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Parts A & B Files

Medicare

Description

Our Parts A & B files have the following data on the health services provided to each Medicare enrollee during a calendar year:

  • beneficiary demographics;
  • diagnosis codes;
  • drug codes;
  • procedure codes;
  • processing codes;
  • provider characteristics;
  • service costs; and
  • service dates.

To organize this information, CMS groups these data into seven service categories or "settings"–namely, Carrier (PB), Durable Medical Equipment (DM), Home Health (HH), Hospice (HS), Inpatient (IP), Outpatient (OP), and Skilled Nursing Facility (SN).

Variables Summary

The table below lists variable categories for and some key variables in Parts A & B data. For a comprehensive list of variables, review the Parts A & B data dictionary.

Costs

Beneficiary Payment Amount, Claim Payment Amount, Medicare Coinsurance Amount, Medicare Copay Amount, Provider Payment Amount

Dates

Claim From Date, Claim Processing Dates (e.g., Claim Receipt Date), Claim Through Date, Stay From Date, Stay Through Date

Demographics

Age, Beneficiary Identification Number, Gender, Race

Diagnoses

Claim Diagnosis Codes (including International Classification of Diseases (ICD)-9 and ICD-10), Claim Diagnosis Version Code, Principal Diagnosis Code

Drugs

Revenue Center National Drug Codes (NDCs)

Procedures, Services & Treatments

Claim Procedure Codes, Healthcare Common Procedure Coding System (HCPCS) Codes, HCPCS Modifiers, Revenue Center Codes based on Common Procedure Terminology (CPT)

Processing

Claim Check Indicator, Claim Total Line Count, Claim Total Segment Count, Line Duplicate, Line Service Count, National Claims History (NCH) Processing Dates, NCH Record Version Code

Provider

Facility Type, Physician Specialty Code

Years Available

1991 - 2018

Data Dictionary Link

Visit the Data Documentation Page

NIA Surveys Offering Parts A & B

CE, HABC, HRS, LLFS, NLTCS, NSHAP, PT, PSAD, PSID, RADC, WLS

NIA Surveys Not Offering Parts A & B

BLSA, NHAS, NHATS, UAS, UFOVT

Additional Resources