United States Health Information Knowledgebase

 

File Submission Comparison

Selected Items
Action Item Name Version State Type Organization
Medical Claims File Submission December 1, 2010 - v2.1 Massachusetts File Specification Massachusetts Center for Health Information and Analysis (MCHIA)
Medical Claims File Submission June 7, 2013 - v3.1 Massachusetts File Specification Massachusetts Center for Health Information and Analysis (MCHIA)
Medical Claims File Submission October 1, 2014 - v4.0 Massachusetts File Specification Massachusetts Center for Health Information and Analysis (MCHIA)
File Specification: Medical Claims File Submission - December 1, 2010 - v2.1 (Massachusetts) Medical Claims File Submission - June 7, 2013 - v3.1 (Massachusetts) Medical Claims File Submission - October 1, 2014 - v4.0 (Massachusetts)
[Shared] Responsible Organization:
Massachusetts Center for Health Information and Analysis Massachusetts Center for Health Information and Analysis Massachusetts Center for Health Information and Analysis
[Shared] Definition:
A MA APCD File Type for reporting all Paid Medical Claim Lines of a given time period. File accommodates Facility, Professional, Reimbursement Forms and Replacement and Void lines. A MA APCD File Type for reporting all Paid Medical Claim Lines of a given time period. File accommodates Facility, Professional, Reimbursement Forms and Replacement and Void lines. A MA APCD File Type for reporting all Paid Medical Claim Lines of a given time period. File accommodates Facility, Professional, Reimbursement Forms and Replacement and Void lines.
File Specification: Medical Claims File Submission - December 1, 2010 - v2.1 (Massachusetts) Medical Claims File Submission - June 7, 2013 - v3.1 (Massachusetts) Medical Claims File Submission - October 1, 2014 - v4.0 (Massachusetts)
HD001
[Shared] Name: Record Type
[Shared] Type: Text
[Shared] Length: 2
Codes:
HD
 
[Shared] Name: Record Type
[Shared] Type: Text
[Shared] Length: 2
Codes:
HD
Header Elements
[Shared] Name: Record Type
[Shared] Type: Text
[Shared] Length: 2
Codes:
HD
Header Elements
HD002
[Unshared] Name: Payer
[Unshared] Type: Text
[Unshared] Length: 8
[Unshared] Name: Submitter
[Unshared] Type: Integer
[Unshared] Length: 6
[Unshared] Name: Submitter
[Unshared] Type: Integer
[Unshared] Length: 6
HD003
[Shared] Name: National Plan ID
[Unshared] Type: Text
[Unshared] Length: 30
[Shared] Name: National Plan ID
[Unshared] Type: Integer
[Unshared] Length: 10
[Shared] Name: National Plan ID
[Unshared] Type: Integer
[Unshared] Length: 10
HD004
[Shared] Name: Type of File
[Shared] Type: Text
[Shared] Length: 2
Codes:
MC
 
[Shared] Name: Type of File
[Shared] Type: Text
[Shared] Length: 2
Codes:
MC
MEDICAL CLAIM
[Shared] Name: Type of File
[Shared] Type: Text
[Shared] Length: 2
Codes:
MC
MEDICAL CLAIM
HD005
[Shared] Name: Period Beginning Date
[Unshared] Type: Date Period
[Shared] Length: 6
[Shared] Name: Period Beginning Date
[Unshared] Type: Date Period - Integer
[Shared] Length: 6
[Shared] Name: Period Beginning Date
[Unshared] Type: Date Period - Integer
[Shared] Length: 6
HD006
[Shared] Name: Period Ending Date
[Unshared] Type: Date Period
[Shared] Length: 6
[Shared] Name: Period Ending Date
[Unshared] Type: Date Period - Integer
[Shared] Length: 6
[Shared] Name: Period Ending Date
[Unshared] Type: Date Period - Integer
[Shared] Length: 6
HD007
[Shared] Name: Record Count
[Shared] Type: Integer
[Shared] Length: 10
[Shared] Name: Record Count
[Shared] Type: Integer
[Shared] Length: 10
[Shared] Name: Record Count
[Shared] Type: Integer
[Shared] Length: 10
HD008
[Shared] Name: Comments
[Shared] Type: Text
[Shared] Length: 80
[Shared] Name: Comments
[Shared] Type: Text
[Shared] Length: 80
[Shared] Name: Comments
[Shared] Type: Text
[Shared] Length: 80
HD009
Data Element: HD009
not present in this file submission.
[Unshared] Name: APCD Version Number
[Unshared] Type: Decimal - Numeric
[Unshared] Length: 3
Codes:
2.1
Prior Version; valid only for reporting periods prior to October 2013
3.0
Current Version; required for reporting periods as of October 2013
 
 
[Unshared] Name: APCD Version Number
[Unshared] Type: Decimal - Numeric
[Unshared] Length: 3
Codes:
2.1
Prior Version; valid only for reporting periods prior to October 2013
3.0
Version 3.0; required for reporting periods as of October 2013; No Longer Valid as of May 2015
4.0
Version 4.0; required for reporting periods October 2013 onward as of May 2015
MC001
[Unshared] Name: Payer
[Unshared] Type: Text
[Unshared] Length: 8
[Unshared] Name: Submitter
[Unshared] Type: Integer
[Unshared] Length: 6
[Unshared] Name: Submitter
[Unshared] Type: Integer
[Unshared] Length: 6
MC002
[Shared] Name: National Plan ID
[Unshared] Type: Text
[Unshared] Length: 30
[Shared] Name: National Plan ID
[Unshared] Type: Integer
[Unshared] Length: 10
[Shared] Name: National Plan ID
[Unshared] Type: Integer
[Unshared] Length: 10
MC003
[Shared] Name: Insurance Type Code/Product
[Unshared] Type: Text
[Shared] Length: 2
Codes:
09
Self-pay
10
Central Certification
11
Other Non-Federal Programs
12
Preferred Provider Organization (PPO)
13
Point of Service (POS)
14
Exclusive Provider Organization (EPO)
15
Indemnity Insurance
16
Health Maintenance Organization (HMO) Medicare Risk
 
 
AM
Automobile Medical
BL
Blue Cross / Blue Shield
CC
Commonwealth Care
CE
Commonwealth Choice
CH
Champus
CI
Commercial Insurance Co.
DS
Disability
HM
Health Maintenance Organization
LI
Liability
LM
Liability Medical
MA
Medicare Part A
MB
Medicare Part B
MC
Medicaid
OF
Other Federal Program
 
 
TV
Title V
VA
Veterans Administration Plan
WC
Workers' Compensation
 
 
[Shared] Name: Insurance Type Code/Product
[Unshared] Type: Lookup Table - Text
[Shared] Length: 2
Codes:
09
Self-pay
10
Central Certification
11
Other Non-Federal Programs
12
Preferred Provider Organization (PPO)
13
Point of Service (POS)
14
Exclusive Provider Organization (EPO)
15
Indemnity Insurance
16
Health Maintenance Organization (HMO) Medicare Risk
17
Dental Maintenance Organization (DMO)
AM
Automobile Medical
BL
Blue Cross / Blue Shield
CC
Commonwealth Care
CE
Commonwealth Choice
CH
Champus
CI
Commercial Insurance Co.
DS
Disability
HM
Health Maintenance Organization
LI
Liability
LM
Liability Medical
MA
Medicare Part A
MB
Medicare Part B
MC
Medicaid
OF
Other Federal Program
TF
HSN Trust Fund
TV
Title V
VA
Veterans Administration Plan
WC
Workers' Compensation
ZZ
Other
[Shared] Name: Insurance Type Code/Product
[Unshared] Type: Lookup Table - Text
[Shared] Length: 2
Codes:
09
Self-pay
10
Central Certification
11
Other Non-Federal Programs
12
Preferred Provider Organization (PPO)
13
Point of Service (POS)
14
Exclusive Provider Organization (EPO)
15
Indemnity Insurance
16
Health Maintenance Organization (HMO) Medicare Risk
17
Dental Maintenance Organization (DMO)
AM
Automobile Medical
BL
Blue Cross / Blue Shield
CC
Commonwealth Care
CE
Commonwealth Choice
CH
Champus
CI
Commercial Insurance Co.
DS
Disability
HM
Health Maintenance Organization
LI
Liability
LM
Liability Medical
MA
Medicare Part A
MB
Medicare Part B
MC
Medicaid
OF
Other Federal Program
TF
HSN Trust Fund
TV
Title V
VA
Veterans Administration Plan
WC
Workers' Compensation
ZZ
Other
MC004
[Shared] Name: Payer Claim Control Number
[Shared] Type: Text
[Shared] Length: 35
[Shared] Name: Payer Claim Control Number
[Shared] Type: Text
[Shared] Length: 35
[Shared] Name: Payer Claim Control Number
[Shared] Type: Text
[Shared] Length: 35
MC005
[Shared] Name: Line Counter
[Shared] Type: Integer
[Shared] Length: 4
[Shared] Name: Line Counter
[Shared] Type: Integer
[Shared] Length: 4
[Shared] Name: Line Counter
[Shared] Type: Integer
[Shared] Length: 4
MC005A
[Shared] Name: Version Number
[Shared] Type: Integer
[Shared] Length: 4
[Shared] Name: Version Number
[Shared] Type: Integer
[Shared] Length: 4
[Shared] Name: Version Number
[Shared] Type: Integer
[Shared] Length: 4
MC006
[Shared] Name: Insured Group or Policy Number
[Shared] Type: Text
[Shared] Length: 30
[Shared] Name: Insured Group or Policy Number
[Shared] Type: Text
[Shared] Length: 30
[Shared] Name: Insured Group or Policy Number
[Shared] Type: Text
[Shared] Length: 30
MC007
[Shared] Name: Subscriber SSN
[Unshared] Type: Text
[Shared] Length: 9
[Shared] Name: Subscriber SSN
[Unshared] Type: Numeric
[Shared] Length: 9
[Shared] Name: Subscriber SSN
[Unshared] Type: Numeric
[Shared] Length: 9
MC008
[Shared] Name: Plan Specific Contract Number
[Shared] Type: Text
[Shared] Length: 30
[Shared] Name: Plan Specific Contract Number
[Shared] Type: Text
[Shared] Length: 30
[Shared] Name: Plan Specific Contract Number
[Shared] Type: Text
[Shared] Length: 30
MC009
[Shared] Name: Member Suffix or Sequence Number
[Shared] Type: Text
[Shared] Length: 20
[Shared] Name: Member Suffix or Sequence Number
[Shared] Type: Text
[Shared] Length: 20
[Shared] Name: Member Suffix or Sequence Number
[Shared] Type: Text
[Shared] Length: 20
MC010
[Shared] Name: Member SSN
[Unshared] Type: Text
[Shared] Length: 9
[Shared] Name: Member SSN
[Unshared] Type: Numeric
[Shared] Length: 9
[Shared] Name: Member SSN
[Unshared] Type: Numeric
[Shared] Length: 9
MC011
[Shared] Name: Individual Relationship Code
[Unshared] Type: Integer
[Shared] Length: 2
Codes:
1
Spouse
4
Grandfather or Grandmother
5
Grandson or Granddaughter
7
Nephew or Niece
 
 
 
 
 
 
 
 
10
Foster Child
15
Ward
17
Stepson or Stepdaughter
19
Child
20
Self/Employee
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
[Unshared] Type: Lookup Table - Text
[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
Self/Employee
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
[Unshared] Type: Lookup Table - Text
[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
Self/Employee
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
MC012
[Shared] Name: Member Gender
[Unshared] Type: Text
[Shared] Length: 1
Codes:
F
Female
M
Male
O
Other
U
Unknown
[Shared] Name: Member Gender
[Unshared] Type: Lookup Table - Text
[Shared] Length: 1
Codes:
F
Female
M
Male
O
Other
U
Unknown
[Shared] Name: Member Gender
[Unshared] Type: Lookup Table - Text
[Shared] Length: 1
Codes:
F
Female
M
Male
O
Other
U
Unknown
MC013
[Shared] Name: Member Date of Birth
[Unshared] Type: Date
[Shared] Length: 8
[Shared] Name: Member Date of Birth
[Unshared] Type: Full Date - Integer
[Shared] Length: 8
[Shared] Name: Member Date of Birth
[Unshared] Type: Full Date - Integer
[Shared] Length: 8
MC014
[Shared] Name: Member City Name
[Shared] Type: Text
[Shared] Length: 30
[Shared] Name: Member City Name
[Shared] Type: Text
[Shared] Length: 30
[Shared] Name: Member City Name
[Shared] Type: Text
[Shared] Length: 30
MC015
[Unshared] Name: Member State or Province
[Unshared] Type: Text
[Shared] Length: 2
[Unshared] Name: Member State
[Unshared] Type: External Code Source 2 - Text
[Shared] Length: 2
[Unshared] Name: Member State
[Unshared] Type: External Code Source 2 - Text
[Shared] Length: 2
MC016
[Shared] Name: Member ZIP Code
[Unshared] Type: Text
[Unshared] Length: 11
[Shared] Name: Member ZIP Code
[Unshared] Type: External Code Source 2 - Text
[Unshared] Length: 9
[Shared] Name: Member ZIP Code
[Unshared] Type: External Code Source 2 - Text
[Unshared] Length: 9
MC017
[Shared] Name: Date Service Approved (AP Date)
[Unshared] Type: Date
[Shared] Length: 8
[Shared] Name: Date Service Approved (AP Date)
[Unshared] Type: Full Date - Integer
[Shared] Length: 8
[Shared] Name: Date Service Approved (AP Date)
[Unshared] Type: Full Date - Integer
[Shared] Length: 8
MC018
[Shared] Name: Admission Date
[Unshared] Type: Date
[Shared] Length: 8
[Shared] Name: Admission Date
[Unshared] Type: Full Date - Integer
[Shared] Length: 8
[Shared] Name: Admission Date
[Unshared] Type: Full Date - Integer
[Shared] Length: 8
MC019
[Unshared] Name: Admission Hour
[Unshared] Type: Integer
[Shared] Length: 4
[Unshared] Name: Admission Hour
[Unshared] Type: Numeric
[Shared] Length: 4
[Unshared] Name: Filler
[Unshared] Type: Filler
[Shared] Length: 4
MC020
[Shared] Name: Admission Type
[Unshared] Type: Integer
[Shared] Length: 1
[Shared] Name: Admission Type
[Unshared] Type: External Code Source 14 - Integer
[Shared] Length: 1
[Shared] Name: Admission Type
[Unshared] Type: External Code Source 14 - Integer
[Shared] Length: 1
MC021
[Shared] Name: Admission Source
[Unshared] Type: Text
[Shared] Length: 1
[Shared] Name: Admission Source
[Unshared] Type: External Code Source 14 - Text
[Shared] Length: 1
[Shared] Name: Admission Source
[Unshared] Type: External Code Source 14 - Text
[Shared] Length: 1
MC022
[Unshared] Name: Discharge Hour
[Unshared] Type: Integer
[Unshared] Length:
[Unshared] Name: Discharge Hour
[Unshared] Type: Numeric
[Unshared] Length: 4
[Unshared] Name: Filler
[Unshared] Type: Filler
[Unshared] Length: 4
MC023
[Shared] Name: Discharge Status
[Unshared] Type: Integer
[Shared] Length: 2
[Shared] Name: Discharge Status
[Unshared] Type: External Code Source 14 - Numeric
[Shared] Length: 2
[Shared] Name: Discharge Status
[Unshared] Type: External Code Source 14 - Numeric
[Shared] Length: 2
MC024
[Shared] Name: Service Provider Number
[Shared] Type: Text
[Shared] Length: 30
[Shared] Name: Service Provider Number
[Shared] Type: Text
[Shared] Length: 30
[Shared] Name: Service Provider Number
[Shared] Type: Text
[Shared] Length: 30
MC025
[Shared] Name: Service Provider Tax ID Number
[Unshared] Type: Text
[Unshared] Length: 10
[Shared] Name: Service Provider Tax ID Number
[Unshared] Type: Numeric
[Unshared] Length: 9
[Shared] Name: Service Provider Tax ID Number
[Unshared] Type: Numeric
[Unshared] Length: 9
MC026
[Unshared] Name: National Service Provider ID
[Unshared] Type: Text
[Unshared] Length: 20
[Unshared] Name: National Provider ID - Service
[Unshared] Type: External Code Source 3 - Integer
[Unshared] Length: 10
[Unshared] Name: National Provider ID - Service
[Unshared] Type: External Code Source 3 - Integer
[Unshared] Length: 10
MC027
[Shared] Name: Service Provider Entity Type Qualifier
[Unshared] Type: Integer
[Shared] Length: 1
Codes:
1
Person
2
Non-person entity
[Shared] Name: Service Provider Entity Type Qualifier
[Unshared] Type: Lookup Table - integer
[Shared] Length: 1
Codes:
1
Person
2
Non-person entity
[Shared] Name: Service Provider Entity Type Qualifier
[Unshared] Type: Lookup Table - integer
[Shared] Length: 1
Codes:
1
Person
2
Non-person entity
MC028
[Shared] Name: Service Provider First Name
[Shared] Type: Text
[Shared] Length: 25
[Shared] Name: Service Provider First Name
[Shared] Type: Text
[Shared] Length: 25
[Shared] Name: Service Provider First Name
[Shared] Type: Text
[Shared] Length: 25
MC029
[Unshared] Name: Service Provider Middle Name
[Shared] Type: Text
[Shared] Length: 25
[Unshared] Name: Service Provider Middle Initial
[Shared] Type: Text
[Shared] Length: 25
[Unshared] Name: Service Provider Middle Initial
[Shared] Type: Text
[Shared] Length: 25
MC030
[Shared] Name: Servicing Provider Last Name or Organization Name
[Shared] Type: Text
[Shared] Length: 60
[Shared] Name: Servicing Provider Last Name or Organization Name
[Shared] Type: Text
[Shared] Length: 60
[Shared] Name: Servicing Provider Last Name or Organization Name
[Shared] Type: Text
[Shared] Length: 60
MC031
[Shared] Name: Service Provider Suffix
[Unshared] Type: Text
[Unshared] Length: 10
Codes:
0
Unknown / Not Applicable
1
I.
2
II.
3
III.
4
Jr.
5
Sr.
[Shared] Name: Service Provider Suffix
[Unshared] Type: Lookup Table - Integer
[Unshared] Length: 1
Codes:
0
Unknown / Not Applicable
1
I.
2
II.
3
III.
4
Jr.
5
Sr.
[Shared] Name: Service Provider Suffix
[Unshared] Type: Lookup Table - Integer
[Unshared] Length: 1
Codes:
0
Unknown / Not Applicable
1
I.
2
II.
3
III.
4
Jr.
5
Sr.
MC032
[Unshared] Name: Service Provider Specialty
[Unshared] Type: Text
[Unshared] Length: 50
[Unshared] Name: Service Provider Taxonomy
[Unshared] Type: External Code Source 5 - Text
[Unshared] Length: 10
[Unshared] Name: Service Provider Taxonomy
[Unshared] Type: External Code Source 5 - Text
[Unshared] Length: 10
MC033
[Shared] Name: Service Provider City Name
[Shared] Type: Text
[Shared] Length: 30
[Shared] Name: Service Provider City Name
[Shared] Type: Text
[Shared] Length: 30
[Shared] Name: Service Provider City Name
[Shared] Type: Text
[Shared] Length: 30
MC034
[Shared] Name: Service Provider State
[Unshared] Type: Text
[Shared] Length: 2
[Shared] Name: Service Provider State
[Unshared] Type: External Code Source 2 - Text
[Shared] Length: 2
[Shared] Name: Service Provider State
[Unshared] Type: External Code Source 2 - Text
[Shared] Length: 2
MC035
[Shared] Name: Service Provider ZIP Code
[Unshared] Type: Text
[Unshared] Length: 11
[Shared] Name: Service Provider ZIP Code
[Unshared] Type: External Code Source 2 - Text
[Unshared] Length: 9
[Shared] Name: Service Provider ZIP Code
[Unshared] Type: External Code Source 2 - Text
[Unshared] Length: 9
MC036
[Shared] Name: Type of Bill - on Facility Claims
[Unshared] Type: Integer
[Shared] Length: 2
[Shared] Name: Type of Bill - on Facility Claims
[Unshared] Type: External Code Source 14 - Integer
[Shared] Length: 2
[Shared] Name: Type of Bill - on Facility Claims
[Unshared] Type: External Code Source 14 - Integer
[Shared] Length: 2
MC037
[Shared] Name: Site of Service - on NSF/CMS 1500 Claims
[Unshared] Type: Text
[Shared] Length: 2
[Shared] Name: Site of Service - on NSF/CMS 1500 Claims
[Unshared] Type: External Code Source 13 - Numeric
[Shared] Length: 2
[Shared] Name: Site of Service - on NSF/CMS 1500 Claims
[Unshared] Type: External Code Source 13 - Numeric
[Shared] Length: 2
MC038
[Shared] Name: Claim Status
[Unshared] Type: Integer
[Shared] Length: 2
Codes:
 
 
 
 
 
 
 
 
01
Processed as primary
02
Processed as secondary
03
Processed as tertiary
04
Denied
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
[Unshared] Type: Lookup Table - Numeric
[Shared] Length: 2
Codes:
1
Processed as primary
2
Processed as secondary
3
Processed as tertiary
4
Denied
 
 
 
 
 
 
 
 
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
23
Not our claim, forwarded to additional payer(s)
25
Predetermination Pricing Only - no payment
[Shared] Name: Claim Status
[Unshared] Type: Lookup Table - Numeric
[Shared] Length: 2
Codes:
1
Processed as primary
2
Processed as secondary
3
Processed as tertiary
4
Denied
 
 
 
 
 
 
 
 
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
23
Not our claim, forwarded to additional payer(s)
25
Predetermination Pricing Only - no payment
MC039
[Shared] Name: Admitting Diagnosis
[Unshared] Type: Text
[Shared] Length: 7
[Shared] Name: Admitting Diagnosis
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
[Shared] Name: Admitting Diagnosis
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
MC040
[Shared] Name: E-Code
[Unshared] Type: Text
[Shared] Length: 7
[Shared] Name: E-Code
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
[Shared] Name: E-Code
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
MC041
[Shared] Name: Principal Diagnosis
[Unshared] Type: Text
[Shared] Length: 7
[Shared] Name: Principal Diagnosis
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
[Shared] Name: Principal Diagnosis
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
MC042
[Shared] Name: Other Diagnosis - 1
[Unshared] Type: Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 1
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 1
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
MC043
[Shared] Name: Other Diagnosis - 2
[Unshared] Type: Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 2
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 2
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
MC044
[Shared] Name: Other Diagnosis - 3
[Unshared] Type: Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 3
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 3
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
MC045
[Shared] Name: Other Diagnosis - 4
[Unshared] Type: Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 4
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 4
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
MC046
[Shared] Name: Other Diagnosis - 5
[Unshared] Type: Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 5
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 5
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
MC047
[Shared] Name: Other Diagnosis - 6
[Unshared] Type: Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 6
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 6
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
MC048
[Shared] Name: Other Diagnosis - 7
[Unshared] Type: Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 7
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 7
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
MC049
[Shared] Name: Other Diagnosis - 8
[Unshared] Type: Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 8
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 8
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
MC050
[Shared] Name: Other Diagnosis - 9
[Unshared] Type: Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 9
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 9
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
MC051
[Shared] Name: Other Diagnosis - 10
[Unshared] Type: Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 10
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 10
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
MC052
[Shared] Name: Other Diagnosis - 11
[Unshared] Type: Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 11
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 11
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
MC053
[Shared] Name: Other Diagnosis - 12
[Unshared] Type: Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 12
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
[Shared] Name: Other Diagnosis - 12
[Unshared] Type: External Code Source 8 - Text
[Shared] Length: 7
MC054
[Unshared] Name: Revenue Code
[Unshared] Type: Text
[Unshared] Length: 10
[Unshared] Name: Revenue Code
[Unshared] Type: External Code Source 14 - Numeric
[Unshared] Length: 4
[Unshared] Name: Revenue Code
[Unshared] Type: External Code Source 14 - Numeric
[Unshared] Length: 4
MC055
[Shared] Name: Procedure Code
[Unshared] Type: Text
[Shared] Length: 10
[Shared] Name: Procedure Code
[Unshared] Type: External Code Source 9 - Text
[Shared] Length: 10
[Shared] Name: Procedure Code
[Unshared] Type: External Code Source 9 - Text
[Shared] Length: 10
MC056
[Shared] Name: Procedure Modifier - 1
[Unshared] Type: Text
[Shared] Length: 2
[Shared] Name: Procedure Modifier - 1
[Unshared] Type: External Code Source 9 - Text
[Shared] Length: 2
[Shared] Name: Procedure Modifier - 1
[Unshared] Type: External Code Source 9 - Text
[Shared] Length: 2
MC057
[Shared] Name: Procedure Modifier - 2
[Unshared] Type: Text
[Shared] Length: 2
[Shared] Name: Procedure Modifier - 2
[Unshared] Type: External Code Source 9 - Text
[Shared] Length: 2
[Shared] Name: Procedure Modifier - 2
[Unshared] Type: External Code Source 9 - Text
[Shared] Length: 2
MC058
[Unshared] Name: ICD9-CM Procedure Code
[Unshared] Type: Text
[Unshared] Length: 6
[Unshared] Name: ICD-CM Primary Procedure Code
[Unshared] Type: External Codes Source 8 - Text
[Unshared] Length: 7
[Unshared] Name: ICD-CM Primary Procedure Code
[Unshared] Type: External Codes Source 8 - Text
[Unshared] Length: 7
MC059
[Shared] Name: Date of Service - From
[Unshared] Type: Date
[Shared] Length: 8
[Shared] Name: Date of Service - From
[Unshared] Type: Full Date - Integer
[Shared] Length: 8
[Shared] Name: Date of Service - From
[Unshared] Type: Full Date - Integer
[Shared] Length: 8
MC060
[Shared] Name: Date of Service - To
[Unshared] Type: Date
[Shared] Length: 8
[Shared] Name: Date of Service - To
[Unshared] Type: Full Date - Integer
[Shared] Length: 8
[Shared] Name: Date of Service - To
[Unshared] Type: Full Date - Integer
[Shared] Length: 8
MC061
[Shared] Name: Quantity
[Unshared] Type: Integer
[Shared] Length: 15
[Shared] Name: Quantity
[Unshared] Type: Quantity - Integer
[Shared] Length: 15
[Shared] Name: Quantity
[Unshared] Type: Quantity - Integer
[Shared] Length: 15
MC062
[Shared] Name: Charge Amount
[Shared] Type: Integer
[Shared] Length: 10
[Shared] Name: Charge Amount
[Shared] Type: Integer
[Shared] Length: 10
[Shared] Name: Charge Amount
[Shared] Type: Integer
[Shared] Length: 10
MC063
[Shared] Name: Paid Amount
[Shared] Type: Integer
[Shared] Length: 10
[Shared] Name: Paid Amount
[Shared] Type: Integer
[Shared] Length: 10
[Shared] Name: Paid Amount
[Shared] Type: Integer
[Shared] Length: 10
MC064
[Shared] Name: Prepaid Amount
[Shared] Type: Integer
[Shared] Length: 10
[Shared] Name: Prepaid Amount
[Shared] Type: Integer
[Shared] Length: 10
[Shared] Name: Prepaid Amount
[Shared] Type: Integer
[Shared] Length: 10
MC065
[Shared] Name: Copay Amount
[Shared] Type: Integer
[Shared] Length: 10
[Shared] Name: Copay Amount
[Shared] Type: Integer
[Shared] Length: 10
[Shared] Name: Copay Amount
[Shared] Type: Integer
[Shared] Length: 10
MC066
[Shared] Name: Coinsurance Amount
[Shared] Type: Integer
[Shared] Length: 10
[Shared] Name: Coinsurance Amount
[Shared] Type: Integer
[Shared] Length: 10
[Shared] Name: Coinsurance Amount
[Shared] Type: Integer
[Shared] Length: 10
MC067
[Shared] Name: Deductible Amount
[Shared] Type: Integer
[Shared] Length: 10
[Shared] Name: Deductible Amount
[Shared] Type: Integer
[Shared] Length: 10
[Shared] Name: Deductible Amount
[Shared] Type: Integer
[Shared] Length: 10
MC068
[Shared] Name: Patient Control Number
[Shared] Type: Text
[Shared] Length: 20
[Shared] Name: Patient Control Number
[Shared] Type: Text
[Shared] Length: 20
[Shared] Name: Patient Control Number
[Shared] Type: Text
[Shared] Length: 20
MC069
[Shared] Name: Discharge Date
[Unshared] Type: Date
[Shared] Length: 8
[Shared] Name: Discharge Date
[Unshared] Type: Full Date - Integer
[Shared] Length: 8
[Shared] Name: Discharge Date
[Unshared] Type: Full Date - Integer
[Shared] Length: 8
MC070
[Shared] Name: Service Provider Country Code
[Unshared] Type: Text
[Shared] Length: 3
[Shared] Name: Service Provider Country Code
[Unshared] Type: External Code Source 1 - Text
[Shared] Length: 3
[Shared] Name: Service Provider Country Code
[Unshared] Type: External Code Source 1 - Text
[Shared] Length: 3
MC071
[Shared] Name: DRG
[Unshared] Type: Text
[Unshared] Length: 10
[Shared] Name: DRG
[Unshared] Type: External Code Source 15 - Text
[Unshared] Length: 7
[Shared] Name: DRG
[Unshared] Type: External Code Source 15 - Text
[Unshared] Length: 7
MC072
[Shared] Name: DRG Version
[Unshared] Type: Text
[Shared] Length: 2
[Shared] Name: DRG Version
[Unshared] Type: External Code Source 15 - Text
[Shared] Length: 2
[Shared] Name: DRG Version
[Unshared] Type: External Code Source 15 - Text
[Shared] Length: 2
MC073
[Unshared] Name: APC
[Unshared] Type: Text
[Shared] Length: 4
[Unshared] Name: APC
[Unshared] Type: External Code Source 15 - Text
[Shared] Length: 4
[Unshared] Name: Filler
[Unshared] Type: