State Only Input Process

File Name: DAILYSTO.XXXXXX.YYYYMMDD.TXT

SFTP: XXX/PROD/IN

Header Record

Data Name / Picture / Actual Positions / Remarks
From / To
Header ID / X(5) / 1 / 5 / Required - ‘HDR1’
HDR-Description / X(13) / 6 / 18 / Required - ‘PMMIS_TRANS’
File Date / X(08) / 19 / 26 / Required-Format YYYYMMDD
Filler / X(674) / 27 / 700

Detail Record

Data Name / Picture / Actual Positions / Remarks
From / To
SOURCE / X(02) / 1 / 2 / Required – ‘CI’, ‘HA’, ‘MI’
ACTN-CD / X(01) / 3 / 3 / Required - ‘A’, ‘C’, ‘T’
DAT / X(8) / 4 / 11 / Required-Format YYYYMMDD
AHCCCS-ID / X(9) / 12 / 20 / Required for ‘C’, ‘T’
Optional for ‘A’
SSN / X(9) / 21 / 29 / Optional
RBHA-ID / X(10) / 30 / 39 / Required - ID used to identify the member in the RBHA system
LAST-NAME / X(20) / 40 / 59 / Required
SUFFIX / X(4) / 60 / 63 / Optional
FIRST-NAME / X(12) / 64 / 75 / Required
MID-INIT / X(1) / 76 / 76 / Optional
SEX / X(1) / 77 / 77 / Required – ‘M’ or ‘F’
DAT-OF-BRTH / X(8) / 78 / 85 / Required – Format YYYYMMDD
RACE / X(2) / 86 / 87 / Optional – See Table RF518 below
CITIZEN-CD / X(2) / 88 / 89 / Optional -See Table RF569 below
ETHNICITY / X(2) / 90 / 91 / Optional – See Table RF535below
R-STR-1 / X(25) / 92 / 116 / Required – Residential Address Line1
R-STR-2 / X(25) / 117 / 141 / Optional – Residential Address Line 2
R-CITY / X(20) / 142 / 161 / Required – Residential City
R-ST / X(2) / 162 / 163 / Required – Residential State
2 position State Code
R-ZIP / X(5) / 164 / 168 / Required – Residential Zip Code
R-ZIP4 / X(4) / 169 / 172 / Optional
R-CTY / X(2) / 173 / 174 / Optional
M-STR-1 / X(25) / 175 / 199 / Optional
M-STR-2 / X(25) / 200 / 224 / Optional
M-CITY / X(20) / 225 / 244 / Optional
M-ST / X(2) / 245 / 246 / Optional
M-ZIP / X(5) / 247 / 251 / Optional
M-ZIP4 / X(4) / 252 / 255 / Optional
RES-PHO-AC / X(3) / 256 / 258 / Optional
RES-PHO-NO / X(7) / 259 / 265 / Optional
EMR-PHO-AC / X(3) / 266 / 268 / Optional
EMR-PHO-NO / X(7) / 269 / 275 / Optional
LANG-SPK / X(2) / 276 / 277 / Optional – See Table RF514 below.
2 byte field with position1 filler for future use
LANG-READ / X(2) / 278 / 279 / Optional – See Table RF514 below.
2 byte field with position1 filler for future use
EMAIL-ADDR / X(200) / 280 / 479 / Optional
ATTN / X(35) / 480 / 514 / Optional
ELG-KEY-CD / X(3) / 515 / 517 / Required – ‘ST1’
ELG-BEG-DAT / X(8) / 518 / 525 / Required – Format YYYYMMDD
ELG-END-DAT / X(8) / 526 / 533 / Required for Terminations – Format YYYYMMDD; Optional for ‘A’ and ‘C’
TRM-RSN / X(2) / 534 / 535 / Required - Termination Reason - for ‘T’ action code of ‘AO’
BHS-CAT / X(1) / 536 / 536 / Optional – ‘S’-SMI
If any other BHS category, leave blank.
FILLER / X(164) / 537 / 700

Trailer Record Layout

Data Name / Picture / Actual Positions / Remarks / Remarks
From / To
TRAILER-ID / X(5) / 1 / 5 / Required - ‘TRL1 ’
FILLER / X(14) / 6 / 19
TOTAL-RECS / X(7) / 20 / 26 / Required
FILLER / X(6) / 27 / 32
TOTAL-ADDS / X(7) / 33 / 39 / Required
FILLER / X(9) / 40 / 48
TOTAL-CHGS / X(7) / 49 / 55 / Required
FILLER / X(7) / 56 / 62
TOTAL-TERM / X(7) / 63 / 69 / Required
FILLER / X(631) / 70 / 700

Table RF518

RACE CODE / RACE DESCRIPTION
AS / ASIAN/PAC ISLND
BL / BLACK
CH / CUBAN/HAITIAN
CW / CAUCASIAN/WHITE
HS / HISPANIC
NA / NATIVE AMERICAN
OT / OTHER
UN / UNKNWN
CN / CHINESE
FI / FILIPINO
JA / JAPANESE
KO / KOREAN
VI / VIETNAMESE
HA / NATIVE HAWAIIAN
GU / GUAM/CHAMORRO
SA / SAMOAN
AI / ASIAN INDIAN
AO / OTHER ASIAN
NU / NAT HAW OR OTHER PAC ISLND UNKNOWN
US / UNSPECIFIED
AU / ASIAN UNKNOWN
OP / OTHER PACIFIC ISLANDER

Table RF569

CITIZEN CODE / CITIZEN DESCRIPTION
HB / HB HOUSE BILL
NC / NC NOT A CITIZEN
OT / OT UNDOCUMENTED
US / US US CITIZEN

Table RF535

ETHNICITY CODE / ETHNICITY DESCRIPTION
00 / Not of Hispanic, Latino/a, or Spanish origin
01 / Mexican, Mexican American, Chicano/a
02 / Puerto Rican
03 / Cuban
04 / Another Hispanic, Latino or Spanish origin
05 / Hispanic or Latino Unknown
06 / Ethnicity Unspecified
09 / Ethnicity Unknown

Table RF514

LANGUAGE CODE / LANGUAGE DESCRIPTION
& / YIDDISH
% / VIETNAMESE
# / TAGALOG
@ / SOMALI
A / ALBANIAN
B / AMERICAN SIGN LANGUAGE
C / AMHARIC
D / ARABIC
E / ENGLISH
F / ARMENIAN
G / CANTONESE
H / CHINESE
I / CROATION
J / FARSI
L / FRENCH
M / GERMAN
N / GREEK
O / OTHER
P / HAITIAN/CREOLE
Q / HINDI
R / HMONG
S / SPANISH
T / HOPI
U / UNKNOWN/UNSPECIFIC
V / HUNGARIAN
W / INDIAN (INDIA)
X / ITALIAN
Y / JAPANESE
Z / KHMER
0 / SERBIAN
1 / KOREAN
2 / LAOTIAN
3 / MANDARIN
4 / MON-KHMER
5 / NATIVE AMERICAN
6 / NAVAJO
7 / POLISH
8 / PORTUGUESE
9 / RUSSIAN