CMS National Do not report any value here until Plan National PlanID is fully implemented. National PC 2 11/8/12 Integer ID Nat'l PlanID int[10] Identification This is a unique identifier as outlined by All 0% Z Plan ID Number Centers for Medicare and Medicaid (PlanID) Services (CMS) for Plans or Sub plans Insurance Report the code that defines the type of Lookup Type / Product Type insurance which this patient's claim PC 3 Table - char[2] Identification All 95% A2 line was processed. EXAMPLE: HM = Text Code HMO Code Description 09 Self-pay 10 Central Certification 11 Other Non-Federal Programs 12 Preferred Provider Organization (PPO) 13 Point of Service (POS) 14 Exclusive Provider Organization (EPO) 15 Indemnity Insurance Health Maintenance Organization (HMO) 16 Medicare Risk 17 Dental Maintenance Organization (DMO) AM Automobile Medical BL Blue / Blue Shield CC Commonwealth Care CE Commonwealth Choice CH Champus CI Commercial Insurance Co. DS Disability HM Health Maintenance Organization LI Liability LM Liability Medical MA Medicare Part A MB Medicare Part B MC Medicaid OF Other Federal Program TF HSN Fund TV Title V VA Veterans Administration Plan WC Workers' Compensation ZZ Other
PC 2 National Plan ID 11/8/12 Integer ID Nat'l PlanID int[10] CMS National Plan Identification Number (PlanID) Do not report any value here until National PlanID is fully implemented. This is a unique identifier as outlined by Centers for Medicare and Medicaid Services (CMS) for Plans or Sub plans All 0% Z PC 3 Insurance Type Lookup Table - Text char[2] Type / Product Identification Code Report the code that defines the type of insurance which this patient's claim line was processed. EXAMPLE: HM = HMO All 95% A2 Code Description 09 Self-pay 10 Central Certification 11 Other Non-Federal Programs 12 Preferred Provider Organization (PPO) 13 Point of Service (POS) 14 Exclusive Provider Organization (EPO) 15 Indemnity Insurance 16 Health Maintenance Organization (HMO) Medicare Risk 17 Dental Maintenance Organization (DMO) AM Automobile Medical BL Blue / Blue Shield CC Commonwealth Care CE Commonwealth Choice CH Champus CI Commercial Insurance Co. DS Disability HM Health Maintenance Organization LI Liability LM Liability Medical MA Medicare Part A MB Medicare Part B MC Medicaid OF Other Federal Program TF HSN Fund TV Title V VA Veterans Administration Plan WC Workers' Compensation ZZ Other
v5-apcd-pharmacy-claim-file-submission-guide-FINAL.docx