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MAX Other Services File
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File Version:
CCW record layout accessed May, 2019; CMS MAX 2014 data dictionary Aug 18, 2016
CCW Codebook MAX Other Services_Version 2014.pdf
456.7 KB
CCW Record Layout MAX_Version 022023_1.xlsx
95.87 KB
Number
SAS Name
Variable 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
Medicare 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
HCBS_TXNMY_WVR_CD
Home and community-based services (HCBS) taxonomy code for waviers
25
MAX_TOS
MAX Type of Service (TOS)
26
CLTC_FLAG
Community-based LT care (CLTC) flag
27
PRVDR_ID_NMBR
Billing provider identification number (MAX)
28
NPI
National Provider Identifier (MAX)
29
TAXONOMY
Provider Taxonomy
30
TYPE_CLM_CD
Type of claim
31
ADJUST_CD
Adjustment code
32
PHP_TYPE
Managed care type of plan code
33
PHP_ID
Managed care plan identification code
34
MDCD_PYMT_AMT
Medicaid payment amount
35
TP_PYMT_AMT
Third party payment amount
36
PYMT_DT
Payment/adjudication date
37
CHRG_AMT
Charge amount
38
PHP_VAL
Prepaid plan value
39
MDCR_COINSUR_PYMT_AMT
Medicare coinsurance payment amount
40
MDCR_DED_PYMT_AMT
Medicare deductible payment amount
41
SRVC_BGN_DT
Beginning date of service
42
SRVC_END_DT
Ending date of service
43
PRCDR_CD_SYS
Procedure (service) coding system
44
PRCDR_CD
Procedure (service) code
45
PRCDR_SRVC_MDFR_CD
Procedure (service) code modifier
46
DIAG_CD_1
Principle Diagnosis code
47
ICD_DGNS_VRSN_CD1
Claim Diagnosis Code 1 Diagnosis Version Code (ICD-9 or ICD-10) (Encounter)
48
DIAG_CD_2
Diagnosis codes (2nd diagnosis)
49
QTY_SRVC_UNITS
Quantity of service
50
SRVC_PRVDR_ID_NMBR
Servicing provider identification number (MAX)
51
SRVC_PRVDR_SPEC_CD
Servicing provider specialty code (MAX)
52
PLC_OF_SRVC_CD
Place of service
53
UB_92_REV_CD
UB-92 revenue code