Updated research request forms and data security approval requirement effective 4/24/23
Data File Search
What does this file include? (variable highlights)
Beneficiary ID
Model-Assigned Practice ID
Model-Assigned Patient ID
Provider NPI
Activity Date
Activity End Date
Provider NPI
Clinical Service Procedure Code
Clinical Service Procedure Modifier
Service Units
A record represents one clinical data element per beneficiary. Beneficiaries that have multiple clinical data elements will have multiple records.
The Unique Model-Assigned Patient ID can be used to link to other Million Hearts® beneficiary…
Program:
Medicare
These data files may be used as ‘finder files’ in combination with other requested Chronic Conditions Warehouse (CCW) files to isolate results to include (or not include as desired) entities, providers and or beneficiaries participating in specific models.
Each model has a set of up to three (3) files, one per participant type:
Entity file
Provider file
Beneficiary file
Data for each model will be updated the first month of each calendar quarter, unless the model has ended. Models which have ended are…
Program:
Medicare
What does this file include? (variable highlights)
Model-Assigned Practice ID
Model-Assigned Patient ID
Visit Date
Baseline CVD Risk Score
CVD Risk Score at the time of the visit
Baseline risk group (low, medium, high)
A record represents a patient at the time of a particular visit, and includes information such as visit date, baseline risk score, visit risk score, and baseline group.
The Unique Model-Assigned Patient ID can be used to link to other Million Hearts® beneficiary files (demographic, visit…
Program:
Medicare
What does this file include? (variable highlights)
Model ID (with which the Beneficiary is associated)
Entity ID (with which the Beneficiary is associated)
CCW Beneficiary ID
Beneficiary Start Date
Beneficiary End Date
Voluntary Alignment Indicator
The Entity ID is the only key field needed to link a Beneficiary to their Entity.
The Beneficiary file also contains the CCW Beneficiary ID that can be used to link to claims and other relevant CCW data.
A Beneficiary may have an End Date of 12/31/9999,…
Program:
Medicare
What does this file include? (variable highlights)
Model-Assigned Practice ID
Practice Name
Practice TIN
Unique Model-Assigned Patient ID
Aligned Flag
Eligible Flag
Patient Status Change Reason Code
A record represents the eligibility and alignment status of a beneficiary.
The Unique Model-Assigned Patient ID can be used to link to other Million Hearts® beneficiary files (demographic, visit, and alignment), but cannot link to other CCW non-Million Hearts® files.
The Model-Assigned Practice ID can be…
Program:
Medicare
What is a clinical data element? Data fields that can be collected, utilized, or stored in various application systems.
What does this file include? (variable highlights)
Beneficiary ID
Model-Assigned Practice ID
Model-Assigned Patient ID
Provider NPI
Activity Date
Activity End Date
Provider NPI
Clinical Service Procedure Code
Clinical Service Procedure Modifier
Service Units
A record represents one clinical data element per beneficiary. Beneficiaries that have multiple clinical data elements will…
Program:
Medicare
What does this file include? (variable highlights)
Model ID (in which the Entity participates)
Model Name (in which the Entity particpates)
Entity ID
Entity Name
Entity Type
Entity Start Date
Entity End Date
The Entity ID is unique to CMMI systems and cannot be used to link to claims data or other CCW data. The Entity ID is the key field for tying CMDS Provider and Beneficiary participation data to a specific Entity and is unique across all models.
An Entity may have an End Date of 12/31/9999, which…
Program:
Medicare
What does this file include? (variable highlights)
Model-Assigned Practice ID
Practice Billing TIN
Practice Location
Comma-Separated Lists of Affiliated Practice NPIs and CCNs (Facility Numbers)
A record represents a single physician practice (billing TIN).
The practice TIN can be linked to other Medicare data that contains TINs.
The Model-Assigned Practice ID can be used to link all Million Hearts® data files for provider-oriented analytics. It does not link to other CCW provider data.
Program:
Medicare
The Million Hearts® Cardiovascular Disease Risk Reduction Model used data-driven predictive modeling approaches to generate individualized risk scores and mitigation plans for eligible Medicare fee-for-service beneficiaries.
The data from the trial is released as a suite of seventeen linked data files. The data include detailed information about the beneficiaries, physician practices, specific providers and clinic visits. The files do not contain names, street addresses or contact information. However, they…
Program:
Medicare
What does this file include? (variable highlights)
Beneficiary ID
Model-Assigned Patient ID
Patient Date of Birth
Patient Gender
Patient Race
Patient Ethnicity
A record represents a single beneficiary. Some beneficiaries may have more than one record if more than one organization tried to enroll them in the trial.
The Unique Model-Assigned Patient ID can be used to link to other Million Hearts® beneficiary files (demographic, visit, and alignment), but cannot link to other CCW non-Million Hearts® files…
Program:
Medicare
What does this file include? (variable highlights)
Model ID (in which the Provider participates)
Entity ID (with which the Provider is associated)
National Provider Identifier (NPI)
Tax Identification Number (TIN)
CMS Certification Number (CCN)
Provider Start Date
Provider End Date
Provider Participation Type Code
The Entity ID is the only key field needed to link a Provider to their Entity.
The NPI, TIN, and/or CCN can be used to link to claims and other relevant CCW data.
A Provider may have an…
Program:
Medicare
What does this file include? (variable highlights)
NPI of the Participating Provider
Provider First and Last Name
Model-Assigned Practice ID the provider is associated with
Practice Name
Practice TIN
A record represents a provider (NPI) who is enrolled in the registry.
The Model-Assigned Practice ID can be used to link all Million Hearts® data files for provider-oriented analytics. It does not link to other CCW provider data.
Program:
Medicare
What does this file include? (variable highlights)
State, county annual SSA codes
State, county monthly FIPS codes
Zip code, State and County
Date of birth, date of death
Race
Reason for entitlement
Monthly enrollment for each part of the Medicare program, A/B/C/D
Dual eligible status
Part C plan and enrollment information
Part D plan and enrollment information
Part D low income cost sharing
Special considerations
Four additional segments are available for order with this file:
Chronic…
Program:
Medicare
What does this file include? (variable highlights)
Two flags for each chronic condition:
First occurrence date
End of year indicator
Special considerations
The algorithms used to assign the flags are available from the CCW website.
Algorithms requiring a multiple-year look back period are completed without requiring the researcher to order multiple years of data.
Algorithms search data from Medicare Fee-For-Service (FFS) claims.
This file is a segment that can be requested in addition to the Master…
Program:
Medicare
What does this file include? (variable highlights)
Three flags for each chronic condition:
First occurrence date
Mid year indicator
End of year indicator
Special considerations
The algorithms used to assign the flags are available from the CCW website.
Algorithms requiring a multiple-year look back period are completed without requiring the researcher to order multiple years of data.
Algorithms search data from Medicare Fee-For-Service (FFS) claims.
The 27 CCW algorithms are being replaced with 30…
Program:
Medicare
What does this file include? (variable highlights)
Two flags for each chronic condition:
First ever occurrence date
End of year indicator
This file is a segment that can be requested in addition to the Master Beneficiary Summary File (MBSF) base file.
Special considerations
This file uses information from Fee-For-Service (FFS) Medicare claims.
Program:
Medicare
What does this file include? (variable highlights)
Summary of utilization and total annual payments for services such as:
physician visits, dialysis, DME, IP recorded emergency room visits, Ambulatory Surgical Centers, anesthesia, imaging, Part B drugs from Fee-for-service (FFS) Medicare
Number of hospital stays, Medicare covered days and total annual inpatient payments for services covered by FFS Medicare
Summary of Part D payments, events and prescription fills
This file is a segment that can be…
Program:
Medicare
What does this file include? (variable highlights)
NDI date of death
ICD-10 code for cause of death
Underlying conditions for cause of death
CDC category code for cause of death
This file is a segment that can be requested in addition to the Master Beneficiary Summary File (MBSF) base file.
Program:
Medicare
What does this file include? (variable highlights)
Admission, discharge dates
Diagnosis (ICD diagnosis)
Procedure (ICD procedure code)
FFS reimbursement amount
Hospital provider number
Program:
Medicare
This file includes (variable highlights)
Diagnosis (ICD diagnosis),
Procedure (ICD procedure code)
Admission, discharge dates or end date of covered benefits
Charge amounts, total and assigned to specific departments
FFS reimbursement amount
Hospital provider identification number
Some dummy records for Medicare managed care coverage of IP stays
Program:
Medicare
What does this file include? (variable highlights)
Diagnosis (ICD diagnosis)
Procedure (ICD procedure code)
Healthcare Common Procedure Coding System (HCPCS) codes, including CPT codes
Dates of service
Medicare FFS reimbursement amount
Outpatient facility provider number
Program:
Medicare
What does this file include? (variable highlights)
Diagnosis (ICD diagnosis)
Procedure (CPT code)
Dates of service
Charges
Allowed amounts
Reimbursement amount
Provider NPI number
Program:
Medicare
What does this file include? (variable highlights)
Diagnosis codes (ICD diagnosis)
Procedure codes (ICD procedure)
Admission/discharge dates
FFS Reimbursement amount
SNF provider number
Program:
Medicare
What does this file include? (variable highlights)
Diagnosis, (ICD diagnosis code)
Services provided (CMS Common Procedure Coding System (HCPCS) codes)
Dates of service
Charge
Reimbursement amounts
Supplier provider number
Supplier NPI
Program:
Medicare
What does this file include? (variable highlights)
Type of visit (eg: skilled care, home health aide, physical therapy)
Quantity of services
Diagnosis (ICD diagnosis),
Dates of service
Reimbursement amount
Home health agency provider number
Program:
Medicare