Table Detail Report

RX_CLAIM_PENDING



Column Section Relationship Section Top of Page


Table-level Detail

Description: RX Claim Pending
Definition: Claim transactions waiting to be picked up by the claim server.
Table Type: ACTIVITY





Column Detail - RX_CLAIM_PENDING


Column Name Type Null? Definition
ACTION_SEQUENCE_NBR DOUBLE N The action sequence taken from the order action table.
CARD_HOLDER_IDENT VARCHAR(100) N The member number of the subscriber to the health plan.
CLAIM_FORMAT_CD DOUBLE N Format used in building the Message string, containing the claims information that is sent in the transaction.
CLAIM_FORMAT_TYPE_CD DOUBLE N This field contains the type of claim format that is used to submit the claim.
CLAIM_PENDING_ID DOUBLE N This field uniquely identifies this pending claim.
CLAIM_TRANS_CD DOUBLE N Type of claim transaction.
COPAY_AMT DOUBLE N This field contains the amount of co-pay that comes out of patient's pocket.
DISPENSE_HX_ID DOUBLE N Dispense_hx_id from Dispense_hx table.
DISP_EVENT_TYPE_CD DOUBLE N Type of dispense that generated the claim.
FILL_NBR DOUBLE N This field contains the fill number for the current transaction.
HEALTH_PLAN_ID DOUBLE N This field contains a unique reference back to the RX_HEALTH_PLAN table.
LEVEL5_CD DOUBLE N Location of the Workstation (PC) that was used in filling the prescription.
ORDER_ID DOUBLE N This field contains a unique reference to the ORDERS table.
PRICE_AMT DOUBLE N This field contains the price amount for the current transaction.
REIMBURSEMENT_AMT DOUBLE N The field contains the reimbursement amount for the current transaction.
SUBSECTION_CD DOUBLE N Location of the Pharmacy that filled the prescription.
SWITCH_CD DOUBLE N Switch to which the claim transaction was sent.
TRANS_DT_TM DATETIME Y This field contains the date and time for this transaction.
TRANS_TZ DOUBLE N Time zone for the claim transaction
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_PENDING


Child Column in RX_CLAIM_PENDING(FK) Parent Table Name Parent Column Name
Parents: DISPENSE_HX_ID DISPENSE_HX DISPENSE_HX_ID
ACTION_SEQUENCE_NBR 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
HEALTH_PLAN_ID RX_HEALTH_PLAN HEALTH_PLAN_ID


RX_CLAIM_RESPONSE



Column Section Relationship Section Top of Page


Table-level Detail

Description: Pharmacy Claim Response
Definition: Contains information on claim responses from the insurance payer.
Table Type: ACTIVITY





Column Detail - RX_CLAIM_RESPONSE


Column Name Type Null? Definition
REJECT_CD DOUBLE N The NCPDP reject code supplied by the payer when they rejected the claim
RX_CLAIM_ID DOUBLE N The claim that this response pertains to.
RX_CLAIM_RESPONSE_ID DOUBLE N Unique generated number that identifies a single row on the RX_CLAIM_RESPONSE table.
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_RESPONSE


Child Column in RX_CLAIM_RESPONSE(FK) Parent Table Name Parent Column Name
Parents: RX_CLAIM_ID RX_CLAIM RX_CLAIM_ID


RX_CLAIM_SOURCE



Column Section Top of Page


Table-level Detail

Description: RX CLAIM SOURCE
Definition: Rx_Claim_Source - Stores all possible source fields for claim fields.
Table Type: REFERENCE





Column Detail - RX_CLAIM_SOURCE


Column Name Type Null? Definition
FIELD_DECIMAL_CNT DOUBLE Y NUMBER OF DIGITS AFTER DECIMAL TO BE USED
FIELD_LENGTH DOUBLE Y LENGTH OF CLAIM SOURCE
FIELD_TYPE_FLAG DOUBLE Y DATA TYPE OF SOURCE FIELD
SOURCE_FIELD_CD DOUBLE N CODE VALUE FROM CODE SET 4518
SOURCE_TYPE_CD DOUBLE N CODE VALUE FROM CODE SET 4521
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_VALIDATION



Column Section Top of Page


Table-level Detail

Description: RX CLAIM VALIDATION
Definition: Rx_claim_validation - Stores validation rules for prescription entry.
Table Type: REFERENCE





Column Detail - RX_CLAIM_VALIDATION


Column Name Type Null? Definition
MANF_ITEM_ID DOUBLE N *** OBSOLETE ***
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.
VALIDATION_CD DOUBLE N CODE VALUE FROM CODE SET 4519
VALIDATION_FIELD_CD DOUBLE N CODE VALUE FROM CODE SET 4522
VALIDATION_ID DOUBLE N UNIQUE ID FOR EACH FIELD
VALIDATION_SEQ DOUBLE Y SEQUENCE OF VALIDATION FIELDS
VALIDATION_TYPE_CD DOUBLE N CODE VALUE FROM CODE SET 4520
VALUE DOUBLE Y THRESHOLD VALUE FOR EACH FIELD


RX_CONNECTION



Column Section Relationship Section Top of Page


Table-level Detail

Description: rx connection
Definition: rx connection
Table Type: REFERENCE





Column Detail - RX_CONNECTION


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.
CONNECTION_TYPE_CD DOUBLE N The type of internet connection a particular row represents. Examples would be a modem or VPN
IP_ADDRESS VARCHAR(50) Y Identifies IP_address that is connected
MODEM DOUBLE Y Identifies sequential modem number that is connected
PORT VARCHAR(30) Y Identifies Port logical that is connected
RX_CONNECTION_ID DOUBLE N Unique key
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_CONNECTION




Parent Column in RX_CONNECTION (PK) Child Table Name Child Column Name
Children: RX_CONNECTION_ID PHA_SWITCH_CONN_R RX_CONNECTION_ID