1 |
BENE_ID |
CCW Beneficiary ID |
2 |
MSIS_ID |
Encrypted State Assigned Beneficiary Unique Identifier |
3 |
STATE_CD |
Submitting State Alpha Abbreviation |
4 |
MME_TYPE_CD |
Medicare — Medicaid Eligibility Type Code: Annual Dual Eligibility Status |
5 |
SAMPLE_GRP |
Sample Group Indicator — 1% |
6 |
BIRTH_DT |
Date of Birth |
7 |
AGE |
Age (in years) |
8 |
ALIVE_MOS |
Months Alive |
9 |
BENE_DEATH_DT |
Beneficiary Date of Death |
10 |
SEX_CD |
Sex (Biological) - Latest in Year |
11 |
MDCR_RTI_RACE |
Medicare — Research Triangle Institute (RTI) Race Code |
12 |
MDCD_RACE_ETHNCTY_CD |
Medicaid — Race and Ethnicity Constructed Code — Latest in Year |
13 |
MDCR_STATE_CD |
Medicare — State Code — FIPS |
14 |
MDCR_COUNTY_CD |
Medicare — County FIPS Code — Latest in Year |
15 |
MDCR_PTA_MOS |
Medicare Part A Enrolled Months |
16 |
MDCR_PTB_MOS |
Medicare Part B Enrolled Months |
17 |
MDCR_PTAPTB_MOS |
Medicare Part A and Part B Enrolled Months |
18 |
MDCR_PTD_MOS |
Medicare — Part D Months |
19 |
FD_MOS |
Medicare — Full Dual Months |
20 |
PD_MOS |
Partial Dual Months |
21 |
MDCR_ONLY_MOS |
Medicare Only Months |
22 |
MDCD_ELGBLTY_GRP_CD_LTST |
Medicaid — Eligibility Group Code — Latest in Year |
23 |
MDCD_ABD_MOS |
Medicaid Enrollment — Aged, Blind, Disabled Months |
24 |
MDCD_ONLY_MOS |
Medicaid Aged, Blind, Disabled Only Months |
25 |
MDCD_CHIP_NON_ABD_MOS |
MDCD or CHIP Enrollment — Non-ABD Months |
26 |
MDCD_RSTRCTD_BNFTS_CD_LTST |
Medicaid — Scope of Medicaid or CHIP Benefits — Latest in Year |
27 |
MDCR_COVSTART |
Medicare — Coverage Start Date |
28 |
MDCR_OREC |
Medicare — Original Reason for Entitlement Code (OREC) |
29 |
MDCR_CREC |
Medicare — Current Reason for Entitlement Code (CREC) |
30 |
MDCR_MS_CD |
Medicare Status Code — Latest in Year |
31 |
MDCR_DIB_AWD_CD |
Medicare — SSA Disability Insurance Benefit Award Code |
32 |
MDCR_DIB_JSTFCTN_CD |
Medicare — Disability Insurance Benefit Entitlement to Medicare Justification Code |
33 |
MDCR_DIB_PRMRY_IMPRMNT_CD |
Medicare — SSA Disability Insurance Benefit Dx Primary Impairment Code |
34 |
MDCR_DIB_SCNDRY_IMPRMNT_CD |
Medicare — SSA Disability Insurance Benefit Dx Secondary Impairment Code |
35 |
MDCR_FFS_MEDICAL_MOS |
Medicare — Fee-for-Service Medical Coverage Months |
36 |
MDCR_HMO_MOS |
Medicare — HMO Coverage Months |
37 |
MDCR_MC_PACE_MOS |
Medicare — Program of All-Inclusive Care for the Elderly (PACE) Months |
38 |
MDCR_MC_MMP_MOS |
Medicare-Medicaid Plan (MMP) Coverage Months |
39 |
MDCR_MC_OTHER_MOS |
Medicare — Other Managed Care Months |
40 |
MDCR_MC_UNKNOWN_MOS |
Medicare — Unknown Plan Type Manage Care Months |
41 |
MDCR_C_SNP_MOS |
Medicare-Medicaid Chronic Conditions Special Needs Plan (C-SNP) Months |
42 |
MDCR_D_SNP_MOS |
Medicare-Medicaid Dual Eligible Special Needs Plan (D-SNP) Months |
43 |
MDCR_I_SNP_MOS |
Medicare-Medicaid Institutional Special Needs Plan (I-SNP) Months |
44 |
MDCD_FFS_MEDICAL_MOS |
Medicaid — Fee-for-Service Medical Coverage Months |
45 |
MDCD_MC_MEDICAL_MOS |
Medicaid — Managed Care Medicaid Coverage Months |
46 |
MDCD_OTHR_MC_MOS |
Medicaid — Other (non-Comprehensive) Managed Care Medicaid Coverage Months |
47 |
MDCD_CMC_COV_MOS |
Medicaid — Comprehensive Managed Care Months |
48 |
MDCD_PCCM_COV_MOS |
Medicaid — Primary Care Case Management (PCCM) Months |
49 |
MDCD_HIO_COV_MOS |
Medicaid — Health Insuring Organization (HIO) Months |
50 |
MDCD_PHP_COV_MOS |
Medicaid — Prepaid Inpatient or Ambulatory Health Plan (PIHP/PAHP) Months |
51 |
MDCD_LTC_COV_MOS |
Medicaid — Long-Term Care Prepaid Inpatient Health Plan (PIHP) Months |
52 |
MDCD_BEHAVIORAL_COV_MOS |
Medicaid Managed Care Mental Health or Substance Abuse Coverage Months |
53 |
MDCD_DENTAL_COV_MOS |
Medicaid — Managed Care Dental Coverage Months |
54 |
MDCD_TRANSPORTATION_COV_MOS |
Medicaid — Managed Care Transportation Months |
55 |
MDCD_DISEASE_MGMT_COV_MOS |
Medicaid — Managed Care Disease Management Plan Coverage Months |
56 |
MDCD_PACE_COV_MOS |
Medicaid — Program of All-Inclusive Care for the Elderly (PACE) Months |
57 |
MDCD_PHARMACY_COV_MOS |
Medicaid — Managed Care Pharmacy Months |
58 |
MDCD_HLTH_MDCL_HOME_COV_MOS |
Medicaid — Health or Medical Home Months |
59 |
MDCD_INTEGRATED_DUAL_COV_MOS |
Medicaid — Integrated care for Dual Eligible Months |
60 |
MDCD_WVR_1115_TYPE_CD |
Medicaid — 1115 Waiver Type Code — Latest in Year |
61 |
MDCD_WVR_1915C_TYPE_CD |
Medicaid — 1915(c) Waiver Type Code — Latest in Year |
62 |
MDCD_WVR_1915B_MOS |
Medicaid — 1915(b) Waiver Months |
63 |
MDCD_WVR_1915C_TYPE_CD |
Medicaid — 1915(c) Waiver Type Code — Latest in Year |
64 |
MDCD_WVR_1915BC_MOS |
Medicaid — 1915(b)(c) Waiver Months |
65 |
MDCR_LTCH_MOS |
Medicare — Long-Term Care Hospital Months (from Claims) |
66 |
MDCR_SNF_MOS |
Medicare — Skilled Nursing Facility Months (from Claims) |
67 |
MDCR_NF_MOS |
Medicare — Nursing Facility months (from MDS) |
68 |
MDCD_HOSPITAL_LTSS_MOS |
Medicaid — Hospital LTSS Months |
69 |
MDCD_IPF_LTSS_MOS |
Medicaid — IP Psych Facility for Individuals under age 21 — LTSS Months |
70 |
MDCD_NF_LTSS_MOS |
Medicaid — Nursing Facility LTSS Months |
71 |
MDCD_ICF_IID_LTSS_MOS |
Medicaid — Intermediate Care Facility for individuals with intellectual disabilities — LTSS Months |
72 |
MDCD_OTHER_LTSS_MOS |
Medicaid — Other Type of Facility LTSS Months |
73 |
MDCD_CARE_LEVEL_MOS |
Medicaid — Total LTSS Months (All Levels of Care) |
74 |
MDCD_SKILLED_CARE_MOS |
Medicaid — Skilled Level of Care for LTSS Months |
75 |
MDCD_INTERMEDIATE_CARE_MOS |
Medicaid — Intermediate level of Care for LTSS Months |
76 |
MDCD_CUSTODIAL_CARE_MOS |
Medicaid — Custodial Level of Care for LTSS Months |
77 |
MDCD_LTSS_LEVEL_MOS |
Medicaid — LTSS Provider 1 Level of Care Code Months |
78 |
MDCR_DUAL_STUS_CD_01 |
Medicare — Medicaid Dual Eligibility Code — January |
79 |
MDCR_BUYIN_01 |
Medicare — Entitlement/Buy-In Indicator — January |
80 |
MDCR_FFS_MEDICAL_01 |
Medicare — Fee-for-Service Medical Coverage Indicator — January |
81 |
MDCR_DUAL_STUS_CD_02 |
Medicare — Medicaid Dual Eligibility Code — February |
82 |
MDCR_BUYIN_02 |
Medicare — Entitlement/Buy-In Indicator — February |
83 |
MDCR_FFS_MEDICAL_02 |
Medicare — Fee-for-Service Medical Coverage Indicator — February |
84 |
MDCR_DUAL_STUS_CD_03 |
Medicare — Medicaid Dual Eligibility Code — March |
85 |
MDCR_BUYIN_03 |
Medicare — Entitlement/Buy-In Indicator — March |
86 |
MDCR_FFS_MEDICAL_03 |
Medicare — Fee-for-Service Medical Coverage Indicator — March |
87 |
MDCR_DUAL_STUS_CD_04 |
Medicare — Medicaid Dual Eligibility Code — April |
88 |
MDCR_BUYIN_04 |
Medicare — Entitlement/Buy-In Indicator — April |
89 |
MDCR_FFS_MEDICAL_04 |
Medicare — Fee-for-Service Medical Coverage Indicator — April |
90 |
MDCR_DUAL_STUS_CD_05 |
Medicare — Medicaid Dual Eligibility Code — May |
91 |
MDCR_BUYIN_05 |
Medicare — Entitlement/Buy-In Indicator — May |
92 |
MDCR_FFS_MEDICAL_05 |
Medicare — Fee-for-Service Medical Coverage Indicator — May |
93 |
MDCR_DUAL_STUS_CD_06 |
Medicare — Medicaid Dual Eligibility Code — June |
94 |
MDCR_BUYIN_06 |
Medicare — Entitlement/Buy-In Indicator — June |
95 |
MDCR_FFS_MEDICAL_06 |
Medicare — Fee-for-Service Medical Coverage Indicator — June |
96 |
MDCR_DUAL_STUS_CD_07 |
Medicare — Medicaid Dual Eligibility Code — July |
97 |
MDCR_BUYIN_07 |
Medicare — Entitlement/Buy-In Indicator — July |
98 |
MDCR_FFS_MEDICAL_07 |
Medicare — Fee-for-Service Medical Coverage Indicator — July |
99 |
MDCR_DUAL_STUS_CD_08 |
Medicare — Medicaid Dual Eligibility Code — August |
100 |
MDCR_BUYIN_08 |
Medicare — Entitlement/Buy-In Indicator — August |
101 |
MDCR_FFS_MEDICAL_08 |
Medicare — Fee-for-Service Medical Coverage Indicator — August |
102 |
MDCR_DUAL_STUS_CD_09 |
Medicare — Medicaid Dual Eligibility Code — September |
103 |
MDCR_BUYIN_09 |
Medicare — Entitlement/Buy-In Indicator — September |
104 |
MDCR_FFS_MEDICAL_09 |
Medicare — Fee-for-Service Medical Coverage Indicator — September |
105 |
MDCR_DUAL_STUS_CD_10 |
Medicare — Medicaid Dual Eligibility Code — October |
106 |
MDCR_BUYIN_10 |
Medicare — Entitlement/Buy-In Indicator — October |
107 |
MDCR_FFS_MEDICAL_10 |
Medicare — Fee-for-Service Medical Coverage Indicator — October |
108 |
MDCR_DUAL_STUS_CD_11 |
Medicare — Medicaid Dual Eligibility Code — November |
109 |
MDCR_BUYIN_11 |
Medicare — Entitlement/Buy-In Indicator — November |
110 |
MDCR_FFS_MEDICAL_11 |
Medicare — Fee-for-Service Medical Coverage Indicator — November |
111 |
MDCR_DUAL_STUS_CD_12 |
Medicare — Medicaid Dual Eligibility Code — December |
112 |
MDCR_BUYIN_12 |
Medicare — Entitlement/Buy-In Indicator — December |
113 |
MDCR_FFS_MEDICAL_12 |
Medicare — Fee-for-Service Medical Coverage Indicator — December |
114 |
MDCD_STATE_CD_01 |
Medicaid — State Alpha Abbreviation — January |
115 |
MDCD_STATE_CD_02 |
Medicaid — State Alpha Abbreviation — February |
116 |
MDCD_STATE_CD_03 |
Medicaid — State Alpha Abbreviation — March |
117 |
MDCD_STATE_CD_04 |
Medicaid — State Alpha Abbreviation — April |
118 |
MDCD_STATE_CD_05 |
Medicaid — State Alpha Abbreviation — May |
119 |
MDCD_STATE_CD_06 |
Medicaid — State Alpha Abbreviation — June |
120 |
MDCD_STATE_CD_07 |
Medicaid — State Alpha Abbreviation — July |
121 |
MDCD_STATE_CD_08 |
Medicaid — State Alpha Abbreviation — August |
122 |
MDCD_STATE_CD_09 |
Medicaid — State Alpha Abbreviation — September |
123 |
MDCD_STATE_CD_10 |
Medicaid — State Alpha Abbreviation — October |
124 |
MDCD_STATE_CD_11 |
Medicaid — State Alpha Abbreviation — November |
125 |
MDCD_STATE_CD_12 |
Medicaid — State Alpha Abbreviation — December |
126 |
MDCD_FFS_MEDICAL_01 |
Medicaid — Fee-for-Service Medical Coverage Indicator — January |
127 |
MDCD_ELGBLTY_GRP_CD_01 |
Medicaid — Eligibility Group Code — January |
128 |
MDCD_ABD_01 |
Medicaid Enrollment — Aged, Blind, Disabled Indicator — January |
129 |
MDCD_FFS_MEDICAL_02 |
Medicaid — Fee-for-Service Medical Coverage Indicator — February |
130 |
MDCD_ELGBLTY_GRP_CD_02 |
Medicaid — Eligibility Group Code — February |
131 |
MDCD_ABD_02 |
Medicaid Enrollment — Aged, Blind, Disabled Indicator — February |
132 |
MDCD_FFS_MEDICAL_03 |
Medicaid — Fee-for-Service Medical Coverage Indicator — March |
133 |
MDCD_ELGBLTY_GRP_CD_03 |
Medicaid — Eligibility Group Code — March |
134 |
MDCD_ABD_03 |
Medicaid Enrollment — Aged, Blind, Disabled Indicator — March |
135 |
MDCD_FFS_MEDICAL_04 |
Medicaid — Fee-for-Service Medical Coverage Indicator — April |
136 |
MDCD_ELGBLTY_GRP_CD_04 |
Medicaid — Eligibility Group Code — April |
137 |
MDCD_ABD_04 |
Medicaid Enrollment — Aged, Blind, Disabled Indicator — April |
138 |
MDCD_FFS_MEDICAL_05 |
Medicaid — Fee-for-Service Medical Coverage Indicator — May |
139 |
MDCD_ELGBLTY_GRP_CD_05 |
Medicaid — Eligibility Group Code — May |
140 |
MDCD_ABD_05 |
Medicaid Enrollment — Aged, Blind, Disabled Indicator — May |
141 |
MDCD_FFS_MEDICAL_06 |
Medicaid — Fee-for-Service Medical Coverage Indicator — June |
142 |
MDCD_ELGBLTY_GRP_CD_06 |
Medicaid — Eligibility Group Code — June |
143 |
MDCD_ABD_06 |
Medicaid Enrollment — Aged, Blind, Disabled Indicator — June |
144 |
MDCD_FFS_MEDICAL_07 |
Medicaid — Fee-for-Service Medical Coverage Indicator — July |
145 |
MDCD_ELGBLTY_GRP_CD_07 |
Medicaid — Eligibility Group Code — July |
146 |
MDCD_ABD_07 |
Medicaid Enrollment — Aged, Blind, Disabled Indicator — July |
147 |
MDCD_FFS_MEDICAL_08 |
Medicaid — Fee-for-Service Medical Coverage Indicator — August |
148 |
MDCD_ELGBLTY_GRP_CD_08 |
Medicaid — Eligibility Group Code — August |
149 |
MDCD_ABD_08 |
Medicaid Enrollment — Aged, Blind, Disabled Indicator — August |
150 |
MDCD_FFS_MEDICAL_10 |
Medicaid — Fee-for-Service Medical Coverage Indicator — September |
151 |
MDCD_ELGBLTY_GRP_CD_09 |
Medicaid — Eligibility Group Code — September |
152 |
MDCD_ABD_09 |
Medicaid Enrollment — Aged, Blind, Disabled Indicator — September |
153 |
MDCD_FFS_MEDICAL_10 |
Medicaid — Fee-for-Service Medical Coverage Indicator — October |
154 |
MDCD_ELGBLTY_GRP_CD_10 |
Medicaid — Eligibility Group Code — October |
155 |
MDCD_ABD_10 |
Medicaid Enrollment — Aged, Blind, Disabled Indicator — October |
156 |
MDCD_FFS_MEDICAL_11 |
Medicaid — Fee-for-Service Medical Coverage Indicator — November |
157 |
MDCD_ELGBLTY_GRP_CD_11 |
Medicaid — Eligibility Group Code — November |
158 |
MDCD_ABD_11 |
Medicaid Enrollment — Aged, Blind, Disabled Indicator — November |
159 |
MDCD_FFS_MEDICAL_12 |
Medicaid — Fee-for-Service Medical Coverage Indicator — December |
160 |
MDCD_ELGBLTY_GRP_CD_12 |
Medicaid — Eligibility Group Code — December |
161 |
MDCD_ABD_12 |
Medicaid Enrollment — Aged, Blind, Disabled Indicator — December |
162 |
MME_TYPE_CD_01 |
Medicare-Medicaid Eligibility Type Code: Dual Eligibility Status — January |
163 |
MME_TYPE_CD_02 |
Medicare-Medicaid Eligibility Type Code: Dual Eligibility Status — February |
164 |
MME_TYPE_CD_03 |
Medicare-Medicaid Eligibility Type Code: Dual Eligibility Status — March |
165 |
MME_TYPE_CD_04 |
Medicare-Medicaid Eligibility Type Code: Dual Eligibility Status — April |
166 |
MME_TYPE_CD_05 |
Medicare-Medicaid Eligibility Type Code: Dual Eligibility Status — May |
167 |
MME_TYPE_CD_06 |
Medicare-Medicaid Eligibility Type Code: Dual Eligibility Status — June |
168 |
MME_TYPE_CD_07 |
Medicare-Medicaid Eligibility Type Code: Dual Eligibility Status — July |
169 |
MME_TYPE_CD_08 |
Medicare-Medicaid Eligibility Type Code: Dual Eligibility Status — August |
170 |
MME_TYPE_CD_09 |
Medicare-Medicaid Eligibility Type Code: Dual Eligibility Status — September |
171 |
MME_TYPE_CD_10 |
Medicare-Medicaid Eligibility Type Code: Dual Eligibility Status — October |
172 |
MME_TYPE_CD_11 |
Medicare-Medicaid Eligibility Type Code: Dual Eligibility Status — November |
173 |
MME_TYPE_CD_12 |
Medicare-Medicaid Eligibility Type Code: Dual Eligibility Status — December |
174 |
RFRNC_YR |
Reference Year (MMLEADS) |