1 |
BENE_ID |
Encrypted CCW Beneficiary Identifier |
2 |
PRACTICE_ID |
Model-Assigned Practice ID |
3 |
PRACTICE_NAME |
Name of Practice |
4 |
TIN |
Practice's Taxpayer Identification Number |
5 |
UNIQUE_PATIENT_ID |
Unique Model-Assigned Patient ID |
6 |
PATIENT_DOB |
Patient's Date of Birth |
7 |
PATIENT_GENDER |
Patient's Gender |
8 |
PATIENT_RACE |
Patient's Race |
9 |
PATIENT_ETHNICITY |
Patient's Ethnicity |
10 |
IS_MEDICARE_PARTB |
Identify if the Patient is Enrolled in Medicare Part B |
11 |
INSERT_DATE |
Date the Record was Created |
12 |
UPDATE_DATE |
Date the Record was Modified |