AHCCCS Technical Interface Guidelines (TIG)

Health Plan Interface - Review File Layout


FIELD NAME TYPE SIZE DESCRIPTION
HP-ID X 6  
RATE-CD X 4  
SRC-AGENCY X 3  
CASE-ID X 9  
AHCCCS-ID X 9  
SSN X 9  
NAME  
LNAME X 20  
FNAME X 10  
MI X 1  
DOB X 8 CCYYMMDD
GENDER X 1 M or F
RES-ADDR-LINE1 X 25  
RES-ADDR-LINE2 X 25  
RES-ADDR-CITY X 20  
RES-ADDR-STATE X 2  
RES-ADDR-ZIP X 9  
MAIL-ADDR-LINE1 X 25  
MAIL-ADDR-LINE2 X 25  
MAIL-ADDR-CITY X 20  
MAIL-ADDR-STATE X 2  
MAIL-ADDR-ZIP X 9  
PHONE X 10  
EMAIL X 40  
LANG X 20  
MEM-TYP X 3  
RBHA X 2  
FILLER X 33