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Data Element
CRX156
CRX.002.156
No Updates
Definition | The state-specific provider id of the provider who actually dispensed the prescription medication. |
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Size | X(30) |
FLF Start Position | 1320 |
FLF Stop Position | 1349 |
Segment Key Field Identifier | Not Applicable |
Coding Requirements | 1. Value must be 30 characters or less 2. When Type of Claim not in ('Z','3','C','W',"2","B","V"," 4","D","X") then value may match Submitting State Provider ID (PRV.002.019) or 3. When Type of Claim not in ('Z','3','C','W',"2","B","V"," 4","D","X") then value may match Provider Identifier (PRV.005.081) where the Provider Identifier Type (PRV.005.077) = '1' 4. Mandatory |
Valid Value Code Set | Valid Value Code | Valid Value Name | Valid Value Description | Effective Start Date | Effective End Date |
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DE Number | System DE Number | DE Name | File Segment Number | File Segment Name |
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