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TMSIS Dataguide Medicaid.gov

Version:

4.0.20

RULE-7936

Data Quality Measure
Last updated

Key Information

Measure Name % of claim headers with a Dispensing Prescription Drug Provider Number that does not have a match in PRV00007 with an active provider enrollment status on Prescription Fill Date
File Type CRX
Measure ID RULE-7936
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 PROV-MEDICAID-ENROLLMENT-STATUS-CODE • DISPENSING-PRESCRIPTION-DRUG-PROV-NUM • PRESCRIPTION-FILL-DATE • SUBMITTING-STATE-PROV-ID
DD Data Element Number PRV100 • CRX156 • CRX085 • PRV097

Annotation N/A
Specification RULE-7936