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TMSIS Dataguide Medicaid.gov

Version:

PAYEE-TAX-ID-TYPE-OTHER-TEXT

Data Element

DE Number

FTX083

System DE Number

FTX.003.083

File Segment Number

FTX00003

Last updated

Definition This is a description of what the PAYEE-TAX-ID-TYPE represents when the PAYEE-TAX-ID-TYPE was reported with a payee tax ID type of "Other".
Size X(100)
FLF Start Position 463
FLF Stop Position 562
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be 100 characters or less
2. Value must be populated when Payee Tax 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
FTX040 FTX.002.040 PAYEE-TAX-ID-TYPE-OTHER-TEXT FTX00002 INDIVIDUAL-CAPITATION-PMPM
FTX124 FTX.004.124 PAYEE-TAX-ID-TYPE-OTHER-TEXT FTX00004 GROUP-INSURANCE-PREMIUM-PAYMENT
FTX170 FTX.005.170 PAYEE-TAX-ID-TYPE-OTHER-TEXT FTX00005 COST-SHARING-OFFSET
FTX213 FTX.006.213 PAYEE-TAX-ID-TYPE-OTHER-TEXT FTX00006 VALUE-BASED-PAYMENT
FTX257 FTX.007.257 PAYEE-TAX-ID-TYPE-OTHER-TEXT FTX00007 STATE-DIRECTED-PAYMENT-SEPARATE-PAYMENT-TERM
FTX300 FTX.008.300 PAYEE-TAX-ID-TYPE-OTHER-TEXT FTX00008 COST-SETTLEMENT-PAYMENT
FTX339 FTX.009.339 PAYEE-TAX-ID-TYPE-OTHER-TEXT FTX00009 FQHC-WRAP-PAYMENT
FTX380 FTX.095.380 PAYEE-TAX-ID-TYPE-OTHER-TEXT FTX00095 MISCELLANEOUS-PAYMENT