PRV.003.055

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TMSIS Dataguide

Medicaid.gov

Version 3.27.0

ADDR-FAX-NUM

Data Element

DE Number

PRV055

System DE Number

PRV.003.055

File Name

File Segment Number

File Segment Name

PROV-LOCATION-AND-CONTACT-INFO

Last updated

No Updates

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The fax number of the provider for the location being captured on this record.
Size	X(10)
FLF Start Position	363
FLF Stop Position	372
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be 10-digit number 2. Optional

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

RULE ID	RULE Definition
RULE-2860	If a segment is a provider location and contact information segment from an PRV file, then the address fax number value reported must be compatible with the specified T-MSIS picture format: X(10).
RULE-7151	If a provider location and contact information segment has a value populated for address fax number it must be in a valid number format.

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