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TMSIS Dataguide Medicaid.gov

Version:

3.38.0

MEDICARE-DEDUCTIBLE-AMT

Data Element

DE Number

CRX127

System DE Number

CRX.003.127

File Name

CRX - CLAIM PHARMACY

File Segment Number

CRX00003

File Segment Name

CLAIM-LINE-RECORD-RX

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances
Definition The amount paid by Medicaid/CHIP on this claim at the claim line level toward the beneficiary's Medicare deductible. If the Medicare deductible amount can be identified separately from Medicare coinsurance payments, code that amount in this field. If the Medicare coinsurance and deductible payments cannot be separated, fill this field with the combined payment amount and Medicare Coinsurance Payment is not required.
Size S9(11)V99
FLF Start Position 251
FLF Stop Position 263
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
4. Value should not be populated if associated Crossover Indicator value equals "0" (not a crossover claim)
5. If value is greater than "0", then Crossover Indicator must be "1"
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