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File Version: K, CCW Data Documentation May, 2019

SAS NameVariable Name
1BENE_IDEncrypted CCW Beneficiary ID
2CLM_IDClaim ID
3NCH_NEAR_LINE_REC_IDENT_CDNCH Near Line Record Identification Code (RIC)
4NCH_CLM_TYPE_CDNCH Claim Type Code
5CLM_FROM_DTClaim From Date (FFS)
6CLM_THRU_DTClaim Through Date (FFS)
7NCH_WKLY_PROC_DTNCH Weekly Claim Processing Date
8CARR_CLM_ENTRY_CDCarrier Claim Entry Code
9CLM_DISP_CDClaim Disposition Code
10CARR_NUMCarrier or MAC Number
11CARR_CLM_PMT_DNL_CDCarrier Claim Payment Denial Code
12CLM_PMT_AMTClaim (Medicare) Payment Amount
13NCH_PRMRY_PYR_CLM_PD_AMTNCH Primary Payer (if not Medicare) Claim Paid Amount
14CARR_CLM_PRVDR_ASGNMT_IND_SWCarrier Claim Provider Assignment Indicator Switch
15NCH_CLM_PRVDR_PMT_AMTNCH Claim Provider Payment Amount
16NCH_CLM_BENE_PMT_AMTNCH Claim Payment Amount to Beneficiary
17NCH_CARR_CLM_SBMTD_CHRG_AMTNCH Carrier Claim Submitted Charge Amount (sum of all line-level submitted charges)
18NCH_CARR_CLM_ALOWD_AMTNCH Carrier Claim Allowed Charge Amount (sum of all line-level allowed charges)
19CARR_CLM_CASH_DDCTBL_APLD_AMTCarrier Claim Cash Deductible Applied Amount (sum of all line-level deductible amounts)
20CARR_CLM_HCPCS_YR_CDClaim Healthcare Common Procedure Coding System (HCPCS) Year Code
21PRNCPAL_DGNS_CDClaim Principal Diagnosis Code (FFS)
22PRNCPAL_DGNS_VRSN_CDClaim Principal Diagnosis Version Code (FFS)
23ICD_DGNS_CD1Claim Diagnosis Code I (FFS)
24ICD_DGNS_VRSN_CD1Claim Diagnosis Code I Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
25ICD_DGNS_CD2Claim Diagnosis Code II (FFS)
26ICD_DGNS_VRSN_CD2Claim Diagnosis Code II Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
27ICD_DGNS_CD3Claim Diagnosis Code III (FFS)
28ICD_DGNS_VRSN_CD3Claim Diagnosis Code III Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
29ICD_DGNS_CD4Claim Diagnosis Code IV (FFS)
30ICD_DGNS_VRSN_CD4Claim Diagnosis Code IV Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
31ICD_DGNS_CD5Claim Diagnosis Code V (FFS)
32ICD_DGNS_VRSN_CD5Claim Diagnosis Code V Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
33ICD_DGNS_CD6Claim Diagnosis Code VI (FFS)
34ICD_DGNS_VRSN_CD6Claim Diagnosis Code VI Diagnosis Version Code (ICD-9/ICD-10) (FFS)
35ICD_DGNS_CD7Claim Diagnosis Code VII (FFS)
36ICD_DGNS_VRSN_CD7Claim Diagnosis Code VII Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
37ICD_DGNS_CD8Claim Diagnosis Code VIII (FFS)
38ICD_DGNS_VRSN_CD8Claim Diagnosis Code VIII Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
39ICD_DGNS_CD9Claim Diagnosis Code IX (FFS)
40ICD_DGNS_VRSN_CD9Claim Diagnosis Code IX Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
41ICD_DGNS_CD10Claim Diagnosis Code X (FFS)
42ICD_DGNS_VRSN_CD10Claim Diagnosis Code X Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
43ICD_DGNS_CD11Claim Diagnosis Code XI (FFS)
44ICD_DGNS_VRSN_CD11Claim Diagnosis Code XI Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
45ICD_DGNS_CD12Claim Diagnosis Code XII (FFS)
46ICD_DGNS_VRSN_CD12Claim Diagnosis Code XII Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
47RFR_PHYSN_UPINCarrier/DMERC Claim Ordering Physician UPIN Number
48RFRG_NPIClaim Referring Physician NPI Number
49CLM_CLNCL_TRIL_NUMClinical Trial Number
50DOB_DTDate of Birth from Claim
51GNDR_CDGender Code from Claim
52BENE_RACE_CDBeneficiary Race Code (FFS)
53BENE_CNTY_CDCounty Code from Claim (SSA)
54BENE_STATE_CDBeneficiary Residence (SSA) State Code (FFS)
55BENE_MLG_CNTCT_ZIP_CDZip Code of Residence from Claim
56ACO_ID_NUMClaim Accountable Care Organization (ACO) Identification Number
200CLM_BENE_ID_TYPE_CDClaim Beneficiary Identifier Type Code
205CLM_RSDL_PYMT_IND_CDClaim Residual Payment Indicator Code

LINE FILE

SAS NameVariable Name
1BENE_IDEncrypted CCW Beneficiary ID
2CLM_IDClaim ID
3CLM_LINE_NUMClaim Line Number
4NCH_CLM_TYPE_CDNCH Claim Type Code
5CLM_THRU_DTClaim Through Date (FFS)
6TAX_NUMLine Provider Tax Number
7PRVDR_SPCLTYLine CMS Provider Specialty Code
8PRTCPTNG_IND_CDLine Provider Participating Indicator Code
9LINE_SRVC_CNTLine Service Count (FFS)
10LINE_CMS_TYPE_SRVC_CDLine CMS Type Service Code
11LINE_PLACE_OF_SRVC_CDLine Place Of Service Code (FFS)
12LINE_1ST_EXPNS_DTLine First Expense Date (FFS)
13LINE_LAST_EXPNS_DTLine Last Expense Date (FFS)
14HCPCS_CDHealthcare Common Procedure Coding System (HCPCS) Code (FFS)
15HCPCS_1st_mdfr_cdHCPCS Initial Modifier Code (FFS)
16HCPCS_2ND_MDFR_CDHCPCS Second Modifier Code (FFS)
202HCPCS_3RD_MDFR_CDHCPCS Third Modifier Code (FFS)
203HCPCS_4TH_MDFR_CDHCPCS Fourth Modifier Code (FFS)
17BETOS_CDLine Berenson-Eggers Type of Service (BETOS) Code
18LINE_NCH_PMT_AMTLine NCH Medicare Payment Amount
19LINE_BENE_PMT_AMTLine Payment Amount to Beneficiary
20LINE_PRVDR_PMT_AMTLine Provider Payment Amount
21LINE_BENE_PTB_DDCTBL_AMTLine Beneficiary Part B Deductible Amount
22LINE_BENE_PRMRY_PYR_CDLine Primary Payer Code (if not Medicare)
23LINE_BENE_PRMRY_PYR_PD_AMTLine Primary Payer (if not Medicare) Paid Amount
24LINE_COINSRNC_AMTLine Beneficiary Coinsurance Amount
25LINE_PRMRY_ALOWD_CHRG_AMTLine Primary Payer Allowed Charge Amount
26LINE_SBMTD_CHRG_AMTLine Submitted Charge Amount
27LINE_ALOWD_CHRG_AMTLine Allowed Charge Amount
28LINE_PRCSG_IND_CDLine Processing Indicator Code
29LINE_PMT_80_100_CDLine Payment 80% / 100% Code
30LINE_SERVICE_DEDUCTIBLELine Service Deductible Indicator Switch
31LINE_ICD_DGNS_CDLine Diagnosis Code
32LINE_ICD_DGNS_VRSN_CDLine Diagnosis Code Diagnosis Version Code (ICD-9 or ICD-10)
33LINE_DME_PRCHS_PRICE_AMTLine DME Purchase Price Amount
34PRVDR_NUMDMERC Line Supplier Provider Number
35PRVDR_NPIDMERC Line Item Supplier NPI Number
36DMERC_LINE_PRCNG_STATE_CDDMERC Line Pricing State Code (SSA)
37PRVDR_STATE_CDNCH Provider SSA State Code
38DMERC_LINE_SUPPLR_TYPE_CDDMERC Line Supplier Type Code
41DMERC_LINE_SCRN_SVGS_AMTDMERC Line Screen Savings Amount
42DMERC_LINE_MTUS_CNTDMERC Line Miles/Time/Units/Services (MTUS) Count
43DMERC_LINE_MTUS_CDDMERC Line Miles/Time/Units/Services (MTUS) Indicator Code
44LINE_HCT_HGB_RSLT_NUMHematocrit/Hemoglobin Test Results
45LINE_HCT_HGB_TYPE_CDHematocrit/Hemoglobin Test Type Code
46LINE_NDC_CDLine National Drug Code (NDC) (FFS)
47LINE_OTHR_APLD_IND_CD1Line Other Applied Indicator 1st Code
48LINE_OTHER_APLD_IND_CD2Line Other Applied Indicator 2nd Code
49LINE_OTHR_APLD_IND_CD3Line Other Applied Indicator 3rd Code
50LINE_OTHR_APLD_IND_CD4Line Other Applied Indicator 4th Code
51LINE_OTHR_APLD_IND_CD5Line Other Applied Indicator 5th Code
52LINE_OTHR_APLD_IND_CD6Line Other Applied Indicator 6th Code
53LINE_OTHR_APLD_IND_CD7Line Other Applied Indicator 7th Code
54LINE_OTHR_APLD_AMT1Line Other Applied Amount for 1st Code
55LINE_OTHR_APLD_AMT2Line Other Applied Amount for 2nd Code
56LINE_OTHR_APLD_AMT3Line Other Applied Amount for 3rd Code
57LINE_OTHR_APLD_AMT4Line Other Applied Amount for 4th Code
58LINE_OTHR_APLD_AMT5Line Other Applied Amount for 5th Code
59LINE_OTHR_APLD_AMT6Line Other Applied Amount for 6th Code
60LINE_OTHR_APLD_AMT7Line Other Applied Amount for 7th Code

Demonstrations/Innovations Code File

SAS NameVariable Name
206LINE_RSDL_PYMT_IND_CDLine Residual Payment Indicator Code
207LINE_RP_IND_CDLine Representative Payee (RP) Indicator Code
208DMERC_LINE_FRGN_ADR_INDLine Foreign Address Indicator
209LINE_RR_BRD_EXCLSN_IND_SWLine Railroad Board Exclusion Indicator Switch
1BENE_IDEncrypted CCW Beneficiary ID
2CLM_IDClaim ID
3NCH_CLM_TYPE_CDNCH Claim Type Code
4DEMO_ID_SQNC_NUMDemonstration sequence number
5DEMO_ID_NUMDemonstration number
6DEMO_INFO_TXTDemo information text
CSV