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TMSIS Dataguide Medicaid.gov

Version:

3.38.0

PAYER-ID-TYPE-OTHER-TEXT

Data Element

DE Number

FTX077

System DE Number

FTX.003.077

File Name

FTX - FINANCIAL TRANSACTION

File Segment Number

FTX00003

File Segment Name

INDIVIDUAL-HEALTH-INSURANCE-PREMIUM-PAYMENT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances
Definition This is a description of what the payer ID represents when the payer ID was reported with a payer type of "Other".
Size X(100)
FLF Start Position 199
FLF Stop Position 298
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be 100 characters or less
2. Value must be populated when Payer Identifier Type equals "95"
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
FTX030 FTX.002.030 PAYER-ID-TYPE-OTHER-TEXT FTX00002 INDIVIDUAL-CAPITATION-PMPM
FTX118 FTX.004.118 PAYER-ID-TYPE-OTHER-TEXT FTX00004 GROUP-INSURANCE-PREMIUM-PAYMENT
FTX162 FTX.005.162 PAYER-ID-TYPE-OTHER-TEXT FTX00005 COST-SHARING-OFFSET
FTX205 FTX.006.205 PAYER-ID-TYPE-OTHER-TEXT FTX00006 VALUE-BASED-PAYMENT
FTX249 FTX.007.249 PAYER-ID-TYPE-OTHER-TEXT FTX00007 STATE-DIRECTED-PAYMENT-SEPARATE-PAYMENT-TERM
FTX292 FTX.008.292 PAYER-ID-TYPE-OTHER-TEXT FTX00008 COST-SETTLEMENT-PAYMENT
FTX331 FTX.009.331 PAYER-ID-TYPE-OTHER-TEXT FTX00009 FQHC-WRAP-PAYMENT
FTX370 FTX.095.370 PAYER-ID-TYPE-OTHER-TEXT FTX00095 MISCELLANEOUS-PAYMENT