Data Documentation

Original Medicare (Fee-for-Service) Carrier

For most files, a table of variables will display below, with links to the variable definitions. If no table displays, or if you need additional information for a specific variable, please see the CCW website. Data documentation is available for all files and codebooks for many.

If you are unable to locate the information you need, please contact ResDAC.

CCW Codebook - Medicare Fee-For-Service (FFS) Claims

CCW Record Layout - Medicare Fee-For-Service (FFS) Claims

Base Claim File

Line File

Demonstrations/Innovations Code File

Base Claim File
SAS Name	Variable Name
BENE_ID	Encrypted CCW Beneficiary ID
CLM_ID	Claim ID
NCH_NEAR_LINE_REC_IDENT_CD	NCH Near Line Record Identification Code (RIC)
NCH_CLM_TYPE_CD	NCH Claim Type Code
CLM_FROM_DT	Claim From Date (FFS)
CLM_THRU_DT	Claim Through Date (FFS)
NCH_WKLY_PROC_DT	NCH Weekly Claim Processing Date
CARR_CLM_ENTRY_CD	Carrier Claim Entry Code
CLM_DISP_CD	Claim Disposition Code
CARR_NUM	Carrier or MAC Number
CARR_CLM_PMT_DNL_CD	Carrier Claim Payment Denial Code
CLM_PMT_AMT	Claim (Medicare) Payment Amount
NCH_PRMRY_PYR_CLM_PD_AMT	NCH Primary Payer (if not Medicare) Claim Paid Amount
RFR_PHYSN_UPIN	Carrier/DMERC Claim Referring Physician UPIN Number
RFR_PHYSN_NPI	Claim Referring Physician NPI Number
CARR_CLM_PRVDR_ASGNMT_IND_SW	Carrier Claim Provider Assignment Indicator Switch
NCH_CLM_PRVDR_PMT_AMT	NCH Claim Provider Payment Amount
NCH_CLM_BENE_PMT_AMT	NCH Claim Payment Amount to Beneficiary
CLM_BENE_PD_AMT	Carrier Claim Beneficiary Paid Amount
NCH_CARR_CLM_SBMTD_CHRG_AMT	NCH Carrier Claim Submitted Charge Amount (sum of all line-level submitted charges)
NCH_CARR_CLM_ALOWD_AMT	NCH Carrier Claim Allowed Charge Amount (sum of all line-level allowed charges)
CARR_CLM_CASH_DDCTBL_APLD_AMT	Carrier Claim Cash Deductible Applied Amount (sum of all line-level deductible amounts)
CARR_CLM_HCPCS_YR_CD	Claim Healthcare Common Procedure Coding System (HCPCS) Year Code
CARR_CLM_RFRNG_PIN_NUM	Carrier Claim Referring Provider ID Number (PIN)
CPO_PRVDR_NUM	Care Plan Oversight (CPO) Provider Number
CPO_ORG_NPI_NUM	CPO Organization NPI Number
CARR_CLM_BLG_NPI_NUM	Carrier Claim Billing NPI Number
BLG_PRVDR_SPCLTY_CD1	Claim Billing Provider Secondary Specialty Code 1
BLG_PRVDR_SPCLTY_CD2	Claim Billing Provider Secondary Specialty Code 2
BLG_PRVDR_SPCLTY_CD3	Claim Billing Provider Secondary Specialty Code 3
BLG_PRVDR_TXNMY_CD	Claim Billing Provider Taxonomy Code
PRNCPAL_DGNS_CD	Claim Principal Diagnosis Code (FFS)
PRNCPAL_DGNS_VRSN_CD	Claim Principal Diagnosis Version Code (FFS)
ICD_DGNS_CD1	Claim Diagnosis Code I (FFS)
ICD_DGNS_VRSN_CD1	Claim Diagnosis Code I Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
ICD_DGNS_CD2	Claim Diagnosis Code II (FFS)
ICD_DGNS_VRSN_CD2	Claim Diagnosis Code II Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
ICD_DGNS_CD3	Claim Diagnosis Code III (FFS)
ICD_DGNS_VRSN_CD3	Claim Diagnosis Code III Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
ICD_DGNS_CD4	Claim Diagnosis Code IV (FFS)
ICD_DGNS_VRSN_CD4	Claim Diagnosis Code IV Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
ICD_DGNS_CD5	Claim Diagnosis Code V (FFS)
ICD_DGNS_VRSN_CD5	Claim Diagnosis Code V Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
ICD_DGNS_CD6	Claim Diagnosis Code VI (FFS)
ICD_DGNS_VRSN_CD6	Claim Diagnosis Code VI Diagnosis Version Code (ICD-9/ICD-10) (FFS)
ICD_DGNS_CD7	Claim Diagnosis Code VII (FFS)
ICD_DGNS_VRSN_CD7	Claim Diagnosis Code VII Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
ICD_DGNS_CD8	Claim Diagnosis Code VIII (FFS)
ICD_DGNS_VRSN_CD8	Claim Diagnosis Code VIII Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
ICD_DGNS_CD9	Claim Diagnosis Code IX (FFS)
ICD_DGNS_VRSN_CD9	Claim Diagnosis Code IX Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
ICD_DGNS_CD10	Claim Diagnosis Code X (FFS)
ICD_DGNS_VRSN_CD10	Claim Diagnosis Code X Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
ICD_DGNS_CD11	Claim Diagnosis Code XI (FFS)
ICD_DGNS_VRSN_CD11	Claim Diagnosis Code XI Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
ICD_DGNS_CD12	Claim Diagnosis Code XII (FFS)
ICD_DGNS_VRSN_CD12	Claim Diagnosis Code XII Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
CLM_CLNCL_TRIL_NUM	Clinical Trial Number
DOB_DT	Date of Birth from Claim
BENE_RACE_CD	Beneficiary Race Code (Encounter)
BENE_CNTY_CD	County Code from Claim (SSA)
BENE_STATE_CD	Beneficiary Residence (SSA) State Code (FFS)
BENE_MLG_CNTCT_ZIP_CD	Zip Code of Residence from Claim
ACO_ID_NUM	Claim Accountable Care Organization (ACO) Identification Number
CARR_CLM_SOS_NPI_NUM	Carrier Claim Site of Service NPI Number
CLM_BENE_ID_TYPE_CD	Claim Beneficiary Identifier Type Code
CLM_RSDL_PYMT_IND_CD	Claim Residual Payment Indicator Code
PRVDR_VLDTN_TYPE_CD	Provider Validation Type Code

Line File
SAS Name	Variable Name
BENE_ID	Encrypted CCW Beneficiary ID
CLM_ID	Claim ID
CLM_LINE_NUM	Claim Line Number
NCH_CLM_TYPE_CD	NCH Claim Type Code
CLM_THRU_DT	Claim Through Date (FFS)
CARR_PRFRNG_PIN_NUM	Carrier Line Performing Provider ID Number (PIN)
PRF_PHYSN_UPIN	Carrier Line Performing UPIN Number
PRF_PHYSN_NPI	Carrier Line Performing NPI Number
ORG_NPI_NUM	Organization (or group) NPI Number
CARR_LINE_PRVDR_TYPE_CD	Carrier Line Provider Type Code
TAX_NUM	Line Provider Tax Number
PRVDR_STATE_CD	NCH Provider SSA State Code
PRVDR_ZIP	Carrier Line Performing Provider ZIP Code
PRVDR_SPCLTY	Line CMS Provider Specialty Code
RNDRNG_PRVDR_SPCLTY_CD1	Rendering Provider Secondary Specialty Code 1
RNDRNG_PRVDR_SPCLTY_CD2	Rendering Provider Secondary Specialty Code 2
RNDRNG_PRVDR_SPCLTY_CD3	Rendering Provider Secondary Specialty Code 3
RNDRNG_PRVDR_TXNMY_CD	Rendering Provider Taxonomy Code
PRTCPTNG_IND_CD	Line Provider Participating Indicator Code
CARR_LINE_RDCD_PMT_PHYS_ASTN_C	Carrier Line Reduced Payment Physician Assistant Code
LINE_SRVC_CNT	Line Service Count (FFS)
LINE_CMS_TYPE_SRVC_CD	Line CMS Type Service Code
LINE_PLACE_OF_SRVC_CD	Line Place Of Service Code (FFS)
CARR_LINE_PRCNG_LCLTY_CD	Carrier Line Pricing Locality Code
LINE_1ST_EXPNS_DT	Line First Expense Date (FFS)
LINE_LAST_EXPNS_DT	Line Last Expense Date (FFS)
HCPCS_CD	Healthcare Common Procedure Coding System (HCPCS) Code (FFS)
HCPCS_1ST_MDFR_CD	HCPCS Initial Modifier Code (FFS)
HCPCS_2ND_MDFR_CD	HCPCS Second Modifier Code (FFS)
BETOS_CD	Line Berenson-Eggers Type of Service (BETOS) Code
LINE_NCH_PMT_AMT	Line NCH Medicare Payment Amount
LINE_BENE_PMT_AMT	Line Payment Amount to Beneficiary
LINE_PRVDR_PMT_AMT	Line Provider Payment Amount
LINE_BENE_PTB_DDCTBL_AMT	Line Beneficiary Part B Deductible Amount
LINE_BENE_PRMRY_PYR_CD	Line Primary Payer Code (if not Medicare)
LINE_BENE_PRMRY_PYR_PD_AMT	Line Primary Payer (if not Medicare) Paid Amount
LINE_COINSRNC_AMT	Line Beneficiary Coinsurance Amount
LINE_SBMTD_CHRG_AMT	Line Submitted Charge Amount
LINE_ALOWD_CHRG_AMT	Line Allowed Charge Amount
LINE_PRCSG_IND_CD	Line Processing Indicator Code
LINE_PMT_80_100_CD	Line Payment 80%/100% Code
LINE_SERVICE_DEDUCTIBLE	Line Service Deductible Indicator Switch
CARR_LINE_MTUS_CNT	Carrier Line Miles/Time/Units/Services (MTUS) Count
CARR_LINE_MTUS_CD	Carrier Line Miles/Time/Units/Services (MTUS) Indicator Code
LINE_ICD_DGNS_CD	Line Diagnosis Code
LINE_ICD_DGNS_VRSN_CD	Line Diagnosis Code Diagnosis Version Code (ICD-9 or ICD-10)
HPSA_SCRCTY_IND_CD	Carrier Line Health Professional Shortage Area (HPSA)/Scarcity Indicator Code
CARR_LINE_RX_NUM	Carrier Line RX Number (FFS)
LINE_HCT_HGB_RSLT_NUM	Hematocrit/Hemoglobin Test Results
LINE_HCT_HGB_TYPE_CD	Hematocrit/Hemoglobin Test Type Code
LINE_NDC_CD	Line National Drug Code (NDC) (FFS)
CARR_LINE_CLIA_LAB_NUM	Clinical Laboratory Improvement Amendments (CLIA) monitored laboratory number
CARR_LINE_ASNTHSA_UNIT_CNT	Carrier Line Anesthesia Unit Count
CARR_LINE_CL_CHRG_AMT	Carrier Line Clinical Lab Charge Amount
PHYSN_ZIP_CD	Line Place of Service (POS) Physician Zip Code
LINE_POINT_OF_PCKP_ZIP_CD	Line Point of Pickup Zip Code
LINE_DROP_OFF_ZIP_CD	Line Drop Off Zip Code
LINE_OTHR_APLD_IND_CD1	Line Other Applied Indicator 1st Code
LINE_OTHR_APLD_IND_CD2	Line Other Applied Indicator 2nd Code
LINE_OTHR_APLD_IND_CD3	Line Other Applied Indicator 3rd Code
LINE_OTHR_APLD_IND_CD4	Line Other Applied Indicator 4th Code
LINE_OTHR_APLD_IND_CD5	Line Other Applied Indicator 5th Code
LINE_OTHR_APLD_IND_CD6	Line Other Applied Indicator 6th Code
LINE_OTHR_APLD_IND_CD7	Line Other Applied Indicator 7th Code
LINE_OTHR_APLD_AMT1	Line Other Applied Amount for 1st Code
LINE_OTHR_APLD_AMT2	Line Other Applied Amount for 2nd Code
LINE_OTHR_APLD_AMT3	Line Other Applied Amount for 3rd Code
LINE_OTHR_APLD_AMT4	Line Other Applied Amount for 4th Code
LINE_OTHR_APLD_AMT5	Line Other Applied Amount for 5th Code
LINE_OTHR_APLD_AMT6	Line Other Applied Amount for 6th Code
LINE_OTHR_APLD_AMT7	Line Other Applied Amount for 7th Code
THRPY_CAP_IND_CD1	Therapy cap Indicator 1 Code
THRPY_CAP_IND_CD2	Therapy cap Indicator 2 Code
THRPY_CAP_IND_CD3	Therapy cap Indicator 3 Code
THRPY_CAP_IND_CD4	Therapy cap Indicator 4 Code
THRPY_CAP_IND_CD5	Therapy cap Indicator 5 Code
CLM_NEXT_GNRTN_ACO_IND_CD1	Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Population-Based Payment (PBP)
CLM_NEXT_GNRTN_ACO_IND_CD2	Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Telehealth
CLM_NEXT_GNRTN_ACO_IND_CD3	Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Post Discharge HH visits
CLM_NEXT_GNRTN_ACO_IND_CD4	Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - 3-day SNF waiver
CLM_NEXT_GNRTN_ACO_IND_CD5	Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Capitation
CARR_LINE_MDPP_NPI_NUM	Carrier Line Medicare Diabetes Prevention Program (MDPP) NPI Number
LINE_RSDL_PYMT_IND_CD	Line Residual Payment Indicator Code
LINE_RP_IND_CD	Line Representative Payee (RP) Indicator Code
LINE_PRVDR_VLDTN_TYPE_CD	Line Provider Validation Type Code
LINE_VLNTRY_SRVC_IND_CD	Line Voluntary Service Indicator Code
LINE_ADJUST_GRP_CD	Line Adjustment Group Code
LINE_ADJUST_RSN_CD	Line Adjustment Reason Code
LINE_RA_RMRK_CD	Line Remittance Advice Remark Code

Demonstrations/Innovations Code File
SAS Name	Variable Name
BENE_ID	Encrypted CCW Beneficiary ID
CLM_ID	Claim ID
NCH_CLM_TYPE_CD	NCH Claim Type Code
DEMO_ID_SQNC_NUM	Demonstration sequence number
DEMO_ID_NUM	Demonstration number
DEMO_INFO_TXT	Demo information text