| 1 | BENE_ID | Encrypted CCW Beneficiary ID | |
| 2 | BENE_ENROLLMT_REF_YR | Reference Year (Base) | |
| 3 | ENRL_SRC | Enrollment Source | |
| 201 | SAMPLE_GROUP | Medicare Sample Group Indicator | |
| 5 | ENHANCED_FIVE_PERCENT_FLAG | Enhanced Medicare 5% Sample Indicator | |
| 6 | CRNT_BIC_CD | Current Beneficiary Identification Code | |
| 7 | STATE_CODE | State code for beneficiary (SSA code) | |
| 8 | COUNTY_CD | County code for beneficiary (SSA code) | |
| 9 | ZIP_CD | Zip code for beneficiary | |
| 202 | STATE_CNTY_FIPS_CD_01 | State and county FIPS code - January | |
| 203 | STATE_CNTY_FIPS_CD_02 | State and county FIPS code - February | |
| 204 | STATE_CNTY_FIPS_CD_03 | State and county FIPS code - March | |
| 205 | STATE_CNTY_FIPS_CD_04 | State and county FIPS code - April | |
| 206 | STATE_CNTY_FIPS_CD_05 | State and county FIPS code - May | |
| 207 | STATE_CNTY_FIPS_CD_06 | State and county FIPS code - June | |
| 208 | STATE_CNTY_FIPS_CD_07 | State and county FIPS code - July | |
| 209 | STATE_CNTY_FIPS_CD_08 | State and county FIPS code - August | |
| 210 | STATE_CNTY_FIPS_CD_09 | State and county FIPS code - September | |
| 211 | STATE_CNTY_FIPS_CD_10 | State and county FIPS code - October | |
| 212 | STATE_CNTY_FIPS_CD_11 | State and county FIPS code - November | |
| 213 | STATE_CNTY_FIPS_CD_12 | State and county FIPS code - December | |
| 22 | AGE_AT_END_REF_YR | Age of beneficiary at end of year | |
| 23 | BENE_BIRTH_DT | Beneficiary date of birth | |
| 24 | VALID_DEATH_DT_SW | Valid Date of Death Switch | |
| 25 | BENE_DEATH_DT TYPE: DATE | Date of Death | |
| 26 | SEX_IDENT_CD | Sex | |
| 27 | BENE_RACE_CD | Beneficiary Race Code (Base) | |
| 28 | RTI_RACE_CD | Research Triangle Institute (RTI) Race Code | |
| 29 | COVSTART | Medicare Coverage Start Date | |
| 30 | ENTLMT_RSN_ORIG | Original Reason for Entitlement Code | |
| 31 | ENTLMT_RSN_CURR | Current Reason for Entitlement Code | |
| 32 | ESRD_IND | End-Stage Renal Disease (ESRD) Indicator | |
| 214 | MDCR_STATUS_CODE_01 | Medicare Status Code - January | |
| 215 | MDCR_STATUS_CODE_02 | Medicare Status Code - February | |
| 216 | MDCR_STATUS_CODE_03 | Medicare Status Code - March | |
| 216 | MDCR_STATUS_CODE_04 | Medicare Status Code - April | |
| 217 | MDCR_STATUS_CODE_05 | Medicare Status Code - May | |
| 218 | MDCR_STATUS_CODE_06 | Medicare Status Code - June | |
| 219 | MDCR_STATUS_CODE_07 | Medicare Status Code - July | |
| 220 | MDCR_STATUS_CODE_08 | Medicare Status Code - August | |
| 221 | MDCR_STATUS_CODE_09 | Medicare Status Code - September | |
| 250 | MDCR_STATUS_CODE_10 | Medicare Status Code - October | |
| 251 | MDCR_STATUS_CODE_11 | Medicare Status Code - November | |
| 252 | MDCR_STATUS_CODE_12 | Medicare Status Code - December | |
| 45 | BENE_PTA_TRMNTN_CD | Part A Termination Code | |
| 46 | BENE_PTB_TRMNTN_CD | Part B Termination Code | |
| 47 | BENE_HI_CVRAGE_TOT_MONS | Part A Months Count | |
| 48 | BENE_SMI_CVRAGE_TOT_MONS | Part B Months Count | |
| 49 | BENE_STATE_BUYIN_TOT_MONS | State Buy-In Coverage Count | |
| 50 | BENE_HMO_CVRAGE_TOT_MONS | HMO Coverage Count | |
| 54 | MDCR_ENTLMT_BUYIN_IND_01 | Medicare Entitlement/Buy-In Indicator - January | |
| 55 | MDCR_ENTLMT_BUYIN_IND_02 | Medicare Entitlement/Buy-In Indicator - February | |
| 56 | MDCR_ENTLMT_BUYIN_IND_03 | Medicare Entitlement/Buy-In Indicator - March | |
| 57 | MDCR_ENTLMT_BUYIN_IND_04 | Medicare Entitlement/Buy-In Indicator - April | |
| 58 | MDCR_ENTLMT_BUYIN_IND_05 | Medicare Entitlement/Buy-In Indicator - May | |
| 59 | MDCR_ENTLMT_BUYIN_IND_06 | Medicare Entitlement/Buy-In Indicator - June | |
| 60 | MDCR_ENTLMT_BUYIN_IND_07 | Medicare Entitlement/Buy-In Indicator - July | |
| 61 | MDCR_ENTLMT_BUYIN_IND_08 | Medicare Entitlement/Buy-In Indicator - August | |
| 62 | MDCR_ENTLMT_BUYIN_IND_09 | Medicare Entitlement/Buy-In Indicator - September | |
| 63 | MDCR_ENTLMT_BUYIN_IND_10 | Medicare Entitlement/Buy-In Indicator - October | |
| 64 | MDCR_ENTLMT_BUYIN_IND_11 | Medicare Entitlement/Buy-In Indicator - November | |
| 65 | MDCR_ENTLMT_BUYIN_IND_12 | Medicare Entitlement/Buy-In Indicator - December | |
| 66 | HMO_IND_01 | HMO Indicator - January | |
| 67 | HMO_IND_02 | HMO Indicator - February | |
| 68 | HMO_IND_03 | HMO Indicator - March | |
| 69 | HMO_IND_04 | HMO Indicator - April | |
| 70 | HMO_IND_05 | HMO Indicator - May | |
| 71 | HMO_IND_06 | HMO Indicator - June | |
| 72 | HMO_IND_07 | HMO Indicator - July | |
| 73 | HMO_IND_08 | HMO Indicator - August | |
| 74 | HMO_IND_09 | HMO Indicator - September | |
| 75 | HMO_IND_10 | HMO Indicator - October | |
| 76 | HMO_IND_11 | HMO Indicator - November | |
| 77 | HMO_IND_12 | HMO Indicator - December | |
