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TMSIS Dataguide Medicaid.gov

Version:

3.39.0

STATE-NOTATION

Data Element

DE Number

ELG267

System DE Number

ELG.022.267

File Name

ELG - ELIGIBLE

File Segment Number

ELG00022

File Segment Name

ELG-IDENTIFIERS

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances
Definition A free text field for the submitting state to enter whatever information it chooses.
Size X(500)
FLF Start Position 107
FLF Stop Position 606
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be 500 characters or less
2. Value must not contain a pipe or asterisk symbols
3. Situational
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
CIP014 CIP.001.014 STATE-NOTATION CIP00001 FILE-HEADER-RECORD-IP
CIP229 CIP.002.229 STATE-NOTATION CIP00002 CLAIM-HEADER-RECORD-IP
CIP273 CIP.003.273 STATE-NOTATION CIP00003 CLAIM-LINE-RECORD-IP
CIP334 CIP.004.334 STATE-NOTATION CIP00004 CLAIM-DX-IP
CLT014 CLT.001.014 STATE-NOTATION CLT00001 FILE-HEADER-RECORD-LT
CLT173 CLT.002.173 STATE-NOTATION CLT00002 CLAIM-HEADER-RECORD-LT
CLT226 CLT.003.226 STATE-NOTATION CLT00003 CLAIM-LINE-RECORD-LT
CLT280 CLT.004.280 STATE-NOTATION CLT00004 CLAIM-DX-LT
COT014 COT.001.014 STATE-NOTATION COT00001 FILE-HEADER-RECORD-OT
COT152 COT.002.152 STATE-NOTATION COT00002 CLAIM-HEADER-RECORD-OT
COT214 COT.003.214 STATE-NOTATION COT00003 CLAIM-LINE-RECORD-OT
COT285 COT.004.285 STATE-NOTATION COT00004 CLAIM-DX-OT
CRX014 CRX.001.014 STATE-NOTATION CRX00001 FILE-HEADER-RECORD-RX
CRX106 CRX.002.106 STATE-NOTATION CRX00002 CLAIM-HEADER-RECORD-RX
CRX153 CRX.003.153 STATE-NOTATION CRX00003 CLAIM-LINE-RECORD-RX
CRX207 CRX.004.207 STATE-NOTATION CRX00004 CLAIM-DX-RX
ELG014 ELG.001.014 STATE-NOTATION ELG00001 FILE-HEADER-RECORD-ELIGIBILITY
ELG028 ELG.002.028 STATE-NOTATION ELG00002 PRIMARY-DEMOGRAPHICS-ELIGIBILITY
ELG059 ELG.003.059 STATE-NOTATION ELG00003 VARIABLE-DEMOGRAPHICS-ELIGIBILITY
ELG077 ELG.004.077 STATE-NOTATION ELG00004 ELIGIBLE-CONTACT-INFORMATION
ELG101 ELG.005.101 STATE-NOTATION ELG00005 ELIGIBILITY-DETERMINANTS
ELG112 ELG.006.112 STATE-NOTATION ELG00006 HEALTH-HOME-SPA-PARTICIPATION-INFORMATION
ELG124 ELG.007.124 STATE-NOTATION ELG00007 HEALTH-HOME-SPA-PROVIDERS
ELG134 ELG.008.134 STATE-NOTATION ELG00008 HEALTH-HOME-CHRONIC-CONDITIONS
ELG144 ELG.009.144 STATE-NOTATION ELG00009 LOCK-IN-INFORMATION
ELG157 ELG.010.157 STATE-NOTATION ELG00010 MFP-INFORMATION
ELG166 ELG.011.166 STATE-NOTATION ELG00011 STATE-PLAN-OPTION-PARTICIPATION
ELG176 ELG.012.176 STATE-NOTATION ELG00012 WAIVER-PARTICIPATION
ELG186 ELG.013.186 STATE-NOTATION ELG00013 LTSS-PARTICIPATION
ELG198 ELG.014.198 STATE-NOTATION ELG00014 MANAGED-CARE-PARTICIPATION
ELG207 ELG.015.207 STATE-NOTATION ELG00015 ETHNICITY-INFORMATION
ELG218 ELG.016.218 STATE-NOTATION ELG00016 RACE-INFORMATION
ELG227 ELG.017.227 STATE-NOTATION ELG00017 DISABILITY-INFORMATION
ELG236 ELG.018.236 STATE-NOTATION ELG00018 1115A-DEMONSTRATION-INFORMATION
ELG245 ELG.020.245 STATE-NOTATION ELG00020 HCBS-CHRONIC-CONDITIONS-NON-HEALTH-HOME
ELG255 ELG.021.255 STATE-NOTATION ELG00021 ENROLLMENT-TIME-SPAN-SEGMENT
FTX015 FTX.001.015 STATE-NOTATION FTX00001 FILE-HEADER-RECORD-FTX
FTX062 FTX.002.062 STATE-NOTATION FTX00002 INDIVIDUAL-CAPITATION-PMPM
FTX103 FTX.003.103 STATE-NOTATION FTX00003 INDIVIDUAL-HEALTH-INSURANCE-PREMIUM-PAYMENT
FTX147 FTX.004.147 STATE-NOTATION FTX00004 GROUP-INSURANCE-PREMIUM-PAYMENT
FTX190 FTX.005.190 STATE-NOTATION FTX00005 COST-SHARING-OFFSET
FTX234 FTX.006.234 STATE-NOTATION FTX00006 VALUE-BASED-PAYMENT
FTX277 FTX.007.277 STATE-NOTATION FTX00007 STATE-DIRECTED-PAYMENT-SEPARATE-PAYMENT-TERM
FTX316 FTX.008.316 STATE-NOTATION FTX00008 COST-SETTLEMENT-PAYMENT
FTX355 FTX.009.355 STATE-NOTATION FTX00009 FQHC-WRAP-PAYMENT
FTX405 FTX.095.405 STATE-NOTATION FTX00095 MISCELLANEOUS-PAYMENT
MCR014 MCR.001.014 STATE-NOTATION MCR00001 FILE-HEADER-RECORD-MANAGED-CARE
MCR032 MCR.002.032 STATE-NOTATION MCR00002 MANAGED-CARE-MAIN
MCR052 MCR.003.052 STATE-NOTATION MCR00003 MANAGED-CARE-LOCATION-AND-CONTACT-INFO
MCR061 MCR.004.061 STATE-NOTATION MCR00004 MANAGED-CARE-SERVICE-AREA
MCR071 MCR.005.071 STATE-NOTATION MCR00005 MANAGED-CARE-OPERATING-AUTHORITY
MCR080 MCR.006.080 STATE-NOTATION MCR00006 MANAGED-CARE-PLAN-POPULATION-ENROLLED
MCR089 MCR.007.089 STATE-NOTATION MCR00007 MANAGED- CARE-ACCREDITATION-ORGANIZATION
MCR122 MCR.010.122 STATE-NOTATION MCR00010 MANAGED-CARE-ID
PRV014 PRV.001.014 STATE-NOTATION PRV00001 FILE-HEADER-RECORD-PROVIDER
PRV037 PRV.002.037 STATE-NOTATION PRV00002 PROV-ATTRIBUTES-MAIN
PRV058 PRV.003.058 STATE-NOTATION PRV00003 PROV-LOCATION-AND-CONTACT-INFO
PRV070 PRV.004.070 STATE-NOTATION PRV00004 PROV-LICENSING-INFO
PRV082 PRV.005.082 STATE-NOTATION PRV00005 PROV-IDENTIFIERS
PRV092 PRV.006.092 STATE-NOTATION PRV00006 PROV-TAXONOMY-CLASSIFICATION
PRV104 PRV.007.104 STATE-NOTATION PRV00007 PROV-MEDICAID-ENROLLMENT
PRV113 PRV.008.113 STATE-NOTATION PRV00008 PROV-AFFILIATED-GROUPS
PRV123 PRV.009.123 STATE-NOTATION PRV00009 PROV-AFFILIATED-PROGRAMS
PRV136 PRV.010.136 STATE-NOTATION PRV00010 PROV-BED-TYPE-INFO
TPL014 TPL.001.014 STATE-NOTATION TPL00001 FILE-HEADER-RECORD-TPL
TPL027 TPL.002.027 STATE-NOTATION TPL00002 TPL-MEDICAID-ELIGIBLE-PERSON-MAIN
TPL050 TPL.003.050 STATE-NOTATION TPL00003 TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-INFO
TPL061 TPL.004.061 STATE-NOTATION TPL00004 TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-CATEGORIES
TPL070 TPL.005.070 STATE-NOTATION TPL00005 TPL-MEDICAID-ELIGIBLE-OTHER-THIRD-PARTY-COVERAGE-INFORMATION
TPL086 TPL.006.086 STATE-NOTATION TPL00006 TPL-ENTITY-CONTACT-INFORMATION