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 Hive Schema | CDR Table Layouts | Data Dictionaries and Supplemental Information | Most Recent Refresh | Refresh Frequency | Next Refresh | DUA Required |
---|---|---|---|---|---|---|---|---|
ADI | The Area Deprivation Index (ADI) contains the GIS information for US neighborhoods. | public_data | Neighborhood Atlas Web Page | 4/10/2020 | Annually | 5/13/2021 | No | |
FDA | The FDA data contains packaging and product information for FDA approved drugs. | public_data | 4/10/2020 | Monthly | 5/13/2020 | No | ||
Nursing Home Compare | This is the official data for the Nursing Home Compare website. | compare_nursing_home | 4/9/2020 | Monthly | 5/13/2020 | No | ||
ZIP | This table contains the ZIP Codes and other information for cities and towns in the US. | public_data | 4/10/2020 | Monthly | 5/13/2020 | No |
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.