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 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 License Type Line of Product Business / Report the code that defines the Line Line of Lookup PR 4 char[2] Insurance of Business that this product All 100% A0 Business - Text the Product follows. EXAMPLE: 12 = PPO Model relates to. Code Description 12 Preferred Provider Organization (PPO) 13 of Service (POS) 14 Exclusive Provider Organization (EPO) 15 Indemnity Insurance
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 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 License Type PR 4 Product Line of Business Model Lookup - Text char[2] Line of Business / Insurance the Product relates to. Report the code that defines the Line of Business that this product follows. EXAMPLE: 12 = PPO All 100% A0 Code Description 12 Preferred Provider Organization (PPO) 13 of Service (POS) 14 Exclusive Provider Organization (EPO) 15 Indemnity Insurance
apcd-product-file-submission-guide.docx