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TMSIS Dataguide Medicaid.gov

Version:

3.38.0

PAYEE-ID-TYPE-OTHER-TEXT

Data Element

DE Number

FTX080

System DE Number

FTX.003.080

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 PAYEE-ID-TYPE represents when the PAYEE-ID-TYPE was reported with a payee ID type of "Other".
Size X(100)
FLF Start Position 331
FLF Stop Position 430
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be 100 characters or less
2. Value must be populated when Payee 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
FTX035 FTX.002.035 PAYEE-ID-TYPE-OTHER-TEXT FTX00002 INDIVIDUAL-CAPITATION-PMPM
FTX121 FTX.004.121 PAYEE-ID-TYPE-OTHER-TEXT FTX00004 GROUP-INSURANCE-PREMIUM-PAYMENT
FTX165 FTX.005.165 PAYEE-ID-TYPE-OTHER-TEXT FTX00005 COST-SHARING-OFFSET
FTX208 FTX.006.208 PAYEE-ID-TYPE-OTHER-TEXT FTX00006 VALUE-BASED-PAYMENT
FTX252 FTX.007.252 PAYEE-ID-TYPE-OTHER-TEXT FTX00007 STATE-DIRECTED-PAYMENT-SEPARATE-PAYMENT-TERM
FTX295 FTX.008.295 PAYEE-ID-TYPE-OTHER-TEXT FTX00008 COST-SETTLEMENT-PAYMENT
FTX334 FTX.009.334 PAYEE-ID-TYPE-OTHER-TEXT FTX00009 FQHC-WRAP-PAYMENT
FTX375 FTX.095.375 PAYEE-ID-TYPE-OTHER-TEXT FTX00095 MISCELLANEOUS-PAYMENT