Medicare Advantage and Prescription Drug Plans December 28 ...

Plan Communications User Guide Appendices, Version 6.3
F.14.2 Verbatim Plan Submitted Transaction on Daily Transaction Reply Report (DTRR)
Item Field Size Position Description
1 HICN 12 1-12 HICN
2 Surname 12 13-24 Beneficiary Surname
3 First Name 7 25-31 Beneficiary Given Name
4 Middle Initial 1 32 Beneficiary Middle Initial
5 Gender Code 1 33 Beneficiary Gender Identification Code
‘0’ = Unknown;
‘1’ = Male;
‘2’ = Female.
6 Date of Birth 8 34-41 YYYYMMDD Format
7 Record Type 1 42 ‘P’ = Plan submitted transaction text.
8 Contract Number 5 43-47 Plan Contract Number
9 Plan Transaction Text 300 48-347 Copy of plan submitted transaction.
10 Filler 126 348-473 Spaces
11 Transaction Accept/Reject Status Flag 1 474 ‘A’ = System accepted transaction or
‘R’ = System Rejected transaction.
12 System Assigned Transaction Tracking ID 11 475-485 System assigned request tracking ID.
13 Plan Assigned Transaction Tracking ID 15 486-500 Plan submitted batch input transaction
tracking ID.
Total Length = 500
December 28, 2012 F-89 DTRR Data File