| Name: | Pharmacy Service Providers File Submission |
|---|---|
| State: | Maine |
| Definition: | Not Provided |
| Version | v1.1 |
| Data Element ID | Data Element | Description | Type | Format | Length |
|---|---|---|---|---|---|
 PCSP901 |
Payer | This field contains the MHDO submitter code for the payer submitting payments. The first character of the submitter code indicates the type of submitter. This field is primarily used for tracking compliance by payer. It is derived from PC001 in the pharmacy claims data. | CHAR | 6 | |
| PCSP902 |
Data Processing Center Code | This field contains the unique pharmacy identifier that crosses all payers. This field is the link to the Pharmacy Master file (PM901). | NUMBER | 12 | |
| PCSP903 |
Pharmacy Number | This is the pharmacy number assigned by the payer. This field is derived from PC018 in the pharmacy claims data. | CHAR | 30 | |
| PCSP904 |
Pharmacy Tax ID Number | This field should contain the pharmacy''s tax identification number. This field is derived from PC019 in the pharmacy claims data. | CHAR | 10 | |
| PCSP905 |
Pharmacy Name | This field contains the name of the pharmacy filling the prescription. This field is derived from PC020 in the pharmacy claims data. | CHAR | 100 | |
| PCSP906 |
National Pharmacy ID Number | This field is derived from PC021 in the pharmacy claims data. | CHAR | 20 | |
| PCSP907 |
Pharmacy City Name | This field contains the city name of the pharmacy. This field is derived from PC022 in the pharmacy claims data. | CHAR | 30 | |
| PCSP908 |
Pharmacy State or Province | This is the two character abbreviation for city as defined by the US Postal Service. This field is derived from PC023 in the pharmacy claims data. | CHAR | 2 | |
| PCSP909 |
Pharmacy Zip Code | This field contains the zip code of the pharmacy location. It may contain non US codes. This field is derived from PC024 in the pharmacy claims data. | VARCHAR | 11 | |
| PCSP910 |
Pharmacy ID # | This field is used to link to the pharmacy claims data (PC913). It is the primary identification number for each Pharmacy Detail record. | Number | 12 |
| Data Element ID | Data Element | Code | Value |
|---|---|---|---|
| PCSP901 | Payer | C | Commercial carrier |
| T | Third Party Administrator | ||
| U | Unlicensed entity |
Agency for Healthcare Research and Quality • 5600 Fishers Lane, Rockville, MD 20857 • Telephone: (301) 427-1364
