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TMSIS Dataguide Medicaid.gov
Version 3.27.0

TPL-ENTITY-CONTACT-INFORMATION

File Segment

File Segment Number

TPL00006

File Name

TPL - THIRD-PARTY LIABILITY

Last updated

No Updates

Data Elements Reference
DE Number System DE Number Data Element Definition Valid Values
TPL072 TPL.006.072 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.). TPL072 Values
TPL073 TPL.006.073 SUBMITTING-STATE A code that uniquely identifies the U.S. State or Territory from which T-MSIS system data resources were received. TPL073 Values
TPL074 TPL.006.074 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
TPL075 TPL.006.075 INSURANCE-CARRIER-ID-NUM The state-assigned identification number of the Third Party Liability (TPL) Entity. N/A
TPL076 TPL.006.076 TPL-ENTITY-ADDR-TYPE The type of address for a TPL Entity submitted in the record segment. TPL076 Values
TPL077 TPL.006.077 INSURANCE-CARRIER-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
TPL078 TPL.006.078 INSURANCE-CARRIER-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
TPL079 TPL.006.079 INSURANCE-CARRIER-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
TPL080 TPL.006.080 INSURANCE-CARRIER-CITY

The city component of an address associated with a given entity (e.g. person, organization, agency, etc.).

 N/A
TPL081 TPL.006.081 INSURANCE-CARRIER-STATE

The ANSI state numeric code for the U.S. state, Territory, or the District of Columbia code of the TPL Insurance carrier.

 TPL081 Values
TPL082 TPL.006.082 INSURANCE-CARRIER-ZIP-CODE

The ZIP Code for the location being captured on the TPL Entity Contact Information record.

 TPL082 Values
TPL083 TPL.006.083 INSURANCE-CARRIER-PHONE-NUM

Phone number for a given entity (e.g. person, organization, agency).

 N/A
TPL084 TPL.006.084 TPL-ENTITY-CONTACT-INFO-EFF-DATE The first calendar day on which all of the other data elements in the same segment were effective. N/A
TPL085 TPL.006.085 TPL-ENTITY-CONTACT-INFO-END-DATE The last calendar day on which all of the other data elements in the same segment were effective. N/A
TPL086 TPL.006.086 STATE-NOTATION

A free text field for the submitting state to enter whatever information it chooses.

 N/A
TPL090 TPL.006.090 INSURANCE-CARRIER-NAIC-CODE

The National Association of Insurance Commissioners (NAIC) code of the TPL Insurance carrier.

 N/A
TPL091 TPL.006.091 INSURANCE-CARRIER-NAME

The name of the TPL Insurance carrier.

 N/A
Definition
A record to capture addresses and phone numbers of the entity providing TPL insurance coverage.

File Segment Length
900