(Updated April 4, 2025)
User Submission Guides |
Format |
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Member Eligibility File Submission Guide
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Member Simplified File Submission Guide
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(Published April 29, 2024)
User Submission Guides |
Format |
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Medical Claims File Submission Guide
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Pharmacy Claims File Submission Guide
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Dental Claims File Submission Guide
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Member Eligibility File Submission Guide
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Product File Submission Guide
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Provider File Submission Guide
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Benefit Plan Control Total File
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Other Submission Documents |
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| CDC Ethnicity Codes (Added January 30, 2025) |
CDC Ethnicity Codes (PDF) |
| Provider Suffix Codes | |
| Carrier Defined Lookup Table Form | |
| APCD Submission FAQs | |
| File Secure Instructions | |
| File Secure FAQs | |
File Edits |
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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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