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TMSIS Dataguide Medicaid.gov

Version:

3.38.0

SDP-ALLOWED-AMT

Data Element

DE Number

CLT266

System DE Number

CLT.003.266

File Name

CLT - CLAIM LONG-TERM CARE

File Segment Number

CLT00003

File Segment Name

CLAIM-LINE-RECORD-LT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances
Definition The component (in dollar and cents) of the allowed amount that represents the difference between what would have been the managed care plan's typical contractual allowed amount and the enhanced allowed amount for this specific claim as defined by the State's SPA, waiver, or demonstration for a State Directed Payment model per 42 CFR 438.6(c)(1)(iii).
Size S9(11)V99
FLF Start Position 593
FLF Stop Position 605
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. Conditional
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
CIP336 CIP.003.336 SDP-ALLOWED-AMT CIP00003 CLAIM-LINE-RECORD-IP
COT272 COT.003.272 SDP-ALLOWED-AMT COT00003 CLAIM-LINE-RECORD-OT
CRX194 CRX.003.194 SDP-ALLOWED-AMT CRX00003 CLAIM-LINE-RECORD-RX