|
Name |
Type |
Discontinued? |
|
| 1 |
RECORD_ID |
NUMERIC |
No |
|
|
|
| The unique identifier (.1 item) 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 |
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 |
I_O_BEN_TYPE_ID |
NUMERIC |
No |
|
|
|
| The type of other benefit for the date of service requested (D40-PN). |
|
|
| 6 |
I_O_BEN_TYPE_ID_EXT_CODE_LST_NAME |
VARCHAR |
No |
|
|
|
| The name of the list value. |
|
|
| 7 |
I_OTH_BEN_EFF_DATE |
DATETIME |
No |
|
|
|
| The effective date of the benefit for the date of service requested (D34-MZ). |
|
|
| 8 |
I_OTH_BEN_TERM_DATE |
DATETIME |
No |
|
|
|
| The termination date of the benefit for the date of service requested (D39-NN). |
|
|
| 9 |
I_O_BEN_ST_PROV_ADD_ID |
NUMERIC |
No |
|
|
|
| The State/Province Code of the address (729-TA). |
|
|
| 10 |
I_O_BEN_ST_PROV_ADD_ID_EXT_CODE_LST_NAME |
VARCHAR |
No |
|
|
|
| The name of the list value. |
|
|
| 11 |
I_OTH_BEN_TYPE_ID_S |
VARCHAR |
No |
|
|
|
| The ID for the entity providing the benefit (D38-N9). |
|
|
| 12 |
I_OTH_BEN_FAC_NAME |
VARCHAR |
No |
|
|
|
| Name identifying the other benefit facility where the service was rendered (D35-N1). |
|
|
| 13 |
I_OTH_BEN_FAC_PHONE |
VARCHAR |
No |
|
|
|
| Phone number of the Other Benefit Facility (D36-N7). |
|
|