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
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)
52 HCBS_TXNMY_WVR_CD Home and community-based services (HCBS) taxonomy code for waviers
25 CLTC_FLAG Community-based LT care (CLTC) flag
24 MAX_TOS MAX Type of Service (TOS)
26 PRVDR_ID_NMBR Billing provider identification number (MAX)
27 NPI National Provider Identifier (MAX)
28 TAXONOMY Provider Taxonomy
29 TYPE_CLM_CD Type of claim
30 ADJUST_CD Adjustment code
31 PHP_TYPE Managed care type of plan code
32 PHP_ID Managed care plan identification code
33 MDCD_PYMT_AMT Medicaid payment amount
34 TP_PYMT_AMT Third party payment amount
35 PYMT_DT Payment/adjudication date
36 CHRG_AMT Charge amount
37 PHP_VAL Prepaid plan value
38 MDCR_COINSUR_PYMT_AMT Medicare coinsurance payment amount
39 MDCR_DED_PYMT_AMT Medicare deductible payment amount
40 SRVC_BGN_DT Beginning date of service
41 SRVC_END_DT Ending date of service
42 PRCDR_CD_SYS Procedure (service) coding system
43 PRCDR_CD Procedure (service) code
44 PRCDR_SRVC_MDFR_CD Procedure (service) code modifier
45 DIAG_CD_1 Principle Diagnosis code
46 DIAG_CD_2 Diagnosis codes (2nd diagnosis)
47 QTY_SRVC_UNITS Quantity of service
48 SRVC_PRVDR_ID_NMBR Servicing provider identification number (MAX)
49 SRVC_PRVDR_SPEC_CD Servicing provider specialty code (MAX)
50 PLC_OF_SRVC_CD Place of service
51 UB_92_REV_CD UB-92 revenue code