| ELG061 |
ELG.004.061
|
RECORD-ID |
The Record ID represents the type of segment being reported. The Record ID communicates how the contents of a
given row of data should be interpreted depending on which segment type the Record ID represents. Each type of
segment collects different data elements so each segment type has a distinct layout. The first 3 characters identify
the relevant file (e.g., ELG, PRV, CIP, etc.). The last 5 digits are the segment identifier padded with leading zeros (e.g.,
00001, 00002, 00003, etc.). |
ELG061 Values
|
| ELG062 |
ELG.004.062
|
SUBMITTING-STATE |
A code that uniquely identifies the U.S. State or Territory from which T-MSIS system data resources were received. |
ELG062 Values
|
| ELG063 |
ELG.004.063
|
RECORD-NUMBER |
A sequential number assigned by the submitter to identify each record segment row in the submission file. The Record Number, in conjunction with the Record Identifier, uniquely identifies a single record within the submission file. |
N/A
|
| ELG064 |
ELG.004.064
|
MSIS-IDENTIFICATION-NUM |
A state-assigned unique identification number used to identify a Medicaid/CHIP enrolled individual (except on service tracking payments). Value may be an SSN, temporary SSN or State-assigned eligible individual identifier. MSIS Identification Numbers are a unique "key" value used to maintain referential integrity of data distributed over multiples files, segments and reporting periods. See T-MSIS Guidance Document, "CMS Guidance: Reporting Shared MSIS Identification Numbers" for information on reporting the MSIS Identification Numbers ID for pregnant women, unborn children, mothers, and their deemed newborns younger than 1 year of age who share the same MSIS Identification Number. https://www.medicaid.gov/medicaid/data-and-systems/macbis/tmsis/tmsis-blog/entry/47572 |
N/A
|
| ELG065 |
ELG.004.065
|
ADDR-TYPE |
The type of address and contact information for the eligible submitted in the record segment. |
ELG065 Values
|
| ELG066 |
ELG.004.066
|
ELIGIBLE-ADDR-LN1 |
The first line of a potentially multi-line physical street or mailing address for a given entity (e.g. person, organization, agency, etc.). |
N/A
|
| ELG067 |
ELG.004.067
|
ELIGIBLE-ADDR-LN2 |
The second line of a multi-line physical street or mailing address for a given entity (e.g. person, organization, agency, etc.). |
N/A
|
| ELG068 |
ELG.004.068
|
ELIGIBLE-ADDR-LN3 |
The third line of a multi-line physical street or mailing address for a given entity (e.g. person, organization, agency, etc.). |
N/A
|
| ELG069 |
ELG.004.069
|
ELIGIBLE-CITY |
The city component of an address associated with a given entity (e.g. person, organization, agency, etc.). |
N/A
|
| ELG070 |
ELG.004.070
|
ELIGIBLE-STATE |
The ANSI state numeric code for the U.S. state, Territory, or the District of Columbia code for where the individual
eligible to receive healthcare services resides. (The state for the type of address indicated in Address Type.) |
ELG070 Values
|
| ELG071 |
ELG.004.071
|
ELIGIBLE-ZIP-CODE |
U.S. ZIP Code component of an address associated with a given entity (e.g. person, organization, agency, etc.) |
ELG071 Values
|
| ELG072 |
ELG.004.072
|
ELIGIBLE-COUNTY-CODE |
Standard ANSI code used to identify a specific U.S. County. |
ELG072 Values
|
| ELG073 |
ELG.004.073
|
ELIGIBLE-PHONE-NUM |
Phone number for a given entity (e.g. person, organization, agency). |
N/A
|
| ELG074 |
ELG.004.074
|
TYPE-OF-LIVING-ARRANGEMENT |
A free-form text field to describe the type of living arrangement used for the eligibility determination process. |
N/A
|
| ELG075 |
ELG.004.075
|
ELIGIBLE-ADDR-EFF-DATE |
The first calendar day on which all of the other data elements in the same segment were effective. |
N/A
|
| ELG076 |
ELG.004.076
|
ELIGIBLE-ADDR-END-DATE |
The last calendar day on which all of the other data elements in the same segment were effective. |
N/A
|
| ELG077 |
ELG.004.077
|
STATE-NOTATION |
A free text field for the submitting state to enter whatever information it chooses. |
N/A
|
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