Data Documentation

Base Claim File

Number	SAS Name	Variable Name
1	BENE_ID	Encrypted CCW Beneficiary Identifier
2	MSIS_ID	Encrypted State Assigned Beneficiary Unique Identifier
3	STATE_CD	Submitting State Alpha Abbreviation
4	SUBMTG_STATE_CD	Submitting State FIPS Code
5	CLM_ID	CCW Claim Identifier
6	CLM_NUM_ORIG	Original Claim Identifier
7	CLM_NUM_ADJ	Adjustment Claim Identifier
8	CLM_TYPE_CD	Claim Type Code (TAF)
9	BILL_TYPE_CD	Bill Type Code
10	CROSSOVER_CLM_IND	Code To Indicate if a Portion of Claim is Paid by Medicare
11	ADJUST_CD	Claim Adjustment Code
12	ADJUST_RSN_CD	Adjustment Reason Code
13	ADJDCTN_DT	Adjudication Date
14	MDCD_PD_DT	Medicaid Paid Date
15	CLL_CNT	Claim Line Count - Original
16	CLL_CNT_CALC	Claim Line Count - Calculated
17	PRSN_CLM_IND	Indicator of a Claim for a Person
18	SRVC_TRKNG_TYPE_CD	Service Tracking Type Code
19	FED_SRVC_CTGRY_CD	Federally Assigned Service Category Code Added During TAF Production
20	BIRTH_DT	Date of Birth
21	PGM_TYPE_CD	Program Type Code
22	MC_PLAN_ID	Managed Care Plan Identification Number
23	WVR_TYPE_CD	Waiver Type Code
24	WVR_ID	Waiver Identification Number
25	OTHR_INSRNC_IND	Indicator Insured is Covered by Another Plan (Not Medicare or Medicaid)
26	SECT_1115A_DEMO_IND	1115(A) Demonstration Participation Indicator
27	SRVC_BGN_DT	Claim Beginning Date of Service
28	SRVC_END_DT	Claim Ending Date of Service
29	SRVC_END_DT_CD	Identifies the Date Field Used to Populate SRVC_END_DT
30	DGNS_CD_1	Primary or Principal Diagnosis Code
31	DGNS_VRSN_CD_1	Diagnosis Version Code 1 (ICD-9 or ICD-10)
32	DGNS_POA_IND_1	Diagnosis Present on Admission Indicator 1
33	DGNS_1_CCSR_CTGRY_CD	AHRQ Clinical Classifications Software Refined (CCSR) Diagnosis 1 Category Code
34	DGNS_CD_2	Diagnosis Code 2
35	DGNS_VRSN_CD_2	Diagnosis Version Code 2 (ICD-9 or ICD-10)
36	DGNS_POA_IND_2	Diagnosis Present on Admission Indicator 2
37	HAC_IND	Health Care Acquired Condition (HAC) Indicator
38	IP_MH_DGNS_IND	Mental Health Diagnosis Indicator
39	IP_SUD_DGNS_IND	Substance Use Disorder Diagnosis Indicator
40	POS_CD	Place of Service Code
41	BLG_PRVDR_ID	Billing Provider Identification Number (TAF)
42	BLG_PRVDR_NPI	Billing Provider NPI
43	BLG_PRVDR_TXNMY_CD	Billing Provider Taxonomy Code
44	BLG_PRVDR_NPPES_TXNMY_CD	Billing Provider NPPES Taxonomy Code
45	BLG_PRVDR_TYPE_CD	Billing Provider Type Code
46	BLG_PRVDR_SPCLTY_CD	Billing Provider Specialty Code
47	RFRG_PRVDR_ID	Referring Provider Identification Number
48	RFRG_PRVDR_NPI	Referring Provider NPI
49	RFRG_PRVDR_TXNMY_CD	Referring Provider Taxonomy Code
50	RFRG_PRVDR_TYPE_CD	Referring Provider Type Code
51	RFRG_PRVDR_SPCLTY_CD	Referring Provider Specialty Code
52	DRCTNG_PRVDR_NPI	NPI of Provider Directing the Patient's Care
53	DRCTNG_PRVDR_TXNMY_CD	Taxonomy Code of Provider Directing the Patient's Care
54	SPRVSNG_PRVDR_NPI	Supervising Provider NPI
55	SPRVSNG_PRVDR_TXNMY_CD	Supervising Provider Taxonomy Code
56	HLTH_HOME_PRVDR_IND	Health Home Provider Indicator
57	HLTH_HOME_PRVDR_NPI	Health Home Provider NPI
58	HLTH_HOME_ENT_NAME	Health Home Entity Name
59	PRVDR_LCTN_CD	Provider Location Code
60	BRDR_STATE_IND	Border State Indicator
61	IP_MH_TXNMY_IND	Mental Health Provider Taxonomy Indicator
62	IP_SUD_TXNMY_IND	Substance Use Disorder Provider Taxonomy Indicator
63	FIXD_PYMT_IND	Fixed Payment Indicator
64	SRVC_TRKNG_PYMT_AMT	Service Tracking Payment Amount
65	PYMT_LVL_IND	Payment Level Indicator - Header or Line
66	CPTATD_PYMT_BILLED_AMT	Capitated Payment Billed Amount
67	CPTATD_PYMT_BILLED_DT	Capitated Payment Billed Date
68	BILLED_AMT	Total Claim Billed Amount
69	MDCD_ALOWD_AMT	Total Medicaid Allowed Amount
70	MDCD_PD_AMT	Total Amount Paid By Medicaid
71	DAILY_RATE	Daily Rate that a Policy will Pay for a Covered Service
72	MDCD_COPAY_AMT	Total Copay Amount Paid by Beneficiary
73	MDCR_DDCTBL_PD_AMT	Total Medicare Deductible Amount
74	MDCR_COINSRNC_PD_AMT	Total Medicare Coinsurance Amount
75	MDCR_CMBND_DDCTBL_IND	Medicare Combined Deductible and Coinsurance Indicator
76	MDCR_REIMBRSMT_TYPE_CD	Medicare Reimbursement Type Code
77	COINSRNC_AMT	Beneficiary Coinsurance Amount
78	COINSRNC_PD_DT	Beneficiary Coinsurance Paid Date
79	COPAY_AMT	Beneficiary Copayment Amount
80	COPAY_PD_DT	Beneficiary Copayment Paid Date
81	DDCTBL_AMT	Beneficiary Deductible Amount
82	DDCTBL_PD_DT	Beneficiary Deductible Paid Date
83	COPAY_WVD_IND	Indicator Signifying Copay was Waived by Provider
84	TP_PD_AMT	Total Third Party Liability Paid Amount
85	TP_COINSRNC_PD_AMT	Third Party Coinsurance Paid Amount
86	TP_COPAY_PD_AMT	Third Party Copayment Paid Amount
87	OTHR_INSRNC_PD_AMT	Total Other Than Medicare or Medicaid -Insurance Paid Amount
88	OTHR_TP_CLCTN_CD	Other Third Party Collection Code
89	FUNDNG_CD	Code To Indicate Source of Non-Federal Funding
90	FUNDNG_SRC_NON_FED_SHR_CD	Funding Source Non-Federal Share Code
91	REMITTANCE_NUM	Remittance Number
92	DA_RUN_ID	TAF Production Run Identifier (unique for each TAF run)
93	TMSIS_RUN_ID	TMSIS State Data Processing Run Identifier
94	OT_VRSN	Other Services Version Representing the Iteration of the File
95	OT_FIL_DT	Other Services File Date - Represents the Year and Month of the Reporting Period
96	CCW_LD_DT	CCW Load Date (Claims)

Occurrence Code File

Number	SAS Name	Variable Name
97	BENE_ID	Encrypted CCW Beneficiary Identifier
98	MSIS_ID	Encrypted State Assigned Beneficiary Unique Identifier
99	STATE_CD	Submitting State Alpha Abbreviation
100	SUBMTG_STATE_CD	Submitting State FIPS Code
101	CLM_ID	CCW Claim Identifier
102	OCRNC_CD_SEQ	Occurrence Code Sequence
103	OCRNC_CD	Occurrence Code
104	OCRNC_CD_START_DT	Occurrence Code Start Date
105	OCRNC_CD_END_DT	Occurrence Code End Date

LINE FILE

Number	SAS Name	Variable Name
1	BENE_ID	Encrypted CCW Beneficiary Identifier
2	MSIS_ID	Encrypted State Assigned Beneficiary Unique Identifier
3	STATE_CD	Submitting State Alpha Abbreviation
4	SUBMTG_STATE_CD	Submitting State FIPS Code
5	CLM_ID	CCW Claim Identifier
6	LINE_NUM	Sequential Claim Line Number
7	CLM_NUM_ORIG	Original Claim Identifier
8	LINE_NUM_ORIG	Original Claim Line Number (TAF)
9	CLM_NUM_ADJ	Adjustment Claim Identifier
10	LINE_NUM_ADJ	Adjustment Claim Line Number
11	ADJDCTN_DT	Adjudication Date
12	LINE_CLAIM_STUS_CD	Claim Line Status Code
13	LINE_ADJUST_CD	Claim Line Adjustment Code
14	LINE_ADJUST_RSN_CD	Claim Line Adjustment Reason Code
15	LINE_SRVC_BGN_DT	Claim Line Beginning Date of Service
16	LINE_SRVC_END_DT	Claim Line Ending Date of Service
17	BNFT_TYPE_CD	Benefit Type Code
18	TOS_CD	Type of Service Code
19	XIX_SRVC_CTGRY_CD	CMS-64 Form Category of Service for the Paid Claim
20	XXI_SRVC_CTGRY_CD	CMS-21 Form Category of Service for the Paid Claim
21	CMS_64_FED_CTGRY_CD	CMS-64 Form Code for Federal Reimbursement
22	REV_CNTR_CD	Revenue Center Code (TAF)
23	ACTL_SRVC_QTY	Actual Service Quantity
24	ALOWD_SRVC_QTY	Maximum Allowed Service Quantity
25	LINE_PRCDR_CD_DT	Date Line Procedure Performed
26	LINE_PRCDR_CD	Line Procedure Code
27	LINE_PRCDR_CD_SYS	Line Procedure Code System/Nomenclature
28	LINE_PRCDR_MDFR_CD_1	Line Procedure Code Modifier Code 1
29	LINE_PRCDR_MDFR_CD_2	Line Procedure Code Modifier Code 2
30	LINE_PRCDR_MDFR_CD_3	Line Procedure Code Modifier Code 3
31	LINE_PRCDR_MDFR_CD_4	Line Procedure Code Modifier Code 4
32	LINE_PRCDR_CCS_CTGRY_CD	Line Procedure AHRQ Clinical Classifications Software Refined (CCSR) Category Cd
33	NDC	National Drug Code
34	NDC_UOM_CD	NDC Unit of Measure Code
35	NDC_QTY	NDC Quantity Dispensed
36	IMNZTN_TYPE_CD	Immunization Type Code
37	SELF_DRCTN_TYPE_CD	Beneficiary Service Self-Direction Type Code
38	PRE_AUTHRZTN_NUM	Pre-Authorization Number
39	HCBS_SRVC_CD	Home- and Community-Based Services Service Code
40	HCBS_TXNMY_CD	Home- and Community-Based Services Taxonomy Code
41	TOOTH_DSGNTN_SYS	Tooth Designation System/Nomenclature
42	TOOTH_NUM	Tooth Number
43	TOOTH_ORAL_CVTY_AREA_DSGNTD_CD	Tooth Oral Cavity Area Designated Code
44	TOOTH_SRFC_CD	Tooth Surface Code
45	SRVC_PRVDR_ID	Servicing Provider Identification Number (TAF)
46	SRVC_PRVDR_NPI	Servicing Provider NPI
47	SRVC_PRVDR_TXNMY_CD	Servicing Provider Taxonomy Code
48	SRVC_PRVDR_NPPES_TXNMY_CD	Servicing Provider NPPES Taxonomy Code
49	SRVC_PRVDR_TYPE_CD	Servicing Provider Type Code
50	SRVC_PRVDR_SPCLTY_CD	Servicing Provider Specialty Code (TAF)
51	LINE_BILLED_AMT	Line Billed Amount
52	LINE_MDCD_ALOWD_AMT	Line Medicaid Allowed Amount
53	LINE_MDCD_PD_AMT	Line Medicaid Paid Amount
54	LINE_MDCD_FFS_EQUIV_AMT	Line Medicaid Fee For Service Equivalent Amount
55	LINE_MDCR_PD_AMT	Line Medicare Paid Amount
56	LINE_COPAY_AMT	Line Beneficiary Copayment Amount
57	LINE_TP_PD_AMT	Line Third Party Liability Paid Amount
58	LINE_OTHR_INSRNC_PD_AMT	Line Other Than Medicare or Medicaid -Insurance Paid Amount
59	OT_ACCMDTN_HCPCS_RATE	Other Services Accommodation Rate
60	DA_RUN_ID	TAF Production Run Identifier (unique for each TAF run)
61	TMSIS_RUN_ID	TMSIS State Data Processing Run Identifier