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TMSIS Dataguide Medicaid.gov
Version 3.27.0

OTHER-INSURANCE-AMT

Data Element

DE Number

CRX152

System DE Number

CRX.003.152

File Name

CRX - CLAIM PHARMACY

File Segment Number

CRX00003

File Segment Name

CLAIM-LINE-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 388
FLF Stop Position 400
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
CIP272 CIP.003.272 OTHER-INSURANCE-AMT CIP00003 CLAIM-LINE-RECORD-IP
CLT207 CLT.003.207 OTHER-INSURANCE-AMT CLT00003 CLAIM-LINE-RECORD-LT
COT213 COT.003.213 OTHER-INSURANCE-AMT COT00003 CLAIM-LINE-RECORD-OT