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File Version: K, CCW Data Documentation May, 2019

Short SAS NameLong SAS NameVariable Name
1BENE_IDBENE_IDEncrypted CCW Beneficiary ID
2CLM_IDCLM_IDClaim ID
3RIC_CDNCH_NEAR_LINE_REC_IDENT_CDNCH Near Line Record Identification Code (RIC)
4CLM_TYPENCH_CLM_TYPE_CDNCH Claim Type Code
5FROM_DTCLM_FROM_DTClaim From Date (FFS)
6THRU_DTCLM_THRU_DTClaim Through Date (FFS)
7WKLY_DTNCH_WKLY_PROC_DTNCH Weekly Claim Processing Date
8ENTRY_CDCARR_CLM_ENTRY_CDCarrier Claim Entry Code
9DISP_CDCLM_DISP_CDClaim Disposition Code
10CARR_NUMCARR_NUMCarrier or MAC Number
11PMTDNLCDCARR_CLM_PMT_DNL_CDCarrier Claim Payment Denial Code
12PMT_AMTCLM_PMT_AMTClaim (Medicare) Payment Amount
450PRPAYAMTNCH_PRMRY_PYR_CLM_PD_AMTNCH Primary Payer (if not Medicare) Claim Paid Amount
14RFRG_PHYSN_NPIRFRG_PHYSN_NPICarrier/DMERC Claim Referring Physician UPIN Number
15RFR_PHYSN_NPIRFRG_NPIClaim Referring Physician NPI Number
16ASGMNTCDCARR_CLM_PRVDR_ASGNMT_IND_SWCarrier Claim Provider Assignment Indicator Switch
17PROV_PMTNCH_CLM_PRVDR_PMT_AMTNCH Claim Provider Payment Amount
18BENE_PMTNCH_CLM_BENE_PMT_AMTNCH Claim Payment Amount to Beneficiary
501PRVDR_VLDTN_TYPE_CDPRVDR_VLDTN_TYPE_CDProvider Validation Type Code
451CLM_BENE_PD_AMTCLM_BENE_PD_AMTCarrier Claim Beneficiary Paid Amount
19SBMTCHRGNCH_CARR_CLM_SBMTD_CHRG_AMTNCH Carrier Claim Submitted Charge Amount (sum of all line-level submitted charges)
60CLM_BENE_ID_TYPE_CDCLM_BENE_ID_TYPE_CDClaim Beneficiary Identifier Type Code
20ALOWCHRGNCH_CARR_CLM_ALOWD_AMTNCH Carrier Claim Allowed Charge Amount (sum of all line-level allowed charges)
21DEDAPPLYCARR_CLM_CASH_DDCTBL_APLD_AMTCarrier Claim Cash Deductible Applied Amount (sum of all line-level deductible amounts)
22HCPCS_YRCARR_CLM_HCPCS_YR_CDClaim Healthcare Common Procedure Coding System (HCPCS) Year Code
23RFR_PRFLCARR_CLM_RFRNG_PIN_NUMCarrier Claim Referring Provider ID Number (PIN)
452CPO_PRVDR_NUMCPO_PRVDR_NUMCare Plan Oversight (CPO) Provider Number
453CPO_ORG_NPI_NUMCPO_ORG_NPI_NUMCPO Organization NPI Number
454CARR_CLM_BLG_NPI_NUMCARR_CLM_BLG_NPI_NUMCarrier Claim Billing NPI Number
24PRNCPAL_DGNS_CDPRNCPAL_DGNS_CDClaim Principal Diagnosis Code (FFS)
25PRNCPAL_DGNS_VRSN_CDPRNCPAL_DGNS_VRSN_CDClaim Principal Diagnosis Version Code (FFS)
26ICD_DGNS_CD1ICD_DGNS_CD1Claim Diagnosis Code I (FFS)
27ICD_DGNS_VRSN_CD1ICD_DGNS_VRSN_CD1Claim Diagnosis Code I Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
28ICD_DGNS_CD2ICD_DGNS_CD2Claim Diagnosis Code II (FFS)
29ICD_DGNS_VRSN_CD2ICD_DGNS_VRSN_CD2Claim Diagnosis Code II Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
30ICD_DGNS_CD3ICD_DGNS_CD3Claim Diagnosis Code III (FFS)
31ICD_DGNS_VRSN_CD3ICD_DGNS_VRSN_CD3Claim Diagnosis Code III Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
32ICD_DGNS_CD4ICD_DGNS_CD4Claim Diagnosis Code IV (FFS)
33ICD_DGNS_VRSN_CD4ICD_DGNS_VRSN_CD4Claim Diagnosis Code IV Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
34ICD_DGNS_CD5ICD_DGNS_CD5Claim Diagnosis Code V (FFS)
35ICD_DGNS_VRSN_CD5ICD_DGNS_VRSN_CD5Claim Diagnosis Code V Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
36ICD_DGNS_CD6ICD_DGNS_CD6Claim Diagnosis Code VI (FFS)
37ICD_DGNS_VRSN_CD6ICD_DGNS_VRSN_CD6Claim Diagnosis Code VI Diagnosis Version Code (ICD-9/ICD-10) (FFS)
38ICD_DGNS_CD7ICD_DGNS_CD7Claim Diagnosis Code VII (FFS)
39ICD_DGNS_VRSN_CD7ICD_DGNS_VRSN_CD7Claim Diagnosis Code VII Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
40ICD_DGNS_CD8ICD_DGNS_CD8Claim Diagnosis Code VIII (FFS)
41ICD_DGNS_VRSN_CD8ICD_DGNS_VRSN_CD8Claim Diagnosis Code VIII Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
42ICD_DGNS_CD9ICD_DGNS_CD9Claim Diagnosis Code IX (FFS)
43ICD_DGNS_VRSN_CD9ICD_DGNS_VRSN_CD9Claim Diagnosis Code IX Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
44ICD_DGNS_CD10ICD_DGNS_CD10Claim Diagnosis Code X (FFS)
45ICD_DGNS_VRSN_CD10ICD_DGNS_VRSN_CD10Claim Diagnosis Code X Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
46ICD_DGNS_CD11ICD_DGNS_CD11Claim Diagnosis Code XI (FFS)
47ICD_DGNS_VRSN_CD11ICD_DGNS_VRSN_CD11Claim Diagnosis Code XI Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
48ICD_DGNS_CD12ICD_DGNS_CD12Claim Diagnosis Code XII (FFS)
49ICD_DGNS_VRSN_CD12ICD_DGNS_VRSN_CD12Claim Diagnosis Code XII Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
50CCLTRNUMCLM_CLNCL_TRIL_NUMClinical Trial Number
51DOB_DTDOB_DTDate of Birth from Claim
52GNDR_CDGNDR_CDGender Code from Claim
53RACEBENE_RACE_CDBeneficiary Race Code (Encounter)
54CNTY_CDBENE_CNTY_CDCounty Code from Claim (SSA)
55BENE_STATE_CDBENE_STATE_CDBeneficiary Residence (SSA) State Code (FFS)
56ZIP_CDBENE_MLG_CNTCT_ZIP_CDZip Code of Residence from Claim
58ACO_ID_NUMACO_ID_NUMClaim Accountable Care Organization (ACO) Identification Number
59CARR_CLM_SOS_NPI_NUMCarrier Claim Site of Service NPI Number
500CLM_RSDL_PYMT_IND_CDCLM_RSDL_PYMT_IND_CDClaim Residual Payment Indicator Code

LINE FILE

Short SAS NameLong SAS NameVariable Name
1BENE_IDBENE_IDEncrypted CCW Beneficiary ID
2CLM_IDCLM_IDClaim ID
3CLM_LNCLM_LINE_NUMClaim Line Number
4CLM_TYPENCH_CLM_TYPE_CDNCH Claim Type Code
5THRU_DTCLM_THRU_DTClaim Through Date (FFS)
6PRF_PRFLCARR_PRFRNG_PIN_NUMCarrier Line Performing Provider ID Number (PIN)
7PRF_UPINPRF_PHYSN_UPINCarrier Line Performing UPIN Number
8PRFNPIPRF_PHYSN_NPICarrier Line Performing NPI Number
9ORGNPINMORG_NPI_NUMOrganization (or group) NPI Number
10PRV_TYPECARR_LINE_PRVDR_TYPE_CDCarrier Line Provider Type Code
11TAX_NUMTAX_NUMLine Provider Tax Number
12PRVSTATEPRVDR_STATE_CDNCH Provider SSA State Code
13PROVZIPPRVDR_ZIPCarrier Line Performing Provider ZIP Code
14HCFASPCLPRVDR_SPCLTYLine CMS Provider Specialty Code
15PRTCPTGPRTCPTNG_IND_CDLine Provider Participating Indicator Code
16ASTNT_CDCARR_LINE_RDCD_PMT_PHYS_ASTN_CCarrier Line Reduced Payment Physician Assistant Code
17SRVC_CNTLINE_SRVC_CNTLine Service Count (FFS)
18TYPSRVCBLINE_CMS_TYPE_SRVC_CDLine CMS Type Service Code
19PLCSRVCLINE_PLACE_OF_SRVC_CDLine Place Of Service Code (FFS)
20LCLTY_CDCARR_LINE_PRCNG_LCLTY_CDCarrier Line Pricing Locality Code
21EXPNSDT1LINE_1ST_EXPNS_DTLine First Expense Date (FFS)
22EXPNSDT2LINE_LAST_EXPNS_DTLine Last Expense Date (FFS)
23HCPCS_CDHCPCS_CDHealthcare Common Procedure Coding System (HCPCS) Code (FFS)
24MDFR_CD1HCPCS_1st_mdfr_cdHCPCS Initial Modifier Code (FFS)
25MDFR_CD2HCPCS_2ND_MDFR_CDHCPCS Second Modifier Code (FFS)
26BETOSBETOS_CDLine Berenson-Eggers Type of Service (BETOS) Code
27LINEPMTLINE_NCH_PMT_AMTLine NCH Medicare Payment Amount
28LBENPMTLINE_BENE_PMT_AMTLine Payment Amount to Beneficiary
29LPRVPMTLINE_PRVDR_PMT_AMTLine Provider Payment Amount
30LDEDAMTLINE_BENE_PTB_DDCTBL_AMTLine Beneficiary Part B Deductible Amount
31LPRPAYCDLINE_BENE_PRMRY_PYR_CDLine Primary Payer Code (if not Medicare)
32LPRPDAMTLINE_BENE_PRMRY_PYR_PD_AMTLine Primary Payer (if not Medicare) Paid Amount
33COINAMTLINE_COINSRNC_AMTLine Beneficiary Coinsurance Amount
34LSBMTCHGLINE_SBMTD_CHRG_AMTLine Submitted Charge Amount
35LALOWCHGLINE_ALOWD_CHRG_AMTLine Allowed Charge Amount
36PRCNGINDLINE_PRCSG_IND_CDLine Processing Indicator Code
37PMTINDSWLINE_PMT_80_100_CDLine Payment 80% / 100% Code
38DED_SWLINE_SERVICE_DEDUCTIBLELine Service Deductible Indicator Switch
39MTUS_CNTCARR_LINE_MTUS_CNTCarrier Line Miles/Time/Units/Services (MTUS) Count
40MTUS_INDCARR_LINE_MTUS_CDCarrier Line Miles/Time/Units/Services (MTUS) Indicator Code
41LINE_ICD_DGNS_CDLINE_ICD_DGNS_CDLine Diagnosis Code
42LINE_ICD_DGNS_VRSN_CDLINE_ICD_DGNS_VRSN_CDLine Diagnosis Code Diagnosis Version Code (ICD-9 or ICD-10)
43HPSASCCDHPSA_SCRCTY_IND_CDCarrier Line Health Professional Shortage Area (HPSA)/Scarcity Indicator Code
44CARRXNUMLINE_RX_NUMCarrier Line RX Number
45HCTHGBRSLINE_HCT_HGB_RSLT_NUMHematocrit/Hemoglobin Test Results
46HCTHGBTPLINE_HCT_HGB_TYPE_CDHematocrit/Hemoglobin Test Type Code
47LNNDCCDLINE_NDC_CDLine National Drug Code (NDC) (FFS)
48CARR_LINE_CLIA_LAB_NUMCARR_LINE_CLIA_LAB_NUMClinical Laboratory Improvement Amendments (CLIA) monitored laboratory number
49CARR_LINE_ANSTHSA_UNIT_CNTCARR_LINE_ASNTHSA_UNIT_CNTCarrier Line Anesthesia Unit Count
50CARR_LINE_CL_CHRG_AMTCARR_LINE_CL_CHRG_AMTCarrier Line Clinical Lab Charge Amount
51PHYSN_ZIP_CDPHYSN_ZIP_CDLine Place of Service (POS) Physician Zip Code
52LINE_OTHR_APLD_IND_CD1LINE_OTHR_APLD_IND_CD1Line Other Applied Indicator 1st Code
53LINE_OTHR_APLD_IND_CD2LINE_OTHER_APLD_IND_CD2Line Other Applied Indicator 2nd Code
54LINE_OTHR_APLD_IND_CD3LINE_OTHR_APLD_IND_CD3Line Other Applied Indicator 3rd Code
55LINE_OTHR_APLD_IND_CD4LINE_OTHR_APLD_IND_CD4Line Other Applied Indicator 4th Code
56LINE_OTHR_APLD_IND_CD5LINE_OTHR_APLD_IND_CD5Line Other Applied Indicator 5th Code
57LINE_OTHR_APLD_IND_CD6LINE_OTHR_APLD_IND_CD6Line Other Applied Indicator 6th Code
58LINE_OTHR_APLD_IND_CD7LINE_OTHR_APLD_IND_CD7Line Other Applied Indicator 7th Code
59LINE_OTHR_APLD_AMT1LINE_OTHR_APLD_AMT1Line Other Applied Amount for 1st Code
60LINE_OTHR_APLD_AMT2LINE_OTHR_APLD_AMT2Line Other Applied Amount for 2nd Code
61LINE_OTHR_APLD_AMT3LINE_OTHR_APLD_AMT3Line Other Applied Amount for 3rd Code
62LINE_OTHR_APLD_AMT4LINE_OTHR_APLD_AMT4Line Other Applied Amount for 4th Code
63LINE_OTHR_APLD_AMT5LINE_OTHR_APLD_AMT5Line Other Applied Amount for 5th Code
64LINE_OTHR_APLD_AMT6LINE_OTHR_APLD_AMT6Line Other Applied Amount for 6th Code
65LINE_OTHR_APLD_AMT7LINE_OTHR_APLD_AMT7Line Other Applied Amount for 7th Code
66THRPY_CAP_IND_CD1THRPY_CAP_IND_CD1Therapy cap Indicator 1 Code
67THRPY_CAP_IND_CD2THRPY_CAP_IND_CD2Therapy cap Indicator 2 Code
68THRPY_CAP_IND_CD3THRPY_CAP_IND_CD3Therapy cap Indicator 3 Code
69THRPY_CAP_IND_CD4THRPY_CAP_IND_CD4Therapy cap Indicator 4 Code
70THRPY_CAP_IND_CD5THRPY_CAP_IND_CD5Therapy cap Indicator 5 Code
71CLM_NEXT_GNRTN_ACO_IND_1_CDCLM_NEXT_GNRTN_ACO_IND_CD1Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Population-Based Payment (PBP)
72CLM_NEXT_GNRTN_ACO_IND_2_CDCLM_NEXT_GNRTN_ACO_IND_CD2Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Telehealth
73CLM_NEXT_GNRTN_ACO_IND_3_CDCLM_NEXT_GNRTN_ACO_IND_CD3Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Post Discharge HH visits
74CLM_NEXT_GNRTN_ACO_IND_4_CDCLM_NEXT_GNRTN_ACO_IND_CD4Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - 3-day SNF waiver
75CLM_NEXT_GNRTN_ACO_IND_5_CDCLM_NEXT_GNRTN_ACO_IND_CD5Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Capitation
456CARR_LINE_MDPP_NPI_NUMCarrier Line Medicare Diabetes Prevention Program (MDPP) NPI Number
502LINE_RSDL_PYMT_IND_CDLINE_RSDL_PYMT_IND_CDLine Residual Payment Indicator Code
503LINE_RP_IND_CDLINE_RP_IND_CDLine Representative Payee (RP) Indicator Code
504LINE_PRVDR_VLDTN_TYPE_CDLINE_PRVDR_VLDTN_TYPE_CDLine Provider Validation Type Code

Demonstrations/Innovations Code File

Short SAS NameLong SAS NameVariable Name
1BENE_IDBENE_IDEncrypted CCW Beneficiary ID
2CLM_IDCLM_IDClaim ID
3CLM_TYPENCH_CLM_TYPE_CDNCH Claim Type Code
4DEMO_ID_SQNC_NUMDEMO_ID_SQNC_NUMDemonstration sequence number
5DEMO_ID_NUMDEMO_ID_NUMDemonstration number
6DEMO_INFO_TXTDEMO_INFO_TXTDemo information text
CSV