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TMSIS Dataguide Medicaid.gov

Version:

3.39.0

TOT-BENEFICIARY-COPAYMENT-PAID-AMOUNT

Data Element

DE Number

CIP208

System DE Number

CIP.002.208

File Name

CIP - CLAIM INPATIENT

File Segment Number

CIP00002

File Segment Name

CLAIM-HEADER-RECORD-IP

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances
Definition The amount the beneficiary or his or her representative (e.g., their guardian) paid towards their copayment for the covered services on the claim. Do not include copayment payments made by a third party/s on behalf of the beneficiary.
Size S9(11)V99
FLF Start Position 1088
FLF Stop Position 1100
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. Situational
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
CLT155 CLT.002.155 TOT-BENEFICIARY-COPAYMENT-PAID-AMOUNT CLT00002 CLAIM-HEADER-RECORD-LT
COT132 COT.002.132 TOT-BENEFICIARY-COPAYMENT-PAID-AMOUNT COT00002 CLAIM-HEADER-RECORD-OT
CRX089 CRX.002.089 TOT-BENEFICIARY-COPAYMENT-PAID-AMOUNT CRX00002 CLAIM-HEADER-RECORD-RX