CRX.002.100

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

THIRD-PARTY-COPAYMENT-AMOUNT-PAID

Data Element

DE Number

CRX100

System DE Number

CRX.002.100

File Name

CRX - CLAIM PHARMACY

File Segment Number

File Segment Name

CLAIM-HEADER-RECORD-RX

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The amount of money paid by a third party on behalf of the beneficiary towards copayment.
Size	S9(11)V99
FLF Start Position	767
FLF Stop Position	779
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

RULE ID	RULE Definition
RULE-6974	If a claim line is a non-denied claim line from an RX file, then the third party copayment amount paid value reported must be compatible with specified T-MSIS picture format: S9(11)V99.

Measure ID	Measure Name

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
COT142	COT.002.142	THIRD-PARTY-COPAYMENT-AMOUNT-PAID	COT00002	CLAIM-HEADER-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
08/29/2023	3.12.0	CRX.002.100	UPDATE	Necessity	Optional	Situational
08/23/2023	3.12.0	CRX.002.100	UPDATE	Coding requirement	1. Value must be between -99999999999.99 and 99999999999.992. Value must be expressed as a number with 2-digit precision (e.g. 100.50 )3. Optional	1. Value must be between -99999999999.99 and 99999999999.992. Value must be expressed as a number with 2-digit precision (e.g. 100.50 )3. Situational