Common use of The Input and Response File Data Layouts Clause in Contracts

The Input and Response File Data Layouts. A. The PAP Input File: This is the data set transmitted from a PAP partner to the COBC on a monthly basis. It is used to report information regarding PAP enrollees – individuals who are eligible for and enrolled in a PAP and receive pharmaceutical coverage through such a plan. Full file replacement is the method used to update eligibility files. Each month’s transmitted file will fully replace the previous month’s file. The business rules for use of the PAP Input File immediately follow the data file layout itself. 1. SSN 9 1-9 Numeric Social Security Number. If unavailable, fill with spaces. 2. HICN 12 10-21 Alpha-Numeric Medicare Health Insurance Claim Number (HICN). Required if SSN not provided. If unavailable, fill with spaces. 3. Surname 6 22-27 Text Surname of Covered Individual – Required. 4. First Initial 1 28-28 Text First Initial of Covered Individual – Required. 5. DOB 8 29-36 Date Date of Birth of Covered Individual – Required. CCYYMMDD 6. Sex Code 1 37-37 Numeric Sex of Covered Individual – Required. 0: Unknown 1: Male 2: Female 7. Effective Date 8 38-45 Date Effective Date of PAP Coverage – Required. CCYYMMDD 8. Termination Date* 8 46-53 Date Termination Date of PAP Coverage – Required. CCYYMMDD *Use all zeros if open-ended 9. N-Plan ID 10 54-63 Filler Future use; for National Health Plan Identifier. Fill with spaces only. 10. Rx ID/Policy Number 20 64-83 Text Populate this field with all 9s. Required.

The Input and Response File Data Layouts. A. The PAP Input File: This is the data set dataset transmitted from a PAP partner to the COBC on a monthly basis. It is used to report information regarding PAP enrollees – individuals who are eligible for and enrolled in a PAP and receive pharmaceutical coverage through such a plan. Full file replacement is the method used to update eligibility files. Each month’s transmitted file will fully replace the previous month’s file. The business rules for use of the PAP Input File immediately follow the data file layout itself. 1. SSN 9 1-9 Numeric Social Security NumberNumber – Required. If unavailable, fill with spaces. 2. HICN 12 10-21 Alpha-Numeric Medicare Health Insurance Claim Number (HICN). Required if SSN not provided. If unavailable, fill with spaces. 3. Surname 6 22-27 Text Surname of Covered Individual – Required. 4. First Initial 1 28-28 Text First Initial of Covered Individual – Required. 5. DOB 8 29-36 Date Date of Birth of Covered Individual – Required. CCYYMMDD 6. Sex Code 1 37-37 Numeric Sex of Covered Individual – Required. 0: Unknown 1: Male 2: Female 7. Effective Date 8 38-45 Date Effective Date of PAP Coverage – Required. CCYYMMDD 8. Termination Date* 8 46-53 Date Termination Date of PAP Coverage – Required. CCYYMMDD *Use all zeros if open-ended 9. N-Plan ID 10 54-63 Filler Future use; for National Health Plan Identifier. Fill with spaces only. 10. Rx ID/Policy Number 20 64-83 Text Populate this field with all 9s. Required.

The Input and Response File Data Layouts. A. The PAP Input File: This is the data set transmitted from a PAP partner to the COBC on a monthly basis. It is used to report information regarding PAP enrollees – individuals who are eligible for and enrolled in a PAP and receive pharmaceutical coverage through such a plan. Full file replacement is the method used to update eligibility files. Each month’s month‟s transmitted file will fully replace the previous month’s month‟s file. The business rules for use of the PAP Input File immediately follow the data file layout itself. 1. SSN 9 1-9 Numeric Social Security Number. If unavailable, fill with spaces. 2. HICN 12 10-21 Alpha-Numeric Medicare Health Insurance Claim Number (HICN). Required if SSN not provided. If unavailable, fill with spaces. 3. Surname 6 22-27 Text Surname of Covered Individual – Required. 4. First Initial 1 28-28 Text First Initial of Covered Individual – Required. 5. DOB 8 29-36 Date Date of Birth of Covered Individual – Required. CCYYMMDD 6. Sex Code 1 37-37 Numeric Sex of Covered Individual – Required. 0: Unknown 1: Male 2: Female 7. Effective Date 8 38-45 Date Effective Date of PAP Coverage – Required. CCYYMMDD 8. Termination Date* 8 46-53 Date Termination Date of PAP Coverage – Required. CCYYMMDD *Use all zeros if open-ended 9. N-Plan ID 10 54-63 Filler Future use; for National Health Plan Identifier. Fill with spaces only. 10. Rx ID/Policy Number 20 64-83 Text Populate this field with all 9s. Required.