Database Description

North Carolina Medicaid and Blue Cross Blue Shield of North Carolina (BCBSNC) claims data are available as limited datasets. Patient identifiers are encrypted and no identification of individual patients is possible.

NC Medicaid Claims Data 

The NC Medicaid database contains claims data from the North Carolina Department of Health and Human Services Division of Health Benefits.  These data are updated monthly

The database includes the following:

  • Claims information (including doctor visits, inpatient and outpatient care, prescription medications, dental treatments, charge amounts, dates of service, and diagnoses and procedures).
  • Provider information (including specialty and location).
  • Member information (including date of birth, gender, county/ZIP code of residence, race and ethnicity).

Dates available: Jan. 2013 – 3 months prior to the current month (e.g., if today is April, data thru January is available)

Blue Cross Blue Shield of North Carolina (BCBSNC) Claims Data 

The BCBSNC database contains claims data on health care services reimbursed by BCBSNC. The database includes claim records from insured groups, administrative services only (ASO) groups, and individual market and Affordable Care Act Exchange Plans.

The database includes the following:

  • Claims information (including doctor visits, inpatient and outpatient care, prescription medications, dental treatments, charge amounts, dates of service, and diagnoses and procedures).
  • Provider information (including specialty and location).
  • Member information (including date of birth, gender, county/ZIP code of residence).

Data are updated approximately every January and July and are on a 3 month lag, i.e. data ingested in July would contain claims through March.  Data ingested in January would contain data through September.

Dates available: January 2006 – March 2023.

North Carolina State Health Plan (SHP) Claims Data

The SHP database contains claims data on health care services reimbursed by NC SHP.

The database includes the following:

  • Claims information (including doctor visits, inpatient and outpatient care, prescription medications, dental treatments, charge amounts, dates of service, and diagnoses and procedures).
  • Provider information (including specialty and location).
  • Member information (including date of birth, gender, county/ZIP code of residence).

Data are updated approximately every April and October and are on a 3 month lag, i.e. data ingested in April would contain claims through January.  Data ingested in October would contain data through July.

Dates available: January 2017 – September 2022