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Data Element
FTX080
FTX.003.080
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". |
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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 |
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DE Number | System DE Number | DE Name | File Segment Number | File Segment Name |
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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 |