This page provides new and existing COBA trading partners with files layouts for the following processes:

Eligibility EO1 Record Layout
Acknowledgement File Layout
Eligibility Response File (ERF) Layout

We also have layouts for the Drug Coverage Record Layout available.

If you have further questions please contact your EDI rep or contact the COBC at 1-800-999-1118 or TTY/TDD 1-800-318-8782 for the hearing and speech impaired, Monday through Friday, from 9:00 a.m. - 5:00 p.m., Eastern Standard Time, except holidays.

Downloads
COBA Eligibility E01 Record Layout (pdf, 73KB) COBA Eligibility Acknowledgment (pdf, 49KB) COBA Eligibility Response File Layout (PDF, 50KB) Drug Coverage Record Layout (pdf, 146KB) Drug Coverage Eligibility Response (pdf, 46KB)
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Related Links Outside CMS
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Page Last Modified: 03/12/2010 9:16:02 AM
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