1                              CROSS-REFERENCE HEALTH INSURANCE CLAIM NUMBER INPUT RECORD

                                                 POSITIONS
                  NAME              TYPE  LENGTH BEG  END                            CONTENTS
       ---------------------------  ----  ------ ---------  ------------------------------------------------------------

 ****  CROSS-REFERENCE HEALTH       REC      14     1   14  INPUT FINDER RECORD
       INSURANCE CLAIM NUMBER
       INPUT RECORD                                         SYSTEM ALIAS: XREF1
                                                            DA1 ALIAS: XREF1@

 ****  HEALTH INSURANCE CLAIM       GROUP    11     1   11  THIS NUMBER IDENTIFIES A MEDICARE BENEFICIARY
       ACCOUNT NUMBER                                       IN AN INPUT FINDER

                                                            STANDARD ALIAS: INP_BENE_CLM_NUM_GRP
                                                            COMMON ALIAS: HIC

    1. INPUT BENEFICIARY ACCOUNT    CHAR      9     1    9  THE NUMBER IDENTIFYING THE WAGE EARNER
       NUMBER                                               ON A FINDER RECORD SUBMITTED.

                                                            STANDARD ALIAS: INP_BENE_CLM_ACNT_NUM
                                                            COMMON ALIAS: CAN

                                                            SOURCE:
                                                            USER

    2. INPUT BENEFICIARY            CHAR      2    10   11  THE BENEFICIARY IDENTIFICATION CODE SUPPLIED
       IDENTIFICATION CODE                                  BY THE USER ON AN INPUT FINDER RECORD.

                                                            STANDARD ALIAS: INP_BENE_IDENT_CD
                                                            COMMON ALIAS: BIC

                                                            SOURCE:
                                                            USER

    3. INPUT USER REFERENCE CODE    CHAR      2    12   13  OPTIONAL USER SUPPLIED REFERENCE CODE

                                                            STANDARD ALIAS: INP_USER_RFRNC_CD

                                                            SOURCE:
                                                            USER

    4. INPUT SEX CODE               CHAR      1    14   14  BENEFIARY'S GENDER PER THE INPUT FINDER

                                                            STANDARD ALIAS: INP_SEX_CD

                                                            EDIT-RULES:
                                                            OPTIONAL

                                                            CODES:
                                                            1 = MALE
                                                            2 = FEMALE

                                                            SOURCE:
                                                            USER
1                              CROSS-REFERENCE HEALTH INSURANCE CLAIM NUMBER OUTPUT RECORD

                                                 POSITIONS
                  NAME              TYPE  LENGTH BEG  END                            CONTENTS
       ---------------------------  ----  ------ ---------  ------------------------------------------------------------

 ****  CROSS-REFERENCE HEALTH       REC      30     1   30  A CROSS-REFERENCE HEALTH INSURANCE CLAIM
       INSURANCE CLAIM NUMBER                               NUMBER (HIC) OUTPUT RECORD IN RESPONSE TO AN
       OUTPUT RECORD                                        INPUT FINDER CROSS-REFERENCE HIC INPUT RECORD.

                                                            SYSTEM ALIAS: XREF2
                                                            DA1 ALIAS: XREF2@

 ****  HEALTH INSURANCE CLAIM       GROUP    11     1   11  THIS NUMBER UNIQUELY IDENTIFIES A MEDICARE
       ACCOUNT NUMBER (HIC)                                 BENEFICIARY.

                                                            STANDARD ALIAS: BENE_CLM_NUM_GRP
                                                            COMMON ALIAS: HIC
                                                            COBOL ALIAS: BENE_CLM_NUM

    1. BENEFICIARY ACCOUNT NUMBER   CHAR      9     1    9  THE NUMBER IDENTIFYING THE WAGE EARNER
                                                            UNDER THE SSA OR RRB PROGRAMS SUBMITTED.

                                                            STANDARD ALIAS: BENE_CLM_ACNT_NUM
                                                            COMMON ALIAS: CAN
                                                            TITLE ALIAS: CAN
                                                            SAS ALIAS: CAN

                                                            SQL-INFO:
                                                            CHAR(9)       NOT NULL

                                                            SOURCE:
                                                            SSA,RRB

                                                            LIMITATIONS:
                                                            RRB-ISSUED NUMBERS CONTAIN AN OVERPUNCH IN
                                                            THE FIRST POSITION THAT MAY APPEAR AS A PLUS
                                                            ZERO OR A-G.   RRB-FORMATTED NUMBERS MAY
                                                            CAUSE MATCHING PROBLEMS ON NON-IBM MACHINES.

    2. INPUT BENEFICIARY            CHAR      2    10   11  THE BENEFICIARY IDENTIFICATION CODE SUPPLIED
       IDENTIFICATION CODE                                  BY THE USER ON AN INPUT FINDER RECORD.

                                                            STANDARD ALIAS: INP_BENE_IDENT_CD
                                                            COMMON ALIAS: BIC

                                                            SOURCE:
                                                            USER

    3. INPUT USER REFERENCE CODE    CHAR      2    12   13  OPTIONAL USER SUPPLIED REFERENCE CODE

                                                            STANDARD ALIAS: INP_USER_RFRNC_CD

                                                            SOURCE:
                                                            USER

    4. FILLER                       CHAR      1    14   14  STANDARD ALIAS: FILLER
                                                            SAS ALIAS: FILLER

1                              CROSS-REFERENCE HEALTH INSURANCE CLAIM NUMBER OUTPUT RECORD

                                                 POSITIONS
                  NAME              TYPE  LENGTH BEG  END                            CONTENTS
       ---------------------------  ----  ------ ---------  ------------------------------------------------------------
    5. EQUATED BENEFICIARY          CHAR      2    15   16  THIS CODE SPECIFIES THE TYPE OF BENEFICIARY
       IDENTIFICATION CODE (BIC)                            FOR CASH PAYMENT PROGRAMS AND IDENTIFIES THE
                                                            TYPE OF RELATIONSHIP BETWEEN THE INDIVIDUAL
                                                            AND PRIMARY BENEFICIARY WHEN THE INDIVIDUAL
                                                            IS QUALIFIED UNDER ANOTHER'S ACCOUNT.
                                                            THE CODE IS EQUATED TO A COMMON BIC.
                                                            FOR EXAMPLE, THE RECORDS FOR A WIFE
                                                            (BIC B) WHO BECOMES A WIDOW (BIC D) IN THE
                                                            FILE YEAR WOULD HAVE ALL RECORDS CODED TO
                                                            THE FIRST BIC.

                                                            COMMON ALIAS: BIC

                                                            CODES:
                                                            SOCIAL SECURITY ADMINISTRATION:

                                                            A  = PRIMARY CLAIMANT
                                                            B  = AGED WIFE, AGE 62 OR OVER (1ST
                                                                 CLAIMANT)
                                                            B1 = AGED HUSBAND, AGE 62 OR OVER (1ST
                                                                 CLAIMANT)
                                                            B2 = YOUNG WIFE, WITH A CHILD IN HER CARE
                                                                 (1ST CLAIMANT)
                                                            B3 = AGED WIFE (2ND CLAIMANT)
                                                            B4 = AGED HUSBAND (2ND CLAIMANT)
                                                            B5 = YOUNG WIFE (2ND CLAIMANT)
                                                            B6 = DIVORCED WIFE, AGE 62 OR OVER (1ST
                                                                 CLAIMANT)
                                                            B7 = YOUNG WIFE (3RD CLAIMANT)
                                                            B8 = AGED WIFE (3RD CLAIMANT)
                                                            B9 = DIVORCED WIFE (2ND CLAIMANT)
                                                            BA = AGED WIFE (4TH CLAIMANT)
                                                            BD = AGED WIFE (5TH CLAIMANT)
                                                            BG = AGED HUSBAND (3RD CLAIMANT)
                                                            BH = AGED HUSBAND (4TH CLAIMANT)
                                                            BJ = AGED HUSBAND (5TH CLAIMANT)
                                                            BK = YOUNG WIFE (4TH CLAIMANT)
                                                            BL = YOUNG WIFE (5TH CLAIMANT)
                                                            BN = DIVORCED WIFE (3RD CLAIMANT)
                                                            BP = DIVORCED WIFE (4TH CLAIMANT)
                                                            BQ = DIVORCED WIFE (5TH CLAIMANT)
                                                            BR = DIVORCED HUSBAND (1ST CLAIMANT)
                                                            BT = DIVORCED HUSBAND (2ND CLAIMANT)
                                                            BW = YOUNG HUSBAND (2ND CLAIMANT)
                                                            BY = YOUNG HUSBAND (1ST CLAIMANT)
                                                            C1-C9,CA-CK = CHILD (INCLUDES MINOR, STUDENT
                                                                          OR DISABLED CHILD)
                                                            D  = AGED WIDOW, 60 OR OVER (1ST CLAIMANT)
                                                            D1 = AGED WIDOWER, AGE 60 OR OVER (1ST
                                                                 CLAIMANT)
                                                            D2 = AGED WIDOW (2ND CLAIMANT)
                                                            D3 = AGED WIDOWER (2ND CLAIMANT)
                                                            D4 = WIDOW (REMARRIED AFTER ATTAINMENT OF
                                                                 AGE 60) (1ST CLAIMANT)
1                              CROSS-REFERENCE HEALTH INSURANCE CLAIM NUMBER OUTPUT RECORD

                                                 POSITIONS
                  NAME              TYPE  LENGTH BEG  END                            CONTENTS
       ---------------------------  ----  ------ ---------  ------------------------------------------------------------
                                                            D5 = WIDOWER (REMARRIED AFTER ATTAINMENT OF
                                                                 AGE 60) (1ST CLAIMANT)
                                                            D6 = SURVIVING DIVORCED WIFE, AGE 60 OR OVER
                                                                 (1ST CLAIMANT)
                                                            D7 = SURVIVING DIVORCED WIFE (2ND CLAIMANT)
                                                            D8 = AGED WIDOW (3RD CLAIMANT)
                                                            D9 = REMARRIED WIDOW (2ND CLAIMANT)
                                                            DA = REMARRIED WIDOW (3RD CLAIMANT)
                                                            DD = AGED WIDOW (4TH CLAIMANT)
                                                            DG = AGED WIDOW (5TH CLAIMANT)
                                                            DH = AGED WIDOWER (3RD CLAIMANT)
                                                            DJ = AGED WIDOWER (4TH CLAIMANT)
                                                            DK = AGED WIDOWER (5TH CLAIMANT)
                                                            DL = REMARRIED WIDOW (4TH CLAIMANT)
                                                            DM = SURVIVING DIVORCED HUSBAND (2ND
                                                                 CLAIMANT)
                                                            DN = REMARRIED WIDOW (5TH CLAIMANT)
                                                            DP = REMARRIED WIDOWER (2ND CLAIMANT)
                                                            DQ = REMARRIED WIDOWER (3RD CLAIMANT)
                                                            DR = REMARRIED WIDOWER (4TH CLAIMANT)
                                                            DS = SURVIVING DIVORCED HUSBAND (3RD
                                                                 CLAIMANT)
                                                            DT = REMARRIED WIDOWER (5TH CLAIMANT)
                                                            DV = SURVIVING DIVORCED WIFE (3RD CLAIMANT)
                                                            DW = SURVIVING DIVORCED WIFE (4TH CLAIMANT)
                                                            DX = SURVIVING DIVORCED HUSBAND (4TH
                                                                 CLAIMANT)
                                                            DY = SURVIVING DIVORCED WIFE (5TH CLAIMANT)
                                                            DZ = SURVIVING DIVORCED HUSBAND (5TH
                                                                 CLAIMANT)
                                                            E  = MOTHER (WIDOW) (1ST CLAIMANT)
                                                            E1 = SURVIVING DIVORCED MOTHER (1ST
                                                                 CLAIMANT)
                                                            E2 = MOTHER (WIDOW) (2ND CLAIMANT)
                                                            E3 = SURVIVING DIVORCED MOTHER (2ND
                                                                 CLAIMANT)
                                                            E4 = FATHER (WIDOWER) (1ST CLAIMANT)
                                                            E5 = SURVIVING DIVORCED FATHER (WIDOWER)
                                                                 (1ST CLAIMANT)
                                                            E6 = FATHER (WIDOWER) (2ND CLAIMANT)
                                                            E7 = MOTHER (WIDOW) (3RD CLAIMANT)
                                                            E8 = MOTHER (WIDOW) (4TH CLAIMANT)
                                                            E9 = SURVIVING DIVORCED FATHER (WIDOWER)
                                                                 (2ND CLAIMANT)
                                                            EA = MOTHER (WIDOW) (5TH CLAIMANT)
                                                            EB = SURVIVING DIVORCED MOTHER (3RD
                                                                 CLAIMANT)
                                                            EC = SURVIVING DIVORCED MOTHER (4TH
                                                                 CLAIMANT)
                                                            ED = SURVIVING DIVORCED MOTHER (5TH
                                                                 CLAIMANT
                                                            EF = FATHER (WIDOWER) (3RD CLAIMANT)
                                                            EG = FATHER (WIDOWER) (4TH CLAIMANT)
                                                            EH = FATHER (WIDOWER) (5TH CLAIMANT)
1                              CROSS-REFERENCE HEALTH INSURANCE CLAIM NUMBER OUTPUT RECORD

                                                 POSITIONS
                  NAME              TYPE  LENGTH BEG  END                            CONTENTS
       ---------------------------  ----  ------ ---------  ------------------------------------------------------------
                                                            EJ = SURVIVING DIVORCED FATHER (3RD
                                                                 CLAIMANT)
                                                            EK = SURVIVING DIVORCED FATHER (4TH
                                                                 CLAIMANT)
                                                            EM = SURVIVING DIVORCED FATHER (5TH
                                                                 CLAIMANT)
                                                            F1 = FATHER
                                                            F2 = MOTHER
                                                            F3 = STEPFATHER
                                                            F4 = STEPMOTHER
                                                            F5 = ADOPTING FATHER
                                                            F6 = ADOPTING MOTHER
                                                            F7 = SECOND ALLEGED FATHER
                                                            F8 = SECOND ALLEGED MOTHER
                                                            J1 = PRIMARY PROUTY ENTITLED TO HIB
                                                                 (LESS THAN 3 Q.C.) (GENERAL FUND)
                                                            J2 = PRIMARY PROUTY ENTITLED TO HIB
                                                                 (OVER 2 Q.C.) (RSI TRUST FUND)
                                                            J3 = PRIMARY PROUTY NOT ENTITLED TO HIB
                                                                 (LESS THAN 3 Q.C.) (GENERAL FUND)
                                                            J4 = PRIMARY PROUTY NOT ENTITLED TO HIB
                                                                 (OVER 2 Q.C.) (RSI TRUST FUND)
                                                            K1 = PROUTY WIFE ENTITLED TO HIB (LESS THAN
                                                                 3 Q.C.) (GENERAL FUND) (1ST CLAIMANT)
                                                            K2 = PROUTY WIFE ENTITLED TO HIB (OVER 2
                                                                 Q.C.) (RSI TRUST FUND) (1ST CLAIMANT)
                                                            K3 = PROUTY WIFE NOT ENTITLED TO HIB (LESS
                                                                 THAN 3 Q.C.) (GENERAL FUND) (1ST
                                                                 CLAIMANT)
                                                            K4 = PROUTY WIFE NOT ENTITLED TO HIB (OVER
                                                                 2 Q.C.) (RSI TRUST FUND) (1ST
                                                                 CLAIMANT)
                                                            K5 = PROUTY WIFE ENTITLED TO HIB (LESS THAN
                                                                 3 Q.C.) (GENERAL FUND) (2ND CLAIMANT)
                                                            K6 = PROUTY WIFE ENTITLED TO HIB (OVER 2
                                                                 Q.C.) (RSI TRUST FUND) (2ND CLAIMANT)
                                                            K7 = PROUTY WIFE NOT ENTITLED TO HIB (LESS
                                                                 THAN 3 Q.C.) (GENERAL FUND) (2ND
                                                                 CLAIMANT)
                                                            K8 = PROUTY WIFE NOT ENTITLED TO HIB (OVER
                                                                 2 Q.C.) (RSI TRUST FUND) (2ND
                                                                 CLAIMANT)
                                                            K9 = PROUTY WIFE ENTITLED TO HIB (LESS THAN
                                                                 3 Q.C.) (GENERAL FUND) (3RD CLAIMANT)
                                                            KA = PROUTY WIFE ENTITLED TO HIB (OVER 2
                                                                 Q.C.) (RSI TRUST FUND) (3RD CLAIMANT)
                                                            KB = PROUTY WIFE NOT ENTITLED TO HIB (LESS
                                                                 THAN 3 Q.C.) (GENERAL FUND) (3RD
                                                                 CLAIMANT)
                                                            KC = PROUTY WIFE NOT ENTITLED TO HIB (OVER
                                                                 2 Q.C.) (RSI TRUST FUND) (3RD
                                                                 CLAIMANT)
                                                            KD = PROUTY WIFE ENTITLED TO HIB (LESS THAN
                                                                 3 Q.C.) (GENERAL FUND) (4TH CLAIMANT)
1                              CROSS-REFERENCE HEALTH INSURANCE CLAIM NUMBER OUTPUT RECORD

                                                 POSITIONS
                  NAME              TYPE  LENGTH BEG  END                            CONTENTS
       ---------------------------  ----  ------ ---------  ------------------------------------------------------------
                                                            KE = PROUTY WIFE ENTITLED TO HIB (OVER 2 Q.C
                                                                 (4TH CLAIMANT)
                                                            KF = PROUTY WIFE NOT ENTITLED TO HIB (LESS
                                                                 THAN 3 Q.C.)(4TH CLAIMANT)
                                                            KG = PROUTY WIFE NOT ENTITLED TO HIB (OVER
                                                                 2 Q.C.)(4TH CLAIMANT)
                                                            KH = PROUTY WIFE ENTITLED TO HIB (LESS THAN
                                                                 3 Q.C.)(5TH CLAIMANT)
                                                            KJ = PROUTY WIFE ENTITLED TO HIB (OVER 2
                                                                 Q.C.) (5TH CLAIMANT)
                                                            KL = PROUTY WIFE NOT ENTITLED TO HIB (LESS
                                                                 THAN 3 Q.C.)(5TH CLAIMANT)
                                                            KM = PROUTY WIFE NOT ENTITLED TO HIB (OVER
                                                                 2 Q.C.) (5TH CLAIMANT)
                                                            M  = UNINSURED-NOT QUALIFIED FOR DEEMED HIB
                                                            M1 = UNINSURED-QUALIFIED BUT REFUSED HIB
                                                            T  = UNINSURED-ENTITLED TO HIB UNDER DEEMED
                                                                 OR RENAL PROVISIONS
                                                            TA = MQGE (PRIMARY CLAIMANT)
                                                            TB = MQGE AGED SPOUSE (FIRST CLAIMANT)
                                                            TC = MQGE DISABLED ADULT CHILD (FIRST CLAIMANT)
                                                            TD = MQGE AGED WIDOW(ER) (FIRST CLAIMANT)
                                                            TE = MQGE YOUNG WIDOW(ER) (FIRST CLAIMANT)
                                                            TF = MQGE PARENT (MALE)
                                                            TG = MQGE AGED SPOUSE (SECOND CLAIMANT)
                                                            TH = MQGE AGED SPOUSE (THIRD CLAIMANT)
                                                            TJ = MQGE AGED SPOUSE (FOURTH CLAIMANT)
                                                            TK = MQGE AGED SPOUSE (FIFTH CLAIMANT)
                                                            TL = MQGE AGED WIDOW(ER) (SECOND CLAIMANT)
                                                            TM = MQGE AGED WIDOW(ER) (THIRD CLAIMANT)
                                                            TN = MQGE AGED WIDOW(ER) (FOURTH CLAIMANT)
                                                            TP = MQGE AGED WIDOW(ER) (FIFTH CLAIMANT)
                                                            TQ = MQGE PARENT (FEMALE)
                                                            TR = MQGE YOUNG WIDOW(ER) (SECOND CLAIMANT)
                                                            TS = MQGE YOUNG WIDOW(ER) (THIRD CLAIMANT)
                                                            TT = MQGE YOUNG WIDOW(ER) (FOURTH CLAIMANT)
                                                            TU = MQGE YOUNG WIDOW(ER) (FIFTH CLAIMANT)
                                                            TV = MQGE DISABLED WIDOW(ER) FIFTH CLAIMANT
                                                            TW = MQGE DISABLED WIDOW(ER) FIRST CLAIMANT
                                                            TX = MQGE DISABLED WIDOW(ER) SECOND CLAIMANT
                                                            TY = MQGE DISABLED WIDOW(ER) THIRD CLAIMANT
                                                            TZ = MQGE DISABLED WIDOW(ER) FOURTH CLAIMANT
                                                            T2-T9 = DISABLED CHILD (SECOND TO NINTH
                                                                    CLAIMANT)
                                                            W  = DISABLED WIDOW, AGE 50 OR OVER (1ST
                                                                 CLAIMANT)
                                                            W1 = DISABLED WIDOWER, AGE 50 OR OVER (1ST
                                                                 CLAIMANT)
                                                            W2 = DISABLED WIDOW (2ND CLAIMANT)
                                                            W3 = DISABLED WIDOWER (2ND CLAIMANT)
                                                            W4 = DISABLED WIDOW (3RD CLAIMANT)
                                                            W5 = DISABLED WIDOWER (3RD CLAIMANT)
                                                            W6 = DISABLED SURVIVING DIVORCED WIFE (1ST
                                                                 CLAIMANT)
1                              CROSS-REFERENCE HEALTH INSURANCE CLAIM NUMBER OUTPUT RECORD

                                                 POSITIONS
                  NAME              TYPE  LENGTH BEG  END                            CONTENTS
       ---------------------------  ----  ------ ---------  ------------------------------------------------------------
                                                            W7 = DISABLED SURVIVING DIVORCED WIFE (2ND
                                                                 CLAIMANT)
                                                            W8 = DISABLED SURVIVING DIVORCED WIFE (3RD
                                                                 CLAIMANT)
                                                            W9 = DISABLED WIDOW (4TH CLAIMANT)
                                                            WB = DISABLED WIDOWER (4TH CLAIMANT)
                                                            WC = DISABLED SURVIVING DIVORCED WIFE (4TH
                                                                 CLAIMANT)
                                                            WF = DISABLED WIDOW (5TH CLAIMANT)
                                                            WG = DISABLED WIDOWER (5TH CLAIMANT)
                                                            WJ = DISABLED SURVIVING DIVORCED WIFE (5TH
                                                                 CLAIMANT)
                                                            WR = DISABLED SURVIVING DIVORCED HUSBAND
                                                                 (1ST CLAIMANT)
                                                            WT = DISABLED SURVIVING DIVORCED HUSBAND
                                                                 (2ND CLAIMANT)

                                                            RAILROAD RETIREMENT BOARD:

                                                               NOTE:
                                                               EMPLOYEE:  A MEDICARE BENEFICIARY WHO IS
                                                                          STILL WORKING OR A WORKER WHO
                                                                          DIED BEFORE RETIREMENT
                                                               ANNUITANT: A PERSON WHO RETIRED UNDER THE
                                                                          RAILROAD RETIREMENT ACT AFTER
                                                                          03/01/37
                                                               PENSIONER: A PERSON WHO RETIRED PRIOR TO
                                                                          03/01/37 AND WAS INCLUDED IN THE
                                                                          RAILROAD RETIREMENT ACT

                                                            10 = RETIREMENT - EMPLOYEE OR ANNUITANT
                                                            80 = RR PENSIONER (AGE OR DISABILITY)
                                                            14 = SPOUSE OF RR EMPLOYEE OR ANNUITANT
                                                                 (HUSBAND OR WIFE)
                                                            84 = SPOUSE OF RR PENSIONER
                                                            43 = CHILD OF RR EMPLOYEE
                                                            13 = CHILD OF RR ANNUITANT
                                                            17 = DISABLED ADULT CHILD OF RR ANNUITANT
                                                            46 = WIDOW/WIDOWER OF RR EMPLOYEE
                                                            16 = WIDOW/WIDOWER OF RR ANNUITANT
                                                            86 = WIDOW/WIDOWER OF RR PENSIONER
                                                            43 = WIDOW OF EMPLOYEE WITH A CHILD IN HER CARE
                                                            13 = WIDOW OF ANNUITANT WITH A CHILD IN HER CARE
                                                            83 = WIDOW OF PENSIONER WITH A CHILD IN HER CARE
                                                            45 = PARENT OF EMPLOYEE
                                                            15 = PARENT OF ANNUITANT
                                                            85 = PARENT OF PENSIONER
                                                            11 = SURVIVOR JOINT ANNUITANT
                                                                 (REDUCED BENEFITS TAKEN TO INSURE BENEFITS
                                                                 FOR SURVIVING SPOUSE)

                                                            SOURCE:
                                                            EDB

1                              CROSS-REFERENCE HEALTH INSURANCE CLAIM NUMBER OUTPUT RECORD

                                                 POSITIONS
                  NAME              TYPE  LENGTH BEG  END                            CONTENTS
       ---------------------------  ----  ------ ---------  ------------------------------------------------------------
    6. CROSS REFERENCE CLAIM        CHAR     11    17   27  THE HEALTH INSURANCE CLAIM NUMBER FROM THE INPUT
       NUMBER                                               FINDER RECORD OR A LOCATED CROSS-REFERENCE CLAIM
                                                            ACCOUNT WITH AN EQUATED BENEFICIARY IDENTIFICATION
                                                            CODE.

                                                            STANDARD ALIAS: XREF_BENE_CLM_NUM
                                                            COMMON ALIAS: XREF_HIC

    7. FILLER                       CHAR      3    28   30  STANDARD ALIAS: FILLER
                                                            SAS ALIAS: FILLER
