Medicare Advantage and Prescription Drug Plans December 28 ...

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Plan Communications User Guide Appendices, Version 6.3 Item Field Position Leng th Type Description 37 Part B Fee Amount 61-73 13 Numeric Fee Assessed for Part B Format: SSSSSSSSS9.99 38 NMEC Part D Subject to Fee 74-86 13 Numeric Part D amount subject to National Medicare Educational Campaign fees. Format: ZZZZZZZZZ9.99 39 NMEC Part D Rate 87-93 7 Numeric Rate used to calculate the fees for Part D. Format: 0.99999 40 Part D Fee Amount 94-106 13 Numeric Fee Assessed for Part D Format: SSSSSSSSS9.99 41 Total NMEC Fee Assessed 107- 119 13 Numeric Total NMEC Fee Assessed for Part A, B and D Format: SSSSSSSSS9.99 42 Total Prospective Part D Members 43 Rate for COB Fees 44 Amount of COB Fees 45 Total of Assessed Fees 120- 127 8 Numeric Total members for Part D Format: ZZZZZZZ9 128- 131 4 Numeric Rate used to calculate the COB fees. Format: 0.99 132- 144 13 Numeric COB Fee Format: SSSSSSSSS9.99 145- 157 13 Numeric Total of all Fees Assessments Format: SSSSSSSSS9.99 46 Filler 158- 200 43 Character Spaces Total Length = 200 F.25.5 Special Adjustments Item Field Position Length Type Description 47 Contract 1 – 5 5 Character Contract Number Number 48 Record Identification 6 – 6 1 Character Record Type Identifier S = Special Adjustments Code 49 Table ID 7 – 7 1 Character 4 Number 50 Document ID 8 – 15 8 Numeric The document ID for identifying the adjustment. 51 Source 16-20 5 Character The CMS division responsible for initiating the adjustments. 52 Description 21 – 70 50 Character The reason the adjustment was made. 53 Type 71 – 90 20 Character The payment component the adjustment is for: • CGD=Coverage Gap Discount Invoice • CMP=Civil Monetary Penalty • CST=Cost Plan Adjustment • PTD=Part D Risk Adjustment • PRS=Annual Part D Reconciliation • RAC=Recovery Audit Contract Adjustment • RSK=Risk Adjustment • HTC=HITECH Incentive Payment • OTH=default non-specific group. December 28, 2012 F-132 PPR/IPPR Data File
Plan Communications User Guide Appendices, Version 6.3 Item Field Position Length Type Description 54 Adjustment to Part A 55 Adjustment to Part B 56 Adjustment to Part D or Adjustment to HITECH Incentive Payment 57 Premium C Withholding Part A 58 Premium C Withholding Part B 59 Premium D Withholding 60 Part D Low Income Premium Subsidy 61 Total Adjustment Amount 91 – 103 13 Numeric Adjustment amount for Part A Format: SSSSSSSSS9.99 104 – 116 13 Numeric Adjustment amount for Part B Format: SSSSSSSSS9.99 117 – 129 13 Numeric Adjustment amount for HITECH Incentive Payment when the adjustment type in data item 53 is “HTC”. The adjustment amount is for Part D for the rest of the types. Format: SSSSSSSSS9.99 130 - 142 13 Numeric Adjustment amount for Premium Withholding Part A. Format: SSSSSSSSS9.99 143 – 155 13 Numeric Adjustment amount for Premium Withholding Part B. Format: SSSSSSSSS9.99 156 – 168 13 Numeric Adjustment amount for Premium D Withholding. Format: SSSSSSSSS9.99 169 - 181 13 Numeric Adjustment amount for Low Income Subsidy. Format: SSSSSSSSS9.99 182 – 194 13 Numeric Total Adjustments Format: SSSSSSSSS9.99 62 Filler 195 – 200 6 Character Spaces Total Length = 200 F.25.6 Previous Cycle Balance Summary Item Field Position Length Type Description 63 Contract Number 1 – 5 5 Character Contract Number 64 Record Identification Code 6 – 6 1 Character Record Type Identifier L = Last Period Carry Over Amounts carried over to this month from previous months 65 Table ID Number 7 – 7 1 Character 5 66 Part A Carry Over Amount 67 Part B Carry Over Amount 68 Part D Carry Over Amount 8 – 20 13 Numeric Part A Carry Over Amount from Table 5 ** - Previous Balance Column. Format: SSSSSSSSS9.99 21 – 33 13 Numeric Part B Carry Over Amount from Table 5 ** - Previous Balance Column. Format: SSSSSSSSS9.99 34 – 46 13 Numeric Part D Carry Over Amount from Table 5 ** - Previous Balance Column. Format: SSSSSSSSS9.99 December 28, 2012 F-133 PPR/IPPR Data File
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I.3 Obsolete Transaction Reply Code
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CMS Transmittals to the Plans Plan
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ID# Transmittal Monthly Transmittal
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Medicare Advantage and Prescription Drug Plans December 28 ...

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