RXA_DUR_TABLE

Description: |
Contains information relating to Drug Utilization Review (DUR) conflicts in adjudication records. Adjudication records are used by Ambulatory Pharmacy during prescription copay adjudication.

Primary Key

Column Name | Ordinal Position |
--- | --- | ---
RECORD_ID | 1 |
CONTACT_DATE_REAL | 2 |
LINE | 3 |

Column Information

| Name | Type | Discontinued? |
--- | --- | --- | --- | ---
1 | RECORD_ID | NUMERIC | No |
The unique identifier for the adjudication record.
2 | CONTACT_DATE_REAL | FLOAT | No |
A unique, internal contact date in decimal format. The integer portion of the number indicates the date of the contact. The digits after the decimal distinguish different contacts on the same date and are unique for each contact on that date. For example, .00 is the first/only contact, .01 is the second contact, etc.
3 | LINE | INTEGER | No |
The line number for the information associated with this contact. Multiple pieces of information can be associated with this contact.
4 | CONTACT_DATE | DATETIME | No |
The date of this contact in calendar format.
5 | CM_CT_OWNER_ID | VARCHAR | No |
The Community ID (CID) of the instance that owns this contact. This is only populated if you use IntraConnect.
6 | REASON_FOR_SERV_C_NAME | VARCHAR | No |
NCPDP code identifying the type of utilization conflict detected or the reason for the pharmacist's professional service.
May contain organization-specific values: No
Category Entries:
Additional Drug Needed
Prescription Authentication
Adverse Drug Reaction
Additive Toxicity
Chronic Disease Management
Call Help Desk
Patient Complaint/Symptom
Drug-Allergy
Drug-Disease (Inferred)
Drug-Drug Interaction
Drug-Food Interaction
Drug Incompatibility
Drug-Lab Conflict
Apparent Drug Misuse
Tobacco Use
Patient Education/Instruction
Overuse
Excessive Quantity
High Dose
Iatrogenic Condition
Ingredient Duplication
Low Dose
Lock In Recipient
Underuse
Drug-Disease (Reported)
Insufficient Duration
Missing Information/Clarification
Excessive Duration
Drug Not Available
Non-covered Drug Purchase
New Disease/Diagnosis
Non-Formulary Drug
Unnecessary Drug
New Patient Processing
Lactation/Nursing Interaction
Insufficient Quantity
Alcohol Conflict
Drug-Age
Patient Question/Concern
Drug-Pregnancy
Preventive Health Care
Prescriber Consultation
Plan Protocol
Prior Adverse Reaction
Product Selection Opportunity
Suspected Environmental Risk
Health Provider Referral
Suboptimal Compliance
Suboptimal Drug/Indication
Side Effect
Suboptimal Dosage Form
Suboptimal Regimen
Drug-Sex
Therapeutic
Laboratory Test Needed
Payor/Processor Question
7 | CLINICAL_SIGN_C_NAME | VARCHAR | No |
NCPDP code identifying the significance or severity level of a clinical event.
May contain organization-specific values: No
Category Entries:
Major
Moderate
Minor
8 | OTHER_PHR_IND_C_NAME | VARCHAR | No |
NCPDP code indicating the pharmacy responsible for the previous event involved in the DUR conflict.
May contain organization-specific values: No
Category Entries:
Not Specified
Your Pharmacy
Other Pharmacy in Same Chain
Other Pharmacy
9 | PREV_FILL_DATE | DATETIME | No |
The date that the prescription was previously filled
10 | QUANT_OF_PREV_FILL | NUMERIC | No |
Amount of the conflicting agent that was previously filled (in metric decimal units).
11 | DATABASE_INDICAT_C_NAME | VARCHAR | No |
NCPDP code identifying the source of drug information used for DUR processing.
May contain organization-specific values: No
Category Entries:
First Databank
Medi-Span
Micromedix/Medical Economics
Processor Developed
Other
12 | OTH_PRSCRBR_IND_C_NAME | VARCHAR | No |
NCPDP code comparing the prescriber of the current prescription to the prescriber of the previously filled conflicting prescription.
May contain organization-specific values: No
Category Entries:
Not Specified
Same Prescriber
Other Prescriber
13 | DUR_FREE_TXT_MSG | VARCHAR | No |
Text that provides additional detail regarding a DUR conflict.
14 | PROF_SERVICE_C_NAME | VARCHAR | No |
NCPDP code identifying the type of utilization conflict detected or the reason for the pharmacist's professional service.
May contain organization-specific values: No
Category Entries:
No intervention
Patient assessment
Coordination of care
Dosing evaluation/determination
Formulary enforcement
Generic product selection
Medication administration
Prescriber consulted
Medication review
Patient education/instruction
Patient medication history
Patient monitoring
Patient consulted
Perform laboratory test
Pharmacist consulted other source
Recommend laboratory test
Self-care consultation
Literature search/review
Payor/processor consulted
Therapeutic product interchange
15 | SERVICE_RESULT_C_NAME | VARCHAR | No |
Action taken by a pharmacist in response to a conflict or the result of a pharmacist’s professional service.
May contain organization-specific values: No
Category Entries:
Not Specified
Filled As Is, False Positive
Filled Prescription As Is
Filled With Different Dose
Filled With Different Directions
Filled With Different Drug
Filled With Different Quantity
Filled With Prescriber Approval
Brand-to-Generic Change
Rx-to-OTC Change
Filled with Different Dosage Form
Prescription Not Filled
Not Filled, Directions Clarified
Recommendation Accepted
Recommendation Not Accepted
Discontinued Drug
Regimen Changed
Therapy Changed
Therapy Changed-Cost Increased Acknowledged
Drug Therapy Unchanged
Follow-Up/Report
Patient Referral
Instructions Understood
Compliance Aid Provided
Medication Administered
16 | EFFORT_LEVEL_C_NAME | VARCHAR | No |
The level of service for the DUR. Indicates how much effort and time was spent by the pharmacist dealing with the DUR or PPS.
May contain organization-specific values: No
Category Entries:
Not Specified
Level 1
Level 2
Level 3
Level 4
Level 5
17 | COAGENT_QUALIFIER_C_NAME | VARCHAR | No |
NCPDP code qualifying the value in ‘DUR Co-Agent ID’ when a pharmacist when resolving an DUR when doing an Rx Adjudication.
May contain organization-specific values: No
Category Entries:
Universal Product Code
Health Related Item
National Drug Code
Universal Product Number
Department of Defense
Common Procedure Terminology (CPT4)
Common Procedure Terminology (CPT5)
Health Care Financing Administration Common Procedural Coding System
National Pharmaceutical Product Interface Code
International Article Numbering System
Drug Identification Number
Medi-Span GPI
First DataBank GCN
Medical Economics GPO
Medi-Span DDID
First DataBank SmartKey
Medical Economics GM
International Classification of Diseases (ICD9)
International Classification of Diseases (ICD10)
Medi-Span Diagnosis Code
National Criteria Care Institute
The Systematized Nomenclature of Human and Veterinary Medicine
Common Dental Terminology
American Psychiatric Association Diagnostic Statistical Manual of Mental Disorders
Other
18 | COAGENT_ID | VARCHAR | No |
The field used to respond to DURs for prescription adjudication