An official website of the United States government

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS
A lock () or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

TMSIS Dataguide Medicaid.gov

Version:

MEMO

Data Element

DE Number

FTX102

System DE Number

FTX.003.102

File Segment Number

FTX00003

Last updated

Definition This represents any notes from the state's ledger/accounting system associated with the payment.
Size X(500)
FLF Start Position 854
FLF Stop Position 1353
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be 500 characters or less
2. 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
FTX061 FTX.002.061 MEMO FTX00002 INDIVIDUAL-CAPITATION-PMPM
FTX146 FTX.004.146 MEMO FTX00004 GROUP-INSURANCE-PREMIUM-PAYMENT
FTX189 FTX.005.189 MEMO FTX00005 COST-SHARING-OFFSET
FTX233 FTX.006.233 MEMO FTX00006 VALUE-BASED-PAYMENT
FTX276 FTX.007.276 MEMO FTX00007 STATE-DIRECTED-PAYMENT-SEPARATE-PAYMENT-TERM
FTX315 FTX.008.315 MEMO FTX00008 COST-SETTLEMENT-PAYMENT
FTX354 FTX.009.354 MEMO FTX00009 FQHC-WRAP-PAYMENT
FTX404 FTX.095.404 MEMO FTX00095 MISCELLANEOUS-PAYMENT