Annual Per Per Person Report the value that defines the Total Lookup Person Deductible Per Person Deductible for all benefits PR 12 11/8/12 Table - char[3] All 100% A2 Deductible bandwidth under this product. EXAMPLE: 000 = Text Code reporting Plans with no Per Person Deductible Value Description 000 No per person deductible Deductible Total under $1,000 Deductible Total of $1,000 thru $1,999 Deductible of $2,000 thru $2,999 Deductible Total greater than $3000 999 Not Applicable Annual Per Per Family Report the value that defines the Total Lookup Family Deductible Per Family Deductible for all benefits PR 13 11/8/12 Table - char[3] All 100% A2 Deductible bandwidth under this product.. EXAMPLE: 000 = Text Code reporting Plans with no Per Family Deductible Value Description 000 No per family deductible 001 Deductible Total under $1,000 002 Deductible Total of $1,000 thru $1,999 003 Deductible of $2,000 thru $2,999 Deductible Total of $3,000 thru $3,999 Deductible Total of $4,000 thru $4,999 Deductible Total of $5,000 thru $5,999 Deductible Total greater than $6,000 999 Not Applicable Report the value that defines the Lookup Indicator - element. EXAMPLE: 1 = Yes, PR 14 Care 11/8/12 Table - int[1] Clinical All 100% A2 Member's care is clinically model Integer Coordination coordinated/managed. Value Description 1 Yes
PR 12 Annual Per Person Deductible Code 11/8/12 Lookup Table - Text char[3] Per Person Deductible bandwidth reporting Report the value that defines the Total Per Person Deductible for all benefits under this product. EXAMPLE: 000 = Plans with no Per Person Deductible All 100% A2 Value Description 000 No per person deductible Deductible Total under $1,000 Deductible Total of $1,000 thru $1,999 Deductible of $2,000 thru $2,999 Deductible Total greater than $3000 999 Not Applicable PR 13 Annual Per Family Deductible Code 11/8/12 Lookup Table - Text char[3] Per Family Deductible bandwidth reporting Report the value that defines the Total Per Family Deductible for all benefits under this product.. EXAMPLE: 000 = Plans with no Per Family Deductible All 100% A2 Value Description 000 No per family deductible 001 Deductible Total under $1,000 002 Deductible Total of $1,000 thru $1,999 003 Deductible of $2,000 thru $2,999 Deductible Total of $3,000 thru $3,999 Deductible Total of $4,000 thru $4,999 Deductible Total of $5,000 thru $5,999 Deductible Total greater than $6,000 999 Not Applicable PR 14 Care model 11/8/12 Lookup Table - Integer int[1] Indicator - Clinical Coordination Report the value that defines the element. EXAMPLE: 1 = Yes, Member's care is clinically coordinated/managed. All 100% A2 Value Description 1 Yes
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