CRX.003.141

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TMSIS Dataguide

Medicaid.gov

Version 3.28.0

DISPENSE-FEE-SUBMITTED

Data Element

DE Number

CRX141

System DE Number

CRX.003.141

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 charge to cover the cost of the professional dispensing fee for the prescription.
Size	S9(6)V99
FLF Start Position	334
FLF Stop Position	341
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be between -99999999999.99 and 99999999999.99 2. Value must be expressed as a number with 2-digit precision (e.g. 100.50 ) 3. Value may include up to 6 digits to the left of the decimal point, and 2 digits to the right e.g. 123456.78 4. Mandatory

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

RULE ID	RULE Definition
RULE-1946	If a claim is a non-denied claim from an RX file, then the dispense fee submitted value reported must be a valid dollar amount that matches the specified T-MSIS picture format: S9(6)V99.

Measure ID	Measure Name
MIS-9-007-7	% missing: DISPENSE-FEE-SUBMITTED (CRX00003)
MIS-28-007-7	% missing: DISPENSE-FEE-SUBMITTED (CRX00003)
MIS-86-006-6	% missing: DISPENSE-FEE-SUBMITTED (CRX00003)

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	CRX141/ DISPENSE-FEE-SUBMITTED	Rename DE	Data Dictionary - Record Layout	DE No\|Data Element Name CRX141\|DISPENSE-FEE	DE No\|Data Element Name CRX141\|DISPENSE-FEE-SUBMITTED
06/24/2022	3.0.0	CRX141	UPDATE	Data Dictionary	\|DE NO\| DATA ELEMENT NAME\|NECESSITY\|DEFINITION CRX141\|DISPENSE-FEE\|\|The charge to cover the cost of dispensing the prescription. Dispensing costs include overhead, supplies, and labor, etc. to fill the prescription.	\|DE NO\| DATA ELEMENT NAME\|NECESSITY\|DEFINITION CRX141\|DISPENSE-FEE-SUBMITTED \|\|The charge to cover the cost of the professional dispensing fee for the prescription.