Minnesota’s All Payer Claims Database (APCD)
Provider Data Elements
Name
Location
Identifiers
Billing Provider
Service Provider first
name, middle name, last
name or organization
name, suffix
Service Provider
city name, state or
province, ZIP code
Service Provider
number, Tax ID
Number, National
Service Provider ID (NPI)
Last name or organization
name, Billing Provider
Number, National Billing
Provider ID (NPI)
Medical Claims
Payments
Charges
Charge Amount
Paid Amount, Prepaid
Amount, Copay/Coinsurance
Amount, Deductible Amount
Other
Institutional &
Professional Claims
Managed Care
Withhold
Version Number
Pharmacy Data
Name/Identifiers
Pharmacy name,
Pharmacy number,
National Pharmacy ID
Number (NPI)
Prescribing
Physician
First name, middle
name, last name,
DEA/Legacy number,
National Provider
Identification Number
Charges/Payments
Other
Gross Amount Due, Total
Amount Paid, Other Amount
Paid, Dispensing Fee Paid,
Copay/Coinsurance Amount,
Deductible Amount, Patient Pay
Amount
Other Payer
Amount
Recognized,
Ingredient
Cost/List Price
Enrollment Data
Payer
Information
Member
Information
Payer, Insurance
Type, Enrollment
Year/Month, Eligible
Year/Month, Planspecific contract
number*
Relationship to
subscriber, Gender,
DOB*, City/State/Zip,
Coverage flags, Last
name*, First name*,
Middle Initial*
*These data elements are fully encrypted before submission
Claim Adjustments
Subscriber
Information
Last name*, First
name*, Middle
Initial*
Medicaid Fee-for-Service
 Common adjustments: legislative cutbacks,
capitation payments, incentive payments,
DSH.
 Payments outside claim stream: capitation
payments, Meaningful Use.
Medicare Fee-for-Service
 Adjustments to the base DRG
reimbursement rate: DSH,IME NTAP, highcost outlier adjustment.
 Payments outside claim stream: DGME,
hospital value-based purchasing (HVBP),
Meaningful Use, adj. for rurality/size.
Commercial Payers
 Little consistency.