MEPS HC-178B Codebook › ... › pufs › h178b › h178bcb.pdf163 164 DENTMED RECEIVED MEDICINE INCLUDING FREE SAMPLE 165 166 FFDVTYPE FLAT FEE BUNDLE 167 168 FFBEF15 TOTAL # OF

MEPS HC-178B CODEBOOK PAGE: 1 2015 DENTAL VISITS

DATE: April 10, 2017

ALPHABETICAL AND POSITIONAL LISTING OF VARIABLES

-----ALPHABETICAL LISTING OF VARIABLES----- START END NAME DESCRIPTION 108 109 ABSCESS ABSCESS OR INFECTION TREATMENT 116 117 BRIDGES BRIDGES 114 115 BRIDGESX EDITED BRIDGES 68 69 CLENTETH CLEANING, PROPHYLAXIS, OR POLISHING 88 89 CROWNS CROWNS OR CAPS 86 87 CROWNSX EDITED CROWNS 52 53 DENTHYG DENTAL HYGIENIST SEEN 163 164 DENTMED RECEIVED MEDICINE INCLUDING FREE SAMPLE 138 162 DENTOTHX OTHER SPECIFY DENTAL PROCEDURES EDITED 136 137 DENTPROC OTHER DENTAL PROCEDURES 134 135 DENTPROX EDITED DENTPROC 56 57 DENTSURG DENTAL SURGEON SEEN 54 55 DENTTECH DENTAL TECHNICIAN SEEN 120 121 DENTURES DENTURES OR PARTIAL DENTURES 118 119 DENTUREX EDITED DENTURES 64 65 DENTYPE OTHER DENTAL SPECIALIST SEEN 1 5 DUID DWELLING UNIT ID 9 16 DUPERSID PERSON ID (DUID + PID) 48 49 DVDATEMM EVENT DATE - MONTH 44 47 DVDATEYR EVENT DATE - YEAR 186 192 DVMD15X AMOUNT PAID, MEDICAID (IMPUTED) 179 185 DVMR15X AMOUNT PAID, MEDICARE (IMPUTED) 215 221 DVOF15X AMOUNT PAID, OTHER FEDERAL (IMPUTED) 234 240 DVOR15X AMOUNT PAID, OTHER PRIVATE (IMPUTED) 248 254 DVOT15X AMOUNT PAID, OTHER INSURANCE (IMPUTED) 241 247 DVOU15X AMOUNT PAID, OTHER PUBLIC (IMPUTED) 193 200 DVPV15X AMOUNT PAID, PRIVATE INSURANCE (IMPUTED) 171 178 DVSF15X AMOUNT PAID, FAMILY (IMPUTED) 222 227 DVSL15X AMOUNT PAID, STATE & LOCAL GOV (IMPUTED) 263 270 DVTC15X HHLD REPORTED TOTAL CHARGE (IMPUTED) 208 214 DVTR15X AMOUNT PAID, TRICARE(IMPUTED) 201 207 DVVA15X AMOUNT PAID, VETERANS/CHAMPVA(IMPUTED) 228 233 DVWC15X AMOUNT PAID, WORKERS COMP (IMPUTED) 255 262 DVXP15X SUM OF DVSF15X-DVOT15X (IMPUTED) 60 61 ENDODENT ENDODONTIST SEEN 29 29 EVENTRN EVENT ROUND NUMBER 17 28 EVNTIDX EVENT ID 66 67 EXAMINE GENERAL EXAM OR CONSULTATION 102 103 EXTRACT EXTRACTION, TOOTH PULLED 167 168 FFBEF15 TOTAL # OF VISITS IN FF BEFORE 2015 165 166 FFDVTYPE FLAT FEE BUNDLE 30 41 FFEEIDX FLAT FEE ID 169 170 FFTOT16 TOTAL # OF VISITS IN FF AFTER 2015 82 83 FILLING FILLINGS




-----ALPHABETICAL LISTING OF VARIABLES----- START END NAME DESCRIPTION 80 81 FILLINGX EDITED FILLING 74 75 FLUORIDE FLUORIDE TREATMENT 50 51 GENDENT GENERAL DENTIST SEEN 96 97 GUMSURG PERIODONTAL SCALING, ROOT PLANING OR GUM 94 95 GUMSURGX EDITED GUMSURG 271 271 IMPFLAG IMPUTATION STATUS 106 107 IMPLANT IMPLANTS 104 105 IMPLANTX EDITED IMPLANT 84 85 INLAY INLAYS 72 73 JUSTXRAY X-RAYS, RADIOGRAPHS OR BITEWINGS 70 71 JUSTXRYX EDITED JUSTXRAY 112 113 ORALSURG ORAL SURGERY 110 111 ORALSURX EDITED ORALSURG 126 127 ORTHDONT ORTHODONTIA, BRACES OR RETAINERS 124 125 ORTHDONX EDITED ORTHDONT 58 59 ORTHODNT ORTHODONTIST SEEN 42 43 PANEL PANEL NUMBER 62 63 PERIODNT PERIODONTIST SEEN 272 283 PERWT15F EXPENDITURE FILE PERSON WEIGHT, 2015 6 8 PID PERSON NUMBER 100 101 RECLVIS PERIODONTAL RECALL VISIT 98 99 RECLVISX EDITED RECLVIS 122 123 REPAIR REPAIR OF BRIDGES/DENTURES OR RELINING 92 93 ROOTCANL ROOT CANAL 90 91 ROOTCANX EDITED ROOTCANL 78 79 SEALANT SEALANT APPLICATION 76 77 SEALANTX EDITED SEALANT 132 133 TMDTMJ TREATMENT FOR TMD OR TMJ 288 288 VARPSU VARIANCE ESTIMATION PSU, 2015 284 287 VARSTR VARIANCE ESTIMATION STRATUM, 2015 130 131 WHITEN BONDING, WHITENING, OR BLEACHING 128 129 WHITENX EDITED WHITEN




-----POSITIONAL LISTING OF VARIABLES----- START END NAME DESCRIPTION 1 5 DUID DWELLING UNIT ID 6 8 PID PERSON NUMBER 9 16 DUPERSID PERSON ID (DUID + PID) 17 28 EVNTIDX EVENT ID 29 29 EVENTRN EVENT ROUND NUMBER 30 41 FFEEIDX FLAT FEE ID 42 43 PANEL PANEL NUMBER 44 47 DVDATEYR EVENT DATE - YEAR 48 49 DVDATEMM EVENT DATE - MONTH 50 51 GENDENT GENERAL DENTIST SEEN 52 53 DENTHYG DENTAL HYGIENIST SEEN 54 55 DENTTECH DENTAL TECHNICIAN SEEN 56 57 DENTSURG DENTAL SURGEON SEEN 58 59 ORTHODNT ORTHODONTIST SEEN 60 61 ENDODENT ENDODONTIST SEEN 62 63 PERIODNT PERIODONTIST SEEN 64 65 DENTYPE OTHER DENTAL SPECIALIST SEEN 66 67 EXAMINE GENERAL EXAM OR CONSULTATION 68 69 CLENTETH CLEANING, PROPHYLAXIS, OR POLISHING 70 71 JUSTXRYX EDITED JUSTXRAY 72 73 JUSTXRAY X-RAYS, RADIOGRAPHS OR BITEWINGS 74 75 FLUORIDE FLUORIDE TREATMENT 76 77 SEALANTX EDITED SEALANT 78 79 SEALANT SEALANT APPLICATION 80 81 FILLINGX EDITED FILLING 82 83 FILLING FILLINGS 84 85 INLAY INLAYS 86 87 CROWNSX EDITED CROWNS 88 89 CROWNS CROWNS OR CAPS 90 91 ROOTCANX EDITED ROOTCANL 92 93 ROOTCANL ROOT CANAL 94 95 GUMSURGX EDITED GUMSURG 96 97 GUMSURG PERIODONTAL SCALING, ROOT PLANING OR GUM 98 99 RECLVISX EDITED RECLVIS 100 101 RECLVIS PERIODONTAL RECALL VISIT 102 103 EXTRACT EXTRACTION, TOOTH PULLED 104 105 IMPLANTX EDITED IMPLANT 106 107 IMPLANT IMPLANTS 108 109 ABSCESS ABSCESS OR INFECTION TREATMENT 110 111 ORALSURX EDITED ORALSURG 112 113 ORALSURG ORAL SURGERY 114 115 BRIDGESX EDITED BRIDGES 116 117 BRIDGES BRIDGES 118 119 DENTUREX EDITED DENTURES




-----POSITIONAL LISTING OF VARIABLES----- START END NAME DESCRIPTION 120 121 DENTURES DENTURES OR PARTIAL DENTURES 122 123 REPAIR REPAIR OF BRIDGES/DENTURES OR RELINING 124 125 ORTHDONX EDITED ORTHDONT 126 127 ORTHDONT ORTHODONTIA, BRACES OR RETAINERS 128 129 WHITENX EDITED WHITEN 130 131 WHITEN BONDING, WHITENING, OR BLEACHING 132 133 TMDTMJ TREATMENT FOR TMD OR TMJ 134 135 DENTPROX EDITED DENTPROC 136 137 DENTPROC OTHER DENTAL PROCEDURES 138 162 DENTOTHX OTHER SPECIFY DENTAL PROCEDURES EDITED 163 164 DENTMED RECEIVED MEDICINE INCLUDING FREE SAMPLE 165 166 FFDVTYPE FLAT FEE BUNDLE 167 168 FFBEF15 TOTAL # OF VISITS IN FF BEFORE 2015 169 170 FFTOT16 TOTAL # OF VISITS IN FF AFTER 2015 171 178 DVSF15X AMOUNT PAID, FAMILY (IMPUTED) 179 185 DVMR15X AMOUNT PAID, MEDICARE (IMPUTED) 186 192 DVMD15X AMOUNT PAID, MEDICAID (IMPUTED) 193 200 DVPV15X AMOUNT PAID, PRIVATE INSURANCE (IMPUTED) 201 207 DVVA15X AMOUNT PAID, VETERANS/CHAMPVA(IMPUTED) 208 214 DVTR15X AMOUNT PAID, TRICARE(IMPUTED) 215 221 DVOF15X AMOUNT PAID, OTHER FEDERAL (IMPUTED) 222 227 DVSL15X AMOUNT PAID, STATE & LOCAL GOV (IMPUTED) 228 233 DVWC15X AMOUNT PAID, WORKERS COMP (IMPUTED) 234 240 DVOR15X AMOUNT PAID, OTHER PRIVATE (IMPUTED) 241 247 DVOU15X AMOUNT PAID, OTHER PUBLIC (IMPUTED) 248 254 DVOT15X AMOUNT PAID, OTHER INSURANCE (IMPUTED) 255 262 DVXP15X SUM OF DVSF15X-DVOT15X (IMPUTED) 263 270 DVTC15X HHLD REPORTED TOTAL CHARGE (IMPUTED) 271 271 IMPFLAG IMPUTATION STATUS 272 283 PERWT15F EXPENDITURE FILE PERSON WEIGHT, 2015 284 287 VARSTR VARIANCE ESTIMATION STRATUM, 2015 288 288 VARPSU VARIANCE ESTIMATION PSU, 2015


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END DUID DWELLING UNIT ID 5.0 NUM 1 5 VALUE UNWEIGHTED WEIGHTED BY PERWT15F VALID ID 28,090 305,997,894 TOTAL 28,090 305,997,894 PID PERSON NUMBER 3.0 NUM 6 8 VALUE UNWEIGHTED WEIGHTED BY PERWT15F VALID ID 28,090 305,997,894 TOTAL 28,090 305,997,894 DUPERSID PERSON ID (DUID + PID) 8.0 CHAR 9 16 VALUE UNWEIGHTED WEIGHTED BY PERWT15F VALID ID 28,090 305,997,894 TOTAL 28,090 305,997,894 EVNTIDX EVENT ID 12.0 CHAR 17 28 VALUE UNWEIGHTED WEIGHTED BY PERWT15F VALID ID 28,090 305,997,894 TOTAL 28,090 305,997,894 EVENTRN EVENT ROUND NUMBER 1.0 NUM 29 29 VALUE UNWEIGHTED WEIGHTED BY PERWT15F ROUND 1 4,058 45,780,332 ROUND 2 6,872 75,317,277 ROUND 3 6,424 69,512,634 ROUND 4 6,126 66,782,714 ROUND 5 4,610 48,604,937 TOTAL 28,090 305,997,894


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END FFEEIDX FLAT FEE ID 12.0 CHAR 30 41 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -1 INAPPLICABLE 24,587 263,448,117 VALID ID 3,503 42,549,778 TOTAL 28,090 305,997,894 PANEL PANEL NUMBER 2.0 NUM 42 43 VALUE UNWEIGHTED WEIGHTED BY PERWT15F PANEL 19 13,235 142,130,577 PANEL 20 14,855 163,867,318 TOTAL 28,090 305,997,894 DVDATEYR EVENT DATE - YEAR 4.0 NUM 44 47 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 14 119,805 -8 DK 10 115,156 2015 28,066 305,762,934 TOTAL 28,090 305,997,894 DVDATEMM EVENT DATE - MONTH 2.0 NUM 48 49 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 69 701,497 -8 DK 14 91,514 1 - 12 MONTH 28,007 305,204,884 TOTAL 28,090 305,997,894


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END GENDENT GENERAL DENTIST SEEN 2.0 NUM 50 51 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 92 968,741 -8 DK 110 881,729 -7 REFUSED 2 7,507 1 YES 21,515 235,420,297 2 NO 6,371 68,719,621 TOTAL 28,090 305,997,894 DENTHYG DENTAL HYGIENIST SEEN 2.0 NUM 52 53 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 92 968,741 -8 DK 110 881,729 -7 REFUSED 2 7,507 1 YES 8,559 106,653,942 2 NO 19,327 197,485,976 TOTAL 28,090 305,997,894 DENTTECH DENTAL TECHNICIAN SEEN 2.0 NUM 54 55 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 92 968,741 -8 DK 110 881,729 -7 REFUSED 2 7,507 1 YES 1,338 15,951,134 2 NO 26,548 288,188,784 TOTAL 28,090 305,997,894


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END DENTSURG DENTAL SURGEON SEEN 2.0 NUM 56 57 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 92 968,741 -8 DK 110 881,729 -7 REFUSED 2 7,507 1 YES 992 11,271,802 2 NO 26,894 292,868,115 TOTAL 28,090 305,997,894 ORTHODNT ORTHODONTIST SEEN 2.0 NUM 58 59 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 92 968,741 -8 DK 110 881,729 -7 REFUSED 2 7,507 1 YES 3,313 33,259,478 2 NO 24,573 270,880,440 TOTAL 28,090 305,997,894 ENDODENT ENDODONTIST SEEN 2.0 NUM 60 61 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 92 968,741 -8 DK 110 881,729 -7 REFUSED 2 7,507 1 YES 256 3,010,819 2 NO 27,630 301,129,099 TOTAL 28,090 305,997,894


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END PERIODNT PERIODONTIST SEEN 2.0 NUM 62 63 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 92 968,741 -8 DK 110 881,729 -7 REFUSED 2 7,507 1 YES 353 4,592,220 2 NO 27,533 299,547,698 TOTAL 28,090 305,997,894 DENTYPE OTHER DENTAL SPECIALIST SEEN 2.0 NUM 64 65 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 92 968,741 -8 DK 110 881,729 -7 REFUSED 2 7,507 1 YES 254 2,771,585 2 NO 27,632 301,368,332 TOTAL 28,090 305,997,894 EXAMINE GENERAL EXAM OR CONSULTATION 2.0 NUM 66 67 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 15,234 171,614,519 2 NO 12,707 132,897,144 TOTAL 28,090 305,997,894


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END CLENTETH CLEANING, PROPHYLAXIS, OR POLISHING 2.0 NUM 68 69 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 14,719 162,892,947 2 NO 13,222 141,618,716 TOTAL 28,090 305,997,894 JUSTXRYX EDITED JUSTXRAY 2.0 NUM 70 71 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 7,769 83,653,065 2 NO 20,172 220,858,598 TOTAL 28,090 305,997,894 JUSTXRAY X-RAYS, RADIOGRAPHS OR BITEWINGS 2.0 NUM 72 73 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 7,767 83,638,879 2 NO 20,174 220,872,784 TOTAL 28,090 305,997,894


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END FLUORIDE FLUORIDE TREATMENT 2.0 NUM 74 75 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 3,032 30,709,339 2 NO 24,909 273,802,324 TOTAL 28,090 305,997,894 SEALANTX EDITED SEALANT 2.0 NUM 76 77 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 535 4,369,961 2 NO 27,406 300,141,702 TOTAL 28,090 305,997,894 SEALANT SEALANT APPLICATION 2.0 NUM 78 79 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 532 4,347,497 2 NO 27,409 300,164,166 TOTAL 28,090 305,997,894


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END FILLINGX EDITED FILLING 2.0 NUM 80 81 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 3,301 32,682,868 2 NO 24,640 271,828,795 TOTAL 28,090 305,997,894 FILLING FILLINGS 2.0 NUM 82 83 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 3,258 32,171,263 2 NO 24,683 272,340,400 TOTAL 28,090 305,997,894 INLAY INLAYS 2.0 NUM 84 85 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 44 447,496 2 NO 27,897 304,064,167 TOTAL 28,090 305,997,894


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END CROWNSX EDITED CROWNS 2.0 NUM 86 87 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 1,548 19,299,803 2 NO 26,393 285,211,860 TOTAL 28,090 305,997,894 CROWNS CROWNS OR CAPS 2.0 NUM 88 89 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 1,518 18,788,671 2 NO 26,423 285,722,992 TOTAL 28,090 305,997,894 ROOTCANX EDITED ROOTCANL 2.0 NUM 90 91 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 601 6,742,486 2 NO 27,340 297,769,177 TOTAL 28,090 305,997,894


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END ROOTCANL ROOT CANAL 2.0 NUM 92 93 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 585 6,531,197 2 NO 27,356 297,980,466 TOTAL 28,090 305,997,894 GUMSURGX EDITED GUMSURG 2.0 NUM 94 95 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 348 4,015,624 2 NO 27,593 300,496,039 TOTAL 28,090 305,997,894 GUMSURG PERIODONTAL SCALING, ROOT PLANING OR GUM 2.0 NUM 96 97 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 320 3,685,354 2 NO 27,621 300,826,308 TOTAL 28,090 305,997,894


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END RECLVISX EDITED RECLVIS 2.0 NUM 98 99 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 168 2,036,989 2 NO 27,773 302,474,673 TOTAL 28,090 305,997,894 RECLVIS PERIODONTAL RECALL VISIT 2.0 NUM 100 101 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 164 1,994,648 2 NO 27,777 302,517,015 TOTAL 28,090 305,997,894 EXTRACT EXTRACTION, TOOTH PULLED 2.0 NUM 102 103 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 1,606 15,192,750 2 NO 26,335 289,318,913 TOTAL 28,090 305,997,894


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END IMPLANTX EDITED IMPLANT 2.0 NUM 104 105 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 307 3,671,492 2 NO 27,634 300,840,171 TOTAL 28,090 305,997,894 IMPLANT IMPLANTS 2.0 NUM 106 107 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 298 3,592,023 2 NO 27,643 300,919,640 TOTAL 28,090 305,997,894 ABSCESS ABSCESS OR INFECTION TREATMENT 2.0 NUM 108 109 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 148 1,613,886 2 NO 27,793 302,897,777 TOTAL 28,090 305,997,894


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END ORALSURX EDITED ORALSURG 2.0 NUM 110 111 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 175 1,970,766 2 NO 27,766 302,540,897 TOTAL 28,090 305,997,894 ORALSURG ORAL SURGERY 2.0 NUM 112 113 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 154 1,752,605 2 NO 27,787 302,759,058 TOTAL 28,090 305,997,894 BRIDGESX EDITED BRIDGES 2.0 NUM 114 115 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 166 2,156,537 2 NO 27,775 302,355,126 TOTAL 28,090 305,997,894


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END BRIDGES BRIDGES 2.0 NUM 116 117 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 159 2,078,081 2 NO 27,782 302,433,582 TOTAL 28,090 305,997,894 DENTUREX EDITED DENTURES 2.0 NUM 118 119 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 590 6,133,077 2 NO 27,351 298,378,586 TOTAL 28,090 305,997,894 DENTURES DENTURES OR PARTIAL DENTURES 2.0 NUM 120 121 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 562 5,884,383 2 NO 27,379 298,627,280 TOTAL 28,090 305,997,894


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END REPAIR REPAIR OF BRIDGES/DENTURES OR RELINING 2.0 NUM 122 123 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 215 2,265,521 2 NO 27,726 302,246,142 TOTAL 28,090 305,997,894 ORTHDONX EDITED ORTHDONT 2.0 NUM 124 125 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 3,054 30,108,374 2 NO 24,887 274,403,289 TOTAL 28,090 305,997,894 ORTHDONT ORTHODONTIA, BRACES OR RETAINERS 2.0 NUM 126 127 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 2,989 29,544,775 2 NO 24,952 274,966,888 TOTAL 28,090 305,997,894


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END WHITENX EDITED WHITEN 2.0 NUM 128 129 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 64 785,509 2 NO 27,877 303,726,154 TOTAL 28,090 305,997,894 WHITEN BONDING, WHITENING, OR BLEACHING 2.0 NUM 130 131 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 59 745,646 2 NO 27,882 303,766,017 TOTAL 28,090 305,997,894 TMDTMJ TREATMENT FOR TMD OR TMJ 2.0 NUM 132 133 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 46 545,666 2 NO 27,895 303,965,997 TOTAL 28,090 305,997,894


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END DENTPROX EDITED DENTPROC 2.0 NUM 134 135 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 503 6,034,537 2 NO 27,438 298,477,125 TOTAL 28,090 305,997,894 DENTPROC OTHER DENTAL PROCEDURES 2.0 NUM 136 137 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 93 971,848 -8 DK 50 492,189 -7 REFUSED 6 22,195 1 YES 764 8,906,067 2 NO 27,177 295,605,596 TOTAL 28,090 305,997,894 DENTOTHX OTHER SPECIFY DENTAL PROCEDURES EDITED 25.0 CHAR 138 162 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -1 INAPPLICABLE 27,587 299,963,357 2 TEETH REPLACEMENT 1 10,939 ABCESS 1 14,505 ADJ PROSTETHIC 1 16,185 ADJUSTMENT 3 12,635 ANESTHESIA 1 10,250 ANESTIZING GUM AREA TO XR 1 8,717 ANTIBIOTIC TREATMENT 1 7,980 APLICATION FOR ATENTION 1 0 (CONT’D ON NEXT PAGE)


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END DENTOTHX OTHER SPECIFY DENTAL PROCEDURES EDITED 25.0 CHAR 138 162 VALUE UNWEIGHTED WEIGHTED BY PERWT15F (CONT’D FROM PREVIOUS PAGE) APPLIED MEDICIN UNDER GUM 1 6,406 AREA BETWEEN TEETH FOOD 1 4,347 ASKED FOR PRICE INFO 1 5,800 ASSESS FOR IMPLANTS 1 4,609 BABY ROOT CANAL 1 3,448 BIO LINER 1 9,416 BIOPSY 1 11,225 BITE ADJUSTMENT 1 10,528 BITE BLOCK FITTED 1 14,449 BITE GUARD 5 109,063 BITE GUARD FITTING 1 4,289 BITE GUARD IMPRESSION 1 4,473 BITE IMPRINT REPLC BRIDGE 1 12,277 BITE PLATE 1 8,279 BITE SPLINT 2 41,331 BONDED A CHIPPED TOOTH 1 18,099 BONDING ON CHIPPED TOOTH 1 14,135 BONE EROSION TREATMENT 5 45,828 BONE GRAFT 2 19,323 BONE GRAPH 1 23,667 BONE GRATH 1 5,013 BOTOX INJECTIONS 1 4,738 BROKE A TOOTH 1 20,170 BROKE HALF OF TOOTH 1 22,921 BROKEN PIECE OF TOOTH 2 54,647 BROKEN TEETH 4 21,756 BROKEN TOOTH 6 89,246 BROKEN TOOTH REPAIR 2 35,418 BROKEN TOOTH REPAIRED 1 16,651 BUFFED FILLINGS 1 21,557 BUILD UP 1 18,217 BUILTHUP FRONT TOOTH 1 9,551 (CONT’D ON NEXT PAGE)


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END DENTOTHX OTHER SPECIFY DENTAL PROCEDURES EDITED 25.0 CHAR 138 162 VALUE UNWEIGHTED WEIGHTED BY PERWT15F (CONT’D FROM PREVIOUS PAGE) CALL FOR ON GOING INFECTI 1 4,579 CALL FOR PRESCRIPTION 1 9,949 CANCER SCREEN 1 22,797 CANCER TEST 1 20,515 CAPS EXTRACTIONS SEALANT 1 0 CAT SCAN 1 11,311 CAVITY FILLING 1 35,590 CEMENTATION OF CROWN 1 12,569 CHECK FOR MOUTH CANCER 1 9,409 CHECKED BITE AND GUARD 1 5,187 CHECKED INSURANCE 1 4,417 CHIPED TOOTH 1 8,595 CHIPPED TOOTH SANDED 1 4,973 CLEAN UNDER GUME 2 9,149 CLEANING UNDER GUMS 2 19,362 CONSTATION FOR EXTRACT 1 21,656 CONSULATION 1 7,727 CONSULT 1 23,552 CONSULT ON THE IMPLANT 2 13,183 CONSULT PARTIAL DENTURE 1 10,706 CONSULT THE IMPLANT 1 6,592 CONSULTATION 9 114,300 CORE BUILDUP 1 12,050 CORTOZONE SHOT 1 4,738 COSULTATION REFERAL 1 7,894 CRACKED TOOTH 4 39,670 CRACKED TOOTH ANO CROWN 1 17,551 CROWN REDUCTION 1 28,000 CT SCAN 2 13,109 CT SCAN ON TEETH 1 9,249 DEBREDING 1 12,887 DEEP CLEANING OF THE GUMS 1 2,714 (CONT’D ON NEXT PAGE)


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END DENTOTHX OTHER SPECIFY DENTAL PROCEDURES EDITED 25.0 CHAR 138 162 VALUE UNWEIGHTED WEIGHTED BY PERWT15F (CONT’D FROM PREVIOUS PAGE) DELIVER BITE SPLINT 1 20,665 DENTAL CASTS 1 6,044 DENTAL CHECK/CANCER CHECK 1 11,225 DENTAL IMPRESSION 1 3,585 DENTAL IMPRESSIONS 1 20,161 DENTAL MOLDS 2 12,089 DEVICE FOR GRINDING 1 21,129 DEVICES 1 4,880 DIAGNOSIS FOR LOOSE TOOTH 1 5,943 DIAGNOSTIC AND PREVENTIVE 1 21,460 DIAGNOSTIC CASTS 1 9,625 DIGSONA 1 19,346 DISCUSSEDSTOPPINPROCESS 1 11,845 DONT KNOW 3 24,189 EMERGENCY VISIT 1 3,423 ENAMAL BONDING 1 27,318 ESTIMATE FOR SERVICES 1 6,277 EXAM BUT NOTHING DONE 1 8,117 EXAMINED BROKEN TOOTH 1 14,300 EYE EXAM 1 2,501 FALLOW UP 1 7,431 FILE DENTURES 1 2,583 FILE DOWN A TOOTH 1 11,126 FILE DOWN TOOTH 1 14,605 FILED DOWN CHIPPED TOOTH 1 11,163 FILED DOWN THE PARTIAL 1 4,333 FILED FILLING DOWN 1 10,557 FILED SHARP POINT OFF 1 26,841 FILED TOOTH BOTTOM EDGE 1 11,006 FILING OF TOOTH 1 11,879 FIT FOR BITE GUARD 1 26,945 FIT FOR MOUTH PIECE 1 9,330 (CONT’D ON NEXT PAGE)


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END DENTOTHX OTHER SPECIFY DENTAL PROCEDURES EDITED 25.0 CHAR 138 162 VALUE UNWEIGHTED WEIGHTED BY PERWT15F (CONT’D FROM PREVIOUS PAGE) FITTED FOR A BITE SPLINT 1 21,129 FITTED FOR A BITEGUARD 1 18,707 FITTED FOR MOUTH GUARD 1 9,614 FITTED MOUTH GUARD 1 14,007 FITTING FOR A BITE SPLINT 1 21,129 FITTING FOR BITE GUARD 1 4,289 FITTING MOUTH GUARD 1 7,777 FITTINGS FOR APPLIANCE 1 22,715 FIX BROKEN TOOTH 1 4,448 FIXED 1 7,899 FIXED BROKEN TOOTH 4 64,337 FIXED CHIPPED TOOTH 1 4,743 FIXED CRACK TOOTH 1 15,482 FIXED PRIOR WORK 1 7,899 FIXED TOOTH 1 10,180 FIXING CHIP TOOTH 1 14,925 FLIPPER CHECKED 1 5,076 FLOURISENE TRAYS 1 16,535 FOLLOW FOR PRIOR GRAPH 1 10,329 FOLLOW UP 20 185,329 FOLLOW UP FOR SURGERY 1 10,074 FOLLOW UP FROM PREVIOUS 1 43,592 FOLLOW UP FROM SURGERY 1 10,074 FOLLOW UP FROM THE EXTRAC 1 8,435 FOLLOW UP ON PARTIAL 2 0 FOLLOW UP STITCH REMOVAL 1 14,969 FOLLOW UP TO CHECK BONDIN 1 8,189 FOLLOW UP TO SURGERY 1 3,519 FOLLOW UP VISIT 2 20,753 FOLLOW-UP 5 36,408 FOLLOW-UP CHECK 3 8,379 FOLLOW-UP W/ EXPANDER 1 8,080 (CONT’D ON NEXT PAGE)


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END DENTOTHX OTHER SPECIFY DENTAL PROCEDURES EDITED 25.0 CHAR 138 162 VALUE UNWEIGHTED WEIGHTED BY PERWT15F (CONT’D FROM PREVIOUS PAGE) FOLLOWUP 3 29,544 FOLLOWUP AND PRESCRIPTION 1 10,490 FOLLOWUP FOR DENTAL SURGE 1 17,499 FOLLOWUP ON PARTIAL 4 0 FOLLOWUP STITCH REMOVAL 1 4,181 FRONT TOOTH BROKE 1 4,133 GLUE CROWN BACK ON 1 16,862 GLUED BROKEN TOOTH SPLINT 1 14,300 GRIND CROWN TOP FOR ALIGN 1 10,597 GRIND DOWN BONE 1 13,598 GRIND DOWN JAW BONE 2 27,196 GRIND DOWN TOOTH 1 3,087 GROUND DOWN TOOTH 1 22,066 GROUND LONG TEETH DOWN 1 18,428 GUARD 1 12,580 HAD BROKEN TOOTH REPAIRED 1 19,227 IGHTNING BRACES 1 3,165 IMPRES 1 20,161 IMPRESENTS 1 16,797 IMPRESS FITTINGS 2 40,322 IMPRESSION 2 35,441 IMPRESSION APPLIANCE BROK 1 22,715 IMPRESSION FOR GUARD 1 14,007 IMPRESSION OF TEETH 1 8,720 IMPRESSION/MOLDS 1 8,305 IMPRESSIONS 11 138,168 IMPRESSIONS FOR GUARD 1 10,163 IMPRINT 1 6,413 INFECTION IN TEETH 1 7,122 INFECTION ON TOOTH 1 10,393 INFECTION RE TOOTH EXTRAC 1 15,989 INFECTION RELATED SYM EXA 1 5,532 (CONT’D ON NEXT PAGE)


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END DENTOTHX OTHER SPECIFY DENTAL PROCEDURES EDITED 25.0 CHAR 138 162 VALUE UNWEIGHTED WEIGHTED BY PERWT15F (CONT’D FROM PREVIOUS PAGE) INJURY FOLLOW-UP 1 12,400 INJURY FOLLOWUP 1 12,400 INSERTION OF PERM BRIDGE 1 13,363 INSTALLED BRIDGE 1 16,958 INTRAORAL-PERIAPICAL 1 18,771 INVISILINE 2 23,831 IRROGATION OF THE TOOTH 1 8,505 IV DEEP CONSCIOUS SEDATIO 1 15,440 JAW ALIGNMENT. SUTURES 1 15,989 JAW BONE GRAPH 1 8,717 JAW EXTENDER 2 11,761 JAW EXTENDER PLACED 1 5,881 LASER 2 30,278 LASER PREVENTIVE 1 20,684 LASER TREATMENT 1 2,281 LAST FOLLOWUP FOR IMPLANT 1 11,311 LOOSE RETAINER 1 7,317 MADE A MOLD FOR IMPLANT 1 14,300 MEASURE AGAIN 1 6,093 MEASURING OF TEETH 1 7,741 MEDICINE INSIDE GUM 1 11,656 MESURE FOR CROWNS 1 5,898 MOLD FOR TEETH 1 30,163 MOLD OF TEETH 1 7,720 MOLD SETTIMG 1 8,291 MOLD SETTING 1 8,291 MOLD TAKEN 1 21,534 MOLDING FOR SPACER 1 3,281 MOLDS 2 31,003 MOUTH GARD 1 9,942 MOUTH GAURD MOLD 1 10,946 MOUTH GUARD 8 150,256 (CONT’D ON NEXT PAGE)


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END DENTOTHX OTHER SPECIFY DENTAL PROCEDURES EDITED 25.0 CHAR 138 162 VALUE UNWEIGHTED WEIGHTED BY PERWT15F (CONT’D FROM PREVIOUS PAGE) MOUTH GUARD ADJUSTMT 1 31,751 MOUTH GUARD FITTING 3 76,298 MOUTH GUARD MADE 2 28,554 MOUTH GURAD DELIERY 1 16,300 MOUTH INJURY TREATMENT 1 12,400 MOUTH MOLDING 1 4,540 MOUTHGUARD 1 4,585 MOUTHPIECE APPLICANCE 1 17,692 MRI 1 7,393 NIGHT GUARD FOR GRINDING 1 7,777 NIGHT GUARD IMPRESSION 1 4,466 NIGHT/BITE GUARD 1 9,452 NITROUS OXIDE 1 9,881 NITROUS OXIDE GAS 1 5,555 NO TREATMENTS DONE 1 9,825 NO TX DUE TO HIGH BLOOD P 1 4,410 NOTHING 1 10,906 NOTHING-CHILD NO-COPERATE 1 6,488 NOVACANE 1 7,079 OCCI GUARD 1 10,726 OCCLUSAL GUARD 1 14,449 OCCULAR GUARD 1 10,324 ORAL CANCER SCAN 1 29,633 ORAL CANCER SCREENING 2 37,075 ORAL CANCER TEST 1 12,757 ORDERED PARTIAL 1 3,136 PAIN IN BACK TOOTH 1 28,887 PAIN IN BOTTOM TOOTH 1 7,288 PAIN TOOTH 2 10,144 PASTE OR GLUE BK CROWN 1 12,812 PEDIATRIC DENTIST 1 10,509 PERIODONIC EXAM 1 24,946 (CONT’D ON NEXT PAGE)


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END DENTOTHX OTHER SPECIFY DENTAL PROCEDURES EDITED 25.0 CHAR 138 162 VALUE UNWEIGHTED WEIGHTED BY PERWT15F (CONT’D FROM PREVIOUS PAGE) PHONE CALL FOR NEW RX 1 28,000 PHONE CALL FOR QUESTION 1 7,344 PHONE CALL TO MAKE APPT 1 19,638 PHONE CALL TO MAKE APT. 1 12,842 PICK UP PAPERWORK 1 3,931 PICK-UP MOUTH GUARD 1 7,777 PICKED UP NIGHTGUARD 1 9,210 PICKED UP PARTIAL 1 5,529 PINS AND POST IN TOOTH 1 12,289 PLACED A SCREW FOR AN IMP 1 2,409 PLASMA INJECTION SOCKET 1 8,435 PONTIC PORCELAIN WITHY HI 1 2,198 POST BEHIND TOOTH 1 8,124 POST INSERTION 1 29,975 POST N CORE 1 4,905 POST OP 2 32,370 POST-OP FOLLOW-UP 1 18,431 PREFAB POST AND CORE 1 34,516 PREFAB POST/CORE RESIN 1 1 4,347 PREOP 1 15,440 PRESCRIPTION 1 2,845 PRESSURE TEST 1 17,271 PREVENTATIVE CARE 1 8,451 PRO ADIT CLEANING 1 4,602 PULLED OUT STICHES 1 9,111 PUT CHAIN ON TOOTH 1 18,809 PUT PASTE ON WORKED TEETH 1 7,026 PUT PERMANENT TOOTH 1 13,742 PUT SOME PUTTY 1 16,906 PUTTING BARS IN MOUTH 1 5,927 QUICK LOOK IN MOUTH 1 9,911 QUOTE BRACES 1 12,397 (CONT’D ON NEXT PAGE)


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END DENTOTHX OTHER SPECIFY DENTAL PROCEDURES EDITED 25.0 CHAR 138 162 VALUE UNWEIGHTED WEIGHTED BY PERWT15F (CONT’D FROM PREVIOUS PAGE) RE-BOND CROWN 1 4,861 RECEIVED MOUTH GUARD 1 10,163 RECHECK AFTER INFEC TRMT 1 8,908 RECIEVED MOUTH GUARD 1 16,839 RECONSTRUCTION AND REPAIR 1 10,957 REFERRAL 2 12,914 REFILL RX 1 18,345 REFIT TEMPORARY CAP 1 4,461 REGLUED A CROWN 1 10,938 REGLUED PERMANEN RETAINER 1 11,534 REMOVAL CEMENT RETAINER 1 2,533 REMOVAL OF STICHES 1 4,363 REMOVAL OF STITCHES 1 9,573 REMOVE FILLINGS 1 4,600 REMOVE STITCHES 3 17,912 REMOVE SURGERY PACKING 1 16,185 REMOVE WISDOM TOOTH CHIP 1 2,285 REMOVED A GROWTH ON GUM 1 4,861 REMOVED BRIDGE 1 9,330 REMOVED CROWN 1 10,434 REMOVED CROWN FROM IMLANT 1 11,155 REMOVED CROWN/TEMP CROWN 1 13,363 REMOVED POPCORN FROM TOOT 1 20,222 REMOVED STICHES 2 37,917 REMOVED STITCHES - EXTRAT 1 14,300 REPAIR CAP RT UPPER TOOTH 1 8,189 REPAIR GAP IN TOOTH 1 8,908 REPAIR OF BROKEN TOOTH 1 0 REPAIR OF R FRONT TOOTH 1 22,527 REPAIR OF TOOTH 1 11,885 REPAIR TOOTH 1 7,390 REPAIRED THE FRONT TOOTH 1 4,117 (CONT’D ON NEXT PAGE)


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END DENTOTHX OTHER SPECIFY DENTAL PROCEDURES EDITED 25.0 CHAR 138 162 VALUE UNWEIGHTED WEIGHTED BY PERWT15F (CONT’D FROM PREVIOUS PAGE) REPLACED PERM BRIDGE 1 11,117 REPLACEMENT 3 17,206 REPLACEMENT RETAINER 1 7,317 RERPAIRED TOOTH CHIP 1 8,929 RESIDUAL TOOTH 1 11,841 RESIN SURFACE OF TOOTH 1 31,929 RESTORATIVE SURGERY 1 6,375 RESTORE AND PONTIC 1 29,773 RESTORE TOOTH FILLING 1 16,241 RESTORED CRACKED TOOTH 1 8,281 SECOND OPINION SALIVARY G 1 7,873 SEDATION 3 35,963 SEE ALL DENTAL CARE 1 11,225 SET UP APPOINTMENT ONLY 1 5,276 SHAPING 1 10,369 SHAVE DOWN THE TEETH 1 24,435 SHOT OF NOVACAINE 1 21,715 SHOT TO KILL BACTERIA GUM 1 5,059 SINUS AUGMENTATION 1 36,135 SINUS LIFT AND BONE GRAFT 1 13,889 SLEEP APEANA 1 27,295 SLEEP APEANA ISSUES 1 27,295 SLEEP APNEA 1 11,587 SLEEP APNEA APPLIANCE 1 9,330 SLEEP APNEA DEVICE 1 29,111 SLEEP APNEA MOUTH BRACE 1 29,111 SMOOTHED OUT TEETH 1 26,911 SMOOTHED TOOTH OFF 1 32,262 SNORE DEVICE 1 3,255 SONOGRAM OF TOOTH 1 10,997 SPLINT 1 27,651 STABALIZATION OF TEETH 1 9,557 (CONT’D ON NEXT PAGE)


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END DENTOTHX OTHER SPECIFY DENTAL PROCEDURES EDITED 25.0 CHAR 138 162 VALUE UNWEIGHTED WEIGHTED BY PERWT15F (CONT’D FROM PREVIOUS PAGE) STARTED DRILLING FOR IMPL 1 14,899 STITCHED CHEEK TOGETHER 1 21,707 STITCHES REMOVED 3 34,927 SURGERY FOLLOW UP 1 9,166 SUTURES REMOVED 1 19,611 SWOLLEN GUMS 1 12,950 SWOLLEN JAWS 1 6,911 TAKE OUT STICHES 1 1,730 TELECALL- FILLINGS CHIPPI 1 7,868 TELECALL-FILLING FELL OUT 1 7,868 TELEPHONE CALL 2 25,540 TEMPORARY 1 24,424 TEMPORARY CAP ON TOOTH 1 7,390 TEMPORARY PLASTIC BRIDGE 1 16,952 TEMPORARY TOOTH 2 56,198 TESTING GUM DEPTH 1 9,688 TETH MEASUREMENT 1 4,864 THEY REFERRED TO ANOTHER 1 2,775 TIEDING UP THE BRACES 1 9,698 TOOK IMPRESSION 1 8,630 TOOK MOLD OF TEETH 1 3,564 TOOK MOLD OF TEETH FOR WH 1 8,133 TOOK TEETH MODEL 1 7,741 TOOTH ACHE 3 73,306 TOOTH BUILDUP 1 22,527 TOOTH CHIPPED AS PLAYING 1 9,004 TOOTH IMPRESSION 2 8,277 TOOTH IMPRESSIONS 2 16,032 TOOTH INFECTION 1 10,469 TOOTH PAIN 3 13,431 TOOTH RECHECK 1 5,103 TOOTH REIMPLATATION 1 6,919 (CONT’D ON NEXT PAGE)


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END DENTOTHX OTHER SPECIFY DENTAL PROCEDURES EDITED 25.0 CHAR 138 162 VALUE UNWEIGHTED WEIGHTED BY PERWT15F (CONT’D FROM PREVIOUS PAGE) TOOTH REPAIR 2 39,057 TOOTH REPAIRED 2 37,482 TOOTH SWOLLEN INFECTED 1 9,784 TOOTHACHE 2 17,642 TREAT A TOOTH ACHE 1 18,733 TREAT AN INFECTION 1 12,842 TREATMENT FOR INFECTION 1 8,908 TREATMENT OF LOWER TOOTH 1 11,097 TREATMENT SENSITIVE TOOTH 1 31,690 TUMOR EXTRACTION 1 2,791 TUTH FELL 1 4,167 UNCOVER POST 1 19,346 UNKNOWN ISSUE IN MOUTH 1 14,505 UNKNOWN PROBLEM IN MOUTH 1 14,505 VENEERS 1 4,339 WAITING LIST FOR APPT 1 5,923 WENT FOR TOOTH PAINCAVITY 1 6,194 TOTAL 28,090 305,997,894 DENTMED RECEIVED MEDICINE INCLUDING FREE SAMPLE 2.0 NUM 163 164 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 275 2,809,015 -8 DK 77 640,387 -7 REFUSED 7 63,361 1 YES 1,600 16,312,181 2 NO 26,131 286,172,951 TOTAL 28,090 305,997,894


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END FFDVTYPE FLAT FEE BUNDLE 2.0 NUM 165 166 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -1 INAPPLICABLE 24,587 263,448,117 1 FLAT FEE STEM 744 9,326,932 2 FLAT FEE LEAF 2,759 33,222,846 TOTAL 28,090 305,997,894 FFBEF15 TOTAL # OF VISITS IN FF BEFORE 2015 2.0 NUM 167 168 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 75 787,404 -8 DK 36 551,583 -1 INAPPLICABLE 24,587 263,448,117 0 2,398 29,220,832 1 - 48 994 11,989,959 TOTAL 28,090 305,997,894 FFTOT16 TOTAL # OF VISITS IN FF AFTER 2015 2.0 NUM 169 170 VALUE UNWEIGHTED WEIGHTED BY PERWT15F -9 NOT ASCERTAINED 71 754,912 -8 DK 16 106,632 -1 INAPPLICABLE 24,587 263,448,117 0 2,657 33,843,673 1 - 40 759 7,844,560 TOTAL 28,090 305,997,894 DVSF15X AMOUNT PAID, FAMILY (IMPUTED) 8.2 NUM 171 178 VALUE UNWEIGHTED WEIGHTED BY PERWT15F 0 16,677 167,402,153 $1.00 - $40.00 2,901 34,264,248 $40.01 - $100.00 2,860 33,398,814 $100.01 - $213.00 2,803 35,520,056 $213.01 - $25,000.00 2,849 35,412,623 TOTAL 28,090 305,997,894


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END DVMR15X AMOUNT PAID, MEDICARE (IMPUTED) 7.2 NUM 179 185 VALUE UNWEIGHTED WEIGHTED BY PERWT15F 0 27,640 301,198,627 $1.00 - $98.00 116 1,434,026 $98.01 - $144.00 110 1,165,803 $144.01 - $295.00 119 1,144,152 $295.01 - $6,020.00 105 1,055,285 TOTAL 28,090 305,997,894 DVMD15X AMOUNT PAID, MEDICAID (IMPUTED) 7.2 NUM 186 192 VALUE UNWEIGHTED WEIGHTED BY PERWT15F 0 21,834 269,165,964 $0.54 - $67.28 1,571 8,968,819 $67.29 - $97.44 1,561 8,712,074 $97.45 - $162.40 1,576 9,408,526 $162.41 - $4,936.96 1,548 9,742,511 TOTAL 28,090 305,997,894 DVPV15X AMOUNT PAID, PRIVATE INSURANCE (IMPUTED) 8.2 NUM 193 200 VALUE UNWEIGHTED WEIGHTED BY PERWT15F 0 16,483 157,063,012 $1.00 - $100.00 3,019 39,164,386 $100.01 - $148.00 2,811 37,515,979 $148.01 - $229.00 2,893 36,898,873 $229.01 - $15,101.00 2,884 35,355,644 TOTAL 28,090 305,997,894


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END DVVA15X AMOUNT PAID, VETERANS/CHAMPVA(IMPUTED) 7.2 NUM 201 207 VALUE UNWEIGHTED WEIGHTED BY PERWT15F 0 27,910 304,188,121 $35.00 - $103.50 45 529,160 $103.51 - $171.50 45 411,787 $171.51 - $292.00 45 466,694 $292.01 - $5,000.00 45 402,133 TOTAL 28,090 305,997,894 DVTR15X AMOUNT PAID, TRICARE(IMPUTED) 7.2 NUM 208 214 VALUE UNWEIGHTED WEIGHTED BY PERWT15F 0 27,960 304,424,471 $19.50 - $93.00 34 526,181 $93.01 - $145.00 32 375,148 $145.01 - $202.50 32 320,320 $202.51 - $5,000.00 32 351,775 TOTAL 28,090 305,997,894 DVOF15X AMOUNT PAID, OTHER FEDERAL (IMPUTED) 7.2 NUM 215 221 VALUE UNWEIGHTED WEIGHTED BY PERWT15F 0 27,981 304,849,740 $15.00 - $68.00 28 305,682 $68.01 - $125.00 28 309,022 $125.01 - $214.00 27 274,003 $214.01 - $5,000.00 26 259,448 TOTAL 28,090 305,997,894


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END DVSL15X AMOUNT PAID, STATE & LOCAL GOV (IMPUTED) 6.2 NUM 222 227 VALUE UNWEIGHTED WEIGHTED BY PERWT15F 0 28,021 305,368,460 $5.00 - $67.00 19 191,057 $67.01 - $140.00 16 162,815 $140.01 - $253.00 17 174,352 $253.01 - $660.00 17 101,210 TOTAL 28,090 305,997,894 DVWC15X AMOUNT PAID, WORKERS COMP (IMPUTED) 6.2 NUM 228 233 VALUE UNWEIGHTED WEIGHTED BY PERWT15F 0 28,088 305,977,958 $160.00 - $161.00 2 19,936 TOTAL 28,090 305,997,894 DVOR15X AMOUNT PAID, OTHER PRIVATE (IMPUTED) 7.2 NUM 234 240 VALUE UNWEIGHTED WEIGHTED BY PERWT15F 0 27,707 302,193,952 $9.00 - $91.00 97 1,126,873 $91.01 - $135.00 95 996,854 $135.01 - $250.00 96 874,211 $250.01 - $6,500.00 95 806,005 TOTAL 28,090 305,997,894 DVOU15X AMOUNT PAID, OTHER PUBLIC (IMPUTED) 7.2 NUM 241 247 VALUE UNWEIGHTED WEIGHTED BY PERWT15F 0 28,001 305,680,239 $14.80 - $50.46 23 77,178 $50.47 - $79.46 22 80,057 $79.47 - $109.52 22 85,466 $109.53 - $1,102.00 22 74,955 TOTAL 28,090 305,997,894


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END DVOT15X AMOUNT PAID, OTHER INSURANCE (IMPUTED) 7.2 NUM 248 254 VALUE UNWEIGHTED WEIGHTED BY PERWT15F 0 27,985 305,106,488 $6.00 - $60.00 27 226,015 $60.01 - $130.00 29 237,388 $130.01 - $208.00 23 188,019 $208.01 - $3,700.00 26 239,984 TOTAL 28,090 305,997,894 DVXP15X SUM OF DVSF15X-DVOT15X (IMPUTED) 8.2 NUM 255 262 VALUE UNWEIGHTED WEIGHTED BY PERWT15F 0 3,602 43,393,296 $5.00 - $97.44 6,146 54,542,212 $97.45 - $149.00 6,135 69,070,084 $149.01 - $250.00 6,127 70,895,607 $250.01 - $25,000.00 6,080 68,096,696 TOTAL 28,090 305,997,894 DVTC15X HHLD REPORTED TOTAL CHARGE (IMPUTED) 8.2 NUM 263 270 VALUE UNWEIGHTED WEIGHTED BY PERWT15F 0 2,759 33,222,846 $5.00 - $120.00 6,371 66,708,202 $120.01 - $180.00 6,434 70,628,634 $180.01 - $300.00 6,217 67,385,906 $300.01 - $85,628.57 6,309 68,052,307 TOTAL 28,090 305,997,894


DATE: April 10, 2017 NAME DESCRIPTION FORMAT TYPE START END IMPFLAG IMPUTATION STATUS 1.0 NUM 271 271 VALUE UNWEIGHTED WEIGHTED BY PERWT15F 0 NOT ELIGIBLE FOR IMPUTATION 2,759 33,222,846 1 COMPLETE HC DATA 8,248 106,755,227 3 FULLY IMPUTED 14,045 131,602,413 4 PARTIALLY IMPUTED 3,038 34,417,409 TOTAL 28,090 305,997,894 PERWT15F EXPENDITURE FILE PERSON WEIGHT, 2015 12.6 NUM 272 283 VALUE UNWEIGHTED 0.000000 WEIGHT 452 678.130566 - 98103.984953 WEIGHT 27,638 TOTAL 28,090 VARSTR VARIANCE ESTIMATION STRATUM, 2015 4.0 NUM 284 287 VALUE UNWEIGHTED 1,001 - 1,165 28,090 TOTAL 28,090 VARPSU VARIANCE ESTIMATION PSU, 2015 1.0 NUM 288 288 VALUE UNWEIGHTED 1 - 3 28,090 TOTAL 28,090

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MEPS HC-178B Codebook › ... › pufs › h178b › h178bcb.pdf163 164 DENTMED RECEIVED MEDICINE INCLUDING FREE SAMPLE 165 166 FFDVTYPE FLAT FEE BUNDLE 167 168 FFBEF15 TOTAL # OF