File Version:
L, CCW Data Documentation February 2021
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 RFRG_PHYSN_NPI 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 PRVDR_VLDTN_TYPE_CD Provider Validation Type Code
20 CLM_BENE_PD_AMT Carrier Claim Beneficiary Paid Amount
21 NCH_CARR_CLM_SBMTD_CHRG_AMT NCH Carrier Claim Submitted Charge Amount (sum of all line-level submitted charges)
22 CLM_BENE_ID_TYPE_CD Claim Beneficiary Identifier Type Code
23 NCH_CARR_CLM_ALOWD_AMT NCH Carrier Claim Allowed Charge Amount (sum of all line-level allowed charges)
24 CARR_CLM_CASH_DDCTBL_APLD_AMT Carrier Claim Cash Deductible Applied Amount (sum of all line-level deductible amounts)
25 CARR_CLM_HCPCS_YR_CD Claim Healthcare Common Procedure Coding System (HCPCS) Year Code
26 CARR_CLM_RFRNG_PIN_NUM Carrier Claim Referring Provider ID Number (PIN)
27 CPO_PRVDR_NUM Care Plan Oversight (CPO) Provider Number
28 CPO_ORG_NPI_NUM CPO Organization NPI Number
29 CARR_CLM_BLG_NPI_NUM Carrier Claim Billing NPI Number
30 PRNCPAL_DGNS_CD Claim Principal Diagnosis Code (FFS)
31 PRNCPAL_DGNS_VRSN_CD Claim Principal Diagnosis Version Code (FFS)
32 ICD_DGNS_CD1 Claim Diagnosis Code I (FFS)
33 ICD_DGNS_VRSN_CD1 Claim Diagnosis Code I Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
34 ICD_DGNS_CD2 Claim Diagnosis Code II (FFS)
35 ICD_DGNS_VRSN_CD2 Claim Diagnosis Code II Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
36 ICD_DGNS_CD3 Claim Diagnosis Code III (FFS)
37 ICD_DGNS_VRSN_CD3 Claim Diagnosis Code III Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
38 ICD_DGNS_CD4 Claim Diagnosis Code IV (FFS)
39 ICD_DGNS_VRSN_CD4 Claim Diagnosis Code IV Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
40 ICD_DGNS_CD5 Claim Diagnosis Code V (FFS)
41 ICD_DGNS_VRSN_CD5 Claim Diagnosis Code V Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
42 ICD_DGNS_CD6 Claim Diagnosis Code VI (FFS)
43 ICD_DGNS_VRSN_CD6 Claim Diagnosis Code VI Diagnosis Version Code (ICD-9/ICD-10) (FFS)
44 ICD_DGNS_CD7 Claim Diagnosis Code VII (FFS)
45 ICD_DGNS_VRSN_CD7 Claim Diagnosis Code VII Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
46 ICD_DGNS_CD8 Claim Diagnosis Code VIII (FFS)
47 ICD_DGNS_VRSN_CD8 Claim Diagnosis Code VIII Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
48 ICD_DGNS_CD9 Claim Diagnosis Code IX (FFS)
49 ICD_DGNS_VRSN_CD9 Claim Diagnosis Code IX Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
50 ICD_DGNS_CD10 Claim Diagnosis Code X (FFS)
51 ICD_DGNS_VRSN_CD10 Claim Diagnosis Code X Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
52 ICD_DGNS_CD11 Claim Diagnosis Code XI (FFS)
53 ICD_DGNS_VRSN_CD11 Claim Diagnosis Code XI Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
54 ICD_DGNS_CD12 Claim Diagnosis Code XII (FFS)
55 ICD_DGNS_VRSN_CD12 Claim Diagnosis Code XII Diagnosis Version Code (ICD-9 or ICD-10) (FFS)
56 CLM_CLNCL_TRIL_NUM Clinical Trial Number
57 DOB_DT Date of Birth from Claim
58 GNDR_CD Gender Code from Claim
59 BENE_RACE_CD Beneficiary Race Code (Encounter)
60 BENE_CNTY_CD County Code from Claim (SSA)
61 BENE_STATE_CD Beneficiary Residence (SSA) State Code (FFS)
62 BENE_MLG_CNTCT_ZIP_CD Zip Code of Residence from Claim
63 ACO_ID_NUM Claim Accountable Care Organization (ACO) Identification Number
64 CARR_CLM_SOS_NPI_NUM Carrier Claim Site of Service NPI Number
65 CLM_RSDL_PYMT_IND_CD Claim Residual Payment Indicator 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 PRTCPTNG_IND_CD Line Provider Participating Indicator Code
16 CARR_LINE_RDCD_PMT_PHYS_ASTN_C Carrier Line Reduced Payment Physician Assistant Code
17 LINE_SRVC_CNT Line Service Count (FFS)
18 LINE_CMS_TYPE_SRVC_CD Line CMS Type Service Code
19 LINE_PLACE_OF_SRVC_CD Line Place Of Service Code (FFS)
20 CARR_LINE_PRCNG_LCLTY_CD Carrier Line Pricing Locality Code
21 LINE_1ST_EXPNS_DT Line First Expense Date (FFS)
22 LINE_LAST_EXPNS_DT Line Last Expense Date (FFS)
23 HCPCS_CD Healthcare Common Procedure Coding System (HCPCS) Code (FFS)
24 HCPCS_1st_mdfr_cd HCPCS Initial Modifier Code (FFS)
25 HCPCS_2ND_MDFR_CD HCPCS Second Modifier Code (FFS)
26 BETOS_CD Line Berenson-Eggers Type of Service (BETOS) Code
27 LINE_NCH_PMT_AMT Line NCH Medicare Payment Amount
28 LINE_BENE_PMT_AMT Line Payment Amount to Beneficiary
29 LINE_PRVDR_PMT_AMT Line Provider Payment Amount
30 LINE_BENE_PTB_DDCTBL_AMT Line Beneficiary Part B Deductible Amount
31 LINE_BENE_PRMRY_PYR_CD Line Primary Payer Code (if not Medicare)
32 LINE_BENE_PRMRY_PYR_PD_AMT Line Primary Payer (if not Medicare) Paid Amount
33 LINE_COINSRNC_AMT Line Beneficiary Coinsurance Amount
34 LINE_SBMTD_CHRG_AMT Line Submitted Charge Amount
35 LINE_ALOWD_CHRG_AMT Line Allowed Charge Amount
36 LINE_PRCSG_IND_CD Line Processing Indicator Code
37 LINE_PMT_80_100_CD Line Payment 80% / 100% Code
38 LINE_SERVICE_DEDUCTIBLE Line Service Deductible Indicator Switch
39 CARR_LINE_MTUS_CNT Carrier Line Miles/Time/Units/Services (MTUS) Count
40 CARR_LINE_MTUS_CD Carrier Line Miles/Time/Units/Services (MTUS) Indicator Code
41 LINE_ICD_DGNS_CD Line Diagnosis Code
42 LINE_ICD_DGNS_VRSN_CD Line Diagnosis Code Diagnosis Version Code (ICD-9 or ICD-10)
43 HPSA_SCRCTY_IND_CD Carrier Line Health Professional Shortage Area (HPSA)/Scarcity Indicator Code
44 LINE_RX_NUM Carrier Line RX Number
45 LINE_HCT_HGB_RSLT_NUM Hematocrit/Hemoglobin Test Results
46 LINE_HCT_HGB_TYPE_CD Hematocrit/Hemoglobin Test Type Code
47 LINE_NDC_CD Line National Drug Code (NDC) (FFS)
48 CARR_LINE_CLIA_LAB_NUM Clinical Laboratory Improvement Amendments (CLIA) monitored laboratory number
49 CARR_LINE_ASNTHSA_UNIT_CNT Carrier Line Anesthesia Unit Count
50 CARR_LINE_CL_CHRG_AMT Carrier Line Clinical Lab Charge Amount
51 PHYSN_ZIP_CD Line Place of Service (POS) Physician Zip Code
66 THRPY_CAP_IND_CD1 Therapy cap Indicator 1 Code
67 THRPY_CAP_IND_CD2 Therapy cap Indicator 2 Code
68 THRPY_CAP_IND_CD3 Therapy cap Indicator 3 Code
69 THRPY_CAP_IND_CD4 Therapy cap Indicator 4 Code
70 THRPY_CAP_IND_CD5 Therapy cap Indicator 5 Code
71 CLM_NEXT_GNRTN_ACO_IND_CD1 Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Population-Based Payment (PBP)
72 CLM_NEXT_GNRTN_ACO_IND_CD2 Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Telehealth
73 CLM_NEXT_GNRTN_ACO_IND_CD3 Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Post Discharge HH visits
74 CLM_NEXT_GNRTN_ACO_IND_CD4 Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - 3-day SNF waiver
75 CLM_NEXT_GNRTN_ACO_IND_CD5 Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Capitation
76 Carrier Line Medicare Diabetes Prevention Program (MDPP) NPI Number
77 LINE_RSDL_PYMT_IND_CD Line Residual Payment Indicator Code
78 LINE_RP_IND_CD Line Representative Payee (RP) Indicator Code
79 LINE_PRVDR_VLDTN_TYPE_CD Line Provider Validation Type Code
80 LINE_VLNTRY_SRVC_IND_CD Line Voluntary Service Indicator 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