4 Other 5 Not Applicable Indicator - eVisit The MA APCD reserves this field. PV 50 Filler Filler char[1] All 0% Z –Filler Option Do not populate with any data. The APCD reserves this element for PV 51 Filler 11/8/12 Filler Filler char[0] Filler future use. Do not populate with any All 0% Z data. Required Has Lookup Report the value that defines the Indicator - Multiple when PV 52 multiple 11/8/12 - int[1] element. EXAMPLE: 1 = Yes, 100% A0 Office Provider PV034 = 1, offices Integer provider has multiple offices. 2, or 3 Value Description 1 Yes 2 No 3 Unknown 4 5 Not Applicable The APCD reserves this element for PV 53 Filler 11/8/12 Text Filler char[0] Filler future use. Do not populate with any All 0% Z data. Report the identifier of the medical home the provider Require Medical / Medical Home is linked-to here. The value in this when PV 54 Healthcare 6/24/10 Text ID Link to PV002 Identification 0% B element must have a corresponding PV034 = Home ID Number Provider ID (PV002) in this or a 1, 2, or 3 previously submitted provider file. Lookup Report the value that defines the Required Indicator - Provider PV 55 PCP Flag 11/8/12 Table - int[1] element. EXAMPLE: 1 = Yes, when 100% A0 is a PCP Integer provider is a PCP. PV034 = 1 Value Description 1 Yes 2 No 3 Unknown
4 Other 5 Not Applicable PV 50 Filler –Filler Filler char[1] Indicator - eVisit Option The MA APCD reserves this field. Do not populate with any data. All 0% Z PV 51 Filler 11/8/12 Filler Filler char[0] Filler The APCD reserves this element for future use. Do not populate with any data. All 0% Z PV 52 Has multiple offices 11/8/12 Lookup - Integer int[1] Indicator - Multiple Office Provider Report the value that defines the element. EXAMPLE: 1 = Yes, provider has multiple offices. Required when PV034 = 1, 2, or 3 100% A0 Value Description 1 Yes 2 No 3 Unknown 4 5 Not Applicable PV 53 Filler 11/8/12 Text Filler char[0] Filler The APCD reserves this element for future use. Do not populate with any data. All 0% Z PV 54 Medical / Healthcare Home ID 6/24/10 Text ID Link to PV002 Medical Home Identification Number Report the identifier of the medical home the provider is linked-to here. The value in this element must have a corresponding Provider ID (PV002) in this or a previously submitted provider file. Require when PV034 = 1, 2, or 3 0% B PV 55 PCP Flag 11/8/12 Lookup Table - Integer int[1] Indicator - Provider is a PCP Report the value that defines the element. EXAMPLE: 1 = Yes, provider is a PCP. Required when PV034 = 1 100% A0 Value Description 1 Yes 2 No 3 Unknown