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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
18NCH_PRMRY_PYR_CLM_PD_AMTNCH Primary Payer (if not Medicare) Claim Paid Amount
300NCH_PRMRY_PYR_CDNCH Primary Payer Code (if not Medicare)
19FI_CLM_ACTN_CDFI or MAC Claim Action Code
20PRVDR_STATE_CDNCH Provider SSA State Code
21ORG_NPI_NUMOrganization (or group) 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)
29OP_PHYSN_SPCLTY_CDClaim Operating Physician Specialty Code
28OT_PHYSN_UPINClaim Other Physician UPIN Number
27OT_PHYSN_NPIClaim Other Physician NPI Number (FFS)
30OT_PHYSN_SPCLTY_CDClaim Other Physician Specialty Code
500RNDRNG_PHYSN_NPIRendering Physician NPI (FFS)
32CLM_RNDRNG_PHYSN_SPCLTY_CDClaim Rendering Physician Specialty Code
33CLM_MCO_PD_SWClaim MCO Paid Switch
34PTNT_DSCHRG_STUS_CDPatient Discharge Status Code (FFS)
35CLM_PPS_IND_CDClaim PPS Indicator Code
36CLM_TOT_CHRG_AMTClaim Total Charge Amount
37CLM_ADMSN_DTClaim Admission Date (FFS)
38CLM_IP_ADMSN_TYPE_CDClaim Inpatient Admission Type Code (FFS)
39CLM_SRC_IP_ADMSN_CDClaim Source Inpatient Admission Code (FFS)
40NCH_PTNT_STATUS_IND_CDNCH Patient Status Indicator Code
41NCH_BENE_IP_DDCTBL_AMTNCH Beneficiary Inpatient (or other Part A) Deductible Amount
42NCH_BENE_PTA_COINSRNC_LBLTY_AMNCH Beneficiary Part A Coinsurance Liability Amount
43NCH_BENE_BLOOD_DDCTBL_LBLTY_AMNCH Beneficiary Blood Deductible Liability Amount
44NCH_IP_NCVRD_CHRG_AMTNCH Inpatient (or other Part A) Non-covered Charge Amount
45NCH_IP_TOT_DDCTN_AMTNCH Inpatient (or other Part A) Total Deductible/Coinsurance Amount
46CLM_PPS_CPTL_FSP_AMTClaim PPS Capital Federal Specific Portion (FSP) Amount
47CLM_PPS_CPTL_OUTLIER_AMTClaim PPS Capital Outlier Amount
48CLM_PPS_CPTL_DSPRPRTNT_SHR_AMTClaim PPS Capital Disproportionate Share Amount
49CLM_PPS_CPTL_IME_AMTClaim PPS Capital Indirect Medical Education (IME) Amount
50CLM_PPS_CPTL_EXCPTN_AMTClaim PPS Capital Exception Amount
51CLM_PPS_OLD_CPTL_HLD_HRMLS_AMTClaim PPS Old Capital Hold Harmless Amount
52CLM_UTLZTN_DAY_CNTClaim Medicare Utilization Day Count
53BENE_TOT_COINSRNC_DAYS_CNTBeneficiary Total Coinsurance Days Count
54CLM_NON_UTLZTN_DAYS_CNTClaim Medicare Non Utilization Days Count
55NCH_BLOOD_PNTS_FRNSHD_QTYNCH Blood Pints Furnished Quantity
56NCH_QLFYD_STAY_FROM_DTNCH Qualified Stay From Date
57NCH_QLFYD_STAY_THRU_DTNCH Qualified Stay Through Date
58NCH_VRFD_NCVRD_STAY_FROM_DTNCH Verified Non-covered Stay From Date
59NCH_VRFD_NCVRD_STAY_THRU_DTNCH Verified Non-covered Stay Through Date
60NCH_ACTV_OR_CVRD_LVL_CARE_THRUNCH Active or Covered Level Care Thru Date
61NCH_BENE_MDCR_BNFTS_EXHTD_DT_INCH Beneficiary Medicare Benefits Exhausted Date
62NCH_BENE_DSCHRG_DTNCH Beneficiary Discharge Date
63CLM_DRG_CDClaim Diagnosis Related Group Code (or MS-DRG Code)
64ADMTG_DGNS_CDClaim Admitting Diagnosis Code (FFS)
65PRNCPAL_DGNS_CDClaim Principal Diagnosis Code (FFS)
66ICD_DGNS_CD1Claim Diagnosis Code I (FFS)
67ICD_DGNS_CD2Claim Diagnosis Code II (FFS)
68ICD_DGNS_CD3Claim Diagnosis Code III (FFS)
69ICD_DGNS_CD4Claim Diagnosis Code IV (FFS)
70ICD_DGNS_CD5Claim Diagnosis Code V (FFS)
71ICD_DGNS_CD6Claim Diagnosis Code VI (FFS)
72ICD_DGNS_CD7Claim Diagnosis Code VII (FFS)
73ICD_DGNS_CD8Claim Diagnosis Code VIII (FFS)
74ICD_DGNS_CD9Claim Diagnosis Code IX (FFS)
75ICD_DGNS_CD10Claim Diagnosis Code X (FFS)
76ICD_DGNS_CD11Claim Diagnosis Code XI (FFS)
77ICD_DGNS_CD12Claim Diagnosis Code XII (FFS)
78ICD_DGNS_CD13Claim Diagnosis Code XIII (FFS)
79ICD_DGNS_CD14Claim Diagnosis Code XIV (FFS)
80ICD_DGNS_CD15Claim Diagnosis Code XV (FFS)
81ICD_DGNS_CD16Claim Diagnosis Code XVI (FFS)
82ICD_DGNS_CD17Claim Diagnosis Code XVII (FFS)
83ICD_DGNS_CD18Claim Diagnosis Code XVIII (FFS)
84ICD_DGNS_CD19Claim Diagnosis Code XIX (FFS)
85ICD_DGNS_CD20Claim Diagnosis Code XX (FFS)
86ICD_DGNS_CD21Claim Diagnosis Code XXI (FFS)
87ICD_DGNS_CD22Claim Diagnosis Code XXII (FFS)
88ICD_DGNS_CD23Claim Diagnosis Code XXIII (FFS)
89ICD_DGNS_CD24Claim Diagnosis Code XXIV (FFS)
90ICD_DGNS_CD25Claim Diagnosis Code XXV (FFS)
91FST_DGNS_E_CDFirst Claim Diagnosis E Code (FFS)
92ICD_DGNS_E_CD1Claim Diagnosis E Code I (FFS)
93ICD_DGNS_E_CD2Claim Diagnosis E Code II (FFS)
94ICD_DGNS_E_CD3Claim Diagnosis E Code III (FFS)
95ICD_DGNS_E_CD4Claim Diagnosis E Code IV (FFS)
96ICD_DGNS_E_CD5Claim Diagnosis E Code V (FFS)
97ICD_DGNS_E_CD6Claim Diagnosis E Code VI (FFS)
98ICD_DGNS_E_CD7Claim Diagnosis E Code VII (FFS)
99ICD_DGNS_E_CD8Claim Diagnosis E Code VIII (FFS)
100ICD_DGNS_E_CD9Claim Diagnosis E Code IX (FFS)
101ICD_DGNS_E_CD10Claim Diagnosis E Code X (FFS)
102ICD_DGNS_E_CD11Claim Diagnosis E Code XI
103ICD_DGNS_E_CD12Claim Diagnosis E Code XII
104ICD_PRCDR_CD1Claim Procedure Code I (FFS)
105PRCDR_DT1Claim Procedure Code I Date (FFS)
106ICD_PRCDR_CD2Claim Procedure Code II (FFS)
107PRCDR_DT2Claim Procedure Code II Date (FFS)
108ICD_PRCDR_CD3Claim Procedure Code III (FFS)
109PRCDR_DT3Claim Procedure Code III Date (FFS)
110ICD_PRCDR_CD4Claim Procedure Code IV (FFS)
111PRCDR_DT4Claim Procedure Code IV Date (FFS)
112ICD_PRCDR_CD5Claim Procedure Code V (FFS)
113PRCDR_DT5Claim Procedure Code V Date (FFS)
114ICD_PRCDR_CD6Claim Procedure Code VI (FFS)
115PRCDR_DT6Claim Procedure Code VI Date (FFS)
116ICD_PRCDR_CD7Claim Procedure Code VII (FFS)
117PRCDR_DT7Claim Procedure Code VII Date (FFS)
118ICD_PRCDR_CD8Claim Procedure Code VIII (FFS)
119PRCDR_DT8Claim Procedure Code VIII Date (FFS)
120ICD_PRCDR_CD9Claim Procedure Code IX (FFS)
121PRCDR_DT9Claim Procedure Code IX Date (FFS)
122ICD_PRCDR_CD10Claim Procedure Code X (FFS)
123PRCDR_DT10Claim Procedure Code X Date (FFS)
124ICD_PRCDR_CD11Claim Procedure Code XI (FFS)
125PRCDR_DT11Claim Procedure Code XI Date (FFS)
126ICD_PRCDR_CD12Claim Procedure Code XII (FFS)
127PRCDR_DT12Claim Procedure Code XII Date (FFS)
128ICD_PRCDR_CD13Claim Procedure Code XIII (FFS)
129PRCDR_DT13Claim Procedure Code XIII Date (FFS)
130ICD_PRCDR_CD14Claim Procedure Code XIV
131PRCDR_DT14Claim Procedure Code XIV Date
132ICD_PRCDR_CD15Claim Procedure Code XV
133PRCDR_DT15Claim Procedure Code XV Date
134ICD_PRCDR_CD16Claim Procedure Code XVI
135PRCDR_DT16Claim Procedure Code XVI Date
136ICD_PRCDR_CD17Claim Procedure Code XVII
137PRCDR_DT17Claim Procedure Code XVII Date
138ICD_PRCDR_CD18Claim Procedure Code XVIII
139PRCDR_DT18Claim Procedure Code XVIII Date
140ICD_PRCDR_CD19Claim Procedure Code XIX
141PRCDR_DT19Claim Procedure Code XIX Date
142ICD_PRCDR_CD20Claim Procedure Code XX
143PRCDR_DT20Claim Procedure Code XX Date
144ICD_PRCDR_CD21Claim Procedure Code XXI
145PRCDR_DT21Claim Procedure Code XXI Date
146ICD_PRCDR_CD22Claim Procedure Code XXII
147PRCDR_DT22Claim Procedure Code XXII Date
148ICD_PRCDR_CD23Claim Procedure Code XXIII
149PRCDR_DT23Claim Procedure Code XXIII Date
150ICD_PRCDR_CD24Claim Procedure Code XXIV
151PRCDR_DT24Claim Procedure Code XXIV Date
152ICD_PRCDR_CD25Claim Procedure Code XXV
153PRCDR_DT25Claim Procedure Code XXV Date
154DOB_DTDate of Birth from Claim
155GNDR_CDGender Code from Claim
156BENE_RACE_CDBeneficiary Race Code (FFS)
157BENE_CNTY_CDCounty Code from Claim (SSA)
158BENE_STATE_CDBeneficiary Residence (SSA) State Code (FFS)
159BENE_MLG_CNTCT_ZIP_CDZip Code of Residence from Claim
160CLM_MDCL_RECClaim Medical Record Number (FFS)
161CLM_TRTMT_AUTHRZTN_NUMClaim Treatment Authorization Number
310CLM_PRCR_RTRN_CDClaim Pricer Return Code
311CLM_SRVC_FAC_ZIP_CDClaim service facility ZIP code (where service was provided)
312NCH_PROFNL_CMPNT_CHRG_AMTProfessional Component Charge Amount
314CLM_NEXT_GNRTN_ACO_IND_CD1Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Population-Based Payment (PBP)
315CLM_NEXT_GNRTN_ACO_IND_CD2Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Telehealth
316CLM_NEXT_GNRTN_ACO_IND_CD3Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Post Discharge HH visits
317CLM_NEXT_GNRTN_ACO_IND_CD4Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - 3-day SNF waiver
318CLM_NEXT_GNRTN_ACO_IND_CD5Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Capitation
170ACO_ID_NUMClaim Accountable Care Organization (ACO) Identification Number
313CLM_BENE_ID_TYPE_CDClaim Beneficiary Identifier Type Code
300CLM_RSDL_PYMT_IND_CDClaim Residual Payment Indicator Code
301PRVDR_VLDTN_TYPE_CDProvider Validation Type Code
302RR_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)
7HCPCS_CDHealthcare Common Procedure Coding System (HCPCS) Code (FFS)
8HCPCS_1st_mdfr_cdHCPCS Initial Modifier Code (FFS)
9HCPCS_2ND_MDFR_CDHCPCS Second Modifier Code (FFS)
10HCPCS_3RD_MDFR_CDHCPCS Third Modifier Code (FFS)
11REV_CNTR_UNIT_CNTRevenue Center Unit Count (FFS)
12REV_CNTR_RATE_AMTRevenue Center Rate Amount
13REV_CNTR_TOT_CHRG_AMTRevenue Center Total Charge Amount
14REV_CNTR_NCVRD_CHRG_AMTRevenue Center Non-Covered Charge Amount
15REV_CNTR_DDCTBL_COINSRNC_CDRevenue Center Deductible Coinsurance Code
16REV_CNTR_NDC_QTYRevenue Center National Drug Code (NDC) Quantity (FFS)
17REV_CNTR_NDC_QTY_QLFR_CDRevenue Center NDC Quantity Qualifier Code (FFS)
18RNDRNG_PHYSN_UPINRevenue Center Rendering Physician UPIN
501RNDRNG_PHYSN_NPIRendering Physician NPI (FFS)
20RNDRNG_PHYSN_SPCLTY_CDClaim or Revenue Center Rendering Physician Specialty Code
21REV_CNTR_IDE_NDC_UPC_NUMRevenue Center IDE, NDC, or UPC Number (FFS)
22REV_CNTR_PRCNG_IND_CDRevenue Center Pricing Indicator Code
23THRPY_CAP_IND_CD1Therapy cap Indicator 1 Code
24THRPY_CAP_IND_CD2Therapy cap Indicator 2 Code
303REV_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