United States Health Information Knowledgebase

 

File Submission Comparison

Selected Items
Action Item Name Version State Type Organization
Pharmacy Claims File Submission August 2011 - v3 Colorado File Specification Center for Improving Value in Health Care (CIVHC)
Pharmacy Claims File Submission March 2013 - v5 Colorado File Specification Center for Improving Value in Health Care (CIVHC)
Pharmacy Claims File Submission March 2014 - v6 Colorado File Specification Center for Improving Value in Health Care (CIVHC)
File Specification: Pharmacy Claims File Submission - August 2011 - v3 (Colorado) Pharmacy Claims File Submission - March 2013 - v5 (Colorado) Pharmacy Claims File Submission - March 2014 - v6 (Colorado)
[Shared] Responsible Organization:
Center for Improving Value in Health Care Center for Improving Value in Health Care Center for Improving Value in Health Care
[Shared] Definition:
Not Provided Not Provided Not Provided
File Specification: Pharmacy Claims File Submission - August 2011 - v3 (Colorado) Pharmacy Claims File Submission - March 2013 - v5 (Colorado) Pharmacy Claims File Submission - March 2014 - v6 (Colorado)
HD001
[Shared] Name: Record Type
[Shared] Type: char
[Shared] Length: 2
Codes:
PC
 
[Shared] Name: Record Type
[Shared] Type: char
[Shared] Length: 2
Codes:
PC
 
[Shared] Name: Record Type
[Shared] Type: char
[Shared] Length: 2
Codes:
PC
 
HD002
[Shared] Name: Payer Code
[Unshared] Type: char
[Shared] Length: 8
[Shared] Name: Payer Code
[Unshared] Type: varchar
[Shared] Length: 8
[Shared] Name: Payer Code
[Unshared] Type: char
[Shared] Length: 8
HD003
[Shared] Name: Payer Name
[Unshared] Type: char
[Shared] Length: 75
[Shared] Name: Payer Name
[Unshared] Type: varchar
[Shared] Length: 75
[Shared] Name: Payer Name
[Unshared] Type: char
[Shared] Length: 75
HD004
[Shared] Name: Beginning Month
[Shared] Type: Date
[Shared] Length: 6
[Shared] Name: Beginning Month
[Shared] Type: Date
[Shared] Length: 6
[Shared] Name: Beginning Month
[Shared] Type: Date
[Shared] Length: 6
HD005
[Shared] Name: Ending Month
[Shared] Type: Date
[Shared] Length: 6
[Shared] Name: Ending Month
[Shared] Type: Date
[Shared] Length: 6
[Shared] Name: Ending Month
[Shared] Type: Date
[Shared] Length: 6
HD006
[Shared] Name: Record count
[Shared] Type: int
[Shared] Length: 10
[Shared] Name: Record count
[Shared] Type: int
[Shared] Length: 10
[Shared] Name: Record count
[Shared] Type: int
[Shared] Length: 10
PC001
[Unshared] Name: Payer
[Shared] Type: varchar
[Shared] Length: 8
[Unshared] Name: Payer Code
[Shared] Type: varchar
[Shared] Length: 8
[Unshared] Name: Payer Code
[Shared] Type: varchar
[Shared] Length: 8
PC002
[Unshared] Name: Plan ID
[Shared] Type: varchar
[Shared] Length: 30
[Unshared] Name: Payer Name
[Shared] Type: varchar
[Shared] Length: 30
[Unshared] Name: Payer Name
[Shared] Type: varchar
[Shared] Length: 30
PC003
[Shared] Name: Insurance Type/Product Code
[Shared] Type: char
[Shared] Length: 2
Codes:
12
Preferred Provider Organization (PPO)
13
Point of Service (POS)
15
Indemnity Insurance
16
Health Maintenance Organization (HMO) Medicare Advantage
 
 
99
Other
CI
Commercial Insurance Company
 
 
HM
Health Maintenance Organization
HN
HMO Medicare Risk/ Medicare Part C
MA
Medicare Part A
MB
Medicare Part B
MC
Medicaid
MD
Medicare Part D
MP
Medicare Primary
QM
Qualified Medicare Beneficiary
SP
Supplemental Policy
TV
Title V
[Shared] Name: Insurance Type/Product Code
[Shared] Type: char
[Shared] Length: 2
Codes:
12
Preferred Provider Organization (PPO)
13
Point of Service (POS)
15
Indemnity Insurance
16
Health Maintenance Organization (HMO) Medicare Advantage
17
Dental Maintenance Organization (DMO)
99
Other
CI
Commercial Insurance Company
DN
Dental
HM
Health Maintenance Organization
HN
HMO Medicare Risk/ Medicare Part C
MA
Medicare Part A
MB
Medicare Part B
MC
Medicaid
MD
Medicare Part D
MP
Medicare Primary
QM
Qualified Medicare Beneficiary
SP
Medicare Supplemental (Medi-gap) plan
TV
Title V
[Shared] Name: Insurance Type/Product Code
[Shared] Type: char
[Shared] Length: 2
Codes:
12
Preferred Provider Organization (PPO)
13
Point of Service (POS)
15
Indemnity Insurance
16
Health Maintenance Organization (HMO) Medicare Advantage
17
Dental Maintenance Organization (DMO)
99
Other
CI
Commercial Insurance Company
DN
Dental
HM
Health Maintenance Organization
HN
HMO Medicare Risk/ Medicare Part C
MA
Medicare Part A
MB
Medicare Part B
MC
Medicaid
MD
Medicare Part D
MP
Medicare Primary
QM
Qualified Medicare Beneficiary
SP
Medicare Supplemental (Medi-gap) plan
TV
Title V
PC004
[Shared] Name: Payer Claim Control Number
[Shared] Type: varchar
[Shared] Length: 35
[Shared] Name: Payer Claim Control Number
[Shared] Type: varchar
[Shared] Length: 35
[Shared] Name: Payer Claim Control Number
[Shared] Type: varchar
[Shared] Length: 35
PC005
[Shared] Name: Line Counter
[Unshared] Type: tinyint
[Shared] Length: 4
[Shared] Name: Line Counter
[Unshared] Type: int
[Shared] Length: 4
[Shared] Name: Line Counter
[Unshared] Type: int
[Shared] Length: 4
PC006
[Shared] Name: Insured Group Number
[Shared] Type: varchar
[Shared] Length: 30
[Shared] Name: Insured Group Number
[Shared] Type: varchar
[Shared] Length: 30
[Shared] Name: Insured Group Number
[Shared] Type: varchar
[Shared] Length: 30
PC007
[Shared] Name: Subscriber Social Security Number
[Shared] Type: varchar
[Shared] Length: 9
[Shared] Name: Subscriber Social Security Number
[Shared] Type: varchar
[Shared] Length: 9
[Shared] Name: Subscriber Social Security Number
[Shared] Type: varchar
[Shared] Length: 9
PC008
[Shared] Name: Plan Specific Contract Number
[Shared] Type: varchar
[Shared] Length: 128
[Shared] Name: Plan Specific Contract Number
[Shared] Type: varchar
[Shared] Length: 128
[Shared] Name: Plan Specific Contract Number
[Shared] Type: varchar
[Shared] Length: 128
PC009
[Shared] Name: Member Suffix or Sequence Number
[Shared] Type: varchar
[Shared] Length: 20
[Shared] Name: Member Suffix or Sequence Number
[Shared] Type: varchar
[Shared] Length: 20
[Shared] Name: Member Suffix or Sequence Number
[Shared] Type: varchar
[Shared] Length: 20
PC010
[Shared] Name: Member Identification Code
[Shared] Type: varchar
[Shared] Length: 128
[Shared] Name: Member Identification Code
[Shared] Type: varchar
[Shared] Length: 128
[Shared] Name: Member Identification Code
[Shared] Type: varchar
[Shared] Length: 128
PC011
[Shared] Name: Individual Relationship Code
[Shared] Type: char
[Shared] Length: 2
Codes:
01
Spouse
04
Grandfather or Grandmother
05
Grandson or Granddaughter
07
Nephew or Niece
10
Foster Child
15
Ward
17
Stepson or Stepdaughter
19
Child
20
Employee/Self
21
Unknown
22
Handicapped Dependent
23
Sponsored Dependent
24
Dependent of a Minor Dependent
29
Significant Other
32
Mother
33
Father
36
Emancipated Minor
39
Organ Donor
40
Cadaver Donor
41
Injured Plaintiff
43
Child Where Insured Has No Financial Responsibility
53
Life Partner
76
Dependent
[Shared] Name: Individual Relationship Code
[Shared] Type: char
[Shared] Length: 2
Codes:
01
Spouse
04
Grandfather or Grandmother
05
Grandson or Granddaughter
07
Nephew or Niece
10
Foster Child
15
Ward
17
Stepson or Stepdaughter
19
Child
20
Employee/Self
21
Unknown
22
Handicapped Dependent
23
Sponsored Dependent
24
Dependent of a Minor Dependent
29
Significant Other
32
Mother
33
Father
36
Emancipated Minor
39
Organ Donor
40
Cadaver Donor
41
Injured Plaintiff
43
Child Where Insured Has No Financial Responsibility
53
Life Partner
76
Dependent
[Shared] Name: Individual Relationship Code
[Shared] Type: char
[Shared] Length: 2
Codes:
01
Spouse
04
Grandfather or Grandmother
05
Grandson or Granddaughter
07
Nephew or Niece
10
Foster Child
15
Ward
17
Stepson or Stepdaughter
19
Child
20
Employee/Self
21
Unknown
22
Handicapped Dependent
23
Sponsored Dependent
24
Dependent of a Minor Dependent
29
Significant Other
32
Mother
33
Father
36
Emancipated Minor
39
Organ Donor
40
Cadaver Donor
41
Injured Plaintiff
43
Child Where Insured Has No Financial Responsibility
53
Life Partner
76
Dependent
PC012
[Shared] Name: Member Gender
[Shared] Type: char
[Shared] Length: 1
Codes:
1
Male
2
Female
3
Unknown
 
 
 
 
 
 
[Shared] Name: Member Gender
[Shared] Type: char
[Shared] Length: 1
Codes:
 
 
 
 
 
 
F
Female
M
Male
U
Unknown
[Shared] Name: Member Gender
[Shared] Type: char
[Shared] Length: 1
Codes:
 
 
 
 
 
 
F
Female
M
Male
U
UNKNOWN
PC013
[Shared] Name: Member Date of Birth
[Shared] Type: Date
[Shared] Length: 8
[Shared] Name: Member Date of Birth
[Shared] Type: Date
[Shared] Length: 8
[Shared] Name: Member Date of Birth
[Shared] Type: Date
[Shared] Length: 8
PC014
[Shared] Name: Member City Name of Residence
[Shared] Type: varchar
[Shared] Length: 50
[Shared] Name: Member City Name of Residence
[Shared] Type: varchar
[Shared] Length: 50
[Shared] Name: Member City Name of Residence
[Shared] Type: varchar
[Shared] Length: 50
PC015
[Shared] Name: Member State or Province
[Shared] Type: char
[Shared] Length: 2
[Shared] Name: Member State or Province
[Shared] Type: char
[Shared] Length: 2
[Shared] Name: Member State or Province
[Shared] Type: char
[Shared] Length: 2
PC016
[Shared] Name: Member ZIP Code
[Shared] Type: varchar
[Shared] Length: 11
[Shared] Name: Member ZIP Code
[Shared] Type: varchar
[Shared] Length: 11
[Shared] Name: Member ZIP Code
[Shared] Type: varchar
[Shared] Length: 11
PC017
[Shared] Name: Date Service Approved (AP Date)
[Shared] Type: Date
[Shared] Length: 8
[Shared] Name: Date Service Approved (AP Date)
[Shared] Type: Date
[Shared] Length: 8
[Shared] Name: Date Service Approved (AP Date)
[Shared] Type: Date
[Shared] Length: 8
PC018
[Shared] Name: Pharmacy Number
[Shared] Type: varchar
[Shared] Length: 30
[Shared] Name: Pharmacy Number
[Shared] Type: varchar
[Shared] Length: 30
[Shared] Name: Pharmacy Number
[Shared] Type: varchar
[Shared] Length: 30
PC019
[Shared] Name: Pharmacy Tax ID Number
[Shared] Type: varchar
[Shared] Length: 10
[Shared] Name: Pharmacy Tax ID Number
[Shared] Type: varchar
[Shared] Length: 10
[Shared] Name: Pharmacy Tax ID Number
[Shared] Type: varchar
[Shared] Length: 10
PC020
[Shared] Name: Pharmacy Name
[Shared] Type: varchar
[Shared] Length: 50
[Shared] Name: Pharmacy Name
[Shared] Type: varchar
[Shared] Length: 50
[Shared] Name: Pharmacy Name
[Shared] Type: varchar
[Shared] Length: 50
PC021
[Shared] Name: National Provider ID Number
[Shared] Type: varchar
[Shared] Length: 20
[Shared] Name: National Provider ID Number
[Shared] Type: varchar
[Shared] Length: 20
[Shared] Name: National Provider ID Number
[Shared] Type: varchar
[Shared] Length: 20
PC022
[Shared] Name: Pharmacy Location City
[Shared] Type: varchar
[Shared] Length: 30
[Shared] Name: Pharmacy Location City
[Shared] Type: varchar
[Shared] Length: 30
[Shared] Name: Pharmacy Location City
[Shared] Type: varchar
[Shared] Length: 30
PC023
[Shared] Name: Pharmacy Location State
[Shared] Type: char
[Shared] Length: 2
[Shared] Name: Pharmacy Location State
[Shared] Type: char
[Shared] Length: 2
[Shared] Name: Pharmacy Location State
[Shared] Type: char
[Shared] Length: 2
PC024
[Shared] Name: Pharmacy ZIP Code
[Shared] Type: varchar
[Shared] Length: 10
[Shared] Name: Pharmacy ZIP Code
[Shared] Type: varchar
[Shared] Length: 10
[Shared] Name: Pharmacy ZIP Code
[Shared] Type: varchar
[Shared] Length: 10
PC024A
[Unshared] Name: Pharmacy Country Name
[Unshared] Type: varchar
[Unshared] Length: 30
Data Element: PC024A
not present in this file submission.
Data Element: PC024A
not present in this file submission.
PC024d
Data Element: PC024d
not present in this file submission.
[Unshared] Name: Pharmacy Country Name
[Unshared] Type: varchar
[Unshared] Length: 30
[Unshared] Name: Pharmacy Country Name
[Unshared] Type: varchar
[Unshared] Length: 30
PC025
[Shared] Name: Claim Status
[Shared] Type: char
[Shared] Length: 2
Codes:
01
Processed as primary
02
Processed as secondary
03
Processed as tertiary
19
Processed as primary, forwarded to additional payer(s)
20
Processed as secondary, forwarded to additional payer(s)
21
Processed as tertiary, forwarded to additional payer(s)
22
Reversal of previous payment
[Shared] Name: Claim Status
[Shared] Type: char
[Shared] Length: 2
Codes:
01
Processed as primary
02
Processed as secondary
03
Processed as tertiary
19
Processed as primary, forwarded to additional payer(s)
20
Processed as secondary, forwarded to additional payer(s)
21
Processed as tertiary, forwarded to additional payer(s)
22
Reversal of previous payment
[Shared] Name: Claim Status
[Shared] Type: char
[Shared] Length: 2
Codes:
01
Processed as primary
02
Processed as secondary
03
Processed as tertiary
19
Processed as primary, forwarded to additional payer(s)
20
Processed as secondary, forwarded to additional payer(s)
21
Processed as tertiary, forwarded to additional payer(s)
22
Reversal of previous payment
PC026
[Shared] Name: Drug Code
[Shared] Type: varchar
[Shared] Length: 11
[Shared] Name: Drug Code
[Shared] Type: varchar
[Shared] Length: 11
[Shared] Name: Drug Code
[Shared] Type: varchar
[Shared] Length: 11
PC027
[Shared] Name: Drug Name
[Shared] Type: varchar
[Shared] Length: 80
[Shared] Name: Drug Name
[Shared] Type: varchar
[Shared] Length: 80
[Shared] Name: Drug Name
[Shared] Type: varchar
[Shared] Length: 80
PC028
[Shared] Name: New Prescription or Refill
[Shared] Type: varchar
[Shared] Length: 2
Codes:
01
New prescription
02
Refill
N
new
R
refill
[Shared] Name: New Prescription or Refill
[Shared] Type: varchar
[Shared] Length: 2
Codes:
01
New prescription
02
Refill
N
new
R
refill
[Shared] Name: New Prescription or Refill
[Shared] Type: varchar
[Shared] Length: 2
Codes:
01
New prescription
02
Refill
 
 
 
 
PC029
[Shared] Name: Generic Drug Indicator
[Shared] Type: char
[Shared] Length: 2
Codes:
01
branded drug
02
generic drug
[Shared] Name: Generic Drug Indicator
[Shared] Type: char
[Shared] Length: 2
Codes:
01
branded drug
02
generic drug
[Shared] Name: Generic Drug Indicator
[Shared] Type: char
[Shared] Length: 2
Codes:
01
branded drug
02
generic drug
PC030
[Shared] Name: Dispense as Written Code
[Shared] Type: char
[Shared] Length: 1
Codes:
0
Not dispensed as written
1
Physician dispense as written
2
Member dispense as written
3
Pharmacy dispense as written
4
No generic available
5
Brand dispensed as generic
6
Override
7
Substitution not allowed - brand drug mandated by law
8
Substitution allowed - generic drug not available in marketplace
9
Other
[Shared] Name: Dispense as Written Code
[Shared] Type: char
[Shared] Length: 1
Codes:
0
Not dispensed as written
1
Physician dispense as written
2
Member dispense as written
3
Pharmacy dispense as written
4
No generic available
5
Brand dispensed as generic
6
Override
7
Substitution not allowed - brand drug mandated by law
8
Substitution allowed - generic drug not available in marketplace
9
Other
[Shared] Name: Dispense as Written Code
[Shared] Type: char
[Shared] Length: 1
Codes:
0
Not dispensed as written
1
Physician dispense as written
2
Member dispense as written
3
Pharmacy dispense as written
4
No generic available
5
Brand dispensed as generic
6
Override
7
Substitution not allowed - brand drug mandated by law
8
Substitution allowed - generic drug not available in marketplace
9
Other
PC031
[Shared] Name: Compound Drug Indicator
[Shared] Type: char
[Shared] Length: 1
Codes:
N
Non-compound drug
U
Non-specified drug compound
Y
Compound drug
[Shared] Name: Compound Drug Indicator
[Shared] Type: char
[Shared] Length: 1
Codes:
N
Non-compound drug
U
Non-specified drug compound
Y
Compound drug
[Shared] Name: Compound Drug Indicator
[Shared] Type: char
[Shared] Length: 1
Codes:
N
Non-compound drug
U
Non-specified drug compound
Y
Compound drug
PC032
[Shared] Name: Date Prescription Filled
[Shared] Type: Date
[Shared] Length: 8
[Shared] Name: Date Prescription Filled
[Shared] Type: Date
[Shared] Length: 8
[Shared] Name: Date Prescription Filled
[Shared] Type: Date
[Shared] Length: 8
PC033
[Shared] Name: Quantity Dispensed
[Shared] Type: int
[Shared] Length: 5
[Shared] Name: Quantity Dispensed
[Shared] Type: int
[Shared] Length: 5
[Shared] Name: Quantity Dispensed
[Shared] Type: int
[Shared] Length: 5
PC034
[Shared] Name: Days Supply
[Shared] Type: int
[Shared] Length: 3
[Shared] Name: Days Supply
[Shared] Type: int
[Shared] Length: 3
[Shared] Name: Days Supply
[Shared] Type: int
[Shared] Length: 3
PC035
[Shared] Name: Charge Amount
[Shared] Type: int
[Shared] Length: 10
[Shared] Name: Charge Amount
[Shared] Type: int
[Shared] Length: 10
[Shared] Name: Charge Amount
[Shared] Type: int
[Shared] Length: 10
PC036
[Shared] Name: Paid Amount
[Shared] Type: int
[Shared] Length: 10
[Shared] Name: Paid Amount
[Shared] Type: int
[Shared] Length: 10
[Shared] Name: Paid Amount
[Shared] Type: int
[Shared] Length: 10
PC037
[Shared] Name: Ingredient Cost/List Price
[Shared] Type: int
[Shared] Length: 10
[Shared] Name: Ingredient Cost/List Price
[Shared] Type: int
[Shared] Length: 10
[Shared] Name: Ingredient Cost/List Price
[Shared] Type: int
[Shared] Length: 10
PC038
[Shared] Name: Postage Amount Claimed
[Shared] Type: int
[Shared] Length: 10
[Shared] Name: Postage Amount Claimed
[Shared] Type: int
[Shared] Length: 10
[Shared] Name: Postage Amount Claimed
[Shared] Type: int
[Shared] Length: 10
PC039
[Shared] Name: Dispensing Fee
[Shared] Type: int
[Shared] Length: 10
[Shared] Name: Dispensing Fee
[Shared] Type: int
[Shared] Length: 10
[Shared] Name: Dispensing Fee
[Shared] Type: int
[Shared] Length: 10
PC040
[Shared] Name: Co-pay Amount
[Shared] Type: int
[Shared] Length: 10
[Shared] Name: Co-pay Amount
[Shared] Type: int
[Shared] Length: 10
[Shared] Name: Co-pay Amount
[Shared] Type: int
[Shared] Length: 10
PC041
[Shared] Name: Coinsurance Amount
[Shared] Type: int
[Shared] Length: 10
[Shared] Name: Coinsurance Amount
[Shared] Type: int
[Shared] Length: 10
[Shared] Name: Coinsurance Amount
[Shared] Type: int
[Shared] Length: 10
PC042
[Shared] Name: Deductible Amount
[Shared] Type: int
[Shared] Length: 10
[Shared] Name: Deductible Amount
[Shared] Type: int
[Shared] Length: 10
[Shared] Name: Deductible Amount
[Shared] Type: int
[Shared] Length: 10
PC043
[Shared] Name: Unassigned
[Unshared] Type: N/A
[Unshared] Length: N/A
[Shared] Name: Unassigned
[Unshared] Type: N/A
[Unshared] Length: Not Provided
[Shared] Name: Unassigned
[Unshared] Type: Not Provided
[Unshared] Length: Not Provided
PC044
[Shared] Name: Prescribing Physician First Name
[Shared] Type: varchar
[Shared] Length: 25
[Shared] Name: Prescribing Physician First Name
[Shared] Type: varchar
[Shared] Length: 25
[Shared] Name: Prescribing Physician First Name
[Shared] Type: varchar
[Shared] Length: 25
PC045
[Shared] Name: Prescribing Physician Middle Name
[Shared] Type: varchar
[Shared] Length: 25
[Shared] Name: Prescribing Physician Middle Name
[Shared] Type: varchar
[Shared] Length: 25
[Shared] Name: Prescribing Physician Middle Name
[Shared] Type: varchar
[Shared] Length: 25
PC046
[Shared] Name: Prescribing Physician Last Name
[Shared] Type: varchar
[Shared] Length: 60
[Shared] Name: Prescribing Physician Last Name
[Shared] Type: varchar
[Shared] Length: 60
[Shared] Name: Prescribing Physician Last Name
[Shared] Type: varchar
[Shared] Length: 60
PC047
[Unshared] Name: Prescribing Physician Number
[Shared] Type: varchar
[Shared] Length: 20
[Unshared] Name: Prescribing Physician NPI
[Shared] Type: varchar
[Shared] Length: 20
[Unshared] Name: Prescribing Physician NPI
[Shared] Type: varchar
[Shared] Length: 20
PC047a
Data Element: PC047a
not present in this file submission.
[Unshared] Name: Prescribing Physician Provider ID
[Unshared] Type: varchar
[Unshared] Length: 30
[Unshared] Name: Prescribing Physician Provider ID
[Unshared] Type: varchar
[Unshared] Length: 30
PC047b
Data Element: PC047b
not present in this file submission.
[Unshared] Name: Prescribing Physician DEA
[Unshared] Type: varchar
[Unshared] Length: 20
[Unshared] Name: Prescribing Physician DEA
[Unshared] Type: varchar
[Unshared] Length: 20
PC048
[Shared] Name: Pharmacy Location Street Address
[Shared] Type: Varchar
[Shared] Length: 30
[Shared] Name: Pharmacy Location Street Address
[Shared] Type: Varchar
[Shared] Length: 30
[Shared] Name: Pharmacy Location Street Address
[Shared] Type: Varchar
[Shared] Length: 30
PC049
[Shared] Name: Member Street Address
[Shared] Type: varchar
[Shared] Length: 50
[Shared] Name: Member Street Address
[Shared] Type: varchar
[Shared] Length: 50
[Shared] Name: Member Street Address
[Shared] Type: varchar
[Shared] Length: 50
PC101
[Shared] Name: Subscriber Last Name
[Shared] Type: varchar
[Shared] Length: 128
[Shared] Name: Subscriber Last Name
[Shared] Type: varchar
[Shared] Length: 128
[Shared] Name: Subscriber Last Name
[Shared] Type: varchar
[Shared] Length: 128
PC102
[Shared] Name: Subscriber First Name
[Shared] Type: varchar
[Shared] Length: 128
[Shared] Name: Subscriber First Name
[Shared] Type: varchar
[Shared] Length: 128
[Shared] Name: Subscriber First Name
[Shared] Type: varchar
[Shared] Length: 128
PC103
[Shared] Name: Subscriber Middle Initial
[Shared] Type: char
[Shared] Length: 1
[Shared] Name: Subscriber Middle Initial
[Shared] Type: char
[Shared] Length: 1
[Shared] Name: Subscriber Middle Initial
[Shared] Type: char
[Shared] Length: 1
PC104
[Shared] Name: Member Last Name
[Shared] Type: varchar
[Shared] Length: 128
[Shared] Name: Member Last Name
[Shared] Type: varchar
[Shared] Length: 128
[Shared] Name: Member Last Name
[Shared] Type: varchar
[Shared] Length: 128
PC105
[Shared] Name: Member First Name
[Shared] Type: varchar
[Shared] Length: 128
[Shared] Name: Member First Name
[Shared] Type: varchar
[Shared] Length: 128
[Shared] Name: Member First Name
[Shared] Type: varchar
[Shared] Length: 128
PC106
[Shared] Name: Member Middle Initial
[Shared] Type: char
[Shared] Length: 1
[Shared] Name: Member Middle Initial
[Shared] Type: char
[Shared] Length: 1
[Shared] Name: Member Middle Initial
[Shared] Type: char
[Shared] Length: 1
PC201
Data Element: PC201
not present in this file submission.
[Unshared] Name: Version Number
[Unshared] Type: int
[Unshared] Length: 4
[Unshared] Name: Version Number
[Unshared] Type: int
[Unshared] Length: 4
PC202
Data Element: PC202
not present in this file submission.
[Unshared] Name: Prescription Written Date
[Unshared] Type: Date
[Unshared] Length: 8
[Unshared] Name: Prescription Written Date
[Unshared] Type: Date
[Unshared] Length: 8
PC899
[Shared] Name: Record Type
[Shared] Type: char
[Shared] Length: 2
Codes:
PC
 
[Shared] Name: Record Type
[Shared] Type: char
[Shared] Length: 2
Codes:
PC
 
[Shared] Name: Record Type
[Shared] Type: char
[Shared] Length: 2
Codes:
PC
 
TR001
[Shared] Name: Record Type
[Shared] Type: char
[Shared] Length: 2
Codes:
PC
 
[Shared] Name: Record Type
[Shared] Type: char
[Shared] Length: 2
Codes:
PC
 
[Shared] Name: Record Type
[Shared] Type: char
[Shared] Length: 2
Codes:
PC
 
TR002
[Shared] Name: Payer Code
[Shared] Type: varchar
[Shared] Length: 8
[Shared] Name: Payer Code
[Shared] Type: varchar
[Shared] Length: 8
[Shared] Name: Payer Code
[Shared] Type: varchar
[Shared] Length: 8
TR003
[Shared] Name: Payer Name
[Shared] Type: varchar
[Shared] Length: 75
[Shared] Name: Payer Name
[Shared] Type: varchar
[Shared] Length: 75
[Shared] Name: Payer Name
[Shared] Type: varchar
[Shared] Length: 75
TR004
[Shared] Name: Beginning Month
[Shared] Type: Date
[Shared] Length: 6
[Shared] Name: Beginning Month
[Shared] Type: Date
[Shared] Length: 6
[Shared] Name: Beginning Month
[Shared] Type: Date
[Shared] Length: 6
TR005
[Shared] Name: Ending Month
[Shared] Type: Date
[Shared] Length: 6
[Shared] Name: Ending Month
[Shared] Type: Date
[Shared] Length: 6
[Shared] Name: Ending Month
[Shared] Type: Date
[Shared] Length: 6
TR006
[Shared] Name: Extraction Date
[Shared] Type: Date
[Shared] Length: 8
[Shared] Name: Extraction Date
[Shared] Type: Date
[Shared] Length: 8
[Shared] Name: Extraction Date
[Shared] Type: Date
[Shared] Length: 8
Took 1.18512951 seconds to complete.
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