Schedule F3- Data Feed-Medicare Medical.csv

Request for Proposal No. 250000003097 ,,,,,,, Health Insurance Database Management System for the Michigan Office of Retirement Services,,,,,,, #Table Name, File Format, Fixed record length,,,,, BCBSM_MA_DME_CLAIMS_DETAIL, Delimited,,,,,, # Description: ,,,,,,, # Column Layouts:,,,,,,, # col name, alias, missing value, type, start, length, file missing value, format RECTYP, RECTYP,, Character(1),1,1,, ASCII FILLER1, FILLER1,, Character(1),2,1,, ASCII FILLER2, FILLER2,, Character(1),3,1,, ASCII GRPNBRCD, GRPNBRCD,, Character(20),4,20,, ASCII SEGMENTCD, SEGMENTCD,, Character(20),5,20,, ASCII FILLER3, FILLER3,, Character(1),6,1,, ASCII FILLER4, FILLER4,, Character(1),7,1,, ASCII FILLER5, FILLER5,, Character(1),8,1,, ASCII FILLER6, FILLER6,, Character(1),9,1,, ASCII FILLER7, FILLER7,, Character(1),10,1,, ASCII CONTRACTNUM, CONTRACTNUM,, Character(20),11,20,, ASCII CLAIMID, CLAIMID,, Character(38),12,38,, ASCII LINENBR, LINENBR,, Character(38),13,38,, ASCII CLAIMCONTROLNUM, CLAIMCONTROLNUM,, Character(20),14,20,, ASCII FILLER8, FILLER8,, Character(1),15,1,, ASCII FILLER9, FILLER9,, Character(1),16,1,, ASCII FILLER10, FILLER10,, Character(1),17,1,, ASCII FILLER11, FILLER11,, Character(1),18,1,, ASCII FILLER12, FILLER12,, Character(1),19,1,, ASCII MEMBERID, MEMBERID,, Character(38),20,38,, ASCII FILLER13, FILLER13,, Character(1),21,1,, ASCII FIRSTNAME, FIRSTNAME,, Character(80),22,80,, ASCII MIDNAME, MIDNAME,, Character(10),23,10,, ASCII LASTNAME, LASTNAME,, Character(80),24,80,, ASCII FILLER14, FILLER14,, Character(1),25,1,, ASCII PATDOB, PATDOB,, Character(38),26,38,, ASCII GENDER, GENDER,, Character(20),27,20,, ASCII FILLER15, FILLER15,, Character(1),28,1,, ASCII CLMTYP, CLMTYP,, Character(38),29,38,, ASCII FILLER16, FILLER16,, Character(1),30,1,, ASCII CLMSTATCD, CLMSTATCD,, Character(2),31,2,, ASCII RECEIPTDT, RECEIPTDT,, Character(38),32,38,, ASCII PAIDDT, PAIDDT,, Character(38),33,38,, ASCII ADJTYP, ADJTYP,, Character(20),34,20,, ASCII ADJREASCD, ADJREASCD,, Character(20),35,20,, ASCII ADJNUMCD, ADJNUMCD,, Character(2),36,2,, ASCII FIRSTSVCDT, FIRSTSVCDT,, Character(38),37,38,, ASCII LASTSVCDT, LASTSVCDT,, Character(38),38,38,, ASCII ADMDTKEY, ADMDTKEY,, Character(38),39,38,, ASCII DISCHARGEDT, DISCHARGEDT,, Character(38),40,38,, ASCII FILLER17, FILLER17,, Character(1),41,1,, ASCII PLACE, PLACE,, Character(20),42,20,, ASCII BILLTYPCD, BILLTYPCD,, Character(20),43,20,, ASCII FILLER18, FILLER18,, Character(1),44,1,, ASCII ADMITSRC, ADMITSRC,, Character(20),45,20,, ASCII DSTATUS, DSTATUS,,Integer,46,18,, ASCII FILLER19, FILLER19,, Character(1),47,1,, ASCII FILLER20, FILLER20,, Character(1),48,1,, ASCII FILLER21, FILLER21,, Character(1),49,1,, ASCII PREAUTHIND, PREAUTHIND,, Character(10),50,10,, ASCII FILLER22, FILLER22,, Character(1),51,1,, ASCII FILLER23, FILLER23,, Character(1),52,1,, ASCII PDNTWK, PDNTWK,, Character(10),53,10,, ASCII NTWKPROV, NTWKPROV,, Character(1),54,1,, ASCII FILLER24, FILLER24,, Character(1),55,1,, ASCII FILLER25, FILLER25,, Character(1),56,1,, ASCII FILLER26, FILLER26,, Character(1),57,1,, ASCII ITSAREAIND, ITSAREAIND,, Character(5),58,5,, ASCII FILLER27, FILLER27,, Character(1),59,1,, ASCII DX1, DX1,, Character(20),60,20,, ASCII DX2, DX2,, Character(20),61,20,, ASCII DX3, DX3,, Character(20),62,20,, ASCII DX4, DX4,, Character(20),63,20,, ASCII DX5, DX5,, Character(20),64,20,, ASCII DX6, DX6,, Character(20),65,20,, ASCII DX7, DX7,, Character(20),66,20,, ASCII DX8, DX8,, Character(20),67,20,, ASCII DX9, DX9,, Character(20),68,20,, ASCII DX10, DX10,, Character(20),69,20,, ASCII REVCD, REVCD,, Character(20),70,20,, ASCII SVCTYPCD, SVCTYPCD,, Character(20),71,20,, ASCII PROCCD, PROCCD,, Character(20),72,20,, ASCII PROCMOD1, PROCMOD1,, Character(20),73,20,, ASCII PROCMOD2, PROCMOD2,, Character(20),74,20,, ASCII PROCMOD3, PROCMOD3,, Character(20),75,20,, ASCII ICDPROCCD01, ICDPROCCD01,, Character(20),76,20,, ASCII ICDPROCCD02, ICDPROCCD02,, Character(20),77,20,, ASCII ICDPROCCD03, ICDPROCCD03,, Character(20),78,20,, ASCII ICDPROCCD04, ICDPROCCD04,, Character(20),79,20,, ASCII ICDPROCCD05, ICDPROCCD05,, Character(20),80,20,, ASCII ICDPROCCD06, ICDPROCCD06,, Character(20),81,20,, ASCII POA01, POA01,, Character(20),82,20,, ASCII POA02, POA02,, Character(20),83,20,, ASCII POA03, POA03,, Character(20),84,20,, ASCII POA04, POA04,, Character(20),85,20,, ASCII POA05, POA05,, Character(20),86,20,, ASCII POA06, POA06,, Character(20),87,20,, ASCII POA07, POA07,, Character(20),88,20,, ASCII POA08, POA08,, Character(20),89,20,, ASCII POA09, POA09,, Character(20),90,20,, ASCII UNITS, UNITS,, Character(38),91,38,, ASCII DAYSCOV, DAYSCOV,, Character(38),92,38,, ASCII CHGSUBMIT, CHGSUBMIT,, Float,93,18,, ASCII CHGALLOW, CHGALLOW,, Float,94,18,, ASCII NETPAY, NETPAY,, Float,95,18,, ASCII COPAYAMT, COPAYAMT,, Float,96,18,, ASCII COINSAMT, COINSAMT,, Float,97,18,, ASCII DEDUCTAMT, DEDUCTAMT,, Float,98,18,, ASCII FILLER28, FILLER28,, Character(1),99,1,, ASCII FILLER29, FILLER29,, Character(1),100,1,, ASCII FILLER30, FILLER30,, Character(1),101,1,, ASCII NONCOVAMT, NONCOVAMT,, Float,102,18,, ASCII THIRDPARTY, THIRDPARTY,, Float,103,18,, ASCII FILLER31, FILLER31,, Character(1),104,1,, ASCII CHECKNUMBERID, CHECKNUMBERID,, Character(38),105,38,, ASCII FILLER32, FILLER32,, Character(1),106,1,, ASCII FILLER33, FILLER33,, Character(1),107,1,, ASCII FILLER34, FILLER34,, Character(1),108,1,, ASCII FILLER35, FILLER35,, Character(1),109,1,, ASCII FILLER36, FILLER36,, Character(1),110,1,, ASCII FILLER37, FILLER37,, Character(1),111,1,, ASCII FILLER38, FILLER38,, Character(1),112,1,, ASCII FILLER39, FILLER39,, Character(1),113,1,, ASCII FILLER40, FILLER40,, Character(1),114,1,, ASCII FILLER41, FILLER41,, Character(1),115,1,, ASCII FILLER42, FILLER42,, Character(1),116,1,, ASCII SERVPROVTAXID, SERVPROVTAXID,, Character(20),117,20,, ASCII FILLER43, FILLER43,, Character(1),118,1,, ASCII SERVPROVNPI, SERVPROVNPI,, Character(20),119,20,, ASCII SERVPROVFIRSTNAME, SERVPROVFIRSTNAME,, Character(35),120,35,, ASCII SERVPROVMIDNAME, SERVPROVMIDNAME,, Character(10),121,10,, ASCII SERVPROVLASTNAME, SERVPROVLASTNAME,, Character(35),122,35,, ASCII SERVPROVADDR1, SERVPROVADDR1,, Character(50),123,50,, ASCII SERVPROVADDR2, SERVPROVADDR2,, Character(50),124,50,, ASCII SERVPROVCITY, SERVPROVCITY,, Character(20),125,20,, ASCII SERVPROVSTATE, SERVPROVSTATE,, Character(20),126,20,, ASCII SERVPROVZIP, SERVPROVZIP,, Character(9),127,9,, ASCII FILLER44, FILLER44,, Character(1),128,1,, ASCII SERVPROVSPECIALTY, SERVPROVSPECIALTY,, Character(20),129,20,, ASCII FILLER45, FILLER45,, Character(1),130,1,, ASCII FILLER46, FILLER46,, Character(1),131,1,, ASCII FILLER47, FILLER47,, Character(1),132,1,, ASCII BILLPROVID, BILLPROVID,, Character(20),133,20,, ASCII BILLPROVTAXID, BILLPROVTAXID,, Character(20),134,20,, ASCII FILLER48, FILLER48,, Character(1),135,1,, ASCII BILLPROVNPI, BILLPROVNPI,, Character(20),136,20,, ASCII FILLER49, FILLER49,, Character(1),137,1,, ASCII FILLER50, FILLER50,, Character(1),138,1,, ASCII BILLPROVLASTNAME, BILLPROVLASTNAME,, Character(35),139,35,, ASCII BILLPROVADDR1, BILLPROVADDR1,, Character(50),140,50,, ASCII BILLPROVADDR2, BILLPROVADDR2,, Character(50),141,50,, ASCII BILLPROVCITY, BILLPROVCITY,, Character(20),142,20,, ASCII FILLER51, FILLER51,, Character(1),143,1,, ASCII BILLPROVZIP, BILLPROVZIP,, Character(9),144,9,, ASCII ORDPROV, ORDPROV,, Character(20),145,20,, ASCII FILLER52, FILLER52,, Character(1),146,1,, ASCII FILLER53, FILLER53,, Character(1),147,1,, ASCII FILLER54, FILLER54,, Character(1),148,1,, ASCII HICN, HICN,, Character(20),149,20,, ASCII DRGCD, DRGCD,, Character(4),150,4,, ASCII POACD01, POACD01,, Character(20),151,20,, ASCII POACD02, POACD02,, Character(20),152,20,, ASCII POACD03, POACD03,, Character(20),153,20,, ASCII POACD04, POACD04,, Character(20),154,20,, ASCII POACD05, POACD05,, Character(20),155,20,, ASCII POACD06, POACD06,, Character(20),156,20,, ASCII POACD07, POACD07,, Character(20),157,20,, ASCII POACD08, POACD08,, Character(20),158,20,, ASCII POACD09, POACD09,, Character(20),159,20,, ASCII