| FileMan FileNo | FileMan Filename | Package |
|---|---|---|
| 90330 | BME MEDICAID GIS 834 HOLD | IHS Medicaid Eligibility Download |
| Package | Total | Routines |
|---|---|---|
| IHS Medicaid Eligibility Download | 2 | BME834 BME8340 |
| Field # | Name | Loc | Type | Details |
|---|---|---|---|---|
| .01 | CASE ID | 0;1 | FREE TEXT | ************************REQUIRED FIELD************************
|
| .02 | SSN | 0;2 | FREE TEXT |
|
| .03 | AHCCCS ID | 0;3 | FREE TEXT |
|
| .04 | ENROLLMENT BEGIN DATE | 0;4 | FREE TEXT |
|
| .05 | DATE OF BIRTH | 0;5 | FREE TEXT |
|
| .06 | SEX | 0;6 | FREE TEXT |
|
| .07 | RATE CODE | 0;7 | FREE TEXT |
|
| .08 | LAST NAME | 0;8 | FREE TEXT |
|
| .09 | FIRST NAME | 0;9 | FREE TEXT |
|
| .11 | MIDDLE INITIAL | 0;11 | FREE TEXT |
|
| .12 | PROCESS DATE | 0;12 | FREE TEXT |
|
| .13 | MEDICARE COVERAGE | 0;13 | FREE TEXT |
|
| .14 | COUNTY CODE | 0;14 | FREE TEXT |
|
| 1101 | HEALTH PLAN ID | 11;1 | FREE TEXT |
|
| 1102 | HEALTH PLAN NAME | 11;2 | FREE TEXT |
|
| 1103 | ETHNICITY CODE | 11;3 | FREE TEXT |
|
| 1104 | RESIDENCE ADDRESS 1 | 11;4 | FREE TEXT |
|
| 1105 | RESIDENCE ADDRESS 2 | 11;5 | FREE TEXT |
|
| 1106 | RESIDENCE CITY | 11;6 | FREE TEXT |
|
| 1107 | RESIDENCE STATE | 11;7 | FREE TEXT |
|
| 1108 | RESIDENCE ZIP | 11;8 | FREE TEXT |
|
| 1201 | MAIL ADDRESS 1 | 12;1 | FREE TEXT |
|
| 1202 | MAIL ADDRESS 2 | 12;2 | FREE TEXT |
|
| 1203 | MAIL ADDRESS CITY | 12;3 | FREE TEXT |
|
| 1204 | MAIL ADDRESS STATE | 12;4 | FREE TEXT |
|
| 1205 | MAIL ADDRESS ZIP | 12;5 | FREE TEXT |
|
| 1206 | TELEPHONE | 12;6 | FREE TEXT |
|