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TMSIS Dataguide Medicaid.gov
Version 3.36.0

SUBMITTER-ID

Data Element

DE Number

CRX118

System DE Number

CRX.003.118

File Name

CRX - CLAIM PHARMACY

File Segment Number

CRX00003

File Segment Name

CLAIM-LINE-RECORD-RX

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances
Definition The Submitter Identification number is the value that identifies the provider/trading partner/clearing house organization to the state's claim adjudication system.
Size X(12)
FLF Start Position 152
FLF Stop Position 163
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be 12 characters or less
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
CIP021 CIP.002.021 SUBMITTER-ID CIP00002 CLAIM-HEADER-RECORD-IP
CIP241 CIP.003.241 SUBMITTER-ID CIP00003 CLAIM-LINE-RECORD-IP
CLT021 CLT.002.021 SUBMITTER-ID CLT00002 CLAIM-HEADER-RECORD-LT
CLT194 CLT.003.194 SUBMITTER-ID CLT00003 CLAIM-LINE-RECORD-LT
COT021 COT.002.021 SUBMITTER-ID COT00002 CLAIM-HEADER-RECORD-OT
COT164 COT.003.164 SUBMITTER-ID COT00003 CLAIM-LINE-RECORD-OT
CRX021 CRX.002.021 SUBMITTER-ID CRX00002 CLAIM-HEADER-RECORD-RX