12/2019 (old version) | 10/2020 (new version) | Type of Change | Reason for Change | Burden Change |
Header: MEDICAID DRUG REBATE PROGRAM STATE INVOICE RECORD FORMAT (Form CMS-R-144) Effective: February 1, 2020 |
Header: MEDICAID DRUG REBATE PROGRAM ELECTRONIC STATE INVOICE Form CMS-R-144 RECORD FORMAT Effective: July 1, 2021 |
Rev | To align Header with other Medicaid Drug Rebate Program documentation. | N/A |
N/A | New File Format Column: Ordinal Position Coresponding Rows Numbered 1-15 |
Add | To update File Format to include .CSV Ordinal Numbering Column | N/A |
File Format - Column Name Update: Field |
File Format - Column Name Update: Field Name (.TXT) Header Row (.CSV |
Rev | To include .CSV Header Row in additon to the .TXT Field Name | N/A |
File Format - Field Positions: 1 - 120 |
File Format - Field Positions: 1 - 136 |
Rev | Field positions were adjusted due to increased field sizes in several other fields | N/A |
Unit Rebate Amount (URA) Size: 12 Position: 33 - 44 Remarks: 9(5).9(6) |
Unit Rebate Amount Size: 15 Position: 33-47 Remarks: 99999.999999 |
Rev | To update the field size from 12 to 15 digits, to remove (URA). | N/A |
Units Reimbursed Size: 15 Position: 45 - 59 Remarks: 9(11).999 |
Units Reimbursed Size: 16 Position: 48 - 63 Remarks: 999999999999.999 |
Rev | To update the field size from 15 to 16 digits | N/A |
Rebate Amount Claimed Size: 12 Position: 60 - 71 Remarks: 9(9).99 |
Rebate Amount Claimed Size: 16 Position: 64 - 79 Remarks: 9999999999999.99 |
Rev | To update the field size from 12 to 16 digits | N/A |
Number of Prescriptions Size: 8 Position: 72 - 79 Remarks: 9(8) |
Number of Prescriptions Size: 8 Position: 80 - 87 Remarks: 99999999 |
Rev | To update the field poistions due to icreased field sizes in preceding fields | N/A |
Medicaid Amount Reimbursed (MAR) Size: 13 Position: 80 - 92 Remarks: 9(10).99 |
Medicaid Amount Reimbursed Size: 16 Position: 88 - 103 Remarks: 9999999999999.99 |
Rev | To update the field size from 13 to 16 digits, and to remove (MAR) | N/A |
Non-Medicaid Amount Reimbursed (NMAR) Size: 13 Position: 93 - 105 Remarks: 9(10).99 |
Non-Medicaid Amount Reimbursed Size: 16 Position: 104 - 119 Remarks: 9999999999999.99 |
Rev | To update the field size from 13 to 16 digits, and to remove (NMAR) | N/A |
Total Amount Reimbursed (TAR) Size: 14 Position: 106 – 119 Remarks: 9(11).99 |
Total Amount Reimbursed Size: 16 Position: 120 – 135 Remarks: 9999999999999.99 |
Rev | To update the field size from 14 to 16 digits, and to remove (TAR) | N/A |
Filler Position: 120 - 120 Remarks: N/A |
Filler - State Invoice Delete Flag - SDUD Submission to CMS Position: 136 - 136 Remarks: See Data Definitions |
Rev | The Filler position pertains only to the State Invoice whereas a Delete Flag will be used in the SDUD Submission to CMS. | N/A |
All fields with decimals now require actual decimal | Del | Verbiage no longer relevant | N/A |
File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |