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TMSIS Dataguide Medicaid.gov
Version 3.27.0

THIRD-PARTY-COPAYMENT-AMOUNT-PAID

Data Element

DE Number

COT142

System DE Number

COT.002.142

File Name

COT - CLAIM OTHER

File Segment Number

COT00002

File Segment Name

CLAIM-HEADER-RECORD-OT

Last updated

Definition

The amount of money paid by a third party on behalf of the beneficiary towards copayment.

Size S9(11)V99
FLF Start Position 981
FLF Stop Position 993
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. Situational

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
CIP218 CIP.002.218 THIRD-PARTY-COPAYMENT-AMOUNT-PAID CIP00002 CLAIM-HEADER-RECORD-IP
CLT165 CLT.002.165 THIRD-PARTY-COPAYMENT-AMOUNT-PAID CLT00002 CLAIM-HEADER-RECORD-LT
CRX100 CRX.002.100 THIRD-PARTY-COPAYMENT-AMOUNT-PAID CRX00002 CLAIM-HEADER-RECORD-RX