TS3 Transaction Statistics

To supply provider level control information

Position: TS3-01 · Element: 127 · Name: Reference Number · Type: String (AN) · Requirement: Mandatory · Min: 1 · Max: 30 · Repeat: -

Reference number or identification number as defined for a particular Transaction Set, or as specified by the Reference Number Qualifier.

TS301 is the provider number.

Position: TS3-02 · Element: 1331 · Name: Facility Code Value · Type: String (AN) · Requirement: Mandatory · Min: 1 · Max: 2 · Repeat: -

Code identifying the type of facility where services were performed; the first and second positions of the Uniform Bill Type code or the Place of Service code from the Electronic Media Claims National Standard Format

Position: TS3-03 · Element: 373 · Name: Date · Type: Date (DT) · Requirement: Mandatory · Min: 6 · Max: 6 · Repeat: -

Date (YYMMDD).

TS303 is the last day of the provider's fiscal year.

Position: TS3-04 · Element: 380 · Name: Quantity · Type: Decimal number (R) · Requirement: Mandatory · Min: 1 · Max: 15 · Repeat: -

Numeric value of quantity.

TS304 is the total number of claims.

Position: TS3-05 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Mandatory · Min: 1 · Max: 15 · Repeat: -

Monetary amount.

TS305 is the total of reported charges.

Position: TS3-06 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Monetary amount.

TS306 is the total of covered charges.

Position: TS3-07 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Monetary amount.

TS307 is the totl of non-covered charges.

Position: TS3-08 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Monetary amount.

TS308 is the total of denied charges.

Position: TS3-09 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Monetary amount.

TS309 is the total provider payment.

Position: TS3-10 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Monetary amount.

TS310 is the total amount of interest paid.

Position: TS3-11 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Monetary amount.

TS311 is the total contractual adjustment.

Position: TS3-12 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Monetary amount.

TS312 is the total Gramm-Rudman Reduction.

Position: TS3-13 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Monetary amount.

TS313 is the total Medicare Secondary Payer (MSP) primary payer amount.

Position: TS3-14 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Monetary amount.

TS314 is the total blood deductible amount in dollars.

Position: TS3-15 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Monetary amount.

TS315 is the summary of non-lab charges.

Position: TS3-16 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Monetary amount.

TS316 is the total coinsurance amount.

Position: TS3-17 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Monetary amount.

TS317 is the Health Care Financing Administration Common Procedural Coding System (HCPCS) reported charges.

Position: TS3-18 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Monetary amount.

TS318 is the total Health Care Financing Administration Common Procedural Coding System (HCPCS) payable amount.

Position: TS3-19 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Monetary amount.

TS319 is the total deductible amount.

Position: TS3-20 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Monetary amount.

TS320 is the total professional component amount.

Position: TS3-21 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Monetary amount.

TS321 is the total Medicare Secondary Payer (MSP) patient liability met.

Position: TS3-22 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Monetary amount.

TS322 is the total patient reimbursment.

Position: TS3-23 · Element: 380 · Name: Quantity · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Numeric value of quantity.

TS323 is the total Periodic Interim Payment (PIP) number of claims.

Position: TS3-24 · Element: 782 · Name: Monetary Amount · Type: Decimal number (R) · Requirement: Optional · Min: 1 · Max: 15 · Repeat: -

Monetary amount.

TS324 is total Periodic Interim Payment (PIP) adjustment.