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File Version: CCW record layout accessed May, 2019; CMS MAX 2014 data dictionary Aug 18, 2016

SAS NameVariable Name
1BENE_IDEncrypted 723 CCW Beneficiary ID
2MSIS_IDEncrypted MSIS Identification Number
3STATE_CDState
4YR_NUMYear of MAX Record
5EL_DOB Birth date
6EL_SEX_CDSex (MAX)
7EL_RACE_ETHNCY_CDRace/ethnicity (from MSIS)
8RACE_CODE_1Race - White (from MSIS)
9RACE_CODE_2Race - Black (from MSIS)
10RACE_CODE_3Race - Am Indian/Alaskan (from MSIS)
11RACE_CODE_4Race - Asian (from MSIS)
12RACE_CODE_5Race - Hawaiian/Pac Islands (from MSIS)
13ETHNICITY_CODEEthnicity - Hispanic (from MSIS)
14EL_SS_ELGBLTY_CD_LTSTState specific eligibility - most recent
15EL_SS_ELGBLTY_CD_MOState specific eligibility - mo of svc
16EL_MAX_ELGBLTY_CD_LTSTMAX eligibility - most recent
17EL_MAX_ELGBLTY_CD_MOMAX eligibility - mo of svc
18EL_MDCR_ANN_XOVR_OLDCrossover code (Annual) old values
19MSNG_ELG_DATA Missing eligibility data
20EL_MDCR_XOVR_CLM_BSD_CDCrossover code (from claims only)
21EL_MDCR_ANN_XOVR_99Crossover code (Annual)
22MSIS_TOS MSIS Type of Service (TOS)
23MSIS_TOPMSIS Type of Program (TOP)
24MAX_TOSMAX Type of Service (TOS)
25PRVDR_ID_NMBR Billing provider identification number (MAX)
26NPI National Provider Identifier (MAX)
27TAXONOMY Provider Taxonomy
28TYPE_CLM_CD Type of claim
29ADJUST_CDAdjustment code
30PHP_TYPEManaged care type of plan code
31PHP_IDManaged care plan identification code
32MDCD_PYMT_AMTMedicaid payment amount
33TP_PYMT_AMTThird party payment amount
34PYMT_DTPayment/adjudication date
35CHRG_AMTCharge amount
36PHP_VALPrepaid plan value
37MDCR_COINSUR_PYMT_AMTMedicare coinsurance payment amount
38MDCR_DED_PYMT_AMTMedicare deductible payment amount
39ADMSN_DTAdmission date (MAX)
40SRVC_BGN_DTBeginning date of service
41SRVC_END_DTEnding date of service
42DIAG_CD_1Principle Diagnosis code
43DIAG_CD_2 Diagnosis codes (2nd diagnosis)
44DIAG_CD_3 Diagnosis codes (3rd diagnosis)
45DIAG_CD_4Diagnosis codes (4th diagnosis)
46DIAG_CD_5Diagnosis codes (5th diagnosis)
47DIAG_CD_6Diagnosis codes (6th diagnosis)
48DIAG_CD_7 Diagnosis codes (7th diagnosis)
49DIAG_CD_8Diagnosis codes (8th diagnosis)
50DIAG_CD_9Diagnosis codes (9th diagnosis)
51PRNCPL_PRCDR_DT Principle procedure date
52PRCDR_CD_SYS_1Procedure code system- principal
53PRCDR_CD_1Principle procedure code
54PRCDR_CD_SYS_2Procedure code system (2nd procedure)
55PRCDR_CD_2 Procedure code (2nd procedure)
56PRCDR_CD_SYS_3Procedure code system (3rd procedure)
57PRCDR_CD_3Procedure code (3rd procedure)
58PRCDR_CD_SYS_4Procedure code system (4th procedure)
59PRCDR_CD_4 Procedure code (4th procedure)
60PRCDR_CD_SYS_5Procedure code system (5th procedure)
61PRCDR_CD_5 Procedure code (5th procedure)
62PRCDR_CD_SYS_6Procedure code system (6th procedure)
63PRCDR_CD_6 Procedure code (6th procedure)
64RCPNT_DLVRY_CDDelivery code (MAX IP)
65MDCD_CVRD_IP_DAYSMedicaid covered inpatient days
66PATIENT_STATUS_CDPatient status
67DRG_REL_GROUP_INDDiagnosis Related Group (DRG) indicator
68DRG_REL_GROUPDiagnosis Related Group (DRG)
69UB_92_REV_CD_GP_1UB-92 revenue code (1st)
70UB_92_REV_CD_CHGS_1UB-92 revenue code charge (1st)
71UB_92_REV_CD_UNITS_1UB-92 revenue code units (1st)
72UB_92_REV_CD_GP_2UB-92 revenue code (2nd)
73UB_92_REV_CD_CHGS_2UB-92 revenue code charge (2nd)
74UB_92_REV_CD_UNITS_2UB-92 revenue code units (2nd)
75UB_92_REV_CD_GP_3UB-92 revenue code (3rd)
76UB_92_REV_CD_CHGS_3UB-92 revenue code charge (3rd)
77UB_92_REV_CD_UNITS_3UB-92 revenue code units (3rd)
78UB_92_REV_CD_GP_4UB-92 revenue code (4th)
79UB_92_REV_CD_CHGS_4UB-92 revenue code charge (4th)
80UB_92_REV_CD_UNITS_4UB-92 revenue code units (4th)
81UB_92_REV_CD_GP_5UB-92 revenue code (5th)
82UB_92_REV_CD_CHGS_5UB-92 revenue code charge (5th)
83UB_92_REV_CD_UNITS_5UB-92 revenue code units (5th)
84UB_92_REV_CD_GP_6UB-92 revenue code (6th)
85UB_92_REV_CD_CHGS_6UB-92 revenue code charge (6th)
86UB_92_REV_CD_UNITS_6UB-92 revenue code units (6th)
87UB_92_REV_CD_GP_7UB-92 revenue code (7th)
88UB_92_REV_CD_CHGS_7UB-92 revenue code charge (7th)
89UB_92_REV_CD_UNITS_7UB-92 revenue code units (7th)
90UB_92_REV_CD_GP_8UB-92 revenue code (8th)
91UB_92_REV_CD_CHGS_8UB-92 revenue code charge (8th)
92UB_92_REV_CD_UNITS_8UB-92 revenue code units (8th)
93UB_92_REV_CD_GP_9UB-92 revenue code (9th)
94UB_92_REV_CD_CHGS_9UB-92 revenue code charge (9th)
95UB_92_REV_CD_UNITS_9UB-92 revenue code units (9th)
96UB_92_REV_CD_GP_10UB-92 revenue code (10th)
97UB_92_REV_CD_CHGS_10UB-92 revenue code charge (10th)
98UB_92_REV_CD_UNITS_10UB-92 revenue code units (10th)
99UB_92_REV_CD_GP_11UB-92 revenue code (11th)
100UB_92_REV_CD_CHGS_11UB-92 revenue code charge (11th)
101UB_92_REV_CD_UNITS_11UB-92 revenue code units (11th)
102UB_92_REV_CD_GP_12UB-92 revenue code (12th)
103UB_92_REV_CD_CHGS_12UB-92 revenue code charge (12th)
104UB_92_REV_CD_UNITS_12UB-92 revenue code units (12th)
105UB_92_REV_CD_GP_13UB-92 revenue code (13th)
106UB_92_REV_CD_CHGS_13UB-92 revenue code charge (13th)
107UB_92_REV_CD_UNITS_13UB-92 revenue code units (13th)
108UB_92_REV_CD_GP_14UB-92 revenue code (14th)
109UB_92_REV_CD_CHGS_14UB-92 revenue code charge (14th)
110UB_92_REV_CD_UNITS_14UB-92 revenue code units (14th)
111UB_92_REV_CD_GP_15UB-92 revenue code (15th)
112UB_92_REV_CD_CHGS_15UB-92 revenue code charge (15th)
113UB_92_REV_CD_UNITS_15UB-92 revenue code units (15th)
114UB_92_REV_CD_GP_16UB-92 revenue code (16th)
115UB_92_REV_CD_CHGS_16UB-92 revenue code charge (16th)
116UB_92_REV_CD_UNITS_16UB-92 revenue code units (16th)
117UB_92_REV_CD_GP_17UB-92 revenue code (17th)
118UB_92_REV_CD_CHGS_17UB-92 revenue code charge (17th)
119UB_92_REV_CD_UNITS_17UB-92 revenue code units (17th)
120UB_92_REV_CD_GP_18UB-92 revenue code (18th)
121UB_92_REV_CD_CHGS_18UB-92 revenue code charge (18th)
122UB_92_REV_CD_UNITS_18UB-92 revenue code units (18th)
123UB_92_REV_CD_GP_19UB-92 revenue code (19th)
124UB_92_REV_CD_CHGS_19UB-92 revenue code charge (19th)
125UB_92_REV_CD_UNITS_19UB-92 revenue code units (19th)
126UB_92_REV_CD_GP_20UB-92 revenue code (20th)
127UB_92_REV_CD_CHGS_20UB-92 revenue code charge (20th)
128UB_92_REV_CD_UNITS_20UB-92 revenue code units (20th)
129UB_92_REV_CD_GP_21UB-92 revenue code (21st)
130UB_92_REV_CD_CHGS_21UB-92 revenue code charge (21st)
131UB_92_REV_CD_UNITS_21UB-92 revenue code units (21st)
132UB_92_REV_CD_GP_22UB-92 revenue code (22nd)
133UB_92_REV_CD_CHGS_22UB-92 revenue code charge (22nd)
134UB_92_REV_CD_UNITS_22UB-92 revenue code units (22nd)
135UB_92_REV_CD_GP_23UB-92 revenue code (23rd)
136UB_92_REV_CD_CHGS_23UB-92 revenue code charge (23rd)
137UB_92_REV_CD_UNITS_23UB-92 revenue code units (23rd)
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