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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
8FI_CLM_PROC_DTFI_CLM_PROC_DTFI Claim Process Date
200QUERY_CDCLAIM_QUERY_CODEClaim Query Code
9PROVIDERPRVDR_NUMProvider Number
10FAC_TYPECLM_FAC_TYPE_CDClaim Facility Type Code (FFS)
11TYPESRVCCLM_SRVC_CLSFCTN_TYPE_CDClaim Service Classification Type Code (FFS)
12FREQ_CDCLM_FREQ_CDClaim Frequency Code (FFS)
13FI_NUMFI_NUMFI or MAC Number
14NOPAY_CDCLM_MDCR_NON_PMT_RSN_CDClaim Medicare Non Payment Reason Code
15PMT_AMTCLM_PMT_AMTClaim (Medicare) Payment Amount
16PRPAYAMTNCH_PRMRY_PYR_CLM_PD_AMTNCH Primary Payer (if not Medicare) Claim Paid Amount
17PRPAY_CDNCH_PRMRY_PYR_CDNCH Primary Payer Code (if not Medicare)
203ACTIONCDFI_CLM_ACTN_CDFI or MAC Claim Action Code
18PRVSTATEPRVDR_STATE_CDNCH Provider SSA State Code
19ORGNPINMORG_NPI_NUMOrganization (or group) NPI Number
20SRVC_LOC_NPI_NUMSRVC_LOC_NPI_NUMClaim Service Location NPI Number
21AT_UPINAT_PHYSN_UPINClaim Attending Physician UPIN Number
22AT_NPIAT_PHYSN_NPIClaim Attending Physician NPI Number (FFS)
23AT_PHYSN_SPCLTY_CDAT_PHYSN_SPCLTY_CDClaim Attending Physician Specialty Code
24OP_NPIOP_PHYSN_NPIClaim Operating Physician NPI Number (FFS)
25OP_PHYSN_SPCLTY_CDOP_PHYSN_SPCLTY_CDClaim Operating Physician Specialty Code
26OT_NPIOT_PHYSN_NPIClaim Other Physician NPI Number (FFS)
27OT_PHYSN_SPCLTY_CDOT_PHYSN_SPCLTY_CDClaim Other Physician Specialty Code
28RNDRNG_PHYSN_NPIRNDRNG_PHYSN_NPIRendering Physician NPI (FFS)
29RNDRNG_PHYSN_SPCLTY_CDRNDRNG_PHYSN_SPCLTY_CDClaim or Revenue Center Rendering Physician Specialty Code
500RFR_PHYSN_NPIRFRG_NPIClaim Referring Physician NPI Number
31RFR_PHYSN_SPCLTY_CDRFRG_SPCLTY_CDClaim Referring Physician Specialty Code
205MCOPDSWCLM_MCO_PD_SWClaim MCO Paid Switch
32STUS_CDPTNT_DSCHRG_STUS_CDPatient Discharge Status Code (FFS)
33PPS_INDCLM_PPS_IND_CDClaim PPS Indicator Code
34TOT_CHRGCLM_TOT_CHRG_AMTClaim Total Charge Amount
206DSCHRGDTNCH_BENE_DSCHRG_DTNCH Beneficiary Discharge Date
35PRNCPAL_DGNS_CDPRNCPAL_DGNS_CDClaim Principal Diagnosis Code (FFS)
36ICD_DGNS_CD1ICD_DGNS_CD1Claim Diagnosis Code I (FFS)
37ICD_DGNS_CD2ICD_DGNS_CD2Claim Diagnosis Code II (FFS)
38ICD_DGNS_CD3ICD_DGNS_CD3Claim Diagnosis Code III (FFS)
39ICD_DGNS_CD4ICD_DGNS_CD4Claim Diagnosis Code IV (FFS)
40ICD_DGNS_CD5ICD_DGNS_CD5Claim Diagnosis Code V (FFS)
41ICD_DGNS_CD6ICD_DGNS_CD6Claim Diagnosis Code VI (FFS)
42ICD_DGNS_CD7ICD_DGNS_CD7Claim Diagnosis Code VII (FFS)
43ICD_DGNS_CD8ICD_DGNS_CD8Claim Diagnosis Code VIII (FFS)
44ICD_DGNS_CD9ICD_DGNS_CD9Claim Diagnosis Code IX (FFS)
45ICD_DGNS_CD10ICD_DGNS_CD10Claim Diagnosis Code X (FFS)
46ICD_DGNS_CD11ICD_DGNS_CD11Claim Diagnosis Code XI (FFS)
47ICD_DGNS_CD12ICD_DGNS_CD12Claim Diagnosis Code XII (FFS)
48ICD_DGNS_CD13ICD_DGNS_CD13Claim Diagnosis Code XIII (FFS)
49ICD_DGNS_CD14ICD_DGNS_CD14Claim Diagnosis Code XIV (FFS)
50ICD_DGNS_CD15ICD_DGNS_CD15Claim Diagnosis Code XV (FFS)
51ICD_DGNS_CD16ICD_DGNS_CD16Claim Diagnosis Code XVI (FFS)
52ICD_DGNS_CD17ICD_DGNS_CD17Claim Diagnosis Code XVII (FFS)
53ICD_DGNS_CD18ICD_DGNS_CD18Claim Diagnosis Code XVIII (FFS)
54ICD_DGNS_CD19ICD_DGNS_CD19Claim Diagnosis Code XIX (FFS)
55ICD_DGNS_CD20ICD_DGNS_CD20Claim Diagnosis Code XX (FFS)
56ICD_DGNS_CD21ICD_DGNS_CD21Claim Diagnosis Code XXI (FFS)
57ICD_DGNS_CD22ICD_DGNS_CD22Claim Diagnosis Code XXII (FFS)
58ICD_DGNS_CD23ICD_DGNS_CD23Claim Diagnosis Code XXIII (FFS)
59ICD_DGNS_CD24ICD_DGNS_CD24Claim Diagnosis Code XXIV (FFS)
60ICD_DGNS_CD25ICD_DGNS_CD25Claim Diagnosis Code XXV (FFS)
61FST_DGNS_E_CDFST_DGNS_E_CDFirst Claim Diagnosis E Code (FFS)
62ICD_DGNS_E_CD1ICD_DGNS_E_CD1Claim Diagnosis E Code I (FFS)
63ICD_DGNS_E_CD2ICD_DGNS_E_CD2Claim Diagnosis E Code II (FFS)
64ICD_DGNS_E_CD3ICD_DGNS_E_CD3Claim Diagnosis E Code III (FFS)
65ICD_DGNS_E_CD4ICD_DGNS_E_CD4Claim Diagnosis E Code IV (FFS)
66ICD_DGNS_E_CD5ICD_DGNS_E_CD5Claim Diagnosis E Code V (FFS)
67ICD_DGNS_E_CD6ICD_DGNS_E_CD6Claim Diagnosis E Code VI (FFS)
68ICD_DGNS_E_CD7ICD_DGNS_E_CD7Claim Diagnosis E Code VII (FFS)
69ICD_DGNS_E_CD8ICD_DGNS_E_CD8Claim Diagnosis E Code VIII (FFS)
70ICD_DGNS_E_CD9ICD_DGNS_E_CD9Claim Diagnosis E Code IX (FFS)
71ICD_DGNS_E_CD10ICD_DGNS_E_CD10Claim Diagnosis E Code X (FFS)
72ICD_DGNS_E_CD11ICD_DGNS_E_CD11Claim Diagnosis E Code XI
73ICD_DGNS_E_CD12ICD_DGNS_E_CD12Claim Diagnosis E Code XII
74LUPAINDCLM_HHA_LUPA_IND_CDClaim HHA Low Utilization Payment Adjustment (LUPA) Indicator Code
75HHA_RFRLCLM_HHA_RFRL_CDClaim HHA Referral Code
76VISITCNTCLM_HHA_TOT_VISIT_CNTClaim HHA Total Visit Count
77ADMSN_DTCLM_ADMSN_DTClaim Admission Date (FFS)
78DOB_DTDOB_DTDate of Birth from Claim
79GNDR_CDGNDR_CDGender Code from Claim
80RACE_CDBENE_RACE_CDBeneficiary Race Code (FFS)
81CNTY_CDBENE_CNTY_CDCounty Code from Claim (SSA)
82BENE_STATE_CDBENE_STATE_CDBeneficiary Residence (SSA) State Code (FFS)
83ZIP_CDBENE_MLG_CNTCT_ZIP_CDZip Code of Residence from Claim
84CLM_MDCL_RECCLM_MDCL_RECClaim Medical Record Number (FFS)
85CLM_TRTMT_AUTHRZTN_NUM CLM_TRTMT_AUTHRZTN_NUMClaim Treatment Authorization Number
97CLM_PRCR_RTRN_CDCLM_PRCR_RTRN_CDClaim Pricer Return Code
210CLM_SRVC_FAC_ZIP_CDCLM_SRVC_FAC_ZIP_CDClaim service facility ZIP code (where service was provided)
211CLM_NEXT_GNRTN_ACO_IND_CD1Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code – Population-Based Payment (PBP)
215CLM_NEXT_GNRTN_ACO_IND_2_CDCLM_NEXT_GNRTN_ACO_IND_CD2Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Telehealth
216CLM_NEXT_GNRTN_ACO_IND_3_CDCLM_NEXT_GNRTN_ACO_IND_CD3Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Post Discharge HH visits
217CLM_NEXT_GNRTN_ACO_IND_4_CDCLM_NEXT_GNRTN_ACO_IND_CD4Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - 3-day SNF waiver
218CLM_NEXT_GNRTN_ACO_IND_5_CDCLM_NEXT_GNRTN_ACO_IND_CD5Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Capitation
219ACO_ID_NUMACO_ID_NUMClaim Accountable Care Organization (ACO) Identification Number
222FINL_STD_AMT FINL_STD_AMTClaim Final Standard Payment Amount
223CLM_BENE_ID_TYPE_CDCLM_BENE_ID_TYPE_CDClaim Beneficiary Identifier Type Code
200CLM_RSDL_PYMT_IND_CDCLM_RSDL_PYMT_IND_CDClaim Residual Payment Indicator Code
201PRVDR_VLDTN_TYPE_CDPRVDR_VLDTN_TYPE_CDProvider Validation Type Code
202RR_BRD_EXCLSN_IND_SWRR_BRD_EXCLSN_IND_SWRailroad Board Exclusion Indicator Switch
203PPS_STD_VAL_PYMT_AMTPPS_STD_VAL_PYMT_AMTStandard Payment Amount

Revenue Center File

Short SAS NameLong SAS NameVariable Name
1BENE_IDBENE_IDEncrypted CCW Beneficiary ID
2CLM_IDCLM_IDClaim ID
3THRU_DTCLM_THRU_DTClaim Through Date (FFS)
4CLM_LNCLM_LINE_NUMClaim Line Number
5CLM_TYPENCH_CLM_TYPE_CDNCH Claim Type Code
6REV_CNTRREV_CNTRRevenue Center Code (FFS)
7REV_DTREV_CNTR_DTRevenue Center Date
8REVANSI1REV_CNTR_1ST_ANSI_CDRevenue Center 1st ANSI Code
9APCHIPPSREV_CNTR_APC_HIPPS_CDRevenue Center APC or HIPPS Code
10HCPCS_CDHCPCS_CDHealthcare Common Procedure Coding System (HCPCS) Code (FFS)
11MDFR_CD1HCPCS_1st_mdfr_cdHCPCS Initial Modifier Code (FFS)
12MDFR_CD2HCPCS_2ND_MDFR_CDHCPCS Second Modifier Code (FFS)
13MDFR_CD3HCPCS_3RD_MDFR_CDHCPCS Third Modifier Code (FFS)
14PMTMTHDREV_CNTR_PMT_MTHD_IND_CDRevenue Center Payment Method Indicator Code
230DSCNTINDREV_CNTR_DSCNT_IND_CDRevenue Center Discount Indicator Code
231REV_CNTR_PRCNG_IND_CDREV_CNTR_PRCNG_IND_CDRevenue Center Pricing Indicator Code
232IDENDCREV_CNTR_IDE_NDC_UPC_NUMRevenue Center IDE, NDC, or UPC Number (FFS)
15REV_UNITREV_CNTR_UNIT_CNTRevenue Center Unit Count (FFS)
16REV_RATEREV_CNTR_RATE_AMTRevenue Center Rate Amount
17RPRVDPMTREV_CNTR_PRVDR_PMT_AMTRevenue Center (Medicare) Provider Payment Amount
240PTNTRESPREV_CNTR_PTNT_RSPNSBLTY_PMTRevenue Center Patient Responsibility Payment Amount
241REVPMTREV_CNTR_PMT_AMT_AMTRevenue Center (Medicare) Payment Amount
18REV_CHRGREV_CNTR_TOT_CHRG_AMTRevenue Center Total Charge Amount
19REV_NCVRREV_CNTR_NCVRD_CHRG_AMTRevenue Center Non-Covered Charge Amount
20REVDEDCDREV_CNTR_DDCTBL_COINSRNC_CDRevenue Center Deductible Coinsurance Code
21REVSTINDREVSTINDRevenue Center Status Indicator Code
22REV_CNTR_NDC_QTYREV_CNTR_NDC_QTYRevenue Center National Drug Code (NDC) Quantity (FFS)
23REV_CNTR_NDC_QTY_QLFR_CDREV_CNTR_NDC_QTY_QLFR_CDRevenue Center NDC Quantity Qualifier Code (FFS)
24RNDRNG_PHYSN_UPINRNDRNG_PHYSN_UPINRevenue Center Rendering Physician UPIN
501RNDRNG_PHYSN_NPIRNDRNG_PHYSN_NPIRendering Physician NPI (FFS)
26RNDRNG_PHYSN_SPCLTY_CDRNDRNG_PHYSN_SPCLTY_CDClaim or Revenue Center Rendering Physician Specialty Code
32THRPY_CAP_IND_CD1THRPY_CAP_IND_CD1Therapy cap Indicator 1 Code
33THRPY_CAP_IND_CD2THRPY_CAP_IND_CD2Therapy cap Indicator 2 Code
204REV_CNTR_RP_IND_CDREV_CNTR_RP_IND_CDRevenue Center Representative Payee (RP) Indicator Code

Condition 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
4RLTCNDSQRLT_COND_CD_SEQClaim Related Condition Code Sequence
5RLT_CONDCLM_RLT_COND_CDClaim Related Condition Code (FFS)

Occurence 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
4RLTOCRSQRLT_OCRNC_CD_SEQClaim Related Occurrence Code Sequence
5OCRNC_CDCLM_RLT_OCRNC_CDClaim Related Occurrence Code (FFS)
6OCRNCDTCLM_RLT_OCRNC_DTClaim Related Occurrence Date (FFS)

Span 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
4RLTSPNSQRLT_SPAN_CD_SEQClaim Related Span Code Sequence
5SPAN_CDCLM_SPAN_CDClaim Occurrence Span Code (FFS)
6SPANFROMCLM_SPAN_FROM_DTClaim Occurrence Span From Date (FFS)
7SPANTHRUCLM_SPAN_THRU_DTClaim Occurrence Span Through Date (FFS)

Value 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
4RLTVALSQRLT_VAL_CD_SEQClaim Related Value Code Sequence
5VAL_CDCLM_VAL_CDClaim Value Code (FFS)
6VAL_AMTCLM_VAL_AMTClaim Value Amount

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