Title 42

SECTION 425.706

425.706 Minimum necessary data.

§ 425.706 Minimum necessary data.

(a) ACOs must limit their identifiable data requests to the minimum necessary to accomplish a permitted use of the data. The minimum necessary Parts A and B data elements may include but are not limited to the following data elements:

(1) Beneficiary ID.

(2) Procedure code.

(3) Gender.

(4) Diagnosis code.

(5) Claim ID.

(6) The from and through dates of service.

(7) The provider or supplier ID.

(8) The claim payment type.

(9) Date of birth and death, if applicable.

(10) TIN.

(11) NPI.

(b) The minimum necessary Part D data elements may include but are not limited to the following data elements:

(1) Beneficiary ID.

(2) Prescriber ID.

(3) Drug service date.

(4) Drug product service ID.

(5) Quantity dispensed.

(6) Days supplied.

(7) Brand name.

(8) Generic name.

(9) Drug strength.

(10) TIN.

(11) NPI.

(12) Indication if on formulary.

(13) Gross drug cost.