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	PDF \| Word
Pharmacy Claims File Submission Guide	PDF \| Word
Dental Claims File Submission Guide	PDF \| Word
Member Eligibility File Submission Guide	PDF \| Word
Product File Submission Guide	PDF \| Word
Provider File Submission Guide	PDF \| Word
Benefit Plan Control Total File	PDF \| Word
Other Submission Documents
Provider Suffix Codes	PDF \| Word
Carrier Defined Lookup Table Form	Excel
APCD Submission FAQs	Member Eligibility Guidance \| Word Provider File Examples (Excel) Type of Facility Guidance (PDF) \| Word
File Secure Instructions	PDF \| Word
File Secure FAQs	PDF \| Word
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)	-

2024 APCD Data Submission Guides (Red Line Version)

(Updated March 11 2024)

User Submission Guides	Format
Medical Claims File Submission Guide	PDF \| Word
Pharmacy Claims File Submission Guide	PDF \| Word
Dental Claims File Submission Guide	PDF \| Word
Member Eligibility File Submission Guide	PDF \| Word

2023 APCD Data Submission Guides (FINAL Version)

(Published April 25, 2023)

User Submission Guides	Format
Medical Claims File Submission Guide	PDF \| Word
Pharmacy Claims File Submission Guide	PDF \| Word
Dental Claims File Submission Guide	PDF \| Word
Member Eligibility File Submission Guide	PDF \| Word
Product File Submission Guide	PDF \| Word
Provider File Submission Guide	PDF \| Word
Benefit Plan Control Total File	PDF \| Word
Other Submission Documents
Provider Suffix Codes	PDF \| Word
Carrier Defined Lookup Table Form	Excel
APCD Submission FAQs	Member Eligibility Guidance \| Word Provider File Examples (Excel) Type of Facility Guidance (PDF) \| Word
File Secure Instructions	PDF \| Word
File Secure FAQs	PDF \| Word
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)	-