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 |