CRX.003.131

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

PRESCRIPTION-QUANTITY-ALLOWED

Data Element

DE Number

CRX131

System DE Number

CRX.003.131

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	The maximum allowable quantity of a drug or service that may be dispensed per prescription per date of service or per month. Quantity limits are applied to medications when the majority of appropriate clinical utilizations will be addressed within the quantity allowed. For use with CLAIMOT and CLAIMRX claims. For CLAIMIP and CLAIMLT claims/encounter records, use the Revenue Center Quantity Actual field. One prescription for 100 250 milligram tablets results in Prescription Quantity Allowed =100.
Size	S9(8)V999
FLF Start Position	290
FLF Stop Position	300
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value may include up to 8 digits to the left of the decimal point, and 3 digits to the right e.g. 12345678.999 2. When populated, corresponding Unit of Measure must be populated 3. 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-1934	If a claim is a non-denied claim from an RX file, then the claim prescription quantity allowed value reported must be a valid dollar amount that matches the specified T-MSIS picture format: S9(8)V999.

Measure ID	Measure Name

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
06/24/2022	3.0.0	CRX131	UPDATE	Data Dictionary	\|DE NO\| DATA ELEMENT NAME\|NECESSITY\|DEFINITION \|CODING REQUIREMENT CRX131\|OT-RX-CLAIM-QUANITY-ALLOWED\|\|The maximum allowable quantity of a drug or service that may be dispensed per prescription per date of service or per month. Quantity limits are applied to medications when the majority of appropriate clinical utilizations will be addressed within the quantity allowed.\|NOTE: One prescription for 100 250 milligram tablets results in OT-RX-CLAIM-QUANTITY-ALLOWED =100.	\|DE NO\| DATA ELEMENT NAME\|NECESSITY\|DEFINITION \|CODING REQUIREMENT CRX131\|PRESCRIPTION-QUANTITY-ALLOWED\|\|The maximum allowable quantity of a drug that may be dispensed per prescription per date of service. Quantity limits are applied to medications when the majority of appropriate clinical utilizations will be addressed within the quantity allowed.\|NOTE: One prescription for 100 250 milligram tablets results in PRESCRIPTION-QUANTITY-ALLOWED =100.
06/24/2022	3.0.0	CRX131	Rename DE	Data Dictionary - Record Layout	DE No\|Data Element Name CRX131\|OT-RX-CLAIM-QUANITY-ALLOWED	DE No\|Data Element Name CRX131\|PRESCRIPTION-QUANTITY-ALLOWED
06/24/2022	3.0.0	CRX131	UPDATE	Data Dictionary	\|DE NO\| DATA ELEMENT NAME\|CODING REQUIREMENT CRX131\|OT-RX-CLAIM-QUANITY-ALLOWED\|The value in OT-RX-CLAIM-QUANTITY-ALLOWED must correspond with the value in UNIT-OF-MEASURE.	\|DE NO\| DATA ELEMENT NAME\|CODING REQUIREMENT CRX131\|PRESCRIPTION-QUANTITY-ALLOWED\|The value in PRESCRIPTION-QUANTITY-ALLOWED must correspond with the value in UNIT-OF-MEASURE.
06/24/2022	3.0.0	CRX131	Modify DE Width	Data Dictionary - Record Layout	SIZE S9(6)V999	SIZE S9(8)V999