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TMSIS Dataguide Medicaid.gov
Version 3.27.0

SERVICE-QUANTITY-ALLOWED

Data Element

DE Number

COT184

System DE Number

COT.003.184

File Name

COT - CLAIM OTHER

File Segment Number

COT00003

File Segment Name

CLAIM-LINE-RECORD-OT

Last updated

Definition

The maximum allowable quantity of a service that may be rendered per date of service or per month. For use with CLAIMOT and CLAIMRX claims. For CLAIMIP and CLAIMOT claims/encounter records, use the Revenue center -quantity Allowed field. NOTE: One prescription for 100 250 milligram tablets results in Prescription Quantity allowed=100. This field is only applicable when the service being billed can be quantified in discrete units, e.g., a number of visits or the number of units of a prescription/refill that were filled. For prescriptions/refills, use the Medicaid Drug Rebate definition of a unit, which is the smallest unit by which the drug is normally measured; e.g. tablet, capsule, milliliter, etc. For drugs not identifiable or dispensed by a normal unit, e.g. powder filled vials, use 1 as the number of units. The value in Prescription Quantity allowed must correspond with the value in Unit of measure.

Size S9(8)V999
FLF Start Position 311
FLF Stop Position 321
Segment Key Field Identifier Not Applicable
Coding Requirements

1. Value may include up to 8 digits to the left of the decimal point, and 3 digits to the right e.g. 12345678.999
2. 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