Medicare Inpatient Hospitals
by Provider - 2021
| Variable Name | Term Name | Definition |
|---|---|---|
| Rndrng_Prvdr_CCN | Rendering Provider CCN | The CMS Certification Number (CCN) of the provider billing for inpatient hospital services. |
| Rndrng_Prvdr_Org_Name | Provider Name | The name of the provider. |
| Rndrng_Prvdr_St | Rendering Provider Street Address | The street address in which the provider is physically located. |
| Rndrng_Prvdr_City | Rendering Provider City | The city in which the provider is physically located. |
| Rndrng_Prvdr_Zip | Rendering Provider Zip Code | The zip code in which the provider is physically located. |
| Rndrng_Prvdr_State_Abrvtn | Rendering Provider State Abbreviation | The abbreviation for the state in which the provider is physically located. |
| Rndrng_Prvdr_State_FIPS | Rendering Provider State FIPS Code | The state FIPS code for the state in which the provider is physically located. |
| Rndrng_Prvdr_RUCA | Rendering Provider Rural-Urban Commuting Area Codes | The Rural-Urban Commuting Area (RUCA) code for the zip code in which the provider is physically located. |
| Rndrng_Prvdr_RUCA_Desc | Rendering Provider Rural-Urban Commuting Area Description | The description of the RUCA code. |
| Tot_Benes | Number of Medicare Beneficiaries | Total Medicare beneficiaries receiving services from the provider. The beneficiary counts reported in the demographic sub-groups (i.e., age, sex, race and entitlement) may not aggregate to the ‘Number of Unique Beneficiaries’ due to the suppression of beneficiaries fewer than 11 within the demographic sub-groups. In addition, a small percentage of beneficiaries are reflected in the “Number of Unique Beneficiaries” but are not reflected in the beneficiary demographic information due to the lack of demographic information available at the time of reporting. |
| Tot_Submtd_Cvrd_Chrg | Total Covered Charges | The total submitted charge of all provider services covered by Medicare. Submitted charges will vary from hospital to hospital because of differences in hospital charge structures. |
| Tot_Pymt_Amt | Total Payment Amount | The total payments to providers for the DRG including the MS- DRG amount, teaching, disproportionate share, capital, and outlier payments for all cases. Also included in total payments are co-payment and deductible amounts that the patient is responsible for and any additional payments by third parties for coordination of benefits. |
| Tot_Mdcr_Pymt_Amt | Total Medicare Payment Amount | The total amount that Medicare pays to the provider for Medicare's share of the MS-DRG. Medicare payment amounts include the MS-DRG amount, teaching, disproportionate share, capital, and outlier payments for all cases. Medicare payments DO NOT include beneficiary co- payments and deductible amounts nor any additional payments from third parties for coordination of benefits. |
| Avg_Mdcr_Pymt_Amt | Average Medicare Payments | The average amount that Medicare pays to the provider for Medicare's share of the MS-DRG. Medicare payment amounts include the MS-DRG amount, teaching, disproportionate share, capital, and outlier payments for all cases. Medicare payments DO NOT include beneficiary co- payments and deductible amounts nor any additional payments from third parties for coordination of benefits. |
| Tot_Dschrgs | Total Discharges | The number of discharges billed by the provider for inpatient hospital services. |
| Tot_Cvrd_Days | Total Covered Days | The total number of days of care, per provider, which were covered in full or in part by Hospital Insurance (HI) Medicare benefits; excluded are days of care prior to a beneficiary's entitlement to HI benefits, and days of care after exhaustion of benefits. |
| Tot_Days | Total Days | The accumulated count of days, per provider, during which inpatient hospital services were furnished to a person eligible for Part A benefits under Medicare, including covered and non- covered days of care. |
| Bene_Avg_Age | Beneficiary Average Age | The average age of Medicare enrollees who used a covered health care or medical service from the provider. |
| Bene_Age_LT_65_Cnt | Number of Beneficiaries Age Less 65 | Number of beneficiaries under the age of 65. Beneficiary age is calculated at the end of the calendar year or at the time of death. |
| Bene_Age_65_74_Cnt | Number of Beneficiaries Age 65 to 74 | Number of beneficiaries between the ages of 65 and 74. Beneficiary age is calculated at the end of the calendar year or at the time of death. |
| Bene_Age_75_84_Cnt | Number of Beneficiaries Age 75 to 84 | Number of beneficiaries between the ages of 75 and 84. Beneficiary age is calculated at the end of the calendar year or at the time of death. |
| Bene_Age_GT_84_Cnt | Number of Beneficiaries Age Greater 84 | Number of beneficiaries over the age of 84. Beneficiary age is calculated at the end of the calendar year or at the time of death. |
| Bene_Feml_Cnt | Number of Female Beneficiaries | Number of female beneficiaries. |
| Bene_Male_Cnt | Number of Male Beneficiaries | Number of male beneficiaries. |
| Bene_Race_Wht_Cnt | Number of Non-Hispanic White Beneficiaries | Number of non-Hispanic white beneficiaries. Race/ethnicity information is based on the variable RTI_RACE_CD from the CMS CCW enrollment database. The RTI_RACE_CD variable is based upon a validated algorithm that uses Census surname lists and geography to improve the accuracy of race/ethnicity classification, particularly for those who are Hispanic or Asian/Pacific Islanders. |
| Bene_Race_Black_Cnt | Number of Black or African American Beneficiaries | Number of non-Hispanic black or African American beneficiaries. Race/ethnicity information is based on the variable RTI_RACE_CD from the CMS CCW enrollment database. The RTI_RACE_CD variable is based upon a validated algorithm that uses Census surname lists and geography to improve the accuracy of race/ethnicity classification, particularly for those who are Hispanic or Asian/Pacific Islanders. |
| Bene_Race_API_Cnt | Number of Asian Pacific Islander Beneficiaries | Number of Asian Pacific Islander beneficiaries. Race/ethnicity information is based on the variable RTI_RACE_CD from the CMS CCW enrollment database. The RTI_RACE_CD variable is based upon a validated algorithm that uses Census surname lists and geography to improve the accuracy of race/ethnicity classification, particularly for those who are Hispanic or Asian/Pacific Islanders. |
| Bene_Race_Hspnc_Cnt | Number of Hispanic Beneficiaries | Number of Hispanic beneficiaries. Race/ethnicity information is based on the variable RTI_RACE_CD from the CMS CCW enrollment database. The RTI_RACE_CD variable is based upon a validated algorithm that uses Census surname lists and geography to improve the accuracy of race/ethnicity classification, particularly for those who are Hispanic or Asian/Pacific Islanders. |
| Bene_Race_NatInd_Cnt | Number of American Indian/Alaska Native Beneficiaries | Number of American Indian or Alaska Native beneficiaries. Race/ethnicity information is based on the variable RTI_RACE_CD from the CMS CCW enrollment database. The RTI_RACE_CD variable is based upon a validated algorithm that uses Census surname lists and geography to improve the accuracy of race/ethnicity classification, particularly for those who are Hispanic or Asian/Pacific Islanders. |
| Bene_Race_Othr_Cnt | Number of Beneficiaries With Race Not Elsewhere Classified | Number of beneficiaries with race not elsewhere classified. |
| Bene_Dual_Cnt | Number of Beneficiaries With Medicare & Medicaid Entitlement | Number of Medicare beneficiaries qualified to receive Medicare and Medicaid benefits. Beneficiaries are classified as Medicare and Medicaid entitlement if in any month in the given calendar year they were receiving full or partial Medicaid benefits. |
| Bene_Ndual_Cnt | Number of Beneficiaries With Medicare Only Entitlement | Number of Medicare beneficiaries qualified to receive Medicare only benefits. Beneficiaries are classified as Medicare only entitlement if they received zero months of any Medicaid benefits (full or partial) in the given calendar year. |
| Bene_CC_AF_Pct | Percent of Beneficiaries With Atrial Fibrillation | Percent of beneficiaries meeting the CCW chronic condition algorithm for atrial fibrillation. To protect the privacy of Medicare beneficiaries, the number of beneficiaries fewer than 11 have been suppressed and the percent of beneficiaries between 75% and 100% have been top-coded at 75%. Information on source data is available from the CMS Chronic Conditions Warehouse (CCW). |
| Bene_CC_Alzhmr_Pct | Percent of Beneficiaries With Alzheimer’s Disease or Dementia | Percent of beneficiaries meeting the CCW chronic condition algorithm for Alzheimer’s, related disorders, or dementia. To protect the privacy of Medicare beneficiaries, the number of beneficiaries fewer than 11 have been suppressed and the percent of beneficiaries between 75% and 100% have been top-coded at 75%. Information on source data is available from the CMS Chronic Conditions Warehouse (CCW). |
| Bene_CC_Asthma_Pct | Percent of Beneficiaries With Asthma | Percent of beneficiaries meeting the CCW chronic condition algorithm for Asthma. To protect the privacy of Medicare beneficiaries, the number of beneficiaries fewer than 11 have been suppressed and the percent of beneficiaries between 75% and 100% have been top-coded at 75%. Information on source data is available from the CMS Chronic Conditions Warehouse (CCW). |
| Bene_CC_Cncr_Pct | Percent of Beneficiaries With Cancer | Percent of beneficiaries meeting the CCW chronic condition algorithms for cancer. Includes breast cancer, colorectal cancer, lung cancer and prostate cancer. To protect the privacy of Medicare beneficiaries, the number of beneficiaries fewer than 11 have been suppressed and the percent of beneficiaries between 75% and 100% have been top-coded at 75%. Information on source data is available from the CMS Chronic Conditions Warehouse (CCW). |
| Bene_CC_CHF_Pct | Percent of Beneficiaries With Congestive Heart Failure | Percent of beneficiaries meeting the CCW chronic condition algorithm for congestive heart failure. To protect the privacy of Medicare beneficiaries, the number of beneficiaries fewer than 11 have been suppressed and the percent of beneficiaries between 75% and 100% have been top-coded at 75%. Information on source data is available from the CMS Chronic Conditions Warehouse (CCW). |
| Bene_CC_CKD_Pct | Percent of Beneficiaries With Chronic Kidney Disease | Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic kidney disease. To protect the privacy of Medicare beneficiaries, the number of beneficiaries fewer than 11 have been suppressed and the percent of beneficiaries between 75% and 100% have been top-coded at 75%. Information on source data is available from the CMS Chronic Conditions Warehouse (CCW). |
| Bene_CC_COPD_Pct | Percent of Beneficiaries With Chronic Obstructive Pulmonary Disease | Percent of beneficiaries meeting the CCW chronic condition algorithm for chronic obstructive pulmonary disease. To protect the privacy of Medicare beneficiaries, the number of beneficiaries fewer than 11 have been suppressed and the percent of beneficiaries between 75% and 100% have been top-coded at 75%. Information on source data is available from the CMS Chronic Conditions Warehouse (CCW). |
| Bene_CC_Dprssn_Pct | Percent of Beneficiaries With Depression | Percent of beneficiaries meeting the CCW chronic condition algorithm for depression. To protect the privacy of Medicare beneficiaries, the number of beneficiaries fewer than 11 have been suppressed and the percent of beneficiaries between 75% and 100% have been top-coded at 75%. Information on source data is available from the CMS Chronic Conditions Warehouse (CCW) |
| Bene_CC_Dbts_Pct | Percent of Beneficiaries With Diabetes | Percent of beneficiaries meeting the CCW chronic condition algorithm for diabetes. To protect the privacy of Medicare beneficiaries, the number of beneficiaries fewer than 11 have been suppressed and the percent of beneficiaries between 75% and 100% have been top-coded at 75%. Information on source data is available from the CMS Chronic Conditions Warehouse (CCW). |
| Bene_CC_Hyplpdma_Pct | Percent of Beneficiaries With Hyperlipidemia | Percent of beneficiaries meeting the CCW chronic condition algorithm for hyperlipidemia. To protect the privacy of Medicare beneficiaries, the number of beneficiaries fewer than 11 have been suppressed and the percent of beneficiaries between 75% and 100% have been top-coded at 75%. Information on source data is available from the CMS Chronic Conditions Warehouse (CCW). |
| Bene_CC_Hyprtnsn_Pct | Percent of Beneficiaries With Hypertension | Percent of beneficiaries meeting the CCW chronic condition algorithm for hypertension. To protect the privacy of Medicare beneficiaries, the number of beneficiaries fewer than 11 have been suppressed and the percent of beneficiaries between 75% and 100% have been top-coded at 75%. Information on source data is available from the CMS Chronic Conditions Warehouse (CCW). |
| Bene_CC_IHD_Pct | Percent of Beneficiaries With Ischemic Heart Disease | Percent of beneficiaries meeting the CCW chronic condition algorithm for ischemic heart disease. To protect the privacy of Medicare beneficiaries, the number of beneficiaries fewer than 11 have been suppressed and the percent of beneficiaries between 75% and 100% have been top-coded at 75%. Information on source data is available |
| Bene_CC_Opo_Pct | Percent of Beneficiaries With Osteoporosis | Percent of beneficiaries meeting the CCW chronic condition algorithm for osteoporosis. To protect the privacy of Medicare beneficiaries, the number of beneficiaries fewer than 11 have been suppressed and the percent of beneficiaries between 75% and 100% have been top-coded at 75%. Information on source data is available from the CMS Chronic Conditions Warehouse (CCW). |
| Bene_CC_RAOA_Pct | Percent of Beneficiaries With Rheumatoid Arthritis / Osteoarthritis | Percent of beneficiaries meeting the CCW chronic condition algorithm for rheumatoid arthritis/osteoarthritis. To protect the privacy of Medicare beneficiaries, the number of beneficiaries fewer than 11 have been suppressed and the percent of beneficiaries between 75% and 100% have been top-coded at 75%. Information on source data is available from the CMS Chronic Conditions Warehouse (CCW). |
| Bene_CC_Sz_Pct | Percent of Beneficiaries With Schizophrenia / Other Psychotic Disorders | Percent of beneficiaries meeting the CCW chronic condition algorithm for schizophrenia and other psychotic disorders. To protect the privacy of Medicare beneficiaries, the number of beneficiaries fewer than 11 have been suppressed and the percent of beneficiaries between 75% and 100% have been top-coded at 75%. Information on source data is available from the CMS Chronic Conditions Warehouse (CCW). |
| Bene_CC_Strok_Pct | Percent of Beneficiaries With Stroke | Percent of beneficiaries meeting the CCW chronic condition algorithm for stroke. To protect the privacy of Medicare beneficiaries, the number of beneficiaries fewer than 11 have been suppressed and the percent of beneficiaries between 75% and 100% have been top-coded at 75%. Information on source data is available from the CMS Chronic Conditions Warehouse (CCW). |
| Bene_Avg_Risk_Scre | Average HCC Risk Score of Beneficiaries | Average Hierarchical Condition Category (HCC) risk score of beneficiaries. |