CRX.003.120

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TMSIS Dataguide

Medicaid.gov

Version:

NATIONAL-DRUG-CODE

Data Element

DE Number

CRX120

System DE Number

CRX.003.120

File Name

CRX - CLAIM PHARMACY

File Segment Number

File Segment Name

CLAIM-LINE-RECORD-RX

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	A code following the National Drug Code format indicating the drug, device, or medical supply covered by this claim.
Size	X(12)
FLF Start Position	167
FLF Stop Position	178
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 12 digits or less 2. Value must be a valid National Drug Code 3. Mandatory 4. Value must have an associated Dtl Metric Decimal Quantity (CRX.003.144) 5. Value must have an associated Unit of Measure (CRX.003.133)

Valid Value Code Set	Valid Value Code	Valid Value Name	Valid Value Description	Effective Start Date	Effective End Date

RULE ID	RULE Definition
RULE-1921	If the National Drug Code is populated on a non-denied claim line from an RX file, then the National Drug Code (NDC) value reported must be a valid NDC number.
RULE-7060	If a claim line is a non-denied claim line from an RX file, then the National Drug Code value reported must be compatible with specified T-MSIS picture format: X(12).

Measure ID	Measure Name
FFS-14-006-3	% of claim headers with NDC (11 numeric)
FFS-16-006-3	% of claim headers with NDC (11 numeric)
MCR-17-006-3	% of claim headers with NDC (11 numeric)
MCR-19-007-3	% of claim headers with NDC (11 numeric)
MIS-9-016-16	% missing: NATIONAL-DRUG-CODE (CRX00003)
MIS-28-015-15	% missing: NATIONAL-DRUG-CODE (CRX00003)
MIS-86-014-14	% missing: NATIONAL-DRUG-CODE (CRX00003)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP284	CIP.003.284	NATIONAL-DRUG-CODE	CIP00003	CLAIM-LINE-RECORD-IP
CLT228	CLT.003.228	NATIONAL-DRUG-CODE	CLT00003	CLAIM-LINE-RECORD-LT
COT217	COT.003.217	NATIONAL-DRUG-CODE	COT00003	CLAIM-LINE-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/01/2023	3.12.0	CRX.003.120	UPDATE	Coding requirement	1. Value must be 12 digits or less2. Value must be a valid National Drug Code3. Mandatory4. Value must have an associated Metric Decimal Quantity (CRX.003.144)5. Value must have an associated Unit of Measure (CRX.003.133)	1. Value must be 12 digits or less2. Value must be a valid National Drug Code3. Mandatory4. Value must have an associated Dtl Metric Decimal Quantity (CRX.003.144)5. Value must have an associated Unit of Measure (CRX.003.133)