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Referring Provider NPI Number

PRVDR_RFRG_PRVDR_NPI_NUM

A NUMBER IDENTIFYING THE NATIONAL PROVIDER IDENTIFIER (NPI) OF A REFERRING PROVIDER AS SOURCED FROM THE NPI CROSSWALK REFERENCE INFORMATION PROVIDED BY THE NATIONAL PLAN AND PROVIDER ENUMERATION SYSTEM (NPPES).

Field Metadata

FHIR Resource
ExplanationOfBenefit
FHIRPath
ExplanationOfBenefit.careTeam.where(
role.coding.where(code = 'referring').exists()
).provider.identifier.value
Coverage / Claim Type
  • Carrier
  • DME
  • HHA
  • Hospice
  • Outpatient
Source View
V2_MDCR_CLM
Source Column
PRVDR_RFRG_PRVDR_NPI_NUM
Sources
  • FISS
  • MCS
  • NCH
  • VMS
Profiles
  • Basis
  • Regular
  • CMS

Mappings

CCLF
  • CCLF5.CLM_RFRG_PRVDR_NPI_NUM
  • CCLF6.ORDRG_PRVDR_NPI_NUM
  • CCLF6.CLM_RFRG_PRVDR_NPI_NUM
CCW
  • RFR_PHYSN_NPI
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