CRX.002.051

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

SERVICE-TRACKING-PAYMENT-AMT

Data Element

DE Number

CRX051

System DE Number

CRX.002.051

File Name

CRX - CLAIM PHARMACY

File Segment Number

File Segment Name

CLAIM-HEADER-RECORD-RX

Last updated

No Updates

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	On service tracking claims, the payment amount is the lump sum that cannot be attributed to any one beneficiary paid to the provider.
Size	S9(11)V99
FLF Start Position	325
FLF Stop Position	337
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. If associated Type of Claim value is in [4, D, or X], then value is mandatory and must be provided 4. Conditional 5. When populated, Service Tracking Type must be populated 6. When populated, Total Medicaid Amount must not be populated

Valid Value Code Set	Valid Value Code	Valid Value Name	Valid Value Description	Effective Start Date	Effective End Date

RULE ID	RULE Definition
RULE-1808	If a claim is a non-denied claim from an RX file, then the service tracking payment amount value reported must be a valid dollar amount that matches the specified T-MSIS picture format: S9(11)V99.
RULE-7403	If a claim is a non-denied, non-void claim from an RX file, and is a Medicaid/Medicaid-expansion CHIP or S-CHIP service tracking claim and is an original claim or a replacement/resubmission claim payment then the claim header service tracking payment amount must be populated and does not equal '0'.
RULE-7520	If a claim is a non-denied, non-service tracking claim from an RX file, then the service tracking payment amount is not populated or equal to '0.00'.

Measure ID	Measure Name
EXP-43-008-8	# of non-service tracking claim headers with non-missing Service Tracking Payment Amount
MIS-61-001-1	% missing: SERVICE-TRACKING-PAYMENT-AMT (CRX00002)
RULE-7403	% missing: SERVICE-TRACKING-PAYMENT-AMT (CRX00002)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP124	CIP.002.124	SERVICE-TRACKING-PAYMENT-AMT	CIP00002	CLAIM-HEADER-RECORD-IP
CLT074	CLT.002.074	SERVICE-TRACKING-PAYMENT-AMT	CLT00002	CLAIM-HEADER-RECORD-LT
COT060	COT.002.060	SERVICE-TRACKING-PAYMENT-AMT	COT00002	CLAIM-HEADER-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After