Appendix T THIRD PARTY LIABILITY (TPL) FILE LAYOUT to MAGELLAN (Incremental and full reconciliation files) DataBase Name: EB-RECIPIENT-HEADER Location: File Extract Column Name or Field Data Columns Length Accepted Values Description name Type RECIP-ID-CURRENT 13 Numeric 13-digit Medicaid Recipient The current Medicaid ID number recipient’s 1-13 ID number RECIP-ID-ORIGINAL 13 Numeric 13-digit Medicaid Recipient The original Medicaid ID number recipient’s 14-26 ID number RECIP-HIC 12 CHAR SSOC CLAIM BENEFITS(HIC) NUMBER 27-38 RECIP-SSN 9 Numeric 39-47 RECIP-LAST-NAME 12 CHAR 48-59 RECIP-FIRST-NAME 12 CHAR 60-71 RECIP-MID-INITIAL 1 CHAR 72-72 RECIP-RECIP-TITLE 3 CHAR 73-75 RECIP-RECIP-SUFFIX 3 CHAR 76-78 12 CHAR 79-90 12 CHAR 91-102 1 CHAR 103-103 RECIP-ADDR-LN1 25 CHAR Street Address 104-128 RECIP-ADDR-LN2 25 CHAR Street Address, additional if necessary 129-153 RECIP-CITY 18 CHAR 154-171 RECIP-STATE 2 CHAR Uses USPS Standard State 172-173 Abbreviation RECIP-ZIP-CODE 9 Numeric 9-digit USPS code 174-182 RECIP-BIRTH-DATE 8 Numeric Format YYYYMMDD The DOB 183-190 recipient’s RECIP-SEX 1 CHAR 1=Male, 2=Female, 191-191 9=Unknown.
Appendix T THIRD PARTY LIABILITY (TPL) FILE LAYOUT to MAGELLAN (Incremental and full reconciliation files) DataBase Name: EB-RECIPIENT-HEADER Location: File Extract Column Name or Field name Columns Length Data Type Accepted Values Description RECIP-ID-CURRENT 1-13 13 Numeric 13-digit Medicaid Recipient ID number The recipient’s current Medicaid ID number RECIP-ID-ORIGINAL 14-26 13 Numeric 13-digit Medicaid Recipient ID number The recipient’s original Medicaid ID number RECIP-HIC 27-38 12 CHAR SSOC CLAIM BENEFITS(HIC) NUMBER RECIP-SSN 39-47 9 Numeric RECIP-LAST-NAME 48-59 12 CHAR RECIP-FIRST-NAME 60-71 12 CHAR RECIP-MID-INITIAL 72-72 1 CHAR RECIP-RECIP-TITLE 73-75 3 CHAR RECIP-RECIP-SUFFIX 76-78 3 CHAR 79-90 12 CHAR 91-102 12 CHAR 103-103 1 CHAR RECIP-ADDR-LN1 104-128 25 CHAR Street Address RECIP-ADDR-LN2 129-153 25 CHAR Street Address, additional if necessary RECIP-CITY 154-171 18 CHAR RECIP-STATE 172-173 2 CHAR Uses USPS Standard State Abbreviation RECIP-ZIP-CODE 174-182 9 Numeric 9-digit USPS code RECIP-BIRTH-DATE 183-190 8 Numeric Format YYYYMMDD The recipient’s DOB RECIP-SEX 191-191 1 CHAR 1=Male, 2=Female, 9=Unknown.
PIHP_CSoC_SystemsCompanionGuide-Sept2018_V12.docx