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TMSIS Dataguide Medicaid.gov
Version 3.28.0

TOT-OTHER-INSURANCE-AMT

Data Element

DE Number

CRX047

System DE Number

CRX.002.047

File Name

CRX - CLAIM PHARMACY

File Segment Number

CRX00002

File Segment Name

CLAIM-HEADER-RECORD-RX

Last updated

No Updates

Overview Valid Values Related Rules Related DQ Measures Other Instances
Definition The amount paid by insurance other than Medicare or Medicaid on this claim.
Size S9(11)V99
FLF Start Position 306
FLF Stop Position 318
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. 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
CIP119 CIP.002.119 TOT-OTHER-INSURANCE-AMT CIP00002 CLAIM-HEADER-RECORD-IP
CLT070 CLT.002.070 TOT-OTHER-INSURANCE-AMT CLT00002 CLAIM-HEADER-RECORD-LT
COT056 COT.002.056 TOT-OTHER-INSURANCE-AMT COT00002 CLAIM-HEADER-RECORD-OT