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This variable indicates whether a beneficiary met the condition criteria for other developmental delays as of the end of the calendar year.

This variable shows the date when the beneficiary first met the criteria for the other developmental delays indicator. The variable will be blank for beneficiaries that have never had the condition.

This code specifies whether the enrollee met the chronic condition algorithm criteria, considering both Medicare and Medicaid data, for having Other Developmental Delays.

This code specifies whether the enrollee met the chronic condition algorithm criteria, considering only Medicaid data, for having Other Developmental Delays.

This code specifies whether the enrollee met the chronic condition algorithm criteria, considering only Medicare data, for having Other Developmental Delays.

This variable is the sum of Medicare coinsurance and deductible payments in the nonacute inpatient hospital setting for the year. The total “other” inpatient (OIP) beneficiary payments are calculated as the sum of NCH_BENE_IP_DDCTBL_AMT and NCH_BENE_PTA_COINSRNC_LBLTY_AM for all relevant claims where the CLM_PMT_AMT >= 0.

These OIP claims are a subset of the claims in the IP data file consisting of data from IP settings such as long- term care hospitals, inpatient psychiatric facilities, inpatient rehabilitation facilities, and other types of IP facilities such as children’s hospitals or cancer centers.

This variable is the count of covered days in the non-acute inpatient hospital setting for the year. This variable equals the sum of the CLM_UTLZTN_DAY_CNT variables on the source claims.

These “other” inpatient (OIP) claims are a subset of the claims in the IP data file consisting of data from IP settings such as long-term care hospitals, inpatient psychiatric facilities, inpatient rehabilitation facilities, and other types of IP facilities such as children’s hospitals or cancer centers.

This variable is the sum of the Medicare claim payment amounts (CLM_PMT_AMT from each claim) in the other inpatient (OIP) settings for a given year. To obtain the total OIP Medicare payments, take this variable and add in the annual per diem payment amount (OIP_MDCR_PMT + OIP_PERDIEM_AMT).

These OIP claims are a subset of the claims in the IP data file consisting of data from IP settings such as long- term care hospitals, inpatient psychiatric facilities, inpatient rehabilitation facilities, and other types of IP facilities such as children’s hospitals or cancer centers.

This variable is the sum of all the pass through per diem payment amounts (CLM_PASS_THRU_PER_DIEM_AMT from each claim) in the other inpatient (OIP) setting for the year. Medicare payments are designed to include certain "pass-through" expenses such as capital-related costs, direct medical education costs, kidney acquisition costs for hospitals that are renal transplant centers, and bad debts. This variable is the sum of all the daily payments for pass-through expenses. It is not included in the Medicare Payment amount (OIP_MDCR_PMT). To determine the total Medicare payments for other (non-acute) hospitalizations for the beneficiary, this field must be added to the total Medicare payment amount for other hospitalizations.

These “other” inpatient (OIP) claims are a subset of the claims in the IP data file consisting of data from IP settings such as long-term care hospitals, inpatient psychiatric facilities, inpatient rehabilitation facilities, and other types of IP facilities such as children’s hospitals or cancer centers.

This variable indicates the total amount paid for other (non-acute) inpatient stays by a primary payer other than Medicare. It is the sum of all the primary payer amounts (NCH_PRMRY_PYR_CLM_PD_AMT from each claim) in the other inpatient hospital settings for the year.

These “other” inpatient (OIP) claims are a subset of the claims in the IP data file consisting of data from IP settings such as long-term care hospitals, inpatient psychiatric facilities, inpatient rehabilitation facilities, and other types of IP facilities such as children’s hospitals or cancer centers.

This variable is the count of hospital stays (unique admissions, which may span more than one facility) in the non-acute inpatient setting for a given year. A non-acute inpatient stay is defined as a set of one or more consecutive non-acute inpatient claims where the beneficiary is only discharged on the most recent claim in the set. The CLM_FROM_DT for the first claim associated with the stay must have been in the year of the data file, however it was permissible for the CLM_THRU_DT to have occurred in January of the following year.

These “other” inpatient (OIP) claims are a subset of the claims in the IP data file consisting of data from IP settings such as long-term care hospitals, inpatient psychiatric facilities, inpatient rehabilitation facilities, and other types of IP facilities such as children’s hospitals or cancer centers.

This variable is the sum of coinsurance and deductible payments from Part B Carrier and DME claims which appear in settings other than the 10 specific categories which are part of this file for a given year.

The total Beneficiary payments are calculated as the sum of LINE_COINSRNC_AMT + LINE_BENE_PTB_DDCTBL_AMT for the relevant lines.

Claims for other carrier/DME claims are a subset of the claims in the Part B Carrier and DME data files. Types of services which may have been summarized in this other carrier category (OTHC) include ambulance, chiropractor, chemotherapy, vision, hearing and speech services, etc.

This variable is the count of events in the part B other setting for a given year, which includes Part B Carrier and DME claims which appear in settings other than the 10 specific categories which are part of this file for a given year. Claims for other carrier/DME claims are a subset of the claims in the Part B Carrier and DME data files.

Types of services which may have been summarized in this other carrier category (OTHC) include ambulance, chiropractor, chemotherapy, vision, hearing and speech services, etc.

An event is defined as each line item that contains the relevant service.

This variable is the total Medicare payments from Part B Carrier and DME claims which appear in settings other than the 10 specific categories which are part of this file for a given year. Claims for other carrier/DME claims are a subset of the claims in the Part B Carrier and DME data files. Types of services which may have been summarized in this other carrier category (OTHC) include ambulance, chiropractor, chemotherapy, vision, hearing and speech services, etc.

The total Medicare payments are calculated as the sum of LINE_NCH_PMT_AMT where the LINE_PRCSG_IND_CD was ('A','R', or 'S') - for all relevant lines.

This variable indicates the total amount paid for Part B Carrier and DME claims which appear in settings other than the 10 specific categories which are part of this file by a primary payer other than Medicare for a given year. Claims for other carrier/DME claims are a subset of the claims in the Part B Carrier and DME data files. Types of services which may have been summarized in this other carrier category (OTHC) include ambulance, chiropractor, chemotherapy, vision, hearing and speech services, etc.

The total Primary Payer Payments are calculated as the sum of the LINE_BENE_PRMRY_PYR_PD_AMT.

This variable is the sum of coinsurance and deductible payments for services considered part B other procedures (i.e., not anesthesia or dialysis) for a given year. The total Beneficiary payments are calculated as the sum of LINE_COINSRNC_AMT + LINE_BENE_PTB_DDCTBL_AMT for the relevant lines.

Claims for other procedures are a subset of the claims in the Part B Carrier data file. These other procedure claims are defined as those with a line BETOS code (BETOS_CD) where the first 2 digits are ('P1','P2','P3','P4','P5','P6','P7', or 'P8').

This variable is the count of events for part B other procedures for a given year. An event is defined as each line item that contains the relevant service. Claims for other procedures are a subset of the claims in the Part B Carrier data file.

These other procedure claims are defined as those with a line BETOS code (BETOS_CD) where the first 2 digits are ('P1','P2','P3','P4','P5','P6','P7', or 'P8').

This variable is the total Medicare payments for services considered part B other procedures (i.e., not anesthesia or dialysis) for a given year. Claims for other procedures are a subset of the claims, and a subset of procedures in the Part B Carrier data file.

These other procedure claims are defined as those with a line BETOS code (BETOS_CD) where the first 2 digits are ('P1','P2','P3','P4','P5','P6','P7', or 'P8').

The total Medicare payments are calculated as the sum of LINE_NCH_PMT_AMT where the LINE_PRCSG_IND_CD was ('A','R', or 'S') - for all relevant lines.

This variable indicates the total amount paid for services considered part B other procedures (i.e., not anesthesia or dialysis) by a primary payer other than Medicare for a given year. Claims for other procedures are a subset of the claims, and a subset of procedures in the Part B Carrier data file.

These other procedure claims are defined as those with a line BETOS code (BETOS_CD) where the first 2 digits are ('P1','P2','P3','P4','P5','P6','P7', or 'P8'). The total Primary Payer Payments are calculated as the sum of the LINE_BENE_PRMRY_PYR_PD_AMT.

MEDICAID PAYMENT AMOUNT FOR ALL OTHER SERVICE RECORDS CONTAINING MSIS PROGRAM TYPE = 2 (FAMILY PLANNING)

(SAS USERS: ZONED DECIMAL - ZD8)

MEDICAID PAYMENT AMOUNT FOR ALL OTHER SERVICE RECORDS CONTAINING MSIS PROGRAM TYPE = 4 (FEDERALLY QUALIFIED HEALTH CENTERS)

(SAS USERS: ZONED DECIMAL - ZD8)

MEDICAID PAYMENT AMOUNT FOR ALL OTHER SERVICE RECORDS CONTAINING MSIS PROGRAM TYPE = 6 (HOME AND COMMUNITY-BASED CARE FOR DISABLED ELDERLY AND INDIVIDUALS AGE 65 AND OLDER)

(SAS USERS: ZONED DECIMAL - ZD8)

MEDICAID PAYMENT AMOUNT FOR ALL OTHER SERVICE RECORDS CONTAINING MSIS PROGRAM TYPE = 7 (HOME AND COMMUNITY-BASED CARE WAIVER SERVICES)

(SAS USERS: ZONED DECIMAL - ZD8)

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