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TMSIS Dataguide Medicaid.gov

Version:

3.39.0

RULE-1845

Data Quality Measure
Last updated

Key Information

Measure Name % of claim headers with a Billing Provider Number that is not found on the provider file on the Prescription Fill Date
File Type Multiple Files
Measure ID RULE-1845
Measure Type Claims percentage
Content area ALL MULTI PRO

Validation

Validation Type Inferential

Measure Priority

Measure Priority Medium
Focus Area N/A
Category Provider information

Claim Information

Claim Type Medicaid,FFS or Medicaid,Cap or Medicaid,Enc or Medicaid,Serv or Medicaid,Supp or CHIP,FFS or CHIP,Cap or CHIP,Enc or CHIP,Serv or CHIP,Supp
Adjustment Type All Adjustment Types
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-IDENTIFIER • BILLING-PROV-NUM • SUBMITTING-STATE-PROV-ID • PRESCRIPTION-FILL-DATE
DD Data Element Number PRV081 • CRX070 • PRV019 • CRX085

Annotation N/A
Specification RULE-1845