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TMSIS Dataguide Medicaid.gov
Version 3.27.0

PROV-LOCATION-ID

Data Element

DE Number

CRX161

System DE Number

CRX.002.161

File Name

CRX - CLAIM PHARMACY

File Segment Number

CRX00002

File Segment Name

CLAIM-HEADER-RECORD-RX

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances
Definition A code to uniquely identify the geographic location where the provider's services were performed. The Provider Location Identifier values reported on Inpatient, Long-Term Care, Other, and Pharmacy Claim Header Segments must correspond to an active Provider Location Identifier value on a Provider Location and Contact Info (PRV.003) segment. If a particular license (e.g., a physician's medical license) or provider identifier (e.g., an individual provider's NPI or SSN) is applicable to all of their servicing locations, value "000" (a string of exactly three zeros) can be used in the PRV.004 or PRV.005, respectively, to represent all locations, however that location identifier must not be attributed to claims or provider bed type info.
Size X(5)
FLF Start Position 1351
FLF Stop Position 1355
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must not contain a pipe or asterisk symbols
2. Value must be 5 characters or less
3. Mandatory
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
CIP289 CIP.002.289 PROV-LOCATION-ID CIP00002 CLAIM-HEADER-RECORD-IP
CLT237 CLT.002.237 PROV-LOCATION-ID CLT00002 CLAIM-HEADER-RECORD-LT
COT226 COT.002.226 PROV-LOCATION-ID COT00002 CLAIM-HEADER-RECORD-OT
PRV043 PRV.003.043 PROV-LOCATION-ID PRV00003 PROV-LOCATION-AND-CONTACT-INFO
PRV064 PRV.004.064 PROV-LOCATION-ID PRV00004 PROV-LICENSING-INFO
PRV076 PRV.005.076 PROV-LOCATION-ID PRV00005 PROV-IDENTIFIERS
PRV129 PRV.010.129 PROV-LOCATION-ID PRV00010 PROV-BED-TYPE-INFO