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TMSIS Dataguide Medicaid.gov

Version:

SERVICE-FACILITY-LOCATION-ADDR-LN-1

Data Element

DE Number

CIP304

System DE Number

CIP.002.304

File Segment Number

CIP00002

File Segment Name

CLAIM-HEADER-RECORD-IP

Last updated

Definition Service facility location address line 1 from X12 837I loop 2310E.
Size X(60)
FLF Start Position 1539
FLF Stop Position 1598
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must not be more than 60 characters long
2. Conditional
3. Value must not contain a pipe or asterisk symbols
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
CLT250 CLT.002.250 SERVICE-FACILITY-LOCATION-ADDR-LN-1 CLT00002 CLAIM-HEADER-RECORD-LT
COT242 COT.002.242 SERVICE-FACILITY-LOCATION-ADDR-LN-1 COT00002 CLAIM-HEADER-RECORD-OT
COT259 COT.003.259 SERVICE-FACILITY-LOCATION-ADDR-LN-1 COT00003 CLAIM-LINE-RECORD-OT