PRV.003.046

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TMSIS Dataguide

Medicaid.gov

Version 3.28.0

ADDR-TYPE

Data Element

DE Number

PRV046

System DE Number

PRV.003.046

File Name

File Segment Number

File Segment Name

PROV-LOCATION-AND-CONTACT-INFO

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The type of address and contact information for the provider submitted in the record segment.
Size	X(1)
FLF Start Position	73
FLF Stop Position	73
Segment Key Field Identifier	4
Coding Requirements	1. Value must be in Provider Address Type List (VVL) 2. Value must be 1 character 3. Mandatory

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

RULE ID	RULE Definition

Measure ID	Measure Name
PRV-1-008-2	% of unique combinations of SUBMITTING-STATE-PROV-ID and PROV-LOCATION-ID for practice and service locations (provider records) that are represented in claims files
PRV-1-016-6	RX - % of unique combinations of billing providers and PROV-LOCATION-IDs that are found in the provider record's practice and service locations
PRV-1-015-3	OT - % of unique combinations of billing providers and PROV-LOCATION-IDs that are found in the provider record's practice and service locations
PRV-1-014-5	LT - % of unique combinations of billing providers and PROV-LOCATION-IDs that are found in the provider record's practice and service locations
PRV-1-013-4	IP - % of unique combinations of billing providers and PROV-LOCATION-IDs that are found in the provider record's practice and service locations
PRV-1-012-10	RX - % of billing providers with all PROV-LOCATION-IDs represented in the practice and service locations in the Provider file
PRV-1-011-7	OT - % of billing providers with all PROV-LOCATION-IDs represented in the practice and service locations in the Provider file
PRV-1-010-9	LT - % of billing providers with all PROV-LOCATION-IDs represented in the practice and service locations in the Provider file
PRV-1-009-8	IP - % of billing providers with all PROV-LOCATION-IDs represented in the practice and service locations in the Provider file
MIS-11-017-17	% distinct SUBMITTING-STATE-PROV-IDs with only missing values in any active segment: PROV-ADDR-TYPE (PRV00003)
PRV-1-007-1	% of provider records that have all practice and service locations (PROV-LOCATION-IDs) represented in the claims files
PRV-1-006-15	% of records with PROV-ADDR-TYPE = 4 (Service Location)
PRV-1-005-16	Average # of PROV-ADDR-TYPE = 4 (Service Location) per Provider
PRV-1-004-13	% of records with PROV-ADDR-TYPE = 3 (Provider Practice)
PRV-1-003-14	Average # of PROV-ADDR-TYPE = 3 (Provider Practice) per Provider
PRV-1-002-11	% of records with PROV-ADDR-TYPE = 1 (Provider Billing)
PRV-1-001-12	Average # of PROV-ADDR-TYPE = 1 (Provider Billing) per Provider

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
ELG065	ELG.004.065	ADDR-TYPE	ELG00004	ELIGIBLE-CONTACT-INFORMATION

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
06/24/2022	3.0.0	PRV046	UPDATE	Data Dictionary	DE NO\| DATA ELEMENT NAME COMPUTING\| PRV046\|ADDR-TYPE	DE NO\| DATA ELEMENT NAME COMPUTING\| PRV046\|PROV-ADDR-TYPE
06/24/2022	3.0.0	TPL-ENTITY-ADDR-TYPE	UPDATE	Data Dictionary	DE No\|Data Element Name\|Definition\| CODING REQUIREMENT\| TPL.076\|TPL-ENTITY-ADDR-TYPE\|\| 1.(LV) value must be in TPL Entity Address Type List (VVL) 2.(S) value must be 2 characters 3.(N) conditional	DE No\|Data Element Name\|Definition\| CODING REQUIREMENT\| TPL.076\|TPL-ENTITY-ADDR-TYPE\|\| 1.(LV) value must be in TPL Entity Address Type List (VVL) 2.(S) value must be 2 characters 3.(N) mandatory