Table Detail Report

ORDER_HEALTH_PLAN



Column Section Relationship Section Top of Page


Table-level Detail

Description: Order Health Plan
Definition: Claims related information for a Health Plan of a given Order action
Table Type: ACTIVITY





Column Detail - ORDER_HEALTH_PLAN


Column Name Type Null? Definition
ACTION_SEQUENCE DOUBLE N A sequence number used to identify the order of the actions.
ACTUAL_DAYS_SUPPLY DOUBLE N Estimated number of days the prescription will last.
ALTERNATE_IDENT VARCHAR(250) N Person identifier to be used for controlled product reporting. Identifier may be that of the patient or the person picking up the prescription as required by the governing body sent in field 330-cw of claim segment (07)
ASSOC_PRESCRIP_DT_TM DATETIME Y Date of the Associated Prescription/ Service Reference Number.Field 457-EP on Claim Segment (07)
ASSOC_PRESCRIP_NBR VARCHAR(200) N Related 'Prescription/Service Reference Number' To which the service is associated. Field 456-EN on Claim Segment (07)
ASSOC_PRESCRIP_TZ DOUBLE N Time zone for the assoc_prescrip_dt_tm
AUTH_NBR_TXT VARCHAR(250) N Number assigned by the processor to identify an authorized transaction sent in field 503-f3 of prior auth segment (12)
AUTH_REP_CITY VARCHAR(250) N State/Province of the patient's authorized representative sent in field 498-PJ or prior auth segment (12)
AUTH_REP_FIRST_NAME VARCHAR(250) N First name of the patient's authorized representative sent in field 498-PE of prior auth segment (12).
AUTH_REP_LAST_NAME VARCHAR(250) N Last name of the patient's authorized representative sent in field 498-PE of prior auth segment (12)
AUTH_REP_STATE VARCHAR(250) N State/Province of the patient's authorized representative sent in field 498-PJ of prior auth segment (12)
AUTH_REP_STREET VARCHAR(250) N Street address of the patient's authorized representative sent in field 498-PG of prior auth segment (12)
AUTH_REP_ZIP VARCHAR(250) N Zip code/Postal zone of the patient's authorized representative sent in field 498-PK of prior auth segment (12)
CARD_HOLDER_IDENT VARCHAR(100) N The member number of the subscriber to the health plan.
COB_OTHER_PAYER_PAY_AMT DOUBLE N Amount of any payment known by the pharmacy from other sources (including coupons). Sent in field 431-DV of claim segment.
COB_OTHER_PAYER_PAY_TYPE_CD DOUBLE N Service type of payment that the Other Payer amount was applied to. Example: Delivery, Drug Benefit. Sent in field 342-HC of claim segment.
COB_PAYER_CTRL_IDENT VARCHAR(30) Y Used to identify an adjudicated claim, when supplied, in payer-to-payer coordination of benefits only. Sent in field 993-A7 of claim segment.
COMPOUND_FORM_CD DOUBLE N Dosage form for the complete compound mixture as prescribed by NDCPD format.
CONFLICT_CD DOUBLE N DUR Conflict code
COUPON_AMT DOUBLE N Value of coupon sent in field 487-NE of coupon segment (09)
COUPON_NBR_TXT VARCHAR(250) N Unique serial number assigned to the prescription coupons sent in field 486-ME of coupon segment (09)
COUPON_TYPE_CD DOUBLE N Code Indicating the type of coupon being used sent in field 485-KE of coupon segment (09)
DUR_AGENT_QUAL_CD DOUBLE N Drug Utilization Review Co-Agent Id Qualifier for Retail Prescription Claims
DUR_AGENT_QUAL_IDENT VARCHAR(30) N Drug Utilization Review Co-Agent Id for Retail Prescription Claims
DUR_LEVEL_OF_EFFORT_CD DOUBLE N Code indicating the level of effort as determined by the complexity of decision making or resources utilized by a pharmacist to perform a professional service sent in field 474-8E of DUR/PPS segment (08).
ELIGIBILITY_CD DOUBLE N Eligibility Clarification Code
EMPLOYER_IDENT VARCHAR(250) N ID assigned to an employer sent in field 333_CZ of patient segment (01)
FACILITY_IDENT VARCHAR(250) N ID assigned to the patient's clinic/host party sent in field 336-8C of insurance segment (04)
HEALTH_PLAN_ID DOUBLE N Identifier assigned for a Health Plan
HEALTH_PLAN_SEQ DOUBLE N Sequence in which Health Plan is used during claim submission.
HOME_PLAN_IDENT VARCHAR(250) N Code identifying the Blue Cross or Blue Shield plan ID which indicates where the member's coverage has been designated. Usually where the member lives or purchased their coverage. Sent in field 314-CE of the insurance segment (04).
INTERVENTION_CD DOUBLE N DUR Intervention Code
INTER_AUTH_IDENT VARCHAR(250) N Value indicating intermediary authorization occurred sent in field 464-EX of claim segment (07)
INTER_AUTH_TYPE_ID_CD DOUBLE N Value indicating that authorization occurred for intermediary processing sent in field 463-EW of claim segment (07)
LEVEL_OF_SERVICE_CD DOUBLE N Code indicating the type of service the provider rendered sent in field 418-DI of claim segment (07)
MANUAL_ADJUDICATED_IND DOUBLE N Indicates whether the adjudication is manual or electronic for plans that are part of Benefits Coordination. 0 - Electronic, 1 - Manual
MANUAL_COPAY_AMT DOUBLE N Copay Amount for manually adjudicated plans that are part of Benefits Coordination.
ORDER_ID DOUBLE N This field contains the unique value assigned to each orderable procedure associated with an order.
ORIG_PRESCRIBED_QTY DOUBLE N Product initially prescribed amount expressed in metric decimal units sent in field 446-EB of claim segment (07)
ORIG_PRESCRIBED_SERV_QUAL_CD DOUBLE N Code qualifying the value in the Originally Prescribed Product/Service Code sent .
ORIG_PRESCRIBED_SERV_QUAL_TXT VARCHAR(250) N Code of the initially prescribed product of service sent in field 445-EA of claim segment (07)
OTHER_COVERAGE_CD DOUBLE N Other coverage code accept in Order Entry
OUTCOME_CD DOUBLE N DUR Outcome code
PARTIAL_FILL_TYPE_CD DOUBLE N Indicates if a health plan supports NCPDP 51 Partial Fill Submission Process.
PATIENT_LOCATION_ID_CD DOUBLE N The code identifying the location of the patient when receiving Pharmacy Services sent in field 307-C7 of patient segment (01)
PATIENT_PAID_AMT DOUBLE N The amount the pharmacy received from the patient for the prescription dispensed sent in field 433-DX of pricing segment (11)
PA_REQ_BASIS_CD DOUBLE N Prior Authorized Basis of Request for Retail Prescription Claims.
PA_REQ_BEG_DT_TM DATETIME Y Prior Authorized Request Period Begin Date and Time for Retail Prescription claims.
PA_REQ_END_DT_TM DATETIME Y Prior Authorized Request Period End Date and Time for Retail Prescription claims.
PA_REQ_TYPE_CD DOUBLE N Prior Authorized Request Type for Retail Prescription Claims
PA_REQ_TZ DOUBLE N Time zone for the pa_req_beg_dt_tm and pa_req_end_dt_tm.
PRESCRIPTION_CD DOUBLE N Prescription clarification code
PRIOR_AUTH_BEG_EFF_DT_TM DATETIME Y Effective Date from date of prior authorization number
PRIOR_AUTH_END_EFF_DT_TM DATETIME Y Effective To date of prior authorization number
PRIOR_AUTH_NBR_ASSIGN_TXT VARCHAR(250) N Unique number identifying the prior authorization assigned by the processor sent field 498-PY of prior auth segment.
PRIOR_AUTH_NBR_TXT VARCHAR(250) N Prior authorization number
PRIOR_AUTH_SUPPORT_DOC_TXT VARCHAR(500) N Free text message sent in field 498-PP of prior auth segment (12)
PRIOR_AUTH_TYPE_CD DOUBLE N NCPDP Prior Authorization Type Code
PRIOR_AUTH_TZ DOUBLE N Time zone for the prior_auth_beg_eff_dt_tm and prior_auth_end_eff_dt_tm.
SCHED_PRESCRIPT_ID_NBR_TXT VARCHAR(250) N The serial number of the prescription blank/form sent in field 454-EK of claim segment (07)
UPDT_APPLCTX DOUBLE N The application context number from the record info block.
UPDT_CNT DOUBLE N Set to 0 on insert. Incremented by 1 on update. Used to recognize update conflict where data in a row updated by one application is at risk of being lost by a second application attempting to update the row.
UPDT_DT_TM DATETIME N The date and time the row was last inserted or updated.
UPDT_ID DOUBLE N The person_id of the person from the personnel table (prsnl) that caused the last insert or update of the row in the table.
UPDT_TASK DOUBLE N The registered (assigned) task number for the process that inserted or updated the row.
WORKERS_COMP_FLAG DOUBLE N Workers Compensation segment flag indicates whether or not the segment is required to transmit.



Relationship Detail - ORDER_HEALTH_PLAN


Child Column in ORDER_HEALTH_PLAN(FK) Parent Table Name Parent Column Name
Parents: HEALTH_PLAN_ID HEALTH_PLAN HEALTH_PLAN_ID
ORDER_ID ORDERS ORDER_ID




Parent Column in ORDER_HEALTH_PLAN (PK) Child Table Name Child Column Name
Children: ACTION_SEQUENCE ORDER_HEALTH_PLAN_DETAIL ACTION_SEQ
CARD_HOLDER_IDENT ORDER_HEALTH_PLAN_DETAIL CARD_HOLDER_IDENT
HEALTH_PLAN_ID ORDER_HEALTH_PLAN_DETAIL HEALTH_PLAN_ID
ORDER_ID ORDER_HEALTH_PLAN_DETAIL ORDER_ID
ACTION_SEQUENCE RX_CLAIM_PENDING ACTION_SEQUENCE_NBR
CARD_HOLDER_IDENT RX_CLAIM_PENDING CARD_HOLDER_IDENT
HEALTH_PLAN_ID RX_CLAIM_PENDING HEALTH_PLAN_ID
ORDER_ID RX_CLAIM_PENDING ORDER_ID


ORDER_HEALTH_PLAN_DETAIL



Column Section Relationship Section Top of Page


Table-level Detail

Description: Order Health Plan Detail
Definition: For every action on an order, this table stores the NCPDP Claim related information per health plan used.
Table Type: ACTIVITY





Column Detail - ORDER_HEALTH_PLAN_DETAIL


Column Name Type Null? Definition
ACTION_SEQ DOUBLE N A sequence number used to identify the order of the actions.
CARD_HOLDER_IDENT VARCHAR(100) N The member number of the subscriber to the health plan.
DETAIL_FIELD_DT_TM DATETIME Y Value of the current detail record if source field contains date/time value.
DETAIL_FIELD_ID DOUBLE N Stores the order entry detail id. Populated only for a Rebill that is valid for all health plans.
DETAIL_FIELD_IDENT DOUBLE N Field ID for the current detail record
DETAIL_FIELD_MEANING VARCHAR(25) N Stores the string meaning of the order_entry_detail. Populated only for a Rebill that is valid for all health plans.
DETAIL_FIELD_SEQ DOUBLE N The sequence for each occurrence of a given Source Field.
DETAIL_FIELD_TXT VARCHAR(250) N The value of the current detail record if source field contains text.
DETAIL_FIELD_VALUE DOUBLE N The value of the current detail record if source field contains numeric or codified value.
DETAIL_TZ DOUBLE N Time zone for the detail_field_dt_tm
HEALTH_PLAN_ID DOUBLE N The identifier assigned for a health plan.
ORDER_HEALTH_PLAN_DTL_ID DOUBLE N This field contains the unique value assigned to each order health plan detail row.
ORDER_ID DOUBLE N This field contains the unique value assigned to each orderable procedure associated with an order.
UPDT_APPLCTX DOUBLE N The application context number from the record info block.
UPDT_CNT DOUBLE N Set to 0 on insert. Incremented by 1 on update. Used to recognize update conflict where data in a row updated by one application is at risk of being lost by a second application attempting to update the row.
UPDT_DT_TM DATETIME N The date and time the row was last inserted or updated.
UPDT_ID DOUBLE N The person_id of the person from the personnel table (prsnl) that caused the last insert or update of the row in the table.
UPDT_TASK DOUBLE N The registered (assigned) task number for the process that inserted or updated the row.



Relationship Detail - ORDER_HEALTH_PLAN_DETAIL


Child Column in ORDER_HEALTH_PLAN_DETAIL(FK) Parent Table Name Parent Column Name
Parents: HEALTH_PLAN_ID HEALTH_PLAN HEALTH_PLAN_ID
ACTION_SEQ ORDER_HEALTH_PLAN ACTION_SEQUENCE
CARD_HOLDER_IDENT ORDER_HEALTH_PLAN CARD_HOLDER_IDENT
HEALTH_PLAN_ID ORDER_HEALTH_PLAN HEALTH_PLAN_ID
ORDER_ID ORDER_HEALTH_PLAN ORDER_ID


PHARMACY_RANGE



Column Section Relationship Section Top of Page


Table-level Detail

Description: PHARMACY RANGE
Definition: Pharmacy_range - Range of numbers to use for Prescription and Tracking Numbers.
Table Type: REFERENCE





Column Detail - PHARMACY_RANGE


Column Name Type Null? Definition
DESCRIPTION VARCHAR(100) Y Description of range
FROM_RANGE DOUBLE Y Beginning of Range Value
NEXT_VALUE DOUBLE Y Next range value
RANGE_ID DOUBLE N Unique ID identifying pharmacy range
TO_RANGE DOUBLE Y Ending of range value
UPDT_APPLCTX DOUBLE N The application context number from the record info block.
UPDT_CNT DOUBLE N Set to 0 on insert. Incremented by 1 on update. Used to recognize update conflict where data in a row updated by one application is at risk of being lost by a second application attempting to update the row.
UPDT_DT_TM DATETIME N The date and time the row was last inserted or updated.
UPDT_ID DOUBLE N The person_id of the person from the personnel table (prsnl) that caused the last insert or update of the row in the table.
UPDT_TASK DOUBLE N The registered (assigned) task number for the process that inserted or updated the row.



Relationship Detail - PHARMACY_RANGE




Parent Column in PHARMACY_RANGE (PK) Child Table Name Child Column Name
Children: RANGE_ID SERV_RES_EXT_PHARM DOWNTIME_RANGE_ID


PHA_BATCH_REPORT_ACT



Column Section Relationship Section Top of Page


Table-level Detail

Description: Pharmacy Batch Report Activity
Definition: Track the history of Batch Claims runs.
Table Type: ACTIVITY





Column Detail - PHA_BATCH_REPORT_ACT


Column Name Type Null? Definition
BATCH_REPORT_CD DOUBLE N The batch report that generated this activity.
BATCH_TYPE_CD DOUBLE Y Type of report
ENCNTR_ID DOUBLE N The encounter for which the batch has been run.
EXECUTION_END_DT_TM DATETIME Y The time that this particular execution ended.
EXECUTION_START_DT_TM DATETIME N The time that this execution began.
EXECUTION_TYPE_FLAG DOUBLE N Flag to indicate if it was executed as part of ops job or manually executed
ORD_TYPE_CONT_IND DOUBLE N Display/print continuous orders on this report.
ORD_TYPE_INT_IND DOUBLE N Display intermittent IV orders on the report.
ORD_TYPE_MED_IND DOUBLE N Display medication orders on the report.
OUTPUT_DEVICE_CD DOUBLE N Output Deivce (printer) where the report was printedo.
OUTPUT_FORMAT_CD DOUBLE N Output format associated with this report
PHA_BATCH_REPORT_ACT_ID DOUBLE N Unique generated number that identifies a single row on the PHA_BATCH_REPORT_ACT table.
REPORT_FROM_DT_TM DATETIME Y The begin date of this report.
REPORT_FROM_TZ DOUBLE N The time zone associated to the report_from_dt_tm column.
REPORT_TO_DT_TM DATETIME Y The end date/time of this report run.
REPORT_TO_TZ DOUBLE N The time zone associated to the report_to_dt_tm column.
RUNS_TO_PRINT_FLAG DOUBLE N Indicates which runs will be part of the report that is printed once the batch is complete.
RUN_USER_ID DOUBLE N This is the user that ran the batch
RX_WORKSTATION_CD DOUBLE N The workstation that batch was executed from.
STATUSES_TO_PRINT_FLAG DOUBLE N Indicates which records, based on the process status of the records, will be part of the report that is printed once batch is complete.
STATUS_CD DOUBLE N Status of Inpatient to Outpatient Link
UPDT_APPLCTX DOUBLE N The application context number from the record info block. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.
UPDT_CNT DOUBLE N Set to 0 on insert. Incremented by 1 on update. Used to recognize update conflict where data in a row updated by one application is at risk of being lost by a second application attempting to update the row. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.
UPDT_DT_TM DATETIME N The date and time the row was last inserted or updated. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.
UPDT_ID DOUBLE N The person_id of the person from the personnel table (prsnl) that caused the last insert or update of the row in the table. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.
UPDT_TASK DOUBLE N The registered (assigned) task number for the process that inserted or updated the row. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic.



Relationship Detail - PHA_BATCH_REPORT_ACT


Child Column in PHA_BATCH_REPORT_ACT(FK) Parent Table Name Parent Column Name
Parents: ENCNTR_ID ENCOUNTER ENCNTR_ID
BATCH_REPORT_CD PHA_BATCH_REPORT BATCH_REPORT_CD
RUN_USER_ID PRSNL PERSON_ID




Parent Column in PHA_BATCH_REPORT_ACT (PK) Child Table Name Child Column Name
Children: PHA_BATCH_REPORT_ACT_ID PHA_BATCH_REPORT_ACT_DTL PHA_BATCH_REPORT_ACT_ID
RXS_PHA_REPORT_FILTER_HIST PHA_BATCH_REPORT_ACT_ID


PHA_BATCH_REPORT_ACT_DTL



Column Section Relationship Section Top of Page


Table-level Detail

Description: Pharmacy Batch Report Activity Detail
Definition: Stores the records that qualified based on the batch parameters.
Table Type: ACTIVITY





Column Detail - PHA_BATCH_REPORT_ACT_DTL


Column Name Type Null? Definition
CHILD_ORDER_ID DOUBLE N Identifies a child order associated with an original inpatient order (i.e. pass med orders)
DETAIL_PROCESS_STATUS_CD DOUBLE N Identifies a more detailed status for the qualified dispense.
DISPENSE_HX_ID DOUBLE N Identifies a dispense that qualified for the batch.
HEALTH_PLAN_ID DOUBLE N Identifies the health plan used to qualify the dispense.
ORDER_ID DOUBLE N Identifies an inpatient order associated to the inpatient dispense.
PHA_BATCH_REPORT_ACT_DTL_ID DOUBLE N Unique generated number that identifies a single row on the PHA_BATCH_REPORT_ACT_DTL table.
PHA_BATCH_REPORT_ACT_ID DOUBLE N The particular execution of the batch report that this detail i for.
PROCESS_STATUS_CD DOUBLE N Identifies the status for the qualified dispense.
PROD_CLAIM_QTY DOUBLE N Net Dispense Quantity, in terms of Dispensing Package Unit, of the product that is being claimed.
PROD_DISPENSE_HX_ID DOUBLE N Identifies a product associated with the dispense
RX_ADMIN_DISPENSE_HX_ID DOUBLE N Identifies a specific administration associated with the dispense.
RX_ADMIN_PROD_DISPENSE_HX_ID DOUBLE N Identifies a product associated with a specific administration.
SERVICE_END_DT_TM DATETIME Y Identifies the end date of when the service was provided
SERVICE_START_DT_TM DATETIME Y Identifies the start date of when the service was provided.
UPDT_APPLCTX DOUBLE N The application context number from the record info block.
UPDT_CNT DOUBLE N Set to 0 on insert. Incremented by 1 on update. Used to recognize update conflict where data in a row updated by one application is at risk of being lost by a second application attempting to update the row.
UPDT_DT_TM DATETIME N The date and time the row was last inserted or updated.
UPDT_ID DOUBLE N The person_id of the person from the personnel table (prsnl) that caused the last insert or update of the row in the table.
UPDT_TASK DOUBLE N The registered (assigned) task number for the process that inserted or updated the row.



Relationship Detail - PHA_BATCH_REPORT_ACT_DTL


Child Column in PHA_BATCH_REPORT_ACT_DTL(FK) Parent Table Name Parent Column Name
Parents: DISPENSE_HX_ID DISPENSE_HX DISPENSE_HX_ID
HEALTH_PLAN_ID HEALTH_PLAN HEALTH_PLAN_ID
CHILD_ORDER_ID ORDERS ORDER_ID
ORDER_ID ORDERS ORDER_ID
PHA_BATCH_REPORT_ACT_ID PHA_BATCH_REPORT_ACT PHA_BATCH_REPORT_ACT_ID
RX_ADMIN_DISPENSE_HX_ID RX_ADMIN_DISPENSE_HX RX_ADMIN_DISPENSE_HX_ID
RX_ADMIN_PROD_DISPENSE_HX_ID RX_ADMIN_PROD_DISPENSE_HX RX_ADMIN_PROD_DISPENSE_HX_ID