Appendix R RECIP-MULTIPLE-ID-RECORD FILE LAYOUT RECIP-MULTIPLE-ID-RECORD FIELD LEVEL FIELD NAME PICTURE START END LENGTH Format Description NUMBER 1 1 86 86 CURRENT-ID that is no longer 5 RMIR-OBSOLETE-ID 9(13) 1 1 13 13 13-digits valid ORIGINAL-ID no longer to be associated with preceding ID, but 5 9(13) 2 14 26 13 13-digits can be associated with following VALID-ID CURRENT-ID associated with 5 RMIR-VALID-ID 9(13) 3 27 39 13 13-digits Medicaid Recipient ORIGINAL-ID associated with 5 RMIR-VALID-ORIGINAL 9(13) 4 40 52 13 13-digits preceding VALID-ID INVALID or PSEUDO SSN 5 RMIR-OBSOLETE-SSN 9(9) 5 53 61 9 9-digits previously associated with Medicaid Recipient Valid SSN to be used for 5 RMIR-VALID-SSN 9(9) 6 62 70 9 9-digits identifying Medicaid Recipient Date upon which information was 5 RMIR-ADD-DATE 9(8) 7 71 78 8 yyymmdd supplied to Molina Date of last activity associated 5 RMIR-ACTIVITY-DATE 9(8) 8 79 86 8 yyymmdd with the current record End of Record Layout
Appendix R RECIP-MULTIPLE-ID-RECORD FILE LAYOUT RECIP-MULTIPLE-ID-RECORD LEVEL FIELD NAME PICTURE FIELD START END LENGTH Format Description NUMBER 1 1 86 86 5 RMIR-OBSOLETE-ID 9(13) 1 1 13 13 13-digits CURRENT-ID that is no longer valid 5 9(13) 2 14 26 13 13-digits ORIGINAL-ID no longer to be associated with preceding ID, but can be associated with following VALID-ID 5 RMIR-VALID-ID 9(13) 3 27 39 13 13-digits CURRENT-ID associated with Medicaid Recipient 5 RMIR-VALID-ORIGINAL 9(13) 4 40 52 13 13-digits ORIGINAL-ID associated with preceding VALID-ID 5 RMIR-OBSOLETE-SSN 9(9) 5 53 61 9 9-digits INVALID or PSEUDO SSN previously associated with Medicaid Recipient 5 RMIR-VALID-SSN 9(9) 6 62 70 9 9-digits Valid SSN to be used for identifying Medicaid Recipient 5 RMIR-ADD-DATE 9(8) 7 71 78 8 yyymmdd Date upon which information was supplied to Molina 5 RMIR-ACTIVITY-DATE 9(8) 8 79 86 8 yyymmdd Date of last activity associated with the current record End of Record Layout