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File Version: CCW record layout accessed May, 2019; CMS MAX 2014 data dictionary Aug 16, 2018

SAS NameVariable Name
639BENE_IDEncrypted 723 CCW Beneficiary ID
2MSIS_IDEncrypted MSIS Identification Number
4EL_STATE_CASE_NUMEncrypted Case Number
6HGT_FLAGSSN (from MSIS) High Group Test
7EXT_SSN_SRCEExternal SSN source
640EL_DOBDate of Birth (MAX)
9AGE_GRP_CDAge Group
11EL_RACE_ETHNCY_CDRace/ethnicity (from MSIS)
12RACE_CODE_1Race - White (from MSIS)
13RACE_CODE_2Race - Black (from MSIS)
14RACE_CODE_3Race - Am Indian/Alaskan (from MSIS)
15RACE_CODE_4Race - Asian (from MSIS)
16RACE_CODE_5Race - Hawaiian/Pac Islands (from MSIS)
17ETHNICITY_CODEEthnicity - Hispanic (from MSIS)
18MDCR_RACE_ETHNCY_CDRace/ethnicity (from Medicare EDB)
19MDCR_LANG_CDLanguage code (from Medicare EDB)
21EL_DODDate of death (from MSIS)
22MDCR_DODDate of death (from Medicare EDB)
23MDCR_DEATH_DAY_SWDay of death verified (from Mcare EDB)
24EL_RSDNC_CNTY_CD_LTSTCounty of residence
25EL_RSDNC_ZIP_CD_LTSTZip Code of Residence (MAX)
26EL_SS_ELGBLTY_CD_LTSTState specific eligibility - most recent
27EL_MAX_ELGBLTY_CD_LTSTMAX eligibility - most recent (PS)
28MSNG_ELG_DATA Missing eligibility data
29EL_ELGBLTY_MO_CNTEligible months
30EL_PRVT_INSRNC_MO_CNT Private insurance months
31EL_MDCR_ANN_XOVR_OLDCrossover code (Old Annual)
32EL_MDCR_QTR_XOVR_OLD_1Quarterly crossover code (Old Quarter 1)
33EL_MDCR_QTR_XOVR_OLD_2Quarterly crossover code (Old Quarter 2)
34EL_MDCR_QTR_XOVR_OLD_3Quarterly crossover code (Old Quarter 3)
35EL_MDCR_QTR_XOVR_OLD_4Quarterly crossover code (Old Quarter 4)
36EL_MDCR_DUAL_ANNMedicare dual code (Annual)
37EL_MDCR_QTR_XOVR_99_1Quarterly crossover code (Quarter 1)
38EL_MDCR_QTR_XOVR_99_2Quarterly crossover code (Quarter 2)
39EL_MDCR_QTR_XOVR_99_3Quarterly crossover code (Quarter 3)
40EL_MDCR_QTR_XOVR_99_4Quarterly crossover code (Quarter 4)
41EL_MDCR_BEN_MO_CNTMedicare beneficiary mos (from Medicare EDB)
42MDCR_ORIG_REAS_CDMcare orig entitlemt reason (from EDB)
639EL_MDCR_DUAL_MO_1 Medicare dual code (Jan)
640EL_MDCR_DUAL_MO_2Medicare dual code (Feb)
641EL_MDCR_DUAL_MO_3Medicare dual code (Mar)
643EL_MDCR_DUAL_MO_4Medicare dual code (Apr)
643EL_MDCR_DUAL_MO_5Medicare dual code (May)
644EL_MDCR_DUAL_MO_6Medicare dual code (Jun)
645EL_MDCR_DUAL_MO_7Medicare dual code (Jul)
646EL_MDCR_DUAL_MO_8Medicare dual code (Aug)
647EL_MDCR_DUAL_MO_9Medicare dual code (Sep)
648EL_MDCR_DUAL_MO_10Medicare dual code (Oct)
649EL_MDCR_DUAL_MO_11Medicare dual code (Nov)
650EL_MDCR_DUAL_MO_12Medicare dual code (Dec)
651SS_ELG_CD_MO_1 State specific eligibility group (Jan)
652SS_ELG_CD_MO_2State specific eligibility group (Feb)
653SS_ELG_CD_MO_3State specific eligibility group (Mar)
654SS_ELG_CD_MO_4State specific eligibility group (Apr)
655SS_ELG_CD_MO_5State specific eligibility group (May)
656SS_ELG_CD_MO_6State specific eligibility group (Jun)
657SS_ELG_CD_MO_7State specific eligibility group (Jul)
658SS_ELG_CD_MO_8State specific eligibility group (Aug)
659SS_ELG_CD_MO_9State specific eligibility group (Sep)
660SS_ELG_CD_MO_10State specific eligibility group (Oct)
661SS_ELG_CD_MO_11State specific eligibility group (Nov)
662SS_ELG_CD_MO_12State specific eligibility group (Dec)
665MAX_ELG_CD_MO_1MAX eligibility group (Jan)
666MAX_ELG_CD_MO_2MAX eligibility group (Feb)
667MAX_ELG_CD_MO_3MAX eligibility group (Mar)
668MAX_ELG_CD_MO_4MAX eligibility group (Apr)
669MAX_ELG_CD_MO_5MAX eligibility group (May)
670MAX_ELG_CD_MO_6MAX eligibility group (Jun)
671MAX_ELG_CD_MO_7MAX eligibility group (Jul)
672MAX_ELG_CD_MO_8MAX eligibility group (Aug)
673MAX_ELG_CD_MO_9MAX eligibility group (Sep)
674MAX_ELG_CD_MO_10MAX eligibility group (Oct)
872MAX_ELG_CD_MO_11MAX eligibility group (Nov)
676MAX_ELG_CD_MO_12MAX eligibility group (Dec)
677EL_PVT_INS_CD_1Private health insurance group (Jan)
678EL_PVT_INS_CD_2Private health insurance group (Feb)
679EL_PVT_INS_CD_3Private health insurance group (Mar)
680EL_PVT_INS_CD_4Private health insurance group (Apr)
681EL_PVT_INS_CD_5Private health insurance group (May)
682EL_PVT_INS_CD_6Private health insurance group (Jun)
683EL_PVT_INS_CD_7Private health insurance group (Jul)
684EL_PVT_INS_CD_8Private health insurance group (Aug)
685EL_PVT_INS_CD_9Private health insurance group (Sep)
686EL_PVT_INS_CD_10Private health insurance group (Oct)
687EL_PVT_INS_CD_11Private health insurance group (Nov)
688EL_PVT_INS_CD_12Private health insurance group (Dec)
689EL_MDCR_BEN_MO_1 Medicare beneficiary (Jan)
690EL_MDCR_BEN_MO_2Medicare beneficiary (Feb)
690EL_MDCR_BEN_MO_3Medicare beneficiary (Mar)
692EL_MDCR_BEN_MO_4Medicare beneficiary (Apr)
694EL_MDCR_BEN_MO_5Medicare beneficiary (May)
694EL_MDCR_BEN_MO_6Medicare beneficiary (Jun)
695EL_MDCR_BEN_MO_7Medicare beneficiary (Jul)
696EL_MDCR_BEN_MO_8Medicare beneficiary (Aug)
697EL_MDCR_BEN_MO_9Medicare beneficiary (Sep)
698EL_MDCR_BEN_MO_10Medicare beneficiary (Oct)
699EL_MDCR_BEN_MO_11Medicare beneficiary (Nov)
700EL_MDCR_BEN_MO_12Medicare beneficiary (Dec)
103EL_PPH_PLN_MO_CNT_CMCPPrepaid plan months (comprehen plans)
104EL_PPH_PLN_MO_CNT_DMCPPrepaid plan months (DMCP)
105EL_PPH_PLN_MO_CNT_BMCPPrepaid plan months (BMCP)
106EL_PPH_PLN_MO_CNT_PDMCPrepaid plan months (PDMC)
107EL_PPH_PLN_MO_CNT_LTCMPrepaid plan months (LTCM)
108EL_PPH_PLN_MO_CNT_AICEPrepaid plan months (AICE)
109EL_PPH_PLN_MO_CNT_PCCMPrepaid plan months (PCCM)
701EL_PHP_TYPE_1_1Prepaid plan type-1 (Jan)
713EL_PHP_ID_1_1Prepaid plan identifier-1 (Jan)
725EL_PHP_TYPE_2_1Prepaid plan type-2 (Jan)
738EL_PHP_ID_2_1Prepaid plan identifier-2 (Jan)
750EL_PHP_TYPE_3_1Prepaid plan type-3 (Jan)
776EL_PHP_ID_3_1Prepaid plan identifier-3 (Jan)
116EL_PHP_TYPE_4_1 Prepaid plan type-4 (Jan)
816EL_PHP_ID_4_1Prepaid plan identifier-4 (Jan)
702EL_PHP_TYPE_1_2Prepaid plan type-1 (Feb)
714EL_PHP_ID_1_2Prepaid plan identifier-1 (Feb)
727EL_PHP_TYPE_2_2Prepaid plan type-2 (Feb)
739EL_PHP_ID_2_2Prepaid plan identifier-2 (Feb)
751EL_PHP_TYPE_3_2Prepaid plan type-3 (Feb)
777EL_PHP_ID_3_2Prepaid plan identifier-3 (Feb)
805EL_PHP_TYPE_4_2Prepaid plan type-4 (Feb)
817EL_PHP_ID_4_2Prepaid plan identifier-4 (Feb)
703EL_PHP_TYPE_1_3Prepaid plan type-1 (Mar)
715EL_PHP_ID_1_3Prepaid plan identifier-1 (Mar)
728EL_PHP_TYPE_2_3Prepaid plan type-2 (Mar)
740EL_PHP_ID_2_3Prepaid plan identifier-2 (Mar)
752EL_PHP_TYPE_3_3Prepaid plan type-3 (Mar)
778EL_PHP_ID_3_3Prepaid plan identifier-3 (Mar)
806EL_PHP_TYPE_4_3Prepaid plan type-4 (Mar)
818EL_PHP_ID_4_3Prepaid plan identifier-4 (Mar)
704EL_PHP_TYPE_1_4Prepaid plan type-1 (Apr)
716EL_PHP_ID_1_4Prepaid plan identifier-1 (Apr)
729EL_PHP_TYPE_2_4Prepaid plan type-2 (Apr)
741EL_PHP_ID_2_4Prepaid plan identifier-2 (Apr)
753EL_PHP_TYPE_3_4Prepaid plan type-3 (Apr)
779EL_PHP_ID_3_4Prepaid plan identifier-3 (Apr)
807EL_PHP_TYPE_4_4Prepaid plan type-4 (Apr)
819EL_PHP_ID_4_4Prepaid plan identifier-4 (Apr)
705EL_PHP_TYPE_1_5Prepaid plan type-1 (May)
717EL_PHP_ID_1_5Prepaid plan identifier-1 (May)
730EL_PHP_TYPE_2_5Prepaid plan type-2 (May)
742EL_PHP_ID_2_5Prepaid plan identifier-2 (May)
754EL_PHP_TYPE_3_5Prepaid plan type-3 (May)
780EL_PHP_ID_3_5Prepaid plan identifier-3 (May)
808EL_PHP_TYPE_4_5Prepaid plan type-4 (May)
820EL_PHP_ID_4_5Prepaid plan identifier-4 (May)
706EL_PHP_TYPE_1_6Prepaid plan type-1 (Jun)
718EL_PHP_ID_1_6Prepaid plan identifier-1 (Jun)
731EL_PHP_TYPE_2_6Prepaid plan type-2 (Jun)
743EL_PHP_ID_2_6Prepaid plan identifier-2 (Jun)
755EL_PHP_TYPE_3_6Prepaid plan type-3 (Jun)
781EL_PHP_ID_3_6Prepaid plan identifier-3 (Jun)
809EL_PHP_TYPE_4_6Prepaid plan type-4 (Jun)
821EL_PHP_ID_4_6Prepaid plan identifier-4 (Jun)
707EL_PHP_TYPE_1_7Prepaid plan type-1 (Jul)
719EL_PHP_ID_1_7Prepaid plan identifier-1 (Jul)
732EL_PHP_TYPE_2_7Prepaid plan type-2 (Jul)
873EL_PHP_ID_2_7Prepaid plan identifier-2 (Jul)
756EL_PHP_TYPE_3_7Prepaid plan type-3 (Jul)
782EL_PHP_ID_3_7Prepaid plan identifier-3 (Jul)
810EL_PHP_TYPE_4_7Prepaid plan type-4 (Jul)
822EL_PHP_ID_4_7Prepaid plan identifier-4 (Jul)
708EL_PHP_TYPE_1_8Prepaid plan type-1 (Aug)
720EL_PHP_ID_1_8Prepaid plan identifier-1 (Aug)
733EL_PHP_TYPE_2_8Prepaid plan type-2 (Aug)
745EL_PHP_ID_2_8Prepaid plan identifier-2 (Aug)
758EL_PHP_TYPE_3_8Prepaid plan type-3 (Aug)
783EL_PHP_ID_3_8Prepaid plan identifier-3 (Aug)
811EL_PHP_TYPE_4_8Prepaid plan type-4 (Aug)
823EL_PHP_ID_4_8Prepaid plan identifier-4 (Aug)
709EL_PHP_TYPE_1_9Prepaid plan type-1 (Sep)
721EL_PHP_ID_1_9Prepaid plan identifier-1 (Sep)
734EL_PHP_TYPE_2_9Prepaid plan type-2 (Sep)
746EL_PHP_ID_2_9Prepaid plan identifier-2 (Sep)
757EL_PHP_TYPE_3_9Prepaid plan type-3 (Sep)
785EL_PHP_ID_3_9Prepaid plan identifier-3 (Sep)
812EL_PHP_TYPE_4_9 Prepaid plan type-4 (Sep)
824EL_PHP_ID_4_9Prepaid plan identifier-4 (Sep)
800EL_PHP_TYPE_1_10Prepaid plan type-1 (Oct)
801EL_PHP_ID_1_10Prepaid plan identifier-1 (Oct)
802EL_PHP_TYPE_2_10Prepaid plan type-2 (Oct)
747EL_PHP_ID_2_10Prepaid plan identifier-2 (Oct)
772EL_PHP_TYPE_3_10Prepaid plan type-3 (Oct)
786EL_PHP_ID_3_10Prepaid plan identifier-3 (Oct)
813EL_PHP_TYPE_4_10Prepaid plan type-4 (Oct)
825EL_PHP_ID_4_10Prepaid plan identifier-4 (Oct)
773EL_PHP_TYPE_1_11Prepaid plan type-1 (Nov)
723EL_PHP_ID_1_11Prepaid plan identifier-1 (Nov)
736EL_PHP_TYPE_2_11Prepaid plan type-2 (Nov)
774EL_PHP_ID_2_11Prepaid plan identifier-2 (Nov)
771EL_PHP_TYPE_3_11Prepaid plan type-3 (Nov)
803EL_PHP_ID_3_11Prepaid plan identifier-3 (Nov)
814EL_PHP_TYPE_4_11Prepaid plan type-4 (Nov)
826EL_PHP_ID_4_11Prepaid plan identifier-4 (Nov)
712EL_PHP_TYPE_1_12Prepaid plan type-1 (Dec)
724EL_PHP_ID_1_12Prepaid plan identifier-1 (Dec)
737EL_PHP_TYPE_2_12Prepaid plan type-2 (Dec)
749EL_PHP_ID_2_12Prepaid plan identifier-2 (Dec)
775EL_PHP_TYPE_3_12Prepaid plan type-3 (Dec)
804EL_PHP_ID_3_12Prepaid plan identifier-3 (Dec)
815EL_PHP_TYPE_4_12Prepaid plan type-4 (Dec)
827EL_PHP_ID_4_12Prepaid plan identifier-4 (Dec)
206MC_COMBO_MO_1Managed care combinations (Jan)
828MC_COMBO_MO_2Managed care combinations (Feb)
829MC_COMBO_MO_3Managed care combinations (Mar)
830MC_COMBO_MO_4Managed care combinations (Apr)
831MC_COMBO_MO_5Managed care combinations (May)
832MC_COMBO_MO_6Managed care combinations (Jun)
833MC_COMBO_MO_7Managed care combinations (Jul)
834MC_COMBO_MO_8Managed care combinations (Aug)
835MC_COMBO_MO_9Managed care combinations (Sep)
836MC_COMBO_MO_10Managed care combinations (Oct)
837MC_COMBO_MO_11Managed care combinations (Nov)
838MC_COMBO_MO_12Managed care combinations (Dec)
218EL_DAYS_EL_CNT_1Days of eligibility (Jan)
839EL_DAYS_EL_CNT_2Days of eligibility (Feb)
840EL_DAYS_EL_CNT_3Days of eligibility (Mar)
841EL_DAYS_EL_CNT_4Days of eligibility (Apr)
842EL_DAYS_EL_CNT_5Days of eligibility (May)
843EL_DAYS_EL_CNT_6Days of eligibility (Jun)
844EL_DAYS_EL_CNT_7Days of eligibility (Jul)
845EL_DAYS_EL_CNT_8Days of eligibility (Aug)
846EL_DAYS_EL_CNT_9Days of eligibility (Sep)
847EL_DAYS_EL_CNT_10Days of eligibility (Oct)
848EL_DAYS_EL_CNT_11Days of eligibility (Nov)
849EL_DAYS_EL_CNT_12Days of eligibility (Dec)
230EL_TANF_CASH_FLG_1TANF cash eligibility (Jan)
850EL_TANF_CASH_FLG_2TANF cash eligibility (Feb)
851EL_TANF_CASH_FLG_3TANF cash eligibility (Mar)
852EL_TANF_CASH_FLG_4TANF cash eligibility (Apr)
853EL_TANF_CASH_FLG_5TANF cash eligibility (May)
854EL_TANF_CASH_FLG_6TANF cash eligibility (Jun)
855EL_TANF_CASH_FLG_7TANF cash eligibility (Jul)
856EL_TANF_CASH_FLG_8TANF cash eligibility (Aug)
857EL_TANF_CASH_FLG_9TANF cash eligibility (Sep)
858EL_TANF_CASH_FLG_10TANF cash eligibility (Oct)
859EL_TANF_CASH_FLG_11TANF cash eligibility (Nov)
860EL_TANF_CASH_FLG_12TANF cash eligibility (Dec)
242EL_RSTRCT_BNFT_FLG_1Restricted benefits (Jan)
861EL_RSTRCT_BNFT_FLG_2Restricted benefits (Feb)
862EL_RSTRCT_BNFT_FLG_3Restricted benefits (Mar)
863EL_RSTRCT_BNFT_FLG_4Restricted benefits (Apr)
864EL_RSTRCT_BNFT_FLG_5Restricted benefits (May)
865EL_RSTRCT_BNFT_FLG_6Restricted benefits (Jun)
866EL_RSTRCT_BNFT_FLG_7Restricted benefits (Jul)
867EL_RSTRCT_BNFT_FLG_8Restricted benefits (Aug)
868EL_RSTRCT_BNFT_FLG_9Restricted benefits (Sep)
869EL_RSTRCT_BNFT_FLG_10Restricted benefits (Oct)
870EL_RSTRCT_BNFT_FLG_11Restricted benefits (Nov)
871EL_RSTRCT_BNFT_FLG_12Restricted benefits (Dec)
254EL_CHIP_FLAG_1SCHIP eligibility (Jan)
874EL_CHIP_FLAG_2SCHIP eligibility (Feb)
875EL_CHIP_FLAG_3SCHIP eligibility (Mar)
876EL_CHIP_FLAG_4SCHIP eligibility (Apr)
877EL_CHIP_FLAG_5SCHIP eligibility (May)
878EL_CHIP_FLAG_6SCHIP eligibility (Jun)
879EL_CHIP_FLAG_7SCHIP eligibility (Jul)
880EL_CHIP_FLAG_8SCHIP eligibility (Aug)
881EL_CHIP_FLAG_9SCHIP eligibility (Sep)
882EL_CHIP_FLAG_10SCHIP eligibility (Oct)
883EL_CHIP_FLAG_11SCHIP eligibility (Nov)
884EL_CHIP_FLAG_12SCHIP eligibility (Dec)
266MAX_WAIVER_TYPE_1_MO_1MAX Waiver Type Code -1 (Jan)
267MAX_WAIVER_ID_1_MO_1Waiver ID-1 (Jan)
268MAX_WAIVER_TYPE_2_MO_1MAX Waiver Type Code -2 (Jan)
269MAX_WAIVER_ID_2_MO_1Waiver ID-2 (Jan)
270MAX_WAIVER_TYPE_3_MO_1MAX Waiver Type Code -3 (Jan)
271MAX_WAIVER_ID_3_MO_1Waiver ID-3 (Jan)
886MAX_WAIVER_TYPE_1_MO_2MAX Waiver Type Code -1 (Feb)
897MAX_WAIVER_ID_1_MO_2Waiver ID-1 (Feb)
911MAX_WAIVER_TYPE_2_MO_2MAX Waiver Type Code -2 (Feb)
922MAX_WAIVER_ID_2_MO_2Waiver ID-2 (Feb)
933MAX_WAIVER_TYPE_3_MO_2MAX Waiver Type Code -3 (Feb)
944MAX_WAIVER_ID_3_MO_2Waiver ID-3 (Feb)
887MAX_WAIVER_TYPE_1_MO_3MAX Waiver Type Code -1 (Mar)
898MAX_WAIVER_ID_1_MO_3Waiver ID-1 (Mar)
912MAX_WAIVER_TYPE_2_MO_3MAX Waiver Type Code -2 (Mar)
923MAX_WAIVER_ID_2_MO_3Waiver ID-2 (Mar)
934MAX_WAIVER_TYPE_3_MO_3MAX Waiver Type Code -3 (Mar)
945MAX_WAIVER_ID_3_MO_3Waiver ID-3 (Mar)
888MAX_WAIVER_TYPE_1_MO_4MAX Waiver Type Code -1 (Apr)
899MAX_WAIVER_ID_1_MO_4Waiver ID-1 (Apr)
913MAX_WAIVER_TYPE_2_MO_4MAX Waiver Type Code -2 (Apr)
924MAX_WAIVER_ID_2_MO_4Waiver ID-2 (Apr)
935MAX_WAIVER_TYPE_3_MO_4MAX Waiver Type Code -3 (Apr)
946MAX_WAIVER_ID_3_MO_4Waiver ID-3 (Apr)
889MAX_WAIVER_TYPE_1_MO_5MAX Waiver Type Code -1 (May)
900MAX_WAIVER_ID_1_MO_5Waiver ID-1 (May)
914MAX_WAIVER_TYPE_2_MO_5MAX Waiver Type Code -2 (May)
925MAX_WAIVER_ID_2_MO_5Waiver ID-2 (May)
936MAX_WAIVER_TYPE_3_MO_5MAX Waiver Type Code -3 (May)
947MAX_WAIVER_ID_3_MO_5Waiver ID-3 (May)
890MAX_WAIVER_TYPE_1_MO_6MAX Waiver Type Code -1 (Jun)
901MAX_WAIVER_ID_1_MO_6Waiver ID-1 (Jun)
915MAX_WAIVER_TYPE_2_MO_6MAX Waiver Type Code -2 (Jun)
926MAX_WAIVER_ID_2_MO_6Waiver ID-2 (Jun)
937MAX_WAIVER_TYPE_3_MO_6MAX Waiver Type Code -3 (Jun)
948MAX_WAIVER_ID_3_MO_6Waiver ID-3 (Jun)
891MAX_WAIVER_TYPE_1_MO_7MAX Waiver Type Code -1 (Jul)
902MAX_WAIVER_ID_1_MO_7Waiver ID-1 (Jul)
916MAX_WAIVER_TYPE_2_MO_7MAX Waiver Type Code -2 (Jul)
927MAX_WAIVER_ID_2_MO_7Waiver ID-2 (Jul)
938MAX_WAIVER_TYPE_3_MO_7MAX Waiver Type Code -3 (Jul)
949MAX_WAIVER_ID_3_MO_7Waiver ID-3 (Jul)
892MAX_WAIVER_TYPE_1_MO_8MAX Waiver Type Code -1 (Aug)
903MAX_WAIVER_ID_1_MO_8Waiver ID-1 (Aug)
917MAX_WAIVER_TYPE_2_MO_8MAX Waiver Type Code -2 (Aug)
928MAX_WAIVER_ID_2_MO_8Waiver ID-2 (Aug)
939MAX_WAIVER_TYPE_3_MO_8MAX Waiver Type Code -3 (Aug)
950MAX_WAIVER_ID_3_MO_8Waiver ID-3 (Aug)
893MAX_WAIVER_TYPE_1_MO_9MAX Waiver Type Code -1 (Sep)
904MAX_WAIVER_ID_1_MO_9Waiver ID-1 (Sep)
918MAX_WAIVER_TYPE_2_MO_9MAX Waiver Type Code -2 (Sep)
929MAX_WAIVER_ID_2_MO_8Waiver ID-2 (Sep)
940MAX_WAIVER_TYPE_3_MO_9MAX Waiver Type Code -3 (Sep)
951MAX_WAIVER_ID_3_MO_9Waiver ID-3 (Sep)
894MAX_WAIVER_TYPE_1_MO_10MAX Waiver Type Code -1 (Oct)
905MAX_WAIVER_ID_1_MO_10Waiver ID-1 (Oct)
919MAX_WAIVER_TYPE_2_MO_10MAX Waiver Type Code -2 (Oct)
930MAX_WAIVER_ID_2_MO_10Waiver ID-2 (Oct)
941MAX_WAIVER_TYPE_3_MO_10MAX Waiver Type Code -3 (Oct)
952MAX_WAIVER_ID_3_MO_10Waiver ID-3 (Oct)
907MAX_WAIVER_TYPE_1_MO_11MAX Waiver Type Code -1 (Nov)
908MAX_WAIVER_ID_1_MO_11Waiver ID-1 (Nov)
920MAX_WAIVER_TYPE_2_MO_11MAX Waiver Type Code -2 (Nov)
931MAX_WAIVER_ID_2_MO_11Waiver ID-2 (Nov)
942MAX_WAIVER_TYPE_3_MO_11MAX Waiver Type Code -3 (Nov)
953MAX_WAIVER_ID_3_MO_11Waiver ID-3 (Nov)
909MAX_WAIVER_TYPE_1_MO_1MAX Waiver Type Code -1 (Dec)
910MAX_WAIVER_ID_1_MO_12Waiver ID-1 (Dec)
921MAX_WAIVER_TYPE_2_MO_12MAX Waiver Type Code -2 (Dec)
932MAX_WAIVER_ID_2_MO_12Waiver ID-2 (Dec)
943MAX_WAIVER_TYPE_3_MO_12MAX Waiver Type Code -3 (Dec)
954MAX_WAIVER_ID_3_MO_12Waiver ID-3 (Dec)
338MAX_1915C_WAIVER_TYPE_LTSTAnnual 1915(c) MAX Waiver Type
339RCPNT_INDRecipient indicator
340TOT_IP_DSCHRG_CNTIP discharges
342TOT_IP_DAY_CNT_DSCHRG Length of Stay (LOS) - for discharges
343TOT_IP_DAY_CNT_STAYSLength of Stay (LOS) - for stays
344TOT_IP_CVR_DAY_CNT_DSCHRGCovered days - for discharges
345TOT_IP_CVR_DAY_CNT_STAYSCovered days - for stays
346TOT_LTC_CVR_DAY_CNT_AGEDMental hospital covered days
347TOT_LTC_CVR_DAY_CNT_PSYCHInpatient psych (age < 21) covered days
349TOT_LTC_CVR_DAY_CNT_NFNursing facility covered days
350TOT_LTC_CVR_DAY_CNTTotal LT covered days
351TOT_MDCD_CLM_CNTTotal record count
352TOT_MDCD_FFS_CLM_CNTFee-for-service claim count
353TOT_MDCD_PREM_CLM_CNT Premium payment claim count
354TOT_MDCD_ENCT_CLM_CNTEncounter record count
355TOT_MDCD_PYMT_AMTTotal Medicaid payment amount
356TOT_MDCD_FFS_PYMT_AMTFee-for-service Medicaid payment amount
357TOT_MDCD_PREM_PYMT_AMTPremium payment Medicaid payment amount
358TOT_MDCD_CHRG_AMTCharge amount (MAX PS)
359TOT_MDCD_TP_PYMT_AMTThird party payment amount (MAX PS)
360IP_HOSP_REC_FPInpatient hospital records (FP)
361IP_HOSP_PYMT_FPInpatient hospital payments (FP)
362LT_REC_CNT_FPInstitutional LT care records (FP)
363LT_PYMT_AMT_FPInstitutional LT care payments (FP)
364OT_REC_CNT_FPOther service records (FP)
365OT_PYMT_AMT_FPOther service payments (FP)
366RX_REC_CNT_FPPrescription drug records (FP)
367RX_PYMT_AMT_FPPrescription drug payments (FP)
368TOT_REC_CNT_FPTotal records (FP)
369TOT_PYMT_AMT_FPTotal payments (FP)
370IP_HOSP_REC_RHCInpatient hospital records (RHC)
371IP_HOSP_PYMT_RHCInpatient hospital payments (RHC)
372LT_REC_CNT_RHCInstitutional LT care records (RHC)
373LT_PYMT_AMT_RHCInstitutional LT care payments (RHC)
374OT_REC_CNT_RHCOther service records (RHC)
375OT_PYMT_AMT_RHCOther service payments (RHC)
376RX_REC_CNT_RHCPrescription drug records (RHC)
377RX_PYMT_AMT_RHCPrescription drug payments (RHC)
378TOT_REC_CNT_RHC Total records (RHC)
379TOT_PYMT_AMT_RHCTotal payments (RHC)
380IP_HOSP_REC_FQHCInpatient hospital records (FQHC)
381IP_HOSP_PYMT_FQHCInpatient hospital payments (FQHC)
382LT_REC_CNT_FQHCInstitutional LT care records (FQHC)
383LT_PYMT_AMT_FQHCInstitutional LT care payments (FQHC)
384OT_REC_CNT_FQHCOther service records (FQHC)
385OT_PYMT_AMT_FQHCOther service payments (FQHC)
386RX_REC_CNT_FQHCPrescription drug records (FQHC)
387RX_PYMT_AMT_FQHCPrescription drug payments (FQHC)
388TOT_REC_CNT_FQHC Total records (FQHC)
389TOT_PYMT_AMT_FQHCTotal payments (FQHC)
390IP_HOSP_REC_IHS Inpatient hospital records (IHS)
391IP_HOSP_PYMT_IHSInpatient hospital payments (IHS)
392LT_REC_CNT_IHSInstitutional LT care records (IHS)
393LT_PYMT_AMT_IHSInstitutional LT care payments (IHS)
394OT_REC_CNT_IHSOther service records (IHS)
395OT_PYMT_AMT_IHSOther service payments (IHS)
396RX_REC_CNT_IHSPrescription drug records (IHS)
397RX_PYMT_AMT_IHSPrescription drug payments (IHS)
398TOT_REC_CNT_IHSTotal records (IHS)
399TOT_PYMT_AMT_IHSTotal payments (IHS)
400IP_HOSP_REC_HCBCA Inpatient hospital records (HCBCA)
401IP_HOSP_PYMT_HCBCAInpatient hospital payments (HCBCA)
402LT_REC_CNT_HCBCA Institutional LT care records (HCBCA)
403LT_PYMT_AMT_HCBCAInstitutional LT care payments (HCBCA)
404OT_REC_CNT_HCBCAOther service records (HCBCA)
405OT_PYMT_AMT_HCBCAOther service payments (HCBCA)
406RX_REC_CNT_HCBCAPrescription drug records (HCBCA)
407RX_PYMT_AMT_HCBCAPrescription drug payments (HCBCA)
408TOT_REC_CNT_HCBCATotal records (HCBCA)
409TOT_PYMT_AMT_HCBCATotal payments (HCBCA)
410IP_HOSP_REC_HCBCSInpatient hospital records (HCBCS)
411IP_HOSP_PYMT_HCBCSInpatient hospital payments (HCBCS)
412LT_REC_CNT_HCBCSInstitutional LT care records (HCBCS)
413LT_PYMT_AMT_HCBCSInstitutional LT care payments (HCBCS)
414OT_REC_CNT_HCBCSOther service records (HCBCS)
415OT_PYMT_AMT_HCBCSOther service payments (HCBCS)
416RX_REC_CNT_HCBCSPrescription drug records (HCBCS)
417RX_PYMT_AMT_HCBCSPrescription drug payments (HCBCS)
418TOT_REC_CNT_HCBCSTotal records (HCBCS)
419TOT_PYMT_AMT_HCBCSTotal payments (HCBCS)
420RCPNT_DLVRY_CDDelivery code (MAX PS)
421FEE_FOR_SRVC_IND_01Recipient indicator (MAX TOS 01)
422FFS_CLM_CNT_01Claim count (MAX TOS 01)
423FFS_PYMT_AMT_01Medicaid payment amount (MAX TOS 01)
424FFS_CHRG_AMT_01Charge amount (MAX TOS 01)
425FFS_TP_AMT_01Third party payment amount (MAX TOS 01)
426ENCTR_REC_CNT_01Encounter record count (MAX TOS 01)
959FEE_FOR_SRVC_IND_02Recipient indicator (MAX TOS 02)
960FFS_CLM_CNT_02Claim count (MAX TOS 02)
961FFS_PYMT_AMT_02Medicaid payment amount (MAX TOS 02)
962FFS_CHRG_AMT_02Charge amount (MAX TOS 02)
963FFS_TP_AMT_02Third party payment amount (MAX TOS 02)
964ENCTR_REC_CNT_02Encounter record count (MAX TOS 02)
965FEE_FOR_SRVC_IND_04Recipient indicator (MAX TOS 04)
966FFS_CLM_CNT_04Claim count (MAX TOS 04)
967FFS_PYMT_AMT_04Medicaid payment amount (MAX TOS 04)
968FFS_CHRG_AMT_04Charge amount (MAX TOS 04)
969FFS_TP_AMT_04Third party payment amount (MAX TOS 04)
970ENCTR_REC_CNT_04Encounter record count (MAX TOS 04)
971FEE_FOR_SRVC_IND_05Recipient indicator (MAX TOS 05)
972FFS_CLM_CNT_05Claim count (MAX TOS 05)
973FFS_PYMT_AMT_05Medicaid payment amount (MAX TOS 05)
974FFS_CHRG_AMT_05Charge amount (MAX TOS 05)
975FFS_TP_AMT_05Third party payment amount (MAX TOS 05)
976ENCTR_REC_CNT_05Encounter record count (MAX TOS 05)
977FEE_FOR_SRVC_IND_07Recipient indicator (MAX TOS 07)
978FFS_CLM_CNT_07Claim count (MAX TOS 07)
979FFS_PYMT_AMT_07Medicaid payment amount (MAX TOS 07)
980FFS_CHRG_AMT_07Charge amount (MAX TOS 07)
981FFS_TP_AMT_07Third party payment amount (MAX TOS 07)
982ENCTR_REC_CNT_07Encounter record count (MAX TOS 07)
983FEE_FOR_SRVC_IND_08Recipient indicator (MAX TOS 08)
984FFS_CLM_CNT_08Claim count (MAX TOS 08)
985FFS_PYMT_AMT_08Medicaid payment amount (MAX TOS 08)
986FFS_CHRG_AMT_08Charge amount (MAX TOS 08)
987FFS_TP_AMT_08Third party payment amount (MAX TOS 08)
988ENCTR_REC_CNT_08Encounter record count (MAX TOS 08)
989FEE_FOR_SRVC_IND_09Recipient indicator (MAX TOS 09)
990FFS_CLM_CNT_09Claim count (MAX TOS 09)
991FFS_PYMT_AMT_09Medicaid payment amount (MAX TOS 09)
992FFS_CHRG_AMT_09Charge amount (MAX TOS 09)
993FFS_TP_AMT_09Third party payment amount (MAX TOS 09)
994ENCTR_REC_CNT_09Encounter record count (MAX TOS 09)
995FEE_FOR_SRVC_IND_10Recipient indicator (MAX TOS 10)
996FFS_CLM_CNT_10Claim count (MAX TOS 10)
997FFS_PYMT_AMT_10Medicaid payment amount (MAX TOS 10)
998FFS_CHRG_AMT_10Charge amount (MAX TOS 10)
999FFS_TP_AMT_10Third party payment amount (MAX TOS 10)
1 000ENCTR_REC_CNT_10Encounter record count (MAX TOS 10)
1 001FEE_FOR_SRVC_IND_11Recipient indicator (MAX TOS 11)
1 002FFS_CLM_CNT_11Claim count (MAX TOS 11)
1 003FFS_PYMT_AMT_11Medicaid payment amount (MAX TOS 11)
1 004FFS_CHRG_AMT_11Charge amount (MAX TOS 11)
1 005FFS_TP_AMT_11Third party payment amount (MAX TOS 11)
1 006ENCTR_REC_CNT_11Encounter record count (MAX TOS 11)
1 007FEE_FOR_SRVC_IND_12Recipient indicator (MAX TOS 12)
1 008FFS_CLM_CNT_01Claim count (MAX TOS 12)
1 009FFS_PYMT_AMT_12Medicaid payment amount (MAX TOS 12)
1 010FFS_CHRG_AMT_12Charge amount (MAX TOS 12)
1 011FFS_TP_AMT_12Third party payment amount (MAX TOS 12)
1 012ENCTR_REC_CNT_12Encounter record count (MAX TOS 12)
1 013FEE_FOR_SRVC_IND_13Recipient indicator (MAX TOS 13)
1 014FFS_CLM_CNT_13Claim count (MAX TOS 13)
1 015FFS_PYMT_AMT_13Medicaid payment amount (MAX TOS 13)
1 016FFS_CHRG_AMT_13Charge amount (MAX TOS 13)
1 017FFS_TP_AMT_13Third party payment amount (MAX TOS 13)
1 018ENCTR_REC_CNT_13Encounter record count (MAX TOS 13)
1 019FEE_FOR_SRVC_IND_15Recipient indicator (MAX TOS 15)
1 020FFS_CLM_CNT_15Claim count (MAX TOS 15)
1 021FFS_PYMT_AMT_15Medicaid payment amount (MAX TOS 15)
1 022FFS_CHRG_AMT_15Charge amount (MAX TOS 15)
1 023FFS_TP_AMT_15Third party payment amount (MAX TOS 15)
1 024ENCTR_REC_CNT_15Encounter record count (MAX TOS 15)
1 025FEE_FOR_SRVC_IND_16Recipient indicator (MAX TOS 16)
1 026FFS_CLM_CNT_16Claim count (MAX TOS 16)
1 027FFS_PYMT_AMT_16Medicaid payment amount (MAX TOS 16)
1 028FFS_CHRG_AMT_16Charge amount (MAX TOS 16)
1 029FFS_TP_AMT_16Third party payment amount (MAX TOS 16)
1 030ENCTR_REC_CNT_16Encounter record count (MAX TOS 16)
1 031FEE_FOR_SRVC_IND_19Recipient indicator (MAX TOS 19)
1 032FFS_CLM_CNT_19Claim count (MAX TOS 19)
1 033FFS_PYMT_AMT_19Medicaid payment amount (MAX TOS 19)
1 034FFS_CHRG_AMT_19Charge amount (MAX TOS 19)
1 035FFS_TP_AMT_19Third party payment amount (MAX TOS 19)
1 036ENCTR_REC_CNT_19Encounter record count (MAX TOS 19)
1 037FEE_FOR_SRVC_IND_24Recipient indicator (MAX TOS 24)
1 038FFS_CLM_CNT_24Claim count (MAX TOS 24)
1 039FFS_PYMT_AMT_24Medicaid payment amount (MAX TOS 24)
1 040FFS_CHRG_AMT_24Charge amount (MAX TOS 24)
1 041FFS_TP_AMT_24Third party payment amount (MAX TOS 24)
1 042ENCTR_REC_CNT_24Encounter record count (MAX TOS 24)
1 043FEE_FOR_SRVC_IND_01Recipient indicator (MAX TOS 25)
1 044FFS_CLM_CNT_25Claim count (MAX TOS 25)
1 045FFS_PYMT_AMT_25Medicaid payment amount (MAX TOS 25)
1 046FFS_CHRG_AMT_25Charge amount (MAX TOS 25)
1 047FFS_TP_AMT_25Third party payment amount (MAX TOS 25)
1 048ENCTR_REC_CNT_25Encounter record count (MAX TOS 25)
1 049FEE_FOR_SRVC_IND_26Recipient indicator (MAX TOS 26)
1 050FFS_CLM_CNT_26Claim count (MAX TOS 26)
1 051FFS_PYMT_AMT_26Medicaid payment amount (MAX TOS 26)
1 052FFS_CHRG_AMT_26Charge amount (MAX TOS 26)
1 053FFS_TP_AMT_26Third party payment amount (MAX TOS 26)
1 054ENCTR_REC_CNT_26Encounter record count (MAX TOS 26)
1 055FEE_FOR_SRVC_IND_30Recipient indicator (MAX TOS 30)
1 056FFS_CLM_CNT_30Claim count (MAX TOS 30)
1 057FFS_PYMT_AMT_30Medicaid payment amount (MAX TOS 30)
1 058FFS_CHRG_AMT_30Charge amount (MAX TOS 30)
1 059FFS_TP_AMT_30Third party payment amount (MAX TOS 30)
1 060ENCTR_REC_CNT_30Encounter record count (MAX TOS 30)
1 061FEE_FOR_SRVC_IND_31Recipient indicator (MAX TOS 31)
1 062FFS_CLM_CNT_31Claim count (MAX TOS 31)
1 063FFS_PYMT_AMT_31Medicaid payment amount (MAX TOS 31)
1 064FFS_CHRG_AMT_31Charge amount (MAX TOS 31)
1 065FFS_TP_AMT_31Third party payment amount (MAX TOS 31)
1 066ENCTR_REC_CNT_31Encounter record count (MAX TOS 31)
1 067FEE_FOR_SRVC_IND_33Recipient indicator (MAX TOS 33)
1 068FFS_CLM_CNT_33Claim count (MAX TOS 33)
1 069FFS_PYMT_AMT_33Medicaid payment amount (MAX TOS 33)
1 070FFS_CHRG_AMT_33Charge amount (MAX TOS 33)
1 071FFS_TP_AMT_33Third party payment amount (MAX TOS 33)
1 072ENCTR_REC_CNT_33Encounter record count (MAX TOS 33)
1 073FEE_FOR_SRVC_IND_34Recipient indicator (MAX TOS 34)
1 074FFS_CLM_CNT_34Claim count (MAX TOS 34)
1 075FFS_PYMT_AMT_34Medicaid payment amount (MAX TOS 34)
1 076FFS_CHRG_AMT_34Charge amount (MAX TOS 34)
1 077FFS_TP_AMT_34Third party payment amount (MAX TOS 34)
1 078ENCTR_REC_CNT_34Encounter record count (MAX TOS 34)
1 079FEE_FOR_SRVC_IND_35Recipient indicator (MAX TOS 35)
1 080FFS_CLM_CNT_35Claim count (MAX TOS 35)
1 081FFS_PYMT_AMT_35Medicaid payment amount (MAX TOS 35)
1 082FFS_CHRG_AMT_35Charge amount (MAX TOS 35)
1 083FFS_TP_AMT_35Third party payment amount (MAX TOS 35)
1 084ENCTR_REC_CNT_35Encounter record count (MAX TOS 35)
1 085FEE_FOR_SRVC_IND_36Recipient indicator (MAX TOS 36)
1 086FFS_CLM_CNT_36Claim count (MAX TOS 36)
1 087FFS_PYMT_AMT_36Medicaid payment amount (MAX TOS 36)
1 088FFS_CHRG_AMT_36Charge amount (MAX TOS 36)
1 089FFS_TP_AMT_36Third party payment amount (MAX TOS 36)
1 090ENCTR_REC_CNT_36Encounter record count (MAX TOS 36)
1 091FEE_FOR_SRVC_IND_37Recipient indicator (MAX TOS 37)
1 092FFS_CLM_CNT_37Claim count (MAX TOS 37)
1 093FFS_PYMT_AMT_37Medicaid payment amount (MAX TOS 37)
1 094FFS_CHRG_AMT_37Charge amount (MAX TOS 37)
1 095FFS_TP_AMT_37Third party payment amount (MAX TOS 37)
1 096ENCTR_REC_CNT_37Encounter record count (MAX TOS 37)
1 097FEE_FOR_SRVC_IND_38Recipient indicator (MAX TOS 38)
1 098FFS_CLM_CNT_38Claim count (MAX TOS 38)
1 099FFS_PYMT_AMT_38Medicaid payment amount (MAX TOS 38)
1 100FFS_CHRG_AMT_38Charge amount (MAX TOS 38)
1 101FFS_TP_AMT_38Third party payment amount (MAX TOS 38)
1 102ENCTR_REC_CNT_38Encounter record count (MAX TOS 38)
1 103FEE_FOR_SRVC_IND_39Recipient indicator (MAX TOS 39)
1 104FFS_CLM_CNT_39Claim count (MAX TOS 39)
1 105FFS_PYMT_AMT_39Medicaid payment amount (MAX TOS 39)
1 106FFS_CHRG_AMT_39Charge amount (MAX TOS 39)
1 107FFS_TP_AMT_39Third party payment amount (MAX TOS 39)
1 108ENCTR_REC_CNT_39Encounter record count (MAX TOS 39)
1 109FEE_FOR_SRVC_IND_51Recipient indicator (MAX TOS 51)
1 110FFS_CLM_CNT_51Claim count (MAX TOS 51)
1 111FFS_PYMT_AMT_51Medicaid payment amount (MAX TOS 51)
1 112FFS_CHRG_AMT_51Charge amount (MAX TOS 51)
1 113FFS_TP_AMT_51Third party payment amount (MAX TOS 51)
1 114ENCTR_REC_CNT_51Encounter record count (MAX TOS 51)
1 115FEE_FOR_SRVC_IND_52Recipient indicator (MAX TOS 52)
1 116FFS_CLM_CNT_52Claim count (MAX TOS 52)
1 117FFS_PYMT_AMT_52Medicaid payment amount (MAX TOS 52)
1 118FFS_CHRG_AMT_52Charge amount (MAX TOS 52)
1 119FFS_TP_AMT_52Third party payment amount (MAX TOS 52)
1 120ENCTR_REC_CNT_52Encounter record count (MAX TOS 52)
1 121FEE_FOR_SRVC_IND_53Recipient indicator (MAX TOS 53)
1 122FFS_CLM_CNT_53Claim count (MAX TOS 53)
1 123FFS_PYMT_AMT_53Medicaid payment amount (MAX TOS 53)
1 124FFS_CHRG_AMT_53Charge amount (MAX TOS 53)
1 125FFS_TP_AMT_53Third party payment amount (MAX TOS 53)
1 126ENCTR_REC_CNT_53Encounter record count (MAX TOS 53)
1 127FEE_FOR_SRVC_IND_54Recipient indicator (MAX TOS 54)
1 128FFS_CLM_CNT_54Claim count (MAX TOS 54)
1 129FFS_PYMT_AMT_54Medicaid payment amount (MAX TOS 54)
1 130FFS_CHRG_AMT_54Charge amount (MAX TOS 54)
1 131FFS_TP_AMT_54Third party payment amount (MAX TOS 54)
1 132ENCTR_REC_CNT_54Encounter record count (MAX TOS 54)
601FEE_FOR_SRVC_IND_99Recipient indicator (Unknown)
602FFS_CLM_CNT_99Claim count (Unknown)
603FFS_PYMT_AMT_99Medicaid payment amount (Unknown)
604FFS_CHRG_AMT_99Charge amount (Unknown)
605FFS_TP_AMT_99Third party payment amount (Unknown)
606ENCTR_REC_CNT_99Encounter record count (Unknown)
607CLTC_FFS_PYMT_AMT_11Medicaid payment amount (CLTC 11)
608CLTC_FFS_PYMT_AMT_12Medicaid payment amount (CLTC 12)
609CLTC_FFS_PYMT_AMT_13Medicaid payment amount (CLTC 13)
610CLTC_FFS_PYMT_AMT_14Medicaid payment amount (CLTC 14)
611CLTC_FFS_PYMT_AMT_15Medicaid payment amount (CLTC 15)
612CLTC_FFS_PYMT_AMT_16Medicaid payment amount (CLTC 16)
613CLTC_FFS_PYMT_AMT_17Medicaid payment amount (CLTC 17)
614CLTC_FFS_PYMT_AMT_18Medicaid payment amount (CLTC 18)
615CLTC_FFS_PYMT_AMT_19Medicaid payment amount (CLTC 19)
616CLTC_FFS_PYMT_AMT_20Medicaid payment amount (CLTC 20)
617CLTC_FFS_PYMT_AMT_30Medicaid payment amount (CLTC 30)
618CLTC_FFS_PYMT_AMT_31Medicaid payment amount (CLTC 31)
619CLTC_FFS_PYMT_AMT_32Medicaid payment amount (CLTC 32)
620CLTC_FFS_PYMT_AMT_33Medicaid payment amount (CLTC 33)
621CLTC_FFS_PYMT_AMT_34Medicaid payment amount (CLTC 34)
622CLTC_FFS_PYMT_AMT_35Medicaid payment amount (CLTC 35)
623CLTC_FFS_PYMT_AMT_36Medicaid payment amount (CLTC 36)
624CLTC_FFS_PYMT_AMT_37Medicaid payment amount (CLTC 37)
625CLTC_FFS_PYMT_AMT_38Medicaid payment amount (CLTC 38)
626CLTC_FFS_PYMT_AMT_39Medicaid payment amount (CLTC 39)
627CLTC_FFS_PYMT_AMT_40Medicaid payment amount (CLTC 40)
1 133HCBS_TXNMY_MDCD_PYMT_AMT_01Medicaid payment amount (HCBS) - Case Management
1 134HCBS_TXNMY_MDCD_PYMT_AMT_02Medicaid payment amount (HCBS) - Round the Clock Services
1 135HCBS_TXNMY_MDCD_PYMT_AMT_03Medicaid payment amount (HCBS) - Supported Employment
1 136HCBS_TXNMY_MDCD_PYMT_AMT_04Medicaid payment amount (HCBS) - Day Services
1 137HCBS_TXNMY_MDCD_PYMT_AMT_05Medicaid payment amount (HCBS) - Nursing Services
1 138HCBS_TXNMY_MDCD_PYMT_AMT_06Medicaid payment amount (HCBS) - Home Delivered Meals
1 139HCBS_TXNMY_MDCD_PYMT_AMT_07Medicaid payment amount (HCBS) - Rent and Food Expenses for Live-In Caregiver
1 140HCBS_TXNMY_MDCD_PYMT_AMT_08Medicaid payment amount (HCBS) - Home Based Services
1 141HCBS_TXNMY_MDCD_PYMT_AMT_09Medicaid payment amount (HCBS) - Caregiver Support
1 142HCBS_TXNMY_MDCD_PYMT_AMT_10Medicaid payment amount (HCBS) - Other Mental Health and BHS
1 143HCBS_TXNMY_MDCD_PYMT_AMT_11Medicaid payment amount (HCBS) - Other Health and Theraputic Services
1 144HCBS_TXNMY_MDCD_PYMT_AMT_12Medicaid payment amount (HCBS) - Services Supporting Participant Direction
1 145HCBS_TXNMY_MDCD_PYMT_AMT_13Medicaid payment amount (HCBS) - Participant Training
1 146HCBS_TXNMY_MDCD_PYMT_AMT_15Medicaid payment amount (HCBS) - Equipment, Technology, and Modifications
1 147HCBS_TXNMY_MDCD_PYMT_AMT_16Medicaid payment amount (HCBS) - Non-Medical Transportation
1 148HCBS_TXNMY_MDCD_PYMT_AMT_16Medicaid payment amount (HCBS) - Community Transition Services
1 149HCBS_TXNMY_MDCD_PYMT_AMT_17Medicaid payment amount (HCBS) - Other Services
1 150HCBS_TXNMY_MDCD_PYMT_AMT_99Medicaid payment amount (HCBS) - Unknown
628PREM_PYMT_IND_HMOPremium payment indicator (HMO/HIO)
629PREM_PYMT_REC_CNT_HMOPremium payment records (HMO/HIO)
630PREM_MDCD_PYMT_AMT_HMOMedicaid premium payments (HMO/HIO)
631PREM_PYMT_IND_PHPPremium payment indicator (PHP)
632PREM_PYMT_REC_CNT_PHPPremium payment records (PHP)
633PREM_MDCD_PYMT_AMT_PHPMedicaid premium payments (PHP)
634PREM_PYMT_IND_PCCMPremium payment indicator (PCCM)
944PREM_PYMT_REC_CNT_PCCMPremium payment records (PCCM)
945PREM_MDCD_PYMT_AMT_PCCMMedicaid premium payments (PCCM)
946EL_MDCR_ANN_XOVR_99Crossover code (Annual) - Same As Dual Code - In Place for Historical Compatibility
947EL_MDCR_XOVR_MO_1Medicare crossover code (Jan) - Same As Dual Code - In Place for Historical Compatibility
948EL_MDCR_XOVR_MO_2Medicare crossover code (Feb) - Same As Dual Code - In Place for Historical Compatibility
949EL_MDCR_XOVR_MO_3Medicare crossover code (Mar) - Same As Dual Code - In Place for Historical Compatibility
950EL_MDCR_XOVR_MO_4Medicare crossover code (Apr) - Same As Dual Code - In Place for Historical Compatibility
951EL_MDCR_XOVR_MO_5Medicare crossover code (May) - Same As Dual Code - In Place for Historical Compatibility
952EL_MDCR_XOVR_MO_6Medicare crossover code (Jun) - Same As Dual Code - In Place for Historical Compatibility
953EL_MDCR_XOVR_MO_7Medicare crossover code (Jul) - Same As Dual Code - In Place for Historical Compatibility
954EL_MDCR_XOVR_MO_8Medicare crossover code (Aug) - Same As Dual Code - In Place for Historical Compatibility
955EL_MDCR_XOVR_MO_9Medicare crossover code (Sep) - Same As Dual Code - In Place for Historical Compatibility
956EL_MDCR_XOVR_MO_10Medicare crossover code (Oct) - Same As Dual Code - In Place for Historical Compatibility
957EL_MDCR_XOVR_MO_11Medicare crossover code (Nov) - Same As Dual Code - In Place for Historical Compatibility
958EL_MDCR_XOVR_MO_12Medicare crossover code (Dec) - Same As Dual Code - In Place for Historical Compatibility