MedProID

Medical Professional Identification

July 2, 2010 BulkID File Layout Documentation Page: 1 of 11
BulkID File Format AZ75 DRAFT4
Description
The BulkID module of edP!oID

acce"t# an in"ut file of "!actitione!# and matche#

them to the edP!oID

data$a#e of #tate licen#ed "!actitione!#% Follo&ing $ulk

matching, a file i# gene!ated f!om BulkID containing the matching !e#ult# and !elated
licen#ing info!mation% Thi# document de#c!i$e# the BulkID out"ut file layout and content%
!eneral File Description
BulkID out"ut file# can $e !etu!ned in one of t&o fo!mat#: 1' In an ()*II te+t file, comma
delimited, in u""e!ca#e, &ith dou$le ,uotation# a!ound data field# or 2' In an ()*II te+t
file, "i"e -i%e%, ./0' #e"a!ated in u""e!ca#e% ( #&itch at the cu#tome! le1el, maintained $y
edP!o !e#ou!ce#, cont!ol# &hich fo!mat &ill $e !etu!ned%
In addition to choo#ing a !etu!n file fo!mat, cu#tome!# &ill $e a$le to #elect &hich
add!e## ty"e# they "!efe! in the BulkID !etu!n file#% edP!o ha# the a$ility to !etu!n the
add!e## info!mation in the .lite!al0 fo!m a# !ecei1ed f!om the 1a!iou# data #ou!ce# o!
*()) ce!tified .#tanda!di2ed0 fo!m "!o1ided $y the 3nited )tate# Po#tal )e!1ice% (
cu#tome! le1el #&itch &ill cont!ol if the lite!al o! #tanda!di2ed add!e## #hould $e
"!o1ided th!oughout the file%
Record T"pes
The BulkID out"ut file &ill contain a #ingle heade! !eco!d and multi"le detail !eco!d#% The
heade! !eco!d &ill $e "hy#ical fi!#t in the file -unle## the u#e! ha# !e,ue#ted that column
heading# $e included a# the fi!#t !eco!d%' and &ill $e identified &ith a 4eco!d Ty"e 5 1
and detail !eco!d# &ill $e identified $y a 4eco!d Ty"e 1alue $et&een 2 and 6% 7hile the
file maintain# a con#i#tent field fo!mat ac!o## all detail !eco!d#, the ty"e# of detail
!eco!d# !etu!ned de"end# on the #"ecific edP!oID

functionality &hich the cu#tome!

ha# cont!acted fo!% The follo&ing 4eco!d Ty"e# a!e a1aila$le:
# $ %eader Record 8 *ontain# high8le1el info!mation conce!ning the file% Fo!
e+am"le, the heade! !eco!d &ill contain the name of the file and date "!oce##ed
in addition to detail !eco!d total#% 9ach file &ill contain only a #ingle heade!
!eco!d%
& BulkID Detail Record : *ontain# info!mation conce!ning "!actitione!#
#u$mitted fo! 1alidation% )"ecifically, the file &ill contain one !eco!d fo! each
"!actitione! !eco!d #u$mitted fo! 1alidation% The fi!#t #egment of each !eco!d &ill
contain "!actitione! data a# #u$mitted $y the cu#tome!% Fo! !eco!d# &hich &e!e
#ucce##fully matched to the edP!oID

data$a#e, a""ended to each !eco!d &ill

$e one o! mo!e data #egment# containing !elated licen#ing info!mation% The
#egment# included &ill de"end on &hat the #"ecific cu#tome! ha# cont!acted%
The follo&ing #egment# a!e "o##i$le:
1' *u#tome! )u$mitted Data
2' )tate Licen#e Data
;otice: Thi# Document i# the *onfidential P!o"e!ty of edP!o )y#tem#

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MedProID

Medical Professional Identification

July 2, 2010 BulkID File Layout Documentation Page: 2 of 11
<' anual atching 7o!k$ench Info!mation
=' D9( Licen#e Data
>' (( Licen#e Data
?' ;PI Licen#e Data
@' Be#tInfo Info!mation
A' )tate )"ecific Info!mation
6' (#t!aBeneca (dditional Info!mation
' (amplea)ilit" *pdate Functionalit" $ +e,ati-e 8 4eco!d# of thi# ty"e
!e"!e#ent "!actitione!# "!e1iou#ly #u$mitted fo! 1alidation $y the cu#tome! &ho
ha1e changed f!om a "o#iti1e to a negati1e )am"lea$ility #tatu# fo! !ea#on#
othe! than e+"i!ation date% The #egment# contained in thi# !eco!d ty"e a!e the
#ame a# tho#e defined in the Detail 4eco!d ty"e a$o1e in item 2%
4 (amplea)ilit" *pdate Functionalit" $ Positi-e 8 4eco!d# of thi# ty"e
!e"!e#ent "!actitione!# "!e1iou#ly #u$mitted fo! 1alidation $y the cu#tome! &ho
ha1e changed f!om a negati1e to a "o#iti1e )am"lea$ility #tatu# fo! !ea#on#
othe! than e+"i!ation date% The #egment# contained in thi# !eco!d ty"e a!e the
#ame a# tho#e defined in the Detail 4eco!d ty"e a$o1e in item 2% C"tionally, thi#
!eco!d ty"e might contain !ene&ed "!actitione!# that no& ha1e an u"dated futu!e
e+"i!ation date%
5 Reser-ed 8 Thi# !eco!d ty"e ha# $een !e#e!1ed fo! futu!e u#e $y edP!o
)y#tem#%
. /ut$/f$(tate M01 8 4eco!d# of thi# ty"e !e"!e#ent "!actitione!# "!e1iou#ly
#u$mitted fo! 1alidation $y the cu#tome! &ho ha1e #tate licen#e# in othe! #tate#
$a#ed on thei! edical 9ducation ;um$e!% The #egment# contained in thi#
!eco!d ty"e a!e the #ame a# tho#e defined in the Detail 4eco!d ty"e a$o1e in
item 2%
7 /ut$/f$(tate +PI1 8 4eco!d# of thi# ty"e !e"!e#ent "!actitione!# "!e1iou#ly
#u$mitted fo! 1alidation $y the cu#tome! &ho ha1e #tate licen#e# in othe! #tate#
$a#ed on thei! ;ational P!o1ide! Identifie! ;um$e!% The #egment# contained in
thi# !eco!d ty"e a!e the #ame a# tho#e defined in the Detail 4eco!d ty"e a$o1e in
item 2%
2 Alternate 3icense D0A1 8 4eco!d# of thi# ty"e !e"!e#ent "!actitione!#
"!e1iou#ly #u$mitted fo! 1alidation $y the cu#tome! &ho ha1e a #econd D9(
;um$e!% The #egment# contained in thi# !eco!d ty"e a!e the #ame a# tho#e
defined in the Detail 4eco!d ty"e a$o1e in item 2%
4 Reser-ed 8 Thi# !eco!d ty"e ha# $een !e#e!1ed fo! futu!e u#e $y edP!o
)y#tem#
;otice: Thi# Document i# the *onfidential P!o"e!ty of edP!o )y#tem#

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MedProID

Medical Professional Identification

July 2, 2010 BulkID File Layout Documentation Page: < of 11
File (i5e 6onsiderations
Plea#e note that e+t!act !eco!d length# can 1a!y g!eatly de"ending on #"ecific data
1alue# and #egment# !etu!ned% )ome le## #o"hi#ticated edito!# may inad1e!tently cau#e
!eco!d# &ith la!ge !eco!d length# to &!a"% If you "lan on mani"ulating the e+t!act file
"!io! to "!oce##ing, ca!e #hould $e taken to en#u!e !eco!d# in the file do not &!a"%

File 3a"out
a' Deade! 4eco!d:
The heade! !eco!d &ill contain $a#ic info!mation conce!ning the info!mation contained in
the file%
Field
1 Field +ame Field Description 3en,t7
08cel
6olumn
%int
1 4eco!d Ty"e
15Deade! 4eco!d
1 (
2 *u#tome! ;ame
*u#tome! ;ame
<0 B
< In"ut File ;ame
C!iginal file name f!om cu#tome! fo! Bulk file
>0 *
= Data File &a# 4ecei1ed
Date file &a# !ecei1ed -EEEEDDDD))'
1= D
>
Total ;um$e! of Detail
4eco!d#
Total num$e! of ty"e52 !eco!d# in the file
@ 9
?
Total ;on8)am"lea$le
4eco!d#
4eco!d count fo! )am"lea$ility 3"date# if a""lica$le Ty"e5<
@ F
@ Total )am"lea$le 4eco!d#
4eco!d count fo! )am"lea$ility 3"date# if a""lica$le Ty"e5=
@ F
A Date Cut"ut File &a# *!eated
Date out"ut file &a# gene!ated-EEEEDDDD))'
1= D
6 BulkID File Fo!mat Identifie!
Inte!nal edP!oID
9
code fo! out"ut file fo!mat
= I
10
Total Po#iti1e to Po#iti1e
4eco!d#
4eco!d count fo! Po#iti1e to Po#iti1e !eco!d# Ty"e 5 =
@ J
11
Total Cut8Cf8)tate 9G
4eco!d#
4eco!d count fo! Cut8Cf8)tate 9G# Ty"e 5 ?
@ H
12
Total Cut8Cf8)tate ;PIG
4eco!d#
4eco!d count fo! Cut8Cf8)tate ;PIG# Ty"e 5 @
@ L
1<
Total (lte!nate Licen#e D9(
4eco!d#
4eco!d count fo! (lte!nate D9( Licen#e ;um$e!# Ty"e 5 A
@
1=
Ia!ia$le ;um$e! of Dummy
Field#
Pad heade! !eco!d to the num$e! of field# in the detail
!eco!d# to aid in file "a!#ingJloading 1 ;
;otice: Thi# Document i# the *onfidential P!o"e!ty of edP!o )y#tem#

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MedProID

Medical Professional Identification

July 2, 2010 BulkID File Layout Documentation Page: = of 11
$' P!actitione! Detail 4eco!d#:
The follo&ing !eco!d layout &ill $e utili2ed fo! all detail !eco!d ty"e# 286%
Field
1 Field +ame Field Description 3en,t7
08cel
6olumn
%int
1 4eco!d Ty"e 2,<,=,?,@,A 1 (
2 4eco!d )e,uence P!actitione! #e,uence num$e! of !eco!d in file 10 B
(e,ment # $ Practitioner Information Passed )" 6ustomer
< La#t ;ame P!actitione! la#t name =0 *
= Fi!#t ;ame P!actitione! fi!#t name =0 D
> iddle Initial P!actitione! middle name o! initial =0 9
? Title ;ame "!efi+ of !%, !#%, i##%, #, o! othe!% 20 F
@ )uffi+ ;ame ;ame #uffi+ of J!%, )!%, III, o! othe!% 20 F
A (dd!e## Line 1
P!o1ided add!e## of the "!actitione! -;ote: (dd!e## field# A
to 1< &ill contain the cu#tome! #u$mitted add!e## o! the
cu#tome! add!e## in a #tanda!di2ed fo!mat a# cont!acted $y
the cu#tome!%' A0 D
6 (dd!e## Line 2 *ontinuation of "!o1ided "!actitione! add!e## A0 I
10 *ity P!o1ided add!e## city =0 J
11 )tate P!o1ided add!e## #tate 2 H
12 Bi" *ode P!o1ided add!e## 2i" > L
1< Bi" *ode 9+ten#ion P!o1ided add!e## 2i" code e+ten#ion =
1= )tate Licen#e ;um$e! )tate a##igned licen#e num$e! 20 ;
1> Licen#ed )tate )tate g!anting licen#e 2 C
1? D9( ;um$e! D9( a##igned "!actitione! num$e! 20 P
1@ *u#tome! P!actitione! ;um$e! *u#tome! "!o1ided uni,ue inte!nal G fo! "!actitione! 20 K
1A Te!!ito!y ID *u#tome! Te!!ito!y 20 4
16 Bu#ine## 3nit *u#tome! Bu#ine## 3nit 20 )
20 edP!oID ;um$e!
3ni,uely a##igned edP!oID
9
num$e! fo! "!actitione!%
-;ote#: 1' Thi# field &ill contain the )L; edP!oID of the
"!actitione! matched to the cu#tome!8#u""lied "!actitione!%
2' In te!m# of )L; data, each "!actitione! in the edP!oID
9

data$a#e i# a##igned a uni,ue edP!oID
9
$a#ed on thei!
Licen#e )tate, )tate Licen#e ;um$e! and P!ofe##ional
De#ignation%' 20 T
21 )c!i"t T!acking ;um$e! 3ni,ue identifie! a##igned $y #c!i"t data "!o1ide! 20 3
22 edical 9ducation ;um$e!
edical education num$e! -11
th
digit i# a check digit &hich
can $e !emo1ed' 20 I
2< 4anking *u#tome! !anking le1el of "!actitione! < 7
2= Phone ;um$e! P!actitione! "!o1ided "hone num$e! 20 L
2> P!ofe##ional De#ignation P!ofe##ional de#ignation of "!actitione! 20 E
2? )"ecialty *u#tome! #"ecialty of "!actitione! 20 B
2@ ;PI ;um$e! ;PI a##igned "!actitione! num$e! 10 ((
2A *u#tome! *omment Field (ny cu#tome! #"ecific ID, o!de! num$e!, o! comment 100 (B
26 *u#tome! Defined Field 1 *u#tome! defined data field 100 (*
;otice: Thi# Document i# the *onfidential P!o"e!ty of edP!o )y#tem#

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MedProID

Medical Professional Identification

July 2, 2010 BulkID File Layout Documentation Page: > of 11
<0 *u#tome! Defined Field 2 *u#tome! defined data field 100 (D
<1 *u#tome! Defined Field < *u#tome! defined data field 100 (9
(e,ment & $(tate 3icense Information Returned )" MedProID

<2 *u#tome! C!de! ;um$e!

Fi!#t 20 *ha!acte!# of *u#tome! P!actitione! ;um$e!% -;ote:
Thi# field ha# $een !e"eated f!om field 1@ fo! con1enience%' 20 (F
<< edP!oID atch ethod
(5(uto, 353nmatched, 5anual atch, ;5;o atch,
454e#ol1ed, D5Du"licate 1 (F
<= edP!oID atch 4ule BulkID 4ule num$e! u#ed to match the !eco!d < (D
<> )L; edP!oID ;um$e!
3ni,ue num$e! a##igned to "!actitione! )L; !eco!d $y
edP!oID
9
-;ote: In te!m# of )L; data, each "!actitione! in
the edP!oID
9
Data$a#e i# a##igned a uni,ue edP!oID
9

$a#ed on thei! Licen#e )tate, )tate Licen#e ;um$e! and
P!ofe##ional De#ignation%' 20 (I
<? )tate of Licen#u!e )tate g!anting licen#e 2 (J
<@ )tate Licen#e ;um$e! )tate a##igned licen#e num$e! <> (H
<A (lte!nate Licen#e 1 (lte!nate )tate Licen#e 1 <> (L
<6 (lte!nate Licen#e 2 (lte!nate )tate Licen#e 2 <> (
=0 )tate Licen#e I##ue Date Licen#e i##ue date in: EEEEDD fo!mat A (;
=1 )tate Licen#e 9+"i!ation Date Licen#e e+"i!ation date in: EEEEDD fo!mat A (C
=2 )tate Licen#e )tatu# )tate a##igned "hy#ician licen#e #tatu# >0 (P
=< Title ;ame "!efi+ of !%, !#%, i##%, #, o! othe!% 20 (K
== La#t ;ame P!actitione! la#t name =0 (4
=> Fi!#t ;ame P!actitione! fi!#t name =0 ()
=? iddle Initial P!actitione! middle name o! initial =0 (T
=@ )uffi+ ;ame P!actitione! name #uffi+ of J!%, )!%, III, o! othe!% 20 (3
=A P!ofe##ional De#ignation P!ofe##ional de#ignation of "!actitione! >0 (I
=6 P!ofe##ional De#ig% Family P!ofe##ional de#ignation family a# ma""ed in edP!oID
9
20 (7
>0 )"ecialty )tate "!o1ided #"ecialty of "!actitione! 100 (L
>1 (dd!e## Line 1 )tate "!o1ided add!e## of the "!actitione! A0 (E
>2 (dd!e## Line 2 *ontinuation of )tate "!o1ided add!e## A0 (B
>< (dd!e## Line < *ontinuation of )tate "!o1ided add!e## A0 B(
>= *ity )tate "!o1ided add!e## city =0 BB
>> )tate )tate "!o1ided add!e## #tate 2 B*
>? Bi" *ode )tate "!o1ided add!e## 2i" code > BD
>@ Bi" *ode 9+ten#ion )tate "!o1ided add!e## 2i" code e+ten#ion = B9
>A Phone ;um$e! )tate "!o1ided "!actitione! "hone num$e! 20 BF
>6 )am"lea$ility C1e!all EJ;J3JD if the "!actitione! #hould !ecei1e #am"le# 1 BF
?0 )am"lea$ility Licen#e )tatu# EJ;J3 )am"lea$ility $a#ed on licen#e #tatu# 1 BD
?1 )am"lea$ility 9+"% C1e!all EJ;J3 )am"lea$ility $a#ed on e+"i!ation date 1 BI
?2 )tate F!ace Pe!iod ;um$e! of day# #tate $oa!d allo&# a# g!ace "e!iod = BJ
?< *u#tome! )tate F!ace Pe!iod ;um$e! of day# cu#tome! allo&# a# g!ace "e!iod = BH
?=
(dMu#ted )tate Licen#e
9+"i!ation Date
)tate Licen#e e+"i!ation date "lu# g!ace "e!iod:
EEEEDD A BL
;otice: Thi# Document i# the *onfidential P!o"e!ty of edP!o )y#tem#

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MedProID

Medical Professional Identification

July 2, 2010 BulkID File Layout Documentation Page: ? of 11
?> )am"lea$ility De#ig% )tatu# EJ;J3JD )am"lea$ility $a#ed on "!ofe##ional de#ignation 1 B
?? )am"lea$ility Fed%)anction# Date "!actitione! !ecei1ed fede!al #anction: EEEEDD A B;
?@ )am"lea$ility La#t 4ecei1ed Date "!actitione! !ecei1ed in edP!oID
9
: EEEEDD A BC
(e,ment ' Manual Matc7in, :ork)enc7 Information
?A (dMudication )am"lea$ility EJ; 8 *u#tome! o1e!!ide to edP!oID
9
)am"lea$ility 1 BP
?6 (dMudication *ode *u#tome! a##igned adMudication *ode 10 BK
@0 (dMudication *ode De#c!i"tion (dMudication code de#c!i"tion ?0 B4
@1 BulkID 7o!k$ench *omment *u#tome! in"ut comment in BulkID on matching acti1ity 100 B)
@2 Po##i$le atch 3#ed EJ; if "o##i$le match &a# acce"ted in BulkID 1 BT
@< )ea!ch 1ia 7e$ID EJ; if a 7e$ID
9
#ea!ch &a# attem"ted 1ia BulkID 1 B3
@= )ea!ch 1ia )tate 7e$#ite EJ; if a #tate &e$#ite &a# acce##ed 1ia BulkID 1 BI
@> *all to )tate Boa!d EJ; if a "hone call to #tate $oa!d &a# utili2ed 1 B7
@? *all to P!actitione! EJ; if a "hone call to "!actitione! &a# utili2ed 1 BL
@@ *all to )ale# 4e"!e#entati1e EJ; if a "hone call to the )ale# 4e"% &a# utili2ed 1 BE
@A Fle+ Deading 1 P!actitione! #"ecific fle+ heading 1 >0 BB
@6 Fle+ Ialue 1 P!actitione! #"ecific fle+ 1alue 1 100 *(
A0 Fle+ Deading 2 P!actitione! #"ecific fle+ heading 2 >0 *B
A1 Fle+ Ialue 2 P!actitione! #"ecific fle+ 1alue 2 100 **
A2 Fle+ Deading < P!actitione! #"ecific fle+ heading < >0 *D
A< Fle+ Ialue < P!actitione! #"ecific fle+ 1alue < 100 *9
A= Fle+ Deading = P!actitione! #"ecific fle+ heading = >0 *F
A> Fle+ Ialue = P!actitione! #"ecific fle+ 1alue = 100 *F
(e,ment 4 $ D0A 3icense Information Returned )" MedProID

A? D9( edP!oID ;um$e!

3ni,ue num$e! a##igned to "!actitione! D9( !eco!d $y
edP!oID
9
20 *D
A@ D9( ;um$e! D9( num$e! a##igned to "!actitione! 20 *I
AA D9( Bu#ine## (cti1ity *ode D9( B(* code N*O5 P!actitione!, NO 5 idle1el, o! othe! 1 *J
A6 D9( 9+"i!ation Date D9( e+"i!ation date in: EEEEDD fo!mat A *H
60 D9( Licen#e )tatu# D9( licen#e #tatu# >0 *L
61 D9( D!ug )chedule D9( d!ug #cheduled a##ociated &ith "hy#ician 20 *
62 D9( Title ;ame "!efi+ of !%, !#%, i##%, #, o! othe!% 20 *;
6< D9( La#t ;ame P!actitione! la#t name =0 *C
6= D9( Fi!#t ;ame P!actitione! fi!#t name =0 *P
6> D9( iddle ;ame P!actitione! middle name o! initial =0 *K
6? D9( )uffi+ ;ame P!actitione! name #uffi+ of J!%, )!%, III, o! othe!% 20 *4
6@ D9( (dd!e## Line 1 D9( "!o1ided add!e## of the "!actitione! A0 *)
6A D9( (dd!e## Line 2 *ontinuation of D9( "!o1ided add!e## A0 *T
66 D9( (dd!e## Line < *ontinuation of D9( "!o1ided add!e## A0 *3
100 D9( *ity D9( "!o1ided add!e## city =0 *I
101 D9( )tate D9( "!o1ided add!e## #tate 2 *7
102 D9( Bi" *ode D9( "!o1ided add!e## 2i" code > *L
10< D9( Bi" *ode 9+ten#ion D9( "!o1ided add!e## 2i" code e+ten#ion = *E
;otice: Thi# Document i# the *onfidential P!o"e!ty of edP!o )y#tem#

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MedProID

Medical Professional Identification

July 2, 2010 BulkID File Layout Documentation Page: @ of 11
10= D9( C1e!all 9ligi$ility EJ; if the "!actitione! had a 1alid D9( licen#e 1 *B
10> (dMudication 9ligi$ility EJ; 8 *u#tome! o1e!!ide to edP!oID
9
9ligi$ility 1 D(
10? (dMudication *ode *u#tome! a##igned adMudication *ode 10 DB
10@ (dMudication *ode De#c!i"tion (dMudication code de#c!i"tion ?0 D*
(e,ment 5 $ AMA 3icense Information Returned )" MedProID

10A (( edP!oID ;um$e!

3ni,ue num$e! a##igned to "!actitione! (( !eco!d $y
edP!oID
9
20 DD
106 (( 9 ;um$e!
edical 9ducation ;um$e!
-11
th
digit i# a check digit &hich can $e !emo1ed' 11 D9
110 (( )tate of Licen#u!e )tate g!anting licen#e 2 DF
111 (( )tate Licen#e ;um$e! )tate a##igned licen#e num$e! <> DF
112 (( )tate Licen#e 9+"% Date Licen#e e+"i!ation date in: EEEEDD fo!mat A DD
11< (( )tate Licen#e )tatu# )tate a##igned "hy#ician licen#e #tatu# >0 DI
11= (( (# of Date (( a# of date A DJ
11> (( La#t ;ame P!actitione! la#t name =0 DH
11? (( Fi!#t ;ame P!actitione! fi!#t name =0 DL
11@ (( iddle ;ame P!actitione! middle name o! initial =0 D
11A (( )uffi+ ;ame P!actitione! name #uffi+ of J!%, )!%, III, o! othe!% 20 D;
116 (( P!ofe##ional De#ignation P!ofe##ional de#ignation of "!actitione! >0 DC
120 (( P!of% De#ignation Family P!ofe##ional de#ignation family a# ma""ed in edP!oID

20 DP
121 (( P!ima!y )"ecialty (( "!o1ided "!ima!y #"ecialty of "!actitione! 100 DK
122 (( )econda!y )"ecialty (( "!o1ided #econda!y #"ecialty of "!actitione! 100 D4
12<
(( P!ima!y )"ecialty
ac!onym (( "!o1ided "!ima!y #"ecialty ac!onym < D)
12=
(( )econda!y )"ecialty
ac!onym (( "!o1ided #econda!y #"ecialty ac!onym < DT
12> (( (dd!e## Line 1 (( "!o1ided add!e## of the "!actitione! A0 D3
12? (( (dd!e## Line 2 *ontinuation of (( "!o1ided add!e## A0 DI
12@ (( (dd!e## Line < *ontinuation of (( "!o1ided add!e## A0 D7
12A (( *ity (( "!o1ided add!e## city =0 DL
126 (( )tate (( "!o1ided add!e## #tate 2 DE
1<0 (( Bi" *ode (( "!o1ided add!e## 2i" code > DB
1<1 (( Bi" *ode 9+ten#ion (( "!o1ided add!e## 2i" code e+ten#ion = 9(
1<2 (( (dd!e## Ty"e
(( "!o1ided add!e## ty"e: P!ofe##ional, Dome, Both o!
3nkno&n 12 9B
1<< (( Phone ;um$e! (( "!o1ided "!actitione! "hone num$e! 20 9*
1<= (( Phone Loc (( "!o1ided location of "hone num$e! 12 9D
1<> (( Bi!th Date (( "!o1ided date of $i!th A 99
1<? (( Bi!th *ity (( "!o1ided $i!th city <0 9F
1<@ (( Bi!th *ount!y (( "!o1ided $i!th count!y ?0 9F
1<A (( Fende! (( "!o1ided gende! 1 9D
1<6 (( F!aduation Eea! (( "!o1ided g!aduation yea! = 9I
1=0 (( F!aduation )chool (( "!o1ided medical #chool >0 9J
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MedProID

Medical Professional Identification

July 2, 2010 BulkID File Layout Documentation Page: A of 11
(e,ment . $ +PI 3icense Information Returned )" MedProID

1=1 ;PI edP!oID ;um$e!

3ni,ue num$e! a##igned to "!actitione! ;PI !eco!d $y
edP!oID
9
20 9H
1=2 ;PI ;um$e! ;PI ;um$e! a# a##igned to "!actitione! 10 9L
1=< ;PI )tate of Licen#u!e )tate g!anting licen#e 2 9
1== ;PI )tate Licen#e ;um$e! (##igned #tate licen#e num$e! <> 9;
1=> ;PI P!ima!y Ta+onomy *ode P!ima!y Ta+onomy *ode a##igned to the "!actitione! 10 9C
1=? ;PI P!ima!y Ta+onomy ;ame P!ima!y Ta+onomy *ode de#c!i"tion 1>0 9P
1=@ ;PI Cthe! Ta+onomy *ode Cthe! Ta+onomy *ode a##igned to the "!actitione! 10 9K
1=6 ;PI Cthe! Ta+onomy ;ame Cthe! Ta+onomy *ode de#c!i"tion 1>0 94
1=6 ;PI Cthe! Ta+onomy *ode Cthe! Ta+onomy *ode a##igned to the "!actitione! 10 9)
1>0 ;PI Cthe! Ta+onomy ;ame Cthe! Ta+onomy *ode de#c!i"tion 1>0 9T
1>1 ;PI Cthe! Ta+onomy *ode Cthe! Ta+onomy *ode a##igned to the "!actitione! 10 93
1>2 ;PI Cthe! Ta+onomy ;ame Cthe! Ta+onomy *ode de#c!i"tion 1>0 9I
1>< ;PI La#t ;ame P!actitione! la#t name =0 97
1>= ;PI Fi!#t ;ame P!actitione! fi!#t name =0 9L
1>> ;PI iddle ;ame P!actitione! middle name o! initial =0 9E
1>? ;PI )uffi+ ;ame P!actitione! name #uffi+ of J!%, )!%, III, o! othe!% 20 9B
1>@ ;PI Phone ;um$e! P!ofe##ional "hone num$e! 20 F(
1>A ;PI Fi!#t (dd!e## Line 1 Fi!#t "!o1ided add!e## of the "!actitione! A0 FB
1>6 ;PI Fi!#t (dd!e## Line 2 *ontinuation of fi!#t "!o1ided #t!eet add!e## A0 F*
1?0 ;PI Fi!#t (dd!e## Line < *ontinuation of fi!#t "!o1ided #t!eet add!e## A0 FD
1?1 ;PI Fi!#t *ity Fi!#t "!o1ided add!e## city =0 F9
1?2 ;PI Fi!#t )tate Fi!#t "!o1ided add!e## #tate =0 FF
1?< ;PI Fi!#t Bi" *ode Fi!#t "!o1ided add!e## 2i" code > FF
1?= ;PI Fi!#t Bi" *ode 9+ten#ion Fi!#t "!o1ided add!e## 2i" code e+ten#ion = FD
1?> ;PI Fi!#t Phone Phone num$e! a##ociated &ith fi!#t add!e## info!mation 20 FI
1?? ;PI Fi!#t Fa+ Fa+ num$e! a##ociated &ith fi!#t add!e## info!mation 20 FJ
1?@ ;PI Fi!#t (dd!e## Ty"e P!actice o! mailing add!e## ty"e 1? FH
1?A ;PI )econd (dd!e## Line 1 )econd "!o1ided add!e## of the "!actitione! A0 FL
1?6 ;PI )econd (dd!e## Line 2 *ontinuation of #econd "!o1ided #t!eet add!e## A0 F
1@0 ;PI )econd *ity )econd "!o1ided add!e## city =0 F;
1@1 ;PI )econd )tate )econd "!o1ided add!e## #tate =0 FC
1@2 ;PI )econd Bi" *ode )econd "!o1ided add!e## 2i" code > FP
1@< ;PI )econd Bi" *ode 9+t% )econd "!o1ided add!e## 2i" code e+ten#ion = FK
1@= ;PI )econd Phone Phone num$e! a##ociated &ith #econd add!e## info!mation 1? F4
1@> ;PI )econd Fa+ Fa+ num$e! a##ociated &ith #econd add!e## info!mation 20 F)
1@? ;PI )econd (dd!e## Ty"e P!actice o! mailing add!e## ty"e 20 FT
1@@ ;PI Fende! ;PI P!o1ided gende! 1 F3
1@A ;PI 9nume!ation Date Date ;PI num$e! &a# a##igned in: EEEEDD fo!mat A FI
1@6 ;PI La#t 3"date Date Date ;PI num$e! &a# u"dated in: EEEEDD fo!mat A F7
1A0 ;PI P!o1ided )tatu# ;PI a##igned #tatu# <0 FL
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MedProID

Medical Professional Identification

July 2, 2010 BulkID File Layout Documentation Page: 6 of 11
(e,ment 7 BestInfo Information Returned )" MedProID

1A1 Be#t Ii#it (dd!e## 1 Be#t 1i#itation add!e## dete!mined $y edP!o algo!ithm A0 FE
1A2 Be#t Ii#it (dd!e## 2 Be#t 1i#itation add!e## dete!mined $y edP!o algo!ithm A0 FB
1A< Be#t Ii#it (dd!e## < Be#t 1i#itation add!e## dete!mined $y edP!o algo!ithm A0 F(
1A= Be#t Ii#it *ity Be#t 1i#itation add!e## dete!mined $y edP!o algo!ithm =0 FB
1A> Be#t Ii#it )tate Be#t 1i#itation add!e## dete!mined $y edP!o algo!ithm =0 F*
1A? Be#t Ii#it Bi" code Be#t 1i#itation add!e## dete!mined $y edP!o algo!ithm > FD
1A@ Be#t Ii#it Bi" code e+ten#ion Be#t 1i#itation add!e## dete!mined $y edP!o algo!ithm = F9
1AA Be#t Ii#it Data )ou!ce Be#t Ii#it Data )ou!ce < FF
1A6 Be#t Ii#it Phone ;um$e! Phone num$e! a##ociated &ith Be#t Ii#it (dd!e## 20 FF
160 Be#t Ii#it Fa+ ;um$e! Fa+ num$e! a##ociated &ith Be#t Ii#it (dd!e## 20 FD
161 Be#t Ii#it *onfidence Le1el Be#t Ii#it *onfidence Le1el 10 FI
162 Be#t )"ecialty P!ima!y Be#t )"ecialty P!ima!y =0 FJ
16< Be#t )"ecialty )econda!y Be#t )"ecialty )econda!y =0 FH
16= Be#t )"ecialty Data )t!ing Be#t )"ecialty Data )t!ing 2000 FL
16> )tate Licen#e Feocode Lat% )tate licen#e add!e## latitude 10 F
16? )tate Licen#e Feocode Long% )tate licen#e add!e## longitude 10 F;
16@ )tate Licen#e 4DI
)tate licen#e add!e## 4e#idential Indicato!:
4 5 4e#idential, B 5 Bu#ine##, 3 5 3nkno&n 1 FC
16A D9( Licen#e Feocode Lat% D9( licen#e add!e## latitude 10 FP
166 D9( Licen#e Feocode Long% D9( licen#e add!e## longitude 10 FK
200 D9( Licen#e 4DI
D9( licen#e add!e## 4e#idential Indicato!:
4 5 4e#idential, B 5 Bu#ine##, 3 5 3nkno&n 1 F4
201 (( Licen#e Feocode Lat% (( licen#e add!e## latitude 10 F)
202 (( Licen#e Feocode Long% (( licen#e add!e## longitude 10 FT
20< (( Licen#e 4DI
(( licen#e add!e## 4e#idential Indicato!:
4 5 4e#idential, B 5 Bu#ine##, 3 5 3nkno&n 1 F3
20=
;PI Licen#e (dd!e## 1
Feocode Lat% ;PI licen#e fi!#t add!e## latitude 10 FI
20>
;PI Licen#e (dd!e## 1
Feocode Long% ;PI licen#e fi!#t add!e## longitude 10 F7
20? ;PI Licen#e (dd!e## 1 4DI
;PI licen#e fi!#t add!e## 4e#idential Indicato!:
4 5 4e#idential, B 5 Bu#ine##, 3 5 3nkno&n 1 FL
20@
;PI Licen#e (dd!e## 2
Feocode Lat% ;PI licen#e #econd add!e## latitude 10 FE
20A
;PI Licen#e (dd!e## 2
Feocode Long% ;PI licen#e #econd add!e## longitude 10 FB
206 ;PI Licen#e (dd!e## 2 4DI
;PI licen#e #econd add!e## 4e#idential Indicato!:
4 5 4e#idential, B 5 Bu#ine##, 3 5 3nkno&n 1 D(
210 Be#t Ii#it Feocode Lat% Be#t 1i#itation add!e## latitude 10 DB
211 Be#t Ii#it Feocode Long% Be#t 1i#itation add!e## longitude 10 D*
212 Be#t Ii#it 4DI
Be#t 1i#itation add!e## 4e#idential Deli1e!y Indicato!:
4 5 4e#idential, B 5 Bu#ine##, 3 5 3nkno&n 1 DD
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MedProID

Medical Professional Identification

July 2, 2010 BulkID File Layout Documentation Page: 10 of 11
(e,ment 2 (tate (pecific Information Returned )" MedProID

21< )tate of Licen#u!e )tate g!anting licen#e 2 D9
21= )tate Licen#e num$e! )tate $oa!d "!o1ided licen#e num$e! =0 DF
21> )tate ID 1alue )tate $oa!d "!o1ided "!actitione! ID 1alue 20 DF
21? La#t ;ame )tate $oa!d "!o1ided La#t ;ame =0 DD
21@ Fi!#t ;ame )tate $oa!d "!o1ided Fi!#t ;ame =0 DI
21A iddle ;ame )tate $oa!d "!o1ided iddle ;ame =0 DJ
216 )uffi+ )tate $oa!d "!o1ided )uffi+ 20 DH
220 Full ;ame )tate $oa!d "!o1ided Full ;ame A0 DL
221 (dd!e## Line 1 )tate $oa!d "!o1ided (dd!e## Line 1 A0 D
222 (dd!e## Line 2 *ontinuation of )tate $oa!d "!o1ided (dd!e## A0 D;
22< *ity )tate $oa!d "!o1ided (dd!e## *ity =0 DC
22= )tate )tate $oa!d "!o1ided (dd!e## )tate =0 DP
22> Bi" *ode )tate $oa!d "!o1ided (dd!e## Bi" code > DK
22? 9ntity Ty"e )tate $oa!d "!o1ided entity ty"e A0 D4
22@ Licen#e Ty"e )tate $oa!d "!o1ided licen#e ty"e A0 D)
22A Fle+ Deading 1 P!actitione! #"ecific fle+ heading 1 >0 DT
226 Fle+ Ialue 1 P!actitione! #"ecific fle+ 1alue 1 100 D3
2<0 Fle+ Deading 2 P!actitione! #"ecific fle+ heading 2 100 DI
2<1 Fle+ Ialue 2 P!actitione! #"ecific fle+ 1alue 2 100 D7
2<2 Fle+ Deading < P!actitione! #"ecific fle+ heading < 100 DL
2<< Fle+ Ialue < P!actitione! #"ecific fle+ 1alue < 100 DE
2<= Fle+ Deading = P!actitione! #"ecific fle+ heading = 100 DB
2<> Fle+ Ialue = P!actitione! #"ecific fle+ 1alue = 100 I(
(e,ment 4 AstraZeneca Additional Information Returned )" MedProID

2<? Incoming (dd!e## Line < (dd!e## line < a# "!o1ided in (B incoming file A0 IB
2<@ 4DI fo! (B Incoming (dd!e##
(B incoming add!e## 4e#idential Deli1e!y Indicato!:
4 5 4e#idential, B 5 Bu#ine##, 3 5 3nkno&n 1 I*
2<A
C1e!all )am"le *ent!al
9ligi$ility
EJ; eligi$ility $a#ed on )L;, (dd!e## and P!of De#
1e!ification 1 ID
2<6 C1e!all (dd!e## 9ligi$ility
EJ; eligi$ility $a#ed on (B add!e## 1e!ification $u#ine##
!ule# 1 I9
2=0 (dd!e## atch
EJ; $a#ed on (B add!e## 1e!ification $u#ine## !ule# :
match i# $a#ed on *u!!ent and Di#to!ical add!e## 1 IF
2=1 Bi" *ode atch EJ; $a#ed on (B add!e## 1e!ification $u#ine## !ule# 1 IF
2=2 (dd!e## Ty"e ;ot 9+cluded EJ; $a#ed on (B add!e## e+clu#ion# $u#ine## !ule# 1 ID
2=< (dd!e## )ou!ce
)L;, D9(, ((, ;PI, (B (lt Li#t $a#ed on ty"e of add!e##
!eco!d matched to < II
2== *u!!ent (dd!e## atch
EJ; $a#ed on &hethe! the matched add!e## &a# cu!!ent o!
hi#to!ical 1 IJ
2=>
P!ofe##ional De#ignation
9ligi$ility atch
EJ; $a#ed on (B P!ofe##ional De#ignation 1e!ification
$u#ine## !ule# 1 IH
2=? De#ignation Family a""ed
EJ; $a#ed on if the incoming de#ignation ma"# to one of
the fou! (B #am"lea$le de#ignation familie# 1 IL
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MedProID

Medical Professional Identification

July 2, 2010 BulkID File Layout Documentation Page: 11 of 11
2=@
)to!ed P!ofe##ional
De#ignation atch
EJ; $a#ed on P!ofe##ional De#ignation matching
de#ignation #to!ed in )tate Licen#e !eco!d 1 I
2=A 4etu!n e##age 9!!o! me##age fo! !eco!d !eMection >0 I;
2=6 )anction Ty"e 1 Ty"e of )anction: Fede!al, D9(, ((, *u#tome! etc 20 IC
2>0 )anction Indicato! 1 Doe# )anction Ty"e effect )am"lea$ility of "!actitione! EJ; 1 IP
2>1 )anction Ty"e 2 Ty"e of )anction: Fede!al, D9(, ((, *u#tome! etc 20 IK
2>2 )anction Indicato! 2 Doe# )anction Ty"e effect )am"lea$ility of "!actitione! EJ; 1 I4
2>< )anction Ty"e < Ty"e of )anction: Fede!al, D9(, ((, *u#tome! etc 20 I)
2>= )anction Indicato! < Doe# )anction Ty"e effect )am"lea$ility of "!actitione! EJ; 1 IT
2>> )anction Ty"e = Ty"e of )anction: Fede!al, D9(, ((, *u#tome! etc 20 I3
2>? )anction Indicato! = Doe# )anction Ty"e effect )am"lea$ility of "!actitione! EJ; 1 II
2>@ )anction De#c!i"tion 1 Definition of the )anction Ty"e 1 100 I7
2>A )anction De#c!i"tion 2 Definition of the )anction Ty"e 2 100 IL
2>6 )anction De#c!i"tion < Definition of the )anction Ty"e < 100 IE
2?0 )anction De#c!i"tion = Definition of the )anction Ty"e = 100 IB
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