Medicare Advantage and Prescription Drug Plans December 28 ...

Plan Communications User Guide Appendices, Version 6.3
Item Field Size Position Comment Description
account number is a 12-byte
account number.
3
Beneficiary Last
Name
12 14-25 First 12 bytes of the
Bene Last Name
Beneficiary Last Name
4
Beneficiary First
Name
7 26-32 First 7 bytes of the bene
First Name
Beneficiary First Name
5 Beneficiary Initial 1 33 1-byte Initial Beneficiary Initial
6
Date of Birth 8 34-41 Formatted as yyyymmdd The date of birth of the Medicare
Beneficiary
7
Sex 1 42 0=unknown, 1=male, Represents the sex of the
2=female
Medicare Beneficiary. Examples
include Male and Female.
8
9
10
11
12
13
14
15
16
17
Social Security
Number
Age Group
Female0_34
Age Group
Female35_44
Age Group
Female45_54
Age Group
Female55_59
Age Group
Female60_64
Age Group
Female65_69
Age Group
Female70_74
Age Group
Female75_79
Age Group
Female80_84
9 43-51 Also known as
SSN_NUM
1 52 Set to “1” if applicable,
otherwise "0"
1 53 Set to “1” if applicable,
otherwise "0"
1 54 Set to “1” if applicable,
otherwise "0"
1 55 Set to “1” if applicable,
otherwise "0"
1 56 Set to “1” if applicable,
otherwise "0"
1 57 Set to “1” if applicable,
otherwise "0"
1 58 Set to “1” if applicable,
otherwise "0"
1 59 Set to “1” if applicable,
otherwise "0"
1 60 Set to “1” if applicable,
otherwise "0"
The beneficiary's current
identification number that was
assigned by the Social Security
Administration
The sex and age group for the
beneficiary based on a given as of
date: female between ages 0 and
34, inclusive
The sex and age group for the
beneficiary based on a given as of
date: female between ages 35 and
44, inclusive
The sex and age group for the
beneficiary based on a given as of
date: female between ages 45 and
54, inclusive
The sex and age group for the
beneficiary based on a given as of
date: female between ages 55 and
59, inclusive
The sex and age group for the
beneficiary based on a given as of
date: female between ages 60 and
64, inclusive
The sex and age group for the
beneficiary based on a given as of
date: female between ages 65 and
69, inclusive
The sex and age group for the
beneficiary based on a given as of
date: female between ages 70 and
74, inclusive
The sex and age group for the
beneficiary based on a given as of
date: female between ages 75 and
79, inclusive
The sex and age group for the
beneficiary based on a given as of
date: female between ages of 80
December 28, 2012 F-53 Part C Risk Adjustment Model Output
Data File