Data Documentation

Number	SAS Name	Variable Name
1	BENE_ID	Encrypted CCW Beneficiary ID
2	CLM_ID	Claim ID
3	NCH_NEAR_LINE_REC_IDENT_CD	NCH Near Line Record Identification Code (RIC)
4	NCH_CLM_TYPE_CD	NCH Claim Type Code
5	CLM_FROM_DT	Claim From Date (FFS)
6	CLM_THRU_DT	Claim Through Date (FFS)
7	NCH_WKLY_PROC_DT	NCH Weekly Claim Processing Date
8	FI_CLM_PROC_DT	FI Claim Process Date
9	CLAIM_QUERY_CODE	Claim Query Code
10	PRVDR_NUM	Provider Number
11	PRVDR_FULL_CCN_NUM	Full CMS Certification Number for Provider
12	CLM_FAC_TYPE_CD	Claim Facility Type Code (FFS)
13	CLM_SRVC_CLSFCTN_TYPE_CD	Claim Service Classification Type Code (FFS)
14	CLM_FREQ_CD	Claim Frequency Code (FFS)
15	FI_NUM	FI or MAC Number
16	CLM_MDCR_NON_PMT_RSN_CD	Claim Medicare Non-Payment Reason Code
17	CLM_PMT_AMT	Claim (Medicare) Payment Amount
18	NCH_PRMRY_PYR_CLM_PD_AMT	NCH Primary Payer (if not Medicare) Claim Paid Amount
19	NCH_PRMRY_PYR_CD	NCH Primary Payer Code (if not Medicare)
20	FI_CLM_ACTN_CD	FI or MAC Claim Action Code
21	PRVDR_STATE_CD	NCH Provider SSA State Code
22	ORG_NPI_NUM	Organization (or group) NPI Number
23	SRVC_LOC_NPI_NUM	Claim Service Location NPI Number
24	AT_PHYSN_UPIN	Claim Attending Physician UPIN Number
25	AT_PHYSN_NPI	Claim Attending Physician NPI Number (FFS)
26	AT_PHYSN_SPCLTY_CD	Claim Attending Physician Specialty Code
27	OP_PHYSN_NPI	Claim Operating Physician NPI Number (FFS)
28	OP_PHYSN_SPCLTY_CD	Claim Operating Physician Specialty Code
29	OT_PHYSN_NPI	Claim Other Physician NPI Number (FFS)
30	OT_PHYSN_SPCLTY_CD	Claim Other Physician Specialty Code
31	RNDRNG_PHYSN_NPI	Rendering Physician NPI (FFS)
32	RNDRNG_PHYSN_SPCLTY_CD	Claim or Revenue Center Rendering Physician Specialty Code
33	RFRG_NPI	Claim Referring Physician NPI Number
34	RFRG_SPCLTY_CD	Claim Referring Physician Specialty Code
35	CLM_MCO_PD_SW	Claim MCO Paid Switch
36	PTNT_DSCHRG_STUS_CD	Patient Discharge Status Code (FFS)
37	CLM_PPS_IND_CD	Claim PPS Indicator Code
38	CLM_TOT_CHRG_AMT	Claim Total Charge Amount
39	NCH_BENE_DSCHRG_DT	NCH Beneficiary Discharge Date
40	PRNCPAL_DGNS_CD	Claim Principal Diagnosis Code (FFS)
41	ICD_DGNS_CD1	Claim Diagnosis Code I (FFS)
42	ICD_DGNS_CD2	Claim Diagnosis Code II (FFS)
43	ICD_DGNS_CD3	Claim Diagnosis Code III (FFS)
44	ICD_DGNS_CD4	Claim Diagnosis Code IV (FFS)
45	ICD_DGNS_CD5	Claim Diagnosis Code V (FFS)
46	ICD_DGNS_CD6	Claim Diagnosis Code VI (FFS)
47	ICD_DGNS_CD7	Claim Diagnosis Code VII (FFS)
48	ICD_DGNS_CD8	Claim Diagnosis Code VIII (FFS)
49	ICD_DGNS_CD9	Claim Diagnosis Code IX (FFS)
50	ICD_DGNS_CD10	Claim Diagnosis Code X (FFS)
51	ICD_DGNS_CD11	Claim Diagnosis Code XI (FFS)
52	ICD_DGNS_CD12	Claim Diagnosis Code XII (FFS)
53	ICD_DGNS_CD13	Claim Diagnosis Code XIII (FFS)
54	ICD_DGNS_CD14	Claim Diagnosis Code XIV (FFS)
55	ICD_DGNS_CD15	Claim Diagnosis Code XV (FFS)
56	ICD_DGNS_CD16	Claim Diagnosis Code XVI (FFS)
57	ICD_DGNS_CD17	Claim Diagnosis Code XVII (FFS)
58	ICD_DGNS_CD18	Claim Diagnosis Code XVIII (FFS)
59	ICD_DGNS_CD19	Claim Diagnosis Code XIX (FFS)
60	ICD_DGNS_CD20	Claim Diagnosis Code XX (FFS)
61	ICD_DGNS_CD21	Claim Diagnosis Code XXI (FFS)
62	ICD_DGNS_CD22	Claim Diagnosis Code XXII (FFS)
63	ICD_DGNS_CD23	Claim Diagnosis Code XXIII (FFS)
64	ICD_DGNS_CD24	Claim Diagnosis Code XXIV (FFS)
65	ICD_DGNS_CD25	Claim Diagnosis Code XXV (FFS)
66	FST_DGNS_E_CD	First Claim Diagnosis E Code (FFS)
67	ICD_DGNS_E_CD1	Claim Diagnosis E Code I (FFS)
68	ICD_DGNS_E_CD2	Claim Diagnosis E Code II (FFS)
69	ICD_DGNS_E_CD3	Claim Diagnosis E Code III (FFS)
70	ICD_DGNS_E_CD4	Claim Diagnosis E Code IV (FFS)
71	ICD_DGNS_E_CD5	Claim Diagnosis E Code V (FFS)
72	ICD_DGNS_E_CD6	Claim Diagnosis E Code VI (FFS)
73	ICD_DGNS_E_CD7	Claim Diagnosis E Code VII (FFS)
74	ICD_DGNS_E_CD8	Claim Diagnosis E Code VIII (FFS)
75	ICD_DGNS_E_CD9	Claim Diagnosis E Code IX (FFS)
76	ICD_DGNS_E_CD10	Claim Diagnosis E Code X (FFS)
77	ICD_DGNS_E_CD11	Claim Diagnosis E Code XI
78	ICD_DGNS_E_CD12	Claim Diagnosis E Code XII
79	CLM_HHA_LUPA_IND_CD	Claim HHA Low Utilization Payment Adjustment (LUPA) Indicator Code
80	CLM_HHA_RFRL_CD	Claim HHA Referral Code
81	CLM_HHA_TOT_VISIT_CNT	Claim HHA Total Visit Count
82	CLM_ADMSN_DT	Claim Admission Date (FFS)
83	DOB_DT	Date of Birth from Claim
84	GNDR_CD	Gender Code from Claim
85	BENE_RACE_CD	Beneficiary Race Code (FFS)
86	BENE_CNTY_CD	County Code from Claim (SSA)
87	BENE_STATE_CD	Beneficiary Residence (SSA) State Code (FFS)
88	BENE_MLG_CNTCT_ZIP_CD	Zip Code of Residence from Claim
89	CLM_MDCL_REC	Claim Medical Record Number (FFS)
90	CLM_TRTMT_AUTHRZTN_NUM	Claim Treatment Authorization Number
91	CLM_PRCR_RTRN_CD	Claim Pricer Return Code
92	CLM_PRCR_VRSN_CD	Claim Pricer Version Code
93	CLM_SRVC_FAC_ZIP_CD	Claim service facility ZIP code (where service was provided)
94	CLM_NEXT_GNRTN_ACO_IND_CD	Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code – Population-Based Payment (PBP)
95	CLM_NEXT_GNRTN_ACO_IND_CD2	Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Telehealth
96	CLM_NEXT_GNRTN_ACO_IND_CD3	Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Post Discharge HH visits
97	CLM_NEXT_GNRTN_ACO_IND_CD4	Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - 3-day SNF waiver
98	CLM_NEXT_GNRTN_ACO_IND_CD5	Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Capitation
99	ACO_ID_NUM	Claim Accountable Care Organization (ACO) Identification Number
100	FINL_STD_AMT	Claim Final Standard Payment Amount
101	CLM_BENE_ID_TYPE_CD	Claim Beneficiary Identifier Type Code
102	CLM_RSDL_PYMT_IND_CD	Claim Residual Payment Indicator Code
103	PRVDR_VLDTN_TYPE_CD	Provider Validation Type Code
104	RR_BRD_EXCLSN_IND_SW	Railroad Board Exclusion Indicator Switch
105	PPS_STD_VAL_PYMT_AMT	Standard Payment Amount
106	CLM_MODEL_REIMBRSMT_AMT	Claim Model Reimbursement Amount
107	CLM_ADJUST_GRP_CD	Claim Adjustment Group Code
108	CLM_ADJUST_RSN_CD	Claim Adjustment Reason Code
109	CLM_CLNCL_TRIL_NUM	Clinical Trial Number

Revenue Center File

Number	SAS Name	Variable Name
1	BENE_ID	Encrypted CCW Beneficiary ID
2	CLM_ID	Claim ID
3	CLM_THRU_DT	Claim Through Date (FFS)
4	CLM_LINE_NUM	Claim Line Number
5	NCH_CLM_TYPE_CD	NCH Claim Type Code
6	REV_CNTR	Revenue Center Code (FFS)
7	REV_CNTR_DT	Revenue Center Date
8	REV_CNTR_1ST_ANSI_CD	Revenue Center 1st ANSI Code
9	REV_CNTR_APC_HIPPS_CD	Revenue Center APC or HIPPS Code
10	HCPCS_CD	Healthcare Common Procedure Coding System (HCPCS) Code (FFS)
11	HCPCS_1st_mdfr_cd	HCPCS Initial Modifier Code (FFS)
12	HCPCS_2ND_MDFR_CD	HCPCS Second Modifier Code (FFS)
13	HCPCS_3RD_MDFR_CD	HCPCS Third Modifier Code (FFS)
14	REV_CNTR_PMT_MTHD_IND_CD	Revenue Center Payment Method Indicator Code
15	REV_CNTR_DSCNT_IND_CD	Revenue Center Discount Indicator Code
16	REV_CNTR_PRCNG_IND_CD	Revenue Center Pricing Indicator Code
17	REV_CNTR_IDE_NDC_UPC_NUM	Revenue Center IDE, NDC, or UPC Number (FFS)
18	REV_CNTR_UNIT_CNT	Revenue Center Unit Count (FFS)
19	REV_CNTR_RATE_AMT	Revenue Center Rate Amount
20	REV_CNTR_PRVDR_PMT_AMT	Revenue Center (Medicare) Provider Payment Amount
21	REV_CNTR_PTNT_RSPNSBLTY_PMT	Revenue Center Patient Responsibility Payment Amount
22	REV_CNTR_PMT_AMT_AMT	Revenue Center (Medicare) Payment Amount
23	REV_CNTR_TOT_CHRG_AMT	Revenue Center Total Charge Amount
24	REV_CNTR_NCVRD_CHRG_AMT	Revenue Center Non-Covered Charge Amount
25	REV_CNTR_DDCTBL_COINSRNC_CD	Revenue Center Deductible Coinsurance Code
26	REVSTIND	Revenue Center Status Indicator Code
27	REV_CNTR_NDC_QTY	Revenue Center National Drug Code (NDC) Quantity (FFS)
28	REV_CNTR_NDC_QTY_QLFR_CD	Revenue Center NDC Quantity Qualifier Code (FFS)
29	RNDRNG_PHYSN_UPIN	Revenue Center Rendering Physician UPIN
30	RNDRNG_PHYSN_NPI	Rendering Physician NPI (FFS)
31	RNDRNG_PHYSN_SPCLTY_CD	Claim or Revenue Center Rendering Physician Specialty Code
32	THRPY_CAP_IND_CD1	Therapy cap Indicator 1 Code
33	THRPY_CAP_IND_CD2	Therapy cap Indicator 2 Code
34	REV_CNTR_RP_IND_CD	Revenue Center Representative Payee (RP) Indicator Code
35	RC_MODEL_REIMBRSMT_AMT	Revenue Center Model Reimbursement Amount
36	RC_VLNTRY_SRVC_IND_CD	Revenue Center Voluntary Service Indicator Code
37	ORDRG_PHYSN_NPI	Revenue Center Ordering Physician NPI
38	REV_CNTR_ADJUST_GRP_CD	Revenue Center Adjustment Group Code
39	REV_CNTR_ADJUST_RSN_CD	Revenue Center Adjustment Reason Code
40	REV_CNTR_RA_RMRK_CD	Revenue Center Remittance Advice Remark Code

Condition Code File

Number	SAS Name	Variable Name
1	BENE_ID	Encrypted CCW Beneficiary ID
2	CLM_ID	Claim ID
3	NCH_CLM_TYPE_CD	NCH Claim Type Code
4	RLT_COND_CD_SEQ	Claim Related Condition Code Sequence
5	CLM_RLT_COND_CD	Claim Related Condition Code (FFS)

Occurence Code File

Number	SAS Name	Variable Name
1	BENE_ID	Encrypted CCW Beneficiary ID
2	CLM_ID	Claim ID
3	NCH_CLM_TYPE_CD	NCH Claim Type Code
4	RLT_OCRNC_CD_SEQ	Claim Related Occurrence Code Sequence
5	CLM_RLT_OCRNC_CD	Claim Related Occurrence Code (FFS)
6	CLM_RLT_OCRNC_DT	Claim Related Occurrence Date (FFS)

Span Code File

Number	SAS Name	Variable Name
1	BENE_ID	Encrypted CCW Beneficiary ID
2	CLM_ID	Claim ID
3	NCH_CLM_TYPE_CD	NCH Claim Type Code
4	RLT_SPAN_CD_SEQ	Claim Related Span Code Sequence
5	CLM_SPAN_CD	Claim Occurrence Span Code (FFS)
6	CLM_SPAN_FROM_DT	Claim Occurrence Span From Date (FFS)
7	CLM_SPAN_THRU_DT	Claim Occurrence Span Through Date (FFS)

Value Code File

Number	SAS Name	Variable Name
1	BENE_ID	Encrypted CCW Beneficiary ID
2	CLM_ID	Claim ID
3	NCH_CLM_TYPE_CD	NCH Claim Type Code
4	RLT_VAL_CD_SEQ	Claim Related Value Code Sequence
5	CLM_VAL_CD	Claim Value Code (FFS)
6	CLM_VAL_AMT	Claim Value Amount

Demonstrations/Innovations Code File

Number	SAS Name	Variable Name
1	BENE_ID	Encrypted CCW Beneficiary ID
2	CLM_ID	Claim ID
3	NCH_CLM_TYPE_CD	NCH Claim Type Code
4	DEMO_ID_SQNC_NUM	Demonstration sequence number
5	DEMO_ID_NUM	Demonstration number
6	DEMO_INFO_TXT	Demo information text