Managed Care Resources File Layout

Last Updated

This layout document describes the fields in the managed care resource data file. HHSC updates the database weekly. Data from the file appears on the managed care resources search.

Field Name Description Length Format Note
MCO_PLAN_CD Identifies the 2-digit MCO plan code. 2    
MCO_FULL_NM Identifies the name of the MCO. 30   Refer to the valid values
MCO_SERVICE_AREA Identifies the service delivery area (SDA) of the MCO. 30   Refer to the valid values
MCO_PLAN_EFF_DT Identifies the MCO plan code effective date. 10 MM/DD/CCYY  
MCO_PLAN_TERM_DT Identifies the MCO plan code termination date. 10 MM/DD/CCYY  
MCO_PGM Identifies the MCO program name. 20   Refer to the valid values
MCO_PBM_NAME Identifies the name of the MCO’s pharmacy benefits manager. 35   Refer to the valid values
MCO_PLAN_RX_NUM Identifies the MCO’s 6-digit NCPDP Bank Identification Number (BIN). 6    
MCO_PLAN_PCN Identifies the MCO’s x-digit NCPDP Processor Control Number (PCN). 10    
MCO_PLAN_GRP Identifies the MCO’s NCPDP Group ID number(s). 500    
NOTE Identifies the additional information for the record. 1200    
MCO_PHARM_ENROLL_PH_NUM Identifies the MCO’s phone number for pharmacy enrollment. 12    
MCO_PHARM_ENROLL_PH_EXT Identifies the MCO’s phone number extension for pharmacy enrollment. 6    
MCO_PHARM_ENROLL_FAX_NUM Identifies the MCO’s fax number for pharmacy enrollment. 12    
MCO_PHARM_ENROLL_EMAIL Identifies the MCO’s email address for pharmacy enrollment. 100    
MCO_PHARM_ENROLL_WEB Identifies the MCO’s website for pharmacy enrollment. 255    
MCO_DME_ENROLL_PH_NUM Identifies the MCO’s phone number for durable medical equipment (DME) enrollment. 12    
MCO_DME_ENROLL_PH_EXT Identifies the MCO’s phone number extension for durable medical equipment (DME) enrollment. 6    
MCO_DME_ENROLL_FAX_NUM Identifies the MCO’s fax number for DME enrollment. 12    
MCO_DME_ENROLL_EMAIL Identifies the MCO’s email address for DME enrollment. 100    
MCO_DME_ENROLL_WEB Identifies the MCO’s website for DME enrollment. 255    
MCO_PHARM_PH_NUM Identifies the MCO’s pharmacy call center phone number. 12    
MCO_PHARM_PH_EXT Identifies the MCO’s pharmacy call center phone number extension. 6    
MCO_PA_PH_NUM Identifies the MCO’s prior authorization call center phone number. 12    
MCO_PA_PH_EXT Identifies the MCO’s prior authorization call center phone number extension. 6    
MCO_MEMBER_PH_NUM Identifies the MCO’s member call center phone number. 12    
MCO_MEMBER_PH_NUM_EXT Identifies the MCO’s member call center phone number extension. 6    
MCO_CPA_WEB Identifies the MCO’s clinical prior authorization website. 255    
MCO_C_PBM_EFF_DT Identifies the effective date of the MCO’s pharmacy benefits manager. 10 MM/DD/CCYY  
MCO_PHARM_PDL_WEB Identifies the MCO’s preferred drug list website. 4000    
MCO_PHARM_MANUAL_WEB Identifies the MCO’s pharmacy manual website. 4000    
MCO_PHARM_PAYER_SHEETS_WEB Identifies the MCO’s pharmacy payer sheets website. 4000    
MCO_PHARM_FORMS_WEB Identifies the MCO’s pharmacy forms website. 4000    
MCO_FORMULARY_WEB Identifies the MCO’s formulary website. 4000