Medicare Advantage and Prescription Drug Plans December 28 ...
Medicare Advantage and Prescription Drug Plans December 28 ...
Medicare Advantage and Prescription Drug Plans December 28 ...
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Plan Communications User Guide Appendices, Version 6.3<br />
F.9 Monthly Membership Summary Data File .......................................................................... F-44<br />
F.10 Monthly Premium Withholding Report Data File (MPWR) ............................................. F-47<br />
F.10.1 Header Record .................................................................................................. F-47<br />
F.10.2 Detail Record .................................................................................................... F-48<br />
F.10.3 Trailer Record .................................................................................................. F-49<br />
F.11 Part B Claims Data File ..................................................................................................... F-50<br />
F.11.1 Record Type 1 .................................................................................................. F-50<br />
F.11.2 Record Type 2 .................................................................................................. F-51<br />
F.12 Part C Risk Adjustment Model Output Data File .............................................................. F-52<br />
F.12.1 Header Record .................................................................................................. F-52<br />
F.12.2 Detail Record Type A ...................................................................................... F-52<br />
F.12.3 Detail Record Type B ....................................................................................... F-60<br />
F.12.4 Trailer Record .................................................................................................. F-70<br />
F.13 Risk Adjustment System (RAS) <strong>Prescription</strong> <strong>Drug</strong> Hierarchical Condition Category<br />
(RxHCC) Model Output Data File - aka Part D RA Model Output Data File ............ F-71<br />
F.13.1 Header Record .................................................................................................. F-71<br />
F.13.2 Detail/Beneficiary Record ................................................................................ F-71<br />
F.13.3 Trailer Record .................................................................................................. F-80<br />
F.14 Daily Transaction Reply Report (DTRR) Data File .......................................................... F-81<br />
F.14.1 DTRR Data File Detailed Record Layout ........................................................ F-81<br />
F.14.2 Verbatim Plan Submitted Transaction on Daily Transaction Reply Report<br />
(DTRR) ....................................................................................................... F-89<br />
F.15 Monthly Full Enrollment Data File ................................................................................... F-90<br />
F.16 LIS/LEP Data File ............................................................................................................. F-92<br />
F.16.1 Header Record .................................................................................................. F-92<br />
F.16.2 Detail Record .................................................................................................... F-92<br />
F.17 Loss of Subsidy Data File .................................................................................................. F-95<br />
F.17.1 Loss of Subsidy Data File Detail Record ......................................................... F-95<br />
F.18 LIS/Part D Premium Data File .......................................................................................... F-97<br />
F.19 LIS History Data File (LISHIST) ...................................................................................... F-98<br />
F.19.1 Header Record .................................................................................................. F-98<br />
F.19.2 Detail Record (Transaction) ............................................................................. F-99<br />
F.19.3 Trailer Record ................................................................................................ F-101<br />
F.20 NoRx File......................................................................................................................... F-102<br />
F.20.1 Header Record ................................................................................................ F-102<br />
F.20.2 Detail Record .................................................................................................. F-103<br />
F.20.3 Trailer Record ................................................................................................ F-105<br />
F.21 Batch Eligibility Query (BEQ) Request File ................................................................... F-106<br />
F.21.1 Header Record ................................................................................................ F-106<br />
F.21.2 Detail Record (Transaction) ........................................................................... F-107<br />
F.21.3 Trailer Record ................................................................................................ F-108<br />
<strong>December</strong> <strong>28</strong>, 2012 vi Table of Contents