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TMSIS Dataguide Medicaid.gov

Version:

3.38.0

TOT-BENEFICIARY-COINSURANCE-LIABLE-AMOUNT

Data Element

DE Number

CRX164

System DE Number

CRX.002.164

File Name

CRX - CLAIM PHARMACY

File Segment Number

CRX00002

File Segment Name

CLAIM-HEADER-RECORD-RX

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances
Definition The total coinsurance amount on a claim the beneficiary is obligated to pay for covered services. This amount is the total Medicaid or contract negotiated beneficiary coinsurance liability for covered services on the claim. Do not subtract out any payments made toward the coinsurance.
Size S9(11)V99
FLF Start Position 855
FLF Stop Position 867
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
CIP293 CIP.002.293 TOT-BENEFICIARY-COINSURANCE-LIABLE-AMOUNT CIP00002 CLAIM-HEADER-RECORD-IP
CLT240 CLT.002.240 TOT-BENEFICIARY-COINSURANCE-LIABLE-AMOUNT CLT00002 CLAIM-HEADER-RECORD-LT
COT231 COT.002.231 TOT-BENEFICIARY-COINSURANCE-LIABLE-AMOUNT COT00002 CLAIM-HEADER-RECORD-OT