Azahcccs.gov



Daily ReportFile Name: DAILYSTO.XXXXXX.MEDICAID.YYMMDD.TXTData NamePictureActual PositionsRemarksFromToAHCCCS-IDX(09)19FIRST NAMEX(12)1021LAST NAME X(20)2241DATE OF BIRTHX(8)4249YYYYMMDDHEALTH PLAN IDX(6)5055Valid HP IDSTATE ONLY KEY CODEX(3)5658‘STI’STATE ONLY ELIGIBILITY BEGIN DATEX(8)5966YYYYMMDDSTATE ONLY ELIGIBILITY END DATEX(8)6774YYYYMMDDMEDICAID ELIGIBILITY KEY CODEX(3)7577See Table RF538 below for referenceMEDICAID ELIGIBILITY BEGIN DATEX(8)7885YYYYMMDDMEDICAID ELIGIBILITY END DATEX(8)8693YYYYMMDDRBHA-IDX(10)94103ID used to identify the member in the RBHA systemBHS CATEGORYX(1)104105Valid Values – S; C; GMonthly ReportFile Name: MTHLYSTO.XXXXXX.MEDICAID.YYMMDD.TXTData NamePictureActual PositionsRemarksFromToAHCCCS-IDX(09)19FIRST NAMEX(12)1021LAST NAME X(20)2241DATE OF BIRTHX(8)4249YYYYMMDDHEALTH PLAN IDX(6)5055Valid HP IDSTATE ONLY KEY CODEX(3)5658‘STI’STATE ONLY ELIGIBILITY BEGIN DATEX(8)5966YYYYMMDDSTATE ONLY ELIGIBILITY END DATEX(8)6774YYYYMMDDMEDICAID ELIGIBILITY KEY CODEX(3)7577See Table RF538 below for referenceMEDICAID ELIGIBILITY BEGIN DATEX(8)7885YYYYMMDDMEDICAID ELIGIBILITY END DATEX(8)8693YYYYMMDDRBHA-IDX(10)94103ID used to identify the member in the RBHA systemBHS CATEGORYX(1)104105Valid Values – S; C; GTable RF538ELIGIBILITY KEY CODEELIGIBILITY KEY CODE DESCRIPTION JC1 JUVENILE CORRECTIONS PS1 PUBLIC SAFETY (AZ DEPT OF CORRECTIONS)STO STATE-ONLY BHS 040 L SA CASH 050 L SB CASH 060 L SD CASH 080 L AF CASH 085 L AF CASH FOSTER OR ADOPTION SUBSIDY 090 L SA MAO 100 L AF MAO CHILD 110 L AF MAO DEPRIVED 120 L AF MAO PREG 13A MARICOPA CO ADULT INMATES 13J MARICOPA CO JUVENILE DETAINEES 130 L SB MAO 140 L SD MAO 180 A SB CASH FOSTER 190 A SD CASH FOSTER 200 A SA CASH 210 A SB CASH 220 A SD CASH 231 A AF MAO 1931 232 A AF MAO 1931 EXPANDED 240 A AF TANF CASH 245 A AF CA UNEMP PAR 250 A AF CA PREG 3 TRI 260 A AF CASH ACUTE 265 A AF ACUTE 270 A AF CASH FOSTER 275 A AF MAO YOUNG ADULT TRANSITIONAL 280 A AF MAO PREG 285 A AF MAO LESS THAN $10 290 A AF MAO DEEM SIB 294 A AF MAO FOSTER SOBRA PREGNANT 298 A AF MAO FOSTER SOBRA CHILD 300 A AF MAO FOSTER 302 A AF MAO FS CM 305 A AF COBRA (OUT OF STATE) FOSTER 310 A AF MAO 4MO CT ER 320 A AF 4 MO CONT. DUE TO CHILD SUPPORT 325SOBRA HIFA PARENT 327KIDSCARE HIFA PARENT 330A AF MAO 9MO CONT 332A AF 6 MO CONT. TMA 1ST EXT. 334A AF 6 MO CONT. TMA 2ND EXT. 336A AF 6 MO CONT. TMA 3RD EXT. 338A AF 6 MO CONT. TMA 4TH EXT. 340A AF MAO RIBICOFF 345A AF MAO CM 350A AF MAO S.O.B.R.A.CHILD 351A AF MAO SC EXPANDED 352 A AF MAO SOBRA CHILD 100-133% 355 A AF MAO DES SO NB 357 A AF MAO DES NEWBORN 359 DES HIFA NEWBORN 360 A AF MAO S.O.B.R.A. PG 361 A AF MAO SW EXPANDED 365 A AF MAO UNEMP PAR 368 A KIDSCARE 370 A SA MAO 371 SSI (AHCCCS CARE/MI) 372 SSI (AHCCCS CARE EXPANDED)375 A SA MAO EXPANDED 380 A SA MAO PICKLE 382ACUTE SSI AGED MAO EXPARTE385A SB MAO FOSTER JASSO 390 A SB MAO 392 ACUTE SSI BLIND MAO EXPARTE 393 A SB MAO FREEDOM TO WORK 394 ACUTE SSI BLIND MAO APPEAL 395 A SB MAO EXPANDED 400 A SB MAO PICKLE 403 A SD MAO FREEDOM TO WORK 405 A SD MAO FOSTER JASSO 410 A SD MAO 415 A SD MAO EXPANDED 420 A SD MAO PICKLE 422ACUTE SSI DISABLED MAO EXPARTE424ACUTE SSI DISABLED MAO APPEAL 426ACUTE SSI DISABLED MAO DAC 428ACUTE SSI DISABLED MAO DISABLED CHILD430A SD MAO WIDOW/ER 431A SA MAO WIDOW/ER 432A SB MAO WIDOW/ER 435ACUTE STATE-FUNDED MAO ALIEN (N13) 440A AF AHCCCS NEWBORN 445A AF AHCCCS SOBRA NEWBORN 447SOBRA HIFA DEEMED NEWBORN 450A SSI AHCCCS NEWBORN 455A KIDSCARE NEWBORN 460A AF MAO 6MO GUAR 461A AF MAO EXPANDED 6-MO GUARANTEE 462 A AF MAO S.O.B.R.A.CHILD 6M GUAR 463 A AHCCCS CARE > 40% FPL 6MG 464 A AF MAO S.O.B.R.A.PREG 6M GUAR 465 A AF MAO SOBRA 100-133% 6G 466 A AF MAO 6G CM 467 A AHCCCS CARE < 40% FPL 6MG 468 A KIDSCARE 12-MONTH GUARANTEE 470 A SA MAO 6MO GUAR 471 A SA MAO EXPANDED 6-MO GUARANTEE 472 A MED 6-MONTH GUARANTEE 475 A ADULT < 40% 6G 476 A ADULT 40-100% 6G 477 A NEWLY ELIGIBLE 6G 480 A SB MAO 6MO GUAR 481 A SB MAO EXPANDED 6-MO GUARANTEE482 A SB FREEDOM TO WORK 6MO GUAR 485 A SI MAO NEWBORN 6G 490 A SD MAO 6MO GUAR 491 A SD MAO EXPANDED 6-MO GUARANTEE492 A SD FREEDOM TO WORK 6MO GUAR 500 A AF MAO PRIOR QTR 510 A SA MAO PRIOR QTR 515 A SA EXPANDED PRIOR QUARTER 520 A SB MAO PRIOR QTR 525 A SB EXPANDED PRIOR QUARTER 530 A SD MAO PRIOR QTR 535A SD EXPANDED PRIOR QUARTER 540A AF MAO EMERGENCY 550A AF MAO EMER PG 560A AF MAO BC PATIENT 565A AF MAO CC PATIENT 570A AF MAO CL PATIENT 575TEMPORARY MEDICAL COVERAGE SSDI580A MI 581TRANSPLANT OPTION 1 582TRANSPLANT OPTION 2 585A AHCCCS CARE 586A ADULT < 40% 587A AHCCCS CARE/MI 588A ADULT 40-100% 589A NEWLY ELIGIBLE 590A MN 595A MED ELIGIBILITY 600A MI PREG 610A MN PREG 620A EAC 630A ELIC 640A MI NEWBORN 650A MN NEWBORN 660A EAC 6MO GUAR 670A ELIC RETRO 675PRESUMPTIVE ELIGIBILITY680 A MI RETRO 685 A AHCCCS CARE RETRO 690 A MN RETRO 695 A MED ELIGIBILITY RETRO 700 L AF MAO PRIOR QTR 710 L SA MAO PRIOR QTR 720 L SB MAO PRIOR QTR 725 L SB MAO FREEDOM TO WORK 730 L SD MAO PRIOR QTR 735 L SD MAO FREEDOM TO WORK 740 L AF MAO 750 A AF MAO 755 ACUTE AFDC MAO NON-ISSUANCE800QMB ONLY OTHER 810QMB ONLY AGED 820QMB ONLY BLIND 830QMB ONLY DISABLED 840PART B ONLY - SLMB 850PART B ONLY - QI1 900A AFDC MAO EMER SVCE DES UNDOCUMENTED905A AFDC MAO EMER PG DES UNDOCUMENTED 908A AF MA EXPANDED EMER SVCS 910A SA MAO EMER SVCS SSI UNDOCUMENTED 911A SA MAO EMER SVCS EXPANDED 915A SB MAO EMER SVCS SSI UNDOCUMENTED 916A SB MAO EMER SVCS EXPANDED 920 A SD MAO EMER SVCS SSI UNDOCUMENTED 921 A SD MAO EMER SVCS EXPANDED 925 A AHCCCS CARE EMER SVCS 926 A AHCCCS CARE/MI EMER SVCS 927 A AHCCCS CARE EMERGENCY SERVICES 928 A MED EMER SVCS PREGNANT 929 A MED EMERGENCY SERVICES 930 A MN EMERGENCY SERVICES UNDOCUMENTED 931 A MN EMERGENCY SERVICES NON QUALIFIED 932 A MN EMERGENCY SERVICES QUALIFIED 935 A MN EMER SVCS PG UNDOCUMENTED 936 A MN EMERGENCY SERVICES PG NON QUALIFIED937 A MN EMERGENCY SERVICES PG QUALIFIED 938 A MN ESP PG NON QUAL RES < 8/22/96 940 A ELIC EMERGENCY SVCS UNDOCUMENTED 941 A ELIC EMERGENCY SERVICES NON QUALIFIED942 A ELIC EMERGENCY SERVICES QUALIFIED 945 A ELIC EMERGENCY SVCS PG UNDOCUMENTED 946 A ELIC EMERGENCY SERVICES PG NON QUAL 947 A ELIC EMERGENCY SERVICES PG QUALIFIED 948 A ELIC ESP PG NON QUAL RES < 8/22/96 949 A FES YATI 950 A FES ADULT 40-100% 953 FES NEWLY ELIGIBLE 100% - 133% 955 FES ADULT < 40% 960A SB FPS MAO ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download