2 - Text Address Zip Report the 5 Zip Code of the member’s Member Code External Zip Code of residence as defined by the United ME 17 varchar[5] All 99% A0 ZIP Code Source Code Source the Member States Postal Service. Must not submit 2 - 2 - Zip the 9-digit Zip Code . Text Lookup Indicator - Report the value that defines the Medical ME 18 11/8/12 Table - int[1] Medical element. EXAMPLE: 1 = Yes there is All 100% A0 Coverage Integer Option Medical Coverage. Value Description 1 Yes 2 No 3 Unknown 4 5 Not Applicable Prescription Lookup Indicator - Report the value that defines the ME 19 Drug 11/8/12 Table - int[1] Pharmacy element. EXAMPLE: 1 = Yes there is All 100% A2 Coverage Integer Option Prescription Coverage. Value Description 1 Yes 2 No 3 Unknown 4 Other 5 Not Applicable Lookup Report the value that defines the Dental Indicator - ME 20 11/8/12 Table - int[1] element. EXAMPLE: 1 = Yes there is All 100% A2 Coverage Dental Option Integer Dental Coverage. Value Description 1 Yes 2 No 3 Unknown 4 Other
2 - Text ME 17 Member ZIP Code Code Source 2 - Text Address Zip External Code Source 2 - Zip varchar[5] Zip Code of the Member Report the 5 Zip Code of the member’s residence as defined by the United States Postal Service. Must not submit the 9-digit Zip Code . All 99% A0 ME 18 Medical Coverage 11/8/12 Lookup Table - Integer int[1] Indicator - Medical Option Report the value that defines the element. EXAMPLE: 1 = Yes there is Medical Coverage. All 100% A0 Value Description 1 Yes 2 No 3 Unknown 4 5 Not Applicable ME 19 Prescription Drug Coverage 11/8/12 Lookup Table - Integer int[1] Indicator - Pharmacy Option Report the value that defines the element. EXAMPLE: 1 = Yes there is Prescription Coverage. All 100% A2 Value Description 1 Yes 2 No 3 Unknown 4 Other 5 Not Applicable ME 20 Dental Coverage 11/8/12 Lookup Table - Integer int[1] Indicator - Dental Option Report the value that defines the element. EXAMPLE: 1 = Yes there is Dental Coverage. All 100% A2 Value Description 1 Yes 2 No 3 Unknown 4 Other
v6-apcd-member-eligibility-file-submission-guide-FINAL.docx