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TMSIS Dataguide Medicaid.gov
Version 3.27.0

PROV-AFFILIATED-PROGRAMS

File Segment

File Segment Number

PRV00009

File Name

PRV - PROVIDER

Last updated

No Updates

Data Elements Reference
DE Number System DE Number Data Element Definition Valid Values
PRV115 PRV.009.115 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.). PRV115 Values
PRV116 PRV.009.116 SUBMITTING-STATE A code that uniquely identifies the U.S. State or Territory from which T-MSIS system data resources were received. PRV116 Values
PRV117 PRV.009.117 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
PRV118 PRV.009.118 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
PRV119 PRV.009.119 AFFILIATED-PROGRAM-TYPE A code to identify the category of program that the provider is affiliated. PRV119 Values
PRV120 PRV.009.120 AFFILIATED-PROGRAM-ID

A data element to identify the Medicaid/CHIP programs, waivers and demonstrations in which the provider participates.

 N/A
PRV121 PRV.009.121 PROV-AFFILIATED-PROGRAM-EFF-DATE The first calendar day on which all of the other data elements in the same segment were effective. N/A
PRV122 PRV.009.122 PROV-AFFILIATED-PROGRAM-END-DATE The last calendar day on which all of the other data elements in the same segment were effective. N/A
PRV123 PRV.009.123 STATE-NOTATION

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

 N/A
Definition
A record to capture the Medicaid/CHIP health plans, waivers, health home entities, etc. that the provider entity is associated with.

File Segment Length
1100