File Version:
CCW record layout accessed May, 2019; CMS MAX 2014 data dictionary Aug 18, 2016
NumberSAS NameVariable Name
1 BENE_ID Encrypted 723 CCW Beneficiary ID
2 MSIS_ID Encrypted MSIS Identification Number
3 STATE_CD State
4 YR_NUM Year of MAX Record
5 EL_DOB Birth date
6 EL_SEX_CD Sex (MAX)
7 EL_RACE_ETHNCY_CD Race/ethnicity (from MSIS)
8 RACE_CODE_1 Race - White (from MSIS)
9 RACE_CODE_2 Race - Black (from MSIS)
10 RACE_CODE_3 Race - Am Indian/Alaskan (from MSIS)
11 RACE_CODE_4 Race - Asian (from MSIS)
12 RACE_CODE_5 Race - Hawaiian/Pac Islands (from MSIS)
13 ETHNICITY_CODE Ethnicity - Hispanic (from MSIS)
14 EL_SS_ELGBLTY_CD_LTST State specific eligibility - most recent
15 EL_SS_ELGBLTY_CD_MO State specific eligibility - mo of svc
16 EL_MAX_ELGBLTY_CD_LTST MAX eligibility - most recent
17 EL_MAX_ELGBLTY_CD_MO MAX eligibility - mo of svc
18 EL_MDCR_ANN_XOVR_OLD Crossover code (Annual) old values
19 MSNG_ELG_DATA Missing eligibility data
20 EL_MDCR_XOVR_CLM_BSD_CD Crossover code (from claims only)
21 EL_MDCR_ANN_XOVR_99 Crossover code (Annual)
22 MSIS_TOS MSIS Type of Service (TOS)
23 MSIS_TOP MSIS Type of Program (TOP)
24 MAX_TOS MAX Type of Service (TOS)
25 PRVDR_ID_NMBR Billing provider identification number (MAX)
26 NPI National Provider Identifier (MAX)
27 TAXONOMY Provider Taxonomy
28 TYPE_CLM_CD Type of claim
29 ADJUST_CD Adjustment code
30 PHP_TYPE Managed care type of plan code
31 PHP_ID Managed care plan identification code
32 MDCD_PYMT_AMT Medicaid payment amount
33 TP_PYMT_AMT Third party payment amount
34 PYMT_DT Payment/adjudication date
35 CHRG_AMT Charge amount
36 PHP_VAL Prepaid plan value
37 MDCR_COINSUR_PYMT_AMT Medicare coinsurance payment amount
38 MDCR_DED_PYMT_AMT Medicare deductible payment amount
39 ADMSN_DT Admission date (MAX)
40 SRVC_BGN_DT Beginning date of service
41 SRVC_END_DT Ending date of service
42 DIAG_CD_1 Principle Diagnosis code
43 DIAG_CD_2 Diagnosis codes (2nd diagnosis)
44 DIAG_CD_3 Diagnosis codes (3rd diagnosis)
45 DIAG_CD_4 Diagnosis codes (4th diagnosis)
46 DIAG_CD_5 Diagnosis codes (5th diagnosis)
47 DIAG_CD_6 Diagnosis codes (6th diagnosis)
48 DIAG_CD_7 Diagnosis codes (7th diagnosis)
49 DIAG_CD_8 Diagnosis codes (8th diagnosis)
50 DIAG_CD_9 Diagnosis codes (9th diagnosis)
51 PRNCPL_PRCDR_DT Principle procedure date
52 PRCDR_CD_SYS_1 Procedure code system- principal
53 PRCDR_CD_1 Principle procedure code
54 PRCDR_CD_SYS_2 Procedure code system (2nd procedure)
55 PRCDR_CD_2 Procedure code (2nd procedure)
56 PRCDR_CD_SYS_3 Procedure code system (3rd procedure)
57 PRCDR_CD_3 Procedure code (3rd procedure)
58 PRCDR_CD_SYS_4 Procedure code system (4th procedure)
59 PRCDR_CD_4 Procedure code (4th procedure)
60 PRCDR_CD_SYS_5 Procedure code system (5th procedure)
61 PRCDR_CD_5 Procedure code (5th procedure)
62 PRCDR_CD_SYS_6 Procedure code system (6th procedure)
63 PRCDR_CD_6 Procedure code (6th procedure)
64 RCPNT_DLVRY_CD Delivery code (MAX IP)
65 MDCD_CVRD_IP_DAYS Medicaid covered inpatient days
66 PATIENT_STATUS_CD Patient status
67 DRG_REL_GROUP_IND Diagnosis Related Group (DRG) indicator
68 DRG_REL_GROUP Diagnosis Related Group (DRG)
69 UB_92_REV_CD_GP_1 UB-92 revenue code (1st)
70 UB_92_REV_CD_CHGS_1 UB-92 revenue code charge (1st)
71 UB_92_REV_CD_UNITS_1 UB-92 revenue code units (1st)
72 UB_92_REV_CD_GP_2 UB-92 revenue code (2nd)
73 UB_92_REV_CD_CHGS_2 UB-92 revenue code charge (2nd)
74 UB_92_REV_CD_UNITS_2 UB-92 revenue code units (2nd)
75 UB_92_REV_CD_GP_3 UB-92 revenue code (3rd)
76 UB_92_REV_CD_CHGS_3 UB-92 revenue code charge (3rd)
77 UB_92_REV_CD_UNITS_3 UB-92 revenue code units (3rd)
78 UB_92_REV_CD_GP_4 UB-92 revenue code (4th)
79 UB_92_REV_CD_CHGS_4 UB-92 revenue code charge (4th)
80 UB_92_REV_CD_UNITS_4 UB-92 revenue code units (4th)
81 UB_92_REV_CD_GP_5 UB-92 revenue code (5th)
82 UB_92_REV_CD_CHGS_5 UB-92 revenue code charge (5th)
83 UB_92_REV_CD_UNITS_5 UB-92 revenue code units (5th)
84 UB_92_REV_CD_GP_6 UB-92 revenue code (6th)
85 UB_92_REV_CD_CHGS_6 UB-92 revenue code charge (6th)
86 UB_92_REV_CD_UNITS_6 UB-92 revenue code units (6th)
87 UB_92_REV_CD_GP_7 UB-92 revenue code (7th)
88 UB_92_REV_CD_CHGS_7 UB-92 revenue code charge (7th)
89 UB_92_REV_CD_UNITS_7 UB-92 revenue code units (7th)
90 UB_92_REV_CD_GP_8 UB-92 revenue code (8th)
91 UB_92_REV_CD_CHGS_8 UB-92 revenue code charge (8th)
92 UB_92_REV_CD_UNITS_8 UB-92 revenue code units (8th)
93 UB_92_REV_CD_GP_9 UB-92 revenue code (9th)
94 UB_92_REV_CD_CHGS_9 UB-92 revenue code charge (9th)
95 UB_92_REV_CD_UNITS_9 UB-92 revenue code units (9th)
96 UB_92_REV_CD_GP_10 UB-92 revenue code (10th)
97 UB_92_REV_CD_CHGS_10 UB-92 revenue code charge (10th)
98 UB_92_REV_CD_UNITS_10 UB-92 revenue code units (10th)
99 UB_92_REV_CD_GP_11 UB-92 revenue code (11th)
100 UB_92_REV_CD_CHGS_11 UB-92 revenue code charge (11th)
101 UB_92_REV_CD_UNITS_11 UB-92 revenue code units (11th)
102 UB_92_REV_CD_GP_12 UB-92 revenue code (12th)
103 UB_92_REV_CD_CHGS_12 UB-92 revenue code charge (12th)
104 UB_92_REV_CD_UNITS_12 UB-92 revenue code units (12th)
105 UB_92_REV_CD_GP_13 UB-92 revenue code (13th)
106 UB_92_REV_CD_CHGS_13 UB-92 revenue code charge (13th)
107 UB_92_REV_CD_UNITS_13 UB-92 revenue code units (13th)
108 UB_92_REV_CD_GP_14 UB-92 revenue code (14th)
109 UB_92_REV_CD_CHGS_14 UB-92 revenue code charge (14th)
110 UB_92_REV_CD_UNITS_14 UB-92 revenue code units (14th)
111 UB_92_REV_CD_GP_15 UB-92 revenue code (15th)
112 UB_92_REV_CD_CHGS_15 UB-92 revenue code charge (15th)
113 UB_92_REV_CD_UNITS_15 UB-92 revenue code units (15th)
114 UB_92_REV_CD_GP_16 UB-92 revenue code (16th)
115 UB_92_REV_CD_CHGS_16 UB-92 revenue code charge (16th)
116 UB_92_REV_CD_UNITS_16 UB-92 revenue code units (16th)
117 UB_92_REV_CD_GP_17 UB-92 revenue code (17th)
118 UB_92_REV_CD_CHGS_17 UB-92 revenue code charge (17th)
119 UB_92_REV_CD_UNITS_17 UB-92 revenue code units (17th)
120 UB_92_REV_CD_GP_18 UB-92 revenue code (18th)
121 UB_92_REV_CD_CHGS_18 UB-92 revenue code charge (18th)
122 UB_92_REV_CD_UNITS_18 UB-92 revenue code units (18th)
123 UB_92_REV_CD_GP_19 UB-92 revenue code (19th)
124 UB_92_REV_CD_CHGS_19 UB-92 revenue code charge (19th)
125 UB_92_REV_CD_UNITS_19 UB-92 revenue code units (19th)
126 UB_92_REV_CD_GP_20 UB-92 revenue code (20th)
127 UB_92_REV_CD_CHGS_20 UB-92 revenue code charge (20th)
128 UB_92_REV_CD_UNITS_20 UB-92 revenue code units (20th)
129 UB_92_REV_CD_GP_21 UB-92 revenue code (21st)
130 UB_92_REV_CD_CHGS_21 UB-92 revenue code charge (21st)
131 UB_92_REV_CD_UNITS_21 UB-92 revenue code units (21st)
132 UB_92_REV_CD_GP_22 UB-92 revenue code (22nd)
133 UB_92_REV_CD_CHGS_22 UB-92 revenue code charge (22nd)
134 UB_92_REV_CD_UNITS_22 UB-92 revenue code units (22nd)
135 UB_92_REV_CD_GP_23 UB-92 revenue code (23rd)
136 UB_92_REV_CD_CHGS_23 UB-92 revenue code charge (23rd)
137 UB_92_REV_CD_UNITS_23 UB-92 revenue code units (23rd)