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TMSIS Dataguide Medicaid.gov
Version 3.27.0

BENEFICIARY-COPAYMENT-DATE-PAID

Data Element

DE Number

CLT156

System DE Number

CLT.002.156

File Segment Number

CLT00002

File Segment Name

CLAIM-HEADER-RECORD-LT

Last updated

No Updates

Definition The date the beneficiary paid the copayment amount.
Size 9(8)
FLF Start Position 986
FLF Stop Position 993
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be 8 characters in the form "CCYYMMDD"
2. The date must be a valid calendar date (i.e. Feb 29th only on the leap year, never April 31st or Sept 31st)
3. Must have an associated Beneficiary Copayment Amount
4. Conditional
Valid Value Code Set Valid Value Code Valid Value Name Valid Value Description Effective Start Date Effective End Date
DE Number System DE Number DE Name File Segment Number File Segment Name
CIP209 CIP.002.209 BENEFICIARY-COPAYMENT-DATE-PAID CIP00002 CLAIM-HEADER-RECORD-IP
COT133 COT.002.133 BENEFICIARY-COPAYMENT-DATE-PAID COT00002 CLAIM-HEADER-RECORD-OT
CRX090 CRX.002.090 BENEFICIARY-COPAYMENT-DATE-PAID CRX00002 CLAIM-HEADER-RECORD-RX