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 3.38.0

RULE-7931

Data Quality Measure
Last updated

Key Information

Measure Name % of claim headers with a Billing Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Beginning Date of Service
File Type COT
Measure ID RULE-7931
Measure Type Claims Percentage
Content area ALL MULTI PRO

Validation

Validation Type Inferential

Measure Priority

Measure Priority High
Focus Area N/A
Category Provider enrollment

Claim Information

Claim Type Medicaid,FFS or CHIP,FFS
Adjustment Type Original and Replacement
Crossover Type All Indicators

Thresholds

Minimum 0
Maximum 0.02
TA Minimun 0
TA Maximum 0.02
Longitudinal Threshold N/A
For TA
(for including in compliance training) 		TA- Inferential
For TA
(Longitudinal) 		No

Data Elements

DD Data Element BILLING-PROV-NUM • PROV-IDENTIFIER • SUBMITTING-STATE-PROV-ID • PRESCRIPTION-FILL-DATE
DD Data Element Number CRX070 • PRV081 • PRV019 • CRX085

Annotation N/A
Specification RULE-7931