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 |
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1103 | ETHNICITY CODE | 11;3 | FREE TEXT |
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1104 | RESIDENCE ADDRESS 1 | 11;4 | FREE TEXT |
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1105 | RESIDENCE ADDRESS 2 | 11;5 | FREE TEXT |
|
1106 | RESIDENCE CITY | 11;6 | FREE TEXT |
|
1107 | RESIDENCE STATE | 11;7 | FREE TEXT |
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1108 | RESIDENCE ZIP | 11;8 | FREE TEXT |
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1201 | MAIL ADDRESS 1 | 12;1 | FREE TEXT |
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1202 | MAIL ADDRESS 2 | 12;2 | FREE TEXT |
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1203 | MAIL ADDRESS CITY | 12;3 | FREE TEXT |
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1204 | MAIL ADDRESS STATE | 12;4 | FREE TEXT |
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1205 | MAIL ADDRESS ZIP | 12;5 | FREE TEXT |
|
1206 | TELEPHONE | 12;6 | FREE TEXT |
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