CAP_PAY_RATE_ELEMENT_REPL

Description: |
This table stores rate element information used in a capitation transaction.

Primary Key

Column Name | Ordinal Position |
--- | --- | ---
TX_ID | 1 |
LINE | 2 |

Column Information

| Name | Type | Discontinued? |
--- | --- | --- | --- | ---
1 | TX_ID | NUMERIC | No |
The unique identifier (.1 item) for the transaction record.
2 | LINE | INTEGER | No |
The line number for the information associated with this record. Multiple pieces of information can be associated with this record.
3 | FRM_TBL_GRP_TYPE_C_NAME | VARCHAR | No |
The group type of the rate elements.
May contain organization-specific values: No
Category Entries:
Constant
Coverage Risk Factor
Benefit Plan Rate Factor
Lookup
Part A
Part B
Part D
Employer Group Rate Factor
Premium Rate Element
Tiered
Employer Group Rate Element
Fee Rate Element
4 | LOOKUP_TABLE_ID | VARCHAR | No |
The lookup table which was used to retrieve the rate element's values.
5 | LOOKUP_TABLE_ID_RATE_TABLE_NAME | VARCHAR | No |
Name of the capitation rate table.
6 | MATCHED_CVG_ATTR_C_NAME | VARCHAR | No |
This column will be deprecated. To continue accessing this data, use the MATCHED_CVG_ATTR_C column from the CAP_PAY_EL_DETAILS table. The coverage attribute used to select the rate group from the lookup table.
May contain organization-specific values: Yes
7 | PREMIUM_BUCKET_ID | NUMERIC | No |
The capitation bucket which was the source of capitation RR subcomponent amounts used in the formula.
8 | MEM_LIST_ROW_KEY | INTEGER | No |
The row number of the member in the member list (TML) to which each row in related group 3510 corresponds for a specialty capitation transaction.
9 | MATCHED_RIDER_PLAN_ID_BENEFIT_PLAN_NAME | VARCHAR | No |
The name of the benefit plan record.
10 | MATCHED_RULE_ID | VARCHAR | No |
This column will be deprecated. To continue accessing this data, use the MATCHED_RULE_ID column from the CAP_PAY_EL_DETAILS table. The rule that passed when selecting the rate group for the lookup table.
11 | MATCHED_RULE_ID_RULE_NAME | VARCHAR | No |
The name of the rule.
12 | REFINEMENT_LOOKUP_TABLE_ID | VARCHAR | No |
This column will be deprecated. To continue accessing this data, use the REFINEMENT_LOOKUP_TABLE_ID column from the CAP_PAY_EL_DETAILS table. The additional refinement rate table used to look up a member's rate.
13 | REFINEMENT_LOOKUP_TABLE_ID_RATE_TABLE_NAME | VARCHAR | No |
Name of the capitation rate table.