An official website of the United States government

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock () or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

TMSIS Dataguide Medicaid.gov

Version:

3.39.0

BILLING-PROV-ADDR-LN-1

Data Element

DE Number

COT236

System DE Number

COT.002.236

File Name

COT - CLAIM OTHER

File Segment Number

COT00002

File Segment Name

CLAIM-HEADER-RECORD-OT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances
Definition Billing provider address line 1 from X12 837I, 837P, and 837D loop 2010AA.
Size X(60)
FLF Start Position 1061
FLF Stop Position 1120
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must not be more than 60 characters
2. Mandatory
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
CIP298 CIP.002.298 BILLING-PROV-ADDR-LN-1 CIP00002 CLAIM-HEADER-RECORD-IP
CLT244 CLT.002.244 BILLING-PROV-ADDR-LN-1 CLT00002 CLAIM-HEADER-RECORD-LT