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Data Element
CIP295
CIP.002.295
Definition | The combined amounts the beneficiary or his or her representative (e.g., their guardian) paid towards their copayment, coinsurance, and/or deductible for the covered services on the claim. Only report this data element when the claim does not differentiate among copayment, coinsurance, and/or deductible payments made by the beneficiary. Do not include beneficiary cost sharing payments made by a third party/ies on behalf of the beneficiary. |
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Size | S9(11)V99 |
FLF Start Position | 1975 |
FLF Stop Position | 1987 |
Segment Key Field Identifier | Not Applicable |
Coding Requirements | 1. Value must be between -99999999999.99 and 99999999999.99 2. Value must be expressed as a number with 2-digit precision (e.g. 100.50 ) 3. Conditional |
Valid Value Code Set | Valid Value Code | Valid Value Name | Valid Value Description | Effective Start Date | Effective End Date |
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DE Number | System DE Number | DE Name | File Segment Number | File Segment Name |
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CLT242 | CLT.002.242 | COMBINED-BENE-COST-SHARING-PAID-AMOUNT | CLT00002 | CLAIM-HEADER-RECORD-LT |
COT233 | COT.002.233 | COMBINED-BENE-COST-SHARING-PAID-AMOUNT | COT00002 | CLAIM-HEADER-RECORD-OT |
CRX166 | CRX.002.166 | COMBINED-BENE-COST-SHARING-PAID-AMOUNT | CRX00002 | CLAIM-HEADER-RECORD-RX |