TS3 Transaction Statistics

To supply provider level summary of control information by provider fiscal year and bill type

Position
Element
Name
Type
Requirement
Min
Max
Repeat
TS3-01
Reference Number
String (AN)
Mandatory
1
30
-
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.
TS3-02
Facility Code
Identifier (ID)
Mandatory
1
2
-
Code identifying the type of facility where services were performed; the first position of the uniform bill type or place of service from health care financing administration claim form or place of treatment from the dental claim form
TS3-03
Date
Date (DT)
Mandatory
6
6
-
Date (YYMMDD).
TS303 is the last day of the provider's fiscal year.
TS3-04
Quantity
Decimal number (R)
Mandatory
1
15
-
Numeric value of quantity.
TS304 is the total number of claims.
TS3-05
Monetary Amount
Decimal number (R)
Mandatory
1
15
-
Monetary amount.
TS305 is the total of reported charges.
TS3-06
Monetary Amount
Decimal number (R)
Optional
1
15
-
Monetary amount.
TS306 is the total of covered charges.
TS3-07
Monetary Amount
Decimal number (R)
Optional
1
15
-
Monetary amount.
TS307 is the totl of non-covered charges.
TS3-08
Monetary Amount
Decimal number (R)
Optional
1
15
-
Monetary amount.
TS308 is the total of denied charges.
TS3-09
Monetary Amount
Decimal number (R)
Optional
1
15
-
Monetary amount.
TS309 is the total provider payment.
TS3-10
Monetary Amount
Decimal number (R)
Optional
1
15
-
Monetary amount.
TS310 is the total amount of interest paid.
TS3-11
Monetary Amount
Decimal number (R)
Optional
1
15
-
Monetary amount.
TS311 is the total contractual adjustment.
TS3-12
Monetary Amount
Decimal number (R)
Optional
1
15
-
Monetary amount.
TS312 is the total Gramm-Rudman Reduction.
TS3-13
Monetary Amount
Decimal number (R)
Optional
1
15
-
Monetary amount.
TS313 is the total Medicare Secondary Payer (MSP) primary payer amount.
TS3-14
Monetary Amount
Decimal number (R)
Optional
1
15
-
Monetary amount.
TS314 is the total blood deductible amount in dollars.
TS3-15
Monetary Amount
Decimal number (R)
Optional
1
15
-
Monetary amount.
TS315 is the summary of non-lab charges.
TS3-16
Monetary Amount
Decimal number (R)
Optional
1
15
-
Monetary amount.
TS316 is the total coinsurance amount.
TS3-17
Monetary Amount
Decimal number (R)
Optional
1
15
-
Monetary amount.
TS317 is the Health Care Financing Administration Common Procedural Coding System (HCPCS) reported charges.
TS3-18
Monetary Amount
Decimal number (R)
Optional
1
15
-
Monetary amount.
TS318 is the total Health Care Financing Administration Common Procedural Coding System (HCPCS) payable amount.
TS3-19
Monetary Amount
Decimal number (R)
Optional
1
15
-
Monetary amount.
TS319 is the total deductible amount.
TS3-20
Monetary Amount
Decimal number (R)
Optional
1
15
-
Monetary amount.
TS320 is the total professional component amount.
TS3-21
Monetary Amount
Decimal number (R)
Optional
1
15
-
Monetary amount.
TS321 is the total Medicare Secondary Payer (MSP) patient liability met.
TS3-22
Monetary Amount
Decimal number (R)
Optional
1
15
-
Monetary amount.
TS322 is the total patient reimbursment.
TS3-23
Quantity
Decimal number (R)
Optional
1
15
-
Numeric value of quantity.
TS323 is the total Periodic Interim Payment (PIP) number of claims.
TS3-24
Monetary Amount
Decimal number (R)
Optional
1
15
-
Monetary amount.
TS324 is total Periodic Interim Payment (PIP) adjustment.

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