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: Data ingest occurs around the 26th of each month and contains data through the previous month.  E.g. Data ingested on October 26th would contain data through September 30th.

 

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.  E.g. Data ingested in July would contain claims through March.  Data ingested in January would contain data through September.

Dates available: January 2006 – March 2021.