Report the last name of the patient / member here. Used to create Unique Member ID. Last name should exclude all punctuation, including hyphens and apostrophes Name should be Member Name Last Last name of ME 87 Text varchar[60] contracted punctuation is removed, All 100% A0 104 Last Name Member Member do not report spaces. EXAMPLE: O'Brien becomes OBRIEN; becomes CARLTONSMYTHE (Will be hashed prior to submission via CHIA’s FileSecure application.) Report the first name of the member here. Used to create Unique Member ID. Exclude all punctuation, including hyphens and apostrophes. Name Member Name First First name of should be contracted where punctuation ME 88 6/24/10 Text varchar[25] All 100% A0 105 First Name Member Member is removed, do not report spaces. EXAMPLE: Anne-Marie becomes ANNEMARIE (Will be hashed prior to submission via CHIA’s FileSecure application.) Report the middle initial of the member Member when available. Used to create Unique Name Middle Middle initial ME 89 Middle 6/24/10 Text char[1] Member ID. All 2% C 106 Member of Member Initial (Will be hashed prior to submission via CHIA’s FileSecure application.) Report the identifier the carrier / Carrier ID Link to submitter uses internally to uniquely Specific MC137, Member's identify the member. Used to create ME 90 11/8/12 Text varchar[50] All 100% A0 107 Unique PC107, Unique ID Unique Member ID and link across Member ID DC056 carrier's / submitter's for reporting and aggregation. . Do not populate with any data. ME 91 Filler 2/2017 Text Filler char[0] Filler All 100% A0 108 Required to be NULL Address Subscriber Code External State of the Report the state of the subscriber here. ME 92 State or 11/8/12 char[2] All 99% A0 109 Source Code Source Subscriber Used to create Unique Member ID. Province 2 - 2 - States Text
ME 87 Member Last Name Text Name Last Member varchar[60] Last name of Member Report the last name of the patient / member here. Used to create Unique Member ID. Last name should exclude all punctuation, including hyphens and apostrophes Name should be contracted punctuation is removed, do not report spaces. EXAMPLE: O'Brien becomes OBRIEN; becomes CARLTONSMYTHE (Will be hashed prior to submission via CHIA’s FileSecure application.) All 100% A0 ME 88 Member First Name 6/24/10 Text Name First Member varchar[25] First name of Member Report the first name of the member here. Used to create Unique Member ID. Exclude all punctuation, including hyphens and apostrophes. Name should be contracted where punctuation is removed, do not report spaces. EXAMPLE: Anne-Marie becomes ANNEMARIE (Will be hashed prior to submission via CHIA’s FileSecure application.) All 100% A0 ME 89 Member Middle Initial 6/24/10 Text Name Middle Member char[1] Middle initial of Member Report the middle initial of the member when available. Used to create Unique Member ID. (Will be hashed prior to submission via CHIA’s FileSecure application.) All 2% C ME 90 Carrier Specific Unique Member ID 11/8/12 Text ID Link to MC137, PC107, DC056 varchar[50] Member's Unique ID Report the identifier the carrier / submitter uses internally to uniquely identify the member. Used to create Unique Member ID and link across carrier's / submitter's for reporting and aggregation. All 100% A0 ME 91 Filler 2/2017 Text Filler char[0] Filler . Do not populate with any data. Required to be NULL All 100% A0 ME 92 Subscriber State or Province 11/8/12 Code Source 2 - Text Address External Code Source 2 - States char[2] State of the Subscriber Report the state of the subscriber here. Used to create Unique Member ID. All 99% A0 104 105 106 107 108 109
v6-apcd-member-eligibility-file-submission-guide-FINAL.docx