Medicare Institutional Data
(Version J, Variable Block Data)

Browse variable description, download data dictionary, view code tables, or file limitations.
Number shown on the matrix for each claim type indicates the variable sequence printed in CMS data dictionary.
An "*" indicates that this variable is found within the CCW file format.
-" indicates this variable is not available in the CMS files for this claim type.
Inpatient [IP], Skilled Nursing Facility [SNF], Outpatient [OP], Home Health Agency [HHA], Hospice [Hospice]

CMS SAS Alias	Short Description	IP/SNF	OP	HHA	Hospice
CMS SAS Alias	Short Description	1. CMS 2. CCW	1.CMS 2.CCW	1.CMS 2.CCW	1.CMS 2.CCW
	Encrypted 723 Beneficiary ID	*	*	*	*
	Claim ID	*	*	*	*
REC_LEN	Record Length Count	3	3	3	3
REC_LVL	NCH Near-Line Record Version code NCH Near-Line Record Version Table	4	4	4	4
RIC_CD	NCH Near Line Record Identification Code NCH Near-Line Record Identification Code Table	5*	5 *	5 *	5*
MQA_RIC	NCH MQA RIC Code NCH MQA RIC Table	6	6	6	6
CLM_TYPE	NCH Claim Type Code NCH Claim Type Table	7 *	7 *	7 *	7 *
CAN	Beneficiary Claim Account Number	10	10	10	10
EQ_BIC	NCH Category Equatable Beneficiary Identification Code Category Equatable Beneficiary Identification Code (BIC) Table	11	11	11	11
BIC	Beneficiary Identification Code Beneficiary Identification Code (BIC) Table	12*	12*	12*	12*
ST_SGMT	NCH State Segment Code NCH State Segment Table	13	13	13	13
STATE_CD	Beneficiary Residence SSA Standard State Code State Table	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 Claim Query Table	22*	22*	22	22
PROVIDER	Provider Number Provider Number Table	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 Payment Edit Record Identification Table	31	31	31	31
TRANS_CD	Claim Transaction Code Claim Transaction Table Claim Transaction Code Limitation	32	32	32	32
FAC_TYPE	Claim Facility Type Code Claim Facility Type Table	34*	34*	34 *	34 *
TYPESRVC	Claim Service Classification Type Code Claim Service Classification Type Table	35*	35*	35*	35*
FREQ_CD	Claim Frequency Code Claim Frequency Table	36*	36*	36*	36*
MQAQUERY	NCH MQA Query Patch Code NCH MQA Query Patch Table	38	38	38	38
DISP_CD	Claim Disposition Code Claim Disposition Table	39	39	39	39
EDITDISP	NCH Edit Disposition Code NCH Edit Disposition Table	40	40	40	40
BIC_MDFY	NCH Claim BIC Modify H Code	41	41	41	41
CNTY_CD	Beneficiary Residence SSA Standard County Code See the County to CBSA crosswalk file for a list of SSA County codes	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 Fiscal Intermediary Number Table	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 Beneficiary Sex Identification Table	50	50	50	50
RACE	Beneficiary Race Code Beneficiary Race Table	51	51	51	51
BENE_DOB	Beneficiary Birth Date	52	52	52	52
MS_CD	CWF Beneficiary Medicare Status Code Beneficiary Medicare Status Table	53	53	53	53
CWFLOCCD	Beneficiary CWF Location Code Beneficiary Common Working File Location Table	57	57	57	57
PDVRSNCD	Claim Principal Diagnosis Version Code Claim Principal Diagnosis Version Table	59	59	59	59
PDGNS_CD	Claim Principal Diagnosis Code	60	60	60	60
NOPAY_CD	Claim Medicare Non Payment Reason Code Claim Medicare Non-Payment Reason Table	62*	62*	62*	62*
TRTMT_CD	Claim Excepted/Nonexcepted Medical Treatment Code Claim Excepted/Nonexcepted Medical Treatment Table	63	63	63	63
PMT_AMT	Claim Payment Amount Claim Payment Amount Exceeding Total Charge Amount Limitation	64*	64*	64*	64*
PRPAYAMT	NCH Primary Payer Claim Paid Amount	65*	65*	65*	65*
PRPAY_CD	NCH Primary Payer Code Beneficiary Primary Payer Table	66*	66*	66*	66*
CANCELCD	FI Requested Claim Cancel Reason Code FI Requested Claim Cancel Reason Code Table	67	67	67	67
ACTIONCD	FI Claim Action Code Fiscal Intermediary Claim Action Table	68*	68	68	68
APRVL_DT	FI Claim Process Date	69	69	69	69
PRSTATE	NCH Provider State Code	70*	70*	70*	70*
ORGNPINM	Organization NPI Number	71*	71*	71*	71*
AT_UPIN	Claim Attending Physician UPIN Number	73*	73*	73*	73*
AT_NPI	Claim Attending Physician NPI Number	74*	74*	74*	74*
AT_SRNM	Claim Attending Physician Surname	75	75	75	75
AT_GVNNM	Claim Attending Physician Given Name	76	76	76	77
AT_MDL	Claim Attending Physician Middle Initial Name	77	77	77	77
OP_UPIN	Claim Operating Physician UPIN Number	79*	79*	79	79
OP_NPI	Claim Operating Physician NPI Number	80*	80*	80	80
OP_SRNM	Claim Operating Physician Surname	81	81	81	81
OP_GVN	Claim Operating Physician Given Name	82	82	82	82
OP_MDL	Claim Operating Physician Middle Initial Name	83	83	83	83
OT_UPIN	Claim Other Physician UPIN Number	85*	85*	85	85
OT_NPI	Claim Other Physician NPI Number	86*	86*	86	86
OT_SRNM	Claim Other Physician Surname	87	87	87	87
OT_GVN	Claim Other Physician Given Name	88	88	88	88
OT_MDL	Claim Other Physician Middle Initial Name	89	89	89	89
MDCD_PRV	Medicaid Provider Identification Number	90	90	90	90
MDCDINFO	Claim Medicaid Information Code	91	91	91	91
MCOPDSW	Claim MCO Paid Switch Claim MCO Paid Switch Table Claim MCO Paid Switch Limitation	92*	92*	92	92
AUTHRZTN	Claim Treatment Authorization Number	93	93	93	93
PTNTCNTL	Patient Control Number	94	94	94	94
MDCL_REC	Claim Medical Record Number	95	95	95	95
PRO_CNTL	Claim PRO Control Number	96	96	96	96
PRO_DT	Claim PRO Process Date	97	97	97	97
STUS_CD	Patient Discharge Status Code Patient Discharge Status Table	98*	98*	98*	98*
E1VRSNCD	Claim 1st Diagnosis E Version Code	100	100	100	100
E1VRSNCD	Claim 1st Diagnosis E Code	101	101	101	101
PPS_IND	Claim PPS Indicator Code Claim PPS Indicator Table	102*	102	102*	102
TOT_CHRG	Claim Total Charge Amount Claim Total Charge Amount Limitation	103*	103*	103*	103*
PRCRRTRN	Claim Pricer Return Code Claim Pricer Return Table	104	104	104	104
SGMT_ID	Claim Business Segment Identifier Code	105	105	105	105
RACINDCD	Recovery Audit Contractor (RAC) Adjustment Indicator Code Recovery Audit Contractor (RAC) Adjustment Indicator Table	106	106	106	106
WCINDCD	Worker's Compensation Indicator Code Worker's Compensation Indicator Table	107	107	107	107
SRVCFAC	Claim Service Facility Zip Code	108	108	108	108
IPEDCNT	Inpatient/SNF NCH Edit Code Count	110	-	-	-
IPPATCNT	Inpatient/SNF NCH Patch Code Count	111	-	-	-
IPMCOCNT	Inpatient/SNF MCO Period Count	112	-	-	-
IPDEMCNT	Inpatient/SNF Claim Demonstration ID Count	113	-	-	-
OPEDCNT	Outpatient NCH Edit Code Count	-	110	-	-
OPPATCNT	Outpatient NCH Patch Code Count	-	111	-	-
OPMCOCNT	Outpatient MCO Period Count	-	112	-	-
OPDEMCNT	Outpatient Claim Demonstration ID Count	-	113	-	-
HHEDCNT	HHA NCH Edit Code Count	-	-	110	-
HHPATCNT	HHA NCH Patch Code Count	-	-	111	-
HHMCOCNT	HHA MCO Period Count	-	-	112	-
HHDEMCNT	HHA Claim Demonstration ID Count	-	-	113	-
HSEDCNT	Hospice NCH Edit Code Count	-	-	-	110
HSPATCNT	Hospice NCH Patch Code Count	-	-	-	111
HSMCOCNT	Hospice MCO Period Count	-	-	-	112
HSDEMCNT	Hospice Claim Demonstration ID Count	-	-	-	113
IPPOACNT	Inpatient Claim POA Diagnosis Code Count	114	-	-	-
IPPECNT	Inpatient Claim POA Diagnosis E Code Count	115	-	-	-
IPDGNCNT	Inpatient/SNF Claim Diagnosis Code J Count	116	-	-	-
IPDECNT	Inpatient Claim Diagnosis E Code Count	117	-	-	-
OPDECNT	Outpatient Claim Diagnosis Code Count	-	116	-	-
OPDECNT	Outpatient Claim Diagnosis E Code Count	-	117	-	-
HHDGNCNT	HHA Claim Diagnosis Code Count	-	-	116	-
HHDECNT	HHA Claim Diagnosis E Code Count	-	-	117	-
HSDGNCNT	Hospice Claim Diagnosis Code Count	-	-	-	116
HSDECNT	Hospice Claim Diagnosis E Code Count	-	-	-	117
IPPRCNT	Inpatient/SNF Claim Procedure Code Count	118	-	-	-
IPCONCNT	Inpatient/SNF Claim Related Condition Code Count	119	-	-	-
IPOCRCNT	Inpatient/SNF Claim Related Occurrence Code Count	120	-	-	-
IPSPNCNT	Inpatient/SNF Claim Occurrence Span Code Count	121	-	-	-
IPVALCNT	Inpatient/SNF Claim Value Code Count	122	-	-	-
IPREVCNT	Inpatient/SNF Revenue Center Code Count	123	-	-	-
OPPRCCNT	Outpatient Claim Procedure Code Count	-	118	-	-
OPCONCNT	Outpatient Claim Related Condition Code Count	-	119	-	-
OPOCRCNT	Outpatient Claim Related Occurrence Code Count	-	120	-	-
OPSPNCNT	Outpatient Claim Occurrence Span Code Count	-	121	-	-
OPVALCNT	Outpatient Claim Value Code Count	-	122	-	-
OPREVCNT	Outpatient Revenue Center Code Count	-	123	-	-
HHCONCNT	HHA Claim Related Condition Code Count	-	-	119	-
HHOCRCNT	HHA Claim Related Occurrence Code Count	-	-	120	-
HHSPNCNT	HHA Claim Occurrence Span Code Count	-	-	121	-
HHVALCNT	HHA Claim Value Code Count	-	-	122	-
HHREVCNT	HHA Revenue Center Code Count	-	-	123	-
HSPRCNT	Hospice Claim Procedure Code Count	-	-	-	118
HSCONCNT	Hospice Claim Related Condition Code Count	-	-	-	119
HSOCRCNT	Hospice Claim Related Occurrence Code Count	-	-	-	120
HSSPNCNT	Hospice Claim Occurrence Span Code Count	-	-	-	121
HSVALCNT	Hospice Claim Value Code Count	-	-	-	122
HSREVCNT	Hospice Revenue Center Code Count	-	-	-	123
ADMSN_DT	Claim Admission Date	126*	-	-	-
TYPE_ADM	Claim Inpatient Admission Type Code Claim Inpatient Admission Type Table	127*	-	-	-
OPSRVTYP	Claim Outpatient Service Type Code Claim Outpatient Service Type Table	-	126	-	-
OP_RFRL	Claim Outpatient Referral Code	-	127	-	-
LUPAIND	Claim HHA Low Utilization Payment Adjustment (LUPA) Indicator Code HHA PPS LUPA Indicator Table HHA PPS LUPA Indicator Code Limitation	-	-	126*	-
HHA_RFRL	Claim HHA Referral Code Claim HHA Referral Code Limitation	-	-	127*	-
VISITCNT	Claim HHA Total Visit Count Claim HHA Total Visit Count Limitation	-	-	128*	-
SRC_ADMS	Claim Source Inpatient Admission Code Claim Source Of Inpatient Admission Table	128*	-	-	-
ADVRSNCD	Claim Admitting Diagnosis Version Code Claim Admitting Diagnosis Version Table	130	-	-	-
AD_DGNS	Claim Admitting Diagnosis Code	131*	-	-	-
PTNTSTUS	NCH Patient Status Indicator Code Patient Status Indicator Table	132*	-	-	126*
APRVL_CD	NCH Inpatient Pro Approval Type Code NCH Inpatient Peer Review Organization Approval Type Table	133	-	-	-
PRO_FROM	NCH Inpatient PRO Approval Service From Date	134	-	-	-
PRO_THRU	NCH Inpatient PRO Approval Service Thru Date	135	-	-	-
GRC_DAY	NCH Inpatient PRO Approval Grace Day Count	136	-	-	-
PER_DIEM	Claim Pass Thru Per Diem Amount	137*	-	-	-
DED_AMT	NCH Beneficiary Inpatient Deductible Amount	138*	-	-	-
COIN_AMT	NCH Beneficiary Part A Coinsurance Liability Amount	139*	-	-	-
BLDDEDAM	NCH Beneficiary Blood Deductible Liability Amount	140*	128*	-	-
BLDTCHRG	NCH Blood Total Charge Amount	141	-	-	-
BLDNCHRG	NCH Blood Non-Covered Charge Amount	142	-	-	-
PTB_DED	NCH Beneficiary Part B Deductible Amount	-	129*	-	-
PTB_COIN	NCH Beneficiary Part B Coinsurance Amount	-	130*	-	-
PCCHGAMT	NCH Professional Component Charge Amount	143*	131*	-	-
INTRMDED	Claim Outpatient Beneficiary Interim Deductible Amount	-	132	-	-
PRVDRPMT	Claim Outpatient Provider Payment Amount	-	133*	-	-
BENEPMT	Claim Outpatient Beneficiary Payment Amount	-	134*	-	-
NCCHGAMT	NCH Inpatient Noncovered Charge Amount	144*	-	-	-
TDEDAMT	NCH Inpatient Total Deduction Amount	145*	-	-	-
PPS_CPTL	Claim Total PPS Capital Amount	146*	-	-	-
CPTL_HSP	Claim PPS Capital HSP Amount	147	-	-	-
CPTL_FSP	Claim PPS Capital FSP Amount	148*	-	-	-
CPTLOUTL	Claim PPS Capital Outlier Amount	149*	-	-	-
DISP_SHR	Claim PPS Capital Disproportionate Share Amount	150*	-	-	-
IME_AMT	Claim PPS Capital IME Amount	151*	-	-	-
CPTL_EXP	Claim PPS Capital Exception Amount	152*	-	-	-
HLDHRMLS	Claim PPS Old Capital Hold Harmless Amount	153*	-	-	-
DSCHFRCT	Claim PPS Capital Discharge Fraction Percent Claim PPS Capital Discharge Fraction Percent Limitation	154	-	-	-
DRGWTAMT	Claim PPS Capital DRG Weight Number Claim PPS Capital DRG Weight Limitation	155*	-	-	-
HSPCSTRT	Claim Hospice Start Date	-	-	-	127*
UTIL_DAY	Claim Utilization Day Count	156*	-	-	130*
CR_DAY	Claim Cost Report Days Count	157	-	-	-
COIN_DAY	Beneficiary Total Coinsurance Days Count	158*	-	-	-
COYR1DAY	Claim Coinsurance Year 1 Day Count	159	-	-	-
COYR1AMT	NCH Coinsurance Year 1 Rate Amount	160	-	-	-
COYR2DAY	Claim Coinsurance Year 2 Day Count	161	-	-	-
COYR2AMT	NCH Coinsurance Year 2 Rate Amount	162	-	-	-
LRD_USE	Beneficiary LRD Used Count	163*	-	-	-
NUTILDAY	Claim Non Utilization Days Count	164*	-	-	-
PSYCHDAY	Beneficiary Prior Psychiatric Day Count	165	-	-	-
BLDFRNSH	NCH Blood Pints Furnished Quantity	166*	135	-	-
BLD_RPLC	NCH Blood Pints Replaced Quantity	167	136	-	-
BLDNRPLC	NCH Blood Pints Not Replaced Quantity	168	137	-	-
BLDDEDPT	NCH Blood Deductible Pints Quantity	169	138	-	-
QLFYFROM	NCH Qualified Stay From Date	170*	-	129	-
QLFYTHRU	NCH Qualify Stay Through Date	171*	-	130	-
NCOVFROM	NCH Verified Noncovered Stay From Date	172*	-	-	-
NCOVTHRU	NCH Verified Noncovered Stay Through Date	173*	-	-	-
GURPMTDT	NCH Provider Guaranteed Payment Start Date	174	-	-	-
URNTCDT	NCH Utilization Review Notice Received Date	175	-	-	-
CARETHRU	NCH Active or Covered Level Care Thru Date	176*	-	-	-
EXHST_DT	NCH Beneficiary Medicare Benefits Exhausted Date	177*	-	-	128
DSCHRGDT	NCH Beneficiary Discharge Date	178*	-	131	129*
DRG_CD	Claim Diagnosis Related Group Code	179*	-	-	-
OUTLR_CD	Claim Diagnosis Related Group Outlier Stay Code Diagnosis Related Group Outlier Patient Stay Table	180*	-	-	-
OUTLRPMT	NCH DRG Outlier Approved Payment Amount	181*	-	-	-
KRON_IND	Claim KRON Indicator Code	182	-	-	-
TRANTYPE	Claim Outpatient Transaction Type Code Claim Outpatient Transaction Type Table	-	139	-	-
ESRDMTHD	Claim Outpatient ESRD Method of Reimbursement Code Claim Outpatient ESRD Method of Reimbursement Table	-	140	-	-
ESRDMTHD	Claim Patient Reason for Visit Version Code Claim Patient Reason for Visit Version Table	-	142	-	-
HHSTRTDT	Claim Patient Reason for Visit Code	-	143	-	-
HHSTRTDT	Claim HHA Care Start Date	-	-	132*	-
HOSPCPRD	Beneficiary Hospice Period Count	-	-	-	131*
EDITIND	NCH Edit Trailer Indicator Code NCH Edit Trailer Indicator Table	186	147	136	135
EDIT_CD	NCH Edit Code NCH Edit Table	187	148	137	136
PATCHIND	NCH Patch Trailer Indicator Code NCH Patch Trailer Indicator Table	189	150	139	138
PATCHCD	NCH Patch Code NCH Patch Table	190	151	140	139
PATCHDT	NCH Patch Applied Date	191	152	141	140
MCOIND	NCH MCO Trailer Indicator Code NCH MCO Trailer Indicator Table	193	154	143	142
MCONUM	MCO Contract Number	194	155	144	143
MCOOPTN	MCO Option Code MCO Option Table	195	156	145	144
MCOEFFDT	MCO Period Effective Date	196	157	146	145
MCOTRMDT	MCO Period Termination Date	197	158	147	146
MCOPLNID	MCO Health PLANID Number	198	159	148	147
DEMOIND	NCH Demonstration Trailer Indicator Code NCH Demonstration Trailer Indicator Table	200	161	150	149
DEMONUM	Claim Demonstration Identification Number	201	162	151	150
DEMOTXT	Claim Demonstration Information Text Choices Demonstration Limitation	202	163	152	151
PTRLRIND	NCH POA Diagnosis Trailer Indicator Code NCH POA Diagnosis Trailer Indicator Table	204	-	-	-
POAINDCD	Claim POA Diagnosis Indicator Code Claim POA Diagnosis Indicator Table	205	-	-	-
PETRLR	NCH POA Diagnosis E Trailer Indicator Code	207	-	-	-
POAEIND	Claim POA Diagnosis E Indicator Code Claim POA Diagnosis E Indicator Table	208	-	-	-
DGNSIND	NCH Diagnosis Trailer Indicator Code NCH Diagnosis Trailer Indicator Table	210	165	154	153
DVRSNCD	Claim Diagnosis Version Code Claim Diagnosis Version Table	211	166	155	154
DGNS_CD	Claim Diagnosis Code	212*	167*	156*	155*
ETRLRIND	NCH Diagnosis E Trailer Indicator Code NCH Diagnosis E Trailer Indicator Table	214	169	158	157
EVRSNCD	Claim Diagnosis E Version Code	215	170	159	158
EDGNSCD	Claim Diagnosis E Code	216	171	160	159
PRCDRIND	NCH Procedure Trailer Indicator Code NCH Procedure Trailer Indicator Table	218	173	-	161
PVRSNDCD	Claim Procedure Version Cod	219	174	-	162
PRCDR_CD	Claim Procedure Code	220*	175*	-	163
PRCDR_DT	Claim Procedure Performed Date	221*	176*	-	164
CONDIND	NCH Condition Trailer Indicator Code NCH Condition Trailer Indicator Table	223	178	162	166
RLT_COND	Claim Related Condition Code Claim Related Condition Table	224	179	163	167
OCRNCIND	NCH Occurrence Trailer Indicator Code NCH Occurrence Trailer Indicator Table	226	181	165	169
OCRNC_CD	Claim Related Occurrence Code Claim Related Occurrence Table	227	182	166	170
OCRNCDT	Claim Related Occurrence Date	228	183	167	171
SPANIND	NCH Span Trailer Indicator Code NCH Span Trailer Indicator Table	230	185	169	173
SPAN_CD	Claim Occurrence Span Code Claim Occurrence Span Table	231	186	170	174
SPANFROM	Claim Occurrence Span From Date	232	187	171	175
SPANTHRU	Claim Occurrence Span Through Date	233	188	172	176
VALIND	NCH Value Trailer Indicator Code NCH Value Trailer Indicator Table	235	190	174	178
VAL_CD	Claim Value Code Claim Value Table	236	191	175	179
VAL_AMT	Claim Value Amount	237	192	176	180
REVIND	NCH Revenue Center Trailer Indicator Code NCH Revenue Center Trailer Indicator Table	239	194	178	182
REV_CNTR	Revenue Center Code Revenue Center Table	240	195	179	183
REV_DT	Revenue Center Date	241	196	180	184
REVANSI1	Revenue Center 1st ANSI Code Revenue Center ANSI Code Table	242	197	181	185
REVANSI2	Revenue Center 2nd ANSI Code	243	198	182	186
REVANSI3	Revenue Center 3rd ANSI Code	244	199	183	187
REVANSI4	Revenue Center 4th ANSI Code	245	200	184	188
APCHIPPS	Revenue Center APC/HIPPS Revenue Center APC Table	246	201	185	189
HCPCS_CD	Revenue Center Healthcare Common Procedure Coding System Claim HIPPS Table HHA HCPCS Limitation	247	202	186	190
MDFR_CD1	Revenue Center HCPCS Initial Modifier Code	248	203	187	191
MDFR_CD2	Revenue Center HCPCS Second Modifier Code	249	204	188	192
MDFR_CD3	Revenue Center HCPCS Third Modifier Code	250	205	189	193
MDFR_CD4	Revenue Center HCPCS Fourth Modifier Code	251	206	190	194
MDFR_CD5	Revenue Center HCPCS Fifth Modifier Code	252	207	191	195
PMTMTHD	Revenue Center Payment Method Indicator Code Revenue Center Payment Method Indicator Table	253	208	192	196
DSCNTIND	Revenue Center Discount Indicator Code Revenue Center Discount Indicator Table	254	209	193	197
PACKGIND	Revenue Center Packaging Indicator Code Revenue Center Packaging Indicator Table	255	210	194	198
PRICNG	Revenue Center Pricing Indicator Code Revenue Center Pricing Indicator Table	256	211	195	199
OTAF	Revenue Center Obligation to Accept As Full (OTAF) Payment Code	257	212	196	200
IDENDC	Revenue Center IDE, NDC, UPC Number Revenue Center IDE, NDC, UPC Limitation	258	213	197	201
QTYQLFR	Revenue Center NDC Quantity Qualifier Code Revenue Center NDC Quantity Qualifier Table	259	214	198	202
NDCQTY	Revenue Center NDC Quantity	260	215	199	203
REV_UNIT	Revenue Center Unit Count	261	216	200	204
REV_RATE	Revenue Center Rate Amount	262	217	201	205
REVBLOOD	Revenue Center Blood Deductible Amount	263	218	202	206
REVDCTBL	Revenue Center Cash Deductible Amount	264	219	203	207
WAGEADJ	Revenue Center Coinsurance/Wage Adjusted Coinsurance Amount	265	220	204	208
RDCDCOIN	Revenue Center Reduced Coinsurance Amount	266	221	205	209
REV_MSP1	Revenue Center 1st Medicare Secondary Payer Paid Amount	267	222	206	210
REV_MSP2	Revenue Center 2nd Medicare Secondary Payer Paid Amount	268	223	207	211
RPRVDPMT	Revenue Center Provider Payment Amount	269	224	208	212
RBENEPMT	Revenue Center Beneficiary Payment Amount	270	225	209	213
PTNTRESP	Revenue Center Patient Responsibility Payment Amount	271	226	210	214
REVPMT	Revenue Center Payment Amount	272	227	211	215
REV_CHRG	Revenue Center Total Charge Amount Multiple Revenue Center '0001' Code Limitation Revenue Center Total Charge Amount Limitation	273	228	212	216
REV_NCVR	Revenue Center Non-Covered Charge Amount	274	229	213	217
REVDEDCD	Revenue Center Deductible Coinsurance Code Revenue Center Deductible Coinsurance Table	275	230	214	218
RCNSLDTD	Revenue Center Consolidated Billing Code Revenue Center Consolidated Billing Table	276	231	215	219
RSTUSIND	Revenue Center Status Indicator Code Revenue Center Status Indicator Table	277	232	216	220
DUP-CHK	Revenue Center Duplicate Claim Check Indicator Code Revenue Center Duplicate Claim Check Indicator Table	278	233	217	221
APCBUFR	Revenue Center APC Buffer Code Revenue Center APC Buffer Table	279	234	218	222
REVNPI	Revenue Center Rendering Physician NPI Num	280	235	219	223
REVSRNM	Revenue Center Rendering Physician Surname	281	236	220	224
EOR	End of Record Code End of Record Table	283	238	222	226

General File Limitations

Last Modified January 18, 2012

Medicare Institutional Data (Version J, Variable Block Data)

General File Limitations

Medicare Institutional Data
(Version J, Variable Block Data)