Medicare provider number check character
How the eight-character provider number is validated.
A Medicare provider number identifies a practitioner at a specific practice location. It has a six-digit
stem, a practice location character and a check character, for example 2426621B.
The algorithm
- Multiply the six stem digits by 3, 5, 8, 4, 2, 1 and sum.
- Map the location character to a value (0–9 then A–Y skipping I and O: A=10 … Y=32) and add six times that value.
- Take the sum modulo 11 and index into
YXWTLKJHFBAto get the check character.
The parser runs this when an XCN or PLN field is typed AUSHICPR, or when a value has the exact
8-character shape. Untyped matches are warnings rather than errors because an 8-character MRN can look the same.