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TMSIS Dataguide Medicaid.gov
Version 3.27.0

PROV-AFFILIATED-GROUPS

File Segment

File Segment Number

PRV00008

File Name

PRV - PROVIDER

Last updated

No Updates

Data Elements Reference
DE Number System DE Number Data Element Definition Valid Values
PRV106 PRV.008.106 RECORD-ID The Record ID represents the type of segment being reported. The Record ID communicates how the contents of a given row of data should be interpreted depending on which segment type the Record ID represents. Each type of segment collects different data elements so each segment type has a distinct layout. The first 3 characters identify the relevant file (e.g., ELG, PRV, CIP, etc.). The last 5 digits are the segment identifier padded with leading zeros (e.g., 00001, 00002, 00003, etc.). PRV106 Values
PRV107 PRV.008.107 SUBMITTING-STATE A code that uniquely identifies the U.S. State or Territory from which T-MSIS system data resources were received. PRV107 Values
PRV108 PRV.008.108 RECORD-NUMBER

A sequential number assigned by the submitter to identify each record segment row in the submission file. The Record Number, in conjunction with the Record Identifier, uniquely identifies a single record within the submission file.

 N/A
PRV109 PRV.008.109 SUBMITTING-STATE-PROV-ID The State-specific Medicaid Provider Identifier is a state-assigned unique identifier that states should report with all individual providers, practice groups, facilities, and other entities. This should be the identifier that is used in the state's Medicaid Management Information System. N/A
PRV110 PRV.008.110 SUBMITTING-STATE-PROV-ID-OF-AFFILIATED-ENTITY The unique, state-assigned identification number for the group or subpart with which the individual or subpart is associated. (The submitting state's unique identifier for the group. (Note: The group will also be in the provider data set as a provider (i.e., the group-as-a-provider). N/A
PRV111 PRV.008.111 PROV-AFFILIATED-GROUP-EFF-DATE The first calendar day on which all of the other data elements in the same segment were effective. N/A
PRV112 PRV.008.112 PROV-AFFILIATED-GROUP-END-DATE The last calendar day on which all of the other data elements in the same segment were effective. N/A
PRV113 PRV.008.113 STATE-NOTATION

A free text field for the submitting state to enter whatever information it chooses.

 N/A
Definition
A record to capture a provider's relationship(s) with other provider(s).

File Segment Length
1100