CY2011 Plan Benefit Package (PBP) Software and Formulary Submission - CMS-R-262

The Plan Benefit Package (PBP) and Formulary Submission for Advantage (MA) Plans and Prescription Drug Plans (PDPs)

Appendix_C_CY 2011 Plan Home Infusion File Record Layout 091109

CY2011 Plan Benefit Package (PBP) Software and Formulary Submission - CMS-R-262

OMB: 0938-0763

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CY 2011 Home Infusion File Record Layout

Required File Format = ASCII File
Do not include a header record
Filename extension should be “.TXT”
Field Name

Field Type

RxCUI

NUMBER
Always
Required

Maximum
Field Length
Maximum of 8
digits

Field Description

Sample Field Value(s)

RxCUI concept unique identifier from the
active Formulary Reference File.

210597

Please Note: Certain characters are restricted from HPMS. The submitted file will be rejected if any of the following characters are
included in any field: 1) greater than sign (>), 2) less than sign (<), 3) semi-colon (;), and 4) ampersand (&).

CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING


File Typeapplication/pdf
File Modified2009-09-17
File Created2009-09-17

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