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TMSIS Dataguide Medicaid.gov
Version 3.27.0

SUBMITTING-STATE

Data Element

DE Number

PRV107

System DE Number

PRV.008.107

File Name

PRV - PROVIDER

File Segment Number

PRV00008

File Segment Name

PROV-AFFILIATED-GROUPS

Last updated

No Updates

Definition A code that uniquely identifies the U.S. State or Territory from which T-MSIS system data resources were received.
Size X(2)
FLF Start Position 9
FLF Stop Position 10
Segment Key Field Identifier 1
Coding Requirements 1. Value must be in State Code List (VVL)
2. Value must be 2 characters
3. Mandatory
4. Value must be the same as Submitting State (PRV.001.007)
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
CIP007 CIP.001.007 SUBMITTING-STATE CIP00001 FILE-HEADER-RECORD-IP
CIP017 CIP.002.017 SUBMITTING-STATE CIP00002 CLAIM-HEADER-RECORD-IP
CIP232 CIP.003.232 SUBMITTING-STATE CIP00003 CLAIM-LINE-RECORD-IP
CLT007 CLT.001.007 SUBMITTING-STATE CLT00001 FILE-HEADER-RECORD-LT
CLT017 CLT.002.017 SUBMITTING-STATE CLT00002 CLAIM-HEADER-RECORD-LT
CLT185 CLT.003.185 SUBMITTING-STATE CLT00003 CLAIM-LINE-RECORD-LT
COT007 COT.001.007 SUBMITTING-STATE COT00001 FILE-HEADER-RECORD-OT
COT017 COT.002.017 SUBMITTING-STATE COT00002 CLAIM-HEADER-RECORD-OT
COT155 COT.003.155 SUBMITTING-STATE COT00003 CLAIM-LINE-RECORD-OT
CRX007 CRX.001.007 SUBMITTING-STATE CRX00001 FILE-HEADER-RECORD-RX
CRX017 CRX.002.017 SUBMITTING-STATE CRX00002 CLAIM-HEADER-RECORD-RX
CRX109 CRX.003.109 SUBMITTING-STATE CRX00003 CLAIM-LINE-RECORD-RX
ELG007 ELG.001.007 SUBMITTING-STATE ELG00001 FILE-HEADER-RECORD-ELIGIBILITY
ELG017 ELG.002.017 SUBMITTING-STATE ELG00002 PRIMARY-DEMOGRAPHICS-ELIGIBILITY
ELG031 ELG.003.031 SUBMITTING-STATE ELG00003 VARIABLE-DEMOGRAPHICS-ELIGIBILITY
ELG062 ELG.004.062 SUBMITTING-STATE ELG00004 ELIGIBLE-CONTACT-INFORMATION
ELG080 ELG.005.080 SUBMITTING-STATE ELG00005 ELIGIBILITY-DETERMINANTS
ELG104 ELG.006.104 SUBMITTING-STATE ELG00006 HEALTH-HOME-SPA-PARTICIPATION-INFORMATION
ELG115 ELG.007.115 SUBMITTING-STATE ELG00007 HEALTH-HOME-SPA-PROVIDERS
ELG127 ELG.008.127 SUBMITTING-STATE ELG00008 HEALTH-HOME-CHRONIC-CONDITIONS
ELG137 ELG.009.137 SUBMITTING-STATE ELG00009 LOCK-IN-INFORMATION
ELG147 ELG.010.147 SUBMITTING-STATE ELG00010 MFP-INFORMATION
ELG160 ELG.011.160 SUBMITTING-STATE ELG00011 STATE-PLAN-OPTION-PARTICIPATION
ELG169 ELG.012.169 SUBMITTING-STATE ELG00012 WAIVER-PARTICIPATION
ELG179 ELG.013.179 SUBMITTING-STATE ELG00013 LTSS-PARTICIPATION
ELG189 ELG.014.189 SUBMITTING-STATE ELG00014 MANAGED-CARE-PARTICIPATION
ELG201 ELG.015.201 SUBMITTING-STATE ELG00015 ETHNICITY-INFORMATION
ELG210 ELG.016.210 SUBMITTING-STATE ELG00016 RACE-INFORMATION
ELG221 ELG.017.221 SUBMITTING-STATE ELG00017 DISABILITY-INFORMATION
ELG230 ELG.018.230 SUBMITTING-STATE ELG00018 1115A-DEMONSTRATION-INFORMATION
ELG239 ELG.020.239 SUBMITTING-STATE ELG00020 HCBS-CHRONIC-CONDITIONS-NON-HEALTH-HOME
ELG249 ELG.021.249 SUBMITTING-STATE ELG00021 ENROLLMENT-TIME-SPAN-SEGMENT
ELG258 ELG.022.258 SUBMITTING-STATE ELG00022 ELG-IDENTIFIERS
MCR007 MCR.001.007 SUBMITTING-STATE MCR00001 FILE-HEADER-RECORD-MANAGED-CARE
MCR017 MCR.002.017 SUBMITTING-STATE MCR00002 MANAGED-CARE-MAIN
MCR035 MCR.003.035 SUBMITTING-STATE MCR00003 MANAGED-CARE-LOCATION-AND-CONTACT-INFO
MCR055 MCR.004.055 SUBMITTING-STATE MCR00004 MANAGED-CARE-SERVICE-AREA
MCR064 MCR.005.064 SUBMITTING-STATE MCR00005 MANAGED-CARE-OPERATING-AUTHORITY
MCR074 MCR.006.074 SUBMITTING-STATE MCR00006 MANAGED-CARE-PLAN-POPULATION-ENROLLED
MCR083 MCR.007.083 SUBMITTING-STATE MCR00007 MANAGED-CARE-ACCREDITATION-ORGANIZATION
PRV007 PRV.001.007 SUBMITTING-STATE PRV00001 FILE-HEADER-RECORD-PROVIDER
PRV017 PRV.002.017 SUBMITTING-STATE PRV00002 PROV-ATTRIBUTES-MAIN
PRV040 PRV.003.040 SUBMITTING-STATE PRV00003 PROV-LOCATION-AND-CONTACT-INFO
PRV061 PRV.004.061 SUBMITTING-STATE PRV00004 PROV-LICENSING-INFO
PRV073 PRV.005.073 SUBMITTING-STATE PRV00005 PROV-IDENTIFIERS
PRV085 PRV.006.085 SUBMITTING-STATE PRV00006 PROV-TAXONOMY-CLASSIFICATION
PRV095 PRV.007.095 SUBMITTING-STATE PRV00007 PROV-MEDICAID-ENROLLMENT
PRV116 PRV.009.116 SUBMITTING-STATE PRV00009 PROV-AFFILIATED-PROGRAMS
PRV126 PRV.010.126 SUBMITTING-STATE PRV00010 PROV-BED-TYPE-INFO
TPL007 TPL.001.007 SUBMITTING-STATE TPL00001 FILE-HEADER-RECORD-TPL
TPL017 TPL.002.017 SUBMITTING-STATE TPL00002 TPL-MEDICAID-ELIGIBLE-PERSON-MAIN
TPL030 TPL.003.030 SUBMITTING-STATE TPL00003 TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-INFO
TPL053 TPL.004.053 SUBMITTING-STATE TPL00004 TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-CATEGORIES
TPL064 TPL.005.064 SUBMITTING-STATE TPL00005 TPL-MEDICAID-ELIGIBLE-OTHER-THIRD-PARTY-COVERAGE-INFORMATION
TPL073 TPL.006.073 SUBMITTING-STATE TPL00006 TPL-ENTITY-CONTACT-INFORMATION