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TMSIS Dataguide Medicaid.gov

Version:

3.39.0

SOURCE-LOCATION

Data Element

DE Number

FTX098

System DE Number

FTX.003.098

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 The field denotes the claims/transaction processing system in which the claims/transactions were originally processed.
Size X(2)
FLF Start Position 735
FLF Stop Position 736
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be 2 characters
2. Value must be in Source Location List (VVL)
3. Mandatory
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
CIP104 CIP.002.104 SOURCE-LOCATION CIP00002 CLAIM-HEADER-RECORD-IP
CLT056 CLT.002.056 SOURCE-LOCATION CLT00002 CLAIM-HEADER-RECORD-LT
COT041 COT.002.041 SOURCE-LOCATION COT00002 CLAIM-HEADER-RECORD-OT
CRX032 CRX.002.032 SOURCE-LOCATION CRX00002 CLAIM-HEADER-RECORD-RX
FTX054 FTX.002.054 SOURCE-LOCATION FTX00002 INDIVIDUAL-CAPITATION-PMPM
FTX142 FTX.004.142 SOURCE-LOCATION FTX00004 GROUP-INSURANCE-PREMIUM-PAYMENT
FTX185 FTX.005.185 SOURCE-LOCATION FTX00005 COST-SHARING-OFFSET
FTX227 FTX.006.227 SOURCE-LOCATION FTX00006 VALUE-BASED-PAYMENT
FTX271 FTX.007.271 SOURCE-LOCATION FTX00007 STATE-DIRECTED-PAYMENT-SEPARATE-PAYMENT-TERM
FTX311 FTX.008.311 SOURCE-LOCATION FTX00008 COST-SETTLEMENT-PAYMENT
FTX350 FTX.009.350 SOURCE-LOCATION FTX00009 FQHC-WRAP-PAYMENT
FTX399 FTX.095.399 SOURCE-LOCATION FTX00095 MISCELLANEOUS-PAYMENT