Search Data Variables

Number of days of CHIP enrollment in the month. There are separate variables for each of the 12 months during the year.

Number of days of CHIP enrollment in the month. There are separate variables for each of the 12 months during the year.

Number of days of CHIP enrollment in the month. There are separate variables for each of the 12 months during the year.

Number of days of CHIP enrollment in the month. There are separate variables for each of the 12 months during the year.

Number of days of CHIP enrollment in the month. There are separate variables for each of the 12 months during the year.

Number of days of CHIP enrollment in the calendar year.

Indicates whether the provider’s taxonomy value maps to the chiropractic provider category; ever in the calendar year.

Indicator for whether beneficiary has Coronary Artery Disease

Indicator for whether beneficiary has COPD

Indicator for whether beneficiary has Diabetes

Indicator for whether beneficiary has Heart Failure

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

This variable indicates whether a beneficiary met the Chronic Condition Data Warehouse (CCW) criteria for chronic kidney disease (CKD) 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 Chronic Kidney Disease.

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

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

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

This variable indicates whether a beneficiary met the Chronic Conditions Warehouse (CCW) criteria for chronic obstructive pulmonary disease (COPD) as of the end of the calendar year.

This variable indicates whether a beneficiary met the Chronic Condition Data Warehouse (CCW) criteria for chronic obstructive pulmonary disease (COPD) and bronchiectasis 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 Chronic Obstructive Pulmonary Disease.

This code specifies whether the enrollee met the chronic condition algorithm criteria, considering only Medicaid data, for having Chronic Obstructive Pulmonary Disease.

This code specifies whether the enrollee met the chronic condition algorithm criteria, considering only Medicare data, for having Chronic Obstructive Pulmonary Disease.

This variable indicates whether a beneficiary met the Chronic Condition Data Warehouse (CCW) criteria for chronic obstructive pulmonary disease (COPD) and bronchiectasis on July 1 of the specified reference period.

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

This code specifies whether the enrollee met the chronic condition algorithm criteria, considering only Medicaid data, for having Chronic Pain, Fatigue, and Fibromyalgia.

This code specifies whether the enrollee met the chronic condition algorithm criteria, considering only Medicare data, for having Chronic Pain, Fatigue, and Fibromyalgia.

City of hospital to which beneficiary was admitted

Chronic Kidney Disease - Combined Medicare & Medicaid Claims

Chronic Kidney Disease - Combined Medicare & Medicaid Claims, First Ever Occurrence Date

Chronic Kidney Disease - Medicaid Only Claims

Chronic Kidney Disease - Medicaid Only Claims, First Ever Occurrence Date

Chronic Kidney Disease - Medicare Only Claims

Chronic Kidney Disease - Medicare Only Claims, First Ever Occurrence Date

The Medicare claim payment amount.

For hospital services, this amount does not include the claim pass-through per diem payments made by Medicare. To obtain the total amount paid by Medicare for the claim, the pass-through amount (which is the daily per diem amount) must be multiplied by the number of Medicare-covered days (i.e., multiply the CLM_PASS_THRU_PER_DIEM_AMT by the CLM_UTLZTN_DAY_CNT), and then added to the claim payment amount (this field).

For non-hospital services (SNF, home health, hospice, and hospital outpatient) and for other non-institutional services (Carrier and DME), this variable equals the total actual Medicare payment amount, and pass-through amounts do not apply.

For Part B non-institutional services (Carrier and DME), this variable equals the sum of all the line item-level Medicare payments (variable called the LINE_NCH_PMT_AMT).

The field identifies the Accountable Care Organization (ACO) Identification Number.

Code indicating the type of adjustment record.

Claim adjustment group code used to categorize a payment adjustment for a claim or claim line. This field is currently only populated for Direct Contracting (DC), Comprehensive Kidney Care Contracting (CKCC) and Kidney Care First (KCF) model claims.

Claim Adjustment Reason Code used to describe why a claim or claim line was paid differently than billed. This field is currently only populated for Direct Contracting (DC), Comprehensive Kidney Care Contracting (CKCC) and Kidney Care First (KCF) model claims.

This is not a comprehensive list of values; refer to website below for current values and descriptions:

On an institutional claim, the date the beneficiary was admitted to the hospital, skilled nursing facility, or religious non- medical health care institution.

For home health services, this is the date care started for the HH services reported on the encounter record. 

On an institutional claim, the date the beneficiary was admitted to the hospital, skilled nursing facility, or religious non-medical health care institution, and starting October 2023 this field is added to reflect the admission date for hospice or to a home health agency (HHA).

A diagnosis code on the institutional encounter indicating the beneficiary's initial diagnosis at admission.

This diagnosis code may not be confirmed after the patient is evaluated; it may be different than the eventual diagnoses (e.g., as in PRNCPAL_DGNS_CD or ICD_DGNS_CD1-25). 

A diagnosis code on the institutional claim indicating the beneficiary's initial diagnosis at admission.

This diagnosis code may not be confirmed after the patient is evaluated; it may be different than the eventual diagnoses (e.g., as in PRNCPAL_DGNS_CD or ICD_DGNS_CD1-25).

On an institutional claim, the national provider identifier (NPI) number assigned to uniquely identify the physician who has overall responsibility for the beneficiary's care and treatment. 

On an institutional claim, the national provider identifier (NPI) number assigned to uniquely identify the physician who has overall responsibility for the beneficiary's care and treatment.

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

This variable is the code used to identify the CMS specialty code corresponding to the attending physician.

The health care provider taxonomy (HCPT) code used to indicate the attending provider's specialty. This is a unique identifier for a classification of health care specialty at a specialized level of defined medical activity within a medical field as created by the National Uniform Claim Committee (NUCC).

On an institutional claim, the unique physician identification number (UPIN) of the physician who would normally be expected to certify and recertify the medical necessity of the services rendered and/or who has primary responsibility for the beneficiary's medical care and treatment (attending physician).

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

The amount of the wage-adjusted DRG operating payment plus the technology add-on payment. 

The date the service covered by this claim began. For capitation premium payments, the date on which the period of coverage related to this payment began.

This field identifies whether the claim was submitted by the provider, during the transition period, with a HICN or MBI (For CMS Internal Use).