST. Home Variable List - MAX - LT 17. STATE_SPECIFIC_ELIG_MO_OF_SVC Type: CHAR Length: 6 Label: STATE-SPECIFIC ELIGIBILITY CODE - FOR MONTH OF SERVICE DESCRIPTION: STATE-SPECIFIC ELIGIBILITY CODE CLASSIFICATION UNDER WHICH THE MEDICAID ELIGIBLE IS COVERED - FOR THE MONTH OF SERVICE. USER NOTES: THESE SOURCE CODES ARE GENERALLY NOT APPLICABLE FOR MOS. Home Variable List - MAX - LT 18. MAX_UNI_ELIG_CODE_MOST_RECENT Type: CHAR Length: 2 Label: MAX UNIFORM ELIGIBILITY CODE - MOST RECENT DESCRIPTION: MEDICAID ANALYTIC EXTRACT (MAX) UNIFORM ELIGIBILITY CODE FOR THE MEDICAID ELIGIBLE - MOST RECENT OBSERVATION. Values: CODES: 00 = NOT ELIGIBLE 11 = AGED, CASH 12 = BLIND/DISABLED, CASH 14 = CHILD (NOT CHILD OF UNEMPLOYED ADULT, NOT FOSTER CARE CHILD), ELIGIBLE UNDER SECTION 1931 OF THE ACT 15 = ADULT (NOT BASED ON UNEMPLOYMENT STATUS), ELIGIBLE UNDER SECTION 1931 OF THE ACT 16 = CHILD OF UNEMPLOYED ADULT, ELIGIBLE UNDER SECTION 1931 OF THE ACT 17 = UNEMPLOYED ADULT, ELIGIBLE UNDER SECTION 1931 OF THE ACT 21 = AGED, MEDICALLY NEEDY 22 = BLIND/DISABLED, MEDICALLY NEEDY 24 = CHILD, MEDICALLY NEEDY (FORMERLY AFDC CHILD, MEDICALLY NEEDY) 25 = ADULT, MEDICALLY NEEDY (FORMERLY AFDC ADULT, MEDICALLY NEEDY) 31 = AGED, POVERTY 32 = BLIND/DISABLED, POVERTY 34 = CHILD, POVERTY (INCLUDES MEDICAID EXPANSION CHIP CHILDREN) 35 = ADULT, POVERTY 3A = INDIVIDUAL COVERED UNDER THE BREAST AND CERVICAL CANCER PREVENTION ACT OF 2000, POVERTY 41 = OTHER AGED 42 = OTHER BLIND/DISABLED 44 = OTHER CHILD 45 = OTHER ADULT 48 = FOSTER CARE CHILD 51 = AGED, SECTION 1115 DEMONSTRATION EXPANSION 52 = BLIND/DISABLED, SECTION 1115 DEMONSTRATION EXPANSION 54 = CHILD, SECTION 1115 DEMONSTRATION EXPANSION 55 = ADULT, SECTION 1115 DEMONSTRATION EXPANSION 99 = UNKNOWN ELIGIBILITY Home Variable List - MAX - LT 19. MAX_UNI_ELIG_CODE_MO_OF_SVC Type: CHAR Length: 2 Label: MAX UNIFORM ELIGIBILITY CODE - FOR MONTH OF SERVICE DESCRIPTION: MEDICAID ANALYTIC EXTRACT (MAX) UNIFORM ELIGIBILITY CODE FOR THE MEDICAID ELIGIBLE - FOR THE MONTH OF SERVICE. Values: CODES: 00 = NOT ELIGIBLE 11 = AGED, CASH 12 = BLIND/DISABLED, CASH 14 = CHILD (NOT CHILD OF UNEMPLOYED ADULT, NOT FOSTER CARE CHILD), ELIGIBLE UNDER SECTION 1931 OF THE ACT 15 = ADULT (NOT BASED ON UNEMPLOYMENT STATUS), ELIGIBLE UNDER SECTION 1931 OF THE ACT 16 = CHILD OF UNEMPLOYED ADULT, ELIGIBLE UNDER SECTION 1931 OF THE ACT 17 = UNEMPLOYED ADULT, ELIGIBLE UNDER SECTION 1931 OF THE ACT 21 = AGED, MEDICALLY NEEDY 22 = BLIND/DISABLED, MEDICALLY NEEDY 24 = CHILD, MEDICALLY NEEDY (FORMERLY AFDC CHILD, MEDICALLY NEEDY) 25 = ADULT, MEDICALLY NEEDY (FORMERLY AFDC ADULT, MEDICALLY NEEDY) 31 = AGED, POVERTY 32 = BLIND/DISABLED, POVERTY 34 = CHILD, POVERTY (INCLUDES MEDICAID EXPANSION CHIP CHILDREN) 35 = ADULT, POVERTY 3A = INDIVIDUAL COVERED UNDER THE BREAST AND CERVICAL CANCER PREVENTION ACT OF 2000, POVERTY 41 = OTHER AGED 42 = OTHER BLIND/DISABLED 44 = OTHER CHILD 45 = OTHER ADULT 48 = FOSTER CARE CHILD 51 = AGED, SECTION 1115 DEMONSTRATION EXPANSION 52 = BLIND/DISABLED, SECTION 1115 DEMONSTRATION EXPANSION 54 = CHILD, SECTION 1115 DEMONSTRATION EXPANSION 55 = ADULT, SECTION 1115 DEMONSTRATION EXPANSION 99 = UNKNOWN ELIGIBILITY Home Variable List - MAX - LT 20. MISSING_ELIG_DATA Type: CHAR Length: 1 Label: MISSING ELIGIBILITY DATA DESCRIPTION: CODE INDICATING A PERSON FOR WHOM NO MONTHS OF ENROLLMENT IN MEDICAID WERE FOUND. Values: CODES: BLANK = MEDICAID ENROLLMENT MONTHS WERE FOUND. 1 = NEITHER MEDICAID ENROLLMENT MONTHS NOR S-CHIP (CHIP CODE = 3) ENROLLMENT MONTHS WERE FOUND. 2 = S-CHIP ENROLLMENT MONTHS (CHIP CODE = 3) WERE FOUND, BUT NO MEDICAID ENROLLMENT MONTHS WERE FOUND. Home Variable List - MAX - LT 21. CROSSOVER_CODE_FROM_CLAIMS_ONLY Type: NUM Length: 1 Label: MEDICARE DUAL CODE - CLAIM-BASED DESCRIPTION: CODE INDICATING THAT THE ELIGIBLE WAS COVERED BY MEDICARE WHEN THIS SERVICE WAS RENDERED. Values: CODES: 0 = NO MEDICARE DEDUCTIBLE OR COINSURANCE PAID BY MEDICAID ON THIS SERVICE 1 = MEDICARE DEDUCTIBLE OR COINSURANCE PAID BY MEDICAID ON THIS SERVICE Home Variable List - MAX - LT 22. CROSSOVER_CODE_ANNUAL_NEW_VALUES Type: CHAR Length: 2 Label: MEDICARE DUAL CODE - ANNUAL DESCRIPTION: CODE INDICATING THAT THE ELIGIBLE IS COVERED BY MEDICARE (KNOWN AS DUAL OR MEDICARE ELIGIBILITY), ACCORDING TO MEDICAID (MSIS), MEDICARE (EDB) OR BOTH IN THE CALENDAR YEAR. Values: CODES: 00 = IN MSIS, ELIGIBLE IS NOT A MEDICARE BENEFICIARY 01 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QMB ONLY 02 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QMB AND FULL MEDICAID COVERAGE 03 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-SLMB ONLY 04 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-SLMB AND FULL MEDICAID COVERAGE 05 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QDWI 06 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QUALIFYING INDIVIDUALS (1) 07 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QUALIFYING INDIVIDUALS (2) 08 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-OTHER DUAL ELIGIBLES 09 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-DUAL ELIGIBILITY CATEGORY UNKNOWN 10 = IN MSIS, S-CHIP ELIGIBLE IS ENTITLED TO MEDICARE 50 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODES 01-09 DO NOT APPLY 51 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 01 APPLIES 52 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 02 APPLIES 53 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 03 APPLIES 54 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 04 APPLIES 55 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 05 APPLIES 56 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 06 APPLIES 57 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 07 APPLIES 58 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 08 APPLIES 59 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 09 APPLIES 60 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE S-CHIP ELIGIBLE AND CODE 10 APPLIES 99 = IN MSIS, ELIGIBLE'S MEDICARE STATUS IS UNKNOWN Home Variable List - MAX - LT 23. MSIS_TYPE_OF_SERVICE Type: NUM Length: 2 Label: MSIS TYPE OF SERVICE CODE DESCRIPTION: CODE INDICATING THE MEDICAID STATISTICAL INFORMATION SYSTEM (MSIS) TYPE OF SERVICE. EXPECTED MSIS TYPES OF SERVICE FOR THIS FILE ARE: 02 = MENTAL HOSPITAL SERVICES FOR THE AGED 04 = INPAT. Home Variable List - MAX - LT 24. MSIS_TYPE_OF_PROGRAM Type: NUM Length: 1 Label: MSIS TYPE OF PROGRAM CODE DESCRIPTION: CODE INDICATING THE SPECIAL MEDICAID PROGRAM UNDER WHICH THE SERVICE WAS PROVIDED. Values: CODES: 0 = NO SPECIAL PROGRAM 1 = EARLY PERIODIC SCREENING DIAGNOSIS AND TREATMENT (EPSDT) 2 = FAMILY PLANNING 3 = RURAL HEALTH CLINIC 4 = FEDERALLY QUALIFIED HEALTH CENTERS (FQHCs) 5 = INDIAN HEALTH SERVICES 6 = HOME AND COMMUNITY-BASED CARE FOR DISABLED ELDERLY AND INDIVIDUALS AGE 65 AND OLDER 7 = HOME AND COMMUNITY-BASED CARE WAIVER SERVICES 9 = UNKNOWN Home Variable List - MAX - LT 25. SMRF_TYPE_OF_SERVICE Type: NUM Length: 2 Label: MAX TYPE OF SERVICE CODE DESCRIPTION: CODE INDICATING THE MEDICAID ANALYTIC EXTRACT (MAX) TYPE OF SERVICE FOR THIS RECORD. EXPECTED MAX TYPES OF SERVICE FOR THIS FILE ARE: 02 = MENTAL HOSPITAL SERVICES FOR THE AGED 04 = INPAT. Home Variable List - MAX - LT 26. BILLING_PROVIDER_IDENTIF_NUMBER Type: CHAR Length: 12 Label: (Blanked) BILLING PROVIDER IDENTIFICATION NUMBER Blanked. Values: Blanked Home Variable List - MAX - LT 27. NPI Type: CHAR Length: 12 Label: (Blanked) NATIONAL PROVIDER IDENTIFIER Blanked. Values: Blanked Home Variable List - MAX - LT 28. PROVIDER_TAXONOMY Type: CHAR Length: 12 Label: PROVIDER TAXONOMY DESCRIPTION: A NATIONAL HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)-COMPLIANT CODE THAT DESCRIBES THE PROVIDER SPECIALTY OR INSTITUTION TYPE OF THE INSTITUTION BILLING/CARIN. Home Variable List - MAX - LT 29. TYPE_OF_CLAIM Type: CHAR Length: 1 Label: TYPE OF CLAIM CODE DESCRIPTION: CODE INDICATING THE TYPE OF CLAIM. Values: CODES: 1 = A CURRENT FEE-FOR-SERVICE CLAIM FOR MEDICAL SERVICES. 2 = CAPITATED PAYMENT. 3 = ENCOUNTER (A.K.A. 'DUMMY') RECORD THAT SIMULATES A BILL FOR A SERVICE RENDERED TO A PATIENT COVERED UNDER SOME FORM OF CAPITATION PLAN. 4 = A 'SERVICE TRACKING CLAIM' THAT DOCUMENTS SERVICES RECEIVED BY AN INDIVIDUAL PATIENT, WHEN THE STATE ACCEPTS A LUMP SUM BILL FROM A PROVIDER THAT COVERED SIMILAR SERVICES DELIVERED TO MORE THAN ONE PATIENT, SUCH AS GROUP SCREENING FOR EARLY PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT (EPSDT). 5 = SUPPLEMENTAL PAYMENT (ABOVE CAPITATION FEE OR ABOVE NEGOTIATED RATE) (E.G. FEDERALLY QUALIFIED HEALTH CENTER (FQHC) ADDITIONAL REIMBURSEMENT). 9 = UNKNOWN. A = S-CHIP CLAIM: A CURRENT FEE-FOR-SERVICE CLAIM FOR MEDICAL SERVICES. B = S-CHIP CLAIM: CAPITATED PAYMENT. C = S-CHIP CLAIM: ENCOUNTER (A.K.A. 'DUMMY' RECORD THAT SIMULATES A BILL FOR A SERVICE RENDERED TO A PATIENT COVERED UNDER SOME FORM OF CAPITATION PLAN. D = S-CHIP CLAIM: A 'SERVICE TRACKING CLAIM' THAT DOCUMENTS SERVICES RECEIVED BY AN INDIVIDUAL PATIENT, WHEN THE STATE ACCEPTS A LUMP SUM BILL FROM A PROVIDER THAT COVERED SIMILAR SERVICES DELIVERED TO MORE THAN ONE PATIENT, SUCH AS GROUP SCREENING FOR EPSDT. E = S-CHIP CLAIM: SUPPLEMENTAL PAYMENT (ABOVE CAPITATION FEE OR ABOVE NEGOTIATED RATE) (E.G. FQHC ADDITIONAL REIMBURSEMENT). Home Variable List - MAX - LT 31. MANAGED_CARE_TYPE_OF_PLAN_CODE Type: NUM Length: 2 Label: MANAGED CARE TYPE OF PLAN CODE DESCRIPTION: CODE INDICATING THE TYPE OF MANAGED CARE PLAN, IF ANY, UNDER WHICH THE NON-FEE-FOR-SERVICE ENCOUNTER WAS PROVIDED. Values: CODES: 00 = INDIVIDUAL WAS NOT ELIGIBLE FOR MEDICAID THIS MONTH. 01 = ELIGIBLE IS ENROLLED IN A MEDICAL OR COMPREHENSIVE MANAGED CARE PLAN THIS MONTH (E.G. HMO). 02 = ELIGIBLE IS ENROLLED IN A DENTAL MANAGED CARE PLAN THIS MONTH. 03 = ELIGIBLE IS ENROLLED IN A BEHAVIORAL MANAGED CARE PLAN THIS MONTH. 04 = ELIGIBLE IS ENROLLED IN A PRENATAL/DELIVERY MANAGED CARE PLAN THIS MONTH. 05 = ELIGIBLE IS ENROLLED IN A LONG-TERM CARE MANAGED CARE PLAN THIS MONTH. 06 = ELIGIBLE IS ENROLLED IN A PROGRAM FOR ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) THIS MONTH. 07 = ELIGIBLE IS ENROLLED IN A PRIMARY CARE CASE MANAGEMENT MANAGED CARE PLAN THIS MONTH. 08 = ELIGIBLE IS ENROLLED IN AN OTHER MANAGED CARE PLAN THIS MONTH. 77 = THIS RECORD IS AN ENCOUNTER RECORD, BUT THERE WAS NO MATCH BETWEEN THE 'MANAGED CARE PLAN IDENTIFICATION NUMBER' AND THE PLAN IDENTIFIERS IN THE ELIGIBILITY RECORD FOR THIS PERSON. 88 = NOT APPLICABLE, THIS RECORD IS NOT AN ENCOUNTER RECORD OR THIS RECORD’S PLAN ID IS 8-FILLED. 99 = ELIGIBLE'S MANAGED CARE PLAN STATUS IS UNKNOWN. Home Variable List - MAX - LT 32. MANAGED_CARE_PLAN_IDENTIF_CODE Type: CHAR Length: 12 Label: (Blanked) MANAGED CARE PLAN IDENTIFICATION NUMBER Blanked. Values: Blanked Home Variable List - MAX - LT 33. MEDICAID_PAYMENT_AMOUNT Type: NUM* Length: 8 Label: MEDICAID PAYMENT AMOUNT DESCRIPTION: TOTAL AMOUNT OF MONEY PAID BY MEDICAID FOR THIS SERVICE. (DISPLAY SIGNED NUMERIC) (SAS USERS: ZONED DECIMAL - ZD8) USER NOTES: THIS PAYMENT AMOUNT IS = $0 FOR ENCOUNTER RECORDS. IN MSIS,. Home Variable List - MAX - LT 34. THIRD_PARTY_PAYMENT_AMOUNT Type: NUM* Length: 8 Label: THIRD PARTY PAYMENT AMOUNT DESCRIPTION: TOTAL AMOUNT OF MONEY PAID BY A THIRD PARTY (I.E. ALL SOURCES OTHER THAN MEDICAID, MEDICARE AND THE ELIGIBLE'S PERSONAL FUNDS) FOR THIS SERVICE. (DISPLAY SIGNED NUMERIC) (SAS USERS: ZONED. Home Variable List - MAX - LT 35. PAYMENT_ADJUDICATION_DATE Type: NUM Length: 8 Label: PAYMENT DATE DESCRIPTION: DATE ON WHICH THE CLAIM OR ENCOUNTER RECORD WAS ADJUDICATED BY THE STATE. EDIT-RULES: YYYYMMDD USER NOTE: FOR FEE-FOR-SERVICE CLAIMS THIS IS THE DATE THE CLAIM WAS ADJUDICATED FOR PAYMENT. Home Variable List - MAX - LT 36. CHARGE_AMOUNT Type: NUM* Length: 8 Label: CHARGE AMOUNT DESCRIPTION: TOTAL AMOUNT OF CHARGES SUBMITTED BY THE PROVIDER FOR THIS SERVICE. (DISPLAY SIGNED NUMERIC) (SAS USERS: ZONED DECIMAL - ZD8) USER NOTE: THIS PAYMENT AMOUNT IS = $0 FOR ENCOUNTER RECORDS. Home Variable List - MAX - LT 37. PREPAID_PLAN_VALUE Type: NUM* Length: 8 Label: PREPAID PLAN SERVICE VALUE DESCRIPTION: DOLLAR VALUE PLACED ON THE SERVICE BY THE PROVIDER. (DISPLAY SIGNED NUMERIC) (SAS USERS: ZONED DECIMAL - ZD8) USER NOTES: THIS PAYMENT AMOUNT IS > $0 ONLY FOR ENCOUNTER RECORDS. WHILE THI. Home Variable List - MAX - LT 38. MEDICARE_COINSURANCE_PAYMENT_AMT Type: NUM* Length: 8 Label: MEDICARE COINSURANCE PAYMENT AMOUNT DESCRIPTION: THE AMOUNT PAID BY MEDICAID FOR THIS SERVICE, TOWARD THE RECIPIENT'S MEDICARE COINSURANCE LIABILITY. (DISPLAY SIGNED NUMERIC) (SAS USERS: ZONED DECIMAL - ZD8). Home Variable List - MAX - LT 39. MEDICARE_DEDUCTIBLE_PAYMENT_AMT Type: NUM* Length: 8 Label: MEDICARE DEDUCTIBLE PAYMENT AMOUNT DESCRIPTION: THE AMOUNT PAID BY MEDICAID FOR THIS SERVICE, TOWARD THE RECIPIENT'S MEDICARE DEDUCTIBLE LIABILITY. (DISPLAY SIGNED NUMERIC) (SAS USERS: ZONED DECIMAL - ZD8) USER NOTE: THIS DATA ELEM. Home Variable List - MAX - LT 40. ADMISSION_DATE Type: NUM Length: 8 Label: INSTITUTIONAL LONG-TERM CARE ADMISSION DATE DESCRIPTION: DATE WHICH THE RECIPIENT WAS ADMITTED TO THE LONG-TERM CARE FACILITY OR UNIT. EDIT-RULES: YYYYMMDD USER NOTE: USERS SHOULD NOTE THAT REPORTING IS NOT CONSISTENT AMONG ALL LONG. Home Variable List - MAX - LT 41. BEGINNING_DATE_OF_SERVICE Type: NUM Length: 8 Label: SERVICE BEGINNING DATE DESCRIPTION: THE BEGINNING DATE OF SERVICE FOR THIS CLAIM. EDIT-RULES: YYYYMMDD. Home Variable List - MAX - LT 42. ENDING_DATE_OF_SERVICE Type: NUM Length: 8 Label: ENDING DATE OF SERVICE DESCRIPTION: THE LAST DATE OF SERVICE COVERED BY THIS CLAIM. EDIT-RULES: YYYYMMDD. Home Variable List - MAX - LT 43. DIAGNOSIS_CODE_1 Type: CHAR Length: 7 Label: DIAGNOSIS CODE - FIRST DIAGNOSIS DESCRIPTION: FIRST DIAGNOSIS CODE FOR THIS RECORD. EDIT-RULES: LEFT JUSTIFIED, NO DECIMAL POINT USER NOTE: USERS SHOULD EXERCISE CAUTION SINCE THIS DATA ELEMENT IS AS IT WAS REPORTED BY EAC. Values: CODES: 0 = ICD-10 9 = ICD-9 BLANK = MISSING Home Variable List - MAX - LT 48. MENTAL_HOSPITAL_FOR_AGED_DAYS Type: NUM* Length: 3 Label: MENTAL HOSPITAL FOR THE AGED DAY COUNT DESCRIPTION: TOTAL NUMBER OF DAYS OF MENTAL HOSPITAL SERVICES FOR THE AGED THAT WAS PAID FOR IN WHOLE OR IN PART BY MEDICAID. (DISPLAY SIGNED NUMERIC) (SAS USERS: ZONED DECIMAL - ZD3) EDIT-RULES: MAX. Home Variable List - MAX - LT 49. INPATIENT_PSYCHIATRIC_DAYS Type: NUM* Length: 3 Label: INPATIENT PSYCHIATRIC FACILITY (AGE < 21) DAY COUNT DESCRIPTION: TOTAL NUMBER OF DAYS OF INPATIENT PSYCHIATRIC FACILITY FOR INDIVIDUALS UNDER THE AGE OF 21 PAID FOR IN WHOLE OR IN PART BY MEDICAID. (DISPLAY SIGNED NUMERIC) (SAS USERS: ZONED DECIMAL - Z. Home Variable List - MAX - LT 50. ICF_MR_DAYS Type: NUM* Length: 3 Label: INTERMEDIATE CARE FACILITY FOR INDIVIDUALS WITH INTELLECTUAL DISABLITIES DAY COUNT DESCRIPTION: TOTAL NUMBER OF DAYS OF INTERMEDIATE CARE FOR INDIVIDUALS WITH INTELLECTUAL DISABLITIES THAT WAS PAID FOR IN WHOLE OR IN PART BY MEDICAID. (DISPLAY SIGNED NUMERIC) (SAS USERS: ZONED DECIM. Home Variable List - MAX - LT 51. NURSING_FACILITY_DAYS Type: NUM* Length: 3 Label: NURSING FACILITY DAY COUNT DESCRIPTION: TOTAL NUMBER OF DAYS OF NURSING FACILITY CARE INCLUDED IN THIS RECORD THAT WAS PAID FOR IN WHOLE OR IN PART BY MEDICAID. (DISPLAY SIGNED NUMERIC) (SAS USERS: ZONED DECIMAL - ZD3) EDIT-RUL. Home Variable List - MAX - LT 52. LEAVE_DAYS Type: NUM* Length: 3 Label: LONG-TERM CARE LEAVE DAY COUNT DESCRIPTION: TOTAL NUMBER OF DAYS, DURING THE PERIOD COVERED BY MEDICAID, ON WHICH THE ELIGIBLE DID NOT RESIDE IN THE LONG-TERM CARE FACILITY. (DISPLAY SIGNED NUMERIC) (SAS USERS: ZONED DECIMAL - ZD3). Home Variable List - MAX - LT 53. PATIENT_STATUS Type: NUM Length: 2 Label: PATIENT STATUS CODE DESCRIPTION: CODE INDICATING THE RECIPIENT'S DISCHARGE STATUS. Values: CODES: 01 = DISCHARGED TO HOME OR SELF CARE (ROUTINE DISCHARGE) 02 = DISCHARGED/TRANSFERRED TO ANOTHER SHORT-TERM HOSPITAL 03 = DISCHARGED/TRANSFERRED TO NF 04 = DISCHARGED/TRANSFERRED TO ICF 05 = DISCHARGED/TRANSFERRED TO ANOTHER TYPE OF INSTITUTION (INCLUDING DISTINCT PARTS) OR REFERRED FOR OUTPATIENT SERVICES TO ANOTHER INSTITUTION 06 = DISCHARGED/TRANSFERRED TO HOME UNDER CARE OF ORGANIZED HOME HEALTH SERVICE ORGANIZATION 07 = LEFT AGAINST MEDICAL ADVICE OR DISCONTINUED CARE 08 = DISCHARGED/TRANSFERRED TO HOME UNDER CARE OF A HOME IV DRUG THERAPY PROVIDER 09 = ADMITTED AS AN INPATIENT TO THIS HOSPITAL 20 = EXPIRED 30 = STILL A PATIENT OR DISCHARGED AND EXPECTED TO RETURN FOR OUTPATIENT SERVICE 40 = EXPIRED AT HOME (HOSPICE CLAIMS ONLY) 41 = EXPIRED IN A MEDICAL FACILITY SUCH AS A HOSPITAL, NF OR FREE-STANDING HOSPICE (HOSPICE CLAIMS ONLY) 42 = EXPIRED - PLACE UNKNOWN (HOSPICE CLAIMS ONLY) 43 = DISCHARGED/TRANSFERRED TO A FEDERAL HOSPITAL 50 = HOSPICE - HOME 51 = HOSPICE - MEDICAL FACILITY 61 = DISCHARGED TO A HOSPITAL-BASED MEDICARE APPROVED SWING BED 62 = DISCHARGED/TRANSFERRED TO ANOTHER REHAB FACILITY/REHAB UNIT OF A HOSPITAL 63 = DISCHARGED/TRANSFERRED TO A LONG-TERM CARE HOSPITAL 65 = DISCHARGED/TRANSFERRED TO A PSYCH HOSPITAL/PSYCH UNIT OF A HOSPITAL 66 = DISCHARGED TO CRITICAL ACCESS HOSPITAL 71 = DISCHARGED/TRANSFERRED TO ANOTHER INSTITUTION FOR OUTPATIENT SERVICES 72 = DISCHARGED/TRANSFERRED TO THIS INSTITUTION FOR OUTPATIENT SERVICES 99 = UNKNOWN Home Variable List - MAX - LT 54. PATIENT_LIABILITY_AMOUNT Type: NUM* Length: 8 Label: PATIENT LIABILITY AMOUNT DESCRIPTION: THE TOTAL AMOUNT THAT AN ELIGIBLE IS REQUIRED TO SPEND OUT OF THEIR OWN FUNDS, TOWARD THE COST OF THEIR CARE, BEFORE MEDICAID PAYMENTS ARE MADE. 8 DIGITS (DISPLAY SIGNED NUMERIC) (SAS USE.
Home Variable List - MAX - OT 1. ADJUSTMENT_CODE Type: NUM Length: 1 Label: ADJUSTMENT CODE DESCRIPTION: CODE INDICATING IF THE CLAIMS FOR THIS SERVICE WERE ONLY ORIGINAL SUBMISSIONS, INCLUDED ADJUSTMENTS OF ANY TYPE OR IF ONE OR MORE ORIGINAL SUBMISSIONS WAS MISSING. Values: 0 = NO ADJUSTMENT OF CLAIMS WAS REQUIRED, SINCE ALL CLAIMS FOR THIS RECORD WERE ORIGINAL CLAIMS (ALL CLAIMS FOR THIS RECORD HAD VALUE = 0 IN THE MSIS DATA ELEMENT 'ADJUSTMENT- INDICATOR'). IN THIS CASE, ORIGINAL CLAIMS WERE COMBINED FOR THIS RECORD. 1 = THIS RECORD REPRESENTS A CLAIMS SET WHERE IT WAS POSSIBLE TO CORRECTLY COMPLETE THE ADJUSTMENT PROCESS, BY COMBINING ORIGINAL AND ADJUSTMENT CLAIMS FOR THIS RECORD. THIS MEANS THAT THERE WAS AT LEAST ONE ORIGINAL CLAIM AND AT LEAST ONE ADJUSTMENT CLAIM IN THE SET OF CLAIMS FOR THIS RECORD (AT LEAST ONE CLAIM FOR THIS RECORD HAD VALUE = 0 IN THE MSIS DATA ELEMENT 'ADJUSTMENT-INDICATOR' AND AT LEAST ONE CLAIM FOR THIS RECORD HAD A VALUE OTHER THAN 0 IN THE MSIS DATA ELEMENT 'ADJUSTMENT-INDICATOR'). 2 = THIS RECORD REPRESENTS A CLAIMS SET WHERE IT WAS NOT POSSIBLE TO CORRECTLY COMPLETE THE ADJUSTMENT PROCESS (NONE OF THE CLAIMS FOR THIS RECORD HAD A VALUE = 0 IN THE MSIS DATA ELEMENT 'ADJUSTMENT-INDICATOR'). Home Variable List - MAX - OT 3. MSIS_IDENTIFICATION_NUMBER Type: CHAR Length: 20 Label: (Encrypted) MSIS IDENTIFICATION NUMBER Encrypted. Values: Encrypted Home Variable List - MAX - OT 4. STATE Type: CHAR Length: 2 Label: STATE ABBREVIATION CODE DESCRIPTION: U. S. POSTAL SERVICE 2-CHARACTER ABBREVIATION FOR THE STATE MEDICAID AGENCY SUBMITTING THE DATA. Values: CODES: AL = ALABAMA AK = ALASKA AZ = ARIZONA AR = ARKANSAS CA = CALIFORNIA CO = COLORADO CT = CONNECTICUT DE = DELAWARE DC = DISTRICT OF COLUMBIA FL = FLORIDA GA = GEORGIA GU = GUAM/AMERICAN SAMOA HI = HAWAII ID = IDAHO IL = ILLINOIS IN = INDIANA IA = IOWA KS = KANSAS KY = KENTUCKY LA = LOUISIANA ME = MAINE MD = MARYLAND MA = MASSACHUSETTS MI = MICHIGAN MN = MINNESOTA MS = MISSISSIPPI MO = MISSOURI MT = MONTANA NE = NEBRASKA NV = NEVADA NH = NEW HAMPSHIRE NJ = NEW JERSEY NM = NEW MEXICO NY = NEW YORK NC = NORTH CAROLINA ND = NORTH DAKOTA OH = OHIO OK = OKLAHOMA OR = OREGON PA = PENNSYLVANIA PR = PUERTO RICO RI = RHODE ISLAND SC = SOUTH CAROLINA SD = SOUTH DAKOTA TN = TENNESSEE TX = TEXAS UT = UTAH VT = VERMONT VI = VIRGIN ISLANDS VA = VIRGINIA WA = WASHINGTON WV = WEST VIRGINIA WI = WISCONSIN WY = WYOMING Home Variable List - MAX - OT 7. BIRTH_DATE Type: NUM Length: 8 Label: BIRTH DATE DESCRIPTION: BIRTH DATE OF THE MEDICAID ELIGIBLE. EDIT-RULES: YYYYMMDD. Home Variable List - MAX - OT 8. SEX Type: CHAR Length: 1 Label: SEX CODE DESCRIPTION: CODE INDICATING THE GENDER OF THE MEDICAID ELIGIBLE. Values: CODES: F = FEMALE M = MALE U = UNKNOWN/ERROR USER NOTE: THESE CODES ARE 1 (FEMALE), 2 (MALE) AND 9 (UNKNOWN) IN THE 1996-98 MSIS DATA. Home Variable List - MAX - OT 9. RACE_ETHNICITY Type: CHAR Length: 1 Label: RACE/ETHNICITY CODE DESCRIPTION: RACE/ETHNICITY OF THE MEDICAID ELIGIBLE. Values: CODES: 1 = WHITE, NOT OF HISPANIC ORIGIN (CHANGED TO "WHITE" BEGINNING 10/98) 2 = BLACK, NOT OF HISPANIC ORIGIN (CHANGED TO "BLACK OR AFRICAN AMERICAN" BEGINNING 10/98) 3 = AMERICAN INDIAN OR ALASKA NATIVE 4 = ASIAN OR PACIFIC ISLANDER (CHANGED TO "ASIAN" BEGINNING 10/98) 5 = HISPANIC (CHANGED TO "HISPANIC OR LATINO - NO RACE INFORMATION AVAILABLE" BEGINNING 10/98) 6 = NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER (NEW CODE BEGINNING 10/98) 7 = HISPANIC OR LATINO AND ONE OR MORE RACES (NEW CODE BEGINNING 10/98) 8 = MORE THAN ONE RACE (HISPANIC OR LATINO NOT INDICATED) (NEW CODE BEGINNING 10/98) 9 = UNKNOWN USER NOTE: SINCE SPECIFICATIONS FOR CODE VALUES = 7 AND 8 WERE NOT ISSUED UNTIL MAY 2000, THESE CODE VALUES MAY NOT APPEAR. THE METHODS OF COLLECTING INFORMATION ON RACE AND ETHNICITY DIFFER SUBSTANTIALLY ACROSS STATES AND TIME PERIODS. Home Variable List - MAX - OT 10. RACE_ETHNICITY_WHITE Type: CHAR Length: 1 Label: RACE - WHITE DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF WHITE. Values: CODES: 0 = NON-WHITE OR RACE UNKNOWN 1 = WHITE Home Variable List - MAX - OT 11. RACE_ETHNICITY_BLACK Type: CHAR Length: 1 Label: RACE - BLACK/AFRICAN AMERICAN DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF BLACK OR AFRICAN AMERICAN. Values: CODES: 0 = NON-BLACK/AFRICAN AMERICAN OR RACE UNKNOWN 1 = BLACK OR AFRICAN AMERICAN Home Variable List - MAX - OT 12. RACE_ETHNICITY_NATIVE Type: CHAR Length: 1 Label: RACE - AMERICAN INDIAN/ALASKAN NATIVE DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF AMERICAN INDIAN/ALASKA NATIVE. Values: CODES: 0 = NON-AMERICAN INDIAN/ALASKA NATIVE OR RACE UNKNOWN 1 = AMERICAN INDIAN/ALASKA NATIVE Home Variable List - MAX - OT 13. RACE_ETHNICITY_ASIAN Type: CHAR Length: 1 Label: RACE - ASIAN DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF ASIAN. Values: CODES: 0 = NON-ASIAN OR RACE UNKNOWN 1 = ASIAN Home Variable List - MAX - OT 14. RACE_ETHNICITY_HAWAI Type: CHAR Length: 1 Label: RACE - NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER. Values: CODES: 0 = NON-NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER OR RACE UNKNOWN 1 = NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER Home Variable List - MAX - OT 15. RACE_ETHNICITY_LATIN Type: CHAR Length: 1 Label: ETHNICITY - HISPANIC OR LATINO DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED AN ETHNICITY OF HISPANIC OR LATINO. Values: CODES: 0 = NON-HISPANIC OR LATINO 1 = HISPANIC OR LATINO 9 = ETHNICITY UNKNOWN Home Variable List - MAX - OT 16. STATE_SPECIFIC_ELIG_MOST_RECENT Type: CHAR Length: 6 Label: STATE-SPECIFIC ELIGIBILITY CODE - MOST RECENT DESCRIPTION: STATE-SPECIFIC ELIGIBILITY CODE CLASSIFICATION UNDER WHICH THE MEDICAID ELIGIBLE IS COVERED - MOST RECENT OBSERVATION. USER NOTES: THESE SOURCE CODES ARE GENERALLY NOT APPLICABLE FOR MOST. Home Variable List - MAX - OT 17. STATE_SPECIFIC_ELIG_MO_OF_SVC Type: CHAR Length: 6 Label: STATE-SPECIFIC ELIGIBILITY CODE - FOR MONTH OF SERVICE DESCRIPTION: STATE-SPECIFIC ELIGIBILITY CODE CLASSIFICATION UNDER WHICH THE MEDICAID ELIGIBLE IS COVERED - FOR THE MONTH OF SERVICE. USER NOTES: THESE SOURCE CODES ARE GENERALLY NOT APPLICABLE FOR MOS. Home Variable List - MAX - OT 18. MAX_UNI_ELIG_CODE_MOST_RECENT Type: CHAR Length: 2 Label: MAX UNIFORM ELIGIBILITY CODE - MOST RECENT DESCRIPTION: MEDICAID ANALYTIC EXTRACT (MAX) UNIFORM ELIGIBILITY CODE FOR THE MEDICAID ELIGIBLE - MOST RECENT OBSERVATION. Values: CODES: 00 = NOT ELIGIBLE 11 = AGED, CASH 12 = BLIND/DISABLED, CASH 14 = CHILD (NOT CHILD OF UNEMPLOYED ADULT, NOT FOSTER CARE CHILD), ELIGIBLE UNDER SECTION 1931 OF THE ACT 15 = ADULT (NOT BASED ON UNEMPLOYMENT STATUS), ELIGIBLE UNDER SECTION 1931 OF THE ACT 16 = CHILD OF UNEMPLOYED ADULT, ELIGIBLE UNDER SECTION 1931 OF THE ACT 17 = UNEMPLOYED ADULT, ELIGIBLE UNDER SECTION 1931 OF THE ACT 21 = AGED, MEDICALLY NEEDY 22 = BLIND/DISABLED, MEDICALLY NEEDY 24 = CHILD, MEDICALLY NEEDY (FORMERLY AFDC CHILD, MEDICALLY NEEDY) 25 = ADULT, MEDICALLY NEEDY (FORMERLY AFDC ADULT, MEDICALLY NEEDY) 31 = AGED, POVERTY 32 = BLIND/DISABLED, POVERTY 34 = CHILD, POVERTY (INCLUDES MEDICAID EXPANSION CHIP CHILDREN) 35 = ADULT, POVERTY 3A = INDIVIDUAL COVERED UNDER THE BREAST AND CERVICAL CANCER PREVENTION ACT OF 2000, POVERTY 41 = OTHER AGED 42 = OTHER BLIND/DISABLED 44 = OTHER CHILD 45 = OTHER ADULT 48 = FOSTER CARE CHILD 51 = AGED, SECTION 1115 DEMONSTRATION EXPANSION 52 = BLIND/DISABLED, SECTION 1115 DEMONSTRATION EXPANSION 54 = CHILD, SECTION 1115 DEMONSTRATION EXPANSION 55 = ADULT, SECTION 1115 DEMONSTRATION EXPANSION 99 = UNKNOWN ELIGIBILITY Home Variable List - MAX - OT 19. MAX_UNI_ELIG_CODE_MO_OF_SVC Type: CHAR Length: 2 Label: MAX UNIFORM ELIGIBILITY CODE - FOR MONTH OF SERVICE DESCRIPTION: MEDICAID ANALYTIC EXTRACT (MAX) UNIFORM ELIGIBILITY CODE FOR THE MEDICAID ELIGIBLE - FOR THE MONTH OF SERVICE. Values: CODES: 00 = NOT ELIGIBLE 11 = AGED, CASH 12 = BLIND/DISABLED, CASH 14 = CHILD (NOT CHILD OF UNEMPLOYED ADULT, NOT FOSTER CARE CHILD), ELIGIBLE UNDER SECTION 1931 OF THE ACT 15 = ADULT (NOT BASED ON UNEMPLOYMENT STATUS), ELIGIBLE UNDER SECTION 1931 OF THE ACT 16 = CHILD OF UNEMPLOYED ADULT, ELIGIBLE UNDER SECTION 1931 OF THE ACT 17 = UNEMPLOYED ADULT, ELIGIBLE UNDER SECTION 1931 OF THE ACT 21 = AGED, MEDICALLY NEEDY 22 = BLIND/DISABLED, MEDICALLY NEEDY 24 = CHILD, MEDICALLY NEEDY (FORMERLY AFDC CHILD, MEDICALLY NEEDY) 25 = ADULT, MEDICALLY NEEDY (FORMERLY AFDC ADULT, MEDICALLY NEEDY) 31 = AGED, POVERTY 32 = BLIND/DISABLED, POVERTY 34 = CHILD, POVERTY (INCLUDES MEDICAID EXPANSION CHIP CHILDREN) 35 = ADULT, POVERTY 3A = INDIVIDUAL COVERED UNDER THE BREAST AND CERVICAL CANCER PREVENTION ACT OF 2000, POVERTY 41 = OTHER AGED 42 = OTHER BLIND/DISABLED 44 = OTHER CHILD 45 = OTHER ADULT 48 = FOSTER CARE CHILD 51 = AGED, SECTION 1115 DEMONSTRATION EXPANSION 52 = BLIND/DISABLED, SECTION 1115 DEMONSTRATION EXPANSION 54 = CHILD, SECTION 1115 DEMONSTRATION EXPANSION 55 = ADULT, SECTION 1115 DEMONSTRATION EXPANSION 99 = UNKNOWN ELIGIBILITY Home Variable List - MAX - OT 20. MISSING_ELIG_DATA Type: CHAR Length: 1 Label: MISSING ELIGIBILITY DATA DESCRIPTION: CODE INDICATING PERSON FOR WHOM NO MONTHS OF ENROLLMENT IN MEDICAID WERE FOUND. Values: CODES: BLANK = MEDICAID ENROLLMENT MONTHS WERE FOUND. 1 = NEITHER MEDICAID ENROLLMENT MONTHS NOR S-CHIP (CHIP CODE = 3) ENROLLMENT MONTHS WERE FOUND. 2 = S-CHIP ENROLLMENT MONTHS (CHIP CODE = 3) WERE FOUND, BUT NO MEDICAID ENROLLMENT MONTHS WERE FOUND. Home Variable List - MAX - OT 21. CROSSOVER_CODE_FROM_CLAIMS_ONLY Type: NUM Length: 1 Label: MEDICARE DUAL CODE - CLAIM-BASED DESCRIPTION: CODE INDICATING THAT THE ELIGIBLE WAS COVERED BY MEDICARE WHEN THIS SERVICE WAS RENDERED. Values: CODES: 0 = NO MEDICARE DEDUCTIBLE OR COINSURANCE PAID BY MEDICAID ON THIS SERVICE 1 = MEDICARE DEDUCTIBLE OR COINSURANCE PAID BY MEDICAID ON THIS SERVICE Home Variable List - MAX - OT 22. CROSSOVER_CODE_ANNUAL_NEW_VALUES Type: CHAR Length: 2 Label: MEDICARE DUAL CODE - ANNUAL DESCRIPTION: CODE INDICATING THAT THE ELIGIBLE IS COVERED BY MEDICARE (KNOWN AS DUAL OR MEDICARE ELIGIBILITY), ACCORDING TO MEDICAID (MSIS), MEDICARE (EDB) OR BOTH IN THE CALENDAR YEAR. Values: CODES: 00 = IN MSIS, ELIGIBLE IS NOT A MEDICARE BENEFICIARY 01 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QMB ONLY 02 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QMB AND FULL MEDICAID COVERAGE 03 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-SLMB ONLY 04 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-SLMB AND FULL MEDICAID COVERAGE 05 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QDWI 06 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QUALIFYING INDIVIDUALS (1) 07 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QUALIFYING INDIVIDUALS (2) 08 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-OTHER DUAL ELIGIBLES 09 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-DUAL ELIGIBILITY CATEGORY UNKNOWN 10 = IN MSIS, S-CHIP ELIGIBLE IS ENTITLED TO MEDICARE 50 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODES 01-09 DO NOT APPLY 51 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 01 APPLIES 52 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 02 APPLIES 53 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 03 APPLIES 54 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 04 APPLIES 55 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 05 APPLIES 56 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 06 APPLIES 57 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 07 APPLIES 58 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 08 APPLIES 59 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 09 APPLIES 60 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE S-CHIP ELIGIBLE AND CODE 10 APPLIES 99 = IN MSIS, ELIGIBLE'S MEDICARE STATUS IS UNKNOWN Home Variable List - MAX - OT 23. MSIS_TYPE_OF_SERVICE Type: NUM Length: 2 Label: MSIS TYPE OF SERVICE CODE DESCRIPTION: CODE INDICATING THE MEDICAID STATISTICAL INFORMATION SYSTEM (MSIS) TYPE OF SERVICE. EXPECTED MSIS TYPES OF SERVICE FOR THIS FILE ARE: TOS = 08-13, 15, 19-22, 24-26, 30, 31, 33-39, 99. COM. Home Variable List - MAX - OT 24. MSIS_TYPE_OF_PROGRAM Type: NUM Length: 1 Label: MSIS TYPE OF PROGRAM CODE DESCRIPTION: CODE INDICATING THE SPECIAL MEDICAID PROGRAM UNDER WHICH THE SERVICE WAS PROVIDED. Values: CODES: 0 = NO SPECIAL PROGRAM 1 = EARLY PERIODIC SCREENING DIAGNOSIS AND TREATMENT (EPSDT) 2 = FAMILY PLANNING 3 = RURAL HEALTH CLINIC 4 = FEDERALLY QUALIFIED HEALTH CENTERS (FQHCs) 5 = INDIAN HEALTH SERVICES 6 = HOME AND COMMUNITY-BASED CARE FOR DISABLED ELDERLY AND INDIVIDUALS AGE 65 AND OLDER 7 = HOME AND COMMUNITY-BASED CARE WAIVER SERVICES 9 = UNKNOWN Home Variable List - MAX - OT 25. SMRF_TYPE_OF_SERVICE Type: NUM Length: 2 Label: MAX TYPE OF SERVICE CODE DESCRIPTION: CODE INDICATING THE MEDICAID ANALYTIC EXTRACT (MAX) TYPE OF SERVICE FOR THIS RECORD. EXPECTED MAX TYPES OF SERVICE FOR THIS FILE ARE: TOS = 08-13, 15, 16, 19-22, 24-26, 30, 31, 33-39, 51-. Home Variable List - MAX - OT 26. COM_BASED_LTC_FLAG Type: CHAR Length: 2 Label: COMMUNITY-BASED LONG-TERM CARE (CLTC) FLAG DESCRIPTION: CODE INDICATING THE MAX TYPE OF SERVICE AND/OR PROGRAM TYPE THAT CAN QUALIFY THE FEE-FOR-SERVICE CLAIM AS A POTENTIAL COMMUNITY-BASED LONG-TERM CARE SERVICE CLAIM. WAIVER SERVICES. Home Variable List - MAX - OT 27. HCBS_TAXONOMY_WAIVERS Type: CHAR Length: 5 Label: HOME AND COMMUNITY-BASED SERVICES (HCBS) TAXONOMY CODE FOR WAIVERS DESCRIPTION: CODE INDICATING THE TAXONOMY CODE FOR HOME AND COMMUNITY-BASED SERVICES. TAXONOMY CODE IS ONLY ADDED FOR WAIVER SERVICES IDENTIFIED IN 'MSIS TYPE OF PROGRAM CODE' = 6 OR 7. THE F. Home Variable List - MAX - OT 28. BILLING_PROVIDER_IDENTIF_NUMBER Type: CHAR Length: 12 Label: (Blanked) BILLING PROVIDER IDENTIFICATION NUMBER Blanked. Values: Blanked Home Variable List - MAX - OT 29. NPI Type: CHAR Length: 12 Label: (Blanked) NATIONAL PROVIDER IDENTIFIER Blanked. Values: Blanked Home Variable List - MAX - OT 30. PROVIDER_TAXONOMY Type: CHAR Length: 12 Label: PROVIDER TAXONOMY DESCRIPTION: A NATIONAL HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)-COMPLIANT CODE THAT DESCRIBES THE SPECIALTY OF THE PROVIDER WHO TREATED THE RECIPIENT (AS OPPOSED TO THE PROVIDER BI. Home Variable List - MAX - OT 31. TYPE_OF_CLAIM Type: CHAR Length: 1 Label: TYPE OF CLAIM CODE DESCRIPTION: CODE INDICATING THE TYPE OF CLAIM. Values: CODES: 1 = A CURRENT FEE-FOR-SERVICE CLAIM FOR MEDICAL SERVICES. 2 = CAPITATED PAYMENT. 3 = ENCOUNTER (A.K.A. 'DUMMY') RECORD THAT SIMULATES A BILL FOR A SERVICE RENDERED TO A PATIENT COVERED UNDER SOME FORM OF CAPITATION PLAN. 4 = A 'SERVICE TRACKING CLAIM' THAT DOCUMENTS SERVICES RECEIVED BY AN INDIVIDUAL PATIENT, WHEN THE STATE ACCEPTS A LUMP SUM BILL FROM A PROVIDER THAT COVERED SIMILAR SERVICES DELIVERED TO MORE THAN ONE PATIENT, SUCH AS GROUP SCREENING FOR EARLY PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT (EPSDT). 5 = SUPPLEMENTAL PAYMENT (ABOVE CAPITATION FEE OR ABOVE NEGOTIATED RATE) (E.G. FEDERALLY QUALIFIED HEALTH CENTER (FQHC) ADDITIONAL REIMBURSEMENT). 9 = UNKNOWN. A = S-CHIP CLAIM: A CURRENT FEE-FOR-SERVICE CLAIM FOR MEDICAL SERVICES. B = S-CHIP CLAIM: CAPITATED PAYMENT. C = S-CHIP CLAIM: ENCOUNTER (A.K.A. 'DUMMY') RECORD THAT SIMULATES A BILL FOR A SERVICE RENDERED TO A PATIENT COVERED UNDER SOME FORM OF CAPITATION PLAN. D = S-CHIP CLAIM: A 'SERVICE TRACKING CLAIM' THAT DOCUMENTS SERVICES RECEIVED BY AN INDIVIDUAL PATIENT, WHEN THE STATE ACCEPTS A LUMP SUM BILL FROM A PROVIDER THAT COVERED SIMILAR SERVICES DELIVERED TO MORE THAN ONE PATIENT, SUCH AS GROUP SCREENING FOR EPSDT. E = S-CHIP CLAIM: SUPPLEMENTAL PAYMENT (ABOVE CAPITATION FEE OR ABOVE NEGOTIATED RATE) (E.G. FQHC ADDITIONAL REIMBURSEMENT). USER NOTE: VOIDED CLAIMS ARE NOT RETAINED IN MAX AS $0 PAID CLAIMS. Home Variable List - MAX - OT 33. MANAGED_CARE_TYPE_OF_PLAN_CODE Type: NUM Length: 2 Label: MANAGED CARE TYPE OF PLAN CODE DESCRIPTION: CODE INDICATING THE TYPE OF MANAGED CARE PLAN, IF ANY, UNDER WHICH THE CAPITATION OR ENCOUNTER WAS PROVIDED. Values: CODES: 00 = INDIVIDUAL WAS NOT ELIGIBLE FOR MEDICAID THIS MONTH. 01 = ELIGIBLE IS ENROLLED IN A MEDICAL OR COMPREHENSIVE MANAGED CARE PLAN THIS MONTH (E.G. HMO). 02 = ELIGIBLE IS ENROLLED IN A DENTAL MANAGED CARE PLAN THIS MONTH. 03 = ELIGIBLE IS ENROLLED IN A BEHAVIORAL MANAGED CARE PLAN THIS MONTH. 04 = ELIGIBLE IS ENROLLED IN A PRENATAL/DELIVERY MANAGED CARE PLAN THIS MONTH. 05 = ELIGIBLE IS ENROLLED IN A LONG-TERM CARE MANAGED CARE PLAN THIS MONTH. 06 = ELIGIBLE IS ENROLLED IN A PROGRAM FOR ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) THIS MONTH. 07 = ELIGIBLE IS ENROLLED IN A PRIMARY CARE CASE MANAGEMENT MANAGED CARE PLAN THIS MONTH. 08 = ELIGIBLE IS ENROLLED IN AN OTHER MANAGED CARE PLAN THIS MONTH. 77 = THIS RECORD IS AN ENCOUNTER RECORD, BUT THERE WAS NO MATCH BETWEEN THE 'MANAGED CARE PLAN IDENTIFICATION NUMBER' AND THE PLAN IDENTIFIERS IN THE ELIGIBILTY RECORD FOR THIS PERSON. 88 = NOT APPLICABLE, THIS RECORD IS NOT AN ENCOUNTER RECORD OR THIS RECORD’S PLAN ID IS 8-FILLED. 99 = ELIGIBLE'S MANAGED CARE PLAN STATUS IS UNKNOWN. USER NOTE: THIS DATA ELEMENT IS 8-FILLED FOR NON-ENCOUNTER RECORDS. IN MAX 1999-2008, THIS DATA ELEMENT WAS 6, 7, 8 OR 9-FILLED FOR ALL RECORDS. IN MAX 2010, VALUE 66 WAS DELETED. IN MAX 2010, WE REVISED THE ALGORITHM TO LOOK FOR THE CLAIM’S PLAN ID IN ALL FOUR PLANS IN ALL 12 MONTHS OF ELIGIBILITY RATHER THAN LOOK ONLY IN THE SERVICE END MONTH. Home Variable List - MAX - OT 34. MANAGED_CARE_PLAN_IDENTIF_CODE Type: CHAR Length: 12 Label: (Blanked) MANAGED CARE PLAN IDENTIFICATION NUMBER Blanked. Values: Blanked Home Variable List - MAX - OT 35. MEDICAID_PAYMENT_AMOUNT Type: NUM* Length: 8 Label: MEDICAID PAYMENT AMOUNT DESCRIPTION: TOTAL AMOUNT OF MONEY PAID BY MEDICAID FOR THIS SERVICE. (DISPLAY SIGNED NUMERIC) (SAS USERS: ZONED DECIMAL - ZD8) USER NOTES: THIS PAYMENT AMOUNT IS = $0 FOR ENCOUNTER RECORDS. IN MSIS,. Home Variable List - MAX - OT 36. THIRD_PARTY_PAYMENT_AMOUNT Type: NUM* Length: 8 Label: THIRD PARTY PAYMENT AMOUNT DESCRIPTION: TOTAL AMOUNT OF MONEY PAID BY A THIRD PARTY (I.E. ALL SOURCES OTHER THAN MEDICAID, MEDICARE AND THE ELIGIBLE'S PERSONAL FUNDS) FOR THIS SERVICE. (DISPLAY SIGNED NUMERIC) (SAS USERS: ZONED. Home Variable List - MAX - OT 37. PAYMENT_ADJUDICATION_DATE Type: NUM Length: 8 Label: PAYMENT DATE DESCRIPTION: DATE ON WHICH THE CLAIM OR ENCOUNTER RECORD WAS ADJUDICATED BY THE STATE. EDIT-RULES: YYYYMMDD USER NOTE: FOR FEE-FOR-SERVICE CLAIMS THIS IS THE DATE THE CLAIM WAS ADJUDICATED FOR PAYMENT. Home Variable List - MAX - OT 38. CHARGE_AMOUNT Type: NUM* Length: 8 Label: CHARGE AMOUNT DESCRIPTION: TOTAL AMOUNT OF CHARGES SUBMITTED BY THE PROVIDER FOR THIS SERVICE. (DISPLAY SIGNED NUMERIC) (SAS USERS: ZONED DECIMAL - ZD8) USER NOTE: THIS PAYMENT AMOUNT IS = $0 FOR ENCOUNTER RECORDS. Home Variable List - MAX - OT 39. PREPAID_PLAN_VALUE Type: NUM* Length: 8 Label: PREPAID PLAN SERVICE VALUE DESCRIPTION: DOLLAR VALUE PLACED ON THE SERVICE BY THE PROVIDER. (DISPLAY SIGNED NUMERIC) (SAS USERS: ZONED DECIMAL - ZD8) USER NOTES: THIS PAYMENT AMOUNT IS > $0 ONLY FOR ENCOUNTER RECORDS. WHILE THI. Home Variable List - MAX - OT 40. MEDICARE_COINSURANCE_PAYMENT_AMT Type: NUM* Length: 8 Label: MEDICARE COINSURANCE PAYMENT AMOUNT DESCRIPTION: THE AMOUNT PAID BY MEDICAID FOR THIS SERVICE, TOWARD THE RECIPIENT'S MEDICARE COINSURANCE LIABILITY. (DISPLAY SIGNED NUMERIC) (SAS USERS: ZONED DECIMAL - ZD8). Home Variable List - MAX - OT 41. MEDICARE_DEDUCTIBLE_PAYMENT_AMT Type: NUM* Length: 8 Label: MEDICARE DEDUCTIBLE PAYMENT AMOUNT DESCRIPTION: THE AMOUNT PAID BY MEDICAID FOR THIS SERVICE, TOWARD THE RECIPIENT'S MEDICARE DEDUCTIBLE LIABILITY. (DISPLAY SIGNED NUMERIC) (SAS USERS: ZONED DECIMAL - ZD8) USER NOTE: THIS DATA ELEM. Home Variable List - MAX - OT 42. BEGINNING_DATE_OF_SERVICE Type: NUM Length: 8 Label: SERVICE BEGINNING DATE DESCRIPTION: THE BEGINNING DATE OF SERVICE FOR THIS CLAIM. EDIT-RULES: YYYYMMDD USER NOTE: THIS DATA ELEMENT WAS CHANGED FROM 6 TO 8 DIGITS BEGINNING IN 1996. Home Variable List - MAX - OT 43. ENDING_DATE_OF_SERVICE Type: NUM Length: 8 Label: ENDING DATE OF SERVICE DESCRIPTION: THE LAST DATE OF SERVICE COVERED BY THIS CLAIM. EDIT-RULES: YYYYMMDD. Home Variable List - MAX - OT 44. PROCEDURE_CODING_SYSTEM Type: CHAR Length: 2 Label: PROCEDURE CODING SYSTEM CODE DESCRIPTION: CODE SPECIFYING THE PROCEDURE CODING SYSTEM USED FOR THE PRINCIPAL AND SECONDARY PROCEDURES. Values: CODES: 01 = CPT-4 02 = ICD-9-CM 03 = CRVS 74 04 = CRVS 69 05 = CRVS 64 06 = HCPCS 07 = ICD-10 10-87 = OTHER SYSTEMS 88 = NOT APPLICABLE 99 = UNKNOWN USER NOTES: THIS DATA ELEMENT SHOULD BE USED WITH 'PROCEDURE (SERVICE) CODE' AND 'PROCEDURE (SERVICE) MODIFIER CODE'. USERS SHOULD MAKE SURE THE CODE VALUE IN THIS DATA ELEMENT ACCURATELY REFLECTS THE CODING SCHEME IN USE. Home Variable List - MAX - OT 45. PROCEDURE_CODE Type: CHAR Length: 8 Label: PROCEDURE (SERVICE) CODE DESCRIPTION: PROCEDURE (SERVICE) PROVIDED. SEE 'PROCEDURE CODING SYSTEM CODE'. Home Variable List - MAX - OT 46. PROCEDURE_CODE_MODIFIER Type: CHAR Length: 2 Label: PROCEDURE (SERVICE) MODIFIER CODE DESCRIPTION: MODIFIER CODE TO PROVIDE MORE INFORMATION ABOUT THE SERVICE PROVIDE IN RELATION TO THIS PROCEDURE (E.G. ASSISTANCE IN SURGERY). Home Variable List - MAX - OT 47. DIAGNOSIS_CODE_1 Type: CHAR Length: 7 Label: DIAGNOSIS CODE-1 DESCRIPTION: THE FIRST DIAGNOSIS CODE FOR THIS RECORD. EDIT-RULES: LEFT JUSTIFIED, NO DECIMAL POINT. USER NOTE: USERS SHOULD EXERCISE CAUTION SINCE THIS DATA ELEMENT IS AS IT WAS REPORTED B. Values: CODES: 0 = ICD-10 9 = ICD-9 BLANK = MISSING Home Variable List - MAX - OT 48. DIAGNOSIS_CODE_2 Type: CHAR Length: 7 Label: DIAGNOSIS CODE-2 DESCRIPTION: THE SECOND DIAGNOSIS CODE FOR THIS RECORD. EDIT-RULES: LEFT JUSTIFIED, NO DECIMAL POINT. USER NOTE: USERS SHOULD EXERCISE CAUTION SINCE THIS DATA ELEMENT IS AS IT WAS REPORTED. Values: CODES: 0 = ICD-10 9 = ICD-9 BLANK = MISSING Home Variable List - MAX - OT 49. QUANTITY_OF_SERVICE Type: NUM Length: 5 Label: QUANTITY OF SERVICE DESCRIPTION: THE NUMBER OF UNITS OF SERVICE RECEIVED BY THE ELIGIBLE. FOR MAX 1999 AND BEYOND, THIS FIELD IS ONLY APPLICABLE WHEN THE SERVICE BEING BILLED CAN BE QUANTIFIED IN DISCRETE UNITS, E.G., A. Home Variable List - MAX - OT 50. SERVICING_PROVIDER_IDENT_NUMBER Type: CHAR Length: 12 Label: SERVICING PROVIDER IDENTIFICATION NUMBER DESCRIPTION: A UNIQUE NUMBER TO IDENTIFY THE PROVIDER WHO TREATED THE RECIPIENT. USER NOTE: THIS IS NOT NECESSARILY THE SAME PROVIDER THAT BILLED FOR THE SERVICE. THIS DATA ELEMENT SHOULD BE 8-FILLED. Home Variable List - MAX - OT 51. SERVICING_PROVIDER_SPECIALTY_CD Type: CHAR Length: 4 Label: SERVICING PROVIDER SPECIALTY CODE DESCRIPTION: CODE INDICATING THE AREA OF SPECIALTY FOR THE SERVICING PROVIDER. THIS CODE APPLIES ONLY TO PHYSICIANS, OSTEOPATHS, DENTISTS AND OTHER LICENSED PRACTITIONERS. USER NOTE: SINC. Home Variable List - MAX - OT 52. PLACE_OF_SERVICE Type: NUM Length: 2 Label: PLACE OF SERVICE CODE 1. Home Variable List - MAX - OT 53. UB_92_REVENUE_CODE Type: NUM Length: 4 Label: UB-92 REVENUE CODE DESCRIPTION: REVENUE CODE REPORTED ON THE LINE ITEM FOR THIS CLAIM OR ENCOUNTER RECORD IN THE UB-92 BILL FOR THE SERVICE. USER NOTE: ONLY VALID CODES AS DEFINED BY THE "NATIONAL UNIFORM BILLING COMMIT.
Home Variable List - MAX - RX 1. ADJUSTMENT_CODE Type: NUM Length: 1 Label: ADJUSTMENT CODE DESCRIPTION: CODE INDICATING IF THE CLAIMS FOR THIS SERVICE WERE ONLY ORIGINAL SUBMISSIONS, INCLUDED ADJUSTMENTS OF ANY TYPE OR IF ONE OR MORE ORIGINAL SUBMISSIONS WAS MISSING. Values: 0 = NO ADJUSTMENT OF CLAIMS WAS REQUIRED, SINCE ALL CLAIMS FOR THIS RECORD WERE ORIGINAL CLAIMS (ALL CLAIMS FOR THIS RECORD HAD VALUE = 0 IN THE MSIS DATA ELEMENT 'ADJUSTMENT- INDICATOR'). IN THIS CASE, ORIGINAL CLAIMS WERE COMBINED FOR THIS RECORD. 1 = THIS RECORD REPRESENTS A CLAIMS SET WHERE IT WAS POSSIBLE TO CORRECTLY COMPLETE THE ADJUSTMENT PROCESS, BY COMBINING ORIGINAL AND ADJUSTMENT CLAIMS FOR THIS RECORD. THIS MEANS THAT THERE WAS AT LEAST ONE ORIGINAL CLAIM AND AT LEAST ONE ADJUSTMENT CLAIM IN THE SET OF CLAIMS FOR THIS RECORD (AT LEAST ONE CLAIM FOR THIS RECORD HAD VALUE = 0 IN THE MSIS DATA ELEMENT 'ADJUSTMENT-INDICATOR' AND AT LEAST ONE CLAIM FOR THIS RECORD HAD A VALUE OTHER THAN 0 IN THE MSIS DATA ELEMENT 'ADJUSTMENT-INDICATOR'). 2 = THIS RECORD REPRESENTS A CLAIMS SET WHERE IT WAS NOT POSSIBLE TO CORRECTLY COMPLETE THE ADJUSTMENT PROCESS (NONE OF THE CLAIMS FOR THIS RECORD HAD A VALUE = 0 IN THE MSIS DATA ELEMENT 'ADJUSTMENT-INDICATOR'). Home Variable List - MAX - RX 3. MSIS_IDENTIFICATION_NUMBER Type: CHAR Length: 20 Label: (Encrypted) MSIS IDENTIFICATION NUMBER Encrypted. Values: Encrypted Home Variable List - MAX - RX 4. STATE Type: CHAR Length: 2 Label: STATE ABBREVIATION CODE DESCRIPTION: U. S. POSTAL SERVICE 2-CHARACTER ABBREVIATION FOR THE STATE MEDICAID AGENCY SUBMITTING THE DATA. Values: CODES: AL = ALABAMA AK = ALASKA AZ = ARIZONA AR = ARKANSAS CA = CALIFORNIA CO = COLORADO CT = CONNECTICUT DE = DELAWARE DC = DISTRICT OF COLUMBIA FL = FLORIDA GA = GEORGIA GU = GUAM/AMERICAN SAMOA HI = HAWAII ID = IDAHO IL = ILLINOIS IN = INDIANA IA = IOWA KS = KANSAS KY = KENTUCKY LA = LOUISIANA ME = MAINE MD = MARYLAND MA = MASSACHUSETTS MI = MICHIGAN MN = MINNESOTA MS = MISSISSIPPI MO = MISSOURI MT = MONTANA NE = NEBRASKA NV = NEVADA NH = NEW HAMPSHIRE NJ = NEW JERSEY NM = NEW MEXICO NY = NEW YORK NC = NORTH CAROLINA ND = NORTH DAKOTA OH = OHIO OK = OKLAHOMA OR = OREGON PA = PENNSYLVANIA PR = PUERTO RICO RI = RHODE ISLAND SC = SOUTH CAROLINA SD = SOUTH DAKOTA TN = TENNESSEE TX = TEXAS UT = UTAH VT = VERMONT VI = VIRGIN ISLANDS VA = VIRGINIA WA = WASHINGTON WV = WEST VIRGINIA WI = WISCONSIN WY = WYOMING Home Variable List - MAX - RX 6. MEDICARE_HIC_NUMBER Type: CHAR Length: 12 Label: MEDICARE HEALTH INSURANCE CLAIM (HIC) NUMBER - FROM MSIS DESCRIPTION: THE ELIGIBLE'S HEALTH INSURANCE CLAIM (HIC) NUMBER. THIS NUMBER IS APPLICABLE ONLY TO MEDICAID ELIGIBLES WHO ARE ALSO ELIGIBLE FOR MEDICARE AND IS ASSIGNED TO AN ELIGIBLE B. Home Variable List - MAX - RX 7. BIRTH_DATE Type: NUM Length: 8 Label: BIRTH DATE DESCRIPTION: BIRTH DATE OF THE MEDICAID ELIGIBLE. EDIT-RULES: YYYYMMDD. Home Variable List - MAX - RX 8. SEX Type: CHAR Length: 1 Label: SEX CODE DESCRIPTION: CODE INDICATING THE GENDER OF THE MEDICAID ELIGIBLE. Values: CODES: F = FEMALE M = MALE U = UNKNOWN/ERROR USER NOTE: THESE CODES ARE 1 (FEMALE), 2 (MALE) AND 9 (UNKNOWN) IN THE 1996-98 MSIS DATA. Home Variable List - MAX - RX 9. RACE_ETHNICITY Type: CHAR Length: 1 Label: RACE/ETHNICITY CODE DESCRIPTION: RACE/ETHNICITY OF THE MEDICAID ELIGIBLE. Values: CODES: 1 = WHITE, NOT OF HISPANIC ORIGIN (CHANGED TO "WHITE" BEGINNING 10/98) 2 = BLACK, NOT OF HISPANIC ORIGIN (CHANGED TO "BLACK OR AFRICAN AMERICAN" BEGINNING 10/98) 3 = AMERICAN INDIAN OR ALASKA NATIVE 4 = ASIAN OR PACIFIC ISLANDER (CHANGED TO "ASIAN" BEGINNING 10/98) 5 = HISPANIC (CHANGED TO "HISPANIC OR LATINO - NO RACE INFORMATION AVAILABLE" BEGINNING 10/98) 6 = NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER (NEW CODE BEGINNING 10/98) 7 = HISPANIC OR LATINO AND ONE OR MORE RACES (NEW CODE BEGINNING 10/98) 8 = MORE THAN ONE RACE (HISPANIC OR LATINO NOT INDICATED) (NEW CODE BEGINNING 10/98) 9 = UNKNOWN USER NOTE: SINCE SPECIFICATIONS FOR CODE VALUES = 7 AND 8 WERE NOT ISSUED UNTIL MAY 2000, THESE CODE VALUES MAY NOT APPEAR. THE METHODS OF COLLECTING INFORMATION ON RACE AND ETHNICITY DIFFER SUBSTANTIALLY ACROSS STATES AND TIME PERIODS. Home Variable List - MAX - RX 10. RACE_ETHNICITY_WHITE Type: CHAR Length: 1 Label: RACE - WHITE DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF WHITE. Values: CODES: 0 = NON-WHITE OR RACE UNKNOWN 1 = WHITE Home Variable List - MAX - RX 11. RACE_ETHNICITY_BLACK Type: CHAR Length: 1 Label: RACE - BLACK/AFRICAN AMERICAN DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF BLACK OR AFRICAN AMERICAN. Values: CODES: 0 = NON-BLACK/AFRICAN AMERICAN OR RACE UNKNOWN 1 = BLACK OR AFRICAN AMERICAN Home Variable List - MAX - RX 12. RACE_ETHNICITY_NATIVE Type: CHAR Length: 1 Label: RACE - AMERICAN INDIAN/ALASKA NATIVE DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF AMERICAN INDIAN/ALASKA NATIVE. Values: CODES: 0 = NON-AMERICAN INDIAN/ALASKA NATIVE OR RACE UNKNOWN 1 = AMERICAN INDIAN/ALASKA NATIVE Home Variable List - MAX - RX 13. RACE_ETHNICITY_ASIAN Type: CHAR Length: 1 Label: RACE - ASIAN DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF ASIAN. Values: CODES: 0 = NON-ASIAN OR RACE UNKNOWN 1 = ASIAN Home Variable List - MAX - RX 14. RACE_ETHNICITY_HAWAI Type: CHAR Length: 1 Label: RACE - NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER. Values: CODES: 0 = NON-NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER OR RACE UNKNOWN 1 = NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER Home Variable List - MAX - RX 15. RACE_ETHNICITY_LATIN Type: CHAR Length: 1 Label: ETHNICITY - HISPANIC OR LATINO DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAS INDICATED AN ETHNICITY OF HISPANIC OR LATINO. Values: CODES: 0 = NON-HISPANIC OR LATINO 1 = HISPANIC OR LATINO 9 = ETHNICITY UNKNOWN Home Variable List - MAX - RX 16. STATE_SPECIFIC_ELIG_MOST_RECENT Type: CHAR Length: 6 Label: STATE-SPECIFIC ELIGIBILITY CODE - MOST RECENT DESCRIPTION: STATE-SPECIFIC ELIGIBILITY CODE CLASSIFICATION UNDER WHICH THE MEDICAID ELIGIBLE IS COVERED - MOST RECENT OBSERVATION. USER NOTES: THESE SOURCE CODES ARE GENERALLY NOT APPLICABLE FOR MOST. Home Variable List - MAX - RX 17. STATE_SPECIFIC_ELIG_MO_OF_SVC Type: CHAR Length: 6 Label: STATE-SPECIFIC ELIGIBILITY CODE - FOR MONTH OF SERVICE DESCRIPTION: STATE-SPECIFIC ELIGIBILITY CODE CLASSIFICATION UNDER WHICH THE MEDICAID ELIGIBLE IS COVERED - FOR THE MONTH OF SERVICE. USER NOTES: THESE SOURCE CODES ARE GENERALLY NOT APPLICABLE FOR MOS. Home Variable List - MAX - RX 18. MAX_UNI_ELIG_CODE_MOST_RECENT Type: CHAR Length: 2 Label: MAX UNIFORM ELIGIBILITY CODE - MOST RECENT DESCRIPTION: MEDICAID ANALYTIC EXTRACT (MAX) UNIFORM ELIGIBILITY CODE FOR THE MEDICAID ELIGIBLE - MOST RECENT OBSERVATION. Values: CODES: 00 = NOT ELIGIBLE 11 = AGED, CASH 12 = BLIND/DISABLED, CASH 14 = CHILD (NOT CHILD OF UNEMPLOYED ADULT, NOT FOSTER CARE CHILD), ELIGIBLE UNDER SECTION 1931 OF THE ACT 15 = ADULT (NOT BASED ON UNEMPLOYMENT STATUS), ELIGIBLE UNDER SECTION 1931 OF THE ACT 16 = CHILD OF UNEMPLOYED ADULT, ELIGIBLE UNDER SECTION 1931 OF THE ACT 17 = UNEMPLOYED ADULT, ELIGIBLE UNDER SECTION 1931 OF THE ACT 21 = AGED, MEDICALLY NEEDY 22 = BLIND/DISABLED, MEDICALLY NEEDY 24 = CHILD, MEDICALLY NEEDY (FORMERLY AFDC CHILD, MEDICALLY NEEDY) 25 = ADULT, MEDICALLY NEEDY (FORMERLY AFDC ADULT, MEDICALLY NEEDY) 31 = AGED, POVERTY 32 = BLIND/DISABLED, POVERTY 34 = CHILD, POVERTY (INCLUDES MEDICAID EXPANSION CHIP CHILDREN) 35 = ADULT, POVERTY 3A = INDIVIDUAL COVERED UNDER THE BREAST AND CERVICAL CANCER PREVENTION ACT OF 2000, POVERTY 41 = OTHER AGED 42 = OTHER BLIND/DISABLED 44 = OTHER CHILD 45 = OTHER ADULT 48 = FOSTER CARE CHILD 51 = AGED, SECTION 1115 DEMONSTRATION EXPANSION 52 = BLIND/DISABLED, SECTION 1115 DEMONSTRATION EXPANSION 54 = CHILD, SECTION 1115 DEMONSTRATION EXPANSION 55 = ADULT, SECTION 1115 DEMONSTRATION EXPANSION 99 = UNKNOWN ELIGIBILITY Home Variable List - MAX - RX 19. MAX_UNI_ELIG_CODE_MO_OF_SVC Type: CHAR Length: 2 Label: MAX UNIFORM ELIGIBILITY CODE - FOR MONTH OF SERVICE DESCRIPTION: MEDICAID ANALYTIC EXTRACT (MAX) UNIFORM ELIGIBILITY CODE FOR THE MEDICAID ELIGIBLE - FOR THE MONTH OF SERVICE. Values: CODES: 00 = NOT ELIGIBLE 11 = AGED, CASH 12 = BLIND/DISABLED, CASH 14 = CHILD (NOT CHILD OF UNEMPLOYED ADULT, NOT FOSTER CARE CHILD), ELIGIBLE UNDER SECTION 1931 OF THE ACT 15 = ADULT (NOT BASED ON UNEMPLOYMENT STATUS), ELIGIBLE UNDER SECTION 1931 OF THE ACT 16 = CHILD OF UNEMPLOYED ADULT, ELIGIBLE UNDER SECTION 1931 OF THE ACT 17 = UNEMPLOYED ADULT, ELIGIBLE UNDER SECTION 1931 OF THE ACT 21 = AGED, MEDICALLY NEEDY 22 = BLIND/DISABLED, MEDICALLY NEEDY 24 = CHILD, MEDICALLY NEEDY (FORMERLY AFDC CHILD, MEDICALLY NEEDY) 25 = ADULT, MEDICALLY NEEDY (FORMERLY AFDC ADULT, MEDICALLY NEEDY) 31 = AGED, POVERTY 32 = BLIND/DISABLED, POVERTY 34 = CHILD, POVERTY (INCLUDES MEDICAID EXPANSION CHIP CHILDREN) 35 = ADULT, POVERTY 3A = INDIVIDUAL COVERED UNDER THE BREAST AND CERVICAL CANCER PREVENTION ACT OF 2000, POVERTY 41 = OTHER AGED 42 = OTHER BLIND/DISABLED 44 = OTHER CHILD 45 = OTHER ADULT 48 = FOSTER CARE CHILD 51 = AGED, SECTION 1115 DEMONSTRATION EXPANSION 52 = BLIND/DISABLED, SECTION 1115 DEMONSTRATION EXPANSION 54 = CHILD, SECTION 1115 DEMONSTRATION EXPANSION 55 = ADULT, SECTION 1115 DEMONSTRATION EXPANSION 99 = UNKNOWN ELIGIBILITY Home Variable List - MAX - RX 20. MISSING_ELIG_DATA Type: CHAR Length: 1 Label: MISSING ELIGIBILITY DATA DESCRIPTION: CODE INDICATING PERSON FOR WHOM NO MONTHS OF ENROLLMENT IN MEDICAID WERE FOUND. Values: CODES: BLANK = MEDICAID ENROLLMENT MONTHS WERE FOUND. 1 = NEITHER MEDICAID ENROLLMENT MONTHS NOR S-CHIP (CHIP CODE = 3) ENROLLMENT MONTHS WERE FOUND. 2 = S-CHIP ENROLLMENT MONTHS (CHIP CODE = 3) WERE FOUND, BUT NO MEDICAID ENROLLMENT MONTHS WERE FOUND. Home Variable List - MAX - RX 21. CROSSOVER_CODE_ANNUAL_NEW_VALUES Type: CHAR Length: 2 Label: MEDICARE DUAL CODE - ANNUAL DESCRIPTION: CODE INDICATING THAT THE ELIGIBLE IS COVERED BY MEDICARE (KNOWN AS DUAL OR MEDICARE ELIGIBILITY), ACCORDING TO MEDICAID (MSIS), MEDICARE (EDB) OR BOTH IN THE CALENDAR YEAR. Values: CODES: 00 = IN MSIS, ELIGIBLE IS NOT A MEDICARE BENEFICIARY 01 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QMB ONLY 02 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QMB AND FULL MEDICAID COVERAGE 03 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-SLMB ONLY 04 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-SLMB AND FULL MEDICAID COVERAGE 05 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QDWI 06 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QUALIFYING INDIVIDUALS (1) 07 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QUALIFYING INDIVIDUALS (2) 08 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-OTHER DUAL ELIGIBLES 09 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-DUAL ELIGIBILITY CATEGORY UNKNOWN 10 = IN MSIS, S-CHIP ELIGIBLE IS ENTITLED TO MEDICARE 50 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODES 01-09 DO NOT APPLY 51 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 01 APPLIES 52 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 02 APPLIES 53 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 03 APPLIES 54 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 04 APPLIES 55 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 05 APPLIES 56 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 06 APPLIES 57 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 07 APPLIES 58 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 08 APPLIES 59 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 09 APPLIES 60 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE S-CHIP ELIGIBLE AND CODE 10 APPLIES 99 = IN MSIS, ELIGIBLE'S MEDICARE STATUS IS UNKNOWN Home Variable List - MAX - RX 22. MSIS_TYPE_OF_SERVICE Type: NUM Length: 2 Label: MSIS TYPE OF SERVICE CODE DESCRIPTION: CODE INDICATING THE MEDICAID STATISTICAL INFORMATION SYSTEM (MSIS) TYPE OF SERVICE. EXPECTED MSIS TYPES OF SERVICE FOR THIS FILE ARE: 16 = PRESCRIBED DRUGS 19 = OTHER SERVICES COMPLETE MS. Home Variable List - MAX - RX 23. MSIS_TYPE_OF_PROGRAM Type: NUM Length: 1 Label: MSIS TYPE OF PROGRAM CODE DESCRIPTION: CODE INDICATING THE SPECIAL MEDICAID PROGRAM UNDER WHICH THE SERVICE WAS PROVIDED. Values: CODES: 0 = NO SPECIAL PROGRAM 1 = EARLY PERIODIC SCREENING DIAGNOSIS AND TREATMENT (EPSDT) 2 = FAMILY PLANNING 3 = RURAL HEALTH CLINIC 4 = FEDERALLY QUALIFIED HEALTH CENTERS (FQHCs) 5 = INDIAN HEALTH SERVICES 6 = HOME AND COMMUNITY-BASED CARE FOR DISABLED ELDERLY AND INDIVIDUALS AGE 65 AND OLDER 7 = HOME AND COMMUNITY-BASED CARE WAIVER SERVICES 9 = UNKNOWN Home Variable List - MAX - RX 24. SMRF_TYPE_OF_SERVICE Type: NUM Length: 2 Label: MAX TYPE OF SERVICE CODE DESCRIPTION: CODE INDICATING THE MEDICAID ANALYTIC EXTRACT (MAX) TYPE OF SERVICE FOR THIS RECORD. EXPECTED MAX TYPES OF SERVICE FOR THIS FILE ARE: 16 = DRUGS 51 = DURABLE MEDICAL EQUIPMENT AND SUPPLIE. Home Variable List - MAX - RX 25. BILLING_PROVIDER_IDENTIF_NUMBER Type: CHAR Length: 12 Label: (Blanked) BILLING PROVIDER IDENTIFICATION NUMBER Blanked. Values: Blanked Home Variable List - MAX - RX 26. NPI Type: CHAR Length: 12 Label: (Blanked) NATIONAL PROVIDER IDENTIFIER Blanked. Values: Blanked Home Variable List - MAX - RX 27. PROVIDER_TAXONOMY Type: CHAR Length: 12 Label: PROVIDER TAXONOMY DESCRIPTION: A NATIONAL HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)-COMPLIANT CODE THAT DESCRIBES THE SPECIALTY OF THE BILLING PROVIDER. Home Variable List - MAX - RX 28. TYPE_OF_CLAIM Type: CHAR Length: 1 Label: TYPE OF CLAIM CODE DESCRIPTION: CODE INDICATING THE TYPE OF CLAIM. Values: CODES: 1 = A CURRENT FEE-FOR-SERVICE CLAIM FOR MEDICAL SERVICES. 2 = CAPITATED PAYMENT. 3 = ENCOUNTER (A.K.A. 'DUMMY') RECORD THAT SIMULATES A BILL FOR A SERVICE RENDERED TO A PATIENT COVERED UNDER SOME FORM OF CAPITATION PLAN. 4 = A 'SERVICE TRACKING CLAIM' THAT DOCUMENTS SERVICES RECEIVED BY AN INDIVIDUAL PATIENT, WHEN THE STATE ACCEPTS A LUMP SUM BILL FROM A PROVIDER THAT COVERED SIMILAR SERVICES DELIVERED TO MORE THAN ONE PATIENT, SUCH AS GROUP SCREENING FOR EARLY PERIODIC SCREENING, DIAGNOSIS, AND TREATMENT (EPSDT). 5 = SUPPLEMENTAL PAYMENT (ABOVE CAPITATION FEE OR ABOVE NEGOTIATED RATE) (E.G. FEDERALLY QUALIFIED HEALTH CENTER (FQHC) ADDITIONAL REIMBURSEMENT). 9 = UNKNOWN. A = S-CHIP CLAIM: A CURRENT FEE-FOR-SERVICE CLAIM FOR MEDICAL SERVICES. B = S-CHIP CLAIM: CAPITATED PAYMENT. C = S-CHIP CLAIM: ENCOUNTER (A.K.A. 'DUMMY') RECORD THAT SIMULATES A BILL FOR A SERVICE RENDERED TO A PATIENT COVERED UNDER SOME FORM OF CAPITATION PLAN. D = S-CHIP CLAIM: A 'SERVICE TRACKING CLAIM' THAT DOCUMENTS SERVICES RECEIVED BY AN INDIVIDUAL PATIENT, WHEN THE STATE ACCEPTS A LUMP SUM BILL FROM A PROVIDER THAT COVERED SIMILAR SERVICES DELIVERED TO MORE THAN ONE PATIENT, SUCH AS GROUP SCREENING FOR EPSDT. E = S-CHIP CLAIM: SUPPLEMENTAL PAYMENT (ABOVE CAPITATION FEE OR ABOVE NEGOTIATED RATE) (E.G. FQHC ADDITIONAL REIMBURSEMENT). USER NOTE: VOIDED CLAIMS ARE NOT RETAINED IN MAX AS $0 PAID CLAIMS. Home Variable List - MAX - RX 30. MANAGED_CARE_TYPE_OF_PLAN_CODE Type: NUM Length: 2 Label: MANAGED CARE TYPE OF PLAN CODE DESCRIPTION: CODE INDICATING THE TYPE OF MANAGED CARE PLAN, IF ANY, UNDER WHICH THE NON-FEE-FOR-SERVICE ENCOUNTER WAS PROVIDED. Values: CODES: 00 = INDIVIDUAL WAS NOT ELIGIBLE FOR MEDICAID THIS MONTH. 01 = ELIGIBLE IS ENROLLED IN A MEDICAL OR COMPREHENSIVE MANAGED CARE PLAN THIS MONTH (E.G. HMO). 02 = ELIGIBLE IS ENROLLED IN A DENTAL MANAGED CARE PLAN THIS MONTH. 03 = ELIGIBLE IS ENROLLED IN A BEHAVIORAL MANAGED CARE PLAN THIS MONTH. 04 = ELIGIBLE IS ENROLLED IN A PRENATAL/DELIVERY MANAGED CARE PLAN THIS MONTH. 05 = ELIGIBLE IS ENROLLED IN A LONG-TERM CARE MANAGED CARE PLAN THIS MONTH. 06 = ELIGIBLE IS ENROLLED IN A PROGRAM FOR ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) THIS MONTH. 07 = ELIGIBLE IS ENROLLED IN A PRIMARY CARE CASE MANAGEMENT MANAGED CARE PLAN THIS MONTH. 08 = ELIGIBLE IS ENROLLED IN AN OTHER MANAGED CARE PLAN THIS MONTH. 77 = THIS RECORD IS AN ENCOUNTER RECORD, BUT THERE WAS NO MATCH BETWEEN THE 'MANAGED CARE PLAN IDENTIFICATION NUMBER' AND THE PLAN IDENTIFIERS IN THE ELIGIBILTY RECORD FOR THIS PERSON. 88 = NOT APPLICABLE, THIS RECORD IS NOT AN ENCOUNTER RECORD OR THIS RECORD’S PLAN ID IS 8-FILLED. 99 = ELIGIBLE'S MANAGED CARE PLAN STATUS IS UNKNOWN. USER NOTE: THIS DATA ELEMENT IS 8-FILLED FOR NON-ENCOUNTER RECORDS. IN MAX 1999-2008, THIS DATA ELEMENT WAS 6, 7, 8 OR 9-FILLED FOR ALL RECORDS. IN MAX 2010, VALUE 66 WAS DELETED. IN MAX 2010, WE REVISED THE ALGORITHM TO LOOK FOR THE CLAIM’S PLAN ID IN ALL FOUR PLANS IN ALL 12 MONTHS OF ELIGIBILITY RATHER THAN LOOK ONLY IN THE SERVICE END MONTH. Home Variable List - MAX - RX 31. MANAGED_CARE_PLAN_IDENTIF_CODE Type: CHAR Length: 12 Label: (Blanked) MANAGED CARE PLAN IDENTIFICATION NUMBER Blanked. Values: Blanked Home Variable List - MAX - RX 32. MEDICAID_PAYMENT_AMOUNT Type: NUM* Length: 8 Label: MEDICAID PAYMENT AMOUNT DESCRIPTION: TOTAL AMOUNT OF MONEY PAID BY MEDICAID FOR THIS SERVICE. (DISPLAY SIGNED NUMERIC) (SAS USERS: ZONED DECIMAL - ZD8) USER NOTES: THIS PAYMENT AMOUNT IS = $0 FOR ENCOUNTER RECORDS. IN MSIS,. Home Variable List - MAX - RX 33. THIRD_PARTY_PAYMENT_AMOUNT Type: NUM* Length: 8 Label: THIRD PARTY PAYMENT AMOUNT DESCRIPTION: TOTAL AMOUNT OF MONEY PAID BY A THIRD PARTY (I.E. ALL SOURCES OTHER THAN MEDICAID, MEDICARE AND THE ELIGIBLE'S PERSONAL FUNDS) FOR THIS SERVICE. (DISPLAY SIGNED NUMERIC) (SAS USERS: ZONED. Home Variable List - MAX - RX 34. PAYMENT_ADJUDICATION_DATE Type: NUM Length: 8 Label: PAYMENT DATE DESCRIPTION: DATE ON WHICH THE CLAIM OR ENCOUNTER RECORD WAS ADJUDICATED BY THE STATE. EDIT-RULES: YYYYMMDD USER NOTE: FOR FEE-FOR-SERVICE CLAIMS THIS IS THE DATE THE CLAIM WAS ADJUDICATED FOR PAYMENT. Home Variable List - MAX - RX 35. CHARGE_AMOUNT Type: NUM* Length: 8 Label: CHARGE AMOUNT DESCRIPTION: TOTAL AMOUNT OF CHARGES SUBMITTED BY THE PROVIDER FOR THIS SERVICE. (DISPLAY SIGNED NUMERIC) (SAS USERS: ZONED DECIMAL - ZD8) USER NOTE: THIS PAYMENT AMOUNT IS = $0 FOR ENCOUNTER RECORDS. Home Variable List - MAX - RX 36. PREPAID_PLAN_VALUE Type: NUM* Length: 8 Label: PREPAID PLAN SERVICE VALUE DESCRIPTION: DOLLAR VALUE PLACED ON THE SERVICE BY THE PROVIDER. (DISPLAY SIGNED NUMERIC) (SAS USERS: ZONED DECIMAL - ZD8) USER NOTES: THIS PAYMENT AMOUNT IS > $0 ONLY FOR ENCOUNTER RECORDS. WHILE THI. Home Variable List - MAX - RX 39. PRESCRIBING_PHYSICIAN_ID_NUMBER Type: CHAR Length: 12 Label: PRESCRIBING PHYSICIAN IDENTIFICATION NUMBER DESCRIPTION: THE UNIQUE IDENTIFICATION NUMBER ASSIGNED TO A PROVIDER, BY THE STATE, WHICH IDENTIFIES THE PHYSICIAN OR OTHER PROVIDER PRESCRIBING THE DRUG, DEVICE OR SUPPLY. USER NOTE: FOR PHYSICIANS,. Home Variable List - MAX - RX 40. PRESCRIBED_DATE Type: NUM Length: 8 Label: PRESCRIBED DATE DESCRIPTION: DATE THE DRUG, DEVICE OR SUPPLY WAS PRESCRIBED BY THE PHSYCIAN OR OTHER PRACTITIONER. EDIT RULES: YYYYMMDD USER NOTE: THIS DATA ELEMENT SHOULD NOT BE CONFUSED WITH THE PRESCRIP. Home Variable List - MAX - RX 41. PRESCRIPTION_FILL_DATE Type: NUM Length: 8 Label: PRESCRIPTION FILLED DATE DESCRIPTION: DATE THE PRESCRIPTION WAS FILLED BY THE PHARMACY OR OTHER PROVIDER. EDIT-RULES: YYYYMMDD USER NOTES: THIS DATA ELEMENT SHOULD NOT BE CONFUSED WITH THE PRESCRIBED DATE. Home Variable List - MAX - RX 42. NEW_OR_REFILL_INDICATOR Type: NUM Length: 2 Label: NEW OR REFILL INDICATOR DESCRIPTION: INDICATOR SHOWING WHETHER THE PRESCRIPTION BEING FILLED WAS A NEW PRESCRIPTION OR A REFILL. IF IT WAS A REFILL, THE INDICATOR WILL IDENTIFY HOW MANY TIMES IT WAS REFILLED. Values: CODES: 00 = NEW PRESCRIPTION 01-98 = NUMBER OF THE REFILL 99 = UNKNOWN Home Variable List - MAX - RX 43. NATIONAL_DRUG_CODE Type: CHAR Length: 12 Label: NATIONAL DRUG CODE (NDC) DESCRIPTION: NATIONAL DRUG CODE (NDC) FOR THIS SERVICE. USER NOTE: THE 11-CHARACTER NDC CODE SHOULD BE LEFT JUSTIFIED AND BLANK-FILLED TO THE RIGHT. HOWEVER, USERS SHOULD CHECK THE 12-C. Home Variable List - MAX - RX 44. QUANTITY_OF_SERVICE Type: NUM Length: 5 Label: QUANTITY OF SERVICE DESCRIPTION: THE NUMBER OF UNITS OF SERVICE RECEIVED BY THE ELIGIBLE. FOR MAX 1999 AND BEYOND, THIS FIELD IS ONLY APPLICABLE WHEN THE SERVICE BEING BILLED CAN BE QUANTIFIED IN DISCRETE UNITS, E.G., A. Home Variable List - MAX - RX 45. DAYS_SUPPLY Type: NUM Length: 3 Label: DAYS SUPPLY DESCRIPTION: THE NUMBER OF DAYS SUPPLY DISPENSED. Home Variable List - MAX - RX 46. NDC_FORMAT Type: CHAR Length: 1 Label: NATIONAL DRUG CODE FORMAT INDICATOR DESCRIPTION: THIS DATA ELEMENT IS USED TO IDENTIFY THE ORIGINAL 10- OR 11- CHARACTER FORMAT OF THE NATIONAL DRUG CODE (NDC) AND THE TYPE OF CODE, SUCH AS NDC, UNIVERSAL PRODUCT CODE (UPC) OR. Home Variable List - MAX - RX 47. DRUG_CLASS Type: CHAR Length: 1 Label: DRUG CLASS DESCRIPTION: CLASSIFIES THE DRUG ACCORDING TO AVAILABILITY TO THE PATIENT. Values: CODES: BLANK = UNSPECIFIED O = OVER THE COUNTER (THIS VALUE IS AN ALHPA LETTER 'O') F = PRESCRIPTION REQUIRED (THIS VALUE IS AN ALPHA LETTER 'F') Home Variable List - MAX - RX 48. MULTI_SOURCE_CODE Type: CHAR Length: 1 Label: MULTI-SOURCE CODE DESCRIPTION: IDENTIFIES WHETHER THIS DRUG IS PROPRIETARY OR AVAILABLE AS A GENERIC BRAND. Values: CODES: N = SINGLE SOURCE, NO GENERICS AVAILABLE M = CONSIDERED SINGLE SOURCE, CO-LICENSED O = ORIGINAL PRODUCT, GENERICS AVAILABLE (INNOVATIVE MULTIPLE SOURCE) Y = CONSIDERED GENERICS, MULTIPLE SOURCES (NON-INNOVATIVE MULTIPLE SOURCE) Home Variable List - MAX - RX 49. HICL Type: CHAR Length: 6 Label: INGREDIENT LIST IDENTIFIER DESCRIPTION: INGREDIENT LIST IDENTIFIER (FORMERLY HIERARCHICAL INGREDIENT CODE LIST SEQUENCE NUMBER) IDENTIFIES A COMBINATION OF ACTIVE INGREDIENTS IRRESPECTIVE OF MANUFACTURER. CONCEPT DEV. Home Variable List - MAX - RX 50. THERAPEUTIC_CLASS_SPECIFIC Type: CHAR Length: 3 Label: HIERARCHICAL SPECIFIC THERAPEUTIC CLASS CODE DESCRIPTION: A THREE-CHARACTER ELEMENT, THAT, DEPENDING ON ITS CONTEXT, IDENTIFIES THE SPECIFIC THERAPEUTIC CLASS OF AN INGREDIENT (HIC_SEQN), A CLINICAL FORMULATION ID (GCN_SEQNO), OR EACH IN. Home Variable List - MAX - RX 51. THERAPEUTIC_CLASS_GENERIC Type: CHAR Length: 2 Label: THERAPEUTIC CLASS CODE, GENERIC DESCRIPTION: GENERIC THERAPEUTIC CLASS CODE. USER NOTE: THIS IS FIRST DATA BANK NATIONAL DRUG DATA FILE (FDB NDDF) DATA ELEMENT 'GTC'. Home Variable List - MAX - RX 52. AMERICAN_HOSPITAL_FORMULARY_CODE Type: CHAR Length: 6 Label: CLINICAL FORMULATION ID DESCRIPTION: 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. Home Variable List - MAX - RX 54. MEDISPAN_CODE Type: GROUP Length: 107 Label: FIRST DATA BANK/MEDISPAN GROUP (PROPRIETARY - ACCESS LIMITED TO LICENSE HOLDERS) DESCRIPTION: PROPRIETARY - ACCESS LIMITED TO LICENSE HOLDERS. DRUG (RX) RECORD. Home Variable List - MAX - RX 55. OVER_THE_COUNTER_INDICATOR Type: CHAR Length: 1 Label: OVER-THE-COUNTER INDICATOR CODE DESCRIPTION: INDICATES WHETHER THE DRUG IS AN OVER-THE-COUNTER OR A PRESCRIBED DRUG. Values: CODES: O = OVER-THE-COUNTER (SINGLE SOURCE) P = OVER-THE-COUNTER (MULTIPLE SOURCE) R = PRESCRIPTION DRUG (SINGLE SOURCE) S = PRESCRIPTION DRUG (MULTIPLE SOURCE)
Home Variable List - MAX - PS 4. MSIS_IDENTIFICATION_NUMBER Type: CHAR Length: 20 Label: (Encrypted) MSIS IDENTIFICATION NUMBER Encrypted. Values: Encrypted Home Variable List - MAX - PS 5. STATE Type: CHAR Length: 2 Label: (Blanked) STATE ABBREVIATION CODE Blanked. Values: Blanked Home Variable List - MAX - PS 6. YEAR Type: NUM Length: 4 Label: MAX YEAR DATE DESCRIPTION: CALENDAR YEAR COVERED BY THE MAX PERSON SUMMARY FILE. EDIT-RULES: YYYY USER NOTE: THIS DATA ELEMENT WAS CHANGED TO 4 CHARACTERS IN 1996. SOURCE: MSIS ELIGIBILITY FILES. Values: PS DED Page 9 PER Home Variable List - MAX - PS 13. DATE_OF_BIRTH Type: NUM Length: 8 Label: BIRTH DATE DESCRIPTION: BIRTH DATE OF THE MEDICAID ELIGIBLE. EDIT-RULES: YYYYMMDD USER NOTE: WHEN SOMEONE HAS CLAIMS BUT NO ELIGIBILITY INFORMATION, THIS DATA ELEMENT IS 0-FILLED. SOURCE: MSIS ELIGIBILITY FILES:. Home Variable List - MAX - PS 14. AGE_GROUP Type: NUM Length: 1 Label: AGE GROUP CODE DESCRIPTION: CODE INDICATING AGE GROUP OF THE MEDICAID ELIGIBLE. PS DED Page 18 CODES: 0 = UNDER 1 YEAR 1 = AGES 1 TO 5 YEARS 2 = AGES 6 TO 14 YEARS 3 = AGES 15 TO 20 YEARS 4 = AGES 21 TO 44 YEARS 5 =. Values: CODES: 0 = UNDER 1 YEAR 1 = AGES 1 TO 5 YEARS 2 = AGES 6 TO 14 YEARS 3 = AGES 15 TO 20 YEARS 4 = AGES 21 TO 44 YEARS 5 = AGES 45 TO 64 YEARS 6 = AGES 65 TO 74 YEARS 7 = AGES 75 TO 84 YEARS 8 = AGES 85 AND OVER 9 = UNKNOWN/ERROR Home Variable List - MAX - PS 15. SEX Type: CHAR Length: 1 Label: SEX CODE DESCRIPTION: CODE INDICATING GENDER OF THE MEDICAID ELIGIBLE. CODES: F = FEMALE M = MALE U = UNKNOWN/ERROR USER NOTE: THESE CODES ARE 1 (FEMALE), 2 (MALE) AND 9 (UNKNOWN) IN THE 1996-98 MSIS DATA. USE. Values: CODES: F = FEMALE M = MALE U = UNKNOWN/ERROR USER NOTE: THESE CODES ARE 1 (FEMALE), 2 (MALE) AND 9 (UNKNOWN) IN THE 1996-98 MSIS DATA. Home Variable List - MAX - PS 16. RACE_ETHNICITY_FROM_MEDICAID Type: CHAR Length: 1 Label: RACE/ETHNICITY CODE DESCRIPTION: CODE INDICATING RACE/ETHNICITY OF THE MEDICAID ELIGIBLE. CODES: 1 = WHITE (WAS "WHITE, NOT OF HISPANIC ORIGIN" THROUGH 9/98) 2 = BLACK OR AFRICAN AMERICAN (WAS "BLACK, NOT OF HISPANIC ORI. Values: CODES: 1 = WHITE, NOT OF HISPANIC ORIGIN (CHANGED TO "WHITE" BEGINNING 10/98) 2 = BLACK, NOT OF HISPANIC ORIGIN (CHANGED TO "BLACK OR AFRICAN AMERICAN" BEGINNING 10/98) 3 = AMERICAN INDIAN OR ALASKA NATIVE 4 = ASIAN OR PACIFIC ISLANDER (CHANGED TO "ASIAN" BEGINNING 10/98) 5 = HISPANIC (CHANGED TO "HISPANIC OR LATINO - NO RACE INFORMATION AVAILABLE" BEGINNING 10/98) 6 = NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER (NEW CODE BEGINNING 10/98) 7 = HISPANIC OR LATINO AND ONE OR MORE RACES (NEW CODE BEGINNING 10/98) 8 = MORE THAN ONE RACE (HISPANIC OR LATINO NOT INDICATED) (NEW CODE BEGINNING 10/98) 9 = UNKNOWN USER NOTE: SINCE SPECIFICATIONS FOR CODE VALUES = 7 AND 8 WERE NOT ISSUED UNTIL MAY 2000, THESE CODE VALUES MAY NOT APPEAR. THE METHODS OF COLLECTING INFORMATION ON RACE AND ETHNICITY DIFFER SUBSTANTIALLY ACROSS STATES AND TIME PERIODS. Home Variable List - MAX - PS 17. RACE_ETHNICITY_WHITE Type: CHAR Length: 1 Label: RACE - WHITE DESCRIPTION: A CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF WHITE. CODES: 0 = NON-WHITE OR RACE UNKNOWN 1 = WHITE 9 = NO ELIGIBILITY INFORMATION (PERSON WITH MEDICAID CLAIMS ONLY) SOURCE: M. Values: CODES: 0 = NON-WHITE OR RACE UNKNOWN 1 = WHITE Home Variable List - MAX - PS 18. RACE_ETHNICITY_BLACK Type: CHAR Length: 1 Label: RACE - BLACK/AFRICAN AMERICAN DESCRIPTION: A CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF BLACK OR AFRICAN AMERICAN. CODES: 0 = NON-BLACK/AFRICAN AMERICAN OR RACE UNKNOWN 1 = BLACK OR AFRICAN AMERICAN 9 = NO ELIGIBILITY. Values: CODES: 0 = NON-BLACK/AFRICAN AMERICAN OR RACE UNKNOWN 1 = BLACK OR AFRICAN AMERICAN Home Variable List - MAX - PS 19. RACE_ETHNICITY_NATIVE Type: CHAR Length: 1 Label: RACE - AMERICAN INDIAN/ALASKAN NATIVE DESCRIPTION: A CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF AMERICAN INDIAN/ALASKA NATIVE. CODES: 0 = NON-AMERICAN INDIAN/ALASKA NATIVE OR RACE UNKNOWN 1 = AMERICAN INDIAN/ALASKA NATIVE 9 =. Values: CODES: 0 = NON-AMERICAN INDIAN/ALASKA NATIVE OR RACE UNKNOWN 1 = AMERICAN INDIAN/ALASKA NATIVE Home Variable List - MAX - PS 20. RACE_ETHNICITY_ASIAN Type: CHAR Length: 1 Label: RACE - ASIAN DESCRIPTION: A CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF ASIAN. CODES: 0 = NON-ASIAN OR RACE UNKNOWN 1 = ASIAN 9 = NO ELIGIBILITY INFORMATION (PERSON WITH MEDICAID CLAIMS ONLY) SOURCE: M. Values: CODES: 0 = NON-ASIAN OR RACE UNKNOWN 1 = ASIAN Home Variable List - MAX - PS 21. RACE_ETHNICITY_HAWAI Type: CHAR Length: 1 Label: RACE - NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER DESCRIPTION: A CODE INDICATING IF THE ELIGIBLE HAS INDICATED A RACE OF NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER. CODES: 0 = NON-NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER OR RACE UNKNOWN 1 = NATIVE HAWAIIAN. Values: CODES: 0 = NON-NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER OR RACE UNKNOWN 1 = NATIVE HAWAIIAN/OTHER PACIFIC ISLANDER Home Variable List - MAX - PS 22. RACE_ETHNICITY_LATIN Type: CHAR Length: 1 Label: ETHNICITY - HISPANIC OR LATINO DESCRIPTION: A CODE INDICATING IF THE ELIGIBLE HAS INDICATED AN ETHNICITY OF HISPANIC OR LATINO. CODES: 0 = NON-HISPANIC OR LATINO 1 = HISPANIC OR LATINO 9 = ETHNICITY UNKNOWN USER NOTE: WHEN SOMEONE. Values: CODES: 0 = NON-HISPANIC OR LATINO 1 = HISPANIC OR LATINO 9 = ETHNICITY UNKNOWN Home Variable List - MAX - PS 23. RACE_ETHNICITY_FROM_EDB Type: CHAR Length: 1 Label: MEDICARE RACE/ETHNICITY CODE DESCRIPTION: RACE/ETHNICITY OF THE MEDICARE ELIGIBLE. PS DED Page 27 CODES: 0 = UNKNOWN 1 = WHITE 2 = BLACK 3 = OTHER 4 = ASIAN 5 = HISPANIC 6 = NORTH AMERICAN NATIVE USER NOTE: WHEN SOMEONE HAS CLAIM. Values: CODES: 0 = UNKNOWN 1 = WHITE 2 = BLACK 3 = OTHER 4 = ASIAN 5 = HISPANIC 6 = NORTH AMERICAN NATIVE Home Variable List - MAX - PS 24. MEDICARE_LANGUAGE_CODE_FROM_EDB Type: CHAR Length: 1 Label: MEDICARE LANGUAGE CODE DESCRIPTION: CODE INDICATING THE LANGUAGE SSA USES FOR BENEFICIARY NOTICES. PS DED Page 28 CODES: C = CHINESE D = GERMAN E = ENGLISH F = FRENCH G = GREEK I = ITALIAN J = JAPANESE N = NORWEGIAN P = POL. Values: CODES: C = CHINESE D = GERMAN E = ENGLISH F = FRENCH G = GREEK I = ITALIAN J = JAPANESE N = NORWEGIAN P = POLISH R = RUSSIAN S = SPANISH V = SWEDISH W = SERBO-CROATIAN BLANK = UNKNOWN, PRESUME ENGLISH Home Variable List - MAX - PS 25. SEX_RACE Type: NUM Length: 1 Label: SEX-RACE CODE DESCRIPTION: CODE INDICATING THE GENDER AND RACE OF THE MEDICAID ELIGIBLE. PS DED Page 29 CODES: 1 = WHITE, MALE 2 = WHITE, FEMALE 3 = NON-WHITE, MALE 4 = NON-WHITE, FEMALE 5 = RACE UNKNOWN, MALE 6 =. Values: CODES: 1 = WHITE, MALE 2 = WHITE, FEMALE 3 = NON-WHITE, MALE 4 = NON-WHITE, FEMALE 5 = RACE UNKNOWN, MALE 6 = RACE UNKNOWN, FEMALE 7 = SEX UNKNOWN, WHITE 8 = SEX UNKNOWN, NON-WHITE 9 = SEX AND RACE UNKNOWN Home Variable List - MAX - PS 26. DATE_OF_DEATH_FROM_MEDICAID Type: NUM Length: 8 Label: MEDICAID DEATH DATE DESCRIPTION: DEATH DATE OF THE MEDICAID ELIGIBLE. EDIT-RULES: YYYYMMDD USER NOTE: THIS DATA ELEMENT SHOULD BE USED WITH CAUTION SINCE THERE MAY BE UNDERREPORTING OF DEATHS IN THE MSIS. Home Variable List - MAX - PS 27. DATE_OF_DEATH_FROM_MEDICARE_EDB Type: NUM Length: 8 Label: MEDICARE DEATH DATE DESCRIPTION: DEATH DATE OF THE MEDICARE BENEFICIARY. EDIT-RULES: YYYYMMDD USER NOTE: THIS DATE OF DEATH HAS BEEN ADDED TO THE MAX FILE BECAUSE THE MEDICAID DEATH DATE MAY BE UNDERREPORTED OR UNRELIABL. Home Variable List - MAX - PS 28. DAY_OF_DEATH_VERIFIED_FROM_EDB Type: CHAR Length: 1 Label: MEDICARE DEATH DAY SWITCH DESCRIPTION: INDICATES WHETHER THE MEDICARE BENEFICIARY'S EXACT DAY OF DEATH HAS BEEN VERIFIED. CODES: N = DAY OF DEATH WAS NOT VERIFIED Y = DAY OF DEATH WAS VERIFIED BLANK = UNKNOWN USER NOTE: THIS D. Values: CODES: N = DAY OF DEATH WAS NOT VERIFIED Y = DAY OF DEATH WAS VERIFIED BLANK = UNKNOWN Home Variable List - MAX - PS 29. DAY_OF_DEATH_FROM_SSA Type: NUM Length: 8 Label: DATE OF DEATH (FROM SSA DEATH MASTER FILE) DESCRIPTION: DATE OF DEATH IN SSA DEATH MASTER FILE. EDIT-RULES: YYYYMMDD USER NOTE: THIS DATE OF DEATH HAS BEEN ADDED TO THE MAX FILE BECAUSE THE MEDICAID DEATH DATE MAY BE UNDERREPORTED OR UNRELIABL. Home Variable List - MAX - PS 30. COUNTY_OF_RESIDENCE Type: CHAR Length: 3 Label: (Blanked) RESIDENCE COUNTY CODE Blanked. Values: Blanked Home Variable List - MAX - PS 31. ZIP_CODE_OF_RESIDENCE Type: NUM Length: 5 Label: (Blanked) RESIDENCE ZIP CODE Blanked. Values: Blanked Home Variable List - MAX - PS 32. STATE_SPECIFIC_ELIGIBLITY Type: CHAR Length: 6 Label: (Blanked) STATE-SPECIFIC ELIGIBILITY CODE - MOST RECENT Blanked. Values: Blanked Home Variable List - MAX - PS 33. SMRF_ELIGIBILITY Type: CHAR Length: 2 Label: MAX UNIFORM ELIGIBILITY CODE - MOST RECENT DESCRIPTION: STATE MEDICAID RESEARCH FILES (MAX) UNIFORM ELIGIBILITY CODE FOR THE MEDICAID ELIGIBLE - MOST RECENT OBSERVATION PS DED Page 38 CODES: 00 = NOT ELIGIBLE 11 = AGED, CASH 12 = BLIND/DISABLE. Values: CODES: 00 = NOT ELIGIBLE 11 = AGED, CASH 12 = BLIND/DISABLED, CASH 14 = CHILD (NOT CHILD OF UNEMPLOYED ADULT, NOT FOSTER CARE CHILD), ELIGIBLE UNDER SECTION 1931 OF THE ACT 15 = ADULT (NOT BASED ON UNEMPLOYMENT STATUS), ELIGIBLE UNDER SECTION 1931 OF THE ACT 16 = CHILD OF UNEMPLOYED ADULT, ELIGIBLE UNDER SECTION 1931 OF THE ACT 17 = UNEMPLOYED ADULT, ELIGIBLE UNDER SECTION 1931 OF THE ACT 21 = AGED, MEDICALLY NEEDY 22 = BLIND/DISABLED, MEDICALLY NEEDY 24 = CHILD, MEDICALLY NEEDY (FORMERLY AFDC CHILD, MEDICALLY NEEDY) 25 = ADULT, MEDICALLY NEEDY (FORMERLY AFDC ADULT, MEDICALLY NEEDY) 31 = AGED, POVERTY 32 = BLIND/DISABLED, POVERTY 34 = CHILD, POVERTY (INCLUDES MEDICAID EXPANSION CHIP CHILDREN) 35 = ADULT, POVERTY 3A = INDIVIDUAL COVERED UNDER THE BREAST AND CERVICAL CANCER PREVENTION ACT OF 2000, POVERTY 41 = OTHER AGED 42 = OTHER BLIND/DISABLED 44 = OTHER CHILD 45 = OTHER ADULT 48 = FOSTER CARE CHILD 51 = AGED, SECTION 1115 DEMONSTRATION EXPANSION 52 = BLIND/DISABLED, SECTION 1115 DEMONSTRATION EXPANSION 54 = CHILD, SECTION 1115 DEMONSTRATION EXPANSION 55 = ADULT, SECTION 1115 DEMONSTRATION EXPANSION 99 = UNKNOWN ELIGIBILITY Home Variable List - MAX - PS 34. MISSING_ELIGIBILITY_DATA Type: CHAR Length: 1 Label: MISSING MEDICAID ELIGIBILITY DATA SWITCH DESCRIPTION: INDICATES PERSON FOR WHOM NO MONTHS OF ENROLLMENT IN MEDICAID WERE FOUND. CODES: BLANK = MEDICAID ENROLLMENT MONTHS WERE FOUND. 1 = NEITHER MEDICAID ENROLLMENT MONTHS NOR S-CHIP (CHIP COD. Values: CODES: BLANK = MEDICAID ENROLLMENT MONTHS WERE FOUND. 1 = NEITHER MEDICAID ENROLLMENT MONTHS NOR S-CHIP (CHIP CODE = 3) ENROLLMENT MONTHS WERE FOUND. 2 = S-CHIP ENROLLMENT MONTHS (CHIP CODE = 3) WERE FOUND, BUT NO MEDICAID ENROLLMENT MONTHS WERE FOUND. Home Variable List - MAX - PS 35. ELIGIBLE_MONTHS Type: NUM Length: 2 Label: MONTHS OF ELIGIBILITY DESCRIPTION: TOTAL NUMBER OF MONTHS THE INDIVIDUAL WAS ELIGIBLE FOR MEDICAID DURING THE CALENDAR YEAR. USER NOTE: THIS IS A NUMBER FROM 0 TO 12. IT IS GIVEN VALUE > 0 BASED ON THE NUMBER OF MONTHS WIT. Home Variable List - MAX - PS 36. PRIVATE_INSURANCE_MONTHS Type: NUM Length: 2 Label: PRIVATE INSURANCE MONTHS COUNT DESCRIPTION: TOTAL NUMBER OF MONTHS THE MEDICAID ELIGIBLE HAD PRIVATE INSURANCE COVERAGE DURING THE CALENDAR YEAR. USER NOTE: THIS IS A NUMBER FROM 0 TO 12. IT IS GIVEN VALUE > 0 BASED ON THE NUMBER O. Home Variable List - MAX - PS 37. CROSSOVER_CODE_NEW_VALUES_ANNUAL Type: CHAR Length: 2 Label: MEDICARE DUAL CODE - ANNUAL DESCRIPTION: CODE INDICATING THAT THE ELIGIBLE IS COVERED BY MEDICARE (KNOWN AS DUAL OR MEDICARE ELIGIBILITY), ACCORDING TO MEDICAID (MSIS), MEDICARE (EDB) OR BOTH IN THE CALENDAR YEAR. PS DED Page 42. Values: CODES: 00 = IN MSIS, ELIGIBLE IS NOT A MEDICARE BENEFICIARY 01 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QMB ONLY 02 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QMB AND FULL MEDICAID COVERAGE 03 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-SLMB ONLY 04 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-SLMB AND FULL MEDICAID COVERAGE 05 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QDWI 06 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QUALIFYING INDIVIDUALS (1) 07 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QUALIFYING INDIVIDUALS (2) 08 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-OTHER DUAL ELIGIBLES 09 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-DUAL ELIGIBILITY CATEGORY UNKNOWN 10 = IN MSIS, S-CHIP ELIGIBLE IS ENTITLED TO MEDICARE 50 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODES 01-09 DO NOT APPLY 51 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 01 APPLIES 52 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 02 APPLIES 53 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 03 APPLIES 54 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 04 APPLIES 55 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 05 APPLIES 56 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 06 APPLIES 57 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 07 APPLIES 58 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 08 APPLIES 59 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 09 APPLIES 60 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE S-CHIP ELIGIBLE AND CODE 10 APPLIES 99 = IN MSIS, ELIGIBLE'S MEDICARE STATUS IS UNKNOWN Home Variable List - MAX - PS 38. MEDICARE_BENEFICIARY_MONTHS Type: NUM Length: 2 Label: MEDICARE BENEFICIARY MONTHS COUNT DESCRIPTION: TOTAL NUMBER OF MONTHS THE MEDICAID ELIGIBLE WAS A MEDICARE BENEFICIARY ACCORDING TO MEDICARE (EDB). USER NOTE: THIS IS A NUMBER FROM 0 TO 12. IF THE 'ELIGIBLE SOCIAL SECURITY NUMBER' REP. Home Variable List - MAX - PS 39. OREC Type: NUM Length: 1 Label: MEDICARE ORIGINAL ENTITLEMENT REASON CODE DESCRIPTION: THE ORIGINAL REASON THE PERSON WAS ENTITLED TO MEDICARE BENEFITS. CODES: 0 = ENTITLED DUE TO AGE 1 = ENTITLED DUE TO DISABILITY 2 = ENTITLED DUE TO END STAGE RENAL DISEASE (ESRD) 3 = ENTI. Values: CODES: 0 = ENTITLED DUE TO AGE 1 = ENTITLED DUE TO DISABILITY 2 = ENTITLED DUE TO END STAGE RENAL DISEASE (ESRD) 3 = ENTITLED DUE TO DISABILITY AND CURRENT ESRD 8 = NOT APPLICABLE (NOT ENTITLED TO MEDICARE) 9 = NO ATTEMPT WAS MADE TO MATCH THE RECORD FOR THIS PERSON TO THE MEDICARE ENROLLMENT DATA BASE (EDB), BECAUSE THERE WAS NO SSN REPORTED BY MEDICAID (E.G. PERSONS FOR WHOM THERE WERE MEDICAID CLAIMS BUT NO MEDICAID ELIGIBILITY DATA). Home Variable List - MAX - PS 40. CROSSOVER_MO_01 Type: CHAR Length: 2 Label: MEDICARE DUAL CODE - FIRST MONTH DESCRIPTION: CODE INDICATING THAT THE ELIGIBLE IS COVERED BY MEDICARE (KNOWN AS DUAL OR MEDICARE ELIGIBILITY), ACCORDING TO MEDICAID (MSIS), MEDICARE (EDB) OR BOTH FOR THE RESPECTIVE MONTH. PS DED Pag. Values: CODES: 00 = IN MSIS, ELIGIBLE IS NOT A MEDICARE BENEFICIARY 01 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QMB ONLY 02 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QMB AND FULL MEDICAID COVERAGE 03 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-SLMB ONLY 04 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-SLMB AND FULL MEDICAID COVERAGE 05 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QDWI 06 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QUALIFYING INDIVIDUALS (1) 07 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-QUALIFYING INDIVIDUALS (2) 08 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-OTHER DUAL ELIGIBLES 09 = IN MSIS, ELIGIBLE IS ENTITLED TO MEDICARE-DUAL ELIGIBILITY CATEGORY UNKNOWN 10 = IN MSIS, S-CHIP ELIGIBLE IS ENTITLED TO MEDICARE 50 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODES 01-09 DO NOT APPLY 51 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 01 APPLIES 52 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 02 APPLIES 53 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 03 APPLIES 54 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 04 APPLIES 55 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 05 APPLIES 56 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 06 APPLIES 57 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 07 APPLIES 58 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 08 APPLIES 59 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE ELIGIBLE AND CODE 09 APPLIES 60 = A RECORD WAS FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB) FOR THE S-CHIP ELIGIBLE AND CODE 10 APPLIES 99 = IN MSIS, ELIGIBLE'S MEDICARE STATUS IS UNKNOWN Home Variable List - MAX - PS 52. STATE_SPECIFIC_ELIGIBILITY_MO_01 Type: CHAR Length: 6 Label: (Blanked) STATE-SPECIFIC ELIGIBILITY CODE - FIRST MONTH Blanked. Values: Blanked Home Variable List - MAX - PS 64. SMRF_UNIFORM_ELIGIBILITY_MO_01 Type: CHAR Length: 2 Label: MAX UNIFORM ELIGIBILITY CODE - FIRST MONTH DESCRIPTION: MEDICAID ANALYTIC EXTRACT (MAX) UNIFORM ELIGIBILITY CODE FOR THE MEDICAID ELIGIBLE AND FOR THE RESPECTIVE MONTH. PS DED Page 50 CODES: 00 = NOT ELIGIBLE 11 = AGED, CASH 12 = BLIND/DISABLE. Values: CODES: 00 = NOT ELIGIBLE 11 = AGED, CASH 12 = BLIND/DISABLED, CASH 14 = CHILD (NOT CHILD OF UNEMPLOYED ADULT, NOT FOSTER CARE CHILD), ELIGIBLE UNDER SECTION 1931 OF THE ACT 15 = ADULT (NOT BASED ON UNEMPLOYMENT STATUS), ELIGIBLE UNDER SECTION 1931 OF THE ACT 16 = CHILD OF UNEMPLOYED ADULT, ELIGIBLE UNDER SECTION 1931 OF THE ACT 17 = UNEMPLOYED ADULT, ELIGIBLE UNDER SECTION 1931 OF THE ACT 21 = AGED, MEDICALLY NEEDY 22 = BLIND/DISABLED, MEDICALLY NEEDY 24 = CHILD, MEDICALLY NEEDY (FORMERLY AFDC CHILD, MEDICALLY NEEDY) 25 = ADULT, MEDICALLY NEEDY (FORMERLY AFDC ADULT, MEDICALLY NEEDY) 31 = AGED, POVERTY 32 = BLIND/DISABLED, POVERTY 34 = CHILD, POVERTY (INCLUDES MEDICAID EXPANSION CHIP CHILDREN) 35 = ADULT, POVERTY 3A = INDIVIDUAL COVERED UNDER THE BREAST AND CERVICAL CANCER PREVENTION ACT OF 2000, POVERTY 41 = OTHER AGED 42 = OTHER BLIND/DISABLED 44 = OTHER CHILD 45 = OTHER ADULT 48 = FOSTER CARE CHILD 51 = AGED, SECTION 1115 DEMONSTRATION EXPANSION 52 = BLIND/DISABLED, SECTION 1115 DEMONSTRATION EXPANSION 54 = CHILD, SECTION 1115 DEMONSTRATION EXPANSION 55 = ADULT, SECTION 1115 DEMONSTRATION EXPANSION 99 = UNKNOWN ELIGIBILITY Home Variable List - MAX - PS 76. PRIVATE_HEALTH_INSURANCE_MO_01 Type: NUM Length: 1 Label: PRIVATE INSURANCE CODE - FIRST MONTH DESCRIPTION: CODE INDICATING IF THE ELIGIBLE HAD PRIVATE INSURANCE FOR THE RESPECTIVE MONTH. CODES: 0 = NOT ELIGIBLE FOR MEDICAID OR CHIP DURING MONTH 1 = ELIGIBLE DID NOT HAVE PRIVATE (INDIVIDUAL OR. Values: CODES: 0 = NOT ELIGIBLE FOR MEDICAID OR CHIP DURING MONTH 1 = ELIGIBLE DID NOT HAVE PRIVATE (INDIVIDUAL OR EMPLOYER-SPONSORED) INSURANCE COVERAGE 2 = ELIGIBLE HAD PRIVATE (INDIVIDUAL OR EMPLOYER-SPONSORED) HEALTH INSURANCE COVERAGE PURCHASED WHOLE OR IN PART BY ELIGIBLE OR FAMILY MEMBER, OR PROVIDED AT NO COST TO ELIGIBLE 3 = ELIGIBLE HAD PRIVATE (INDIVIDUAL OR EMPLOYER-SPONSORED) HEALTH INSURANCE COVERAGE PURCHASED OR SUBSIDIZED, BY THE STATE 4 = BOTH 2 AND 3 APPLY 9 = STATE HAD ONLY INVALID OR MISSING INFORMATION Home Variable List - MAX - PS 88. MEDICARE_BENEFICIARY_MO_01 Type: NUM Length: 1 Label: MEDICARE BENEFICIARY CODE - FIRST MONTH DESCRIPTION: CODE INDICATING WHETHER THE MEDICAID ELIGIBLE WAS COVERED BY MEDICARE FOR THE RESPECTIVE MONTH (BASED ON FINDING A BENEFICIARY RECORD FOR THE ELIGIBLE IN THE MEDICARE ENROLLMENT. Values: CODES: 0 = THERE WAS NO RECORD OF ELIGIBILITY FOR THE MONTH FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB). 1 = THERE WAS A RECORD OF ELIGIBILITY FOR THE MONTH FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB), FOR MEDICARE PART A (HOSPITAL INSURANCE). 2 = THERE WAS A RECORD OF ELIGIBILITY FOR THE MONTH FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB), FOR MEDICARE PART B (SUPPLEMENTARY MEDICAL INSURANCE). 3 = THERE WAS A RECORD OF ELIGIBILITY FOR THE MONTH FOUND IN THE MEDICARE ENROLLMENT DATA BASE (EDB), FOR BOTH MEDICARE PART A AND PART B (BOTH HOSPITAL AND SUPPLEMENTARY MEDICAL INSURANCE). Home Variable List - MAX - PS 100. EL_PPH_PLN_MO_CNT_CMCP Type: NUM Length: 2 Label: PRE-PAID PLAN TYPE-1 CODE - FIRST MONTH DESCRIPTION: CODE INDICATING THE TYPE OF THE FIRST OF UP TO FOUR MANAGED CARE PLAN TYPES IN WHICH THE ELIGIBLE WAS ENROLLED FOR THE RESPECTIVE MONTH. PS DED Page 60 CODES: 00 = INDIVIDUAL WAS NOT ELIG. Values: CODES: 00 = INDIVIDUAL WAS NOT ELIGIBLE FOR MEDICAID THIS MONTH. 01 = ELIGIBLE IS ENROLLED IN A MEDICAL OR COMPREHENSIVE MANAGED CARE PLAN THIS MONTH (E.G. HMO). 02 = ELIGIBLE IS ENROLLED IN A DENTAL MANAGED CARE PLAN THIS MONTH. 03 = ELIGIBLE IS ENROLLED IN A BEHAVIORAL MANAGED CARE PLAN THIS MONTH. 04 = ELIGIBLE IS ENROLLED IN A PRENATAL/DELIVERY MANAGED CARE PLAN THIS MONTH. 05 = ELIGIBLE IS ENROLLED IN A LONG-TERM CARE MANAGED CARE PLAN THIS MONTH. 06 = ELIGIBLE IS ENROLLED IN A PROGRAM FOR ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PLAN THIS MONTH. 07 = ELIGIBLE IS ENROLLED IN A PRIMARY CARE CASE MANAGEMENT (PCCM) PLAN THIS MONTH. 08 = ELIGIBLE IS ENROLLED IN AN OTHER MANAGED CARE PLAN THIS MONTH. 88 = NOT APPLICABLE, INDIVIDUAL IS ELIGIBLE FOR MEDICAID, BUT NOT ENROLLED IN A MANAGED CARE PLAN THIS MONTH. 99 = ELIGIBLE'S MANAGED CARE PLAN STATUS IS UNKNOWN THIS MONTH. Home Variable List - MAX - PS 101. EL_PPH_PLN_MO_CNT_DMCP Type: CHAR Length: 12 Label: (Blanked) PRE-PAID PLAN IDENTIFIER-1 - FIRST MONTH Blanked. Values: Blanked Home Variable List - MAX - PS 102. EL_PPH_PLN_MO_CNT_BMCP Type: NUM Length: 2 Label: PRE-PAID PLAN TYPE-2 CODE - FIRST MONTH DESCRIPTION: CODE INDICATING THE TYPE OF THE SECOND OF UP TO FOUR MANAGED CARE PLAN TYPES IN WHICH THE ELIGIBLE WAS ENROLLED FOR THE RESPECTIVE MONTH. PS DED Page 62 CODES: 00 = INDIVIDUAL WAS NOT ELI. Values: CODES: 00 = INDIVIDUAL WAS NOT ELIGIBLE FOR MEDICAID THIS MONTH. 01 = ELIGIBLE IS ENROLLED IN A MEDICAL OR COMPREHENSIVE MANAGED CARE PLAN THIS MONTH (E.G. HMO). 02 = ELIGIBLE IS ENROLLED IN A DENTAL MANAGED CARE PLAN THIS MONTH. 03 = ELIGIBLE IS ENROLLED IN A BEHAVIORAL MANAGED CARE PLAN THIS MONTH. 04 = ELIGIBLE IS ENROLLED IN A PRENATAL/DELIVERY MANAGED CARE PLAN THIS MONTH. 05 = ELIGIBLE IS ENROLLED IN A LONG-TERM CARE MANAGED CARE PLAN THIS MONTH. 06 = ELIGIBLE IS ENROLLED IN A PROGRAM FOR ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PLAN THIS MONTH. 07 = ELIGIBLE IS ENROLLED IN A PRIMARY CARE CASE MANAGEMENT (PCCM) PLAN THIS MONTH. 08 = ELIGIBLE IS ENROLLED IN AN OTHER MANAGED CARE PLAN THIS MONTH. 88 = NOT APPLICABLE, INDIVIDUAL IS ELIGIBLE FOR MEDICAID, BUT NOT ENROLLED IN A MANAGED CARE PLAN THIS MONTH. 99 = ELIGIBLE'S MANAGED CARE PLAN STATUS IS UNKNOWN THIS MONTH. Home Variable List - MAX - PS 103. EL_PPH_PLN_MO_CNT_PDMC Type: CHAR Length: 12 Label: (Blanked) PRE-PAID PLAN IDENTIFIER-2 - FIRST MONTH Blanked. Values: Blanked Home Variable List - MAX - PS 104. EL_PPH_PLN_MO_CNT_LTCM Type: NUM Length: 2 Label: PRE-PAID PLAN TYPE-3 CODE - FIRST MONTH DESCRIPTION: CODE INDICATING THE TYPE OF THE THIRD OF UP TO FOUR MANAGED CARE PLAN TYPES IN WHICH THE ELIGIBLE WAS ENROLLED FOR THE RESPECTIVE MONTH. PS DED Page 64 CODES: 00 = INDIVIDUAL WAS NOT ELIG. Values: CODES: 00 = INDIVIDUAL WAS NOT ELIGIBLE FOR MEDICAID THIS MONTH. 01 = ELIGIBLE IS ENROLLED IN A MEDICAL OR COMPREHENSIVE MANAGED CARE PLAN THIS MONTH (E.G. HMO). 02 = ELIGIBLE IS ENROLLED IN A DENTAL MANAGED CARE PLAN THIS MONTH. 03 = ELIGIBLE IS ENROLLED IN A BEHAVIORAL MANAGED CARE PLAN THIS MONTH. 04 = ELIGIBLE IS ENROLLED IN A PRENATAL/DELIVERY MANAGED CARE PLAN THIS MONTH. 05 = ELIGIBLE IS ENROLLED IN A LONG-TERM CARE MANAGED CARE PLAN THIS MONTH. 06 = ELIGIBLE IS ENROLLED IN A PROGRAM FOR ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PLAN THIS MONTH. 07 = ELIGIBLE IS ENROLLED IN A PRIMARY CARE CASE MANAGEMENT (PCCM) PLAN THIS MONTH. 08 = ELIGIBLE IS ENROLLED IN AN OTHER MANAGED CARE PLAN THIS MONTH. 88 = NOT APPLICABLE, INDIVIDUAL IS ELIGIBLE FOR MEDICAID, BUT NOT ENROLLED IN A NAMED CARE PLAN THIS MONTH. 99 = ELIGIBLE'S MANAGED CARE PLAN STATUS IS UNKNOWN THIS MONTH. Home Variable List - MAX - PS 105. EL_PPH_PLN_MO_CNT_AICE Type: CHAR Length: 12 Label: (Blanked) PRE-PAID PLAN IDENTIFIER-3 - FIRST MONTH Blanked. Values: Blanked Home Variable List - MAX - PS 106. EL_PPH_PLN_MO_CNT_PCCM Type: NUM Length: 2 Label: PRE-PAID PLAN TYPE-4 CODE - FIRST MONTH DESCRIPTION: CODE INDICATING THE TYPE OF THE FOURTH OF UP TO FOUR MANAGED CARE PLAN TYPES IN WHICH THE ELIGIBLE WAS ENROLLED FOR THE RESPECTIVE MONTH. PS DED Page 66 CODES: 00 = INDIVIDUAL WAS NOT ELI. Values: CODES: 00 = INDIVIDUAL WAS NOT ELIGIBLE FOR MEDICAID THIS MONTH. 01 = ELIGIBLE IS ENROLLED IN A MEDICAL OR COMPREHENSIVE MANAGED CARE PLAN THIS MONTH (E.G. HMO). 02 = ELIGIBLE IS ENROLLED IN A DENTAL MANAGED CARE PLAN THIS MONTH. 03 = ELIGIBLE IS ENROLLED IN A BEHAVIORAL MANAGED CARE PLAN THIS MONTH. 04 = ELIGIBLE IS ENROLLED IN A PRENATAL/DELIVERY MANAGED CARE PLAN THIS MONTH. 05 = ELIGIBLE IS ENROLLED IN A LONG-TERM CARE MANAGED CARE PLAN THIS MONTH. 06 = ELIGIBLE IS ENROLLED IN A PROGRAM FOR ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) PLAN THIS MONTH. 07 = ELIGIBLE IS ENROLLED IN A PRIMARY CARE CASE MANAGEMENT (PCCM) PLAN THIS MONTH. 08 = ELIGIBLE IS ENROLLED IN AN OTHER MANAGED CARE PLAN THIS MONTH. 88 = NOT APPLICABLE, INDIVIDUAL IS ELIGIBLE FOR MEDICAID, BUT NOT ENROLLED IN A MANAGED CARE PLAN THIS MONTH. 99 = ELIGIBLE'S MANAGED CARE PLAN STATUS IS UNKNOWN THIS MONTH. Home Variable List - MAX - PS 107. PREPAID_PLAN_TYPE_1_MO_01 Type: NUM Length: 2 Label: PRE-PAID PLAN MONTHS COUNT - FIRST PLAN TYPE DESCRIPTION: TOTAL NUMBER OF MONTHS THE MEDICAID ELIGIBLE WAS ENROLLED IN THE PARTICULAR TYPE OF PLAN DURING THE CALENDAR YEAR. USER NOTE: THIS IS A NUMBER FROM 0 TO 12. IT IS GIVEN VALUE > 0 BASED ON. Home Variable List - MAX - PS 114. PREPAID_PLAN_IDENTIFIER_4_MO_01 Type: CHAR Length: 12 Label: (Blanked) PRE-PAID PLAN IDENTIFIER-4 - FIRST MONTH Blanked. Values: Blanked Home Variable List - MAX - PS 203. MANAGED_CARE_COMBINATIONS_MO_01 Type: NUM Length: 2 Label: MEDICAID MANAGED CARE COMBINATIONS - FIRST MONTH DESCRIPTION: CODE INDICATING THE TYPES OF MANAGED CARE THE ELIGIBLE WAS ENROLLED IN FOR THE RESPECTIVE MONTH. PS DED Page 69 CODES: 00 = INDIVIDUAL WAS NOT ELIGIBLE FOR MEDICAID THIS MONTH 01 = COMPRE. Values: CODES: 00 = INDIVIDUAL WAS NOT ELIGIBLE FOR MEDICAID THIS MONTH 01 = COMPREHENSIVE PLAN ONLY 02 = DENTAL PLAN ONLY 03 = BEHAVIORAL PLAN ONLY 04 = PRIMARY CARE CASE MANAGEMENT (PCCM) PLAN ONLY 05 = OTHER MANAGED CARE PLAN ONLY 06 = COMPREHENSIVE PLAN AND DENTAL PLAN 07 = COMPREHENSIVE PLAN AND BEHAVIORAL PLAN 08 = COMPREHENSIVE PLAN AND OTHER MANAGED CARE PLAN 09 = COMPREHENSIVE PLAN, DENTAL PLAN AND BEHAVIORAL PLAN 10 = PRIMARY CARE CASE MANAGEMENT (PCCM) AND DENTAL PLAN 11 = PRIMARY CARE CASE MANAGEMENT (PCCM) AND BEHAVIORAL PLAN 12 = PRIMARY CARE CASE MANAGEMENT (PCCM) AND OTHER MANAGED CARE PLAN 13 = PRIMARY CARE CASE MANAGEMENT (PCCM), DENTAL PLAN AND BEHAVIORAL PLAN 14 = DENTAL PLAN AND BEHAVIORAL PLAN 15 = OTHER COMBINATIONS 16 = FEE FOR SERVICE (NO MANAGED CARE PLAN REPORTED) 99 = ELIGIBLE'S MANAGED CARE PLAN STATUS IS UNKNOWN THIS MONTH THE FOLLOWING IS HOW MSIS DATA ELEMENTS PLAN-TYPE-1 TO PLAN-TYPE-4 ARE MAPPED INTO THE CODE VALUES FOR THIS DATA ELEMENT: MAX MSIS CODE CODE 00 = 00 IN ALL FOUR PLAN TYPES THIS MONTH - PERSON WAS NOT ELIGIBLE FOR MEDICAID THIS MONTH 01 = 01 ELIGIBLE IS ENROLLED IN A MEDICAL OR COMPREHENSIVE MANAGED CARE PLAN THIS MONTH (E.G. HMO), AND NO OTHER TYPE OF PLAN 02 = 02 ELIGIBLE IS ENROLLED IN A DENTAL MANAGED CARE PLAN THIS MONTH, AND NO OTHER TYPE OF PLAN 03 = 03 ELIGIBLE IS ENROLLED IN A BEHAVIORAL MANAGED CARE PLAN THIS MONTH, AND NO OTHER TYPE OF PLAN 04 = 07 ELIGIBLE IS ENROLLED IN A PRIMARY CARE CASE MANAGEMENT MANAGED CARE PLAN THIS MONTH, AND NO OTHER TYPE OF PLAN 05 = 04 ELIGIBLE IS ENROLLED IN A PRENATAL/DELIVERY MANAGED CARE PLAN THIS MONTH, OR 05 = 05 ELIGIBLE IS ENROLLED IN A LONG-TERM CARE MANAGED CARE PLAN THIS MONTH, OR 05 = 06 ELIGIBLE IS ENROLLED IN A PROGRAM FOR ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) THIS MONTH, OR 05 = 08 ELIGIBLE IS ENROLLED IN AN OTHER MANAGED CARE PLAN THIS MONTH, OR (ONE OR MORE OF THE MSIS CODES 04, 05, 06, 08 THIS MONTH) 06 = 01 AND 02 07 = 01 AND 03 08 = 01 AND (ONE OR MORE OF THE MSIS CODES 04, 05, 06, 08 THIS MONTH) 09 = 01 AND 02 AND 03 10 = 07 AND 02 11 = 07 AND 03 12 = 07 AND (ONE OR MORE OF THE MSIS CODES 04, 05, 06, 08 THIS MONTH) 13 = 07 AND 02 AND 03 14 = 02 AND 03 15 = ALL OTHER COMBINATIONS OF MANAGED CARE PLAN CODES THIS MONTH (INCLUDING 99 AND ONE OR MORE OTHER MSIS CODES) 16 = 88 IN ALL FOUR MSIS PLAN TYPES THIS MONTH - PERSON WAS ELIGIBLE THIS MONTH BUT NOT ENROLLED IN MANAGED CARE 99 = 99 IN ALL FOUR MSIS PLAN TYPES THIS MONTH - ELIGIBLE'S MANAGED CARE PLAN STATUS IS UNKNOWN THIS MONTH Home Variable List - MAX - PS 215. DAYS_OF_ELIGIBILITY_MO_01 Type: NUM Length: 2 Label: DAYS OF ELIGIBILITY - FIRST MONTH DESCRIPTION: THE NUMBER OF DAYS THE ELIGIBLE WAS ENROLLED IN MEDICAID FOR THE RESPECTIVE MONTH. USER NOTE: WHEN SOMEONE HAS CLAIMS BUT NO ELIGIBILITY INFORMATION, THIS DATA ELEMENT IS 0-FILLED. SOURCE. Home Variable List - MAX - PS 227. TANF_CASH_ELIGIBILITY_MO_01 Type: NUM Length: 1 Label: TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF) CASH FLAG - FIRST MONTH DESCRIPTION: CODE INDICATING WHETHER THE ELIGIBLE RECEIVED TEMPORARY ASSISTANCE FOR NEEDY FAMILIES (TANF) BENEFITS FOR THE RESPECTIVE MONTH. PS DED Page 74 CODES: 0 = INDIVIDUAL WAS NOT EL. Values: CODES: 0 = INDIVIDUAL WAS NOT ELIGIBLE FOR MEDICAID AT ANY TIME DURING THE MONTH. 1 = INDIVIDUAL DID NOT RECEIVE TANF BENEFITS DURING THE MONTH. 2 = INDIVIDUAL DID RECEIVE TANF BENEFITS DURING THE MONTH (STATES SHOULD ONLY USE THIS VALUE IF THEY CAN ACCURATELY SEPARATE ELIGIBLES RECEIVING TANF BENEFITS FROM OTHER SECTION 1931 ELIGIBLES REPORTED INTO MAS VALUE = 1). 9 = INDIVIDUAL'S TANF STATUS IS UNKNOWN. Home Variable List - MAX - PS 239. RESTRICTED_BENEFITS_MO_01 Type: CHAR Length: 1 Label: RESTRICTED BENEFITS FLAG - FIRST MONTH DESCRIPTION: CODE INDICATING THE SCOPE OF MEDICAID BENEFITS TO WHICH AN ELIGIBLE IS ENTITLED FOR THE RESPECTIVE MONTH. CODES: 0 = INDIVIDUAL IS NOT ELIGIBLE FOR MEDICAID OR CHIP DURING THE MONTH. 1 =. Values: CODES: 0 = INDIVIDUAL IS NOT ELIGIBLE FOR MEDICAID OR CHIP DURING THE MONTH. 1 = INDIVIDUAL IS ELIGIBLE FOR MEDICAID OR CHIP DURING THE MONTH AND IS ENTITLED TO THE FULL SCOPE OF MEDICAID BENEFITS. 2 = INDIVIDUAL IS ELIGIBLE FOR MEDICAID OR M-CHIP DURING THE MONTH BUT ONLY ENTITLED TO RESTRICTED BENEFITS BASED ON ALIEN STATUS (INCLUDING ILLEGAL ENTRANTS AND LEGAL ENTRANTS DURING THE 5-YEAR WAITING PERIOD). 3 = INDIVIDUAL IS ELIGIBLE FOR MEDICAID DURING THE MONTH BUT ONLY ENTITLED TO RESTRICTED BENEFITS BASED ON MEDICAID DUAL ELIGIBILITY STATUS (E.G. QMB ONLY OR SLMB ONLY). 4 = INDIVIDUAL IS ELIGIBLE FOR MEDICAID OR CHIP DURING THE MONTH BUT ONLY ENTITLED TO RESTRICTED BENEFITS FOR PREGNANCY-RELATED SERVICES. 5 = INDIVIDUAL IS ELIGIBLE FOR MEDICAID OR M-CHP DURING THE MONTH BUT ONLY ENTITLED TO RESTRICTED BENEFITS FOR REASONS OTHER THAN ALIEN, DUAL ELIGIBILITY OR PREGNANCY RELATED STATUS (E.G. RESTRICTED BENEFITS BASED UPON SUBSTANCE ABUSE, MEDICALLY NEEDY OR OTHER CRITERIA). 6 = INDIVIDUAL IS ELIGIBLE FOR MEDICAID OR M-CHIP BUT ONLY ENTITLED TO RECEIVE FAMILY PLANNING SERVICES (BEGINNING IN 2001). 7 = INDIVIDUAL IS ELIGIBLE FOR MEDICAID AND ENTITLED TO MEDICAID BENEFITS UNDER AN ALTERNATIVE PACKAGE OF BENCHMARK-EQUIVALENT COVERAGE, AS ENACTED BY THE DEFICIT REDUCTION ACT OF 2005. 8 = INDIVIDUAL IS ELIGIBLE FOR MEDICAID AND ENTITLED TO BENEFITS UNDER A 'MONEY FOLLOWS THE PERSON' (MFP) REBALANCING DEMONSTRATION, AS ENACTED BY THE DEFICIT REDUCTION ACT OF 2005, TO ALLOW STATES TO DEVELOP COMMUNITY-BASED LONG-TERM CARE OPPORTUNITIES. 9 = INDIVIDUAL'S BENEFIT RESTRICTIONS ARE UNKNOWN. A = INDIVIDUAL IS ELIGIBLE FOR MEDICAID AND ENTITLED TO BENEFITS UNDER THE PSYCHIATRIC RESIDENTIAL TREATMENT FACILITIES DEMONSTRATION GRANT PROGRAM (PRTF), AS ENACTED BY THE DEFICIT REDUCTION ACT OF 2005. PRTF GRANTS ASSIST STATES TO HELP PROVIDE COMMUNITY ALTERNATIVES TO PSYCHIATRIC RESIDENT TREATMENT FACILITIES FOR CHILDREN. B = INDIVIDUAL IS ELIGIBLE FOR MEDICAID AND ENTITLED TO MEDICAID BENEFITS USING A HEALTH OPPORTUNITY ACCOUNT (HOA). C = INDIVIDUAL IS ELIGIBLE FOR SEPARATE CHIP DENTAL COVERAGE (SUPPLEMENTAL DENTAL WRAPAROUND BENEFIT TO EMPLOYER-SPONSORED INSURANCE). W = INDIVIDUAL IS ONLY ELIGIBLE FOR MEDICAID HEALTH INSURANCE PREMIUM PAYMENT ASSISTANCE (NO ADDITIONAL TITLE XIX or XXI FFS OR MANAGED CARE WRAPAROUND SERVICES) IN MASSACHUSETTS, NEW JERSEY, OKLAHOMA, OR VERMONT. X = INDIVIDUAL IS ELIGIBLE FOR MEDICAID DURING THE MONTH BUT ONLY ENTITLED TO RECEIVE PRESCRIPTION DRUG BENEFITS (BEGINNING IN 2003). Y = INDIVIDUAL IS ELIGIBLE FOR MEDICAID AND MEDICARE DURING THE MONTH BUT ONLY ENTITLED TO RECEIVE PRESCRIPTION DRUG BENEFITS AND RESTRICTED BENEFITS BASED ON MEDICAID DUAL ELIGIBILITY STATUS (E.G. QMB ONLY, SLMB ONLY, OR QDWI OR QI). (BEGINNING IN 2003) Z = INDIVIDUAL IS ELIGIBLE FOR MEDICAID AND MEDICARE DURING THE MONTH BUT ONLY ENTITLED TO RECEIVE PRESCRIPTION DRUG BENEFITS. THE EDB LINK FOUND THAT THE INDIVIDUAL WAS ALSO ELIGIBLE FOR MEDICARE, BUT THE MEDICAID PROGRAM WAS NOT PAYING RESTRICTED BENEFITS BASED ON MEDICAID DUAL ELIGIBILITY STATUS (E.G. QMB ONLY, SLMB ONLY, QDWI OR QI). (BEGINNING IN 2003) Home Variable List - MAX - PS 251. SCHIP_ELIGIBILITY_MO_01 Type: NUM Length: 1 Label: CHILD HEALTH INSURANCE PROGRAM (CHIP) CODE - FIRST MONTH DESCRIPTION: CODE INDICATING WHETHER THE INDIVIDUAL WAS ELIGIBLE FOR THE CHILD HEALTH INSURANCE PROGRAM (CHIP) FOR THE RESPECTIVE MONTH. PS DED Page 79 CODES: 0 = INDIVIDUAL WAS NOT A MEDICAI. Values: CODES: 0 = INDIVIDUAL WAS NOT A MEDICAID ELIGIBLE (INCLUDING M-CHIP) AND NOT ELIGIBLE FOR SEPARATE CHIP DURING THE MONTH. 1 = INDIVIDUAL WAS A MEDICAID ELIGIBLE, BUT WAS NOT INCLUDED IN EITHER A MEDICAID EXPANSION CHIP OR A SEPARATE TITLE XXI CHIP PROGRAM DURING THE MONTH. 2 = INDIVIDUAL WAS ENROLLED IN THE MEDICAID EXPANSION CHIP PROGRAM (M-CHIP) AND SUBJECT TO ENHANCED FEDERAL MATCHING FUNDS DURING THE MONTH. 3 = INDIVIDUAL WAS NOT A MEDICAID ELIGIBLE (INCLUDING M-CHIP), BUT WAS INCLUDED IN A NON MEDICAID EXPANSION TITLE XXI CHIP PROGRAM DURING THE MONTH (S-CHIP). REPORTING OF MSIS ELIGIBILITY RECORDS FOR THESE NON-MEDICAID CHIP INDIVIDUALS IS OPTIONAL FOR STATES. 9 = CHIP STATUS IS UNKNOWN. Home Variable List - MAX - PS 263. MAX_WAIVER_TYPE_CODE_1_01 Type: CHAR Length: 1 Label: MAX WAIVER TYPE CODE - 1 - FIRST MONTH DESCRIPTION: CODE INDICATING WAIVER TYPE. BLANK = INDIVIDUAL’S WAIVER ENROLLMENT IS UNKNOWN (PERSON WITH MISSING ELIGIBILITY INFORMATION) 0 = INDIVIDUAL WAS NOT ELIGIBLE FOR MEDICAID OR CHIP THIS MO. Home Variable List - MAX - PS 264. WAIVER_ID_1_01 Type: CHAR Length: 2 Label: WAIVER ID - 1 - FIRST MONTH DESCRIPTION: STATE-ASSIGNED WAIVER IDENTIFICATION NUMBER. USER NOTE: THIS DATA ELEMENT IS 0-FILLED FOR INDIVIDUALS NOT ELIGIBLE FOR MEDICAID DURING THE MONTH, 8-FILLED FOR INDIVIDUALS. Home Variable List - MAX - PS 265. MAX_WAIVER_TYPE_CODE_2_01 Type: CHAR Length: 1 Label: MAX WAIVER TYPE CODE - 2 - FIRST MONTH DESCRIPTION: CODE INDICATING WAIVER TYPE. CODES: BLANK = INDIVIDUAL’S WAIVER ENROLLMENT IS UNKNOWN (PERSON WITH MISSING ELIGIBILITY INFORMATION) 0 = INDIVIDUAL WAS NOT ELIGIBLE FOR MEDICAID OR CHIP. Values: CODES: BLANK = INDIVIDUAL’S WAIVER ENROLLMENT IS UNKNOWN (PERSON WITH MISSING ELIGIBILITY INFORMATION) 0 = INDIVIDUAL WAS NOT ELIGIBLE FOR MEDICAID OR CHIP THIS MONTH 1 = ENROLLED IN SECTION 1115 WAIVER THIS MONTH 2 = ENROLLED IN SECTION 1915(B) WAIVER THIS MONTH 4 = ENROLLED IN COMBINED SECTION 1915(B)(C) WAIVER THIS MONTH 5 = ENROLLED IN SECTION 1115 HIFA (HEALTH INSURANCE AND FLEXIBILITY AND ACCOUNTABILITY) WAIVER THIS MONTH 6 = SECTION 1115 PHARMACY WAIVER COVERAGE THIS MONTH 7 = ENROLLED IN OTHER TYPE OF WAIVER THIS MONTH 8 = NOT APPLICABLE (NOT ENROLLED IN A WAIVER THIS MONTH) 9 = ENROLLED IN UNKNOWN TYPE OF WAIVER THIS MONTH A = ENROLLED IN SECTION 1115 DISASTER-RELATED WAIVER THAT ALLOWS FOR COVERAGE RELATED TO A HURRICANE OR OTHER DISASTER THIS MONTH F = ENROLLED IN SECTION 1115 FAMILY PLANNING-ONLY WAIVER THIS MONTH G = ENROLLED IN SECTION 1915(C) WAIVER FOR AGED AND DISABLED (A/D) THIS MONTH H = ENROLLED IN SECTION 1915(C) WAIVER FOR AGED THIS MONTH I = ENROLLED IN SECTION 1915(C) WAIVER FOR PHYSICALLY DISABLED (PD) THIS MONTH J = ENROLLED IN SECTION 1915(C) WAIVER FOR PEOPLE WITH BRAIN INJURIES (BI) THIS MONTH K = ENROLLED IN SECTION 1915(C) WAIVER FOR PEOPLE WITH HIV/AIDS THIS MONTH L = ENROLLED IN SECTION 1915(C) WAIVER FOR INTELLECTUALLY DISABLED/DEVELOPMENTALLY DISABLED/ (ID/DD) THIS MONTH M = ENROLLED IN SECTION 1915(C) WAIVER FOR PEOPLE WITH MENTAL ILLNESS/SERIOUS EMOTIONAL DISTURBANCE (MI/SED) THIS MONTH N = ENROLLED IN SECTION 1915(C) WAIVER FOR TECHNOLOGY DEPENDENT/MEDICALLY FRAGILE THIS MONTH O = ENROLLED IN SECTION 1915(C) WAIVER FOR UNSPECIFIED OR UNKNOWN POPULATIONS P = ENROLLED IN SECTION 1915(C) WAIVER FOR AUTISM/AUTISM SPECTRUM DISORDER THIS MONTH Home Variable List - MAX - PS 266. WAIVER_ID_2_01 Type: CHAR Length: 2 Label: WAIVER ID - 2 - FIRST MONTH DESCRIPTION: STATE-ASSIGNED WAIVER IDENTIFICATION NUMBER. USER NOTE: THIS DATA ELEMENT IS 0-FILLED FOR INDIVIDUALS NOT ELIGIBLE FOR MEDICAID DURING THE MONTH, 8-FILLED FOR INDIVIDUALS. Home Variable List - MAX - PS 267. MAX_WAIVER_TYPE_CODE_3_01 Type: CHAR Length: 1 Label: MAX WAIVER TYPE CODE - 3 - FIRST MONTH DESCRIPTION: CODE INDICATING WAIVER TYPE. CODES: BLANK = INDIVIDUAL’S WAIVER ENROLLMENT IS UNKNOWN (PERSON WITH MISSING ELIGIBILITY INFORMATION) 0 = INDIVIDUAL WAS NOT ELIGIBLE FOR MEDICAID OR CHIP. Values: CODES: BLANK = INDIVIDUAL’S WAIVER ENROLLMENT IS UNKNOWN (PERSON WITH MISSING ELIGIBILITY INFORMATION) 0 = INDIVIDUAL WAS NOT ELIGIBLE FOR MEDICAID OR CHIP THIS MONTH 1 = ENROLLED IN SECTION 1115 WAIVER THIS MONTH 2 = ENROLLED IN SECTION 1915(B) WAIVER THIS MONTH 4 = ENROLLED IN COMBINED SECTION 1915(B)(C) WAIVER THIS MONTH 5 = ENROLLED IN SECTION 1115 HIFA (HEALTH INSURANCE AND FLEXIBILITY AND ACCOUNTABILITY) WAIVER THIS MONTH 6 = SECTION 1115 PHARMACY WAIVER COVERAGE THIS MONTH 7 = ENROLLED IN OTHER TYPE OF WAIVER THIS MONTH 8 = NOT APPLICABLE (NOT ENROLLED IN A WAIVER THIS MONTH) 9 = ENROLLED IN UNKNOWN TYPE OF WAIVER THIS MONTH A = ENROLLED IN SECTION 1115 DISASTER-RELATED WAIVER THAT ALLOWS FOR COVERAGE RELATED TO A HURRICANE OR OTHER DISASTER THIS MONTH F = ENROLLED IN SECTION 1115 FAMILY PLANNING-ONLY WAIVER THIS MONTH G = ENROLLED IN SECTION 1915(C) WAIVER FOR AGED AND DISABLED (A/D) THIS MONTH H = ENROLLED IN SECTION 1915(C) WAIVER FOR AGED THIS MONTH I = ENROLLED IN SECTION 1915(C) WAIVER FOR PHYSICALLY DISABLED (PD) THIS MONTH J = ENROLLED IN SECTION 1915(C) WAIVER FOR PEOPLE WITH BRAIN INJURIES (BI) THIS MONTH K = ENROLLED IN SECTION 1915(C) WAIVER FOR PEOPLE WITH HIV/AIDS THIS MONTH L = ENROLLED IN SECTION 1915(C) WAIVER FOR INTELLECTUALLY DISABLED/DEVELOPMENTALLY DISABLED/ (ID/DD) THIS MONTH M = ENROLLED IN SECTION 1915(C) WAIVER FOR PEOPLE WITH MENTAL ILLNESS/SERIOUS EMOTIONAL DISTURBANCE (MI/SED) THIS MONTH N = ENROLLED IN SECTION 1915(C) WAIVER FOR TECHNOLOGY DEPENDENT/MEDICALLY FRAGILE THIS MONTH O = ENROLLED IN SECTION 1915(C) WAIVER FOR UNSPECIFIED OR UNKNOWN POPULATIONS P = ENROLLED IN SECTION 1915(C) WAIVER FOR AUTISM/AUTISM SPECTRUM DISORDER THIS MONTH Home Variable List - MAX - PS 268. WAIVER_ID_3_01 Type: CHAR Length: 2 Label: WAIVER ID - 3 - FIRST MONTH DESCRIPTION: STATE-ASSIGNED WAIVER IDENTIFICATION NUMBER. USER NOTE: THIS DATA ELEMENT IS 0-FILLED FOR INDIVIDUALS NOT ELIGIBLE FOR MEDICAID DURING THE MONTH, 8-FILLED FOR INDIVIDUALS. Home Variable List - MAX - PS 335. MAX_1915C_WAIVER_TYPE_LTST Type: CHAR Length: 1 Label: ANNUAL 1915(C) MAX WAIVER TYPE - MOST RECENT DESCRIPTION: CODE CONTAINS THE TARGET POPULATION FOR THE ENROLLEE'S MOST RECENT SECTION 1915(C) WAIVER. THE TARGET POPULATION CODES ARE DERIVED FROM THE STATES' WAIVER IDS. PS DED Page 87 C. Values: CODES: BLANK = INDIVIDUAL’S WAIVER ENROLLMENT IS UNKNOWN (PERSON WITH MISSING ELIGIBILITY INFORMATION) 0 = INDIVIDUAL WAS NOT ELIGIBLE FOR MEDICAID OR CHIP THIS MONTH 1 = ENROLLED IN SECTION 1115 WAIVER THIS MONTH 2 = ENROLLED IN SECTION 1915(B) WAIVER THIS MONTH 4 = ENROLLED IN COMBINED SECTION 1915(B)(C) WAIVER THIS MONTH 5 = ENROLLED IN SECTION 1115 HIFA (HEALTH INSURANCE AND FLEXIBILITY AND ACCOUNTABILITY) WAIVER THIS MONTH 6 = SECTION 1115 PHARMACY WAIVER COVERAGE THIS MONTH 7 = ENROLLED IN OTHER TYPE OF WAIVER THIS MONTH 8 = NOT APPLICABLE (NOT ENROLLED IN A WAIVER THIS MONTH) 9 = ENROLLED IN UNKNOWN TYPE OF WAIVER THIS MONTH A = ENROLLED IN SECTION 1115 DISASTER-RELATED WAIVER THAT ALLOWS FOR COVERAGE RELATED TO A HURRICANE OR OTHER DISASTER THIS MONTH F = ENROLLED IN SECTION 1115 FAMILY PLANNING-ONLY WAIVER THIS MONTH G = ENROLLED IN SECTION 1915(C) WAIVER FOR AGED AND DISABLED (A/D) THIS MONTH H = ENROLLED IN SECTION 1915(C) WAIVER FOR AGED THIS MONTH I = ENROLLED IN SECTION 1915(C) WAIVER FOR PHYSICALLY DISABLED (PD) THIS MONTH J = ENROLLED IN SECTION 1915(C) WAIVER FOR PEOPLE WITH BRAIN INJURIES (BI) THIS MONTH K = ENROLLED IN SECTION 1915(C) WAIVER FOR PEOPLE WITH HIV/AIDS THIS MONTH L = ENROLLED IN SECTION 1915(C) WAIVER FOR INTELLECTUALLY DISABLED/DEVELOPMENTALLY DISABLED/ (ID/DD) THIS MONTH M = ENROLLED IN SECTION 1915(C) WAIVER FOR PEOPLE WITH MENTAL ILLNESS/SERIOUS EMOTIONAL DISTURBANCE (MI/SED) THIS MONTH N = ENROLLED IN SECTION 1915(C) WAIVER FOR TECHNOLOGY DEPENDENT/MEDICALLY FRAGILE THIS MONTH O = ENROLLED IN SECTION 1915(C) WAIVER FOR UNSPECIFIED OR UNKNOWN POPULATIONS P = ENROLLED IN SECTION 1915(C) WAIVER FOR AUTISM/AUTISM SPECTRUM DISORDER THIS MONTH Home Variable List - MAX - PS 336. RECIPIENT_INDICATOR Type: CHAR Length: 1 Label: RECIPIENT INDICATOR DESCRIPTION: CODE INDICATING IF AND HOW THE ELIGIBLE RECEIVED A MEDICAID SERVICE DURING THE CALENDAR YEAR AND WHETHER THOSE SERVICES WERE RECEIVED UNDER A FEE-FOR-SERVICE OR PRE-PAID PLAN. Values: CODES: 0 = THE ELIGIBLE PERSON DID NOT RECEIVE ANY SERVICES. 1 = THE ELIGIBLE PERSON HAD ONLY FEE-FOR-SERVICE CLAIMS FOR TYPES OF SERVICE = 1-19, 23-54 AND 99. 2 = THE ELIGIBLE PERSON HAD ONLY PREMIUM PAYMENT CLAIMS (PRE-PAID PLAN) FOR TYPES OF SERVICE = 20-22. 3 = THE ELIGIBLE PERSON HAD ONLY ENCOUNTER RECORDS (PRE-PAID PLAN) FOR TYPES OF SERVICE = 1-19, 23-54, 99. 4 = THE ELIGIBLE PERSON HAD FEE-FOR-SERVICE AND PREMIUM PAYMENT CLAIMS, BUT NO ENCOUNTER RECORDS. 5 = THE ELIGIBLE PERSON HAD PREMIUM PAYMENT CLAIMS AND ENCOUNTER RECORDS, BUT NO FEE-FOR- SERVICE CLAIMS. 6 = THE ELIGIBLE PERSON HAD FEE-FOR-SERVICE CLAIMS AND ENCOUNTER RECORDS, BUT NO PREMIUM PAYMENT CLAIMS. 7 = THE ELIGIBLE PERSON HAD FEE-FOR-SERVICE CLAIMS, PREMIUM PAYMENT CLAIMS AND ENCOUNTER RECORDS. 8 = S-CHIP ENROLLMENT MONTHS WERE FOUND BUT NO MEDICAID ENROLLMENT MONTHS WERE FOUND. 9 = NEITHER S-CHIP ENROLLMENT MONTHS NOR MEDICAID ENROLLMENT MONTHS WERE FOUND. Home Variable List - MAX - PS 337. IP_DISCHARGES Type: NUM* Length: 3 Label: TOTAL INPATIENT DISCHARGE COUNT DESCRIPTION: TOTAL NUMBER OF INPATIENT HOSPITAL DISCHARGES, FOR THE CALENDAR YEAR. (SAS USERS: ZONED DECIMAL - ZD3) USER NOTE: THIS DATA ELEMENT COUNTS THE NUMBER OF INPATIENT HOSPITAL STAY. Home Variable List - MAX - PS 338. IP_STAYS Type: NUM* Length: 3 Label: TOTAL INPATIENT STAY COUNT DESCRIPTION: TOTAL NUMBER OF INPATIENT HOSPITAL STAYS, FOR THE CALENDAR YEAR. (SAS USERS: ZONED DECIMAL - ZD3) USER NOTE: THIS DATA ELEMENT COUNTS THE NUMBER OF INPATIENT HOSPITAL STAYS (A. Home Variable List - MAX - PS 339. LENGTH_OF_STAY_FOR_DISCHARGES Type: NUM* Length: 3 Label: TOTAL INPATIENT LENGTH OF STAY (LOS), IN DAYS (FOR DISCHARGES) DESCRIPTION: TOTAL LENGTH OF STAY, IN DAYS, FOR INPATIENT HOSPITAL DISCHARGES, FOR THE CALENDAR YEAR. (SAS USERS: ZONED DECIMAL - ZD3) USER NOTE: THIS DATA ELEMENT COUNTS THE NUMBER OF DAYS FOR INPATI. Home Variable List - MAX - PS 340. LENGTH_OF_STAY_FOR_STAYS Type: NUM* Length: 3 Label: TOTAL INPATIENT LENGTH OF STAY (LOS), IN DAYS (FOR STAYS) DESCRIPTION: TOTAL LENGTH OF STAY, IN DAYS, FOR INPATIENT HOSPITAL STAYS, FOR THE CALENDAR YEAR. (SAS USERS: ZONED DECIMAL - ZD3) USER NOTE: THIS DATA ELEMENT COUNTS THE NUMBER OF DAYS FOR IN. Home Variable List - MAX - PS 341. COVERED_DAYS_FOR_DISCHARGES Type: NUM* Length: 3 Label: TOTAL INPATIENT COVERED DAY COUNT (FOR DISCHARGES) DESCRIPTION: TOTAL MEDICAID-COVERED DAYS OF CARE FOR INPATIENT HOSPITAL DISCHARGES, FOR THE CALENDAR YEAR. (SAS USERS: ZONED DECIMAL - ZD3) USER NOTE: THIS DATA ELEMENT COUNTS THE NUMBER OF MEDICAID-C. Home Variable List - MAX - PS 342. COVERED_DAYS_FOR_STAYS Type: NUM* Length: 3 Label: TOTAL INPATIENT COVERED DAY COUNT (FOR STAYS) DESCRIPTION: TOTAL MEDICAID-COVERED DAYS OF CARE FOR INPATIENT HOSPITAL STAYS, FOR THE CALENDAR YEAR. (SAS USERS: ZONED DECIMAL - ZD3) USER NOTE: THIS DATA ELEMENT COUNTS THE NUMBER OF MEDICA. Home Variable List - MAX - PS 343. MENTAL_HOSPITAL_COVERED_DAYS Type: NUM* Length: 3 Label: LONG-TERM CARE MENTAL HOSPITAL FOR THE AGED COVERED DAY COUNT DESCRIPTION: TOTAL NUMBER OF MEDICAID-COVERED DAYS FOR THE RECIPIENT IN A MENTAL HOSPITAL FOR THE AGED (NOT A HOSPITAL) FOR THE CALENDAR YEAR. PS DED Page 98 (SAS USERS: ZONED DECIMAL -. Home Variable List - MAX - PS 344. INPATIENT_PSYCH_COVERED_DAYS Type: NUM* Length: 3 Label: LONG-TERM CARE INPATIENT PSYCHIATRIC FACILITY (AGE < 21) COVERED DAY COUNT DESCRIPTION: TOTAL NUMBER OF MEDICAID-COVERED DAYS FOR THE RECIPIENT IN AN INPATIENT PSYCHIATRIC FACILITY FOR INDIVIDUALS UNDER THE AGE OF 21 (NOT A HOSPITAL) FOR THE CALENDAR YEAR. PS DED Page 99 (SA. Home Variable List - MAX - PS 345. ICF_MR_COVERED_DAYS Type: NUM* Length: 3 Label: INTERMEDIATE CARE FACILITY FOR INDIVIDUALS WITH INTELLECTUAL DISABLITIES - ICF-IID COVERED DAY COUNT DESCRIPTION: TOTAL NUMBER OF MEDICAID-COVERED DAYS FOR THE RECIPIENT IN AN INTERMEDIATE CARE FACILITY FOR INDIVIDUALS WITH INTELLECTUAL DISABLITIES - ICF-IID - FOR THE CALENDAR YEAR. PS. Home Variable List - MAX - PS 346. NURSING_FACILITY_COVERED_DAYS Type: NUM* Length: 3 Label: NURSING FACILITY - NF - COVERED DAY COUNT DESCRIPTION: TOTAL NUMBER OF MEDICAID-COVERED DAYS FOR THE RECIPIENT IN A NURSING FACILITY FOR THE CALENDAR YEAR. (SAS USERS: ZONED DECIMAL - ZD3) USER NOTE: DAYS MAY BE > 365 IN SOME STATES. Home Variable List - MAX - PS 347. TOTAL_LT_COVERED_DAYS Type: NUM* Length: 3 Label: LONG-TERM CARE COVERED DAY COUNT DESCRIPTION: TOTAL NUMBER OF MEDICAID-COVERED DAYS FOR THE RECIPIENT IN A LONG-TERM CARE FACILITY (NOT A HOSPITAL), FOR THE CALENDAR YEAR. PS DED Page 102 (SAS USERS: ZONED DECIMAL - ZD3) USER NOTE:. Home Variable List - MAX - PS 348. TOTAL_RECORD_COUNT Type: NUM* Length: 5 Label: TOTAL MEDICAID RECORD COUNT DESCRIPTION: RECIPIENT'S TOTAL NUMBER OF FEE-FOR-SERVICE CLAIMS, PREMIUM PAYMENT CLAIMS AND ENCOUNTER RECORDS FOR THE CALENDAR YEAR, FOR ALL TYPES OF SERVICE AND ANY TYPE OF CLAIM. PS DED Page 104 (SA. Home Variable List - MAX - PS 349. FEE_FOR_SERVICE_CLAIM_COUNT Type: NUM* Length: 5 Label: TOTAL MEDICAID FEE-FOR-SERVICE CLAIM COUNT DESCRIPTION: RECIPIENT'S TOTAL NUMBER OF FEE-FOR-SERVICE CLAIMS FOR THE CALENDAR YEAR, FOR TYPES OF SERVICE = 1-19, 23-54 AND 99 AND TYPE OF CLAIM = 1 (FEE-FOR-SERVICE) OR TYPE OF CLAIM = 5 (SUPPLEMEN. Home Variable List - MAX - PS 350. PREMIUM_PAYMENT_CLAIM_COUNT Type: NUM* Length: 5 Label: TOTAL MEDICAID PRE-PAID PLAN PREMIUM PAYMENT RECORD COUNT DESCRIPTION: RECIPIENT'S TOTAL NUMBER OF PREMIUM PAYMENT CLAIMS FOR THE CALENDAR YEAR, FOR TYPES OF SERVICE = 20-22. (SAS USERS: ZONED DECIMAL - ZD5) USER NOTE: RECORDS WITH TYPES OF SERVICE =. Home Variable List - MAX - PS 351. ENCOUNTER_RECORD_COUNT Type: NUM* Length: 5 Label: TOTAL MEDICAID ENCOUNTER RECORD COUNT DESCRIPTION: RECIPIENT'S TOTAL NUMBER OF ENCOUNTER RECORDS FOR THE CALENDAR YEAR FOR TYPES OF SERVICE = 1-19, 23-54 AND 99 AND TYPE OF CLAIM = 3 (ENCOUNTER RECORD). PS DED Page 107 (SAS USERS: ZONED D. Home Variable List - MAX - PS 352. TOTAL_MEDICAID_PAYMENT_AMOUNT Type: NUM* Length: 8 Label: TOTAL MEDICAID PAYMENT AMOUNT DESCRIPTION: TOTAL AMOUNT OF MONEY PAID BY MEDICAID FOR THE RECIPIENT DURING THE CALENDAR YEAR (FEE-FOR-SERVICE AND PREMIUM PAYMENTS), FOR ALL TYPES OF SERVICE AND ANY TYPE OF CLAIM. PS. Home Variable List - MAX - PS 353. FEE_FOR_SERVICE_MEDICAID_PMT_AMT Type: NUM* Length: 8 Label: TOTAL MEDICAID FEE-FOR-SERVICE PAYMENT AMOUNT DESCRIPTION: AMOUNT OF MONEY PAID BY MEDICAID (UNDER FEE-FOR-SERVICE) FOR THE RECIPIENT DURING THE CALENDAR YEAR, FOR TYPES OF SERVICE = 1-19, 23-54 AND 99 AND TYPE OF CLAIM = 1 (FEE-FO. Home Variable List - MAX - PS 354. PREMIUM_PAYMENT_MEDICAID_PMT_AMT Type: NUM* Length: 8 Label: TOTAL MEDICAID PRE-PAID PLAN PREMIUM PAYMENT AMOUNT DESCRIPTION: AMOUNT OF MONEY PAID BY MEDICAID (PREMIUM PAYMENTS TO PREPAID PLANS) FOR THE RECIPIENT DURING THE CALENDAR YEAR, FOR TYPES OF SERVICE = 20-22. PS DED Page 110 (SAS USERS: ZONED DECIMAL -. Home Variable List - MAX - PS 355. CHARGE_AMOUNT Type: NUM* Length: 8 Label: TOTAL MEDICAID CHARGE AMOUNT DESCRIPTION: TOTAL AMOUNT OF CHARGES BY PROVIDERS TO MEDICAID FOR THE RECIPIENT DURING THE CALENDAR YEAR. (SAS USERS: ZONED DECIMAL - ZD8) USER NOTE: THIS AMOUNT IS NOT APPLICABLE FOR ENCOUNTER OR PRE. Home Variable List - MAX - PS 356. THIRD_PARTY_PAYMENT_AMOUNT Type: NUM* Length: 8 Label: TOTAL THIRD PARTY PAYMENT AMOUNT DESCRIPTION: TOTAL NON-MEDICAID PAYMENTS FOR SERVICES FOR THE RECIPIENT DURING THE CALENDAR YEAR. (SAS USERS: ZONED DECIMAL - ZD8) USER NOTE: THIS AMOUNT IS NOT APPLICABLE FOR ENCOUNTER OR PREMIUM PAY. Home Variable List - MAX - PS 357. INPATIENT_HOSPITAL_RECORDS_PT_2 Type: NUM Length: 3 Label: INPATIENT HOSPITAL RECORDS - FIRST TYPE OF PROGRAM DESCRIPTION: NUMBER OF INPATIENT HOSPITAL RECORDS CONTAINING MSIS PROGRAM TYPE = 2 (FAMILY PLANNING). SOURCE: CREATED USING THE MSIS INPATIENT HOSPITAL CLAIMS FILE. PS DED Page 115. Values: PS DED Page 116 PE Home Variable List - MAX - PS 358. INPATIENT_HOSPITAL_PAYMENTS_PT_2 Type: NUM* Length: 8 Label: INPATIENT HOSPITAL PAYMENTS - FIRST TYPE OF PROGRAM DESCRIPTION: MEDICAID PAYMENT AMOUNT FOR ALL INPATIENT HOSPITAL RECORDS CONTAINING MSIS PROGRAM TYPE = 2 (FAMILY PLANNING). (SAS USERS: ZONED DECIMAL - ZD8) SOURCE: CREATED USING THE MSIS INPATIENT HO. Home Variable List - MAX - PS 359. LONG_TERM_CARE_RECORDS_PT_2 Type: NUM Length: 3 Label: INSTITUTIONAL LONG-TERM CARE RECORDS - FIRST TYPE OF PROGRAM DESCRIPTION: NUMBER OF LONG-TERM CARE RECORDS CONTAINING MSIS PROGRAM TYPE = 2 (FAMILY PLANNING). SOURCE: CREATED USING THE MSIS LONG-TERM CARE CLAIMS FILE. PS DED Page 117. Values: PS DED Page 118 PERSON SUM Home Variable List - MAX - PS 360. LONG_TERM_CARE_PAYMENTS_PT_2 Type: NUM* Length: 8 Label: INSTITUTIONAL LONG-TERM CARE PAYMENTS - FIRST TYPE OF PROGRAM DESCRIPTION: MEDICAID PAYMENT AMOUNT FOR ALL LONG-TERM CARE RECORDS CONTAINING MSIS PROGRAM TYPE = 2 (FAMILY PLANNING). (SAS USERS: ZONED DECIMAL - ZD8) SOURCE: CREATED USING THE MSIS LONG-TERM CARE C. Home Variable List - MAX - PS 361. OTHER_SERVICE_RECORDS_PT_2 Type: NUM Length: 3 Label: OTHER SERVICE RECORDS - FIRST TYPE OF PROGRAM DESCRIPTION: NUMBER OF OTHER SERVICE RECORDS CONTAINING MSIS PROGRAM TYPE = 2 (FAMILY PLANNING). SOURCE: CREATED USING THE MSIS OTHER SERVICE CLAIMS FILE. PS DED Page 119. Values: PS DED Page 120 PERSON SUMMA Home Variable List - MAX - PS 362. OTHER_SERVICE_PAYMENTS_PT_2 Type: NUM* Length: 8 Label: OTHER SERVICE PAYMENTS - FIRST TYPE OF PROGRAM DESCRIPTION: MEDICAID PAYMENT AMOUNT FOR ALL OTHER SERVICE RECORDS CONTAINING MSIS PROGRAM TYPE = 2 (FAMILY PLANNING). (SAS USERS: ZONED DECIMAL - ZD8) SOURCE: CREATED USING THE MSIS OTHER SERVICE CLA. Home Variable List - MAX - PS 363. PRESCRIPTION_DRUG_RECORDS_PT_2 Type: NUM Length: 3 Label: PRESCRIPTION DRUG RECORDS - FIRST TYPE OF PROGRAM DESCRIPTION: NUMBER OF PRESCRIPTION DRUG RECORDS CONTAINING MSIS PROGRAM TYPE = 2 (FAMILY PLANNING). SOURCE: CREATED USING THE MSIS PRESCRIPTION DRUG CLAIMS FILE. PS DED Page 121. Values: PS DED Page 122 PERS Home Variable List - MAX - PS 364. PRESCRIPTION_DRUG_PAYMENTS_PT_2 Type: NUM* Length: 8 Label: PRESCRIPTION DRUG PAYMENTS - FIRST TYPE OF PROGRAM DESCRIPTION: MEDICAID PAYMENT AMOUNT FOR ALL PRESCRIPTION DRUG RECORDS CONTAINING MSIS PROGRAM TYPE = 2 (FAMILY PLANNING). (SAS USERS: ZONED DECIMAL - ZD8) SOURCE: CREATED USING THE MSIS PRESCRIPTION. Home Variable List - MAX - PS 365. TOTAL_RECORDS_PT_2 Type: NUM Length: 3 Label: TOTAL RECORDS - FIRST TYPE OF PROGRAM DESCRIPTION: TOTAL NUMBER OF RECORDS CONTAINING MSIS PROGRAM TYPE = 2 (FAMILY PLANNING). SOURCE: CREATED USING ALL OF THE MSIS CLAIMS FILES, ALTHOUGH FAMILY PLANNING SERVICES PROVIDED TO A PE. Home Variable List - MAX - PS 366. TOTAL_PAYMENTS_PT_2 Type: NUM* Length: 8 Label: TOTAL PAYMENTS - FIRST TYPE OF PROGRAM DESCRIPTION: MEDICAID PAYMENT AMOUNT FOR ALL RECORDS CONTAINING MSIS PROGRAM TYPE = 2 (FAMILY PLANNING). (SAS USERS: ZONED DECIMAL - ZD8) SOURCE: CREATED USING ALL OF THE MSIS CLAIMS FILES, A. Home Variable List - MAX - PS 417. DELIVERY_CODE Type: NUM Length: 1 Label: DELIVERY CODE DESCRIPTION: CODE INDICATING WHETHER OR NOT THE ELIGIBLE HAD AT LEAST ONE INPATIENT HOSPITAL STAY IN THE YEAR WITH A MATERNAL DELIVERY DIAGNOSIS CODE. PS DED Page 125 CODES: 0 = NO MA. Values: CODES: 0 = NO MAX INPATIENT CLAIM DURING THE YEAR WITH A MATERNAL DELIVERY DIAGNOSIS CODE. 1 = AT LEAST ONE MAX INPATIENT CLAIM DURING THE YEAR WITH A MATERNAL DELIVERY DIAGNOSIS CODE. Home Variable List - MAX - PS 418. RECIPIENT_INDICATOR_TOS_01 Type: CHAR Length: 1 Label: RECIPIENT INDICATOR - FIRST MAX TOS DESCRIPTION: INDICATOR TO SHOW IF AND HOW THE ELIGIBLE RECEIVED A MEDICAID SERVICE (UNDER FEE-FOR-SERVICE) DURING THE CALENDAR YEAR, FOR THIS TYPE OF SERVICE. THIS DATA ELEMENT IS REPORTED FOR ALL TYP. Values: CODES: 0 = THE ELIGIBLE PERSON DID NOT RECEIVE ANY SERVICES. 1 = THE ELIGIBLE PERSON HAD ONLY FEE-FOR-SERVICE CLAIMS FOR TYPES OF SERVICE = 1-19, 23-54 AND 99. 2 = THE ELIGIBLE PERSON HAD ONLY PREMIUM PAYMENT CLAIMS (PRE-PAID PLAN) FOR TYPES OF SERVICE = 20-22. 3 = THE ELIGIBLE PERSON HAD ONLY ENCOUNTER RECORDS (PRE-PAID PLAN) FOR TYPES OF SERVICE = 1-19, 23-54, 99. 4 = THE ELIGIBLE PERSON HAD FEE-FOR-SERVICE AND PREMIUM PAYMENT CLAIMS, BUT NO ENCOUNTER RECORDS. 5 = THE ELIGIBLE PERSON HAD PREMIUM PAYMENT CLAIMS AND ENCOUNTER RECORDS, BUT NO FEE-FOR- SERVICE CLAIMS. 6 = THE ELIGIBLE PERSON HAD FEE-FOR-SERVICE CLAIMS AND ENCOUNTER RECORDS, BUT NO PREMIUM PAYMENT CLAIMS. 7 = THE ELIGIBLE PERSON HAD FEE-FOR-SERVICE CLAIMS, PREMIUM PAYMENT CLAIMS AND ENCOUNTER RECORDS. 8 = S-CHIP ENROLLMENT MONTHS WERE FOUND BUT NO MEDICAID ENROLLMENT MONTHS WERE FOUND. 9 = NEITHER S-CHIP ENROLLMENT MONTHS NOR MEDICAID ENROLLMENT MONTHS WERE FOUND. Home Variable List - MAX - PS 419. CLAIM_COUNT_TOS_01 Type: NUM* Length: 5 Label: FEE-FOR-SERVICE CLAIM COUNT - FIRST MAX TOS DESCRIPTION: TOTAL NUMBER OF FEE-FOR-SERVICE CLAIMS FOR THE RECIPIENT DURING THE CALENDAR YEAR FOR THIS TYPE OF SERVICE. THIS DATA ELEMENT IS REPORTED FOR ALL TYPES OF SERVICE, EXCEPT TOS = 20, 21 AND. Home Variable List - MAX - PS 420. MEDICAID_PAYMENT_AMOUNT_TOS_01 Type: NUM* Length: 8 Label: FEE-FOR-SERVICE MEDICAID PAYMENT AMOUNT - FIRST MAX TOS DESCRIPTION: TOTAL FEE-FOR-SERVICE MEDICAID PAYMENTS FOR THE RECIPIENT DURING THE CALENDAR YEAR FOR THIS TYPE OF SERVICE. THIS DATA ELEMENT IS REPORTED FOR ALL TYPES OF SERVICE EXCEPT TOS = 20, 21 AND. Home Variable List - MAX - PS 421. CHARGE_AMOUNT_TOS_01 Type: NUM* Length: 8 Label: FEE-FOR-SERVICE CHARGE AMOUNT - FIRST MAX TOS DESCRIPTION: TOTAL AMOUNT OF FEE-FOR-SERVICE CHARGES FOR THE RECIPIENT DURING THE CALENDAR YEAR FOR THIS TYPE OF SERVICE. THIS DATA ELEMENT IS REPORTED FOR ALL TYPES OF SERVICE EXCEPT T. Home Variable List - MAX - PS 422. THIRD_PARTY_PAYMENT_AMT_TOS_01 Type: NUM* Length: 8 Label: FEE-FOR-SERVICE THIRD PARTY PAYMENT AMOUNT - FIRST MAX TOS DESCRIPTION: TOTAL NON-MEDICAID PAYMENTS, RELATED TO FEE-FOR-SERVICE CARE FOR THE RECIPIENT DURING THE CALENDAR YEAR FOR THIS TYPE OF SERVICE. THIS DATA ELEMENT IS REPORTED FOR ALL TYPES OF SERVICE EX. Home Variable List - MAX - PS 423. ENCOUNTER_RECORD_COUNT_TOS_01 Type: NUM Length: 5 Label: ENCOUNTER RECORD COUNT - FIRST MAX TOS DESCRIPTION: TOTAL NUMBER OF ENCOUNTER RECORDS (TYPE OF CLAIM = 3), RELATED TO CARE PROVIDED BY A CAPITATED (PREPAID) PLAN FOR THE RECIPIENT DURING THE CALENDAR YEAR FOR THIS TYPE OF SERVICE. Home Variable List - MAX - PS 604. CLTC_FFS_PYMT_AMT_11 Type: NUM* Length: 8 Label: MEDICAID PAYMENT AMOUNT - FIRST TYPE OF CLTC DESCRIPTION: FIELD CONTAINING THE FIRST OF 21 MEDICAID PAYMENT AMOUNTS EXISTING FOR EACH MAX COMMUNITY-BASED LONG-TERM CARE INDICATOR CODE. THERE IS ONE DATA ELEMENT FOR EACH LIS. Values: CODES: 11 = NON-WAIVER PERSONAL CARE PROGRAM TYPE NOT = (6 OR 7) AND MAX TOS = 30 12 = NON-WAIVER PRIVATE DUTY NURSING PROGRAM TYPE NOT = (6 OR 7) AND MAX TOS = 38 13 = NON-WAIVER ADULT DAY PROGRAM TYPE NOT = (6 OR 7) AND MAX TOS = 54 14 = NON-WAIVER HOME HEALTH PROGRAM TYPE NOT = (6 OR 7) AND MAX TOS = 13 15 = NON-WAIVER RESIDENTIAL CARE PROGRAM TYPE NOT = (6 OR 7) AND MAX TOS = 52 16 = NON-WAIVER REHABILITATION FOR AGED OR DISABLED ENROLLEE PROGRAM TYPE NOT = (6 OR 7) AND MAX TOS = 33 AND BOE = (1 OR 2) 17 = NON-WAIVER TARGETED CASE MANAGEMENT FOR AGED OR DISABLED ENROLLEE PROGRAM TYPE NOT = (6 OR 7) AND MAX TOS = 31 AND BOE = (1 OR 2) 18 = NON-WAIVER TRANSPORTATION FOR AGED OR DISABLED ENROLLEE PROGRAM TYPE NOT = (6 OR 7) AND MAX TOS = 26 AND BOE = (1 OR 2) 19 = NON-WAIVER HOSPICE CARE FOR AGED OR DISABLED ENROLLEE PROGRAM TYPE NOT = (6 OR 7) AND MAX TOS = 35 AND BOE = (1 OR 2) 20 = NON-WAIVER DURABLE MEDICAL EQUIPMENT FOR AGED OR DISABLED ENROLLEE PROGRAM TYPE NOT = (6 OR 7) AND MAX TOS = 51 AND BOE = (1 OR 2) 30 = WAIVER SERVICE IN ANY OTHER TYPE OF SERVICE NOT LISTED BELOW PROGRAM TYPE = (6 OR 7) AND MAX TOS NOT = (30, 38, 54, 13, 52, 33, 31, 26, 35, 51) 31 = WAIVER PERSONAL CARE PROGRAM TYPE = (6 OR 7) AND MAX TOS = 30 32 = WAIVER PRIVATE DUTY NURSING PROGRAM TYPE = (6 OR 7) AND MAX TOS = 38 33 = WAIVER ADULT DAY PROGRAM TYPE = (6 OR 7) AND MAX TOS = 54 34 = WAIVER HOME HEALTH PROGRAM TYPE = (6 OR 7) AND MAX TOS = 13 35 = WAIVER RESIDENTIAL CARE PROGRAM TYPE = (6 OR 7) AND MAX TOS = 52 36 = WAIVER REHABILITATION PROGRAM TYPE = (6 OR 7) AND MAX TOS = 33 37 = WAIVER TARGETED CASE MANAGEMENT PROGRAM TYPE = (6 OR 7) AND MAX TOS = 31 38 = WAIVER TRANSPORTATION PROGRAM TYPE = (6 OR 7) AND MAX TOS = 26 39 = WAIVER HOSPICE CARE PROGRAM TYPE = (6 OR 7) AND MAX TOS = 35 40 = WAIVER DURABLE MEDICAL EQUIPMENT PROGRAM TYPE = (6 OR 7) AND MAX TOS = 51 Home Variable List - MAX - PS 625. HCBS_FFS_PYMT_AMT_01 Type: NUM* Length: 8 Label: MEDICAID PAYMENT AMOUNT - FIRST TYPE OF HCBS TAXONOMY DESCRIPTION: FIELD CONTAINING THE FIRST OF 18 MEDICAID PAYMENT AMOUNTS EXISTING FOR EACH HOME AND COMMUNITY-BASED SERVICES IDENTIFIED BY THE FIRST TWO BYTES OF THE TAXONOMY CODE. Values: CODES: 01 = CASE MANAGEMENT 02 = ROUND-THE-CLOCK SERVICES 03 = SUPPORTED EMPLOYMENT 04 = DAY SERVICES 05 = NURSING SERVICES 06 = HOME DELIVERED MEALS 07 = RENT AND FOOD EXPENSES FOR LIVE-IN CAREGIVER 08 = HOME-BASED SERVICES 09 = CAREGIVER SUPPORT 10 = OTHER MENTAL HEALTH AND BEHAVIORAL SERVICES 11 = OTHER HEALTH AND THERAPEUTIC SERVICES 12 = SERVICES SUPPORTING PARTICIPANT DIRECTION 13 = PARTICIPANT TRAINING 14 = EQUIPMENT, TECHNOLOGY, AND MODIFICATIONS 15 = NON-MEDICAL TRANSPORTATION 16 = COMMUNITY TRANSITION SERVICES 17 = OTHER SERVICES 99 = UNKNOWN Home Variable List - MAX - PS 643. PREMIUM_PAYMENT_INDICATOR_TOS_20 Type: NUM* Length: 1 Label: PREMIUM PAYMENT INDICATOR - FIRST TYPE OF PREMIUM DESCRIPTION: INDICATOR TO SHOW IF ANY PREMIUM PAYMENTS WERE MADE TO A CAPITATED (PREPAID) PLAN FOR THIS ELIGIBLE DURING THE CALENDAR YEAR. THIS DATA ELEMENT IS REPORTED ONLY FOR TOS = 2. Values: CODES: 0 = NO PREMIUM PAYMENTS WERE MADE FOR THIS ELIGIBLE BY MEDICAID 1 = PREMIUM PAYMENTS WERE MADE FOR THIS ELIGIBLE BY MEDICAID Home Variable List - MAX - PS 644. PREMIUM_PAYMENT_RECORDS_TOS_20 Type: NUM* Length: 5 Label: PREMIUM PAYMENT RECORD COUNT - FIRST TYPE OF PREMIUM DESCRIPTION: TOTAL NUMBER OF PREMIUM PAYMENTS THAT WERE MADE TO A CAPITATED (PREPAID) PLAN FOR THIS ELIGIBLE DURING THE CALENDAR YEAR. THIS DATA ELEMENT IS REPORTED ONLY FOR TOS = 20, 21, 22, AND 23. Home Variable List - MAX - PS 645. MEDICAID_PREMIUM_PAYMENTS_TOS_20 Type: NUM* Length: 8 Label: MEDICAID PREMIUM PAYMENT AMOUNT - FIRST TYPE OF PREMIUM DESCRIPTION: TOTAL DOLLAR AMOUNT OF PREMIUM PAYMENTS THAT WERE MADE TO A CAPITATED (PREPAID) PLAN FOR THIS ELIGIBLE DURING THE CALENDAR YEAR. THIS DATA ELEMENT IS REPORTED ONLY FOR TOS. Home Variable List - MAX - PS 655. ENCTR_REC_CNT_HCBS Type: NUM Length: 5 Label: ENCOUNTER RECORD COUNT - HCBS DESCRIPTION: TOTAL NUMBER OF ENCOUNTER RECORDS (TYPE OF CLAIM = 3), RELATED TO HOME AND COMMUNITY-BASED SERVICES FOR THE RECIPIENT DURING THE CALENDAR YEAR. PS DED Page 145 NOTE: IN MAX.