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TMSIS Dataguide Medicaid.gov
Version 3.27.0

RULE-1972

Validation Rule
Last updated

No Updates

Tier 1.1
Tier Description Value Error
Error Category E1102
Error Category Message Value does not match specification
Rule Type One Record Type (Single Record)
File Segment Number CRX00002
Data Element Name CLAIM-HEADER-RECORD-RX.PROV-LOCATION-ID
Validation Logic 'if CLAIM-HEADER-RECORD-RX.CLAIM-STATUS-CATEGORY does not equal 'F2' and CLAIM-HEADER-RECORD-RX has a valid, non-null value for PROV-LOCATION-ID, then CLAIM-HEADER-RECORD-RX.PROV-LOCATION-ID does not contain any pipe (|) or asterisk (*) characters'
Rule Definition If the provider location id is populated on a non-denied claim line from an RX file, then the provider location id reported must not contain any pipe or asterisk characters.
Denominator Logic # of RX claim headers with CLAIM-HEADER-RECORD-RX.CLAIM-STATUS-CATEGORY not equal to 'F2' and with CLAIM-HEADER-RECORD-RX.PROV-LOCATION-ID equal to a valid, non-null value