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

Short SAS NameLong SAS NameVariable Name
1BENE_IDBENE_IDEncrypted 723 CCW Beneficiary ID
2 MSIS_IDEncrypted MSIS Identification Number
3 STATE_CDState
4 YR_NUMYear of MAX Record
5 EL_DOB Birth date
6EL_SEX_CDSex (MAX)
7 EL_RACE_ETHNCY_CDRace/ethnicity (from MSIS)
8RACE_CODE_1Race - White (from MSIS)
9 RACE_CODE_2Race - Black (from MSIS)
10 RACE_CODE_3Race - Am Indian/Alaskan (from MSIS)
11 RACE_CODE_4Race - Asian (from MSIS)
12 RACE_CODE_5Race - Hawaiian/Pac Islands (from MSIS)
13 ETHNICITY_CODEEthnicity - Hispanic (from MSIS)
14 EL_SS_ELGBLTY_CD_LTSTState specific eligibility - most recent
15 EL_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
18 EL_MDCR_ANN_XOVR_OLDCrossover code (Annual) old values
19 EL_MDCR_XOVR_CLM_BSD_CDCrossover code (from claims only)
20 MSNG_ELG_DATA Missing eligibility data
21EL_MDCR_ANN_XOVR_99Crossover code (Annual)
22 MSIS_TOS MSIS Type of Service (TOS)
23 MSIS_TOPMSIS Type of Program (TOP)
24 MAX_TOSMAX Type of Service (TOS)
25 PRVDR_ID_NMBR Billing provider identification number
26 NPI National Provider Identifier
27 TAXONOMY Provider Taxonomy
28 TYPE_CLM_CD Type of claim
29 ADJUST_CDAdjustment code
30 PHP_TYPEManaged care type of plan code
31 PHP_IDManaged care plan identification code
32 MDCD_PYMT_AMTMedicaid payment amount
33 TP_PYMT_AMTThird party payment amount
34 PYMT_DTPayment/adjudication date
35 CHRG_AMTCharge amount
36 PHP_VALPrepaid plan value
37 MDCR_COINSUR_PYMT_AMTMedicare coinsurance payment amount
38 MDCR_DED_PYMT_AMTMedicare deductible payment amount
39 PRES_PHYSICIAN_ID_NUMPrescribing physician id number
40 PRSC_WRTE_DTPrescribed date
41 PRSCRPTN_FILL_DTPrescription fill date
42NEW_REFILL_INDNew or refill indicator
43 NDCNational Drug Code (NDC)
44 QTY_SRVC_UNITSQuantity of service
45DAYS_SUPPLYDays Supply (MAX)
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