RXA_ADJUD_MESSAG_2

Description:

Contains various information relating to a single contact of an adjudication record. Adjudication records are used by Ambulatory Pharmacy during prescription copay adjudication.

Primary Key

Column Name	Ordinal Position
RECORD_ID	1
CONTACT_DATE_REAL	2

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 contact date in decimal format. The integer portion of the number indicates the date of 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	CONTACT_DATE	DATETIME	No
	The date of this contact in calendar format.
4	BIN_NUM	VARCHAR	No
	The BIN (Bank Identification Number) used during prescription adjudication. This number can be stored in the plan and payor, and a different number can be returned based on whether the adjudication is primary or not. (101-A1)
5	PROCESSOR_CTRL_NUM	VARCHAR	No
	The processor control number used during prescription adjudication. This number can be stored in the plan and payor, and a different number can be returned based on whether the adjudication is primary or not.(104-A4)
6	ORG_PRESC_PROD_CODE	VARCHAR	No
	NCPDP code of the initially prescribed product or service.(445-EA)
7	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.
8	I_TX_CODE_ID	NUMERIC	No
	NCPDP code identifying the type of transaction.
9	I_TX_CODE_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
10	I_HEADER_RESP_ST_ID	NUMERIC	No
	NCPDP code indicating the status of the transmission.
11	I_HEADER_RESP_ST_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
12	I_SVC_PROV_QUAL_ID	NUMERIC	No
	NCPDP code qualifying the 'Service Provider ID' (201-B1).
13	I_SVC_PROV_QUAL_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
14	I_PYR_QUAL_ID	NUMERIC	No
	NCPDP code indicating the type of payer ID.
15	I_PYR_QUAL_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
16	I_MCAID_MEM_ID_NUM	VARCHAR	No
	A unique member identification number assigned by the Medicaid Agency.
17	I_MEDICAID_AGNC_NUM	VARCHAR	No
	The Medicaid Agency Number sent to the payer (116-N6)
18	I_CARDHOLDER_ID	VARCHAR	No
	Insurance ID assigned to the cardholder or identification number used by the plan.
19	I_MCARE_D_CVG_ID	NUMERIC	No
	Code indicating the position of Medicare Part D in the billing order (139-UR).
20	I_MCARE_D_CVG_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
21	I_CMS_LICS_LEVEL	VARCHAR	No
	ID for the formulary list
22	I_CONTRACT_NUMBER	VARCHAR	No
	Code indicating the status of the transmission.
23	I_FORMULARY_ID	VARCHAR	No
	ID for the formulary list.
24	I_BENEFIT_ID	VARCHAR	No
	Insurance ID assigned to the cardholder or identification number used by the plan.
25	I_NXT_MDCR_D_EFF_DT	DATETIME	No
	A Medicare Part D coverage's effective starting date
26	I_NXT_MDCR_D_TR_DT	DATETIME	No
	A Medicare Part D coverage's effective ending date
27	I_PATIENT_FIRST_NAM	VARCHAR	No
	Patient's first name sent to the payer (310-CA)
28	I_PATIENT_LAST_NAME	VARCHAR	No
	Patient's last name sent to the payer (311-CB)
29	I_BIRTH_DATE	DATETIME	No
	ID for the formulary list
30	I_TX_RESP_STAT_ID	NUMERIC	No
	NCPDP code indicating the status of the transaction.
31	I_TX_RESP_STAT_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
32	I_HELP_DESK_QUAL_ID	NUMERIC	No
	NCPDP code qualifying the phone number in the 'Help Desk Phone Number' (550-8F).
33	I_HELP_DESK_QUAL_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
34	I_TX_REF_NUM	VARCHAR	No
	A reference number assigned by the provider to each of the data records in the batch or real-time transactions. The purpose of this number is to facilitate the process of matching the transaction response to the transaction. The transaction reference number assigned should be returned in the response. (880-K5)
35	I_INT_CTRL_NUM	VARCHAR	No
	Number assigned by the processor to identify an adjudicated claim when supplied in payer-to-payer coordination of benefits only.
36	I_URL	VARCHAR	No
	The web page address sent to the payer (987-MA)
37	I_RX_RF_NUM_QUAL_ID	NUMERIC	No
	NCPDP code indicating the type of billing submitted.
38	I_RX_RF_NUM_QUAL_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
39	I_MCAID_CLAIM_NUM	VARCHAR	No
	Claim number assigned by the Medicaid Agency.
40	I_TAX_EXEMPT_IND_ID	NUMERIC	No
	Code indicating the source of the percentage tax exempt status of the claim.
41	I_TAX_EXEMPT_IND_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
42	I_BAS_REIM_DET_ID	NUMERIC	No
	NCPDP code identifying how the reimbursement amount was calculated for 'Ingredient Cost Paid' (506-F6).
43	I_BAS_REIM_DET_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
44	I_BAS_DISP_FEE_ID	NUMERIC	No
	NCPDP code indicating how the reimbursement amount was calculated for 'Dispensing Fee Paid' (507-F7).
45	I_BAS_DISP_FEE_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
46	I_BAS_CALC_COPAY_ID	NUMERIC	No
	NCPDP code indicating how the Copay reimbursement amount was calculated for 'Patient Pay Amount' (505-F5).
47	I_BAS_CALC_COPAY_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
48	I_BAS_FLAT_TAX_ID	NUMERIC	No
	Code indicating how the reimbursement amount was calculated for Regulatory Fee Amount Paid (558-AW).
49	I_BAS_FLAT_TAX_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
50	I_BAS_PCT_TAX_ID	NUMERIC	No
	Code indicating how the reimbursement amount was calculated for Percentage Tax Amount Paid (559-AX).
51	I_BAS_PCT_TAX_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
52	I_AMT_ATTR_PROC_FEE	NUMERIC	No
	This specifies the amount that is attributed to the processor fee.
53	I_PAT_SAL_TAX_AMT	NUMERIC	No
	Patient percentage tax obligation or portion thereof when benefit is set up to directly pass percentage tax onto the patient.
54	I_PLAN_SAL_TAX_AMT	NUMERIC	No
	The sales tax amount attributed to the plan.
55	I_AMT_COINS	NUMERIC	No
	The amount of coinsurance that was calculated.
56	I_BAS_CALC_COINS	NUMERIC	No
	Code indicating how the Coinsurance reimbursement amount was calculated for Patient Pay Amount (505-F5).
57	I_BAS_CALC_COINS_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
58	I_EST_GENERC_SAVING	NUMERIC	No
	The amount, not included in the Total Amount Paid (509-F9), that the patient would have saved if they had chosen the generic drug instead of the brand drug.
59	I_SP_ACC_AMT_REM	NUMERIC	No
	The amount remaining on the spending amount. (128-UC)
60	I_HPFA_AMT	NUMERIC	No
	Medicare Part D Coverage Code
61	I_AMT_PROV_NET_SEL	NUMERIC	No
	The amount that has been attributed to the provider network selection
62	I_AMT_PROD_SEL_BRAN	NUMERIC	No
	The amount that is attributed to product selection for branded drugs.
63	I_AMT_NPRF_FRM_SEL	NUMERIC	No
	The amount that is attributed to a product selection for non preferred formulary selections.
64	I_AMT_BRND_NPRF_FRM	NUMERIC	No
	The amount that is attributed to product selection for Brand non preferred formulary selections.
65	I_AMT_ATTR_CVG_GAP	NUMERIC	No
	The amount that is attributed to the coverage gap.
66	I_INGR_COST_CNTRCTD	NUMERIC	No
	Informational field used when Other Payer-Patient Responsibility Amount (352- NQ) or Patient Pay Amount (505-F5) is used for reimbursement. Amount is equal to contracted or reimbursable amount for product being dispensed.
67	I_DISP_FEE_CNTRCTD	NUMERIC	No
	Informational field used when Other Payer-Patient Responsibility Amount (352-NQ) or Patient Pay Amount (505-F5) is used for reimbursement. Amount is equal to contracted or reimbursable dispensing fee for product being dispensed.
68	I_PCT_TAX_PD_ID	NUMERIC	No
	Code indicating the percentage tax paid basis.
69	I_PCT_TAX_PD_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
70	I_COPAY_AMT	NUMERIC	No
	The amount to be collected from the patient that is included in 'Patient Pay Amount' (505-F5) that is due to a per prescription copay.
71	REVERSE_OF_RXA_ID	NUMERIC	No
	The unique ID of the original adjudication that this reversal or rebill is reversing.
72	REVERSE_OF_DATE_REAL	FLOAT	No
	Unique contact date in decimal format of the original adjudication that this reversal or rebill is reversing.
73	IS_MANUALLY_APPROVED_YN	VARCHAR	No
	Indicates if the adjudication attempt was manually approved. 'N' or NULL indicate that the attempt was not manually approved. 'Y' indicates that the attempt as manually approved. May contain organization-specific values: No Category Entries: No Yes
74	PREVIOUS_ADJ_RXA_ID	NUMERIC	No
	Gets the adjudication attempt ID of the previous coverage in the filing order at the moment of this adjudication attempt. For primary coverage adjudications, this will always be null. For secondary coverages, this will point to the primary coverage. For tertiary coverages, this will point to the secondary coverage.
75	PREVIOUS_ADJ_DATE_REAL	FLOAT	No
	Gets the unique adjudication attempt date of the previous coverage in the filing order at the moment of this adjudication attempt. For primary coverage adjudications, this will always be null. For secondary coverages, this will point to the primary coverage. For tertiary coverages, this will point to the secondary coverage.
76	M3P_STATUS_C_NAME	VARCHAR	No
	This is the M3P status inferred from the NCPDP vD.0 field Approved Message Codes (548-6F). Blank - No M3P related status 1 - Patient is likely to benefit from M3P (Code 056) 2 - Patient is enrolled in the M3P (Code 057) and the coverage applied correctly 3 - Patient is enrolled in the M3P (Code 057) but the coverage not applied correctly 4 - Patient not longer participating/elected not to participate (Code 058) May contain organization-specific values: No Category Entries: Likely to Benefit (Code 056) Is Enrolled (Code 057) But Coverage Is Not Applied Is Enrolled (Code 057) And Coverage Is Applied Not Participating (Code 058)
77	RESUB_DOCUMENT_ID	VARCHAR	No
	The document attached in the Resubmission/Attachment field.
78	O_PAT_ID_ASSC_STATE_ID	NUMERIC	No
	State/Province Code associated with the Patient ID Qualifier (331-CX) and the Patient ID (332-CY).
79	O_PAT_ID_ASSC_STATE_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
80	O_PAT_ID_ASSC_CNTRY_ID	NUMERIC	No
	Code of the country (B38-1Y).
81	O_PAT_ID_ASSC_CNTRY_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
82	O_VETERINARY_USE_ID	NUMERIC	No
	To indicate that the prescription was dispensed for use on something other than human (A45-1R).
83	O_VETERINARY_USE_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
84	O_SPECIES	VARCHAR	No
	A basic biological classification containing individuals that resemble one another and may interbreed (E06-S8).
85	O_PROV_FIRST_NAME	VARCHAR	No
	First name of the provider (B96-4A).
86	O_PROV_LAST_NAME	VARCHAR	No
	Last name of the provider (B97-4M).
87	O_RECON_ID_S	VARCHAR	No
	A unique identifier assigned by the processor for the transaction response statuses of Paid/Duplicate of Paid, Capture/Duplicate of Capture, or Approved/Duplicate of Approved that provides a means to identify that transaction should any subsequent transaction or other associated activity occur (B98-34).
88	O_AS_RX_NUM_QUAL_ID	NUMERIC	No
	Code qualifying the Associated Prescription/Service Reference Number ID (456-EN) to which the claim/service is related.
89	O_AS_RX_NUM_QUAL_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
90	O_MULT_RX_GRP_ID_S	VARCHAR	No
	Unique ID assigned by the prescriber or pharmacy system to link multiple product orders together (D21-M3).
91	O_MLT_RX_GRP_RSN_ID	NUMERIC	No
	Indicates the reason for the quantity dispensed and/or days supply as a result of the prescriber issuing grouped prescriptions (D22-M4).
92	O_MLT_RX_GRP_RSN_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
93	O_TOTL_PRES_QTY_REM	NUMERIC	No
	Accumulated Total Prescribed Quantity Remaining as of the date of service. Calculated value based on: (Quantity Prescribed (460-ET)) * (Number Of Refills Authorized (415-DF) + 1) - Accumulated Quantity Dispensed (442-E7) inclusive of current fill.
94	O_PREP_ENV_TYPE_ID	NUMERIC	No
	Code identifying the environment in which the medication was prepared (C99-KU).
95	O_PREP_ENV_TYPE_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
96	O_PREP_ENV_EVT_CODE_ID	NUMERIC	No
	Event which required a special preparation environment (C98-KT).
97	O_PREP_ENV_EVT_CODE_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
98	O_AS_PRES_PROV_QUAL_ID	NUMERIC	No
	Code qualifying the Associated Prescription/Service Provider ID (580-XY) to which the claim/service is related.
99	O_AS_PRES_PROV_QUAL_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
100	O_AS_PRES_PROV_ID_S	VARCHAR	No
	Related Service Provider ID to which the claim/service is associated (580-XY).
101	O_AS_PRES_FILL_NUM	INTEGER	No
	Related Fill Number to which the claim/service is associated (582-X0).
102	O_TIME_OF_SVC_TM	DATETIME (UTC)	No
	The time at which the service is performed as local time that will correspond with the actual date of service (678-Y6).
103	O_SALES_TX_ID_S	VARCHAR	No
	A reference identifier assigned to the sale transaction as assigned by the merchant (681-ZF).
104	O_RPT_ADJ_PROG_TYPE_ID	NUMERIC	No
	The type of prescription benefit plan/program under which the reported claim adjudicated (A29-ZS).
105	O_RPT_ADJ_PROG_TYPE_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
106	O_ORIG_PROD_ID_Q_ID	NUMERIC	No
	Code qualifying the value in Original Manufacturer Product ID (C01-4N).
107	O_ORIG_PROD_ID_Q_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
108	O_ORIG_PROD_ID_S	VARCHAR	No
	Original ID of the Original Manufacturer/Labeler product for the dispensed repackaged drug used by the repackager to create the drug being dispensed (C01-4N).
109	O_LTPAC_DISP_FRQ_ID	NUMERIC	No
	Code indicating the frequency of dispensing medication to a LTPAC patient (C91-KK).
110	O_LTPAC_DISP_FRQ_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
111	O_LTPAC_BILL_MTD_ID	NUMERIC	No
	Code indicating the billing methodology used for the claim (C90-KH).
112	O_LTPAC_BILL_MTD_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
113	O_NUM_LTPAC_DIS_EVT	INTEGER	No
	Value indicating the number of times pharmacy dispensed product or service for the claim period requested (C92-KM).
114	O_DN_DISP_BF_DATE	DATETIME	No
	The earliest date the prescriber indicates a prescribed drug can be dispensed (D18-K9).
115	O_CMPND_LO_CMPLX_ID	NUMERIC	No
	Value used by the pharmacy to indicate the complexity involved in the preparation of the compounded prescription (C60-AG).
116	O_CMPND_LO_CMPLX_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
117	O_PRES_ID_ASC_ST_ID	NUMERIC	No
	State/Province Code associated with the Prescriber ID Qualifier (466-EZ) and the Prescriber ID (411-DB).
118	O_PRES_ID_ASC_ST_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
119	O_PR_ID_AS_CNTRY_ID	NUMERIC	No
	Code of the country (B41-3B).
120	O_PR_ID_AS_CNTRY_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
121	O_PRES_PHONE_NUM_EX	VARCHAR	No
	Extension of the telephone number (B26-7T).
122	O_PRES_ADD_LINE_ONE	VARCHAR	No
	Free form text for prescriber address line 1 information (B27-7U).
123	O_PRES_ADD_LINE_TWO	VARCHAR	No
	Free form text for prescriber address line 2 information (B28-7V).
124	O_PRESC_DEA_NUM	VARCHAR	No
	ID assigned to a health care provider (e.g. Practitioner, Hospital, Manufacturer, etc.) by the US Drug Enforcement Administration, allowing them to distribute, dispense, administer, or conduct research with respect to controlled substances in the course of professional practice or research (D01-KV).
125	O_PRES_PLC_SERV_ID	NUMERIC	No
	Code identifying the place where the patient encounter occurred as reported by the prescriber (D57-RG).
126	O_PRES_PLC_SERV_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
127	O_PRESC_MIDDLE_NAME	VARCHAR	No
	Individual Middle Name (E12-0F).
128	O_SUBRGTN_AMT_RQSTD	NUMERIC	No
	Amount paid by the plan to the pharmacy (D14-KX).