Analytics

Q: What is the difference between BENE_ID and Health Insurance Claim (HIC) number?  (FAQ001)

A: The difference between BENE_ID and Health Insurance Claim (HIC) number is as follows:

  • The BENE_ID is a beneficiary identifier unique to the Chronic Conditions Warehouse (CCW) and protects the identity of the Medicare beneficiary. The BENE_ID can be used to link an individual beneficiary’s data across time and programs.
  • NOTE: There may be multiple HICs per BENE_ID due to the following reasons:
    • Beneficiary Identity Codes (BICs) change in the source Medicare eligibility files due to change in or clarification of the relationship to the covered beneficiary. When the BIC changes, the HIC changes.
  • There may also be multiple BENE_IDs per HIC due to a change in gender or Date of Birth (DOB) in the CCW monthly enrollment updates.

Q: How do I use identifier crosswalks to link data?  (FAQ002)

A: Your request may include one or more identifier crosswalks that allows you to link datasets. These identifier crosswalks may include any of the following identifiers, depending on your data use agreement (DUA):

  • BENE_ID (contained in the CCW data)
  • SSN (social security number)
  • HIC (health insurance claim number)
  • MBI (Medicare beneficiary number)
  • RES_ID / STATE_PTNT_ID (resident identification number from assessment data)

Q: When using the Drug Characteristics file, would Brand Name (BN) equal Generic Name (GNN) if the drug was dispensed as generic?  (FAQ003)

A: If the GNN is the same as BN, it is a generic product. However, this does not cover all the generic products. Many generic products have their own BN.

The Food and Drug Administration (FDA) maintains the Orange Book, which lists the approved generic products. For more information, see www.fda.gov for more details. If Reference List Drug (RLD) is No, then the drug product is considered a generic product. If the RLD is Yes, then it is called an innovator drug (or the brand product as considered by most) and it is the standard by which the generic products are tested.

Q: How do researchers, who are using CCW data, open a File Transfer Summary (.FTS) document?  (FAQ004)

A: Open the .FTS document in Notepad (it is a plain text document). Open the .SAS program with Notepad (if you don't have SAS Enterprise Guide). If you are using an analytic tool other than SAS, use the .FTS for layout to read in the .dat file (Microsoft prompts to open in Word, changes the font automatically; don't save changes).

Q: How is the CCW BENE_ID assigned?  (FAQ005)

A: The BENE_ID assignment is based on an extensive beneficiary matching logic routine, which is updated monthly from CMS’s Common Medicare Enrollment (CME) data feeds. This data source is more timely than other CMS data sources (conflict with other CMS data sources may occur in a small number of cases). One BENE_ID can map to multiple Health Insurance Claim (HIC) numbers due to changes in HICs over time. To be assigned a BENE_ID in the CCW, the matching logic must reach a predetermined confidence interval, based on CMS specifications.

Chronic Conditions Warehouse Virtual Research Data Center

Q: What is the Chronic Conditions Warehouse (CCW) Virtual Research Data Center (VRDC)?  (FAQ006)

A: The CCW is a CMS data warehouse used primarily for conducting research studies. The VRDC is an analytic environment where researchers can access and analyze the CMS program data housed within the CCW. Researchers virtually connect into the CCW VRDC to perform analysis from their own workstation.

Q: Who can get access to CMS data using the CCW VRDC?  (FAQ007)

A: Researchers with a Data Use Agreement (DUA) approved by CMS can access data within the CCW VRDC. To learn about requesting access to the CCW VRDC, refer to the About the VRDC and Requesting Access section of this website. Users may also learn more about getting data for research by visiting the Research Data Assistance Center (ResDAC) website at www.resdac.org/.

Q: Can I still get data shipped to me to conduct research?  (FAQ009)

A: Beginning in August 2024, users with new data projects must access CMS data through the CCW VRDC. No new projects will be able to receive physically shipped data.

Researchers with an active project/DUA for which they receive physical shipped data may continue to receive data physically until the project is identified to be transitioned to the CCW VRDC. Detail on transitioning existing DUAs to the CCW VRDC will be released by CMS in the future and will be implemented in a phased approach throughout 2025. If the project/DUA needs to be amended to add any new data file types or to change the project cohort, then project/DUA will be required to move to the CCW VRDC before the amendment can be approved.

Q: Why is the CCW VRDC a more secure mechanism to share data with researchers?  (FAQ010)

A: Under the VRDC model, beneficiary identifiable information never leaves the CMS environment. Researchers are assigned a dedicated workspace within the CCW VRDC with access to the data they need for their project(s). They are allowed to upload external files to the workspace and then conduct analyses using the CMS data, as well as any data they upload. However, researchers are only allowed to download non-identifiable analytic output to their independent workstations. Researchers are required to request an output review for any analytic files they wish to download, and CMS conducts a review of the output to check for protected health information, personally identifiable information, or small cells, which could be used to deduce the identity of an individual.

Q: What data can be accessed within the CCW VRDC?  (FAQ011)

A: Descriptions of the available data files can be found on the ResDAC website at https://www.resdac.org/research-identifiable-files-rif-requests. Data dictionaries can be found at https://www.ccwdata.org/web/guest/data-dictionaries. Additionally, users can upload their own data into the CCW VRDC to analyze with the CMS data. For more information on uploading external data, view (FAQ030).

Q: What data analysis tools are available to researchers in the CCW VRDC?  (FAQ012)

A: SAS is the main analytic tool in the CCW VRDC. The current version of SAS available is 9.4. The CCW team performs all software upgrades. Users are not able to upgrade to versions of SAS for which they have their own licenses. Additional analytic data products are available, depending on the access purchased. For example, CCW VRDC users may purchase access to Databricks, which supports multiple languages like SQL, R, and Python™ or an analytic container that includes Stata, R (including RStudio), and Python. All researchers also have access to the Microsoft suite of software.

Q: Is training available on the CCW VRDC?  (FAQ013)

A: Several web-based training courses are available on the public website. Users can register for webinars and view additional web-based training courses by logging into the CCW secure website.

Q: Why must users go through identity proofing to obtain a CCW User ID?  (FAQ027)

A: Identity proofing is to ensure the CCW user ID assignment is to an individual that has been verified and authenticated and is required when accessing any federally maintained system such as the CCW VRDC.

Q: Why must users provide sensitive personal information during the identity proofing process?  (FAQ032)

A: The CCW VRDC uses Experian’s robust fraud analytics platform to perform identity proofing. During the identity proofing step of the account creation process, an individual is asked to provide information about themselves, which is securely transmitted to Experian to be verified. Personal information shared with Experian is not stored at any time within the CCW VRDC. Without your personal information, it is not possible to confirm your identity or create your CCW account.

Q: What are the user requirements for accessing the CCW VRDC? (FAQ028)

A: Below is a list of user requirements for using the CCW VRDC:

  • Discuss internal IT/security policies within your organization to ensure there are no firewall/security or administrative rights issues that may require involvement from your IT department prior to installation/updates
  • All CCW VRDC users must be physically present in the United States and must only connect to the CCW VRDC from an IP address registered for use in the United States. The user further agrees to make no attempt to access the CCW VRDC from outside the United States
  • Working knowledge/experience with SAS or one of the other programming languages available in the CCW VRDC. User guides are available for your review
  • Meet CCW security requirements (including annual security training)
  • Register as a participant for My LMS. A secure link to available training courses will be provided
  • Review documentation on the secure My CCW Resource Center page
  • HIPAA Compliance
    • To protect the confidentiality of Medicare and Medicaid beneficiaries, unless authorized by CMS OEDA, CCW performs data output review prior to release from the CCW VRDC
    • Avoids disclosure or perceived disclosure of confidential information:
      • Protected Health Information (PHI)
      • Personally Identifiable Information (PII)
      • Small cell sizes
      • Comply with output review guidelines based on CCW VRDC access approved by CMS

Q: What are the general system requirements for accessing the CCW VRDC? (FAQ029)

A: CCW access:

  • Discuss internal IT/security policies within your organization to ensure there are no firewall/security or administrative rights issues that may require involvement from your IT department prior to installation/updates
  • All CCW VRDC users must be physically present in the United States and must only connect to the CCW VRDC from an IP address registered for use in the United States. The user further agrees to make no attempt to access the CCW VRDC from outside the United States
  • CCW VRDC currently supports Windows 10; does not support MAC
  • Ensure your system is continuously updated to meet CMS standards  
  • Must have VMware Horizon Client 5 and latest version is recommended
  • Multi-factor authentication (MFA) — you need to enroll an Okta factor
  • Google Chrome, Mozilla Firefox, or Microsoft Edge (latest version recommended)
  • Adequate free local disk space to install VMware Horizon Client and file downloads (if applicable)
  • VMware Horizon Keyboard Shortcuts not within the FAQs
    • New Server command Alt+N
    • Display Options menu Alt+O
    • Open the help system in a browser window Alt+O+H, Ctrl+H
    • Display the Support Information window Alt+O+S
    • Display the About Horizon Client window Alt+O+V
    • Display Settings menu Alt+S, Shift+F10+S
    • Full list of shortcuts

Q: May users upload external files to the CCW VRDC? (FAQ030)

A: Yes. Users may upload finder files and external files for utilization in their analysis through the Secure File Transfer System (SFTS).

  • Users are responsible for assuring that any non-public data uploaded into the CCW VRDC environment is not proprietary or restricted by a license agreement. If data are restricted and the researcher obtains approval to upload the data, the approval must be provided with the DUA data request package
  • Users need to attest to approval for data files prior to uploading to the CCW VRDC
  • Uploaded files are subject to review to ensure they are virus free
  • Due to unknown factors such as internet connection and PC speed, it is recommended that uploaded files be limited to five (5) Gigabytes (GB). If you are having trouble uploading files, contact the CCW Help Desk at ccwhelp@ccwdata.org or 1-866-766-1915.

Q: Can I upload my own software into the CCW VRDC?  (FAQ031)

A: No, external software cannot be uploaded by users. Basic software is available to all CCW VRDC users. Users may submit requests for new software to the CCW Help Desk at ccwhelp@ccwdata.org. The CCW Help team sends the user a software, plug-in request document for completion, along with the CCW Software Request End-User Guidelines Document. The request is assigned for evaluation and possible installation into the CCW VRDC. The CCW Help team communicates status updates to the requestor throughout the process.

Logging into the VRDC

Q: How do I log into the CCW environments?  (FAQ090)

A: Review the document CCW Okta Factor Enrollment and Management Guide for information on registering/managing multi-factor authentication and logging into all CCW environments.

Q: How do I change my CCW password?  (FAQ091)

A: After logging into the CCW secure website, click the link at the top of the page for ‘Change Password’. Select the blue information icon to review the password policy (e.g., Password must not be a dictionary word.) Enter your old password followed by your new password twice then select ‘Submit’. The CCW password does not expire.

Alternatively, on the Sign In page, you can use the Forgot Password / Unlock Account link within the Login Assistance box. If you’re having trouble logging in or changing your password, contact the CCW Help Desk at ccwhelp@ccwdata.org or 1-866-766-1915.

Q: How do I recover or reset my CCW password?  (FAQ092)

A: If you have forgotten your password or locked your account, you can use the Forgot Password / Unlock Account link within the Login Assistance box on the Sign In page. If you are having trouble logging in, contact the CCW Help Desk at ccwhelp@ccwdata.org or 1-866-766-1915.

Q: Is the CCW login ID case sensitive?  (FAQ014)

A: Yes. Enter your login ID in lowercase as some of the CCW systems are case sensitive and do not accept an uppercase login ID.

Q: I was previously logged into VMware Horizon Client and now am unable to login in again, what might be the cause for this?  (FAQ015)

A: When you are finished with your VMware Horizon Client session, the best practice to avoid issues logging in again is: if a program is currently running (i.e., SAS EG) in the virtual desktop, disconnect from the session by "X"ing out of the window; if a program is not currently running, end the session by going to Start, then click the Log Off button.

Q: I changed my CCW password and now am not able to login. What should I do?  (FAQ016)

A: After you have changed your password, additional steps may be needed to complete the password change process. If you have any active VMware Horizon Client sessions running (showing option to Reconnect to desktop), logout of the session to clear the cached credentials. In addition, if you have a password embedded in a sasnetrc.sas file, you must also change this password at this time.

VRDC Allocations and Fees

Q: What CCW VRDC services have threshold limits and what are they? (FAQ080)

A: Two CCW VRDC environment services have threshold limits. These services include space and Databricks credit usage. The CMS annual space allocation is 2 terabytes (TB) per DUA for researchers and 5 TB per DUA for innovators.

The second threshold limit is for Databricks users. Databricks measures usage in ‘credit’ consumption, and each project (DUA) comes with an annual allocation of 2,000 credits for researchers and 4,000 credits for innovators. For each tool, space and Databricks credit usage, system emails alert you and your DUA project team at 75%, 90%, and 100% of the DUA allocations. Additional space and Databricks credits are available for purchase.

Q: What is the difference between the DUA project fee per year for SAS only and full CCW VRDC options? (FAQ081)

A: The DUA project fee for SAS only option covers all the same services and access as a full CCW VRDC option except for Databricks. For more details, reference the ResDAC fee list.

Q: What is included in an analytic container as part of the fee structure? (FAQ082)

A: Analytic container access is at the user level and includes Stata, R (including RStudio), and Python for an additional fee. For more details, reference the ResDAC fee list.

Q: When there are additional quarters of data released, does the DUA amendment involve a fee? If so, what is the amount or which fee applies? (FAQ083)

A: Quarterly data requests require a one-time fee. If a quarterly fee has been paid on a DUA in the past, adding new years of quarterly data will not incur a fee. Contact ResDAC to initiate this request.

Databricks Analytic Tool and Allocations

Q: What does the Databricks tool offer? (FAQ050)

A: For users wanting additional analytic tools beyond SAS EG, the full CCW VRDC option includes Databricks. Databricks is a data analytic platform allowing users to write Structured Query Language (SQL) code in a Databricks notebook using the %sql commands. The “Notebooks” concept in Databricks is like a SAS EG project, including support for multiple languages like R and Python.

Q: What is a Databricks credit and what would I use it for? (FAQ051)

A: A Databricks credit, also known as Databricks Unit (DBU), is a normalized unit of processing power on the Databricks platform used for measurement and pricing purposes. Processing metrics drive the number of DBUs a workload consumes, which may include the compute resources used and the amount of data processed.

Q: What are the Databricks cluster specifications for a DUA? (FAQ052)

A: This is what CMS includes in a cluster:

Cluster node — a cluster consisting of an Apache Spark driver and no Spark workers that supports Spark jobs and all Spark data sources. A standard cluster requires a minimum of one Spark worker to run Spark jobs. CMS assigns all DUAs a cluster size with the below configuration:

1 driver node = i3.xlarge (4 vCPU, 30.5 gigabyte [GB] memory)
Databricks auto scales up to four worker nodes automatically (i3.xlarge [4 vCPU, 30.5 GB memory])

Cluster DBU consumption — CCW users consume Databricks units at one DBU per hour per node. The default Databricks cluster in the CCW VRDC running all five nodes consumes five DBUs per hour with a node type of i3.xlarge. CMS does not provide refunds for unused DBUs. Users must use DBUs prior to their DUA project renewals. Users should anticipate using DBUs during troubleshooting.

CCW VRDC project teams are required to specify their Databricks cluster size when initially setting up their DUA. In addition to the default cluster, two additional cluster configuration options, described in the table below, are available. If an upgraded cluster is not requested at the time of your initial DUA request, the CCW team will assign the DUA to the default cluster.

Project teams may subsequently request changes to your Databricks cluster size annually during the project fee renewal process. These cannot be made during your project year. There are no additional fees associated with cluster changes. Contact ResDAC for assistance with submitting a DUA amendment request to renew your CCW VRDC project fee.

Information on purchasing additional DBUs and requesting a Databricks cluster upgrade can be found in the CCW VRDC Databricks Credit Upgrade and Purchase Policy located on the ResDAC website. Contact ResDAC at resdac@umn.edu or 1-888-973-7322 for assistance with submitting a DUA amendment request.

Table. Databricks cluster configuration options

Cluster type Node details DBU consumption
Standard data analysis cluster (default)
  • Driver Node — one i3.xlarge (4 vCPU, 30.5 GB memory)
  • Worker Nodes — up to 4 i3.xlarge
  • This cluster consumes 1 DBU per hour per node
  • A cluster running all five nodes consumes 5 DBUs per hour
Enhanced data analysis cluster
  • Driver Node — one i3.8xlarge (32 vCPU, 244 GB memory)
  • Worker Nodes — up to 4 i3.8xlarge
  • This cluster consumes 8 DBUs per hour per node
  • A cluster running all five nodes consumes 40 DBUs per hour
Artificial intelligence (AI)/Machine Learning cluster
  • Driver Node — one c5d.9xlarge (36 vCPU, 72 GB memory)
  • Worker Nodes — up to 8 c5d.9xlarge
  • This cluster consumes 5.46 DBUs per hour per node
  • A cluster running all five nodes consumes 49.14 DBUs per hour

 

Q: Can I upgrade my Databricks cluster? (FAQ053)

A: CMS will allow CCW VRDC users to request Databricks cluster changes during the project fee renewal process. Databricks cluster changes cannot be made during user’s project year.

Information on requesting a Databricks cluster upgrades can be found in the CCW VRDC Databricks Credit Upgrade and Purchase Policy located on the ResDAC website. Contact ResDAC at resdac@umn.edu or 1-888-973-7322 for assistance with submitting a DUA amendment request to renew your CCW VRDC project fee.

Q: How do I know what my current space or Databricks credit usage is? (FAQ054)

A: Users can access the CCW VRDC User Dashboard application. The dashboard displays a user’s current DUA SAS space and Databricks credit usage. Users have an at-a-glance view to refer to their DUA’s threshold limits. The CCW team refreshes the dashboard daily. Look for additional details on understanding usage on the dashboard “Help” icon.

Q: What if I do not need Databricks? (FAQ055)

A: For users that perform analysis within SAS EG and do not need to use Databricks, a SAS only option is available at a lower fee. For more details, reference the ResDAC fee list.

Q: What should I do if I get a threshold alert for my DUA’s Databricks credit usage? (FAQ056)

A: The CCW VRDC system alerts users and their DUA project team at 75%, 90%, and 100% of the DUA allocations. If users receive a threshold alert for the consumption of DBUs, they and their project team need to determine whether to contact ResDAC to buy more DBUs. Additional DBUs can only be purchased one time after the beginning of the current project year.

Q: What happens if I reach my maximum Databricks credit usage threshold and what should I do? (FAQ057)

A: When a DUA reaches 100% of the allocated DBUs, all users within this DUA will no longer be able to use Databricks. To purchase additional DBUs, users must follow the CCW VRDC Databricks Credit Upgrade and Purchase Policy found on the ResDAC website. Contact ResDAC at resdac@umn.edu or 1-888-973-7322 for assistance with submitting a DUA amendment request. Additional DBUs can only be purchased one time after the beginning of the current project year.

Q: If we reach our Databricks credit threshold for a DUA, how long will it take us to pay for more DBUs and get our access back? (FAQ058)

A: Users need to contact ResDAC to request a cost estimate for purchase of additional DBUs. Once ResDAC processes the cost estimate and CMS confirms payment, the CCW team applies the new DBU allotment to the user’s DUA. Additional DBUs can only be purchased one time after the beginning of the current project year. Contact ResDAC at resdac@umn.edu or 1-888-973-7322 for assistance with submitting a DUA amendment request.

Space Allocations and Thresholds

Q: What should I do if I get a threshold alert for my DUA’s space usage? (FAQ060)

A: The CCW VRDC system emails alerts to users and their DUA project team at 75%, 90%, and 100% of the DUA allocations. To comply with the space usage limits, users within the DUA must act by 1) deleting any files no longer needed and/or 2) contacting ResDAC to purchase additional space and/or 3) contacting the CCW Help Desk to delete or move data files associated with “Disabled” or “Disassociated” users.

Q: What happens when I reach my maximum space usage threshold and what should I do? (FAQ061)

A: When a DUA reaches 100% of the allocated space, all users within this DUA will no longer be able to perform tasks that write files to the space associated with that specific DUA. To comply with the space usage limits, users within the DUA must act by 1) deleting any files no longer needed and/or 2) contacting ResDAC to purchase additional space and/or 3) contacting the CCW Help Desk to delete or move data files associated with “Disabled” or “Disassociated” users.

Q: If we reach our SAS space threshold for a DUA but then delete an adequate number of files, how long will it take us to be able to run SAS programs again after the deletions? (FAQ062)

A: Assuming user’s SAS space usage remains below the threshold, they should have access to run SAS programs again within one hour.

Q: Do my files stored in the root sasCCW > Files folder count towards my DUA space usage? (FAQ063)

A: No. CCW VRDC users should not store folders, datasets, or files in the root Files directory (sasCCW > Files). SAS files and SAS datasets in this location will be deleted without prior notice.

Q: Is there a limit on how much additional space users can purchase for a DUA? (FAQ064)

A: There is currently no limit on how much additional space users can purchase; however, requests of 50 TB or greater require additional review. The intent of the CCW VRDC is for researchers to use CMS data to prepare summary data files for output. Keep in mind that the total size of all the files for output cannot exceed 1 GB.

Output Reviews

Q: Are there changes to my output reviews now that the assignment is at the DUA level? (FAQ070)

A: Requests for output review using the File Transfer Request System (FTRS) is assigned at the DUA level. Researchers get three output reviews per DUA per week, and innovators get six output reviews per DUA per week, shared by all users on the DUA.

Q: Is the GB limit per output review request at the user or the DUA level? (FAQ071)

A: The GB limit is at the DUA level. The FTRS system allows research DUAs up to 1 GB of output review, per week, shared by all users on that DUA. FTRS allows innovator DUAs up to 2 GB of output review, per week, shared by all users on that DUA. However, there is still a 1 GB limit per output review request.

Q: Is there a purchase limit on how many output review requests per DUA users can request? (FAQ073)

A: The CCW VRDC support team reviews each request to purchase additional output reviews to ensure resources are available.

Pricing Application

Q: What browsers can I use for the Pricing application?  (FAQ017)

A: The Pricing application works using Google Chrome, Microsoft Edge, and Mozilla Firefox.

Q: How do I select multiple values (e.g., SSA State Code) when creating a study size estimate?  (FAQ018)

A: Use IN to select multiple values. Comma-separate the values. Or, if the value has a drop down, use the Ctrl button and select all values that apply.

Q: When creating a study size estimate, if I select multiple chronic conditions is this using the AND operator or the OR operator?  (FAQ019)

A: Researchers have the option to use the AND or OR operator when selecting multiple chronic conditions.

Q: Can I select multiple diagnosis codes in the same field? What about wild card or a range of values?  (FAQ020)

A: Ranges of HCPCS or procedure codes can be entered per field. You can add as many fields as needed for your estimate. The LIKE operator has been added for wild card use. When using the LIKE operator, you must enter the first three positions of the code, do not enter %.

Q: When creating a study size estimate, if I select multiple diagnosis, HCPCS, or procedure code is this using the AND operator or the OR operator?  (FAQ021)

A: Selecting multiple diagnosis, HCPCS, or procedure code uses the OR operator. Giving researchers the option of AND or OR is documented on our list of enhancements.

Q: Can I estimate a study size using NDC codes?  (FAQ022)

A: This application allows searches for ICD-10 diagnosis and procedure, CPT, and HCPCS codes. Searches for NDC codes are not available.

Q: Can I estimate a study size using Medicaid criteria? (FAQ023)

A: The cohort estimator portion of this application, available on the Estimate Study Size — Medicaid page, now support Medicaid data. Medicaid Enrollee Counts are also available as a PDF document on the Data Pricing page of this application. Both Medicaid and Medicare/Medicaid Dual Eligible counts are provided. These counts may be manually entered in the "Population Size" field on the Data Pricing page.

Q: I want to study Medicaid only enrollees in New Jersey, but the Data Pricing page of the application does not allow me to select a state. (FAQ025)

A: Medicaid files are not priced by state but rather by beneficiary count. To get the count of Medicaid enrollees in New Jersey, go to the Medicaid Enrollee Counts (PDF) document, which is also available on the Data Pricing page.

Q: I would like to get files for certain years which aren't listed on the Data Pricing page. (FAQ026)

A: Each data file's corresponding years listed in the drop down menus are the current years available for that file. The application is updated as new years become available for certain data files.

Q: When creating a Medicaid study-size estimate, what does "Total Months Enrolled" include? (FAQ027)

A: Medicaid "Total Months Enrolled" identifies the number of months an individual is enrolled in Medicaid in a given year regardless of the Medicaid program in which the individual is enrolled (Medicaid, Children's Health Insurance Program, or Medicaid Expansion).

Q: If I select a claim type code and a diagnosis code for a Medicaid estimate, and the diagnosis code is not found on the claim type selected, does the application include the beneficiary in the estimated results? (FAQ028)

A: The selection criteria is all joined with AND. Therefore, if the claim type code and diagnosis code parameters are selected, the diagnosis code must be found on the claim with the claim type code in order for the beneficiary to be counted in the final estimate.