CRX.002.021

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:

SUBMITTER-ID

Data Element

DE Number

CRX021

System DE Number

CRX.002.021

File Name

CRX - CLAIM PHARMACY

File Segment Number

File Segment Name

CLAIM-HEADER-RECORD-RX

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The Submitter Identification number is the value that identifies the provider/trading partner/clearing house organization to the state's claim adjudication system.
Size	X(12)
FLF Start Position	122
FLF Stop Position	133
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 12 characters or less 2. Situational

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

RULE ID	RULE Definition
RULE-6477	If a claim is a non-denied claim from an RX file, then the submitter identification value reported must be compatible with specified T-MSIS picture format: X(12).

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP021	CIP.002.021	SUBMITTER-ID	CIP00002	CLAIM-HEADER-RECORD-IP
CIP241	CIP.003.241	SUBMITTER-ID	CIP00003	CLAIM-LINE-RECORD-IP
CLT021	CLT.002.021	SUBMITTER-ID	CLT00002	CLAIM-HEADER-RECORD-LT
CLT194	CLT.003.194	SUBMITTER-ID	CLT00003	CLAIM-LINE-RECORD-LT
COT021	COT.002.021	SUBMITTER-ID	COT00002	CLAIM-HEADER-RECORD-OT
COT164	COT.003.164	SUBMITTER-ID	COT00003	CLAIM-LINE-RECORD-OT
CRX118	CRX.003.118	SUBMITTER-ID	CRX00003	CLAIM-LINE-RECORD-RX

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
07/10/2025	4.0.13	CRX.002.021	UPDATE	Necessity	Conditional	Situational
07/10/2025	4.0.13	CRX.002.021	UPDATE	Coding requirement	1. Value must be 12 characters or less2. Conditional	1. Value must be 12 characters or less2. Situational
03/14/2025	4.0.4	CRX.002.021	UPDATE	Necessity	Mandatory	Conditional
03/14/2025	4.0.4	CRX.002.021	UPDATE	Coding requirement	1. Value must be 12 characters or less2. Mandatory	1. Value must be 12 characters or less2. Conditional
09/16/2024	4.0.0	CRX.002.021	UPDATE	File segment	None	40
09/16/2024	4.0.0	CRX.002.021	ADD	N/A		Created