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File Version: K, CCW Data Documentation April, 2020

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)
19FI_CLM_ACTN_CDFI or MAC Claim Action Code
20PRVDR_STATE_CDNCH Provider SSA State Code
21ORG_NPI_NUMOrganization (or group) NPI Number
22SRVC_LOC_NPI_NUMClaim Service Location NPI Number
23AT_PHYSN_UPINClaim Attending Physician UPIN Number
24AT_PHYSN_NPIClaim Attending Physician NPI Number (FFS)
25AT_PHYSN_SPCLTY_CDClaim Attending Physician Specialty Code
26OP_PHYSN_NPIClaim Operating Physician NPI Number (FFS)
27OP_PHYSN_SPCLTY_CDClaim Operating Physician Specialty Code
28OT_PHYSN_NPIClaim Other Physician NPI Number (FFS)
29OT_PHYSN_SPCLTY_CDClaim Other Physician Specialty Code
30RNDRNG_PHYSN_NPIRendering Physician NPI (FFS)
31RNDRNG_PHYSN_SPCLTY_CDClaim or Revenue Center Rendering Physician Specialty Code
32RFRG_NPIClaim Referring Physician NPI Number
33RFRG_SPCLTY_CDClaim Referring Physician Specialty Code
34PTNT_DSCHRG_STUS_CDPatient Discharge Status Code (FFS)
35CLM_TOT_CHRG_AMTClaim Total Charge Amount
36NCH_PTNT_STATUS_IND_CDNCH Patient Status Indicator Code
37CLM_UTLZTN_DAY_CNTClaim Medicare Utilization Day Count
38NCH_BENE_DSCHRG_DTNCH Beneficiary Discharge Date
39PRNCPAL_DGNS_CDClaim Principal Diagnosis Code (FFS)
40ICD_DGNS_CD1Claim Diagnosis Code I (FFS)
41ICD_DGNS_CD2Claim Diagnosis Code II (FFS)
42ICD_DGNS_CD3Claim Diagnosis Code III (FFS)
43ICD_DGNS_CD4Claim Diagnosis Code IV (FFS)
44ICD_DGNS_CD5Claim Diagnosis Code V (FFS)
45ICD_DGNS_CD6Claim Diagnosis Code VI (FFS)
46ICD_DGNS_CD7Claim Diagnosis Code VII (FFS)
47ICD_DGNS_CD8Claim Diagnosis Code VIII (FFS)
48ICD_DGNS_CD9Claim Diagnosis Code IX (FFS)
49ICD_DGNS_CD10Claim Diagnosis Code X (FFS)
50ICD_DGNS_CD11Claim Diagnosis Code XI (FFS)
51ICD_DGNS_CD12Claim Diagnosis Code XII (FFS)
52ICD_DGNS_CD13Claim Diagnosis Code XIII (FFS)
53ICD_DGNS_CD14Claim Diagnosis Code XIV (FFS)
54ICD_DGNS_CD15Claim Diagnosis Code XV (FFS)
55ICD_DGNS_CD16Claim Diagnosis Code XVI (FFS)
56ICD_DGNS_CD17Claim Diagnosis Code XVII (FFS)
57ICD_DGNS_CD18Claim Diagnosis Code XVIII (FFS)
58ICD_DGNS_CD19Claim Diagnosis Code XIX (FFS)
59ICD_DGNS_CD20Claim Diagnosis Code XX (FFS)
60ICD_DGNS_CD21Claim Diagnosis Code XXI (FFS)
61ICD_DGNS_CD22Claim Diagnosis Code XXII (FFS)
62ICD_DGNS_CD23Claim Diagnosis Code XXIII (FFS)
63ICD_DGNS_CD24Claim Diagnosis Code XXIV (FFS)
64ICD_DGNS_CD25Claim Diagnosis Code XXV (FFS)
65FST_DGNS_E_CDFirst Claim Diagnosis E Code (FFS)
66ICD_DGNS_E_CD1Claim Diagnosis E Code I (FFS)
67ICD_DGNS_E_CD2Claim Diagnosis E Code II (FFS)
68ICD_DGNS_E_CD3Claim Diagnosis E Code III (FFS)
69ICD_DGNS_E_CD4Claim Diagnosis E Code IV (FFS)
70ICD_DGNS_E_CD5Claim Diagnosis E Code V (FFS)
71ICD_DGNS_E_CD6Claim Diagnosis E Code VI (FFS)
72ICD_DGNS_E_CD7Claim Diagnosis E Code VII (FFS)
73ICD_DGNS_E_CD8Claim Diagnosis E Code VIII (FFS)
74ICD_DGNS_E_CD9Claim Diagnosis E Code IX (FFS)
75ICD_DGNS_E_CD10Claim Diagnosis E Code X (FFS)
76ICD_DGNS_E_CD11Claim Diagnosis E Code XI
77ICD_DGNS_E_CD12Claim Diagnosis E Code XII
78CLM_HOSPC_START_DT_IDClaim Hospice Start Date
79BENE_HOSPC_PRD_CNTBeneficiary's Hospice Period Count
80DOB_DTDate of Birth from Claim
81GNDR_CDGender Code from Claim
82BENE_RACE_CDBeneficiary Race Code (FFS)
83BENE_CNTY_CDCounty Code from Claim (SSA)
84BENE_STATE_CDBeneficiary Residence (SSA) State Code (FFS)
85BENE_MLG_CNTCT_ZIP_CDZip Code of Residence from Claim
86CLM_MDCL_RECClaim Medical Record Number (FFS)
87CLM_TRTMT_AUTHRZTN_NUMClaim Treatment Authorization Number
88CLM_PRCR_RTRN_CDClaim Pricer Return Code
89CLM_SRVC_FAC_ZIP_CDClaim service facility ZIP code (where service was provided)
90CLM_NEXT_GNRTN_ACO_IND_CD1Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Population-Based Payment (PBP)
91CLM_NEXT_GNRTN_ACO_IND_CD2Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Telehealth
92CLM_NEXT_GNRTN_ACO_IND_CD3Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Post Discharge HH visits
93CLM_NEXT_GNRTN_ACO_IND_CD4Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - 3-day SNF waiver
94CLM_NEXT_GNRTN_ACO_IND_CD5Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Capitation
95ACO_ID_NUMClaim Accountable Care Organization (ACO) Identification Number
96CLM_BENE_ID_TYPE_CDClaim Beneficiary Identifier Type Code
97CLM_RSDL_PYMT_IND_CDClaim Residual Payment Indicator Code
98PRVDR_VLDTN_TYPE_CDProvider Validation Type Code
99RR_BRD_EXCLSN_IND_SWRailroad Board Exclusion Indicator Switch
100CLM_MODEL_REIMBRSMT_AMTClaim Model Reimbursement Amount

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
8HCPCS_CDHealthcare Common Procedure Coding System (HCPCS) Code (FFS)
9HCPCS_1st_mdfr_cdHCPCS Initial Modifier Code (FFS)
10HCPCS_2ND_MDFR_CDHCPCS Second Modifier Code (FFS)
11HCPCS_3RD_MDFR_CDHCPCS Third Modifier Code (FFS)
12REV_CNTR_UNIT_CNTRevenue Center Unit Count (FFS)
13REV_CNTR_RATE_AMTRevenue Center Rate Amount
14REV_CNTR_PRVDR_PMT_AMTRevenue Center (Medicare) Provider Payment Amount
15REV_CNTR_PMT_AMT_AMTRevenue Center (Medicare) Payment Amount
16REV_CNTR_TOT_CHRG_AMTRevenue Center Total Charge Amount
17REV_CNTR_NCVRD_CHRG_AMTRevenue Center Non-Covered Charge Amount
18REV_CNTR_DDCTBL_COINSRNC_CDRevenue Center Deductible Coinsurance Code
19REV_CNTR_BENE_PMT_AMTRevenue Center Payment Amount to Beneficiary
20REV_CNTR_NDC_QTYRevenue Center National Drug Code (NDC) Quantity (FFS)
21REV_CNTR_NDC_QTY_QLFR_CDRevenue Center NDC Quantity Qualifier Code (FFS)
22RNDRNG_PHYSN_UPINRevenue Center Rendering Physician UPIN
23RNDRNG_PHYSN_NPIRendering Physician NPI (FFS)
24RNDRNG_PHYSN_SPCLTY_CDClaim or Revenue Center Rendering Physician Specialty Code
25REV_CNTR_IDE_NDC_UPC_NUMRevenue Center IDE, NDC, or UPC Number (FFS)
26REVSTINDRevenue Center Status Indicator Code
27REV_CNTR_PRCNG_IND_CDRevenue Center Pricing Indicator Code
28THRPY_CAP_IND_CD1Therapy cap Indicator 1 Code
29THRPY_CAP_IND_CD2Therapy cap Indicator 2 Code
30REV_CNTR_RP_IND_CDRevenue Center Representative Payee (RP) Indicator Code
3NCH_CLM_TYPE_CDNCH Claim Type 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
4DEMO_ID_SQNC_NUMDemonstration sequence number
5DEMO_ID_NUMDemonstration number
6DEMO_INFO_TXTDemo information text
CSV