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TMSIS Dataguide Medicaid.gov

Version:

COMPOUND-DOSAGE-FORM

Data Element

DE Number

CRX145

System DE Number

CRX.003.145

File Segment Number

CRX00003

File Segment Name

CLAIM-LINE-RECORD-RX

Last updated

Definition The physical form of a dose of medication, such as a capsule or injection.
Size X(2)
FLF Start Position 384
FLF Stop Position 385
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must be 2 characters
2. Value must be in Compound Dosage Form List (VVL)
3. Conditional
Valid Value Code Set Valid Value Code Valid Value Name Valid Value Description Effective Start Date Effective End Date
DE Number System DE Number DE Name File Segment Number File Segment Name