EXAMPLE: 150.00 is reported as 15000; 150.70 is reported as 15070 Report the maximum amount of the member / subscriber’s deductible that is applied to services before certain medical and / or prescriptions are Maximum out covered. This element should be filled of pocket in when the deductible is not strictly Medical Required amount of based on medical or strictly on and when both ME 96 11/8/12 Integer Currency varchar[10] member's pharmacy out of pocket costs, but on 90% A2 113 Pharmacy and deductible the combination of the two. Report 0 Deductible ME019 = 1 applied to when there is no deductible for this services combined benefit. Do not code decimal or round up / down to whole dollars, code zero cents (00) when applicable. EXAMPLE: 150.00 is reported as 15000; 150.70 is reported as 15070 Report the maximum amount of the Maximum out member / subscriber’s deductible that is of pocket applied to behavioral health services amount of before certain behavioral health Behavioral Required member's services are covered. Report 0 if there ME 97 Health 11/8/12 Integer Currency varchar[10] when ME051 90% A2 114 deductible is no deductible. Do not code decimal or Deductible = 1 applied to round up / down to whole dollars, code behavioral zero cents (00) when applicable. health EXAMPLE: 150.00 is reported as 15000; 150.70 is reported as 15070 Report the maximum amount of the Maximum out member / subscriber's deductible that is of pocket applied to dental services before certain amount of dental services are covered. Report 0 Required Dental member's when there is no deductible for this ME 98 11/8/12 Integer Currency varchar[10] when ME020 98% A2 Deductible deductible benefit. Do not code decimal or round = 1 applied to up / down to whole dollars, code zero dental cents (00) when applicable. EXAMPLE: services 150.00 is reported as 15000; 150.70 is reported as 15070
EXAMPLE: 150.00 is reported as 15000; 150.70 is reported as 15070 ME 96 Medical and Pharmacy Deductible 11/8/12 Integer Currency varchar[10] Maximum out of pocket amount of member's deductible applied to services Report the maximum amount of the member / subscriber’s deductible that is applied to services before certain medical and / or prescriptions are covered. This element should be filled in when the deductible is not strictly based on medical or strictly on pharmacy out of pocket costs, but on the combination of the two. Report 0 when there is no deductible for this combined benefit. Do not code decimal or round up / down to whole dollars, code zero cents (00) when applicable. EXAMPLE: 150.00 is reported as 15000; 150.70 is reported as 15070 Required when both and ME019 = 1 90% A2 ME 97 Behavioral Health Deductible 11/8/12 Integer Currency varchar[10] Maximum out of pocket amount of member's deductible applied to behavioral health Report the maximum amount of the member / subscriber’s deductible that is applied to behavioral health services before certain behavioral health services are covered. Report 0 if there is no deductible. Do not code decimal or round up / down to whole dollars, code zero cents (00) when applicable. EXAMPLE: 150.00 is reported as 15000; 150.70 is reported as 15070 Required when ME051 = 1 90% A2 ME 98 Dental Deductible 11/8/12 Integer Currency varchar[10] Maximum out of pocket amount of member's deductible applied to dental services Report the maximum amount of the member / subscriber's deductible that is applied to dental services before certain dental services are covered. Report 0 when there is no deductible for this benefit. Do not code decimal or round up / down to whole dollars, code zero cents (00) when applicable. EXAMPLE: 150.00 is reported as 15000; 150.70 is reported as 15070 Required when ME020 = 1 98% A2 113 114