United States Health Information Knowledgebase

 

Virginia



At A Glance

Name:Virginia
Abbreviation:VA
Title of SystemThe Virginia All-Payer Claims Database
Websitehttp://vhi.org/APCD Exit Disclaimer [vhi.org]
Who Maintains the SystemVirginia Health Information under the authority of the Virginia Department of Health
Versions:August 2013 - v1.2

Medical Claims

File Specification for Medical Claims File Submission - August 2013 - v1.2

Data Element ID Data Element Description Type Format Length
HD001 Record Type Not Provided char 2
HD002 Payer Code NAIC code (example: 12345); leave blank if not applicable varchar 8
HD003 Payer Name Not Provided varchar 75
HD004 Beginning Month Not Provided date CCYYMM 6
HD005 Ending Month Not Provided date CCYYMM 6
HD006 Record count Total number of records submitted in the medical claims file, excluding header and trailer records int 10
MC001 Payer Payer submitting payments varchar 8
MC002 National Plan ID CMS National Plan ID varchar 30
MC003 Insurance Type/Product Code Not Provided char 2
MC004 Payer Claim Control Number Must apply to the entire claim and be unique within the payer's system. varchar 35
MC005 Line Counter Line number for this service. The line counter begins with 1 and is incremented by 1 for each additional service line of a claim. tinyint 4
MC005A Version Number The version number of this claim service line. The original claim will have a version number of 0, with the next version being assigned a 1, and each subsequent version being incremented by 1 for that service line. tinyint 4
MC006 Insured Group or Policy Number Group or policy number - not the number that uniquely identifies the subscriber. varchar 30
MC007 Subscriber Social Security Number Subscriber's social security number; Set as null if unavailable varchar 9
MC008 Plan Specific Contract Number Plan assigned subscriber's contract number; Set as null if contract number = subscriber's social security number or use an alternate unique identifier such as Medicaid ID. Must be an identifier that is unique to the subscriber. varchar 128
MC009 Member Suffix or Sequence Number Unique number of the member within the contract. Must be an identifier that is unique to the member. varchar 20
MC010 Member Identification Code (patient) Member's social security number; Set as null if contract number = subscriber's social security number or use an alternate unique identifier such as Medicaid ID. Must be an identifier that is unique to the member. varchar 9
MC011 Individual Relationship Code Member's relationship to insured char 2
MC012 Member Gender Not Provided char 1
MC013 Member Date of Birth Not Provided char CCYYMMDD 8
MC014 Member City Name City name of member varchar 30
MC015 Member State or Province As defined by the US Postal Service char 2
MC016 Member ZIP Code ZIP Code of member - may include non-US codes. Plus 4 optional but desired. varchar 11
MC017 Date Service Approved/Accounts Payable Date/Actual Paid Date Not Provided char CCYYMMDD 8
MC018 Admission Date Required for all inpatient claims. char CCYYMMDD 8
MC019 Admission Hour Required for all inpatient claims. Time is expressed in military time char HHMM 4
MC020 Admission Type Required for all inpatient claims (SOURCE: National Uniform Billing Data Element Specifications) tinyint 1
MC021 Admission Source Required for all inpatient claims (SOURCE: National Uniform Billing Data Element Specifications) char 1
MC022 Discharge Hour Time expressed in military time tinyint HHMM 4
MC023 Discharge Status Required for all inpatient claims. See Lookup Table B-1.E for codes. char 2
MC024 Service Provider Number Payer assigned service provider number, preferably for the individual provider but alternately for the clinic where the service occurred. varchar 30
MC025 Service Provider Tax ID Number Federal taxpayer's identification number varchar 10
MC026 Service National Provider ID National Provider ID. This data element pertains to the entity or individual directly providing the service. varchar 20
MC027 Service Provider Entity Type Qualifier HIPAA provider taxonomy classifies provider groups (clinicians who bill as a group practice or under a corporate name, even if that group is composed of one provider) as a "person", and these shall be coded as a person. Health care claims processors shall code according to: char 1
MC028 Service Provider First Name Individual first name. Set to null if provider is a facility or organization. varchar 25
MC029 Service Provider Middle Name Individual middle name or initial. Set to null if provider is a facility or organization. varchar 25
MC030 Service Provider Last Name or Organization Name Full name of provider organization or last name of individual provider varchar 60
MC031 Service Provider Suffix Suffix to individual name. Set to null if provider is a facility or organization. The service provider suffix shall be used to capture the generation of the individual clinician (e.g., Jr., Sr., III), if applicable, rather than the clinician's degree (e.g., MD, LCSW). varchar 10
MC032 Service Provider Specialty As defined by payer. Dictionary for specialty code values must be supplied during testing. varchar 10
MC033 Service Provider City Name City name of provider - preferably practice location varchar 30
MC034 Service Provider State or Province As defined by the US Postal Service char 2
MC035 Service Provider ZIP Code ZIP Code of provider - may include non-US codes; do not include dash. Plus 4 optional but desired. varchar 11
MC036 Type of Bill - Institutional Required for institutional claims; Not to be used for professional claims. char 3
MC037 Place of Service - Professional Required for professional claims. Not to be used for institutional claims. Map where you can and default to "99" for all others. char 2
MC038 Claim Status Not Provided char 2
MC039 Admitting Diagnosis Required on all inpatient admission claims and encounters. ICD-9-CM or ICD-10-CM. Do not code decimal point. varchar 7
MC040 E-Code Describes an injury, poisoning or adverse effect. ICD-9-CM or ICD-10-CM. Do not code decimal point. varchar 7
MC041 Principal Diagnosis ICD-9-CM or ICD-10_CM. Do not code decimal point. varchar 7
MC042 Other Diagnosis - 1 ICD-9-CM or ICD-10_CM. Do not code decimal point. varchar 7
MC043 Other Diagnosis - 2 ICD-9-CM or ICD-10_CM. Do not code decimal point. varchar 7
MC044 Other Diagnosis - 3 ICD-9-CM or ICD-10_CM. Do not code decimal point. varchar 7
MC045 Other Diagnosis - 4 ICD-9-CM or ICD-10_CM. Do not code decimal point. varchar 7
MC046 Other Diagnosis - 5 ICD-9-CM or ICD-10_CM. Do not code decimal point. varchar 7
MC047 Other Diagnosis - 6 ICD-9-CM or ICD-10_CM. Do not code decimal point. varchar 7
MC048 Other Diagnosis - 7 ICD-9-CM or ICD-10_CM. Do not code decimal point. varchar 7
MC049 Other Diagnosis - 8 ICD-9-CM or ICD-10_CM. Do not code decimal point. varchar 7
MC050 Other Diagnosis - 9 ICD-9-CM or ICD-10_CM. Do not code decimal point. varchar 7
MC051 Other Diagnosis - 10 ICD-9-CM or ICD-10_CM. Do not code decimal point. varchar 7
MC052 Other Diagnosis - 11 ICD-9-CM or ICD-10_CM. Do not code decimal point. varchar 7
MC053 Other Diagnosis - 12 ICD-9-CM or ICD-10_CM. Do not code decimal point. varchar 7
MC054 Revenue Code National Uniform Billing Committee Codes. Code using leading zeroes, left justified, and four digits. char 10
MC055 Procedure Code Health Care Common Procedural Coding System (HCPCS); This includes the CPT codes of the American Medical Association. varchar 10
MC056 Procedure Modifier - 1 Procedure modifier required when a modifier clarifies/improves the reporting accuracy of the associated procedure code. char 2
MC057 Procedure Modifier - 2 Procedure modifier required when a modifier clarifies/improves the reporting accuracy of the associated procedure code. char 2
MC058 ICD-9/10-CM Principal Procedure Code Primary procedure code for this line of service. Do not code decimal point. char 7
MC059 Date of Service - From First date of service for this service line. date CCYYMMDD 8
MC060 Date of Service - Thru Last date of service for this service line. date CCYYMMDD 8
MC061 Quantity Count of services performed, which shall be set equal to one on all observation bed service lines and should be set equal to zero on all other room and board service lines, regardless of the length of stay. int 3
MC062 Charge Amount Do not code decimal point or provide any punctuation where $1,000.00 converted to 100000 Same for all financial data that follows. int 10
MC063 Paid Amount Includes any withhold amounts. Do not code decimal point. For capitated claims set to zero. int 10
MC064 Prepaid Amount For capitated services, the fee for service equivalent amount. Do not code decimal point. int 10
MC065 Co-pay Amount The preset, fixed dollar amount for which the individual is responsible. Do not code decimal point. int 10
MC066 Coinsurance Amount The dollar amount an individual is responsible for - not the percentage. Do not code decimal point. int 10
MC067 Deductible Amount Do not code decimal point. int 10
MC068 Patient Account/Control Number Number assigned by hospital varchar 20
MC069 Discharge Date Date patient discharged. Required for all inpatient claims. date CCYYMMDD 8
MC070 Service Provider Country Name Code US for United States. varchar 30
MC071 DRG Insurers and health care claims processors shall code using the CMS methodology when available. Precedence shall be given to DRGs transmitted from the hospital provider. When the CMS methodology for DRGs is not available, but the DRG system is used, the insurer shall format the DRG and the complexity level within the same field with an "A" prefix, and with a hyphen separating the DRG and the complexity level (e.g. AXXX-XX). varchar 10
MC072 DRG Version Version number of the grouper used char 2
MC073 APC Insurers and health care claims processors shall code using the CMS methodology when available. Precedence shall be given to APCs transmitted from the health care provider. char 4
MC074 APC Version Version number of the grouper used char 2
MC075 Drug Code An NDC code used only when a medication is paid for as part of a medical claim. varchar 11
MC076 Billing Provider Number Payer assigned billing provider number. This number should be the identifier used by the payer for internal identification purposes, and does not routinely change. varchar 30
MC077 National Billing Provider ID National Provider ID varchar 20
MC078 Billing Provider LastName or Organization Name Full name of provider billing organization or last name of individual billing provider. varchar 60
MC101 Subscriber Last Name Subscriber last name varchar 128
MC102 Subscriber First Name Subscriber first name varchar 128
MC103 Subscriber Middle Initial Subscriber middle initial char 1
MC104 Member Last Name Member last name varchar 128
MC105 Member First Name Member first name varchar 128
MC106 Member Middle Initial Member middle intial char 1
MC107 Member Street Address Physical street address of the covered member varchar 50
MC108 Service Provider Street Address Physical practice location street address of the provider administering the services varchar 50
MC200 ICD-9 / ICD-10 Flag The purpose of this field is to identify which code set is being utilized. char 1
MC201 ICD-9/10-CM Other Procedure Code - 1 Secondary procedure code for this line of service. Do not code decimal point. varchar 7
MC202 ICD-9/10-CM Other Procedure Code - 2 Secondary procedure code for this line of service. Do not code decimal point. varchar 7
MC203 ICD-9/10-CM Other Procedure Code - 3 Secondary procedure code for this line of service. Do not code decimal point. varchar 7
MC204 ICD-9/10-CM Other Procedure Code - 4 Secondary procedure code for this line of service. Do not code decimal point. varchar 7
MC205 ICD-9/10-CM Other Procedure Code - 5 Secondary procedure code for this line of service. Do not code decimal point. varchar 7
MC206 ICD-9/10-CM Other Procedure Code - 6 Secondary procedure code for this line of service. Do not code decimal point. varchar 7
MC207 Carrier Associated with Claim For each claim, the NAIC code of the carrier when a TPA processes claims on behalf of the carrier. Optional if all medical claims processed by data submitters acting as Third Party Administrators (TPAs) under contract to a data submitter for carved-out services are submitted by the data submitter with unified member IDs in all files. varchar 8
MC208 Carrier Plan Specific Contract Number or Subscriber/Member Social Security Number For each claim, the carrier specific contract number or subscriber/member social security number when a TPA processes claims on behalf of the carrier. Optional if all medical claims processed by data submitters acting as Third Party Administrators (TPAs) under contract to a data submitter for carved-out services are submitted by the data submitter with unified member IDs in all files. varchar 128
MC209 Practitioner Group Practice Name of group practice to which a practitioner is affiliated if different from MC078 varchar 60
MC899 Record Type Not Provided char 2
TR001 Record Type Not Provided char 2
TR002 Payer Code NAIC code (example: 12345); leave blank if not applicable varchar 8
TR003 Payer Name Not Provided varchar 75
TR004 Beginning Month Not Provided date CCYYMM 6
TR005 Ending Month Not Provided date CCYYMM 6
TR006 Extraction Date Not Provided date CCYYMMDD 8

Member Eligibility

File Specification for Member Eligibility File Submission - August 2013 - v1.2

Data Element ID Data Element Description Type Format Length
HD001 Record Type Not Provided char 2
HD002 Payer Code NAIC code (example: 12345); leave blank if not applicable varchar 8
HD003 Payer Name Not Provided varchar 75
HD004 Beginning Month Not Provided date CCYYMM 6
HD005 Ending Month Not Provided date CCYYMM 6
HD006 Record count Total number of records submitted in the medical eligibility file, excluding header and trailer records int 10
ME001 Payer Name/Code Payer submitting payments-assigned by VHI (may be multiple to support different platforms, or as required) varchar 8
ME002 National Plan ID CMS National Plan ID or NAIC varchar 30
ME003 Insurance Type Code/Product Not Provided char 2
ME004 Year 4 digit Year for which eligibility is reported in this submission int 4
ME005 Month Month for which eligibility is reported in this submission expressed numerical from 01 to 12. char 2
ME006 Insured Group or Policy Number Group or policy number - not the number that uniquely identifies the subscriber varchar 30
ME007 Coverage Level Code Benefit coverage level char 3
ME008 Subscriber Social Security Number Subscriber's social security number; Set as null if unavailable varchar 9
ME009 Plan Specific Contract Number Plan assigned subscriber's contract number; Set as null if contract number = subscriber's social security number or use an alternate unique identifier such as Medicaid ID. Must be an identifier that is unique to the subscriber. varchar 128
ME010 Member Suffix or Sequence Number Unique number of the member within the contract. Must be an identifier that is unique to the member. varchar 128
ME011 Member Identification Code Member's social security number; Set as null if contract number = subscriber's social security number or use an alternate unique identifier such as Medicaid ID. Must be an identifier that is unique to the member. varchar 9
ME012 Individual Relationship Code Member's relationship to insured. char 2
ME013 Member Gender Not Provided char 1
ME014 Member Date of Birth Not Provided char CCYYMMDD 8
ME015 Member City Name City location of member varchar 30
ME016 Member State or Province As defined by the US Postal Service char 2
ME017 Member ZIP Code ZIP Code of member - may include non-US codes. Do not include dash. Plus 4 optional but desired. varchar 11
ME018 Medical Coverage Not Provided char 1
ME019 Prescription Drug Coverage Not Provided char 1
ME020 Dental Coverage Not Provided char 1
ME021 Race 1 Not Provided varchar 6
ME022 Race 2 Not Provided varchar 6
ME023 Other Race List race if MC021or MC022 are coded as R9. varchar 15
ME024 Hispanic Indicator Not Provided char 1
ME025 Ethnicity 1 Not Provided varchar 6
ME026 Ethnicity 2 Not Provided varchar 6
ME027 Other Ethnicity List ethnicity if MC025 or MC026 are coded as OTHER. varchar 20
ME028 Primary Insurance Indicator Not Provided char 1
ME029 Coverage Type Not Provided char 3
ME030 Market Category Code Not Provided varchar 4
ME031 Special Coverage Not Provided varchar 3
ME032 Group Name Group name or IND for individual policies varchar 128
ME101 Subscriber Last Name The subscriber last name varchar 128
ME102 Subscriber First Name The subscriber first name varchar 128
ME103 Subscriber Middle Initial The subscriber middle initial char 1
ME104 Member Last Name The member last name varchar 128
ME105 Member First Name The member first name varchar 128
ME201 Member Street Address Street address of member varchar 50
ME202 Employer Name Name of the Employer, or if same as Group Name, null varchar 50
ME897 Plan Effective Date Date eligibility started for this member under this plan type. The purpose of this data element is to maintain eligibility span for each member. char CCYYMMDD 8
ME899 Record Type Not Provided char 2
TR001 Record Type Not Provided char 2
TR002 Payer Code NAIC code (example: 12345); leave blank if not applicable varchar 8
TR003 Payer Name Not Provided varchar 75
TR004 Beginning Month Not Provided date CCYYMM 6
TR005 Ending Month Not Provided date CCYYMM 6
TR006 Extraction Date Not Provided date CCYYMMDD 8

Pharmacy Claims

File Specification for Pharmacy Claims File Submission - August 2013 - v1.2

Data Element ID Data Element Description Type Format Length
HD001 Record Type Not Provided char 2
HD002 Payer Code NAIC code (example: 12345); leave blank if not applicable char 8
HD003 Payer Name Example: char 75
HD004 Beginning Month Not Provided Date CCYYMM 6
HD005 Ending Month Not Provided Date CCYYMM 6
HD006 Record count Total number of records submitted in the medical claims file, excluding header and trailer records int 10
PC001 Payer Payer submitting payments MHDO Submitter Code; MN has its own codes too varchar 8
PC002 Plan ID CMS National Plan ID or NAIC varchar 30
PC003 Insurance Type/Product Code Not Provided char 2
PC004 Payer Claim Control Number Must apply to the entire claim and be unique within the payer's system. varchar 35
PC005 Line Counter Line number for this service. The line counter begins with 1 and is incremented by 1 for each additional service line of a claim. tinyint 4
PC006 Insured Group Number Group or policy number - not the number that uniquely identifies the subscriber varchar 30
PC007 Subscriber Social Security Number Subscriber's social security number; Set as null if unavailable varchar 9
PC008 Plan Specific Contract Number Plan assigned subscriber's contract number; Set as null if contract number = subscriber's social security number or use an alternate unique identifier such as Medicaid ID. Must be an identifier that is unique to the subscriber. varchar 128
PC009 Member Suffix or Sequence Number Unique number of the member within the contract. Must be an identifier that is unique to the member. varchar 20
PC010 Member Identification Code Member's social security number; Set as null if contract number = subscriber's social security number or use an alternate unique identifier such as Medicaid ID. Must be an identifier that is unique to the member. varchar 128
PC011 Individual Relationship Code Member's relationship to insured char 2
PC012 Member Gender Not Provided char 1
PC013 Member Date of Birth Not Provided date CCYYMMDD 8
PC014 Member City Name of Residence City name of member varchar 50
PC015 Member State or Province As defined by the US Postal Service char 2
PC016 Member ZIP Code ZIP Code of member - may include non-US codes; Do not include dash. Plus 4 optional but desired. varchar 11
PC017 Date Service Approved (AP Date) date claim paid if available, otherwise set to Date Prescription Filled date CCYYMMDD 8
PC018 Pharmacy Number Payer assigned pharmacy number. AHFS number is acceptable. varchar 30
PC019 Pharmacy Tax ID Number Federal taxpayer's identification number coded with no punctuation (carriers that contract with outside PBMs will not have this) varchar 10
PC020 Pharmacy Name Name of pharmacy varchar 50
PC021 National Provider ID Number National Provider ID. This data element pertains to the entity or individual directly providing the service. varchar 20
PC022 Pharmacy Location City City name of pharmacy - preferably pharmacy location (if mail order null) varchar 30
PC023 Pharmacy Location State As defined by the US Postal Service (if mail order null) char 2
PC024 Pharmacy ZIP Code ZIP Code of pharmacy - may include non-US codes. Do not include dash. Plus 4 optional but desired (if mail order null) varchar 10
PC024A Pharmacy Country Name Code US for United States varchar 30
PC025 Claim Status Not Provided char 2
PC026 Drug Code NDC Code varchar 11
PC027 Drug Name Text name of drug varchar 80
PC028 New Prescription or Refill Provide '01' for new prescriptions; for refills, provide the refill number varchar 2
PC029 Generic Drug Indicator Not Provided char 2
PC030 Dispensed as Written Code Payers able to map available codes to those listed below char 1
PC031 Compound Drug Indicator Not Provided char 1
PC032 Date Prescription Filled Not Provided date CCYYMMDD 8
PC033 Quantity Dispensed Number of metric units of medication dispensed int 5
PC034 Days Supply Estimated number of days the prescription will last int 3
PC035 Charge Amount Do not code decimal point or provide any punctuation where $1,000.00 converted to 100000 Same for all financial data that follows. int 10
PC036 Paid Amount Includes all health planpayments and excludes all member payments. Do not code decimal point. int 10
PC037 Ingredient Cost/List Price Cost of the drug dispensed. Do not code decimal point. int 10
PC038 Postage Amount Claimed Do not code decimal point. Not typically captured. int 10
PC039 Dispensing Fee Do not code decimal point. int 10
PC040 Co-pay Amount The preset, fixed dollar amount for which the individual is responsible. Do not code decimal point. int 10
PC041 Coinsurance Amount The dollar amount an individual is responsible for - not the percentage. Do not code decimal point. int 10
PC042 Deductible Amount Do not code decimal point. int 10
PC043 Unassigned Reserved for assignment Not Supplied Not Supplied Not Supplied
PC044 Prescribing Physician First Name Physician first name. varchar 25
PC045 Prescribing Physician Middle Name Physician middle name or initial. varchar 25
PC046 Prescribing Physician Last Name Physician last name. varchar 60
PC047 Prescribing Physician Number DEA or NPI number for prescribing physician varchar 20
PC101 Subscriber Last Name Not Provided varchar 128
PC102 Subscriber First Name Not Provided varchar 128
PC103 Subscriber Middle Initial Not Provided char 1
PC104 Member Last Name Not Provided varchar 128
PC105 Member First Name Not Provided varchar 128
PC106 Member Middle Initial Not Provided char 1
PC201 Pharmacy Location Street Address Street address of pharmacy varchar 30
PC202 Member Street Address Street address of member varchar 50
PC203 Carrier Associated with Claim For each claim, the NAIC code of the carrier when a PBM processes claims on behalf of the carrier. Optional if all pharmacy claims processed by data submitters acting as Pharmacy Benefits Managers (PBMs) under contract to a data submitter for carved-out services are submitted by the data submitter with unified member IDs in all files. varchar 8
PC204 Carrier Plan Specific Contract Number or Subscriber/Member Social Security Number For each claim, the carrier specific contract number or subscriber/member social security number when a PBM processes claims on behalf of the carrier. Optional if all pharmacy claims processed by data submitters acting as Pharmacy Benefits Managers (PBMs) under contract to a data submitter for carved-out services are submitted by the data submitter with unified member IDs in all files. varchar 128
PC899 Record Type Not Provided char 2
TR001 Record Type Not Provided char 2
TR002 Payer Code NAIC code (example: 12345); leave blank if not applicable varchar 8
TR003 Payer Name Not Provided varchar 75
TR004 Beginning Month Not Provided Date CCYYMM 6
TR005 Ending Month Not Provided Date CCYYMM 6
TR006 Extraction Date Not Provided Date CCYYMMDD 8

Provider

File Specification for Provider File Submission - August 2013 - v1.2

Data Element ID Data Element Description Type Format Length
HD001 Record Type Not Provided char 2
HD002 Payer Code NAIC code (example: 12345); leave blank if not applicable varchar 8
HD003 Payer Name Not Provided varchar 75
HD004 Beginning Month Example: 200801 Date CCYYMM 6
HD005 Ending Month Example: 200812 Date CCYYMM 6
HD006 Record count Total number of records submitted in the medical eligibility file, excluding header and trailer records int 10
MP001 Provider ID Unique identified for the provider as assigned by the reporting entity varchar 30
MP002 Provider Tax ID Tax ID of the provider. Do not code punctuation. varchar 10
MP003 Provider Entity Not Provided char 1
MP004 Provider First Name Individual first name. Set to null if provider is a facility or organization. varchar 25
MP005 Provider Middle Name or Initial Not Provided varchar 25
MP006 Provider Last Name or Organization Name Full name of provider organization or last name of individual provider varchar 60
MP007 Provider Suffix Example: Jr;null if provider is an organization. Do not use credentials such as MD or PhD varchar 10
MP008 Provider Specialty Report the HIPAA-compliant health care provider taxonomy code. Code set is freely available at the National Uniform Claims Committee's web site http://www.nucc.org/ varchar 50
MP009 Provider Office Street Address Physical address - address where provider delivers health care services varchar 50
MP010 Provider Office City Physical address - address where provider delivers health care services varchar 30
MP011 Provider Office State Physical address - address where provider delivers health care services. Use postal service standard 2 letter abbreviations. char 2
MP012 Provider Office Zip Physical address - address where provider delivers health care services. Minimum 5 digit code. varchar 11
MP013 Provider DEA Number Not Provided varchar 12
MP014 Provider NPI Not Provided varchar 20
MP015 Provider State License Number Prefix with two-character state of licensure with no punctuation. Example COLL12345 varchar 15
MP899 Record Type Not Provided char 2
TR001 Record Type Not Provided char 2
TR002 Payer Code NAIC code (example: 12345); leave blank if not applicable varchar 8
TR003 Payer Name Not Provided varchar 75
TR004 Beginning Month Example: 200801 Date CCYYMM 6
TR005 Ending Month Example: 200812 Date CCYYMM 6
TR006 Extraction Date Not Provided Date CCYYMMDD 8

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