CRX.003.138

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TMSIS Dataguide

Medicaid.gov

Version:

DAYS-SUPPLY

Data Element

DE Number

CRX138

System DE Number

CRX.003.138

File Name

CRX - CLAIM PHARMACY

File Segment Number

File Segment Name

CLAIM-LINE-RECORD-RX

Last updated

No Updates

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	Number of days supply dispensed.
Size	S9(5)
FLF Start Position	326
FLF Stop Position	330
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 5 digits or less 2. Mandatory 3. Value should be between -365 and 365

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

RULE ID	RULE Definition
RULE-1943	If the days supply is populated on a non-denied claim line from an RX file, then the days supply value reported must greater than or equal to -365 and less than or equal to 365.
RULE-6463	If a claim line is a non-denied claim line from an RX file, then the days supply value reported must be compatible with specified T-MSIS picture format: S9(5).
RULE-7356	If a non-denied claim from an RX file has the type of claim equal to '1','3','A','C', and is not a crossover claim, then the claim line days supply must be populated.
RULE-7750	If a non-denied claim from an RX file has the type of claim Medicaid or Medicaid-expansion CHIP Managed Care Encounter or Separate CHIP Encounter, and is not a crossover claim, then the claim line days supply must be populated.
RULE-7816	If a non-denied claim from an RX file has the type of claim Medicaid or Medicaid-expansion CHIP Managed Care Fee-for-service or Separate CHIP Fee-for-service, and is not a crossover claim, then the claim line days supply must be populated.

Measure ID	Measure Name
FFS-14-004-5	% of claim headers with Days Supply > 30
FFS-14-005-1	% of claim headers with missing Days Supply
FFS-16-004-5	% of claim headers with Days Supply > 30
FFS-16-005-1	% of claim headers with missing Days Supply
MCR-17-004-5	% of claim headers with Days Supply > 30
MCR-17-005-1	% of claim headers with missing Days Supply
MCR-19-004-5	% of claim headers with Days Supply > 30
MCR-19-005-1	% of claim headers with missing Days Supply
MIS-9-006-6	% missing: DAYS-SUPPLY (CRX00003)
MIS-28-006-6	% missing: DAYS-SUPPLY (CRX00003)
MIS-86-005-5	% missing: DAYS-SUPPLY (CRX00003)
RULE-7816	% of claim lines with missing Days Supply
RULE-7750	% of claim lines with missing Days Supply

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name

Published Date	Data Guide Version	Data Element	Action	Field	Before	After