The data in this column indicates whether the facility contacted and completed the physician (or physician-designee) prescribed/ recommended actions by midnight of the next calendar day each time potential clinically significant medication issues were identified since the admission.
Indicates the facility contacted and completed physician (or physician-designee) prescribed/recommended actions by midnight of the next calendar day each time potential clinically significant medication issues were identified since the admission.
Provider first name
Provider last name
Provider middle name
A code in National Drug Code (NDC) format indicating the drug, device, or medical supply covered by this claim.
NATIONAL DRUG CODE (NDC) FOR THIS SERVICE.
Indicates that the Part D plan benefit package is a stand-alone Prescription Drug Plan (PDP) offered by a national Part D sponsor.
NATIONAL PROVIDER IDENTIFIER OF THE INSTITUTION BILLING/CARING FOR THE ENROLLEE.
Mandatated by HIPAA as a unique provider number assigned for each health care provider to be used in standard electronic health care transactions. Effective August 2008.
The date on a claim for which the covered level of care ended in a general hospital or the active care ended in a psychiatric/tuberculosis hospital.
The amount of money for which the intermediary determined the beneficiary is liable for the blood deductible.
A blood deductible amount applies to the first 3 pints of blood (or equivalent units; applies only to whole blood or packed red cells - not platelets, fibrinogen, plasma, etc. which are considered biologicals). However, blood processing is not subject to a deductible. Calculation of the deductible amount considers both Part A and Part B claims combined. The blood deductible does not count toward meeting the inpatient hospital deductible or any other applicable deductible and coinsurance amounts for which the patient is responsible.
On an inpatient or Home Health claim, the date the beneficiary was discharged from the facility, or died.
Date matches the "thru" date on the claim (CLM_THRU_DT). When there is a discharge date, the discharge status code (PTNT_DSCHRG_STUS_CD) indicates the final disposition of the patient after discharge.
The amount of the deductible the beneficiary paid for inpatient services, as originally submitted on the institutional claim.
Under Part A, the deductible applies only to inpatient hospital care (whether in an acute care facility, Inpatient psychiatric facility [IPF], inpatient rehabilitation facility [IRF], or long term care hospital [LTCH]) and is charged only at the beginning of each benefit period, which is similar to an episode of illness.
This variable is null/missing for skilled nursing facility (SNF), home health, and hospice claims.
The last date for which the beneficiary has Medicare coverage.
This is completed only where benefits were exhausted before the date of discharge and during the billing period covered by this institutional claim.
The amount of money for which the intermediary has determined that the beneficiary is liable for Part A coinsurance on the institutional claim.
Under Part A, beneficiaries pay coinsurance starting with the 61st day of an inpatient hospital stay (one daily amount for days 61-90, and a higher daily amount for any days after that, which count towards a beneficiary’s 60 lifetime reserve days) or the 21st day of a skilled nursing facility (SNF) stay (a daily amount for days 21-100, after which SNF coverage ends).
This variable is null/missing for home health and hospice claims.
The amount of money for which the intermediary has determined that the beneficiary is liable for Part B coinsurance on the institutional claim.
The amount of money for which the intermediary or carrier has determined that the beneficiary is liable for the Part B cash deductible on the claim.
Number of whole pints of blood furnished to the beneficiary, as reported on the carrier claim (non-DMERC).
The total allowed charges on the claim (the sum of line item allowed charges).
The total submitted charges on the claim (sum of all line-level submitted charges, variable called LINE_SBMTD_CHRG_AMT)