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Data Element
CLT188
CLT.003.188
Definition | A unique number assigned by the state's payment system that identifies an original or adjustment claim. |
---|---|
Size | X(50) |
FLF Start Position | 42 |
FLF Stop Position | 91 |
Segment Key Field Identifier | 2 |
Coding Requirements | 1. Value must be 50 characters or less 2. Value must not contain a pipe or asterisk symbols 3. Mandatory |
Valid Value Code Set | Valid Value Code | Valid Value Name | Valid Value Description | Effective Start Date | Effective End Date |
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DE Number | System DE Number | DE Name | File Segment Number | File Segment Name |
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CIP019 | CIP.002.019 | ICN-ORIG | CIP00002 | CLAIM-HEADER-RECORD-IP |
CIP235 | CIP.003.235 | ICN-ORIG | CIP00003 | CLAIM-LINE-RECORD-IP |
CIP325 | CIP.004.325 | ICN-ORIG | CIP00004 | CLAIM-DX-IP |
CLT019 | CLT.002.019 | ICN-ORIG | CLT00002 | CLAIM-HEADER-RECORD-LT |
CLT271 | CLT.004.271 | ICN-ORIG | CLT00004 | CLAIM-DX-LT |
COT019 | COT.002.019 | ICN-ORIG | COT00002 | CLAIM-HEADER-RECORD-OT |
COT158 | COT.003.158 | ICN-ORIG | COT00003 | CLAIM-LINE-RECORD-OT |
COT277 | COT.004.277 | ICN-ORIG | COT00004 | CLAIM-DX-OT |
CRX019 | CRX.002.019 | ICN-ORIG | CRX00002 | CLAIM-HEADER-RECORD-RX |
CRX112 | CRX.003.112 | ICN-ORIG | CRX00003 | CLAIM-LINE-RECORD-RX |
CRX199 | CRX.004.199 | ICN-ORIG | CRX00004 | CLAIM-DX-RX |
FTX020 | FTX.002.020 | ICN-ORIG | FTX00002 | INDIVIDUAL-CAPITATION-PMPM |
FTX067 | FTX.003.067 | ICN-ORIG | FTX00003 | INDIVIDUAL-HEALTH-INSURANCE-PREMIUM-PAYMENT |
FTX108 | FTX.004.108 | ICN-ORIG | FTX00004 | GROUP-INSURANCE-PREMIUM-PAYMENT |
FTX152 | FTX.005.152 | ICN-ORIG | FTX00005 | COST-SHARING-OFFSET |
FTX195 | FTX.006.195 | ICN-ORIG | FTX00006 | VALUE-BASED-PAYMENT |
FTX239 | FTX.007.239 | ICN-ORIG | FTX00007 | STATE-DIRECTED-PAYMENT-SEPARATE-PAYMENT-TERM |
FTX282 | FTX.008.282 | ICN-ORIG | FTX00008 | COST-SETTLEMENT-PAYMENT |
FTX321 | FTX.009.321 | ICN-ORIG | FTX00009 | FQHC-WRAP-PAYMENT |
FTX360 | FTX.095.360 | ICN-ORIG | FTX00095 | MISCELLANEOUS-PAYMENT |