United States Health Information Knowledgebase

 

Ethnicity 1

ME025, New Hampshire



Name:Ethnicity 1
Data Element ID:ME025
Description:Not provided
State:New Hampshire
Data Type:Text
Length:6
HIPAA Reference Transaction Set/Loop/Segment/Qualifier/Data Element:N/A
Permissible Values: Ethnicity 1 uses the following permissible values:
Code / Value Meaning
2028-9 Asian
2029-7 Asian Indian
2033-9 Cambodian CVERDN Cape Verdean CARIBI Caribbean Island
2034-3 Chinese
2036-2 Filipino
2039-6 Japanese
2040-4 Korean
2041-2 Loatian
2047-9 Vietnamese
2058-6 African American
2060-2 African
2071-9 Haitian
2108-9 European
2118-8 Middle Eastern
2148-5 Mexican, Mexican American, Chicano
2155-0 Central American (not otherwise specified)
2157-6 Guatemalan
2158-4 Honduran
2161-8 Salvadoran
2165-9 South American (not otherwise specified)
2169-1 Columbian
2180-8 Puerto Rican
2182-4 Cuban
2184-0 Dominican
AMERCN American
BRAZIL Brazilian
EASTEU Eastern European
OTHER Other Ethnicity
PORTUG Portuguese
RUSSIA Russian
UNKNOW Unknown/Not Specified
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File Specification for Medical Eligibility File Submission - September 10, 2012

Data Element ID Data Element Description Type Format Length
HD001 Record Type Not provided Text 2
HD002 Payer Payer submitting payments NHID Submitter Code Text 8
HD003 National Plan ID CMS National Plan ID Text 30
HD004 Type of File Not provided Text 2
HD005 Period Beginning Date Beginning of paid period for claims Beginning of month covered for eligibility Integer CCYYMM 6
HD006 Period Ending Date End of paid period for claims End of month covered for eligibility Integer CCYYMM 6
HD007 Record Count Total number of records submitted in this file Integer 10
HD008 Comments Submitted may use to document this submission by assigning a filename, system source, etc. Text 80
ME001 Payer Payer submitting payments NHID Submitter Code Text 8
ME002 National Plan ID CMS National Plan ID Text 30
ME003 Insurance Type Code/Product Not provided Text 2
ME004 Year Year for which eligibility is reported in this submission Integer 4
ME005 Month Month for which eligibility is reported in this submission Integer 2
ME006 Insured Group or Policy Number Group or policy number (not the number that uniquely identifies the subscriber) Text 50
ME007 Coverage Level Code Benefit Coverage Level Text 3
ME008 Subscriber Social Security Number Subscriber's social security number (set as null if unavailable) (this data element will be de-identified by the NHpreprocessor application) Text 128
ME009 Plan Specific Contract Number Plan assigned contract number (set as null if contract number = subscriber's social security number) (this data element will be de-identified by the NHpreprocessor application) Text 128
ME010 Member Suffice or Sequence Number Uniquely numbers the member within the contract Integer 2
ME011 Member Identification Code Member's social security number (set as null if unavailable) (this data element will be de-identified by the NHpreprocessor application) Text 128
ME012 Individual Relationship Code Member's relationship to insured Integer 2
ME013 Member Gender Not provided Text 1
ME014 Member Date of Birth Not provided Date CCYYMMDD 8
ME015 Member City Name City name of member Text 30
ME016 Member State or Province As defined by the US Postal Service Text 2
ME017 Member ZIP Code ZIP Code of member - may include non-US codes. (Do not include dash) Text 11
ME018 Medical Coverage Not provided Text 1
ME019 Prescription Drug Coverage Not provided Text 1
ME020 Dental Coverage Not provided Text 1
ME021 Race 1 Not provided Text 6
ME022 Race 2 Not provided Text 6
ME023 Placeholder Not provided Not Supplied Not Supplied Not Supplied
ME024 Hispanic Indicator Not provided Text 1
ME025 Ethnicity 1 Not provided Text 6
ME026 Ethnicity 2 Not provided Text 6
ME027 Place holder Not provided 20
ME028 Primary Insurance Indicator Not provided Text 1
ME029 Coverage Type Not provided Text 3
ME030 Market Category Not provided Text 4
ME031 Special Coverage Not provided Text 3
ME032 Group Name Name of the group which the member is covered by. If the member is part of a group of one or non-group then this field shall be set as null Text 128
ME101 Subscriber Last Name (this data element will be de-identified by the NHpreprocessor application) Not provided Text 128
ME102 Subscriber First Name (this data element will be de-identified by the NHpreprocessor application) Not provided Text 128
ME103 Subscriber Middle Initial (this data element will be de- identified by the NHpreprocessor application) Not provided Text 1
ME104 Member Last Name (this data element will be de-identified by the NHpreprocessor application) Not provided Text 128
ME105 Member First Name (this data element will be de-identified by the NHpreprocessor application) Not provided Text 128
ME106 Member Middle Initial (this data element will be de-identified by the NHpreprocessor application) Not provided Text 1
ME899 Record Type Not provided Text 2
TR001 Record Type Not provided Text 2
TR002 Payer Payer submitting payments NHID Submitter Code Text 8
TR003 National Plan ID CMS National Plan ID Text 30
TR004 Type of File Not provided Text 2
TR005 Period Beginning Date Beginning of paid period for claims Beginning of month covered for eligibility Integer CCYYMM 6
TR006 Period Ending Date End of paid period for claims End of month covered for eligibility Integer CCYYMM 6
TR007 Date Processed Not provided Date CCYYMMDD 8

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