Medicare Non-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 for this claim type.

Carrier [old name: Physician/Supplier Part B], Durable Medical Equipment [DME]

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 NCH Near-Line Record Version Table	4	4
RIC_CD	NCH Near Line Record Identification Code NCH Near-Line Record Identification Code Table	5*	5*
MQA_RIC	NCH MQA RIC Code NCH MQA Record Identification Code Table	6	6
CLM_TYPE	NCH Claim Type Code NCH Claim Type Table	7*	7*
CAN	Beneficiary Claim Account Number	10	10
EQ_BIC	NCH Category Equatable Beneficiary Identification Code NCH Category Equatable Beneficiary Identification Code (BIC) Table	11	11
BIC	Beneficiary Identification Code Beneficiary Identification Code (BIC) Table	12	12
ST_SGMT	NCH State Segment Code NCH State Segment Table	13	13
STATE_CD	Beneficiary Residence SSA Standard State Code SSA State Table	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 Claim Disposition Table	32*	32*
EDITDISP	NCH Edit Disposition Code NCH Edit Disposition Table	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 Carrier Number Table	39*	39*
FIBATCH	CWF Transmission Batch Number	41	41
BENE_ZIP	Beneficiary Mailing Contact ZIP Code	42*	42*
SEX	Beneficiary Sex Identification Code Beneficiary Sex Identification Table	43*	43*
RACE	Beneficiary Race Code Beneficiary Race Table	44*	44*
BENE_DOB	Beneficiary Birth Date	45*	45*
MS_CD	CWF Beneficiary Medicare Status Code Beneficiary Medicare Status Table	46	46
CWFLOCCD	Beneficiary CWF Location Code Beneficiary CWF Location Table	50	50
PDVRSNCD	Claim Principal Diagnosis Version Code Claim Principal Diagnosis Version Table	52	52
PDGNS_CD	Claim Principal Diagnosis Code	53	53
PMTDNLCD	Carrier Claim Payment Denial Code Carrier Claim Payment Denial Table	55*	55*
TRTMT_CD	Claim Excepted/Nonexcepted Medical Treatment Code	56	56
PMT_AMT	Claim Payment Amount Claim Payment Amount Limitation	57*	57*
PRPAYAMT	Carrier Claim Primary Payer Paid Amount	58*	58*
RFR_UPIN	Carrier Claim Refering Physician UPIN Number	60*	-
RFR_NPI	Carrier Claim Refering Physician NPI Number	61*	-
ORD_UPIN	DMERC Claim Ordering Physician UPIN Number	-	60*
ORD_NPI	DMERC Claim Ordering Physician NPI Number	-	61*
ASGMNTCD	Carrier Claim Provider Assignment Indicator Switch Carrier Claim Provider Assignment Indicator Switch Table	62*	62*
PROV_PMT	NCH Claim Provider Payment Amount	63*	63*
BENE_PMT	NCH Claim Beneficiary Payment Amount	64*	64*
BENEPAID	Carrier Claim Beneficiary Paid Amount	65	65
SBMTCHRG	NCH Carrier Claim Submitted Charge Amount	66*	66*
ALOWCHRG	NCH Carrier Claim Allowed Charge Amount	67*	67*
DEDAPPLY	Carrier Claim Cash Deductible Applied Amount	68*	68*
HCPCS_YR	Carrier Claim HCPCS Year Code	69*	69*
MCOOVRRD	Carrier Claim MCO Override Indicator Code Carrier Claim MCO Override Indicator Table	70	70
HOSPOVRD	Carrier Claim Hospice Override Indicator Code Carrier Claim Hospice Override Indicator Table	71	71
SGMT_ID	Claim Business Segment Identifier Code	72	72
CTRILNUM	Claim Clinical Trial Number	73*	73*
RACINDCD	Recovery Audit Contractor (RAC) Adjustment Indicator Code Recovery Adjustment Contractor (RAC) Adjustment Indicator Table	74	74
CLM_PWK_CD	Claim Paperwork (PWK) Code	75	-
RFR_PRFL	Carrier Claim Referring PIN Number	77*	-
CPO_PROV	Care Plan Oversight (CPO) Provider Number	78	-
CPO_NPI	CPO Organization NPI Number	79	-
BLDFRNSH	Claim Blood Pints Furnished Quantity	80	-
BLD_DED	Claim Blood Deductible Pints Quantity	81	-
CEDCNT	Carrier NCH Edit Code Count	83	-
DEDCNT	DMERC NCH Edit Code Count	-	76
CPATCNT	Carrier NCH Patch Code Count	84	-
DPATCNT	DMERC NCH Patch Code Count	-	77
CMCOCNT	Carrier MCO Period Count	85	-
DMCOCNT	DMERC MCO Period Count	-	78
CDEMCNT	Carrier Claim Demonstration ID Count	86	-
DDEMCNT	DMERC Claim Demonstration ID Count	-	79
CDGNCNT	Carrier Claim Diagnosis Code J Count	87	-
DDGNCNT	DMERC Claim Diagnosis Code Count	-	80
CLINECNT	Carrier Claim Line Count	88	-
DLINECNT	DMERC Claim Line Count	-	81
EDITIND	NCH Edit Trailer Indicator Code NCH Edit Trailer Indicator Table	92	85
EDIT_CD	NCH Edit Code NCH Edit Table	93	86
PATCHIND	NCH Patch Trailer Indicator Code NCH Patch Trailer Indicator Table	95	88
PATCHCD	NCH Patch Code NCH Patch Table	96	89
PATCHDT	NCH Patch Applied Date	97	90
MCOIND	NCH MCO Trailer Indicator Code NCH MCO Trailer Indicator Table	99	92
MCONUM	MCO Contract Number	100	93
MCOOPTN	MCO Option Code MCO Option Table	101	94
MCOEFFDT	MCO Period Effective Date	102	95
MCOTRMDT	MCO Period Termination Date	103	96
MCOPLNID	MCO Health PLANID Number	104	97
DEMOIND	NCH Demonstration Trailer Indicator Code	106	99
DEMONUM	Claim Demonstration Identification Number	107	100
DEMOTXT	Claim Demonstration Information Text Choices Demonstration Limitation	108	101
DGNSIND	NCH Diagnosis Trailer Indicator Code	110	103
DVRSSNCD	Claim Diagnosis Version Code	111	104
DGNS_CD	Claim Diagnosis Code	112*	105*
LINEIND	NCH Line Item Trailer Indicator Code	114	107
PRF_PRFL	Carrier Line Performing PIN Number	115	-
PRF_UPIN	Carrier Line Performing UPIN Number Carrier Line Performing UPIN Limitation	116*	-
PRFNPI	Carrier Line Performing NPI Number	117*	-
PRGRPNPI	Carrier Line Performing Group NPI Number	118*	-
PRV_TYPE	Carrier Line Provider Type Code Carrier Line Provider Type Table	119*	-
SUP_NPI	DMERC Line Supplier Provider Number	-	108*
SUP_NPI	DMERC Line Item Supplier NPI Number	-	109*
PRCNG_ST	DMERC Line Pricing State Code SSA State Table	-	110*
PRCNGZIP	DMERC Line Pricing Zip Code	-	111
MLGSTATE	DMERC Line Beneficiary Mailing State Code	-	112
PRVSTATE	DMERC Line Provider State Code SSA State Table	-	113*
SUP_TYPE	DMERC Line Supplier Type Code DMERC Line Supplier Type Table	-	114*
TAX_NUM	Line Provider Tax Number	120*	115*
PRVSTATE	Line NCH Provider State Code SSA State Table	121*	-
PROVZIP	Carrier Line Performing Provider ZIP Code	122*	-
HCFASPCL	Line HCFA Provider Specialty Code Line HCFA Provider Specialty Table	123*	116*
CARRSPCL	Carrier Line Provider Specialty Code	124	-
PRTCPTG	Line Provider Participating Indicator Code Line Provider Participating Indicator Table	125*	117*
ASTNT_CD	Carrier Line Reduced Payment Physician Assistant Code Carrier Line Part B Reduced Physician Assistant Table	126*	-
SRVC_CNT	Line Service Count	127*	118*
TYPSRVCB	Line HCFA Type of Service Code HCFA Type of Service Table	128*	119*
PTYPESRV	Carrier Line Type of Service Code	129	-
PLCSRVC	Line Place Of Service Code Line Place of Service Table	130*	120*
LCLTY_CD	Carrier Line Pricing Locality Code	131*	-
EXPNSDT1	Line First Expense Date	132*	121*
EXPNSDT2	Line Last Expense Date	133*	122*
HCPCS_CD	Line HCPCS Code	134*	123*
MDFR_CD1	Line HCPCS Initial Modifier Code	135*	124*
MDFR_CD2	Line HCPCS Second Modifier Code	136*	125*
MDFR_CD3	Line HCPCS Third Modifier Code	137	126*
MDFR_CD4	Line HCPCS Fourth Modifier Code	137	127*
BETOS	Line NCH BETOS Code BETOS Table	139*	128*
LINE_IDE	Line IDE Number	140	129
NOC_TXT	DMERC Line Not Otherwise Classified HCPCS Code Text	-	130
NDC_CD	Line National Drug Code	141	131
LINEPMT	Line NCH Payment Amount	142*	132*
LBENPMT	Line Beneficiary Payment Amount	143*	133*
LPRVPMT	Line Provider Payment Amount	144*	134*
LDEDAMT	Line Beneficiary Part B Deductible Amount	145*	135*
LPRPAYCD	Line Beneficiary Primary Payer Code Line Beneficiary Primary Payer Table	146*	136*
LPRPDAMT	Line Beneficiary Primary Payer Paid Amount	147*	137*
COINAMT	Line Coinsurance Amount	148*	138*
LLMTAMT	Carrier Line Psychiatric, Occupational Therapy, Physical Therapy Limit Amount	149	-
LINT_AMT	Line Interest Amount	150	139
PRPYALOW	Line Primary Payer Allowed Charge Amount	151*	140*
PNLTYAMT	Line 10% Penalty Reduction Amount	152	141
LBLD_DED	Carrier Line Blood Deductible Pints Quantity	153	-
LSBMTCHG	Line Submitted Charge Amount	154*	142*
LALOWCHG	Line Allowed Charge Amount	155*	143*
LAB_NUM	Carrier Line Clinical Lab Number	156	-
LAB_AMT	Carrier Line Clinical Lab Charge Amount	157	-
SCRNSVGS	DMERC Line Screen Savings Amount	-	144*
DME_PURC	Line DME Purchase Price Amount	-	145*
PRCNGIND	Line Processing Indicator Code Line Processing Indicator Table	158*	146*
PMTINDSW	Line Payment 80%/100% Code	159*	147*
DED_SW	Line Service Deductible Indicator Switch	160*	148*
PMTINDCD	Line Payment Indicator Code	161	149
MTUS_CNT	Carrier Line Miles/Time/Units/Services Count Carrier Line Miles/Time/Units/Services Count Limitation	162*	-
MTUS_IND	Carrier Line Miles/Time/Units/Services Indicator Code Carrier Line Miles/Time/Units/Services Indicator Code	163*	-
DME_UNIT	DMERC Line Miles/Time/Units/Services Count	-	150*
UNIT_IND	DMERC Line Miles/Time/Units/Services Indicator Code DMERC Line Miles/Time/Units/Services Indicator Code	-	151*
LDVRSNCD	Line Diagnosis Version Code	165	153
LINEDGNS	Line Diagnosis Code	166*	154*
ANSTHUNT	Carrier Line Anesthesia Base Unit Count	167	-
CLIAALRT	Carrier Line CLIA Alert Indicator Code	168	-
DCMTN_CD	Line Additional Claim Documentation Indicator Code Line Additional Claim Documentation Indicator Table	169	155
SUSP_IND	DMERC Line Screen Suspension Indicator Code DMERC Line Screen Suspension Indicator Table	-	156
RSLT_IND	DMERC Line Screen Result Indicator Code DMERC Line Screen Result Indicator Table	-	157
WAIVERSW	DMERC Line Waiver of Provider Liability Switch DMERC Line Waiver of Provider Liability Switch Table	-	158
DCSN_IND	DMERC Line Decision Indicator Switch DMERC Line Decision Indicator Switch Table	-	159
DMEST_DT	Carrier Line DME Coverage Period Start Date	170	-
DME_PURC	Line DME Purchase Price Amount	171	-
NCSTY_MO	Carrier Line DME Medical Necessity Month Count	172	-
LCNSLDTD	Line Consolidated Billing Indicator Code Line Consolidated Billing Indicator Table	173	160
DUP_CHK	Line Duplicate Claim Check Indicator Code Line Duplicate Claim Check Indicator Table	174	161
PNT_PCKP	Carrier Line Point of Pickup Zip Code	175	-
DROP_OFF	Carrier Line Drop Off Zip Code	176	-
HSCRCTY	Carrier Line HPSA/Scarcity Indicator Code	177*	-
RX_NUM	Carrier Line RX Number	178*	-
HTYPECD	Line Hematocrit/Hemoglobin Test Type Code Line Hematocrit/Hemoglobin Test Type Table	179*	162*
HRSLTNUM	Line Hematocrit/Hemoglobin Test Result Number	180*	163*
HRLSTNUM	Line Hematocrit/Hemoglobin Test Result Number - Redefined	181	164
WCINDCD	Worker's Compensation Indicator Code Worker's Compensation Indicator Table	182	165
EOR	End of Record Code End of Record Table	184	167

File Limitations

Last Modified May 16, 2012

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

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