CRX.002.090

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TMSIS Dataguide

Medicaid.gov

Version:

BENEFICIARY-COPAYMENT-DATE-PAID

Data Element

DE Number

CRX090

System DE Number

CRX.002.090

File Name

CRX - CLAIM PHARMACY

File Segment Number

File Segment Name

CLAIM-HEADER-RECORD-RX

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The date the beneficiary paid the copayment amount.
Size	9(8)
FLF Start Position	650
FLF Stop Position	657
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. The date must be a valid calendar date in the form "CCYYMMDD" 2. When populated, value must have an associated Beneficiary Copayment Amount 3. Situational

Valid Value Code Set	Valid Value Code	Valid Value Name	Valid Value Description	Effective Start Date	Effective End Date

RULE ID	RULE Definition
RULE-1877	If a claim is a non-denied claim from an RX file, then the beneficiary copayment date paid value reported must be a valid date of the form CCYYMMDD.

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP209	CIP.002.209	BENEFICIARY-COPAYMENT-DATE-PAID	CIP00002	CLAIM-HEADER-RECORD-IP
CLT156	CLT.002.156	BENEFICIARY-COPAYMENT-DATE-PAID	CLT00002	CLAIM-HEADER-RECORD-LT
COT133	COT.002.133	BENEFICIARY-COPAYMENT-DATE-PAID	COT00002	CLAIM-HEADER-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
07/10/2025	4.0.13	CRX.002.090	UPDATE	Necessity	Conditional	Situational
07/10/2025	4.0.13	CRX.002.090	UPDATE	Coding requirement	1. The date must be a valid calendar date in the form "CCYYMMDD"2. When populated, value must have an associated Beneficiary Copayment Amount3. Conditional	1. The date must be a valid calendar date in the form "CCYYMMDD"2. When populated, value must have an associated Beneficiary Copayment Amount3. Situational
09/16/2024	4.0.0	CRX.002.090	UPDATE	File segment	None	40
09/16/2024	4.0.0	CRX.002.090	ADD	N/A		Created