VALIDITY EDITS
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3-160-01V
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TRANSACTION
CODE MUST =
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A
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ADD A RECORD OR
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I
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INACTIVATE A
RECORD OR
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M
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MODIFY A RECORD
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Relational Edits
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3-160-01R
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IF TRANSACTION
CODE =
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A
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ADD A RECORD
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AND INSTITUTIONAL/NON-INSTITUTIONAL
INDICATOR =
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I
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INSTITUTIONAL
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THEN PROVIDER
TAXPAYER NUMBER
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AND PROVIDER
SUB-IDENTIFIER
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AND ZIP
CODE (FIRST FIVE DIGITS)
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AND PROVIDER
MAJOR SPECIALTY/TYPE OF INSTITUTION MUST NOT ALREADY
EXIST ON THE PROVIDER FILE.
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3-160-02R
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IF TRANSACTION
CODE =
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A
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ADD A RECORD
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AND IF
INSTITUTIONAL/NON-INSTITUTIONAL INDICATOR =
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N
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NON-INSTITUTIONAL
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THEN PROVIDER
TAXPAYER NUMBER
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AND PROVIDER
SUB-IDENTIFIER
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AND ZIP
CODE (FIRST FIVE DIGITS)
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MUST NOT ALREADY
EXIST ON THE PROVIDER FILE.
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3-160-03R
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IF TRANSACTION
CODE =
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A
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ADD A RECORD
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AND INSTITUTIONAL/NON-INSTITUTIONAL
INDICATOR =
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N
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NON-INSTITUTIONAL
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AND THE
PROVIDER TAXPAYER NUMBER
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AND ZIP
CODE (FIRST FIVE DIGITS) ARE THE SAME AS AN EXISTING RECORD ON THE
PROVIDER FILE,
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AND THE
FIRST CHARACTER OF THE PROVIDER SUB-IDENTIFIER IS ALPHABETIC, FOLLOWED
BY A NUMBER OTHER THAN 001
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THEN THE
FIRST CHARACTER OF THE PROVIDER SUB-IDENTIFIER MUST MATCH AN EXISTING
SUB-IDENTIFIER (WHICH ENDS IN 001) FOR THIS TAXPAYER NUMBER AND
ZIP CODE (FIRST FIVE DIGITS) ON THE PROVIDER FILE. THIS LEADING
ALPHA PREFIX MUST BE FOLLOWED BY THREE UNIQUE NUMERIC DIGITS
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OR THE
FIRST TWO CHARACTERS OF THE PROVIDER SUB-IDENTIFIER ARE ALPHABETIC,
FOLLOWED BY A NUMBER OTHER THAN 01.
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THEN THE
FIRST TWO CHARACTERS OF THE PROVIDER SUB-IDENTIFIER MUST MATCH AN
EXISTING SUB-IDENTIFIER (WHICH ENDS IN ‘01’) FOR THIS TAXPAYER NUMBER
AND ZIP CODE ON THE PROVIDER FILE. THE ALPHA PREFIX MUST BE FOLLOWED
BY TWO UNIQUE NUMERIC DIGITS.
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3-160-06R
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IF TRANSACTION
CODE =
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I
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INACTIVATE A
RECORD OR
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|
|
M
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MODIFY A RECORD
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|
AND INSTITUTIONAL/NON-INSTITUTIONAL
INDICATOR =
|
I
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INSTITUTIONAL
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THEN AN
ACTIVE PROVIDER RECORD MUST EXIST ON THE PROVIDER FILE FOR THE SAME
PROVIDER TAXPAYER NUMBER, PROVIDER SUB-IDENTIFIER, PROVIDER ZIP
CODE, AND PROVIDER MAJOR SPECIALTY/TYPE OF INSTITUTION. (IN THE
CASE OF FOREIGN COUNTRY, ZIP WILL BE BLANK; ANY DUPLICATES ADDED WILL
HAVE TO BE ASSIGNED ANOTHER PROVIDER TAXPAYER NUMBER.)
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3-160-07R
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IF TRANSACTION
CODE =
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I
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INACTIVATE A
RECORD OR
|
|
|
M
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MODIFY A RECORD
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AND INSTITUTIONAL/NON-INSTITUTIONAL
INDICATOR =
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N
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NON-INSTITUTIONAL
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THEN AN
ACTIVE PROVIDER RECORD MUST EXIST ON THE PROVIDER FILE FOR THE SAME
PROVIDER TAXPAYER NUMBER, PROVIDER SUB-IDENTIFIER, AND PROVIDER
ZIP CODE (FIRST FIVE DIGITS).
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3-160-08R
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IF TRANSACTION
CODE =
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I
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INACTIVATE A
RECORD
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AND INSTITUTIONAL/NON-INSTITUTIONAL
INDICATOR =
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N
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NON-INSTITUTIONAL
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AND
THE FIRST CHARACTER OF THE PROVIDER SUB-IDENTIFIER IS ALPHABETIC
FOLLOWED BY 001 OR THE FIRST TWO CHARACTERS OF THE
PROVIDER SUB-IDENTIFIER IS ALPHABETIC FOLLOWED BY 01.
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THEN ALL
ASSOCIATED RECORDS USING THE SAME PROVIDER TAXPAYER NUMBER AND PROVIDER
ZIP CODE (FIRST FIVE DIGITS) AND THE SAME ONE OR TWO CHARACTER ALPHA
PREFIX OF THE SUB-IDENTIFIER AND DIFFERENT NUMERIC SUFFIX OF THE
SUB-IDENTIFIER MUST ALSO BE INACTIVATED.
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