DOI: 10.57761/zvs6-t687
title: MarketScan Medicare Supplemental

description: #Section 2  


This file contains data on continuous periods of enrollment per individual. Specifically, it has multiple records per enrollee, with one record per enrollee per month during the database year.



Contains specific start and end dates of continuous enrollment periods Linkable to other tables using Enrollee ID Common measures: percent eligibility over a given time period



Key variables of interest: Date Enrollment Start Date Enrollment End Enrollee ID Member Days Benefit Plan Link Month 1 to 12 Plan Indicator Month 1 to 12




description: #Section 3  


This file contains individual inpatient claim records that were used to create admissions records. One record identifies one inpatient stay at a given facility.



Linkable to other tables using Enrollee ID Common measures: most expensive procedures in inpatient setting, admission rates, etc.



Key variables of interest: Date of Admission Admission Type Data Type Date of Discharge Length of Stay Principal Diagnosis for a given admission Principal diagnosis and 14 secondary diagnoses Procedure principal Principal procedure and 14 secondary procedures Net payments to hospital, respectively Gross payments to hospital, respectively Net payments to physician, respectively Gross payments to physician, respectively Total Coinsurance (for the case) Total copay (for the case) Total deductible (for the case) Net total payments (for the case) Gross total payments (for the case)




description: #Section 4  


Each record represents either a mail-order or card program prescription drug claim. Linkable to other tables using Enrollee ID Linkable to RED BOOK Reference table using NDC Code. RED BOOK provides additional information related to DEA specifications, generic specifications, manufacturer specifications, strength and therapeutic specifications. No inpatient stay drugs. Common use of the data: medication adherence ratio calculation.



Key variables of interest: Capitated Service FLag Coinsurance Copay Deductible Ingredient Cost Net payments as reported by the carrier Gross payments as reported by the carrier Dispensed as written indicator Number of days of drug therapy covered DEA Class Generic Formulation Code Generic ID Long term maintenance ID The number of units dispensed NDC Number Paid Date Physician Specialty Coding Flag Retail pharmacy indicator Quantity of services Revenue Code Service Date Therapeutic/ pharmacologic Category Therapeutic Group




description: #Section 5  


Linkable to other tables using Enrollee ID Common analyses: adherence to treatment for a given condition.



Key variables of interest: Capitated Basis Payment Flag Coinsurance Copay Deductible Net payments as reported by the carrier Gross payments as reported by the carrier Principal diagnosis and three secondary diagnoses Facility ID Facility Proof Paid Date Physician Flag Principal procedure Procedure group Procedure Type Provider ID Quantity Revenue Code Service Setting Provider Type Service Date Service Category The end date for a service




description: #Section 6  


Facility files contain diagnosis and procedure information provided by types of provider at a given facility, for a given individual for a given episode of care. Linkable to other tables using Enrollee ID. Row Entity level: Facility at which a service or set of services were provided for a patient, during a given episode of care. Common analyses: facility cost of a given procedure.



Key variables of interest: Bill Type code Case ID Coinsurance Copayment Net payments Primary diagnosis and eight secondary diagnosis variables Facility Header ID Health Plan ID Diagnosis Related Grouping Principal procedure and five secondary procedure variables Setting where service occurred Provider Type Date of inpatient service End date for a service




description: #Section 7  
This dataset was created on `2020-01-10 18:35:47.115` by merging multiple datasets together. The source datasets for this version were:



**MarketScan Medicare Supplemental Insurance Population**: Aggregate demographic information about the eligible population is contained in the population files.



**MarketScan Medicare Supplemental Enrollment Detail**: The Enrollment Tables contain person-level enrollment records with demographic and plan information on users and non-users of services contained in the MarketScan Commercial Claims and Encounters and Medicare Supplemental Databases.



**MarketScan Medicare Supplemental Insurance Inpatient service**: This file contains individual inpatient claim records that were used to create admissions records.



**MarketScan Medicare Supplemental Insurance Facility header**: Header records from the inpatient and outpatient services. One record represents one facility-based service or set of services for an individual.



**MarketScan Medicare Supplemental Insurance Outpatient service**: Individual outpatient claim records.



**MarketScan Medicare Supplemental Insurance Inpatient admission**: Inpatient admission summary records. Inpatient meaning that the patient is formally admitted to the hospital with a doctor's order



**MarketScan Medicare Supplemental Insurance Outpatient Pharmacy**: Individual outpatient prescription drug claim records.



**MarketScan Medicare Supplemental Insurance Annual enrollment summary**: One record summarizes the number of days an individual was enrolled in a given calendar year. Commercial health data contains benefit information for enrollees and their dependents, for as long as the enrollee is an active employee.