File Version:
K, CCW Data Documentation April, 2020
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 FI_CLM_PROC_DT FI Claim Process Date
9 CLAIM_QUERY_CODE Claim Query Code
10 PRVDR_NUM Provider Number
11 CLM_FAC_TYPE_CD Claim Facility Type Code (FFS)
12 CLM_SRVC_CLSFCTN_TYPE_CD Claim Service Classification Type Code (FFS)
13 CLM_FREQ_CD Claim Frequency Code (FFS)
14 FI_NUM FI or MAC Number
15 CLM_MDCR_NON_PMT_RSN_CD Claim Medicare Non Payment Reason Code
16 CLM_PMT_AMT Claim (Medicare) Payment Amount
17 NCH_PRMRY_PYR_CLM_PD_AMT NCH Primary Payer (if not Medicare) Claim Paid Amount
18 NCH_PRMRY_PYR_CD NCH Primary Payer Code (if not Medicare)
19 FI_CLM_ACTN_CD FI or MAC Claim Action Code
20 PRVDR_STATE_CD NCH Provider SSA State Code
21 ORG_NPI_NUM Organization (or group) NPI Number
22 AT_PHYSN_UPIN Claim Attending Physician UPIN Number
23 AT_PHYSN_NPI Claim Attending Physician NPI Number (FFS)
24 AT_PHYSN_SPCLTY_CD Claim Attending Physician Specialty Code
25 OP_PHYSN_UPIN Claim Operating Physician UPIN Number
26 OP_PHYSN_NPI Claim Operating Physician NPI Number (FFS)
27 OP_PHYSN_SPCLTY_CD Claim Operating Physician Specialty Code
28 OT_PHYSN_UPIN Claim Other Physician UPIN Number
29 OT_PHYSN_NPI Claim Other Physician NPI Number (FFS)
30 OT_PHYSN_SPCLTY_CD Claim Other Physician Specialty Code
31 RNDRNG_PHYSN_NPI Rendering Physician NPI (FFS)
32 CLM_RNDRNG_PHYSN_SPCLTY_CD Claim Rendering Physician Specialty Code
33 CLM_MCO_PD_SW Claim MCO Paid Switch
34 PTNT_DSCHRG_STUS_CD Patient Discharge Status Code (FFS)
35 CLM_PPS_IND_CD Claim PPS Indicator Code
36 CLM_TOT_CHRG_AMT Claim Total Charge Amount
37 CLM_ADMSN_DT Claim Admission Date (FFS)
38 CLM_IP_ADMSN_TYPE_CD Claim Inpatient Admission Type Code (FFS)
39 CLM_SRC_IP_ADMSN_CD Claim Source Inpatient Admission Code (FFS)
40 NCH_PTNT_STATUS_IND_CD NCH Patient Status Indicator Code
41 NCH_BENE_IP_DDCTBL_AMT NCH Beneficiary Inpatient (or other Part A) Deductible Amount
42 NCH_BENE_PTA_COINSRNC_LBLTY_AM NCH Beneficiary Part A Coinsurance Liability Amount
43 NCH_BENE_BLOOD_DDCTBL_LBLTY_AM NCH Beneficiary Blood Deductible Liability Amount
44 NCH_IP_NCVRD_CHRG_AMT NCH Inpatient (or other Part A) Non-covered Charge Amount
45 NCH_IP_TOT_DDCTN_AMT NCH Inpatient (or other Part A) Total Deductible/Coinsurance Amount
46 CLM_PPS_CPTL_FSP_AMT Claim PPS Capital Federal Specific Portion (FSP) Amount
47 CLM_PPS_CPTL_OUTLIER_AMT Claim PPS Capital Outlier Amount
48 CLM_PPS_CPTL_DSPRPRTNT_SHR_AMT Claim PPS Capital Disproportionate Share Amount
49 CLM_PPS_CPTL_IME_AMT Claim PPS Capital Indirect Medical Education (IME) Amount
50 CLM_PPS_CPTL_EXCPTN_AMT Claim PPS Capital Exception Amount
51 CLM_PPS_OLD_CPTL_HLD_HRMLS_AMT Claim PPS Old Capital Hold Harmless Amount
52 CLM_UTLZTN_DAY_CNT Claim Medicare Utilization Day Count
53 BENE_TOT_COINSRNC_DAYS_CNT Beneficiary Total Coinsurance Days Count
54 CLM_NON_UTLZTN_DAYS_CNT Claim Medicare Non Utilization Days Count
55 NCH_BLOOD_PNTS_FRNSHD_QTY NCH Blood Pints Furnished Quantity
56 NCH_QLFYD_STAY_FROM_DT NCH Qualified Stay From Date
57 NCH_QLFYD_STAY_THRU_DT NCH Qualified Stay Through Date
58 NCH_VRFD_NCVRD_STAY_FROM_DT NCH Verified Non-covered Stay From Date
59 NCH_VRFD_NCVRD_STAY_THRU_DT NCH Verified Non-covered Stay Through Date
60 NCH_ACTV_OR_CVRD_LVL_CARE_THRU NCH Active or Covered Level Care Thru Date
61 NCH_BENE_MDCR_BNFTS_EXHTD_DT_I NCH Beneficiary Medicare Benefits Exhausted Date
62 NCH_BENE_DSCHRG_DT NCH Beneficiary Discharge Date
63 CLM_DRG_CD Claim Diagnosis Related Group Code (or MS-DRG Code)
64 ADMTG_DGNS_CD Claim Admitting Diagnosis Code (FFS)
65 PRNCPAL_DGNS_CD Claim Principal Diagnosis Code (FFS)
66 ICD_DGNS_CD1 Claim Diagnosis Code I (FFS)
67 ICD_DGNS_CD2 Claim Diagnosis Code II (FFS)
68 ICD_DGNS_CD3 Claim Diagnosis Code III (FFS)
69 ICD_DGNS_CD4 Claim Diagnosis Code IV (FFS)
70 ICD_DGNS_CD5 Claim Diagnosis Code V (FFS)
71 ICD_DGNS_CD6 Claim Diagnosis Code VI (FFS)
72 ICD_DGNS_CD7 Claim Diagnosis Code VII (FFS)
73 ICD_DGNS_CD8 Claim Diagnosis Code VIII (FFS)
74 ICD_DGNS_CD9 Claim Diagnosis Code IX (FFS)
75 ICD_DGNS_CD10 Claim Diagnosis Code X (FFS)
76 ICD_DGNS_CD11 Claim Diagnosis Code XI (FFS)
77 ICD_DGNS_CD12 Claim Diagnosis Code XII (FFS)
78 ICD_DGNS_CD13 Claim Diagnosis Code XIII (FFS)
79 ICD_DGNS_CD14 Claim Diagnosis Code XIV (FFS)
80 ICD_DGNS_CD15 Claim Diagnosis Code XV (FFS)
81 ICD_DGNS_CD16 Claim Diagnosis Code XVI (FFS)
82 ICD_DGNS_CD17 Claim Diagnosis Code XVII (FFS)
83 ICD_DGNS_CD18 Claim Diagnosis Code XVIII (FFS)
84 ICD_DGNS_CD19 Claim Diagnosis Code XIX (FFS)
85 ICD_DGNS_CD20 Claim Diagnosis Code XX (FFS)
86 ICD_DGNS_CD21 Claim Diagnosis Code XXI (FFS)
87 ICD_DGNS_CD22 Claim Diagnosis Code XXII (FFS)
88 ICD_DGNS_CD23 Claim Diagnosis Code XXIII (FFS)
89 ICD_DGNS_CD24 Claim Diagnosis Code XXIV (FFS)
90 ICD_DGNS_CD25 Claim Diagnosis Code XXV (FFS)
91 FST_DGNS_E_CD First Claim Diagnosis E Code (FFS)
92 ICD_DGNS_E_CD1 Claim Diagnosis E Code I (FFS)
93 ICD_DGNS_E_CD2 Claim Diagnosis E Code II (FFS)
94 ICD_DGNS_E_CD3 Claim Diagnosis E Code III (FFS)
95 ICD_DGNS_E_CD4 Claim Diagnosis E Code IV (FFS)
96 ICD_DGNS_E_CD5 Claim Diagnosis E Code V (FFS)
97 ICD_DGNS_E_CD6 Claim Diagnosis E Code VI (FFS)
98 ICD_DGNS_E_CD7 Claim Diagnosis E Code VII (FFS)
99 ICD_DGNS_E_CD8 Claim Diagnosis E Code VIII (FFS)
100 ICD_DGNS_E_CD9 Claim Diagnosis E Code IX (FFS)
101 ICD_DGNS_E_CD10 Claim Diagnosis E Code X (FFS)
102 ICD_DGNS_E_CD11 Claim Diagnosis E Code XI
103 ICD_DGNS_E_CD12 Claim Diagnosis E Code XII
104 ICD_PRCDR_CD1 Claim Procedure Code I (FFS)
105 PRCDR_DT1 Claim Procedure Code I Date (FFS)
106 ICD_PRCDR_CD2 Claim Procedure Code II (FFS)
107 PRCDR_DT2 Claim Procedure Code II Date (FFS)
108 ICD_PRCDR_CD3 Claim Procedure Code III (FFS)
109 PRCDR_DT3 Claim Procedure Code III Date (FFS)
110 ICD_PRCDR_CD4 Claim Procedure Code IV (FFS)
111 PRCDR_DT4 Claim Procedure Code IV Date (FFS)
112 ICD_PRCDR_CD5 Claim Procedure Code V (FFS)
113 PRCDR_DT5 Claim Procedure Code V Date (FFS)
114 ICD_PRCDR_CD6 Claim Procedure Code VI (FFS)
115 PRCDR_DT6 Claim Procedure Code VI Date (FFS)
116 ICD_PRCDR_CD7 Claim Procedure Code VII (FFS)
117 PRCDR_DT7 Claim Procedure Code VII Date (FFS)
118 ICD_PRCDR_CD8 Claim Procedure Code VIII (FFS)
119 PRCDR_DT8 Claim Procedure Code VIII Date (FFS)
120 ICD_PRCDR_CD9 Claim Procedure Code IX (FFS)
121 PRCDR_DT9 Claim Procedure Code IX Date (FFS)
122 ICD_PRCDR_CD10 Claim Procedure Code X (FFS)
123 PRCDR_DT10 Claim Procedure Code X Date (FFS)
124 ICD_PRCDR_CD11 Claim Procedure Code XI (FFS)
125 PRCDR_DT11 Claim Procedure Code XI Date (FFS)
126 ICD_PRCDR_CD12 Claim Procedure Code XII (FFS)
127 PRCDR_DT12 Claim Procedure Code XII Date (FFS)
128 ICD_PRCDR_CD13 Claim Procedure Code XIII (FFS)
129 PRCDR_DT13 Claim Procedure Code XIII Date (FFS)
130 ICD_PRCDR_CD14 Claim Procedure Code XIV
131 PRCDR_DT14 Claim Procedure Code XIV Date
132 ICD_PRCDR_CD15 Claim Procedure Code XV
133 PRCDR_DT15 Claim Procedure Code XV Date
134 ICD_PRCDR_CD16 Claim Procedure Code XVI
135 PRCDR_DT16 Claim Procedure Code XVI Date
136 ICD_PRCDR_CD17 Claim Procedure Code XVII
137 PRCDR_DT17 Claim Procedure Code XVII Date
138 ICD_PRCDR_CD18 Claim Procedure Code XVIII
139 PRCDR_DT18 Claim Procedure Code XVIII Date
140 ICD_PRCDR_CD19 Claim Procedure Code XIX
141 PRCDR_DT19 Claim Procedure Code XIX Date
142 ICD_PRCDR_CD20 Claim Procedure Code XX
143 PRCDR_DT20 Claim Procedure Code XX Date
144 ICD_PRCDR_CD21 Claim Procedure Code XXI
145 PRCDR_DT21 Claim Procedure Code XXI Date
146 ICD_PRCDR_CD22 Claim Procedure Code XXII
147 PRCDR_DT22 Claim Procedure Code XXII Date
148 ICD_PRCDR_CD23 Claim Procedure Code XXIII
149 PRCDR_DT23 Claim Procedure Code XXIII Date
150 ICD_PRCDR_CD24 Claim Procedure Code XXIV
151 PRCDR_DT24 Claim Procedure Code XXIV Date
152 ICD_PRCDR_CD25 Claim Procedure Code XXV
153 PRCDR_DT25 Claim Procedure Code XXV Date
154 DOB_DT Date of Birth from Claim
155 GNDR_CD Gender Code from Claim
156 BENE_RACE_CD Beneficiary Race Code (FFS)
157 BENE_CNTY_CD County Code from Claim (SSA)
158 BENE_STATE_CD Beneficiary Residence (SSA) State Code (FFS)
159 BENE_MLG_CNTCT_ZIP_CD Zip Code of Residence from Claim
160 CLM_MDCL_REC Claim Medical Record Number (FFS)
161 CLM_TRTMT_AUTHRZTN_NUM Claim Treatment Authorization Number
162 CLM_PRCR_RTRN_CD Claim Pricer Return Code
163 CLM_SRVC_FAC_ZIP_CD Claim service facility ZIP code (where service was provided)
164 NCH_PROFNL_CMPNT_CHRG_AMT Professional Component Charge Amount
165 CLM_NEXT_GNRTN_ACO_IND_CD1 Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Population-Based Payment (PBP)
166 CLM_NEXT_GNRTN_ACO_IND_CD2 Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Telehealth
167 CLM_NEXT_GNRTN_ACO_IND_CD3 Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Post Discharge HH visits
168 CLM_NEXT_GNRTN_ACO_IND_CD4 Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - 3-day SNF waiver
169 CLM_NEXT_GNRTN_ACO_IND_CD5 Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Capitation
170 ACO_ID_NUM Claim Accountable Care Organization (ACO) Identification Number
171 CLM_BENE_ID_TYPE_CD Claim Beneficiary Identifier Type Code
172 CLM_RSDL_PYMT_IND_CD Claim Residual Payment Indicator Code
173 PRVDR_VLDTN_TYPE_CD Provider Validation Type Code
174 RR_BRD_EXCLSN_IND_SW Railroad Board Exclusion Indicator Switch
175 CLM_MODEL_REIMBRSMT_AMT Claim Model Reimbursement Amount

Revenue Center File

NumberSAS NameVariable Name
1 BENE_ID Encrypted CCW Beneficiary ID
2 CLM_ID Claim ID
3 CLM_THRU_DT Claim Through Date (FFS)
4 CLM_LINE_NUM Claim Line Number
5 NCH_CLM_TYPE_CD NCH Claim Type Code
6 REV_CNTR Revenue Center Code (FFS)
7 HCPCS_CD Healthcare Common Procedure Coding System (HCPCS) Code (FFS)
8 HCPCS_1st_mdfr_cd HCPCS Initial Modifier Code (FFS)
9 HCPCS_2ND_MDFR_CD HCPCS Second Modifier Code (FFS)
10 HCPCS_3RD_MDFR_CD HCPCS Third Modifier Code (FFS)
11 REV_CNTR_UNIT_CNT Revenue Center Unit Count (FFS)
12 REV_CNTR_RATE_AMT Revenue Center Rate Amount
13 REV_CNTR_TOT_CHRG_AMT Revenue Center Total Charge Amount
14 REV_CNTR_NCVRD_CHRG_AMT Revenue Center Non-Covered Charge Amount
15 REV_CNTR_DDCTBL_COINSRNC_CD Revenue Center Deductible Coinsurance Code
16 REV_CNTR_NDC_QTY Revenue Center National Drug Code (NDC) Quantity (FFS)
17 REV_CNTR_NDC_QTY_QLFR_CD Revenue Center NDC Quantity Qualifier Code (FFS)
18 RNDRNG_PHYSN_UPIN Revenue Center Rendering Physician UPIN
19 RNDRNG_PHYSN_NPI Rendering Physician NPI (FFS)
20 RNDRNG_PHYSN_SPCLTY_CD Claim or Revenue Center Rendering Physician Specialty Code
21 REV_CNTR_IDE_NDC_UPC_NUM Revenue Center IDE, NDC, or UPC Number (FFS)
22 REV_CNTR_PRCNG_IND_CD Revenue Center Pricing Indicator Code
23 THRPY_CAP_IND_CD1 Therapy cap Indicator 1 Code
24 THRPY_CAP_IND_CD2 Therapy cap Indicator 2 Code
25 REV_CNTR_RP_IND_CD Revenue Center Representative Payee (RP) Indicator Code
26 RC_MODEL_REIMBRSMT_AMT Revenue Center Model Reimbursement Amount

Condition 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 RLT_COND_CD_SEQ Claim Related Condition Code Sequence
5 CLM_RLT_COND_CD Claim Related Condition Code (FFS)

Occurence 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 RLT_OCRNC_CD_SEQ Claim Related Occurrence Code Sequence
5 CLM_RLT_OCRNC_CD Claim Related Occurrence Code (FFS)
6 CLM_RLT_OCRNC_DT Claim Related Occurrence Date (FFS)

Span 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 RLT_SPAN_CD_SEQ Claim Related Span Code Sequence
5 CLM_SPAN_CD Claim Occurrence Span Code (FFS)
6 CLM_SPAN_FROM_DT Claim Occurrence Span From Date (FFS)
7 CLM_SPAN_THRU_DT Claim Occurrence Span Through Date (FFS)

Value 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 RLT_VAL_CD_SEQ Claim Related Value Code Sequence
5 CLM_VAL_CD Claim Value Code (FFS)
6 CLM_VAL_AMT Claim Value Amount

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