Table Detail Report

RX_CLAIM_AUTH_AUDIT



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Table-level Detail

Description: Pharmacy Claim Authorization Audit
Definition: Table used to audit asynchronized transactions for Claim Authorization services
Table Type: ACTIVITY





Column Detail - RX_CLAIM_AUTH_AUDIT


Column Name Type Null? Definition
ACTION_NAME VARCHAR(40) N Specifies the action for which the audit row is entered.
AUTHORIZATION_IDENT_TXT VARCHAR(100) N This column holds the value of pre-generated authorization ID that will be sent for pharmacy prior request transactions. The unique identifier assigned by the health provider to identify the Authorization; must be globally unique and start with EncounterFacilityID followed by a unique identifier assigned by the facility information system, followed by date/time of the transaction.
CONTRIBUTOR_SYSTEM_TXT VARCHAR(5) N Identifies the subsystem that entered this row.
CREATE_DT_TM DATETIME N Identifies date & time the row was created.
MESSAGE_TXT VARCHAR(1000) N Text indicating success or failure message
RX_CLAIM_AUTH_AUDIT_ID DOUBLE N Unique generated number that identifies a single row on the claim_authorization_audit table.
SUCCESS_IND DOUBLE N Indicates if the claim was processed successfully.
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.


RX_CLAIM_DOWNTIME



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Table-level Detail

Description: Retail Claim Downtime
Definition: Rx_Claim_downtime
Table Type: ACTIVITY





Column Detail - RX_CLAIM_DOWNTIME


Column Name Type Null? Definition
ACTIVE_IND DOUBLE N The table row is active or inactive. A row is generally active unless it is in an inactive state such as logically deleted, combined away, pending purge, etc.
BEG_EFFECTIVE_DT_TM DATETIME N The date and time for which this table row becomes effective. Normally, this will be the date and time the row is added, but could be a past or future date and time.
DOWNTIME_TYPE_CD DOUBLE N downtime_type_cd
END_EFFECTIVE_DT_TM DATETIME N The date/time after which the row is no longer valid as active current data. This may be valued with the date that the row became inactive.
PARENT_ENTITY VARCHAR(32) Y Parent Entity name
PARENT_ENTITY_ID DOUBLE N The value of the primary identifier of the table to which the address row is related (i.e., person_id, organization_id, etc.)
RX_CLAIM_DOWNTIME_ID DOUBLE N Rx Claim Downtime
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.


RX_CLAIM_FIELD



Column Section Relationship Section Top of Page


Table-level Detail

Description: RX CLAIM FIELD
Definition: Rx_claim_field - Defines fields on a Prescription claim format.
Table Type: REFERENCE





Column Detail - RX_CLAIM_FIELD


Column Name Type Null? Definition
CLAIM_FIELD_CD DOUBLE N Claim Field Code value
FIELD_DECIMAL_CNT DOUBLE Y Number of digits after decimal to be used.
FIELD_LENGTH DOUBLE Y Field Length
FIELD_TYPE_FLAG DOUBLE Y Field_Type Flag (1-Alpha,2-Alpha/Numeric,3-Numeric,4-Decimal)
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 - RX_CLAIM_FIELD




Parent Column in RX_CLAIM_FIELD (PK) Child Table Name Child Column Name
Children: CLAIM_FIELD_CD RX_HEALTH_PLAN_CLAIM CLAIM_FIELD_CD


RX_CLAIM_FORMAT



Column Section Relationship Section Top of Page


Table-level Detail

Description: RX CLAIM FORMAT
Definition: Details Prescription claim formats
Table Type: REFERENCE





Column Detail - RX_CLAIM_FORMAT


Column Name Type Null? Definition
CLAIM_SEGMENT_CD DOUBLE N The code value of the claim segment that contains the claim field.
FIELD_BEG_POS DOUBLE Y CLAIM FIELD BEGINNING POSITION
FIELD_CD DOUBLE N CODE VALUE FROM CODE SET 4517
FIELD_DECIMAL_CNT DOUBLE Y NUMBER OF DIGITS AFTER DECIMAL TO BE USED
FIELD_END_POS DOUBLE Y CLAIM FIELD ENDING POSITION
FIELD_LENGTH DOUBLE Y LENGTH OF CLAIM FIELD
FIELD_TYPE_FLAG DOUBLE Y Field_Type Flag (1-Alpha,2-Alpha/Numeric,3-Numeric,4-Decimal)
FORMAT_CD DOUBLE N CODE VALUE FROM CODE SET 4515
FORMAT_ID DOUBLE N UNIQUE ID FOR EACH FIELD IN THE FORMAT
FORMAT_SEQ DOUBLE Y SEQUENCE OF THE FIELDS IN THE FORMAT
FORMAT_TYPE_CD DOUBLE N CODE VALUE FROM CODE SET 4516
REQUIRED_IND DOUBLE Y INDICATOR (0 OR 1). indicates whether or not a the field is required for the format. (1=Required)
REVERSAL_REQUIRED_IND DOUBLE N Indicates whether the field is required during claim reversal transaction. (1 = required, 0 = not required.)
SOURCE_BEG_POS DOUBLE Y The position of the character, in the Source value, that is used as the starting point.
SOURCE_END_POS DOUBLE Y CLAIM SOURCE ENDING POSITION
SOURCE_FIELD_CD DOUBLE N CODE VALUE FROM CODE SET 4518
SOURCE_STRING VARCHAR(255) Y Value of the Source, if Source is a literal value.
STANDARD_IND DOUBLE Y INDICATOR (0 OR 1). indicates whether or not the format is modifiable. (1 = Not Modifiable)
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 - RX_CLAIM_FORMAT




Parent Column in RX_CLAIM_FORMAT (PK) Child Table Name Child Column Name
Children: FORMAT_ID RX_HEALTH_PLAN_CLAIM CLAIM_FORMAT_ID


RX_CLAIM_OVERRIDE



Column Section Relationship Section Top of Page


Table-level Detail

Description: RX Claim Override
Definition: Stores the values of fields, which are part of claim request message, overridden by the user.
Table Type: ACTIVITY





Column Detail - RX_CLAIM_OVERRIDE


Column Name Type Null? Definition
CARD_HOLDER_IDENT VARCHAR(100) N The member number of the subscriber to the health plan.
DISPENSE_HX_ID DOUBLE N Relates a particular field to a specific row on the Dispense History table.
HEALTH_PLAN_ID DOUBLE N This column relates a particular field to a specific health plan record.
OVERRIDE_FIELD_CD DOUBLE N National Council for Prescription Drug Program Code taken from code_value , code_set 4517.
OVERRIDE_FIELD_SEQ DOUBLE N Sequence that indicates the multiple occurrences of a particular field_cd.
OVERRIDE_FIELD_TXT VARCHAR(255) N Value entered by the user for a given field_cd and field_seq combination.
RX_CLAIM_OVERRIDE_ID DOUBLE N Uniquely identifies a specific override field.
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 - RX_CLAIM_OVERRIDE


Child Column in RX_CLAIM_OVERRIDE(FK) Parent Table Name Parent Column Name
Parents: DISPENSE_HX_ID DISPENSE_HX DISPENSE_HX_ID
HEALTH_PLAN_ID HEALTH_PLAN HEALTH_PLAN_ID