Data Documentation

Carrier (Fee-for-Service)
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File Version:
L, CCW Data Documentation February 2021

For most files, a table of variables will display below, with links to the variable definitions. If no table displays, or if you need additional information for a specific variable, please see the CCW website. Data documentation is available for all files and codebooks for many.

If you are unable to locate the information you need, please contact ResDAC.

NumberSAS NameVariable Name
1 BENE_ID Encrypted CCW Beneficiary ID
2 CLM_ID Claim ID
3 NCH_NEAR_LINE_REC_IDENT_CD NCH Near Line Record Identification Code (RIC)
4 NCH_CLM_TYPE_CD NCH Claim Type Code
5 CLM_FROM_DT Claim From Date (FFS)
6 CLM_THRU_DT Claim Through Date (FFS)
7 NCH_WKLY_PROC_DT NCH Weekly Claim Processing Date
8 CARR_CLM_ENTRY_CD Carrier Claim Entry Code
9 CLM_DISP_CD Claim Disposition Code
10 CARR_NUM Carrier or MAC Number
11 CARR_CLM_PMT_DNL_CD Carrier Claim Payment Denial Code
12 CLM_PMT_AMT Claim (Medicare) Payment Amount
13 NCH_PRMRY_PYR_CLM_PD_AMT NCH Primary Payer (if not Medicare) Claim Paid Amount
14 RFR_PHYSN_UPIN Carrier/DMERC Claim Referring Physician UPIN Number
15 RFRG_NPI Claim Referring Physician NPI Number
16 CARR_CLM_PRVDR_ASGNMT_IND_SW Carrier Claim Provider Assignment Indicator Switch
17 NCH_CLM_PRVDR_PMT_AMT NCH Claim Provider Payment Amount
18 NCH_CLM_BENE_PMT_AMT NCH Claim Payment Amount to Beneficiary
19 CLM_BENE_PD_AMT Carrier Claim Beneficiary Paid Amount
20 NCH_CARR_CLM_SBMTD_CHRG_AMT NCH Carrier Claim Submitted Charge Amount (sum of all line-level submitted charges)
21 NCH_CARR_CLM_ALOWD_AMT NCH Carrier Claim Allowed Charge Amount (sum of all line-level allowed charges)
22 CARR_CLM_CASH_DDCTBL_APLD_AMT Carrier Claim Cash Deductible Applied Amount (sum of all line-level deductible amounts)
23 CARR_CLM_HCPCS_YR_CD Claim Healthcare Common Procedure Coding System (HCPCS) Year Code
24 CARR_CLM_RFRNG_PIN_NUM Carrier Claim Referring Provider ID Number (PIN)
25 CPO_PRVDR_NUM Care Plan Oversight (CPO) Provider Number
26 CPO_ORG_NPI_NUM CPO Organization NPI Number
27 CARR_CLM_BLG_NPI_NUM Carrier Claim Billing NPI Number
28 BLG_PRVDR_SPCLTY_CD1 Claim Billing Provider Secondary Specialty Code 1
29 BLG_PRVDR_SPCLTY_CD2 Claim Billing Provider Secondary Specialty Code 2
30 BLG_PRVDR_SPCLTY_CD3 Claim Billing Provider Secondary Specialty Code 3
31 BLG_PRVDR_TXNMY_CD Claim Billing Provider Taxonomy Code
32 PRNCPAL_DGNS_CD Claim Principal Diagnosis Code (FFS)
33 PRNCPAL_DGNS_VRSN_CD Claim Principal Diagnosis Version Code (FFS)
34 ICD_DGNS_CD1 Claim Diagnosis Code I (FFS)
35 ICD_DGNS_VRSN_CD1 Claim Diagnosis Code I Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
36 ICD_DGNS_CD2 Claim Diagnosis Code II (FFS)
37 ICD_DGNS_VRSN_CD2 Claim Diagnosis Code II Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
38 ICD_DGNS_CD3 Claim Diagnosis Code III (FFS)
39 ICD_DGNS_VRSN_CD3 Claim Diagnosis Code III Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
40 ICD_DGNS_CD4 Claim Diagnosis Code IV (FFS)
41 ICD_DGNS_VRSN_CD4 Claim Diagnosis Code IV Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
42 ICD_DGNS_CD5 Claim Diagnosis Code V (FFS)
43 ICD_DGNS_VRSN_CD5 Claim Diagnosis Code V Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
44 ICD_DGNS_CD6 Claim Diagnosis Code VI (FFS)
45 ICD_DGNS_VRSN_CD6 Claim Diagnosis Code VI Diagnosis Version Code (ICD-9/ICD-10) (FFS)
46 ICD_DGNS_CD7 Claim Diagnosis Code VII (FFS)
47 ICD_DGNS_VRSN_CD7 Claim Diagnosis Code VII Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
48 ICD_DGNS_CD8 Claim Diagnosis Code VIII (FFS)
49 ICD_DGNS_VRSN_CD8 Claim Diagnosis Code VIII Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
50 ICD_DGNS_CD9 Claim Diagnosis Code IX (FFS)
51 ICD_DGNS_VRSN_CD9 Claim Diagnosis Code IX Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
52 ICD_DGNS_CD10 Claim Diagnosis Code X (FFS)
53 ICD_DGNS_VRSN_CD10 Claim Diagnosis Code X Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
54 ICD_DGNS_CD11 Claim Diagnosis Code XI (FFS)
55 ICD_DGNS_VRSN_CD11 Claim Diagnosis Code XI Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
56 ICD_DGNS_CD12 Claim Diagnosis Code XII (FFS)
57 ICD_DGNS_VRSN_CD12 Claim Diagnosis Code XII Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
58 CLM_CLNCL_TRIL_NUM Clinical Trial Number
59 DOB_DT Date of Birth from Claim
60 GNDR_CD Gender Code from Claim
61 BENE_RACE_CD Beneficiary Race Code (Encounter)
62 BENE_CNTY_CD County Code from Claim (SSA)
63 BENE_STATE_CD Beneficiary Residence (SSA) State Code (FFS)
64 BENE_MLG_CNTCT_ZIP_CD Zip Code of Residence from Claim
65 ACO_ID_NUM Claim Accountable Care Organization (ACO) Identification Number
66 CARR_CLM_SOS_NPI_NUM Carrier Claim Site of Service NPI Number
67 CLM_BENE_ID_TYPE_CD Claim Beneficiary Identifier Type Code
68 CLM_RSDL_PYMT_IND_CD Claim Residual Payment Indicator Code
69 PRVDR_VLDTN_TYPE_CD Provider Validation Type Code

LINE FILE

NumberSAS NameVariable Name
1 BENE_ID Encrypted CCW Beneficiary ID
2 CLM_ID Claim ID
3 CLM_LINE_NUM Claim Line Number
4 NCH_CLM_TYPE_CD NCH Claim Type Code
5 CLM_THRU_DT Claim Through Date (FFS)
6 CARR_PRFRNG_PIN_NUM Carrier Line Performing Provider ID Number (PIN)
7 PRF_PHYSN_UPIN Carrier Line Performing UPIN Number
8 PRF_PHYSN_NPI Carrier Line Performing NPI Number
9 ORG_NPI_NUM Organization (or group) NPI Number
10 CARR_LINE_PRVDR_TYPE_CD Carrier Line Provider Type Code
11 TAX_NUM Line Provider Tax Number
12 PRVDR_STATE_CD NCH Provider SSA State Code
13 PRVDR_ZIP Carrier Line Performing Provider ZIP Code
14 PRVDR_SPCLTY Line CMS Provider Specialty Code
15 RNDRNG_PRVDR_SPCLTY_CD1 Rendering Provider Secondary Specialty Code 1
16 RNDRNG_PRVDR_SPCLTY_CD2 Rendering Provider Secondary Specialty Code 2
17 RNDRNG_PRVDR_SPCLTY_CD3 Rendering Provider Secondary Specialty Code 3
18 RNDRNG_PRVDR_TXNMY_CD Rendering Provider Taxonomy Code
19 PRTCPTNG_IND_CD Line Provider Participating Indicator Code
20 CARR_LINE_RDCD_PMT_PHYS_ASTN_C Carrier Line Reduced Payment Physician Assistant Code
21 LINE_SRVC_CNT Line Service Count (FFS)
22 LINE_CMS_TYPE_SRVC_CD Line CMS Type Service Code
23 LINE_PLACE_OF_SRVC_CD Line Place Of Service Code (FFS)
24 CARR_LINE_PRCNG_LCLTY_CD Carrier Line Pricing Locality Code
25 LINE_1ST_EXPNS_DT Line First Expense Date (FFS)
26 LINE_LAST_EXPNS_DT Line Last Expense Date (FFS)
27 HCPCS_CD Healthcare Common Procedure Coding System (HCPCS) Code (FFS)
28 HCPCS_1st_mdfr_cd HCPCS Initial Modifier Code (FFS)
29 HCPCS_2ND_MDFR_CD HCPCS Second Modifier Code (FFS)
30 BETOS_CD Line Berenson-Eggers Type of Service (BETOS) Code
31 LINE_NCH_PMT_AMT Line NCH Medicare Payment Amount
32 LINE_BENE_PMT_AMT Line Payment Amount to Beneficiary
33 LINE_PRVDR_PMT_AMT Line Provider Payment Amount
34 LINE_BENE_PTB_DDCTBL_AMT Line Beneficiary Part B Deductible Amount
35 LINE_BENE_PRMRY_PYR_CD Line Primary Payer Code (if not Medicare)
36 LINE_BENE_PRMRY_PYR_PD_AMT Line Primary Payer (if not Medicare) Paid Amount
37 LINE_COINSRNC_AMT Line Beneficiary Coinsurance Amount
38 LINE_SBMTD_CHRG_AMT Line Submitted Charge Amount
39 LINE_ALOWD_CHRG_AMT Line Allowed Charge Amount
40 LINE_PRCSG_IND_CD Line Processing Indicator Code
41 LINE_PMT_80_100_CD Line Payment 80% / 100% Code
42 LINE_SERVICE_DEDUCTIBLE Line Service Deductible Indicator Switch
43 CARR_LINE_MTUS_CNT Carrier Line Miles/Time/Units/Services (MTUS) Count
44 CARR_LINE_MTUS_CD Carrier Line Miles/Time/Units/Services (MTUS) Indicator Code
45 LINE_ICD_DGNS_CD Line Diagnosis Code
46 LINE_ICD_DGNS_VRSN_CD Line Diagnosis Code Diagnosis Version Code (ICD-9 or ICD-10)
47 HPSA_SCRCTY_IND_CD Carrier Line Health Professional Shortage Area (HPSA)/Scarcity Indicator Code
48 CARR_LINE_RX_NUM Carrier Line RX Number (FFS)
49 LINE_HCT_HGB_RSLT_NUM Hematocrit/Hemoglobin Test Results
50 LINE_HCT_HGB_TYPE_CD Hematocrit/Hemoglobin Test Type Code
51 LINE_NDC_CD Line National Drug Code (NDC) (FFS)
52 CARR_LINE_CLIA_LAB_NUM Clinical Laboratory Improvement Amendments (CLIA) monitored laboratory number
53 CARR_LINE_ASNTHSA_UNIT_CNT Carrier Line Anesthesia Unit Count
54 CARR_LINE_CL_CHRG_AMT Carrier Line Clinical Lab Charge Amount
55 PHYSN_ZIP_CD Line Place of Service (POS) Physician Zip Code
56 LINE_POINT_OF_PCKP_ZIP_CD Line Point of Pickup Zip Code
57 LINE_DROP_OFF_ZIP_CD Line Drop Off Zip Code
58 LINE_OTHR_APLD_IND_CD1 Line Other Applied Indicator 1st Code
59 LINE_OTHR_APLD_IND_CD2 Line Other Applied Indicator 2nd Code
60 LINE_OTHR_APLD_IND_CD3 Line Other Applied Indicator 3rd Code
61 LINE_OTHR_APLD_IND_CD4 Line Other Applied Indicator 4th Code
62 LINE_OTHR_APLD_IND_CD5 Line Other Applied Indicator 5th Code
63 LINE_OTHR_APLD_IND_CD6 Line Other Applied Indicator 6th Code
64 LINE_OTHR_APLD_IND_CD7 Line Other Applied Indicator 7th Code
65 LINE_OTHR_APLD_AMT1 Line Other Applied Amount for 1st Code
66 LINE_OTHR_APLD_AMT2 Line Other Applied Amount for 2nd Code
67 LINE_OTHR_APLD_AMT3 Line Other Applied Amount for 3rd Code
68 LINE_OTHR_APLD_AMT4 Line Other Applied Amount for 4th Code
69 LINE_OTHR_APLD_AMT5 Line Other Applied Amount for 5th Code
70 LINE_OTHR_APLD_AMT6 Line Other Applied Amount for 6th Code
71 LINE_OTHR_APLD_AMT7 Line Other Applied Amount for 7th Code
72 THRPY_CAP_IND_CD1 Therapy cap Indicator 1 Code
73 THRPY_CAP_IND_CD2 Therapy cap Indicator 2 Code
74 THRPY_CAP_IND_CD3 Therapy cap Indicator 3 Code
75 THRPY_CAP_IND_CD4 Therapy cap Indicator 4 Code
76 THRPY_CAP_IND_CD5 Therapy cap Indicator 5 Code
77 CLM_NEXT_GNRTN_ACO_IND_CD1 Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Population-Based Payment (PBP)
78 CLM_NEXT_GNRTN_ACO_IND_CD2 Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Telehealth
79 CLM_NEXT_GNRTN_ACO_IND_CD3 Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Post Discharge HH visits
80 CLM_NEXT_GNRTN_ACO_IND_CD4 Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - 3-day SNF waiver
81 CLM_NEXT_GNRTN_ACO_IND_CD5 Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Capitation
82 CARR_LINE_MDPP_NPI_NUM Carrier Line Medicare Diabetes Prevention Program (MDPP) NPI Number
83 LINE_RSDL_PYMT_IND_CD Line Residual Payment Indicator Code
84 LINE_RP_IND_CD Line Representative Payee (RP) Indicator Code
85 LINE_PRVDR_VLDTN_TYPE_CD Line Provider Validation Type Code
86 LINE_VLNTRY_SRVC_IND_CD Line Voluntary Service Indicator Code
87 LINE_ADJUST_GRP_CD Line Adjustment Group Code
88 LINE_ADJUST_RSN_CD Line Adjustment Reason Code
89 LINE_RA_RMRK_CD Line Remittance Advice Remark Code

Demonstrations/Innovations Code File

NumberSAS NameVariable Name
1 BENE_ID Encrypted CCW Beneficiary ID
2 CLM_ID Claim ID
3 NCH_CLM_TYPE_CD NCH Claim Type Code
4 DEMO_ID_SQNC_NUM Demonstration sequence number
5 DEMO_ID_NUM Demonstration number
6 DEMO_INFO_TXT Demo information text