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File Version: K, CCW Data Documentation May, 2019

SAS NameVariable Name
1BENE_IDEncrypted CCW Beneficiary ID
2CLM_IDClaim ID
3NCH_NEAR_LINE_REC_IDENT_CDNCH Near Line Record Identification Code (RIC)
4NCH_CLM_TYPE_CDNCH Claim Type Code
5CLM_FROM_DTClaim From Date (FFS)
6CLM_THRU_DTClaim Through Date (FFS)
7NCH_WKLY_PROC_DTNCH Weekly Claim Processing Date
8FI_CLM_PROC_DTFI Claim Process Date
9CLAIM_QUERY_CODEClaim Query Code
10PRVDR_NUMProvider Number
11CLM_FAC_TYPE_CDClaim Facility Type Code (FFS)
12CLM_SRVC_CLSFCTN_TYPE_CDClaim Service Classification Type Code (FFS)
13CLM_FREQ_CDClaim Frequency Code (FFS)
14FI_NUMFI or MAC Number
15CLM_MDCR_NON_PMT_RSN_CDClaim Medicare Non Payment Reason Code
16CLM_PMT_AMTClaim (Medicare) Payment Amount
17NCH_PRMRY_PYR_CLM_PD_AMTNCH Primary Payer (if not Medicare) Claim Paid Amount
18NCH_PRMRY_PYR_CDNCH Primary Payer Code (if not Medicare)
300FI_CLM_ACTN_CDFI or MAC Claim Action Code
19PRVDR_STATE_CDNCH Provider SSA State Code
20ORG_NPI_NUMOrganization (or group) NPI Number
21SRVC_LOC_NPI_NUMClaim Service Location NPI Number
22AT_PHYSN_UPINClaim Attending Physician UPIN Number
23AT_PHYSN_NPIClaim Attending Physician NPI Number (FFS)
24AT_PHYSN_SPCLTY_CDClaim Attending Physician Specialty Code
25OP_PHYSN_UPINClaim Operating Physician UPIN Number
26OP_PHYSN_NPIClaim Operating Physician NPI Number (FFS)
27OP_PHYSN_SPCLTY_CDClaim Operating Physician Specialty Code
28OT_PHYSN_UPINClaim Other Physician UPIN Number
29OT_PHYSN_NPIClaim Other Physician NPI Number (FFS)
30OT_PHYSN_SPCLTY_CDClaim Other Physician Specialty Code
500RNDRNG_PHYSN_NPIRendering Physician NPI (FFS)
32RNDRNG_PHYSN_SPCLTY_CDClaim or Revenue Center Rendering Physician Specialty Code
400RFRG_NPIClaim Referring Physician NPI Number
401RFRG_SPCLTY_CDClaim Referring Physician Specialty Code
35CLM_MCO_PD_SWClaim MCO Paid Switch
36PTNT_DSCHRG_STUS_CDPatient Discharge Status Code (FFS)
37CLM_TOT_CHRG_AMTClaim Total Charge Amount
38NCH_BENE_BLOOD_DDCTBL_LBLTY_AMNCH Beneficiary Blood Deductible Liability Amount
39NCH_PROFNL_CMPNT_CHRG_AMTProfessional Component Charge Amount
301NCH_BLOOD_PNTS_FRNSHD_QTYNCH Blood Pints Furnished Quantity
40PRNCPAL_DGNS_CDClaim Principal Diagnosis Code (FFS)
41ICD_DGNS_CD1Claim Diagnosis Code I (FFS)
42ICD_DGNS_CD2Claim Diagnosis Code II (FFS)
43ICD_DGNS_CD3Claim Diagnosis Code III (FFS)
44ICD_DGNS_CD4Claim Diagnosis Code IV (FFS)
45ICD_DGNS_CD5Claim Diagnosis Code V (FFS)
46ICD_DGNS_CD6Claim Diagnosis Code VI (FFS)
47ICD_DGNS_CD7Claim Diagnosis Code VII (FFS)
48ICD_DGNS_CD8Claim Diagnosis Code VIII (FFS)
49ICD_DGNS_CD9Claim Diagnosis Code IX (FFS)
50ICD_DGNS_CD10Claim Diagnosis Code X (FFS)
51ICD_DGNS_CD11Claim Diagnosis Code XI (FFS)
52ICD_DGNS_CD12Claim Diagnosis Code XII (FFS)
53ICD_DGNS_CD13Claim Diagnosis Code XIII (FFS)
54ICD_DGNS_CD14Claim Diagnosis Code XIV (FFS)
55ICD_DGNS_CD15Claim Diagnosis Code XV (FFS)
56ICD_DGNS_CD16Claim Diagnosis Code XVI (FFS)
57ICD_DGNS_CD17Claim Diagnosis Code XVII (FFS)
58ICD_DGNS_CD18Claim Diagnosis Code XVIII (FFS)
59ICD_DGNS_CD19Claim Diagnosis Code XIX (FFS)
60ICD_DGNS_CD20Claim Diagnosis Code XX (FFS)
61ICD_DGNS_CD21Claim Diagnosis Code XXI (FFS)
62ICD_DGNS_CD22Claim Diagnosis Code XXII (FFS)
63ICD_DGNS_CD23Claim Diagnosis Code XXIII (FFS)
64ICD_DGNS_CD24Claim Diagnosis Code XXIV (FFS)
65ICD_DGNS_CD25Claim Diagnosis Code XXV (FFS)
66FST_DGNS_E_CDFirst Claim Diagnosis E Code (FFS)
67ICD_DGNS_E_CD1Claim Diagnosis E Code I (FFS)
68ICD_DGNS_E_CD2Claim Diagnosis E Code II (FFS)
69ICD_DGNS_E_CD3Claim Diagnosis E Code III (FFS)
70ICD_DGNS_E_CD4Claim Diagnosis E Code IV (FFS)
71ICD_DGNS_E_CD5Claim Diagnosis E Code V (FFS)
72ICD_DGNS_E_CD6Claim Diagnosis E Code VI (FFS)
73ICD_DGNS_E_CD7Claim Diagnosis E Code VII (FFS)
74ICD_DGNS_E_CD8Claim Diagnosis E Code VIII (FFS)
75ICD_DGNS_E_CD9Claim Diagnosis E Code IX (FFS)
76ICD_DGNS_E_CD10Claim Diagnosis E Code X (FFS)
77ICD_DGNS_E_CD11Claim Diagnosis E Code XI
78ICD_DGNS_E_CD12Claim Diagnosis E Code XII
79ICD_PRCDR_CD1Claim Procedure Code I (FFS)
80PRCDR_DT1Claim Procedure Code I Date (FFS)
81ICD_PRCDR_CD2Claim Procedure Code II (FFS)
82PRCDR_DT2Claim Procedure Code II Date (FFS)
83ICD_PRCDR_CD3Claim Procedure Code III (FFS)
84PRCDR_DT3Claim Procedure Code III Date (FFS)
85ICD_PRCDR_CD4Claim Procedure Code IV (FFS)
86PRCDR_DT4Claim Procedure Code IV Date (FFS)
87ICD_PRCDR_CD5Claim Procedure Code V (FFS)
88PRCDR_DT5Claim Procedure Code V Date (FFS)
89ICD_PRCDR_CD6Claim Procedure Code VI (FFS)
90PRCDR_DT6Claim Procedure Code VI Date (FFS)
91ICD_PRCDR_CD7Claim Procedure Code VII (FFS)
92PRCDR_DT7Claim Procedure Code VII Date (FFS)
93ICD_PRCDR_CD8Claim Procedure Code VIII (FFS)
94PRCDR_DT8Claim Procedure Code VIII Date (FFS)
95ICD_PRCDR_CD9Claim Procedure Code IX (FFS)
96PRCDR_DT9Claim Procedure Code IX Date (FFS)
97ICD_PRCDR_CD10Claim Procedure Code X (FFS)
98PRCDR_DT10Claim Procedure Code X Date (FFS)
99ICD_PRCDR_CD11Claim Procedure Code XI (FFS)
100PRCDR_DT11Claim Procedure Code XI Date (FFS)
101ICD_PRCDR_CD12Claim Procedure Code XII (FFS)
102PRCDR_DT12Claim Procedure Code XII Date (FFS)
103ICD_PRCDR_CD13Claim Procedure Code XIII (FFS)
104PRCDR_DT13Claim Procedure Code XIII Date (FFS)
105ICD_PRCDR_CD14Claim Procedure Code XIV
106PRCDR_DT14Claim Procedure Code XIV Date
107ICD_PRCDR_CD15Claim Procedure Code XV
108PRCDR_DT15Claim Procedure Code XV Date
109ICD_PRCDR_CD16Claim Procedure Code XVI
110PRCDR_DT16Claim Procedure Code XVI Date
111ICD_PRCDR_CD17Claim Procedure Code XVII
112PRCDR_DT17Claim Procedure Code XVII Date
113ICD_PRCDR_CD18Claim Procedure Code XVIII
114PRCDR_DT18Claim Procedure Code XVIII Date
115ICD_PRCDR_CD19Claim Procedure Code XIX
116PRCDR_DT19Claim Procedure Code XIX Date
117ICD_PRCDR_CD20Claim Procedure Code XX
118PRCDR_DT20Claim Procedure Code XX Date
119ICD_PRCDR_CD21Claim Procedure Code XXI
120PRCDR_DT21Claim Procedure Code XXI Date
121ICD_PRCDR_CD22Claim Procedure Code XXII
122PRCDR_DT22Claim Procedure Code XXII Date
123ICD_PRCDR_CD23Claim Procedure Code XXIII
124PRCDR_DT23Claim Procedure Code XXIII Date
125ICD_PRCDR_CD24Claim Procedure Code XXIV
126PRCDR_DT24Claim Procedure Code XXIV Date
127ICD_PRCDR_CD25Claim Procedure Code XXV
128PRCDR_DT25Claim Procedure Code XXV Date
129RSN_VISIT_CD1Reason for Visit Diagnosis Code I (FFS)
130RSN_VISIT_CD2Reason for Visit Diagnosis Code II (FFS)
131RSN_VISIT_CD3Reason for Visit Diagnosis Code III (FFS)
132NCH_BENE_PTB_DDCTBL_AMTNCH Beneficiary Part B Deductible Amount
133NCH_BENE_PTB_COINSRNC_AMTNCH Beneficiary Part B Coinsurance Amount
134CLM_OP_PRVDR_PMT_AMTClaim Outpatient Provider Payment Amount
135CLM_OP_BENE_PMT_AMTClaim Outpatient Payment Amount to Beneficiary
136DOB_DTDate of Birth from Claim
137GNDR_CDGender Code from Claim
138BENE_RACE_CDBeneficiary Race Code (FFS)
139BENE_CNTY_CDCounty Code from Claim (SSA)
140BENE_STATE_CDBeneficiary Residence (SSA) State Code (FFS)
141BENE_MLG_CNTCT_ZIP_CDZip Code of Residence from Claim
142CLM_MDCL_RECClaim Medical Record Number (FFS)
145CLM_TRTMT_AUTHRZTN_NUMClaim Treatment Authorization Number
146CLM_PRCR_RTRN_CDClaim Pricer Return Code
147CLM_SRVC_FAC_ZIP_CDClaim service facility ZIP code (where service was provided)
148CLM_OP_TRANS_TYPE_CDClaim Outpatient transaction type
149CLM_OP_ESRD_MTHD_CDClaim Outpatient End Stage Renal Disease (ESRD) Method of Reimbursement Code
150CLM_NEXT_GNRTN_ACO_IND_CD1Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Population-Based Payment (PBP)
151CLM_NEXT_GNRTN_ACO_IND_CD2Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Telehealth
152CLM_NEXT_GNRTN_ACO_IND_CD3Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Post Discharge HH visits
153CLM_NEXT_GNRTN_ACO_IND_CD4Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - 3-day SNF waiver
154CLM_NEXT_GNRTN_ACO_IND_CD5Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Capitation
155ACO_ID_NUMClaim Accountable Care Organization (ACO) Identification Number
303CLM_BENE_ID_TYPE_CDClaim Beneficiary Identifier Type Code
275CLM_RSDL_PYMT_IND_CDClaim Residual Payment Indicator Code
276PRVDR_VLDTN_TYPE_CDProvider Validation Type Code
277RR_BRD_EXCLSN_IND_SWRailroad Board Exclusion Indicator Switch

Revenue Center File

SAS NameVariable Name
1BENE_IDEncrypted CCW Beneficiary ID
2CLM_IDClaim ID
3CLM_THRU_DTClaim Through Date (FFS)
4CLM_LINE_NUMClaim Line Number
5NCH_CLM_TYPE_CDNCH Claim Type Code
6REV_CNTRRevenue Center Code (FFS)
7REV_CNTR_DTRevenue Center Date
8REV_CNTR_1ST_ANSI_CDRevenue Center 1st ANSI Code
9REV_CNTR_2ND_ANSI_CDRevenue Center 2nd ANSI Code
10REV_CNTR_3RD_ANSI_CDRevenue Center 3rd ANSI Code
11REV_CNTR_4TH_ANSI_CDRevenue Center 4th ANSI Code
12REV_CNTR_APC_HIPPS_CDRevenue Center APC or HIPPS Code
13HCPCS_CDHealthcare Common Procedure Coding System (HCPCS) Code (FFS)
14HCPCS_1st_mdfr_cdHCPCS Initial Modifier Code (FFS)
15HCPCS_2ND_MDFR_CDHCPCS Second Modifier Code (FFS)
16HCPCS_3RD_MDFR_CDHCPCS Third Modifier Code (FFS)
17HCPCS_4TH_MDFR_CDHCPCS Fourth Modifier Code (FFS)
18REV_CNTR_PMT_MTHD_IND_CDRevenue Center Payment Method Indicator Code
19REV_CNTR_DSCNT_IND_CDRevenue Center Discount Indicator Code
20REV_CNTR_PACKG_IND_CDRevenue Center Packaging Indicator Code
305REV_CNTR_PRCNG_IND_CDRevenue Center Pricing Indicator Code
21REV_CNTR_OTAF_PMT_CDRevenue Center Obligation to Accept As Full (OTAF) Payment Code
22REV_CNTR_IDE_NDC_UPC_NUMRevenue Center IDE, NDC, or UPC Number (FFS)
23REV_CNTR_UNIT_CNTRevenue Center Unit Count (FFS)
24REV_CNTR_RATE_AMTRevenue Center Rate Amount
25REV_CNTR_BLOOD_DDCTBL_AMTRevenue Center Blood Deductible Amount
26REV_CNTR_CASH_DDCTBL_AMTRevenue Center Cash Deductible Amount
27REV_CNTR_COINSRNC_WGE_ADJSTD_CRevenue Center Coinsurance/Wage Adjusted Coinsurance Amount
28REV_CNTR_RDCD_COINSRNC_AMTRevenue Center Reduced Coinsurance Amount
29REV_CNTR_1ST_MSP_PD_AMTRevenue Center 1st Medicare Secondary Payer (MSP) Paid Amount
30REV_CNTR_2ND_MSP_PD_AMTRevenue Center 2nd Medicare Secondary Payer (MSP) Paid Amount
31REV_CNTR_PRVDR_PMT_AMTRevenue Center (Medicare) Provider Payment Amount
32REV_CNTR_BENE_PMT_AMTRevenue Center Payment Amount to Beneficiary
33REV_CNTR_PTNT_RSPNSBLTY_PMTRevenue Center Patient Responsibility Payment
34REV_CNTR_PMT_AMT_AMTRevenue Center (Medicare) Payment Amount
35REV_CNTR_TOT_CHRG_AMTRevenue Center Total Charge Amount
36REV_CNTR_NCVRD_CHRG_AMTRevenue Center Non-Covered Charge Amount
306REV_CNTR_DDCTBL_COINSRNC_CDRevenue Center Deductible Coinsurance Code
37REVSTINDRevenue Center Status Indicator Code
307RC_PTNT_ADD_ON_PYMT_AMTRevenue Center Patient/Initial Visit Add-On Payment Amount (for initial wellness visit)
38REV_CNTR_NDC_QTYRevenue Center National Drug Code (NDC) Quantity (FFS)
39REV_CNTR_NDC_QTY_QLFR_CDRevenue Center NDC Quantity Qualifier Code (FFS)
40RNDRNG_PHYSN_UPINRevenue Center Rendering Physician UPIN
501RNDRNG_PHYSN_NPIRendering Physician NPI (FFS)
42RNDRNG_PHYSN_SPCLTY_CDClaim or Revenue Center Rendering Physician Specialty Code
45THRPY_CAP_IND_CD1Therapy cap Indicator 1 Code
46THRPY_CAP_IND_CD2Therapy cap Indicator 2 Code
47TRNSTNL_DRUG_ADD_ON_PYMT_AMTTransitional Drug Add-On Payment Amount
278REV_CNTR_RP_IND_CDRevenue Center Representative Payee (RP) Indicator Code

Condition Code File

SAS NameVariable Name
1BENE_IDEncrypted CCW Beneficiary ID
2CLM_IDClaim ID
3NCH_CLM_TYPE_CDNCH Claim Type Code
4RLT_COND_CD_SEQClaim Related Condition Code Sequence
5CLM_RLT_COND_CDClaim Related Condition Code (FFS)

Occurence Code File

SAS NameVariable Name
1BENE_IDEncrypted CCW Beneficiary ID
2CLM_IDClaim ID
3NCH_CLM_TYPE_CDNCH Claim Type Code
4RLT_OCRNC_CD_SEQClaim Related Occurrence Code Sequence
5CLM_RLT_OCRNC_CDClaim Related Occurrence Code (FFS)
6CLM_RLT_OCRNC_DTClaim Related Occurrence Date (FFS)

Span Code File

SAS NameVariable Name
1BENE_IDEncrypted CCW Beneficiary ID
2CLM_IDClaim ID
3NCH_CLM_TYPE_CDNCH Claim Type Code
4RLT_SPAN_CD_SEQClaim Related Span Code Sequence
5CLM_SPAN_CDClaim Occurrence Span Code (FFS)
6CLM_SPAN_FROM_DTClaim Occurrence Span From Date (FFS)
7CLM_SPAN_THRU_DTClaim Occurrence Span Through Date (FFS)

Value Code File

SAS NameVariable Name
1BENE_IDEncrypted CCW Beneficiary ID
2CLM_IDClaim ID
3NCH_CLM_TYPE_CDNCH Claim Type Code
4RLT_VAL_CD_SEQClaim Related Value Code Sequence
5CLM_VAL_CDClaim Value Code (FFS)
6CLM_VAL_AMTClaim Value Amount

Demonstrations/Innovations Code File

SAS NameVariable Name
1BENE_IDEncrypted CCW Beneficiary ID
2CLM_IDClaim ID
3NCH_CLM_TYPE_CDNCH Claim Type Code
4DEMO_ID_SQNC_NUMDemonstration sequence number
5DEMO_ID_NUMDemonstration number
6DEMO_INFO_TXTDemo information text
CSV