Search Data Variables

The number used to identify the prescription order number for drugs and biologicals purchased through the competitive acquisition program (CAP).

The identification number assigned by CMS to a carrier authorized to process claims from a physician or supplier.

Effective July 2006, the Medicare Administrative Contractors (MACs) began replacing the existing carriers and started processing physician or supplier claim records for states assigned to its jurisdiction.

The national provider identifier (NPI) number of the physician who referred the beneficiary or the physician who ordered the Part B services or durable medical equipment (DME).

The unique physician identification number (UPIN) of the physician who referred the beneficiary or the physician who ordered the Part B services or durable medical equipment (DME).

NPIs replaced UPINs as the standard provider identifiers beginning in 2007. The UPIN is almost never populated after 2009.

The unique physician identification number (UPIN) of the physician who referred the beneficiary or the physician who ordered the Part B services or durable medical equipment (DME).

NPIs replaced UPINs as the standard provider identifiers beginning in 2007. The UPIN is almost never populated after 2009.

This variable indicates whether a beneficiary met the Chronic Conditions Warehouse (CCW) criteria for a cataract as of the end of the calendar year.

This variable indicates whether a beneficiary met the Chronic Condition Data Warehouse (CCW) criteria for a cataract as of the end of the calendar year.

This code specifies whether the enrollee met the chronic condition algorithm criteria, considering both Medicare and Medicaid data, for having Cataracts.

This code specifies whether the enrollee met the chronic condition algorithm criteria, considering only Medicaid data, for having Cataracts.

This code specifies whether the enrollee met the chronic condition algorithm criteria, considering only Medicare data, for having Cataracts.

This variable indicates whether a beneficiary met the Chronic Condition Data Warehouse (CCW) criteria for a cataract on July 1 of the specified reference period.

This variable indicates whether the PDE occurred within the catastrophic benefit phase of the Medicare Part D benefit, according to the source PDE.

When the value equals C (above attachment point), then the PDE is in the catastrophic phase. When the value equals A (attachment point), the PDE has caused the beneficiary to move into the catastrophic phase (i.e., this is the “triggering” PDE).

Source: PDE 

Cataract - Combined Medicare & Medicaid Claims

Cataract - Combined Medicare & Medicaid Claims, First Ever Occurrence Date

Cataract - Medicaid Only Claims

Cataract - Medicaid Only Claims, First Ever Occurrence Date

Cataract - Medicare Only Claims

Cataract - Medicare Only Claims, First Ever Occurrence Date

This data in this column identifies whether the facility is designated to be in a rural or urban area.

Code indicating the type of facility represented by the CCN as indicated by the code assigned to the provider by CMS. 

Description of the facility. New data field beginning in 2017; blank for prior years.

CMS certification number of hospital at which hospitalization occurred

The unique CCW identifier for a beneficiary.  The CCW assigns a unique beneficiary identification number to each individual who receives Medicare and/or Medicaid, and uses that number to identify an individual’s records in all CCW data files (e.g., Medicare claims, MAX claims, MDS assessment data).  This number does not change during a beneficiary’s lifetime and each number is used only once.The BENE_ID is specific to the CCW and is not applicable to any other identification system or data source. 

This variable indicates if the beneficiary is part of a random 1, 5, 15, or 20 percent sample of Medicare beneficiaries that the CCW creates using standard CMS processes. All associated encounter records for the sampled beneficiaries are identified in the encounter files.

This is the unique identification number for the claim

The unique CCW identifier for a beneficiary.

The CCW assigns a unique beneficiary identification number to each individual who receives Medicare and/or Medicaid, and uses that number to identify an individual’s records in all CCW data files (e.g., Medicare claims, MAX claims, MDS assessment data).

This number does not change during a beneficiary’s lifetime and each number is used only once.

The BENE_ID is specific to the CCW and is not applicable to any other identification system or data source.

Source: CCW

Identifies a unique Part D event for a beneficiary.

Source: CCW

This variable is a CCW-created identifier for a drug product that is found in a Part D prescription drug plan's formulary.

Part D Plans submit their formularies to CMS and identify drug products using the National Library of Medicine RxNorm Concept Unique Identifiers (RXCUIs).  

There can be several drug products submitted that are the same clinical formulation (same ingredients, strength, and dosage form) but different brand names.  

Each RXCUI corresponds to a unique brand name and clinical formulation. The CCW Formulary drug ID is analogous to an RXCUI.

Values: 8-digit number   
The value: 99999999 indicates diabetic supplies. 

Source: PDE and CMS HPMS (derived)

This variable is first available in 2010. A CCW identifier for a drug product found in a Part D prescription drug plan formulary.

CCW Key to Link Annual Managed Care Plan (APL) Base record to corresponding Supplemental file records.

The Date Source File was loaded to the CCW

The Date Source File was loaded to the CCW

This is the CCW-assigned pharmacy identification number that is used to uniquely identify pharmacy entities. The ID is specific to the CCW and not applicable to any other identification system or data source.

This field also enables linkage between pharmacies in the Part D Event File and the CCW Pharmacy Characteristics File (2006-2013; note that starting in 2014 the NCPDP_ID is used for linkage).

This variable is only available 2006-2013.

Values: Null, or a 5-digit numeric value

Source: PDE and NCDPD dataQ™ (derived)

This variable is the CCW-assigned number that is used to uniquely identify prescribers found in the Part D Event File. The ID is specific to the CCW and not applicable to any other identification system or data source.  

This field also enables linkage between the Part D Event File and the CCW Prescriber Characteristics File. This variable is only available 2006-2013.

Source: PDE and HCIdea™ Prescriber Database (derived)

This is the CCW-assigned pharmacy identification number used to uniquely identify pharmacy entities. The ID is specific to the CCW and not applicable to any other identification system or data source.

This field also enables linkage between pharmacies in the Part D Event file and the CCW Pharmacy Characteristics file.

Values: Null, or a 5-digit numeric value

Source: PDE and NCDPD DataQ™ (derived)

This variable is the CCW-assigned number that is used to uniquely identify prescribers found in the Part D Event File. The ID is specific to the CCW and not applicable to any other identification system or data source.

This field also enables linkage between the Part D Event File and the CCW Prescriber Characteristics file.

Values: Null, or any positive or negative number

Source: PDE and HCIdea™ Prescriber Database (derived)

This field contains the total charge amount for cell therapy drugs.

This field contains the total charge amount for cell/gene therapy procedures.

This variable indicates whether a beneficiary met the condition criteria for cerebral palsy as of the end of the calendar year.

This variable shows the date when the beneficiary first met the criteria for the cerebral palsy indicator. The variable will be blank for beneficiaries that have never had the condition

This code specifies whether the enrollee met the chronic condition algorithm criteria, considering both Medicare and Medicaid data, for having Cerebral Palsy.

This code specifies whether the enrollee met the chronic condition algorithm criteria, considering only Medicaid data, for having Cerebral Palsy.

This code specifies whether the enrollee met the chronic condition algorithm criteria, considering only Medicare data, for having Cerebral Palsy.

Cerebral Palsy - Combined Medicare & Medicaid Claims 

Cerebral Palsy - Combined Medicare & Medicaid Claims, First Evere Occurrence Date

Cerebral Palsy - Medicaid Only Claims 

Cerebral Palsy - Medicaid Only Claims, First Ever Occurrence Date 

Cerebral Palsy - Medicare Only Claims 

Cerebral Palsy - Medicare Only Claims, First Ever Occurrence Date

“American Indian or Alaska Native” means any beneficiary defined at 25 USC 1603(13), 1603(28), or 1679(a), or who has been determined eligible as an Indian, pursuant to 42 CFR § 136.12; i.e., a Certificate of Degree of Indian or Alaska Native Blood (CDIB). Please see COMMENT for a complete definition of CBID.