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File Version: CCW record layout accessed May, 2019; CMS MAX 2014 data dictionary Aug 18, 2016

SAS NameVariable Name
1BENE_IDEncrypted 723 CCW Beneficiary ID
2MSIS_IDEncrypted MSIS Identification Number
4YR_NUMYear of MAX Record
5EL_DOB Birth date
7EL_RACE_ETHNCY_CDRace/ethnicity (from MSIS)
8RACE_CODE_1Race - White (from MSIS)
9RACE_CODE_2Race - Black (from MSIS)
10RACE_CODE_3Race - Am Indian/Alaskan (from MSIS)
11RACE_CODE_4Race - Asian (from MSIS)
12RACE_CODE_5Race - Hawaiian/Pac Islands (from MSIS)
13ETHNICITY_CODEEthnicity - Hispanic (from MSIS)
14EL_SS_ELGBLTY_CD_LTSTState specific eligibility - most recent
15EL_SS_ELGBLTY_CD_MOState specific eligibility - mo of svc
16EL_MAX_ELGBLTY_CD_LTSTMAX eligibility - most recent
17EL_MAX_ELGBLTY_CD_MOMAX eligibility - mo of svc
18EL_MDCR_ANN_XOVR_OLDCrossover code (Annual) old values
19EL_MDCR_XOVR_CLM_BSD_CDCrossover code (from claims only)
20MSNG_ELG_DATA Missing eligibility data
21EL_MDCR_ANN_XOVR_99Crossover code (Annual)
22MSIS_TOS MSIS Type of Service (TOS)
23MSIS_TOPMSIS Type of Program (TOP)
24MAX_TOSMAX Type of Service (TOS)
25PRVDR_ID_NMBR Billing provider identification number (MAX)
26NPI National Provider Identifier (MAX)
27TAXONOMY Provider Taxonomy
28TYPE_CLM_CD Type of claim
29ADJUST_CDAdjustment code
30PHP_TYPEManaged care type of plan code
31PHP_IDManaged care plan identification code
32MDCD_PYMT_AMTMedicaid payment amount
33TP_PYMT_AMTThird party payment amount
34PYMT_DTPayment/adjudication date
35CHRG_AMTCharge amount
36PHP_VALPrepaid plan value
37MDCR_COINSUR_PYMT_AMTMedicare coinsurance payment amount
38MDCR_DED_PYMT_AMTMedicare deductible payment amount
39PRES_PHYSICIAN_ID_NUMPrescribing physician id number
40PRSC_WRTE_DTPrescribed date
41PRSCRPTN_FILL_DTPrescription fill date (MAX)
42NEW_REFILL_INDNew or refill indicator
43NDCNational Drug Code (NDC)
44QTY_SRVC_UNITSQuantity of service
45DAYS_SUPPLYDays Supply (MAX)