Medicare Institutional Data
(Version I, Variable Block Data)

SAS Name

Short Description

IP/SNF

OP

HHA

Hospice

Unique Beneficiary Study Identifier

REC_LEN

Record Length Count

3

3

3

3

REC_LVL

NCH Near-Line Record Version code

4

4

4

4

RIC_CD

NCH Near Line Record Identification Code

5

5

5

5

MQA_RIC

NCH MQA RIC Code

6

6

6

6

CLM_TYPE

NCH Claim Type Code

7

7

7

7

EQ_BIC

NCH Category Equatable Beneficiary Identification Code

11

11

11

11

BIC

Beneficiary Identification Code

12

12

12

12

ST_SGMT

NCH State Segment Code

13

13

13

13

STATE_CD

Beneficiary Residence SSA Standard State Code

14

14

14

14

FROM_DT

Claim From Date

15

15

15

15

THRU_DT

Claim Through Date

16

16

16

16

WKLY_DT

NCH Weekly Claim Processing Date

17

17

17

17

ACRTN_DT

CWF Claim Accretion Date

18

18

18

18

ACRTN_NM

CWF Claim Accretion Number

19

19

19

19

CLM_CNTL

FI Document Claim Control Number

20

20

20

20

ORIGCNTL

FI Original Claim Control Number

21

21

21

21

QUERY_CD

Claim Query Code

22

22

22

22

PROVIDER

Provider Number

23

23

23

23

DAILY_DT

NCH Daily Process Date

24

24

24

24

LINK_NUM

NCH Segment Link Number

25

25

25

25

SGMT_CNT

Claim Total Segment Count

26

26

26

26

SGMT_NUM

Claim Segment Number

27

27

27

27

LINECNT

Claim Total Line Count

28

28

28

28

SGMTLINE

Claim Segment Line Count

29

29

29

29

PE_RIC

NCH Payment and Edit Record Identification Code

31

31

31

31

TRANS_CD

Claim Transaction Code

32

32

32

32

FAC_TYPE

Claim Facility Type Code

34

34

34

34

TYPESRVC

Claim Service Classification Type Code

35

35

35

35

FREQ_CD

Claim Frequency Code

36

36

36

36

MQAQUERY

NCH MQA Query Patch Code

38

38

38

38

DISP_CD

Claim Disposition Code

39

39

39

39

EDITDISP

NCH Edit Disposition Code

40

40

40

40

BIC_MDFY

NCH Claim BIC Modify H Code

41

41

41

41

CNTY_CD

Beneficiary Residence SSA Standard County Code

42

42

42

42

RCPT_DT

FI Claim Receipt Date

43

43

43

43

SCHLD_DT

FI Claim Scheduled Payment Date

44

44

44

44

FRWRD_DT

CWF Forwarded Date

45

45

45

45

FI_NUM

FI Number

46

46

46

46

ASGN_NUM

CWF Claim Assigned Number

47

47

47

47

FIBATCH

CWF Transmission Batch Number

48

48

48

48

BENE_ZIP

Beneficiary Mailing Contact ZIP Code

49

49

49

49

SEX

Beneficiary Sex Identification Code

50

50

50

50

RACE

Beneficiary Race Code

51

51

51

51

BENE_DOB

Beneficiary Birth Date

52

52

52

52

MS_CD

CWF Beneficiary Medicare Status Code

53

53

53

53

CWFLOCCD

Beneficiary CWF Location Code

57

57

57

57

PDGNS_CD

Claim Principal Diagnosis Code

58

58

58

58

NOPAY_CD

Claim Medicare Non Payment Reason Code

60

60

60

60

TRTMT_CD

Claim Excepted/Nonexcepted Medical Treatment Code

61

61

61

61

PMT_AMT

Claim Payment Amount

62

62

62

62

PRPAYAMT

NCH Primary Payer Claim Paid Amount

63

63

63

63

PRPAY_CD

NCH Primary Payer Code

64

64

64

64

CANCELCD

FI Requested Claim Cancel Reason Code

65

65

65

65

ACTIONCD

FI Claim Action Code

66

66

66

66

APRVL_DT

FI Claim Process Date

67

67

67

67

PRSTATE

NCH Provider State Code

68

68

68

68

ORGNPINM

Organization NPI Number

69

69

69

69

AT_UPIN

Claim Attending Physician UPIN Number

71

71

71

71

AT_NPI

Claim Attending Physician NPI Number

72

72

72

72

AT_SRNM

Claim Attending Physician Surname

73

73

73

73

AT_GVNNM

Claim Attending Physician Given Name

74

74

74

74

AT_MDL

Claim Attending Physician Middle Initial Name

75

75

75

75

OP_UPIN

Claim Operating Physician UPIN Number

77

77

77

77

OP_NPI

Claim Operating Physician NPI Number

78

78

78

78

OP_SRNM

Claim Operating Physician Surname

79

79

79

79

OP_GVN

Claim Operating Physician Given Name

80

80

80

80

OP_MDL

Claim Operating Physician Middle Initial Name

81

81

81

81

OT_UPIN

Claim Other Physician UPIN Number

83

83

83

83

OT_NPI

Claim Other Physician NPI Number

84

84

84

84

OT_SRNM

Claim Other Physician Surname

85

85

85

85

OT_GVN

Claim Other Physician Given Name

86

86

86

86

OT_MDL

Claim Other Physician Middle Initial Name

87

87

87

87

MDCD_PRV

Medicaid Provider Identification Number

88

88

88

88

MDCDINFO

Claim Medicaid Information Code

89

89

89

89

MCOPDSW

Claim MCO Paid Switch

90

90

90

90

AUTHRZTN

Claim Treatment Authorization Number

91

91

91

91

PTNTCNTL

Patient Control Number

92

92

92

92

MDCL_REC

Claim Medical Record Number

93

93

93

93

PRO_CNTL

Claim PRO Control Number

94

94

94

94

PRO_DT

Claim PRO Process Date

95

95

95

95

STUS_CD

Patient Discharge Status Code

96

96

96

96

DGNS_E

Claim Diagnosis E Code

97

97

97

97

PPS_IND

Claim PPS Indicator Code

99

99

99

99

TOT_CHRG

Claim Total Charge Amount

100

100

100

100

PRCRRTRN

Claim Pricer Return Code

101

101

101

101

SGMT_ID

Claim Business Segment Identifier Code

102

102

102

102

IPEDCNT

Inpatient/SNF NCH Edit Code Count

104

-

-

-

IPPATCNT

Inpatient/SNF NCH Patch Code Count

105

-

-

-

IPMCOCNT

Inpatient/SNF MCO Period Count

106

-

-

-

IPPLANID

Inpatient/SNF Claim Health PlanID Count

107

-

-

-

IPDEMCNT

Inpatient/SNF Claim Demonstration ID Count

108

-

-

-

IPDGNCNT

Inpatient/SNF Claim Diagnosis Code Count

109

-

-

-

IPPRCNT

Inpatient/SNF Claim Procedure Code Count

110

-

-

-

IPCONCNT

Inpatient/SNF Claim Related Condition Code Count

111

-

-

-

IPOCRCNT

Inpatient/SNF Claim Related Occurrence Code Count

112

-

-

-

IPSPNCNT

Inpatient/SNF Claim Occurrence Span Code Count

113

-

-

-

IPVALCNT

Inpatient/SNF Claim Value Code Count

114

-

-

-

IPREVCNT

Inpatient/SNF Revenue Center Code Count

115

-

-

-

ADMSN_DT

Claim Admission Date

118

-

-

-

TYPE_ADM

Claim Inpatient Admission Type Code

119

-

-

-

SRC_ADMS

Claim Source Inpatient Admission Code

120

-

-

-

AD_DGNS

Claim Admitting Diagnosis Code

121

133

-

-

PTNTSTUS

NCH Patient Status Indicator Code

123

-

-

118

APRVL_CD

NCH Inpatient Pro Approval Type Code

124

-

-

-

PRO_FROM

NCH Inpatient PRO Approval Service From Date

125

-

-

-

PRO_THRU

NCH Inpatient PRO Approval Service Thru Date

126

-

-

-

GRC_DAY

NCH Inpatient PRO Approval Grace Day Count

127

-

-

-

PER_DIEM

Claim Pass Thru Per Diem Amount

128

-

-

-

DED_AMT

NCH Beneficiary Inpatient Deductible Amount

129

-

-

-

COIN_AMT

NCH Beneficiary Part A Coinsurance Liability Amount

130

-

-

-

BLDDEDAM

NCH Beneficiary Blood Deductible Liability Amount

131

120

-

-

BLDTCHRG

NCH Blood Total Charge Amount

132

-

-

-

BLDNCHRG

NCH Blood Non-Covered Charge Amount

133

-

-

-

PCCHGAMT

NCH Professional Component Charge Amount

134

123

-

-

NCCHGAMT

NCH Inpatient Noncovered Charge Amount

135

-

-

-

TDEDAMT

NCH Inpatient Total Deduction Amount

136

-

-

-

PPS_CPTL

Claim Total PPS Capital Amount

137

-

-

-

CPTL_HSP

Claim PPS Capital HSP Amount

138

-

-

-

CPTL_FSP

Claim PPS Capital FSP Amount

139

-

-

-

CPTLOUTL

Claim PPS Capital Outlier Amount

140

-

-

-

DISP_SHR

Claim PPS Capital Disproportionate Share Amount

141

-

-

-

IME_AMT

Claim PPS Capital IME Amount

142

-

-

-

CPTL_EXP

Claim PPS Capital Exception Amount

143

-

-

-

HLDHRMLS

Claim PPS Old Capital Hold Harmless Amount

144

-

-

-

DSCHFRCT

Claim PPS Capital Discharge Fraction Percent

145

-

-

-

DRGWTAMT

Claim PPS Capital DRG Weight Number

146

-

-

-

UTIL_DAY

Claim Utilization Day Count

147

-

-

122

CR_DAY

Claim Cost Report Days Count

148

-

-

-

COIN_DAY

Beneficiary Total Coinsurance Days Count

149

-

-

-

COYR1DAY

Claim Coinsurance Year 1 Day Count

150

-

-

-

COYR1AMT

NCH Coinsurance Year 1 Rate Amount

151

-

-

-

COYR2DAY

Claim Coinsurance Year 2 Day Count

152

-

-

-

COYR2AMT

NCH Coinsurance Year 2 Rate Amount

153

-

-

-

LRD_USE

Beneficiary LRD Used Count

154

-

-

-

NUTILDAY

Claim Non Utilization Days Count

155

-

-

-

PSYCHDAY

Beneficiary Prior Psychiatric Day Count

156

-

-

-

BLDFRNSH

NCH Blood Pints Furnished Quantity

157

127

-

-

BLD_RPLC

NCH Blood Pints Replaced Quantity

158

128

-

-

BLDNRPLC

NCH Blood Pints Not Replaced Quantity

159

129

-

-

BLDDEDPT

NCH Blood Deductible Pints Quantity

160

130

-

-

QLFYFROM

NCH Qualified Stay From Date

161

-

121

-

QLFYTHRU

NCH Qualify Stay Through Date

162

-

122

-

NCOVFROM

NCH Verified Noncovered Stay From Date

163

-

-

-

NCOVTHRU

NCH Verified Noncovered Stay Through Date

164

-

-

-

GURPMTDT

NCH Provider Guaranteed Payment Start Date

165

-

-

-

URNTCDT

NCH Utilization Review Notice Received Date

166

-

-

-

CARETHRU

NCH Active or Covered Level Care Thru Date

167

-

-

-

EXHST_DT

NCH Beneficiary Medicare Benefits Exhausted Date

168

-

-

120

DSCHRGDT

NCH Beneficiary Discharge Date

169

-

123

121

DRG_CD

Claim Diagnosis Related Group Code

170

-

-

-

OUTLR_CD

Claim Diagnosis Related Group Outlier Stay Code

171

-

-

-

OUTLRPMT

NCH DRG Outlier Approved Payment Amount

172

-

-

-

KRON_IND

Claim KRON Indicator Code

173

-

-

-

POAINDCD

-

-

-

EDITIND

NCH Edit Trailer Indicator Code

177

138

128

127

EDIT_CD

NCH Edit Code

178

139

129

128

PATCHIND

NCH Patch Trailer Indicator Code

141

131

130

PATCHCD

NCH Patch Code

181

142

132

131

PATCHDT

NCH Patch Applied Date

182

143

133

132

MCOIND

NCH MCO Trailer Indicator Code

184

145

135

134

MCONUM

MCO Contract Number

185

146

136

135

MCOOPTN

MCO Option Code

186

147

137

136

MCOEFFDT

MCO Period Effective Date

187

148

138

137

MCOTRMDT

MCO Period Termination Date

188

149

139

138

MCOPLNID

MCO Health PLANID Number

189

150

140

139

PLANIDIN

NCH Health PlanID Trailer Indicator Code

191

152

142

141

PLANIDCD

Claim Health PlanID Code

192

153

143

142

PLANID

Claim Health PlanID Number

193

154

144

143

DEMOIND

NCH Demonstration Trailer Indicator Code

195

156

146

145

DEMONUM

Claim Demonstration Identification Number

196

157

147

146

DEMOTXT

Claim Demonstration Information Text

197

158

148

147

DGNSIND

NCH Diagnosis Trailer Indicator Code

199

160

150

149

DGNS_CD

Claim Diagnosis Code

200

161

151

150

PRCDRIND

NCH Procedure Trailer Indicator Code

203

164

-

153

PRCDR_CD

Claim Procedure Code

204

165

-

154

PRCDR_DT

Claim Procedure Performed Date

206

167

-

156

CONDIND

NCH Condition Trailer Indicator Code

208

169

154

158

RLT_COND

Claim Related Condition Code

209

170

155

159

OCRNCIND

NCH Occurrence Trailer Indicator Code

211

172

157

161

OCRNC_CD

Claim Related Occurrence Code

212

173

158

162

OCRNCDT

Claim Related Occurrence Date

213

174

159

163

SPANIND

NCH Span Trailer Indicator Code

215

176

161

165

SPAN_CD

Claim Occurrence Span Code

216

177

162

166

SPANFROM

Claim Occurrence Span From Date

217

178

163

167

SPANTHRU

Claim Occurrence Span Through Date

218

179

164

168

VALIND

NCH Value Trailer Indicator Code

220

181

166

170

VAL_CD

Claim Value Code

221

182

167

171

VAL_AMT

Claim Value Amount

222

183

168

172

REVIND

NCH Revenue Center Trailer Indicator Code

224

185

170

174

REV_CNTR

Revenue Center Code

186

171

175

REV_DT

Revenue Center Date

226

187

172

176

REVANSI1

Revenue Center 1st ANSI Code

227

188

173

177

REVANSI2

Revenue Center 2nd ANSI Code

228

189

174

178

REVANSI3

Revenue Center 3rd ANSI Code

229

190

175

179

REVANSI4

Revenue Center 4th ANSI Code

230

191

176

180

APCHIPPS

Revenue Center APC/HIPPS

231

192

177

181

HCPCS_CD

Revenue Center CMS Common Procedure Coding System

232

193

178

182

MDFR_CD1

Revenue Center HCPCS Initial Modifier Code

233

194

179

183

MDFR_CD2

Revenue Center HCPCS Second Modifier Code

234

195

180

184

MDFR_CD3

Revenue Center HCPCS Third Modifier Code

235

196

181

185

MDFR_CD4

Revenue Center HCPCS Fourth Modifier Code

236

197

182

186

MDFR_CD5

Revenue Center HCPCS Fifth Modifier Code

237

198

183

187

PMTMTHD

Revenue Center Payment Method Indicator Code

238

199

184

188

DSCNTIND

Revenue Center Discount Indicator Code

239

200

185

189

PACKGIND

Revenue Center Packaging Indicator Code

240

201

186

190

PRICNG

Revenue Center Pricing Indicator Code

241

202

187

191

OTAF_1

Revenue Center Obligation to Accept As Full (OTAF) Payment Code

242

203

188

192

OTAF_2

Revenue Center Obligation to Accept As Full (OTAF) Payment Code

243

204

189

193

IDENDC

Revenue Center IDE, NDC, UPC Number

244

205

190

194

REV_UNIT

Revenue Center Unit Count

245

206

191

195

REV_RATE

Revenue Center Rate Amount

246

207

192

196

REVBLOOD

Revenue Center Blood Deductible Amount

247

208

193

197

REVDCTBL

Revenue Center Cash Deductible Amount

248

209

194

198

WAGEADJ

Revenue Center Coinsurance/Wage Adjusted Coinsurance Amount

249

210

195

199

RDCDCOIN

Revenue Center Reduced Coinsurance Amount

250

211

196

200

REV_MSP1

Revenue Center 1st Medicare Secondary Payer Paid Amount

251

212

197

201

REV_MSP2

Revenue Center 2nd Medicare Secondary Payer Paid Amount

252

213

198

202

REVPCCHG

Revenue Center Professional Component Amount

253

214

199

203

RPRVDPMT

Revenue Center Provider Payment Amount

254

215

200

204

RBENEPMT

Revenue Center Beneficiary Payment Amount

255

216

201

205

PTNTRESP

Revenue Center Patient Responsibility Payment

256

217

202

206

REVPMT

Revenue Center Payment Amount

257

218

203

207

REV_CHRG

Revenue Center Total Charge Amount

258

219

204

208

REV_NCVR

Revenue Center Non-Covered Charge Amount

259

220

205

209

REVDEDCD

Revenue Center Deductible Coinsurance Code

260

221

206

210

RCNSLDTD

Revenue Center Consolidated Billing Code

261

222

207

211

RSTUSIND

Revenue Center Status Indicator Code

262

223

208

212

OPEDCNT

Outpatient NCH Edit Code Count

-

104

-

-

OPPATCNT

Outpatient NCH Patch Code Count

-

105

-

-

OPMCOCNT

Outpatient MCO Period Count

-

106

-

-

OPPLNCNT

Outpatient Claim Health PlanID Count

-

107

-

-

OPDEMCNT

Outpatient Claim Demonstration ID Count

-

108

-

-

OPDGNCNT

Outpatient Claim Diagnosis Code Count

-

109

-

-

OPPRCCNT

Outpatient Claim Procedure Code Count

-

110

-

-

OPCONCNT

Outpatient Claim Related Condition Code Count

-

111

-

-

OPOCRCNT

Outpatient Claim Related Occurrence Code Count

-

112

-

-

OPSPNCNT

Outpatient Claim Occurrence Span Code Count

-

113

-

-

OPVALCNT

Outpatient Claim Value Code Count

-

114

-

-

OPREVCNT

Outpatient Revenue Center Code Count

-

115

-

-

OPSRVTYP

Claim Outpatient Service Type Code

-

118

-

-

OP_RFRL

Claim Outpatient Referral Code

-

119

-

-

PTB_DED

NCH Beneficiary Part B Deductible Amount

-

121

-

-

PTB_COIN

NCH Beneficiary Part B Coinsurance Amount

-

122

-

-

INTRMDED

Claim Optpatient Beneficiary Interim Deductible Amount

-

124

-

-

PRVDRPMT

Claim Outpatient Provider Payment Amount

-

125

-

-

BENEPMT

Claim Outpatient Beneficiary Payment Amount

-

126

-

-

TRANTYPE

Claim Outpatient Transaction Type Code

-

131

-

-

ESRDMTHD

Claim Outpatient ESRD Method of Reimbursement Code

-

132

-

-

HHEDCNT

HHA NCH Edit Code Count

-

-

104

-

HHPATCNT

HHA NCH Patch Code Count

-

-

105

-

HHMCOCNT

HHA MCO Period Count

-

-

106

-

HHPLANNT

HHA Claim Health PlanID Count

-

-

107

-

HHDEMCNT

HHA Claim Demonstration ID Count

-

-

108

-

HHDGNCNT

HHA Claim Diagnosis Code Count

-

-

109

-

HHCONCNT

HHA Claim Related Condition Code Count

-

-

111

-

HHOCRCNT

HHA Claim Related Occurrence Code Count

-

-

112

-

HHSPNCNT

HHA Claim Occurrence Span Code Count

-

-

113

-

HHVALCNT

HHA Claim Value Code Count

-

-

114

-

HHREVCNT

HHA Revenue Center Code Count

-

-

115

-

LUPAIND

Claim HHA Low Utilization Payment Adjustment (LUPA) Indicator Code

-

-

118

-

HHA_RFRL

Claim HHA Referral Code

-

-

119

-

VISITCNT

Claim HHA Total Visit Count

-

-

120

-

HHSTRTDT

Claim HHA Care Start Date

-

-

124

-

HSEDCNT

Hospice NCH Edit Code Count

-

-

-

104

HSPATCNT

Hospice NCH Patch Code Count

-

-

-

105

HSMCOCNT

Hospice MCO Period Count

-

-

-

106

HSPLNCNT

Hospice Claim Health PlanID Count

-

-

-

107

HSDEMCNT

Hospice Claim Demonstration ID Count

-

-

-

108

HSDGNCNT

Hospice Claim Diagnosis Code Count

-

-

-

109

HSPRCNT

Hospice Claim Procedure Code Count

-

-

-

110

HSCONCNT

Hospice Claim Related Condition Code Count

-

-

-

111

HSOCRCNT

Hospice Claim Related Occurrence Code Count

-

-

-

112

HSSPNCNT

Hospice Claim Occurrence Span Code Count

-

-

-

113

HSVALCNT

Hospice Claim Value Code Count

-

-

-

114

HSREVCNT

Hospice Revenue Center Code Count

-

-

-

115

HSPCSTRT

Claim Hospice Start Date

-

-

-

119

HOSPCPRD

Beneficiary's Hospice Period Count

-

-

-

123