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TMSIS Dataguide Medicaid.gov

Version:

4.0.20

RULE-7472

Validation Rule
Last updated

Tier 1.1
Tier Description Value Error
Error Category E1102
Error Category Message Value does not match specification
Rule Type One Record Type (Single Record)
File Segment Number PRV00005
Data Element Name PROV-IDENTIFIERS.PROV-IDENTIFIER
Validation Logic 'if PROV-IDENTIFIERS has a non-null value for PROV-IDENTIFIER and PROV-IDENTIFIERS.PROV-IDENTIFIER-TYPE equals '2', then PROV-IDENTIFIERS.PROV-IDENTIFIER is a valid National Provider Identifier (NPI) number that exists in the NPPES NPI data file'
Rule Definition If the provider identifier is populated on a provider identifiers segment from a PRV file, and the PROV-IDENTIFIERS.PROV-IDENTIFIER-TYPE is '2' (NPI), then provider identifier is a valid NPI number that exists in the NPPES NPI data file.
Denominator Logic # of PROV-IDENTIFIERS segments with PROV-IDENTIFIERS has a non-null value for PROV-IDENTIFIER and with PROV-IDENTIFIERS.PROV-IDENTIFIER-TYPE equals '2'