Data Documentation

Number	SAS Name	Variable Name
1	BENE_ID	Encrypted CCW Beneficiary ID
2	CLM_ID	Claim ID
3	NCH_NEAR_LINE_REC_IDENT_CD	NCH Near Line Record Identification Code (RIC)
4	NCH_CLM_TYPE_CD	NCH Claim Type Code
5	CLM_FROM_DT	Claim From Date (FFS)
6	CLM_THRU_DT	Claim Through Date (FFS)
7	NCH_WKLY_PROC_DT	NCH Weekly Claim Processing Date
8	FI_CLM_PROC_DT	FI Claim Process Date
9	CLAIM_QUERY_CODE	Claim Query Code
10	PRVDR_NUM	Provider Number
11	PRVDR_FULL_CCN_NUM	Full CMS Certification Number for Provider
12	CLM_FAC_TYPE_CD	Claim Facility Type Code (FFS)
13	OWNG_PRVDR_TIN_NUM	Owning Provider Tax Identification Number (TIN)
14	CLM_SRVC_CLSFCTN_TYPE_CD	Claim Service Classification Type Code (FFS)
15	CLM_FREQ_CD	Claim Frequency Code (FFS)
16	FI_NUM	FI or MAC Number
17	CLM_MDCR_NON_PMT_RSN_CD	Claim Medicare Non-Payment Reason Code
18	CLM_PMT_AMT	Claim (Medicare) Payment Amount
19	NCH_PRMRY_PYR_CLM_PD_AMT	NCH Primary Payer (if not Medicare) Claim Paid Amount
20	NCH_PRMRY_PYR_CD	NCH Primary Payer Code (if not Medicare)
21	FI_CLM_ACTN_CD	FI or MAC Claim Action Code
22	PRVDR_STATE_CD	NCH Provider SSA State Code
23	ORG_NPI_NUM	Organization (or group) NPI Number
24	SRVC_LOC_NPI_NUM	Claim Service Location NPI Number
25	AT_PHYSN_UPIN	Claim Attending Physician UPIN Number
26	AT_PHYSN_NPI	Claim Attending Physician NPI Number (FFS)
27	AT_PHYSN_SPCLTY_CD	Claim Attending Physician Specialty Code
28	OP_PHYSN_UPIN	Claim Operating Physician UPIN Number
29	OP_PHYSN_NPI	Claim Operating Physician NPI Number (FFS)
30	OP_PHYSN_SPCLTY_CD	Claim Operating Physician Specialty Code
31	OT_PHYSN_UPIN	Claim Other Physician UPIN Number
32	OT_PHYSN_NPI	Claim Other Physician NPI Number (FFS)
33	OT_PHYSN_SPCLTY_CD	Claim Other Physician Specialty Code
34	RNDRNG_PHYSN_NPI	Rendering Physician NPI (FFS)
35	RNDRNG_PHYSN_SPCLTY_CD	Claim or Revenue Center Rendering Physician Specialty Code
36	RFRG_NPI	Claim Referring Physician NPI Number
37	RFRG_SPCLTY_CD	Claim Referring Physician Specialty Code
38	CLM_MCO_PD_SW	Claim MCO Paid Switch
39	PTNT_DSCHRG_STUS_CD	Patient Discharge Status Code (FFS)
40	CLM_TOT_CHRG_AMT	Claim Total Charge Amount
41	NCH_BENE_BLOOD_DDCTBL_LBLTY_AM	NCH Beneficiary Blood Deductible Liability Amount
42	NCH_PROFNL_CMPNT_CHRG_AMT	Professional Component Charge Amount
43	NCH_BLOOD_PNTS_FRNSHD_QTY	NCH Blood Pints Furnished Quantity
44	PRNCPAL_DGNS_CD	Claim Principal Diagnosis Code (FFS)
45	ICD_DGNS_CD1	Claim Diagnosis Code I (FFS)
46	ICD_DGNS_CD2	Claim Diagnosis Code II (FFS)
47	ICD_DGNS_CD3	Claim Diagnosis Code III (FFS)
48	ICD_DGNS_CD4	Claim Diagnosis Code IV (FFS)
49	ICD_DGNS_CD5	Claim Diagnosis Code V (FFS)
50	ICD_DGNS_CD6	Claim Diagnosis Code VI (FFS)
51	ICD_DGNS_CD7	Claim Diagnosis Code VII (FFS)
52	ICD_DGNS_CD8	Claim Diagnosis Code VIII (FFS)
53	ICD_DGNS_CD9	Claim Diagnosis Code IX (FFS)
54	ICD_DGNS_CD10	Claim Diagnosis Code X (FFS)
55	ICD_DGNS_CD11	Claim Diagnosis Code XI (FFS)
56	ICD_DGNS_CD12	Claim Diagnosis Code XII (FFS)
57	ICD_DGNS_CD13	Claim Diagnosis Code XIII (FFS)
58	ICD_DGNS_CD14	Claim Diagnosis Code XIV (FFS)
59	ICD_DGNS_CD15	Claim Diagnosis Code XV (FFS)
60	ICD_DGNS_CD16	Claim Diagnosis Code XVI (FFS)
61	ICD_DGNS_CD17	Claim Diagnosis Code XVII (FFS)
62	ICD_DGNS_CD18	Claim Diagnosis Code XVIII (FFS)
63	ICD_DGNS_CD19	Claim Diagnosis Code XIX (FFS)
64	ICD_DGNS_CD20	Claim Diagnosis Code XX (FFS)
65	ICD_DGNS_CD21	Claim Diagnosis Code XXI (FFS)
66	ICD_DGNS_CD22	Claim Diagnosis Code XXII (FFS)
67	ICD_DGNS_CD23	Claim Diagnosis Code XXIII (FFS)
68	ICD_DGNS_CD24	Claim Diagnosis Code XXIV (FFS)
69	ICD_DGNS_CD25	Claim Diagnosis Code XXV (FFS)
70	FST_DGNS_E_CD	First Claim Diagnosis E Code (FFS)
71	ICD_DGNS_E_CD1	Claim Diagnosis E Code I (FFS)
72	ICD_DGNS_E_CD2	Claim Diagnosis E Code II (FFS)
73	ICD_DGNS_E_CD3	Claim Diagnosis E Code III (FFS)
74	ICD_DGNS_E_CD4	Claim Diagnosis E Code IV (FFS)
75	ICD_DGNS_E_CD5	Claim Diagnosis E Code V (FFS)
76	ICD_DGNS_E_CD6	Claim Diagnosis E Code VI (FFS)
77	ICD_DGNS_E_CD7	Claim Diagnosis E Code VII (FFS)
78	ICD_DGNS_E_CD8	Claim Diagnosis E Code VIII (FFS)
79	ICD_DGNS_E_CD9	Claim Diagnosis E Code IX (FFS)
80	ICD_DGNS_E_CD10	Claim Diagnosis E Code X (FFS)
81	ICD_DGNS_E_CD11	Claim Diagnosis E Code XI
82	ICD_DGNS_E_CD12	Claim Diagnosis E Code XII
83	ICD_PRCDR_CD1	Claim Procedure Code I (FFS)
84	PRCDR_DT1	Claim Procedure Code I Date (FFS)
85	ICD_PRCDR_CD2	Claim Procedure Code II (FFS)
86	PRCDR_DT2	Claim Procedure Code II Date (FFS)
87	ICD_PRCDR_CD3	Claim Procedure Code III (FFS)
88	PRCDR_DT3	Claim Procedure Code III Date (FFS)
89	ICD_PRCDR_CD4	Claim Procedure Code IV (FFS)
90	PRCDR_DT4	Claim Procedure Code IV Date (FFS)
91	ICD_PRCDR_CD5	Claim Procedure Code V (FFS)
92	PRCDR_DT5	Claim Procedure Code V Date (FFS)
93	ICD_PRCDR_CD6	Claim Procedure Code VI (FFS)
94	PRCDR_DT6	Claim Procedure Code VI Date (FFS)
95	ICD_PRCDR_CD7	Claim Procedure Code VII (FFS)
96	PRCDR_DT7	Claim Procedure Code VII Date (FFS)
97	ICD_PRCDR_CD8	Claim Procedure Code VIII (FFS)
98	PRCDR_DT8	Claim Procedure Code VIII Date (FFS)
99	ICD_PRCDR_CD9	Claim Procedure Code IX (FFS)
100	PRCDR_DT9	Claim Procedure Code IX Date (FFS)
101	ICD_PRCDR_CD10	Claim Procedure Code X (FFS)
102	PRCDR_DT10	Claim Procedure Code X Date (FFS)
103	ICD_PRCDR_CD11	Claim Procedure Code XI (FFS)
104	PRCDR_DT11	Claim Procedure Code XI Date (FFS)
105	ICD_PRCDR_CD12	Claim Procedure Code XII (FFS)
106	PRCDR_DT12	Claim Procedure Code XII Date (FFS)
107	ICD_PRCDR_CD13	Claim Procedure Code XIII (FFS)
108	PRCDR_DT13	Claim Procedure Code XIII Date (FFS)
109	ICD_PRCDR_CD14	Claim Procedure Code XIV
110	PRCDR_DT14	Claim Procedure Code XIV Date
111	ICD_PRCDR_CD15	Claim Procedure Code XV
112	PRCDR_DT15	Claim Procedure Code XV Date
113	ICD_PRCDR_CD16	Claim Procedure Code XVI
114	PRCDR_DT16	Claim Procedure Code XVI Date
115	ICD_PRCDR_CD17	Claim Procedure Code XVII
116	PRCDR_DT17	Claim Procedure Code XVII Date
117	ICD_PRCDR_CD18	Claim Procedure Code XVIII
118	PRCDR_DT18	Claim Procedure Code XVIII Date
119	ICD_PRCDR_CD19	Claim Procedure Code XIX
120	PRCDR_DT19	Claim Procedure Code XIX Date
121	ICD_PRCDR_CD20	Claim Procedure Code XX
122	PRCDR_DT20	Claim Procedure Code XX Date
123	ICD_PRCDR_CD21	Claim Procedure Code XXI
124	PRCDR_DT21	Claim Procedure Code XXI Date
125	ICD_PRCDR_CD22	Claim Procedure Code XXII
126	PRCDR_DT22	Claim Procedure Code XXII Date
127	ICD_PRCDR_CD23	Claim Procedure Code XXIII
128	PRCDR_DT23	Claim Procedure Code XXIII Date
129	ICD_PRCDR_CD24	Claim Procedure Code XXIV
130	PRCDR_DT24	Claim Procedure Code XXIV Date
131	ICD_PRCDR_CD25	Claim Procedure Code XXV
132	PRCDR_DT25	Claim Procedure Code XXV Date
133	RSN_VISIT_CD1	Reason for Visit Diagnosis Code I (FFS)
134	RSN_VISIT_CD2	Reason for Visit Diagnosis Code II (FFS)
135	RSN_VISIT_CD3	Reason for Visit Diagnosis Code III (FFS)
136	NCH_BENE_PTB_DDCTBL_AMT	NCH Beneficiary Part B Deductible Amount
137	NCH_BENE_PTB_COINSRNC_AMT	NCH Beneficiary Part B Coinsurance Amount
138	CLM_OP_PRVDR_PMT_AMT	Claim Outpatient Provider Payment Amount
139	CLM_OP_BENE_PMT_AMT	Claim Outpatient Payment Amount to Beneficiary
140	DOB_DT	Date of Birth from Claim
141	GNDR_CD	Gender Code from Claim
142	BENE_RACE_CD	Beneficiary Race Code (FFS)
143	BENE_CNTY_CD	County Code from Claim (SSA)
144	BENE_STATE_CD	Beneficiary Residence (SSA) State Code (FFS)
145	BENE_MLG_CNTCT_ZIP_CD	Zip Code of Residence from Claim
146	CLM_MDCL_REC	Claim Medical Record Number (FFS)
147	CLM_TRTMT_AUTHRZTN_NUM	Claim Treatment Authorization Number
148	CLM_PRCR_RTRN_CD	Claim Pricer Return Code
149	CLM_PRCR_VRSN_CD	Claim Pricer Version Code
150	CLM_SRVC_FAC_ZIP_CD	Claim service facility ZIP code (where service was provided)
151	CLM_OP_TRANS_TYPE_CD	Claim Outpatient transaction type
152	CLM_OP_ESRD_MTHD_CD	Claim Outpatient End Stage Renal Disease (ESRD) Method of Reimbursement Code
153	CLM_NEXT_GNRTN_ACO_IND_CD1	Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Population-Based Payment (PBP)
154	CLM_NEXT_GNRTN_ACO_IND_CD2	Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Telehealth
155	CLM_NEXT_GNRTN_ACO_IND_CD3	Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Post Discharge HH visits
156	CLM_NEXT_GNRTN_ACO_IND_CD4	Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - 3-day SNF waiver
157	CLM_NEXT_GNRTN_ACO_IND_CD5	Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Capitation
158	ACO_ID_NUM	Claim Accountable Care Organization (ACO) Identification Number
159	CLM_BENE_ID_TYPE_CD	Claim Beneficiary Identifier Type Code
160	CLM_RSDL_PYMT_IND_CD	Claim Residual Payment Indicator Code
161	PRVDR_VLDTN_TYPE_CD	Provider Validation Type Code
162	RR_BRD_EXCLSN_IND_SW	Railroad Board Exclusion Indicator Switch
163	CLM_MODEL_REIMBRSMT_AMT	Claim Model Reimbursement Amount
164	CLM_ADJUST_GRP_CD	Claim Adjustment Group Code
165	CLM_ADJUST_RSN_CD	Claim Adjustment Reason Code
166	ESRD_TRTMT_CHS_IND_CD	End-Stage Renal Disease (ESRD) Treatment Choices Demonstration Indicator Code
167	CLM_OP_PPS_IND	Claim Outpatient Prospective Payment System (OPPS) Indicator
168	CLM_CLNCL_TRIL_NUM	Clinical Trial Number

Revenue Center File

Number	SAS Name	Variable Name
1	BENE_ID	Encrypted CCW Beneficiary ID
2	CLM_ID	Claim ID
3	CLM_THRU_DT	Claim Through Date (FFS)
4	CLM_LINE_NUM	Claim Line Number
5	NCH_CLM_TYPE_CD	NCH Claim Type Code
6	REV_CNTR	Revenue Center Code (FFS)
7	REV_CNTR_DT	Revenue Center Date
8	REV_CNTR_1ST_ANSI_CD	Revenue Center 1st ANSI Code
9	REV_CNTR_2ND_ANSI_CD	Revenue Center 2nd ANSI Code
10	REV_CNTR_3RD_ANSI_CD	Revenue Center 3rd ANSI Code
11	REV_CNTR_4TH_ANSI_CD	Revenue Center 4th ANSI Code
12	REV_CNTR_APC_HIPPS_CD	Revenue Center APC or HIPPS Code
13	HCPCS_CD	Healthcare Common Procedure Coding System (HCPCS) Code (FFS)
14	HCPCS_1st_mdfr_cd	HCPCS Initial Modifier Code (FFS)
15	HCPCS_2ND_MDFR_CD	HCPCS Second Modifier Code (FFS)
16	HCPCS_3RD_MDFR_CD	HCPCS Third Modifier Code (FFS)
17	HCPCS_4TH_MDFR_CD	HCPCS Fourth Modifier Code (FFS)
18	REV_CNTR_PMT_MTHD_IND_CD	Revenue Center Payment Method Indicator Code
19	REV_CNTR_DSCNT_IND_CD	Revenue Center Discount Indicator Code
20	REV_CNTR_PACKG_IND_CD	Revenue Center Packaging Indicator Code
21	REV_CNTR_PRCNG_IND_CD	Revenue Center Pricing Indicator Code
22	REV_CNTR_OTAF_PMT_CD	Revenue Center Obligation to Accept As Full (OTAF) Payment Code
23	REV_CNTR_IDE_NDC_UPC_NUM	Revenue Center IDE, NDC, or UPC Number (FFS)
24	REV_CNTR_UNIT_CNT	Revenue Center Unit Count (FFS)
25	REV_CNTR_RATE_AMT	Revenue Center Rate Amount
26	REV_CNTR_BLOOD_DDCTBL_AMT	Revenue Center Blood Deductible Amount
27	REV_CNTR_CASH_DDCTBL_AMT	Revenue Center Cash Deductible Amount
28	REV_CNTR_COINSRNC_WGE_ADJSTD_C	Revenue Center Coinsurance/Wage Adjusted Coinsurance Amount
29	REV_CNTR_RDCD_COINSRNC_AMT	Revenue Center Reduced Coinsurance Amount
30	REV_CNTR_1ST_MSP_PD_AMT	Revenue Center 1st Medicare Secondary Payer (MSP) Paid Amount
31	REV_CNTR_2ND_MSP_PD_AMT	Revenue Center 2nd Medicare Secondary Payer (MSP) Paid Amount
32	REV_CNTR_PRVDR_PMT_AMT	Revenue Center (Medicare) Provider Payment Amount
33	REV_CNTR_BENE_PMT_AMT	Revenue Center Payment Amount to Beneficiary
34	REV_CNTR_PTNT_RSPNSBLTY_PMT	Revenue Center Patient Responsibility Payment
35	REV_CNTR_PMT_AMT_AMT	Revenue Center (Medicare) Payment Amount
36	REV_CNTR_TOT_CHRG_AMT	Revenue Center Total Charge Amount
37	REV_CNTR_NCVRD_CHRG_AMT	Revenue Center Non-Covered Charge Amount
38	REV_CNTR_DDCTBL_COINSRNC_CD	Revenue Center Deductible Coinsurance Code
39	REVSTIND	Revenue Center Status Indicator Code
40	RC_PTNT_ADD_ON_PYMT_AMT	Revenue Center Patient/Initial Visit Add-On Payment Amount (for initial wellness visit)
53	REV_CNTR_CRA_TPNIES_AMT	Revenue Center Capital Related Assets Transitional Add-on Payment Amt New and Innovative Equip
41	REV_CNTR_NDC_QTY	Revenue Center National Drug Code (NDC) Quantity (FFS)
42	REV_CNTR_NDC_QTY_QLFR_CD	Revenue Center NDC Quantity Qualifier Code (FFS)
43	RNDRNG_PHYSN_UPIN	Revenue Center Rendering Physician UPIN
44	RNDRNG_PHYSN_NPI	Rendering Physician NPI (FFS)
45	RNDRNG_PHYSN_SPCLTY_CD	Claim or Revenue Center Rendering Physician Specialty Code
46	THRPY_CAP_IND_CD1	Therapy cap Indicator 1 Code
47	THRPY_CAP_IND_CD2	Therapy cap Indicator 2 Code
48	REV_CNTR_THRPY_RDCTN_AMT	Revenue Center Therapy Reduction Amount
48	TRNSTNL_DRUG_ADD_ON_PYMT_AMT	Transitional Drug Add-On Payment Amount
49	REV_CNTR_RP_IND_CD	Revenue Center Representative Payee (RP) Indicator Code
50	RC_MODEL_REIMBRSMT_AMT	Revenue Center Model Reimbursement Amount
51	RC_VLNTRY_SRVC_IND_CD	Revenue Center Voluntary Service Indicator Code
52	ORDRG_PHYSN_NPI	Revenue Center Ordering Physician NPI
53	REV_CNTR_ADJUST_GRP_CD	Revenue Center Adjustment Group Code
54	REV_CNTR_ADJUST_RSN_CD	Revenue Center Adjustment Reason Code
55	REV_CNTR_RA_RMRK_CD	Revenue Center Remittance Advice Remark Code

Condition Code File

Number	SAS Name	Variable Name
1	BENE_ID	Encrypted CCW Beneficiary ID
2	CLM_ID	Claim ID
3	NCH_CLM_TYPE_CD	NCH Claim Type Code
4	RLT_COND_CD_SEQ	Claim Related Condition Code Sequence
5	CLM_RLT_COND_CD	Claim Related Condition Code (FFS)

Occurence Code File

Number	SAS Name	Variable Name
1	BENE_ID	Encrypted CCW Beneficiary ID
2	CLM_ID	Claim ID
3	NCH_CLM_TYPE_CD	NCH Claim Type Code
4	RLT_OCRNC_CD_SEQ	Claim Related Occurrence Code Sequence
5	CLM_RLT_OCRNC_CD	Claim Related Occurrence Code (FFS)
6	CLM_RLT_OCRNC_DT	Claim Related Occurrence Date (FFS)

Span Code File

Number	SAS Name	Variable Name
1	BENE_ID	Encrypted CCW Beneficiary ID
2	CLM_ID	Claim ID
3	NCH_CLM_TYPE_CD	NCH Claim Type Code
4	RLT_SPAN_CD_SEQ	Claim Related Span Code Sequence
5	CLM_SPAN_CD	Claim Occurrence Span Code (FFS)
6	CLM_SPAN_FROM_DT	Claim Occurrence Span From Date (FFS)
7	CLM_SPAN_THRU_DT	Claim Occurrence Span Through Date (FFS)

Value Code File

Number	SAS Name	Variable Name
1	BENE_ID	Encrypted CCW Beneficiary ID
2	CLM_ID	Claim ID
3	NCH_CLM_TYPE_CD	NCH Claim Type Code
4	RLT_VAL_CD_SEQ	Claim Related Value Code Sequence
5	CLM_VAL_CD	Claim Value Code (FFS)
6	CLM_VAL_AMT	Claim Value Amount

Demonstrations/Innovations Code File

Number	SAS Name	Variable Name
1	BENE_ID	Encrypted CCW Beneficiary ID
2	CLM_ID	Claim ID
3	NCH_CLM_TYPE_CD	NCH Claim Type Code
4	DEMO_ID_SQNC_NUM	Demonstration sequence number
5	DEMO_ID_NUM	Demonstration number
6	DEMO_INFO_TXT	Demo information text