An official website of the United States government

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock () or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

TMSIS Dataguide Medicaid.gov
Version 3.27.0

ELIGIBLE-LAST-NAME

Data Element

DE Number

CRX063

System DE Number

CRX.002.063

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 last name of the individual to whom the services were provided. (The patients name should be captured as it appears on the claim record, it does not need to be the same as it appears on the eligibility file. The MSIS Identification Number will be used to associate a claim record with the appropriate eligibility data.)
Size X(30)
FLF Start Position 385
FLF Stop Position 414
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be 30 characters or less
2. Value must not contain a pipe or asterisk symbols
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
CIP172 CIP.002.172 ELIGIBLE-LAST-NAME CIP00002 CLAIM-HEADER-RECORD-IP
CLT123 CLT.002.123 ELIGIBLE-LAST-NAME CLT00002 CLAIM-HEADER-RECORD-LT
COT105 COT.002.105 ELIGIBLE-LAST-NAME COT00002 CLAIM-HEADER-RECORD-OT
ELG021 ELG.002.021 ELIGIBLE-LAST-NAME ELG00002 PRIMARY-DEMOGRAPHICS-ELIGIBILITY
TPL024 TPL.002.024 ELIGIBLE-LAST-NAME TPL00002 TPL-MEDICAID-ELIGIBLE-PERSON-MAIN