Medicare Non-Institutional Data
(Version I, Variable Block Data)

SAS Name

Short Description

Carrier

DME

Unique Beneficiary Study Identifier

REC_LEN

Record Length Count

3

3

REC_LVL

NCH Near-Line Record Version Code

4

4

RIC_CD

NCH Near Line Record Identification Code

5

5

MQA_RIC

NCH MQA RIC Code

6

6

CLM_TYPE

NCH Claim Type Code

7

7

EQ_BIC

NCH Category Equatable Beneficiary Identification Code

11

11

BIC

Beneficiary Identification Code

12

12

ST_SGMT

NCH State Segment Code

13

13

STATE_CD

Beneficiary Residence SSA Standard State Code

14

14

FROM_DT

Claim From Date

15

15

THRU_DT

Claim Through Date

16

16

WKLY_DT

NCH Weekly Claim Processing Date

17

17

ACRTN_DT

CWF Claim Accretion Date

18

18

ACRTN_NM

CWF Claim Accretion Number

19

19

CARRCNTL

Carrier Claim Control Number

20

20

DAILY_DT

NCH Daily Process Date

22

22

LINK_NUM

NCH Segment Link Number

23

23

SGMT_CNT

Claim Total Segment Count

24

24

SGMT_NUM

Claim Segment Number

25

25

LINECNT

Claim Total Line Count

26

26

SGMTLINE

Claim Segment Line Count

27

27

ENTRY_CD

Carrier Claim Entry Code

30

30

DISP_CD

Claim Disposition Code

32

32

EDITDISP

NCH Edit Disposition Code

33

33

BIC_MDFY

NCH Claim BIC Modify H Code

34

34

CNTY_CD

Beneficiary Residence SSA Standard County Code

35

35

RCPT_DT

Carrier Claim Receipt Date

36

36

SCHLD_DT

Carrier Claim Scheduled Payment Date

37

37

FRWRD_DT

CWF Forwarded Date

38

38

CARR_NUM

Carrier Number

39

39

FIBATCH

CWF Transmission Batch Number

41

41

BENE_ZIP

Beneficiary Mailing Contact ZIP Code

42

42

SEX

Beneficiary Sex Identification Code

43

43

RACE

Beneficiary Race Code

44

44

BENE_DOB

Beneficiary Birth Date

45

45

MS_CD

CWF Beneficiary Medicare Status Code

46

46

CWFLOCCD

Beneficiary CWF Location Code

50

50

PDGNS_CD

Claim Principal Diagnosis Code

51

51

PMTDNLCD

Carrier Claim Payment Denial Code

53

53

TRTMT_CD

Claim Excepted/Nonexcepted Medical Treatment Code

54

54

PMT_AMT

Claim Payment Amount

55

55

PRPAYAMT

Carrier Claim Primary Payer Paid Amount

56

56

RFR_UPIN

Carrier Claim Refering Physician UPIN Number

58

-

RFR_NPI

Carrier Claim Refering Physician NPI Number

59

-

ASGMNTCD

Carrier Claim Provider Assignment Indicator Switch

60

60

PROV_PMT

NCH Claim Provider Payment Amount

61

61

BENE_PMT

NCH Claim Beneficiary Payment Amount

62

62

BENEPAID

Carrier Claim Beneficiary Paid Amount

63

63

SBMTCHRG

NCH Carrier Claim Submitted Charge Amount

64

64

ALOWCHRG

NCH Carrier Claim Allowed Charge Amount

65

65

DEDAPPLY

Carrier Claim Cash Deductible Applied Amount

66

66

HCPCS_YR

Carrier Claim HCPCS Year Code

67

67

MCOOVRRD

Carrier Claim MCO Override Indicator Code

68

68

HOSPOVRD

Carrier Claim Hospice Override Indicator Code

69

69

SGMT_ID

Claim Business Segment Identifier Code

70

70

CTRILNUM

Claim Clinical Trial Number

71

71

RFR_PRFL

Carrier Claim Referring PIN Number

73

-

CPO_PROV

Care Plan Oversight (CPO) Provider Number

74

-

CPO_NPI

CPO Organization NPI Number

75

-

BLDFRNSH

Claim Blood Pints Furnished Quantity

76

-

BLD_DED

Claim Blood Deductible Pints Quantity

77

-

CEDCNT

Carrier NCH Edit Code Count

78

72

CPATCNT

Carrier NCH Patch Code Count

79

73

CMCOCNT

Carrier MCO Period Count

80

74

CPLNCNT

Carrier Claim Health PlanID Count

81

75

CDEMCNT

Carrier Claim Demonstration ID Count

82

76

CDGNCNT

Carrier Claim Diagnosis Code Count

83

77

CLINECNT

Carrier Claim Line Count

84

78

EDITIND

NCH Edit Trailer Indicator Code

88

82

EDIT_CD

NCH Edit Code

89

83

PATCHIND

NCH Patch Trailer Indicator Code

91

85

PATCHCD

NCH Patch Code

92

86

PATCHDT

NCH Patch Applied Date

93

87

MCOIND

NCH MCO Trailer Indicator Code

95

89

MCONUM

MCO Contract Number

96

90

MCOOPTN

MCO Option Code

97

91

MCOEFFDT

MCO Period Effective Date

98

92

MCOTRMDT

MCO Period Termination Date

99

93

MCOPLNID

MCO Health PLANID Number

100

94

PLANIDIN

NCH Health PlanID Trailer Indicator Code

102

96

PLANIDCD

Claim Health PlanID Code

103

97

PLANID

Claim Health PlanID Number

104

98

DEMOIND

NCH Demonstration Trailer Indicator Code

106

100

DEMONUM

Claim Demonstration Identification Number

107

101

DEMOTXT

Claim Demonstration Information Text

108

102

DGNSIND

NCH Diagnosis Trailer Indicator Code

110

104

DGNS_CD

Claim Diagnosis Code

111

105

LINEIND

NCH Line Item Trailer Indicator Code

114

108

PRF_PRFL

Carrier Line Performing PIN Number

115

-

PRF_UPIN

Carrier Line Performing UPIN Number

116

-

PRFNPI

Carrier Line Performing NPI Number

117

-

PRGRPNPI

Carrier Line Performing Group NPI Number

118

-

PRV_TYPE

Carrier Line Provider Type Code

119

-

TAX_NUM

Line Provider Tax Number

120

114

PRVSTATE

Line NCH Provider State Code

121

-

PROVZIP

Carrier Line Performing Provider ZIP Code

122

-

HCFASPCL

Line CMS Provider Specialty Code

123

115

CARRSPCL

Carrier Line Provider Specialty Code

124

-

PRTCPTG

Line Provider Participating Indicator Code

125

116

ASTNT_CD

Carrier Line Reduced Payment Physician Assistant Code

126

-

SRVC_CNT

Line Service Count

127

117

TYPSRVCB

Line CMS Type Service Code

128

118

PTYPESRV

Carrier Line Type Service Code

129

-

PLCSRVC

Line Place Of Service Code

130

119

LCLTY_CD

Carrier Line Pricing Locality Code

131

-

EXPNSDT1

Line First Expense Date

132

120

EXPNSDT2

Line Last Expense Date

133

121

HCPCS_CD

Line HCPCS Code

134

122

MDFR_CD1

Line HCPCS Initial Modifier Code

135

123

MDFR_CD2

Line HCPCS Second Modifier Code

136

124

BETOS

Line NCH BETOS Code

137

127

LINE_IDE

Line IDE Number

138

128

NDC_CD

Line National Drug Code

139

130

LINEPMT

Line NCH Payment Amount

140

131

LBENPMT

Line Beneficiary Payment Amount

141

132

LPRVPMT

Line Provider Payment Amount

142

133

LDEDAMT

Line Beneficiary Part B Deductible Amount

143

134

LPRPAYCD

Line Beneficiary Primary Payer Code

144

135

LPRPDAMT

Line Beneficiary Primary Payer Paid Amount

145

136

COINAMT

Line Coinsurance Amount

146

137

LLMTAMT

Carrier Line Psychiatric, Occupational Therapy, Physical Therapy Limit Amount

147

-

LINT_AMT

Line Interest Amount

148

138

PRPYALOW

Line Primary Payer Allowed Charge Amount

149

139

PNLTYAMT

Line 10% Penalty Reduction Amount

150

140

LBLD_DED

Carrier Line Blood Deductible Pints Quantity

151

-

LSBMTCHG

Line Submitted Charge Amount

152

141

LALOWCHG

Line Allowed Charge Amount

153

142

LAB_NUM

Carrier Line Clinical Lab Number

154

-

LAB_AMT

Carrier Line Clinical Lab Charge Amount

155

-

PRCNGIND

Line Processing Indicator Code

156

145

PMTINDSW

Line Payment 80%/100% Code

157

146

DED_SW

Line Service Deductible Indicator Switch

158

147

PMTINDCD

Line Payment Indicator Code

159

148

MTUS_CNT

Carrier Line Miles/Time/Units/Services Count

160

-

MTUS_IND

Carrier Line Miles/Time/Units/Services Indicator Code

161

-

LINEDGNS

Line Diagnosis Code

162

151

ANSTHUNT

Carrier Line Anesthesia Base Unit Count

164

-

CLIAALRT

Carrier Line CLIA Alert Indicator Code

165

-

DCMTN_CD

Line Additional Claim Documentation Indicator Code

166

153

DMEST_DT

Carrier Line DME Coverage Period Start Date

167

-

DME_PURC

Line DME Purchase Price Amount

168

-

NCSTY_MO

Carrier Line DME Medical Necessity Month Count

169

-

LCNSLDTD

Line Consolidated Billing Indicator Code

170

158

DUP_CHK

Line Duplicate Claim Check Indicator Code

171

159

PNT_PCKP

Carrier Line Point of Pickup Zip Code

172

-

HSCRCTY

Carrier Line HPSA/Scarcity Indicator Code

173

-

RX_NUM

Carrier Line RX Number

174

-

HTYPECD

Line Hematocrit/Hemoglobin Test Type Code

176

161

HRLSTNUM

Line Hematocrit/Hemoglobin Test Result Number

177

162

ORD_UPIN

DMERC Claim Ordering Physician UPIN Number

-

58

ORD_NPI

DMERC Claim Ordering Physician NPI Number

-

59

DEDCNT

DMERC NCH Edit Code Count

-

72

DPATCNT

DMERC NCH Patch Code Count

-

73

SUPLRNUM

DMERC Line Supplier Provider Number

-

109

SUP_NPI

DMERC Line Item Supplier NPI Number

-

110

PRCNG_ST

DMERC Line Pricing State Code

-

111

PRVSTATE

DMERC Line Provider State Code

-

112

SUP_TYPE

DMERC Line Supplier Type Code

-

113

MDFR_CD3

DMERC Line HCPCS Third Modifier Code

-

125

MDFR_CD4

DMERC Line HCPCS Fourth Modifier Code

-

126

NOC_TXT

DMERC Line Not Otherwise Classified HCPCS Code Text

-

129

SCRNSVGS

DMERC Line Screen Savings Amount

-

143

DME_PURC

Line DME Purchase Price Amount

-

144

DME_UNIT

DMERC Line Miles/Time/Units/Services Count

-

149

UNIT_IND

DMERC Line Miles/Time/Units/Services Indicator Code

-

150

SUSP_IND

DMERC Line Screen Suspension Indicator Code

-

154

RSLT_IND

DMERC Line Screen Result Indicator Code

-

155

WAIVERSW

DMERC Line Waiver Of Provider Liability Switch

-

156

DCSN_IND

DMERC Line Decision Indicator Switch

-

157