Download:
pdf |
pdfCY 2020 Indication-Based Coverage File Record Layout
Required File Format = ASCII File – Tab Delimited
Do not include a header record
Filename extension should be “.TXT”
Field Name
RxCUI
Field Type
Number
Maximum
Field
Length
Alphanumeric
Sample Field
Value(s)
8
RxCUI – must exist on the
related formulary file
210597
8
Condition Indication Code
M0010859
Always Required
Indication Code
Field Description
Always Required
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 (<), and 3) semicolon (;).
CMS SENSITIVE INFORMATION - REQUIRES SPECIAL HANDLING
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| File Type | application/pdf |
| File Title | CY 2019 Value Based Insurance Design Record Layout |
| Subject | CY 2019 Value Based Insurance Design Record Layout |
| Author | Lucas, Corey A |
| File Modified | 2018-09-12 |
| File Created | 2018-09-12 |