Claims Data
Schema | Description | CDR Hive Schema | CDR Table Layouts | Data Dictionaries and Supplemental Information | Most Recent Refresh | Refresh Frequency | Next Refresh | DUA Required |
---|---|---|---|---|---|---|---|---|
CSAT | The Healthcare Quality Analytics and Reporting (HCQAR) Complete Statistical Analysis Table (CSAT) is a monthly dataset that provides state and national level claims data variables derived from Medicare Part A / Part B / Part D claims data specifically for the national and state Quality Improvement Networks and Organizations (QIN-QIOs). (SORN) | csat_201908_baseline csat_201909 [monthly] | 9/30/2019 | Pending | Pending | Yes | ||
DDPS Part D | The source data for Part D claims is the Drug Data Processing System. This schema contains all prescription drug claims covered under Medicare Part D. (SORN) | ddps_part_d | 4/12/2020 | Monthly | 5/13/2020 | Yes | ||
NCH Part A | The source data for Part A claims is the National Claims History (NCH) monthly extracts. Part A claims include the Inpatient (IP) and Skilled Nursing Facility (SNF), Home Health (HHA), Hospice, and Outpatient Extracts. (SORN) | nch_part_a | Thursday of Every Week | Weekly | Thursday of Every Week | Yes | ||
NCH Part B | The source data for Part B claims is the NCH monthly extracts. Part B claims include the Professional and the Durable Medical Equipment (DME) extracts. (SORN) | nch_part_b | Thursday of Every Week | Weekly | Thursday of Every Week | Yes |
Beneficiary and Provider Data
Schema | Description | CDR Hive Schema | CDR Table Layouts | Data Dictionaries and Supplemental Information | Most Recent Refresh | Refresh Frequency | Next Refresh | DUA Required |
---|---|---|---|---|---|---|---|---|
Assessment | The Assessment schema contains data the following data sets: | legacy_assessment_data | 4/16/2020 | Monthly | 5/27/2020 | Yes | ||
Beneficiary | The beneficiary schema is a subset of the EDB (enrollment database) that contains information on beneficiary identifiers, plan information for the for the beneficiary, and other information. (SORN) | legacy_beneficiary_data | 4/19/2020 | Monthly | 5/27/2020 | Yes | ||
CRIS | The Case Review Information System (CRIS) was the predecessor to the QMARS system (see below). It was decommissioned October 31, 2018. All data in this system is archival. | legacy_cris | 1/13/2020 | None | Never | Yes | ||
HQR | These schema are copies of the former HQR Oracle databases and applications in SDOL, QNOL, and CLDW. | legacy_hqr_asc | 4/6/2020 | None | Never | Yes | ||
legacy_hqr_cart (QNOL) | 2/13/2020 | Quarterly | 5/27/2020 | Yes | ||||
legacy_hqr_cart_final (CLDW) | 3/14/2020 | Quarterly | 5/27/2020 | Yes | ||||
legacy_hqr_ehqr | 3/16/2020 | Quarterly | 6/10/2020 | Yes | ||||
legacy_hqr_sdol_extfilapp | 3/6/2020 | Quarterly | 5/27/2020 | Yes | ||||
legacy_hqr_qnol_extfilapp | 3/20/2020 | Quarterly | 5/27/2020 | Yes | ||||
legacy_hqr_hai | 3/3/2020 | Quarterly | 5/27/2020 | Yes | ||||
legacy_hqr_hcahps | 4/6/2020 | Quarterly | 7/8/2020 | Yes | ||||
legacy_hqr_hcahps_final | 4/6/2020 | Quarterly | 7/8/2020 | Yes | ||||
legacy_hqr_hvbp | 3/4/2020 | Quarterly | 5/13/2020 | Yes | ||||
legacy_hqr_oat_app | 4/20/2020 | Quarterly | 7/22/2020 | Yes | ||||
legacy_hqr_ipledge_app | 4/15/2020 | Monthly | 5/26/2020 | Yes | ||||
legacy_hqr_opledge_app | 4/15/2020 | Monthly | 5/26/2020 | Yes | ||||
legacy_hqr_opps | 3/11/2020 | Quarterly | 5/13/2020 | Yes | ||||
legacy_hqr_public_reporting | 3/2/2020 | None | Never | Yes | ||||
legacy_hqr_struct_msrs | 3/11/2020 | Quarterly | 5/27/2020 | Yes | ||||
legacy_hqr_validation_app | 4/22/2020 | Quarterly | 7/22/2020 | Yes | ||||
legacy_cldw_rpt_etl | 4/3/2020 | Quarterly | 7/8/2020 | Yes | ||||
legacy_qnol_pch_app | 4/3/2020 | Quarterly | 7/8/2020 | Yes | ||||
Miscellaneous data from the legacy CLDW and QNOL systems | legacy_cldw_prod_data_mgmt | 4/3/2020 | Quarterly | 7/8/2020 | Yes | |||
legacy_qnol_user_admin | 4/3/2020 | Quarterly | 7/8/2020 | Yes | ||||
legacy_sdol_ifmc_common | 3/6/2020 | None | Never | Yes | ||||
PRS | The Program Resource System (PRS) was formerly stored in the SDDW and SDOL schemas. It is the repository of demographic information for hospital providers in the Centers for Medicare & Medicaid Services (CMS), Survey and Certification System (CASPER), and Quality Improvement and Evaluation System (I QIES). | legacy_qio_prs | QIO_PRS_TableLayout.xlsx | 4/9/2020 | Monthly | 5/26/2020 | Yes | |
NPPES | The National Plan and Provider Enumeration System contains provider NPIs, names, and location information. | nppes | NPPES dissemination information on CMS Website | 2/12/2020 | Quarterly | 6/30/2020 | No | |
Provider | The provider schema contains data formerly found in the CASPER and QIES systems. | legacy_provider_data | 4/3/2020 | Monthly | 5/13/2020 | Yes | ||
QMARS | Quality Management and Review Systems (QMARS) is a system for case management and review. | qmars | 4/7/2020 | Monthly | 5/13/2020 | Yes | ||
SDDW | Contains Medicare Beneficiary and Provider enrollment data. (FAQ) | legacy_sddw_np_sdps | For information about beneficiary tables in SDDW: EDB_data_dictionary.doc | 4/21/2020 | Monthly | 5/27/2020 | Yes | |
SDOL | Contains the beneficiary coverage data previously in the Oracle SDOL database. | legacy_sdol_np_sdps | 4/22/2020 | Monthly | 5/26/2020 | Yes |
Public Data
Schema | Description | CDR Schema and CASLIB Name | CDR Table Layouts | Data Dictionaries and Supplemental Information |
---|---|---|---|---|
ADI | The Area Deprivation Index (ADI) contains the GIS information for US neighborhoods. | public_data | Neighborhood Atlas Web Page | |
FDA | The FDA data contains packaging and product information for FDA approved drugs. | public_data | ||
Nursing Home Compare | This is the official data for the Nursing Home Compare website. | compare_nursing_home | ||
ZIP | This table contains the ZIP Codes and other information for cities and towns in the US. | public_data |
Important Notes
- The CDR follows NCH logic; as such, Part A claims are split into multiple records when the number of revenue center line items is greater than 45. In HAJI, these were merged into a single claim.
- The CDR includes claim types 61, 62, 63, 64, 80, and 81, which HAJI did not include.
- The CDR includes claim adjustments older than five years, which HAJI did not include.