All Payer Claims Database Data Submission Guides


2024 APCD Data Submission Guides (FINAL Version)

(Published April 29, 2024)

 User Submission Guides

Format

 Medical Claims File Submission Guide
 Pharmacy Claims File Submission Guide
 Dental Claims File Submission Guide
 Member Eligibility File Submission Guide
 Product File Submission Guide
 Provider File Submission Guide
 Benefit Plan Control Total File

 Other Submission Documents

 Provider Suffix Codes
 Carrier Defined Lookup Table Form
 APCD Submission FAQs
 File Secure Instructions
 File Secure FAQs

 File Edits

List of Version 2024 File Edits
 (includes edits to Medical Claims, Dental Claims, Pharmacy Claims, Member Eligibility, Product File, Provider File, Benefit Plan Control Total File)
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2024 APCD Data Submission Guides (Red Line Version)

(Updated March 11 2024)

 User Submission Guides

Format

 Medical Claims File Submission Guide
 Pharmacy Claims File Submission Guide
 Dental Claims File Submission Guide
 Member Eligibility File Submission Guide

 


 

2023 APCD Data Submission Guides (FINAL Version)

(Published April 25, 2023)

 User Submission Guides

Format

 Medical Claims File Submission Guide
 Pharmacy Claims File Submission Guide
 Dental Claims File Submission Guide
 Member Eligibility File Submission Guide
 Product File Submission Guide
 Provider File Submission Guide
 Benefit Plan Control Total File

 Other Submission Documents

 Provider Suffix Codes
 Carrier Defined Lookup Table Form
 APCD Submission FAQs
 File Secure Instructions
 File Secure FAQs

 File Edits

List of Version 2023 File Edits
 (includes edits to Medical Claims, Dental Claims, Pharmacy Claims, Member Eligibility, Product File, Provider File, Benefit Plan Control Total File)
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