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TMSIS Dataguide Medicaid.gov
Version 3.28.0

BILLING-PROV-TYPE

Data Element

DE Number

COT115

System DE Number

COT.002.115

File Name

COT - CLAIM OTHER

File Segment Number

COT00002

File Segment Name

CLAIM-HEADER-RECORD-OT

Last updated

No Updates

Definition

A code to describe the type of provider being reported.

Size X(2)
FLF Start Position 749
FLF Stop Position 750
Segment Key Field Identifier Not Applicable
Coding Requirements

1. Value must be in Provider Type Code List (VVL).
2. Value must be 2 characters
3. 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
CIP182 CIP.002.182 BILLING-PROV-TYPE CIP00002 CLAIM-HEADER-RECORD-IP
CLT133 CLT.002.133 BILLING-PROV-TYPE CLT00002 CLAIM-HEADER-RECORD-LT