Connect: Direct Applications for RAPS, Encounter, PDE, and MMP

Medicare-Medicaid Plan Data
Connect:Direct Form

OMB No. 0938-1152
Expires 03/31/2025

Contact Information
Contact the Customer Service Support Center (CSSC) Help Desk with any questions using the following contact
information:
Phone Number: 1-877-534-2772
Email Address: csscoperations@palmettogba.com

Network Mapping Values
In order to set up network mapping entry by the submitter, the following values are provided. Palmetto GBA uses Secure
Point of Entry (SPOE) to enforce data security. The CSSC Help Desk will provide the Network Address Translation (NAT) IP
Address and Listener Port to the submitter during the connectivity testing phase.
Node ID

SCA.A70NDM.MC

System Platform

OS390, z/OS

Data Submission Information
Listed below are values needed by the submitter in order to code Connect:Direct scripts. The CSSC Help Desk will provide
the Submitter ID value that will be used in the Data Set Name (DSN).
DISP = NEW,CATLG,DELETE
UNIT = SYSDG
Medicare Prescription Drug Event (PDE) Data Submission Dataset
DSN

MAB.PROD.NDM.MMFS.PDE.(+1)

SPACE

(CYL,(1200,500),RLSE)

DCB

(RECFM=FB,LRECL=512,BLKSIZE=27648)

Medicare Risk Adjustment Data Submission Dataset
DSN

MAB.PROD.NDM.MMFS.RAS.(+1)

SPACE

(CYL,(75,10),RLSE)

DCB

(RECFM=FB,LRECL=512,BLKSIZE=27648)

Form CMS-10340 (03/2025)

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Medicare Encounter Data Submission Dataset
DSN

MAB.PROD.NDM.MMFS.ENC.(+1)

SPACE

(CYL,(100,100),RLSE)

DCB

(RECFM=FB,LRECL=80,BLKSIZE=27920)

Medicaid Data Submission Dataset
DSN

MAB.PROD.NDM.MMFS.MCD.(+1)

SPACE

(CYL,(100,100),RLSE)

DCB

(RECFM=FB,LRECL=80,BLKSIZE=27920)

Medicaid National Council for Prescription Drug Programs (NCPDP) Data Submission Dataset
DSN

MAB.PROD.NDM.MMFS.NCP.(+1)

SPACE

(CYL,(100,100),RLSE)

DCB

(RECFM=FB,LRECL=3700,BLKSIZE=25900)

Form CMS-10340 (03/2025)

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Submitter's Network Mapping Values
Provide the following network mapping values in order to establish bi-directional data transfers with Palmetto GBA.
NAT IP Address
(Obtain from the Network Service
Vendor)
Listener Port
Node ID
System Platform

Mainframe
AS/400
Server

Additional Information
If submitting data files, the Production ID is required. If the submitter's system requires login credentials to receive data files,
provide the Login ID.
Production ID
Login ID
Technical Contact Name
Phone Number
E-mail Address

Form CMS-10340 (03/2025)

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Dataset Names
To receive multiple data files and prevent overwriting of existing files, it is recommended that Generational Data Group
(GDG) dataset names (mainframe platform only) or dataset names containing date and timestamp (any platform) are
provided.

Prescription Drug Event
Frequency = Daily
Prescription Drug Front End System (PDFS) Response
Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name
Drug Data Processing System (DDPS)
Format

DSORG=PS,LRECL=512,RECFM=FB

Dataset Name
DDPS Transaction Error Summary
Format

DSORG=PS,LRECL=512,RECFM=FB

Dataset Name
Monthly reports are grouped by date of service year and will be distributed in one dataset unless datasets containing a
variable for the year is provided.
Frequency = Monthly
DDPS 04 COV Cumulative Beneficiary Summary
Format

DSORG=PS,LRECL=512,RECFM=FB

Dataset Name
DDPS 04 ENH Cumulative Beneficiary Summary
Format

DSORG=PS,LRECL=512,RECFM=FB

Dataset Name
DDPS 04 OTC Cumulative Beneficiary Summary
Format

DSORG=PS,LRECL=512,RECFM=FB

Dataset Name
P2P 40 COV Accounting
Format

DSORG=PS,LRECL=512,RECFM=FB

Dataset Name

Form CMS-10340 (03/2025)

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P2P 40 ENH Accounting
Format

DSORG=PS,LRECL=512,RECFM=FB

Dataset Name
P2P 40 OTC Accounting
Format

DSORG=PS,LRECL=512,RECFM=FB

Dataset Name
P2P 41 COV Receivable
Format

DSORG=PS,LRECL=512,RECFM=FB

Dataset Name
P2P 42 COV Part-D Payment Reconciliation
Format

DSORG=PS,LRECL=512,RECFM=FB

Dataset Name
P2P 43 COV Payable
Format

DSORG=PS,LRECL=512,RECFM=FB

Dataset Name
DDPS 44 Other TrOOP Amount Indicator Summary
DSORG=PS,LRECL=512,RECFM=FB

Format
Dataset Name

Frequency = Quarterly
DDPS Potential Exclusion Warning Report
Format

DSORG=PS,LRECL=500,RECFM=FB

Dataset Name

Frequency = Annually
Phase III
Format

DSORG=PS,LRECL=512,RECFM=FB

Dataset Name

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Risk Adjustment
Frequency = Daily
FERAS Response
Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name
RAPS Return File
Format

DSORG=PS,LRECL=512,RECFM=FB

Dataset Name
RAPS Transaction Error Report
Format

DSORG=PS,LRECL=133,RECFM=FB

Dataset Name
RAPS Transaction Summary
Format

DSORG=PS,LRECL=133,RECFM=FB

Dataset Name
RAPS Duplicate Diagnosis Cluster
Format

DSORG=PS,LRECL=133,RECFM=FB

Dataset Name
Frequency = Monthly
RAPS Monthly Plan Activity
Format

DSORG=PS,LRECL=133,RECFM=FB

Dataset Name
RAPS Cumulative Plan Activity
Format

DSORG=PS,LRECL=133,RECFM=FB

Dataset Name
RAPS Monthly Error Frequency
Format

DSORG=PS,LRECL=133,RECFM=FB

Dataset Name
Frequency = Quarterly
RAPS Quarterly Error Frequency
Format

DSORG=PS,LRECL=133,RECFM=FB

Dataset Name

Form CMS-10340 (03/2025)

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Medicare Encounter Data
Frequency = Daily
Invalid Response
Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name
TA1 Acknowledgement Response
Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name
999A Acknowledgement Response
Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name
999R Acknowledgement Response
Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name
277CA Acknowledgement Response
Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name
MAO-001 Data Duplicates Report
Format

DSORG=PS,LRECL=287,RECFM=FB

Dataset Name
MAO-001 Data Duplicates File
Format

DSORG=PS,LRECL=287,RECFM=FB

Dataset Name
MAO-002 Data Processing Status Report
Format

DSORG=PS,LRECL=154,RECFM=FB

Dataset Name
MAO-002 Data Processing Status File
Format

DSORG=PS,LRECL=154,RECFM=FB

Dataset Name

Form CMS-10340 (03/2025)

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Medicaid Data
Frequency = Daily
Invalid Response
Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name
TA1 Acknowledgement Response
Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name
999A Acknowledgement Response
Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name
999R Acknowledgement Response
Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name
277CA Acknowledgement Response
Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name

Dental
Frequency = Daily
Dental Validation Report
Format

DSORG=PS,LRECL=133,RECFM=FB

Dataset Name

NCPDP
Frequency = Daily
National Council for Prescription Drug Program (NCPDP) Response
Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays
a valid OMB control number. The valid OMB control number for this information collection is 0938-1152. The time required to
complete this information collection is estimated to average 10 minutes per response, including the time to review instructions, search
existing data resources, gather the data needed, and complete and review the information collection. If you have any comments
concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard,
Attn: PRA Reports Clearance Officer, Baltimore, Maryland 21244-1850.
Form CMS-10340 (03/2025)

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