Version 6.0; required for reporting 6.0 periods October 2013 onward as of August 2017 ID Link to Report the submitter-assigned ME040, identifier that uniquely defines this Product ID Product 1 11/8/12 Text MC079, varchar[30] product. This identifier is used to link All 100% A0 number Identification PC056, this Product line with its attributes to DC042 eligibility and claim lines. Report a unique name for every Product in a Carrier's system. For Products with identical names, it is Submitter required that the Submitter add a Product Name 2 6/24/10 Text varchar[70] defined Product refining 'element' to create unique All 100% C Name Product name Product Names that align to unique Product ID Numbers. This refining element can be numeric, alpha or alpha-numeric. Carrier Lookup Report the code that defines the Carrier License PR 3 License 11/8/12 Table - char[3] License Type of this Product. All 100% A0 Type Type Text EXAMPLE: COM = Commercial Code Description BLU Blue Cross and Blue Shield Licensee COM Commercial Carrier HMO Health Maintenance Organization MAO Medicare Advantage Organization PBM Pharmacy Benefit Manager SCO Senior Care Option TPA Third Party Administrator 176 Chapter 176 OTH Other License Type Line of Product Business / Report the code that defines the Line Line of Lookup Insurance PR 4 char[2] of Business that this product All 100% A0 004 Business - Text Model the follows. EXAMPLE: 12 = PPO Model Product relates to.
6.0 Version 6.0; required for reporting periods October 2013 onward as of August 2017 1 Product ID number 11/8/12 Text ID Link to ME040, MC079, PC056, DC042 varchar[30] Product Identification Report the submitter-assigned identifier that uniquely defines this product. This identifier is used to link this Product line with its attributes to eligibility and claim lines. All 100% A0 2 Product Name 6/24/10 Text Name Product varchar[70] Submitter defined Product name Report a unique name for every Product in a Carrier's system. For Products with identical names, it is required that the Submitter add a refining 'element' to create unique Product Names that align to unique Product ID Numbers. This refining element can be numeric, alpha or alpha-numeric. All 100% C PR 3 Carrier License Type 11/8/12 Lookup Table - Text char[3] Carrier License Type Report the code that defines the License Type of this Product. EXAMPLE: COM = Commercial All 100% A0 Code Description BLU Blue Cross and Blue Shield Licensee COM Commercial Carrier HMO Health Maintenance Organization MAO Medicare Advantage Organization PBM Pharmacy Benefit Manager SCO Senior Care Option TPA Third Party Administrator 176 Chapter 176 OTH Other License Type PR 4 Product Line of Business Model Lookup - Text char[2] Line of Business / Insurance Model the Product relates to. Report the code that defines the Line of Business that this product follows. EXAMPLE: 12 = PPO All 100% A0 004
v6-apcd-product-file-submission-guide-FINAL.docx