CRX.003.179

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TMSIS Dataguide

Medicaid.gov

Version:

UNIQUE-DEVICE-IDENTIFIER

Data Element

DE Number

CRX179

System DE Number

CRX.003.179

File Name

CRX - CLAIM PHARMACY

File Segment Number

File Segment Name

CLAIM-LINE-RECORD-RX

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	An unique identifier assigned to every medical device that meets the requirements of 21 CFR 801 and 830.
Size	X(76)
FLF Start Position	497
FLF Stop Position	572
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must not be more than 76 characters long 2. Conditional

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

RULE ID	RULE Definition
RULE-9023	If a claim is a non-denied claim from a RX file, then the unique device identifier value reported must be compatible with the specified T-MSIS picture format: X(76).

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
CIP314	CIP.003.314	UNIQUE-DEVICE-IDENTIFIER	CIP00003	CLAIM-LINE-RECORD-IP
CLT260	CLT.003.260	UNIQUE-DEVICE-IDENTIFIER	CLT00003	CLAIM-LINE-RECORD-LT
COT255	COT.003.255	UNIQUE-DEVICE-IDENTIFIER	COT00003	CLAIM-LINE-RECORD-OT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/16/2024	4.0.0	CRX.003.179	UPDATE	File segment	None	41
09/16/2024	4.0.0	CRX.003.179	ADD	N/A		Created