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Claims File Control Totals File Submission

Oregon

Versions: Claims File Control Totals File Submission• Claims File Control Totals File Submission• Claims File Control Totals File Submission• Claims File Control Totals File SubmissionCompare Versions


Name:Claims File Control Totals File Submission
State:Oregon
Definition:Not Provided
Version2015.0.1

File Specification for Claims File Control Totals File Submission

Data Element ID Data Element Description Type Format Length
Multiple versionsCFCT1 Payer Payer abbreviation. Text 6
Multiple versionsCFCT2 File Not Provided Text 10
Multiple versionsCFCT3 Data_Rows Count of data rows in the submitted file Numeric 8
Multiple versionsCFCT4 Amt_Billed Sum of MC062 (medical) or PC035 (pharmacy). Two explicit decimal places. Leave blank if File is enrollment or provider Numeric 12
Multiple versionsCFCT5 Amt_Paid Sum of MC063 (medical) or PC036 (pharmacy). Two explicit decimal places. Leave blank if File is enrollment or provider Numeric 12

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Data Element ID Data Element Code Value
CFCT1 Payer AAIC ACE AMERICAN INSURANCE COMPANY
AARP AARP Medicare Rx
ACS ACS, Inc. - Healthcare Headquarters
AETNA AETNA LIFE INSURANCE COMPANY
AI A & I BENEFIT PLAN ADMINISTRATORS INC
APM Aetna Pharmacy Management (APM)
ARGUS Argus
ASHN American Specialty Health Networks
ASUR Asuris Northwest Health
ATRIO ATRIO HEALTH PLANS, INC.
BENE Benecard PBF
BIOS BioScrip
BOON BOON
CAREOR HEALTH PLAN OF CAREOREGON INC.
CATRX Catalyst Rx
CBA Cypress Benefit Administrators
CBH CIGNA Behavioral Health, Inc.
CCCRX Community CCRx
CHC CIGNA HealthCare
CIGNA CONNECTICUT GENERAL LIFE INSURANCE COMPANY
CIGNAHL CIGNA Health and Life Insurance Company
CLIC Companion Life Insurance Company
COV Coventry Healthcare
CVS CVS Caremark
CYP Cypress Care
EBMS Employee Benefit Management Services, Inc.
EHIM Employee Health Insurance Management, Inc.
ENVRXP EnvisionRx Plus
EPS Envision Pharmaceutical Services, Inc.
EXPR Express Scripts
FCARE FAMILYCARE HEALTH PLANS, INC.
FHLTH FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY
FHSC First Health Services Corporation
FOURD 4D Pharmacy Management Systems Inc.
FSNS First Script Network Services
FUTSCR FutureScripts
GPADM GROUP & PENSION ADMINISTRATORS INC
GWL GREAT-WEST LIFE & ANNUITY INSURANCE COMPANY
HARR HARRINGTON HEALTH SERVICES INC
HCC HCC LIFE INSURANCE COMPANY
HMA HEALTHCARE MANAGEMENT ADMINISTRATORS, INC.
HMIG HM LIFE INSURANCE COMPANY
HMKT HealthMarkets
HNOR HEALTH NET HEALTH PLAN OF OREGON INC.
HNOR HEALTH NET LIFE INSURANCE COMPANY
HPS Humana Pharmacy Solutions
HSPR HealthSpring Prescription Drug Plan
HTRANS HealthTrans
HUMANA HUMANA INSURANCE COMPANY
IHPBD Independent Health - Pharmacy Benefit Dimensions®
KP KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST
KROGER Kroger Prescription Plans
LDI LDI Integrated Pharmacy Services
LWAC Lifewise Assurance Company
LWH LIFEWISE HEALTH PLAN OF OREGON INC.
MAG MAGELLAN BEHAVIORAL HEALTH SYSTEMS LLC
MEDCO Medco Health Solutions, Inc.
MEDIMP MedImpact Healthcare Systems, Inc.
MEGA MEGA LIFE AND HEALTH INSURANCE COMPANY
MHN MHN SERVICES
MPCHPA Marion Polk Community Health Plan Advantage
MRIPA MID ROGUE HEALTH PLAN, INC.
MYMAT myMatrixx
NOVO NovoLogix
ODS MODA Health (formerly ODS Health Plan Inc.)
OMIP OMIP (c/o REGENCE BLUECROSS BLUESHIELD OF OREGON)
PABM PharmAvail Benefit Management
PBMP PBM Plus, Inc.
PENN Pennsylvania Life Insurance Company
PRESOL Prescription Solutions
PRIME Prime Therapeutics
PRIN PRINCIPAL LIFE INSURANCE COMPANY
PRORX ProCare Rx PBM
PROV PROVIDENCE HEALTH PLAN
PRX Partners Rx
PSADM PACIFICSOURCE ADMINISTRATORS INC
PSCHP Pacific Source Community Health Plans, Inc.
PSHP PACIFICSOURCE HEALTH PLANS
PTI PTI - National Pharmaceutical Services
REG REGENCE BLUECROSS BLUESHIELD OF OREGON
REG REGENCE LIFE AND HEALTH INSURANCE COMPANY
REGRX RegenceRx
RESTAT RESTAT LLC Prescription Benefit Managers
RPHRX Ramsell Public Health Rx
RXAMER RxAmerica
RXMPSS RxMPSS
SAM SAMARITAN HEALTH PLANS, INC.
SHASTA SHASTA ADMINISTRATIVE SVCS INC
SLVR SilverScript Ins. Co
SPHX Symphonix Health
SRC STRATEGIC RESOURCE COMPANY
SRVYOU Serve You Custom Prescription Management
SSAVE ScriptSave
STER Sterling Retiree Rx
SUN SUN LIFE ASSURANCE COMPANY OF CANADA
SXC SXC Health Solutions, Inc.
SYM SYMETRA LIFE INSURANCE COMPANY
TCHP TRILLIUM COMMUNITY HEALTH PLAN, INC.
TIME TIME INSURANCE COMPANY
TLIC Transamerica Life Insurance Company
TOTAL Total Script
UAIC United American Insurance Company
UHC UNITEDHEALTHCARE INSURANCE COMPANY
UHCM UHC MEDICARE ADVANTAGE
UHCOR UNITED HEALTHCARE OF OREGON INC.
UHCORM UHCOR MEDICARE ADVANTAGE
UHS United Healthcare Services, Inc.
UMR UMR INC
UNI UNIMERICA INSURANCE COMPANY
UNICARE UNICARE LIFE & HEALTH INSURANCE COMPANY
USRX US-Rx Care, LLC
USSCR US Script, Inc.
WALG Walgreens Health Initiatives
WCARE Wellcare
WELLD WellDyneRx
WEST WESTPORT INSURANCE CORPORATION
WIND Windsor Rx
CFCT2 File enrollment
medical
pharmacy
provider
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