USHIK: Standards Data Elements

Name:	Retiree Drug Subsidy
Definition:	Assists in the automation of summarized drug cost and related data transfer from one processor/pharmacy benefit manager to another processor/pharmacy benefit manager. It allows for the continuation of CMS Retiree Drug Subsidy (RDS) cost data reporting by the receiving entity for a given application ID plan year.

Select All	sort Name	sort Definition
Select 200124000	Application ID	Application ID assigned by CMS to the Plan Sponsor applying for the Retiree Drug Subsidy.
Select 200305000	Contact Person First Name	First Name of contact person.
Select 200306000	Contact Person Last Name	Last name of contact person.
Select 200335000	Creation Date	Date the file was created.
Select 200336000	Creation Time	Time the file was created.
Select 200351000	Date Of Birth	Date of birth of patient.
Select 200532000	First Name	First name.
Select 200575000	Gross Retiree Cost	Total of all Gross Retiree Costs for the retiree that is valid for Subsidy Billing.
Select 200688000	Last Name	Last name.
Select 200693000	Limit Reduction	Total limit reduction applicable to the retiree's Gross Retiree Cost.
Select 200778000	Middle Initial	Individual middle initial.
Select 201155000	Qualified Covered Retiree HICN	HIC # for each covered individual whom the RDS Plan Sponsor is seeking the subsidy.
Select 201156000	Qualified Covered Retiree SSN	Social Security Number for each covered individual whom the RDS Plan Sponsor is seeking the subsidy.
Select 201215000	Record Type	Type of record being submitted.
Select 201297000	Sender ID	An identification number assigned to the sender of the data by the processor/receiver of the data.
Select 201303000	Sending Entity Identifier	Party creating the data enclosed or the entity for whom the data is being enclosed.
Select 201381000	Telephone Number	Telephone number.
Select 201383000	Telephone Number Extension	Extension of the telephone number.
Select 201397000	Threshold Reduction	Total threshold reduction applicable to the retiree's Gross Retiree Cost.
Select 201423000	Total Record Count	Total number of records being submitted, including header and trailer.
Select 201461000	Unique Benefit Option Identifier	Retiree Drug Subsidy Plan Sponsor-assigned ID to identify a specific benefit design.
Select 201490000	Version/Release Number	Code uniquely identifying the transmission syntax and corresponding Data Dictionary.

Select 200124000

Application ID

Application ID assigned by CMS to the Plan Sponsor applying for the Retiree Drug Subsidy.

Select 200305000

Contact Person First Name

First Name of contact person.

Select 200306000

Contact Person Last Name

Last name of contact person.

Select 200335000

Creation Date

Date the file was created.