Data Documentation

For most files, a table of variables will display below, with links to the variable definitions. If no table displays, or if you need additional information for a specific variable, please see the CCW website. Data documentation is available for all files and codebooks for many.

If you are unable to locate the information you need, please contact ResDAC.

CCW Codebook TAF Claims_Version 022023_0.pdf1.39 MB

If you are unable to locate the information you need, please contact ResDAC.

CCW Record Layout TAF Claims_Version 022023_0.xlsx88.04 KB

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