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Data Element
CIP254
CIP.003.254
Definition | The amount paid by Medicaid/CHIP agency or the managed care plan on this claim or adjustment at the claim detail level. For sub-capitated encounters from a sub-capitated entity that is not a sub-capitated network provider, report the amount that the sub-capitated entity paid the provider at the claim line detail level. Report a null value in this field if the provider is a sub-capitated network provider. For sub-capitated encounters from a sub-capitated network provider, if the sub-capitated network provider directly employs the provider that renders the service to the enrollee, report a null value in this field. |
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Size | S9(11)V99 |
FLF Start Position | 233 |
FLF Stop Position | 245 |
Segment Key Field Identifier | Not Applicable |
Coding Requirements | 1. Value must be between -99999999999.99 and 99999999999.99 |
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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CLT208 | CLT.003.208 | MEDICAID-PAID-AMT | CLT00003 | CLAIM-LINE-RECORD-LT |
COT178 | COT.003.178 | MEDICAID-PAID-AMT | COT00003 | CLAIM-LINE-RECORD-OT |
CRX125 | CRX.003.125 | MEDICAID-PAID-AMT | CRX00003 | CLAIM-LINE-RECORD-RX |