|
Name |
Type |
Discontinued? |
|
1 |
MED_ESTIMATE_ID |
NUMERIC |
No |
|
|
|
The unique identifier (.1 item) for the medication estimate 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 |
PHR_TYPE_C_NAME |
VARCHAR |
No |
|
|
|
Holds the category value indicating the pharmacy type that is covered. |
May contain organization-specific values: No |
Category Entries: |
Retail |
Mail Order |
Specialty |
Long-Term Care |
Durable Medical Equipment |
Compounding |
|
|
6 |
DRUG_STATUS_C_NAME |
VARCHAR |
No |
|
|
|
Holds the category value of the drug coverage status. |
May contain organization-specific values: No |
Category Entries: |
Covered With Restrictions |
Covered |
Error Processing Pharmacy Type |
Not Covered |
Pharmacy Type Not Supported |
Pharmacy Not Found |
|
|
7 |
QTY_PRICED |
INTEGER |
No |
|
|
|
Holds the quantity priced. |
|
|
8 |
QTY_PRICED_UNIT_C_NAME |
VARCHAR |
No |
|
|
|
Holds the category value indicating the unit for the quantity priced. |
May contain organization-specific values: Yes |
Category Entries: |
mL |
L |
mg |
g |
Units |
mmol |
mEq |
mcg |
% |
Int'l Units |
Million Units |
kcal |
ng |
mg PE |
milli-units |
pg |
KBq |
MBq |
GBq |
mcL |
mL/min |
L/min |
mg/min |
g/min |
Units/min |
mmol/min |
mEq/min |
mcg/min |
kJ/min |
Int'l Units/min |
Million Units/min |
kcal/min |
ng/min |
mg PE/min |
milli-units/min |
pg/min |
KBq/min |
MBq/min |
GBq/min |
mcL/min |
mL/hr |
L/hr |
mg/hr |
g/hr |
Units/hr |
mmol/hr |
mEq/hr |
mcg/hr |
kJ/hr |
Int'l Units/hr |
Million Units/hr |
kcal/hr |
ng/hr |
mg PE/hr |
milli-units/hr |
pg/hr |
KBq/hr |
MBq/hr |
GBq/hr |
mcL/hr |
mL/day |
L/day |
mg/day |
g/day |
Units/day |
mmol/day |
mEq/day |
mcg/day |
kJ/day |
Int'l Units/day |
Million Units/day |
kcal/day |
ng/day |
mg PE/day |
milli-units/day |
pg/day |
Inch/day |
KBq/day |
MBq/day |
GBq/day |
mcL/day |
IR/day |
BAU/day |
PFU/day |
Million PFU/day |
Million Int'l Units/day |
Kilo Int'l Units/day |
EIN/day |
Million EIN/day |
mL/kg |
L/kg |
mg/kg |
g/kg |
Units/kg |
mmol/kg |
mEq/kg |
mcg/kg |
kJ/kg |
Int'l Units/kg |
Million Units/kg |
kcal/kg |
ng/kg |
mg PE/kg |
milli-units/kg |
pg/kg |
mg/kg (Actual) |
Each/kg |
Puff/kg |
Package/kg |
Drop/kg |
Inch/kg |
KBq/kg |
MBq/kg |
GBq/kg |
mcL/kg |
IR/kg |
BAU/kg |
Million Int'l Units/kg |
mcmol/kg |
1e12 Vector Genomes/kg |
Vector Genomes/kg |
Dose/kg |
mcg DFE/kg |
Kilo Int'l Units/kg |
1e11 Vector Genomes/kg |
1e13 Vector Genomes/kg |
1e14 Vector Genomes/kg |
1e15 Vector Genomes/kg |
EIN/kg |
IR/min |
BAU/min |
Million Int'l Units/min |
Kilo Int'l Units/min |
IR/hr |
BAU/hr |
Million Int'l Units/hr |
Kilo Int'l Units/hr |
mL/mL |
L/mL |
mg/mL |
g/mL |
Units/mL |
mmol/mL |
mEq/mL |
mcg/mL |
kJ/mL |
Int'l Units/mL |
Million Units/mL |
kcal/mL |
ng/mL |
mg PE/mL |
milli-units/mL |
pg/mL |
KBq/mL |
MBq/mL |
GBq/mL |
mcL/mL |
IR/mL |
BAU/mL |
PFU/mL |
Million PFU/mL |
Million Int'l Units/mL |
mcmol/mL |
1e12 Vector Genomes/mL |
Vector Genomes/mL |
Kilo Int'l Units/mL |
1e11 Vector Genomes/mL |
1e13 Vector Genomes/mL |
1e14 Vector Genomes/mL |
1e15 Vector Genomes/mL |
millicurie/mL |
mL/L |
L/L |
mg/L |
g/L |
Units/L |
mmol/L |
mEq/L |
mcg/L |
kJ/L |
Int'l Units/L |
Million Units/L |
kcal/L |
ng/L |
mg PE/L |
milli-units/L |
pg/L |
KBq/L |
MBq/L |
GBq/L |
mcL/L |
IR/L |
BAU/L |
Million Int'l Units/L |
Kilo Int'l Units/L |
mL/m2 |
L/m2 |
mg/m2 |
g/m2 |
Units/m2 |
mmol/m2 |
mEq/m2 |
mcg/m2 |
kJ/m2 |
Int'l Units/m2 |
Million Units/m2 |
kcal/m2 |
ng/m2 |
mg PE/m2 |
milli-units/m2 |
pg/m2 |
mg/m2 (Actual) |
Each/m2 |
Puff/m2 |
Package/m2 |
Drop/m2 |
KBq/m2 |
MBq/m2 |
GBq/m2 |
mcL/m2 |
IR/m2 |
BAU/m2 |
Million Int'l Units/m2 |
mcmol/m2 |
1e12 Vector Genomes/m2 |
Vector Genomes/m2 |
Kilo Int'l Units/m2 |
1e11 Vector Genomes/m2 |
1e13 Vector Genomes/m2 |
1e14 Vector Genomes/m2 |
1e15 Vector Genomes/m2 |
mL/1.7m2 |
L/1.7m2 |
mg/1.7m2 |
g/1.7m2 |
Units/1.7m2 |
mmol/1.7m2 |
mEq/1.7m2 |
mcg/1.7m2 |
kJ/1.7m2 |
Int'l Units/1.7m2 |
Million Units/1.7m2 |
kcal/1.7m2 |
ng/1.7m2 |
mg PE/1.7m2 |
milli-units/1.7m2 |
pg/1.7m2 |
Each/1.7m2 |
KBq/1.7m2 |
MBq/1.7m2 |
GBq/1.7m2 |
mcL/1.7m2 |
IR/1.7m2 |
BAU/1.7m2 |
Million Int'l Units/1.7m2 |
Kilo Int'l Units/1.7m2 |
mL/kg (IDL) |
L/kg (IDL) |
mg/kg (IDL) |
g/kg (IDL) |
Units/kg (IDL) |
mmol/kg (IDL) |
mEq/kg (IDL) |
mcg/kg (IDL) |
Int'l Units/kg (IDL) |
Million Units/kg (IDL) |
Kcal/kg (IDL) |
ng/kg (IDL) |
mg PE/kg (IDL) |
milli-units/kg (IDL) |
pg/kg (IDL) |
mg/m2 (IDL) |
mL/kg (ADJ) |
L/kg (ADJ) |
mg/kg (ADJ) |
g/kg (ADJ) |
Units/kg (ADJ) |
mmol/kg (ADJ) |
mEq/kg (ADJ) |
mcg/kg (ADJ) |
Int'l Units/kg (ADJ) |
Million Units/kg (ADJ) |
Kcal/kg (ADJ) |
ng/kg (ADJ) |
mg PE/kg (ADJ) |
milli-units/kg (ADJ) |
pg/kg (ADJ) |
mg/m2 (ADJ) |
mL/100 mL |
L/100 mL |
mg/100 mL |
g/100 mL |
Units/100 mL |
mmol/100 mL |
mEq/100 mL |
mcg/100 mL |
kJ/100 mL |
Int'l Units/100 mL |
Million Units/100 mL |
kcal/100 mL |
ng/100 mL |
mg PE/100 mL |
milli-units/100 mL |
pg/100 mL |
KBq/100 mL |
MBq/100 mL |
GBq/100 mL |
mcL/100 mL |
IR/100 mL |
BAU/100 mL |
Million Int'l Units/100 mL |
Kilo Int'l Units/100 mL |
mL/oz |
L/oz |
mg/oz |
g/oz |
Units/oz |
mmol/oz |
mEq/oz |
mcg/oz |
kJ/oz |
Int'l Units/oz |
Million Units/oz |
kcal/oz |
ng/oz |
mg PE/oz |
milli-units/oz |
pg/oz |
KBq/oz |
MBq/oz |
GBq/oz |
mcL/oz |
IR/oz |
BAU/oz |
Million Int'l Units/oz |
Kilo Int'l Units/oz |
mL/kg/min |
L/kg/min |
mg/kg/min |
g/kg/min |
Units/kg/min |
mmol/kg/min |
mEq/kg/min |
mcg/kg/min |
kJ/kg/min |
Int'l Units/kg/min |
Million Units/kg/min |
kcal/kg/min |
ng/kg/min |
mg PE/kg/min |
milli-units/kg/min |
pg/kg/min |
KBq/kg/min |
MBq/kg/min |
GBq/kg/min |
mcL/kg/min |
mL/kg/min (IDL) |
L/kg/min (IDL) |
mg/kg/min (IDL) |
g/kg/min (IDL) |
Units/kg/min (IDL) |
mmol/kg/min (IDL) |
mEq/kg/min (IDL) |
mcg/kg/min (IDL) |
Int'l Units/kg/min (IDL) |
Million Units/kg/min (IDL) |
Kcal/kg/min (IDL) |
ng/kg/min (IDL) |
mg PE/kg/min (IDL) |
milli-units/kg/min (IDL) |
pg/kg/min (IDL) |
mL/kg/min (ADJ) |
L/kg/min (ADJ) |
mg/kg/min (ADJ) |
g/kg/min (ADJ) |
Units/kg/min (ADJ) |
mmol/kg/min (ADJ) |
mEq/kg/min (ADJ) |
mcg/kg/min (ADJ) |
Int'l Units/kg/min (ADJ) |
Million Units/kg/min (ADJ) |
Kcal/kg/min (ADJ) |
ng/kg/min (ADJ) |
mg PE/kg/min (ADJ) |
milli-units/kg/min (ADJ) |
pg/kg/min (ADJ) |
IR/kg/min |
BAU/kg/min |
Million Int'l Units/kg/min |
Kilo Int'l Units/kg/min |
mL/m2/min |
L/m2/min |
mg/m2/min |
g/m2/min |
Units/m2/min |
mmol/m2/min |
mEq/m2/min |
mcg/m2/min |
kJ/m2/min |
Int'l Units/m2/min |
Million Units/m2/min |
kcal/m2/min |
ng/m2/min |
mg PE/m2/min |
milli-units/m2/min |
pg/m2/min |
KBq/m2/min |
MBq/m2/min |
GBq/m2/min |
mcL/m2/min |
mL/1.7m2/min |
L/1.7m2/min |
mg/1.7m2/min |
g/1.7m2/min |
Units/1.7m2/min |
mmol/1.7m2/min |
mEq/1.7m2/min |
mcg/1.7m2/min |
kJ/1.7m2/min |
Int'l Units/1.7m2/min |
Million Units/1.7m2/min |
kcal/1.7m2/min |
ng/1.7m2/min |
mg PE/1.7m2/min |
milli-units/1.7m2/min |
pg/1.7m2/min |
KBq/1.7m2/min |
MBq/1.7m2/min |
GBq/1.7m2/min |
mSv |
mGy |
mcL/1.7m2/min |
mg of pseudoephedrine |
IR/m2/min |
BAU/m2/min |
Million Int'l Units/m2/min |
Kilo Int'l Units/m2/min |
IR/1.7m2/min |
BAU/1.7m2/min |
Million Int'l Units/1.7m2/min |
Kilo Int'l Units/1.7m2/min |
mL/kg/hr |
L/kg/hr |
mg/kg/hr |
g/kg/hr |
Units/kg/hr |
mmol/kg/hr |
mEq/kg/hr |
mcg/kg/hr |
kJ/kg/hr |
Int'l Units/kg/hr |
Million Units/kg/hr |
kcal/kg/hr |
ng/kg/hr |
mg PE/kg/hr |
milli-units/kg/hr |
pg/kg/hr |
KBq/kg/hr |
MBq/kg/hr |
GBq/kg/hr |
mcL/kg/hr |
mL/kg/hr (IDL) |
L/kg/hr (IDL) |
mg/kg/hr (IDL) |
g/kg/hr (IDL) |
Units/kg/hr (IDL) |
mmol/kg/hr (IDL) |
mEq/kg/hr (IDL) |
mcg/kg/hr (IDL) |
Int'l Units/kg/hr (IDL) |
Million Units/kg/hr (IDL) |
Kcal/kg/hr (IDL) |
ng/kg/hr (IDL) |
mg PE/kg/hr (IDL) |
milli-units/kg/hr (IDL) |
pg/kg/hr (IDL) |
mL/kg/hr (ADJ) |
L/kg/hr (ADJ) |
mg/kg/hr (ADJ) |
g/kg/hr (ADJ) |
Units/kg/hr (ADJ) |
mmol/kg/hr (ADJ) |
mEq/kg/hr (ADJ) |
mcg/kg/hr (ADJ) |
Int'l Units/kg/hr (ADJ) |
Million Units/kg/hr (ADJ) |
Kcal/kg/hr (ADJ) |
ng/kg/hr (ADJ) |
mg PE/kg/hr (ADJ) |
milli-units/kg/hr (ADJ) |
pg/kg/hr (ADJ) |
IR/kg/hr |
BAU/kg/hr |
Million Int'l Units/kg/hr |
Kilo Int'l Units/kg/hr |
mL/m2/hr |
L/m2/hr |
mg/m2/hr |
g/m2/hr |
Units/m2/hr |
mmol/m2/hr |
mEq/m2/hr |
mcg/m2/hr |
kJ/m2/hr |
Int'l Units/m2/hr |
Million Units/m2/hr |
kcal/m2/hr |
ng/m2/hr |
mg PE/m2/hr |
milli-units/m2/hr |
pg/m2/hr |
KBq/m2/hr |
MBq/m2/hr |
GBq/m2/hr |
mcL/m2/hr |
mL/1.7m2/hr |
L/1.7m2/hr |
mg/1.7m2/hr |
g/1.7m2/hr |
Units/1.7m2/hr |
mmol/1.7m2/hr |
mEq/1.7m2/hr |
mcg/1.7m2/hr |
kJ/1.7m2/hr |
Int'l Units/1.7m2/hr |
Million Units/1.7m2/hr |
kcal/1.7m2/hr |
ng/1.7m2/hr |
mg PE/1.7m2/hr |
milli-units/1.7m2/hr |
pg/1.7m2/hr |
KBq/1.7m2/hr |
MBq/1.7m2/hr |
GBq/1.7m2/hr |
mcL/1.7m2/hr |
IR/1.7m2/hr |
BAU/1.7m2/hr |
Million Int'l Units/1.7m2/hr |
Kilo Int'l Units/1.7m2/hr |
IR/m2/hr |
BAU/m2/hr |
Million Int'l Units/m2/hr |
Kilo Int'l Units/m2/hr |
mL/kg/day |
L/kg/day |
mg/kg/day |
g/kg/day |
Units/kg/day |
mmol/kg/day |
mEq/kg/day |
mcg/kg/day |
kJ/kg/day |
Int'l Units/kg/day |
Million Units/kg/day |
kcal/kg/day |
ng/kg/day |
mg PE/kg/day |
milli-units/kg/day |
pg/kg/day |
Inch/kg/day |
KBq/kg/day |
MBq/kg/day |
GBq/kg/day |
mL/kg/day (IDL) |
L/kg/day (IDL) |
mg/kg/day (IDL) |
g/kg/day (IDL) |
Units/kg/day (IDL) |
mmol/kg/day (IDL) |
mEq/kg/day (IDL) |
mcg/kg/day (IDL) |
Int'l Units/kg/day (IDL) |
Million Units/kg/day (IDL) |
Kcal/kg/day (IDL) |
ng/kg/day (IDL) |
mg PE/kg/day (IDL) |
milli-units/kg/day (IDL) |
pg/kg/day (IDL) |
mL/kg/day (ADJ) |
L/kg/day (ADJ) |
mg/kg/day (ADJ) |
g/kg/day (ADJ) |
Units/kg/day (ADJ) |
mmol/kg/day (ADJ) |
mEq/kg/day (ADJ) |
mcg/kg/day (ADJ) |
Int'l Units/kg/day (ADJ) |
Million Units/kg/day (ADJ) |
Kcal/kg/day (ADJ) |
ng/kg/day (ADJ) |
mg PE/kg/day (ADJ) |
milli-units/kg/day (ADJ) |
pg/kg/day (ADJ) |
mcL/kg/day |
IR/kg/day |
BAU/kg/day |
Million Int'l Units/kg/day |
mL/m2/day |
L/m2/day |
mg/m2/day |
g/m2/day |
Units/m2/day |
mmol/m2/day |
mEq/m2/day |
mcg/m2/day |
kJ/m2/day |
Int'l Units/m2/day |
Million Units/m2/day |
kcal/m2/day |
ng/m2/day |
mg PE/m2/day |
milli-units/m2/day |
pg/m2/day |
KBq/m2/day |
MBq/m2/day |
GBq/m2/day |
mcL/m2/day |
mL/1.7m2/day |
L/1.7m2/day |
mg/1.7m2/day |
g/1.7m2/day |
Units/1.7m2/day |
mmol/1.7m2/day |
mEq/1.7m2/day |
mcg/1.7m2/day |
kJ/1.7m2/day |
Int'l Units/1.7m2/day |
Million Units/1.7m2/day |
kcal/1.7m2/day |
ng/1.7m2/day |
mg PE/1.7m2/day |
milli-units/1.7m2/day |
pg/1.7m2/day |
KBq/1.7m2/day |
MBq/1.7m2/day |
GBq/1.7m2/day |
mcL/1.7m2/day |
mL/oz/day |
L/oz/day |
mg/oz/day |
g/oz/day |
Units/oz/day |
mmol/oz/day |
mEq/oz/day |
mcg/oz/day |
kJ/oz/day |
Int'l Units/oz/day |
Million Units/oz/day |
kcal/oz/day |
ng/oz/day |
mg PE/oz/day |
milli-units/oz/day |
pg/oz/day |
KBq/oz/day |
MBq/oz/day |
GBq/oz/day |
mcL/oz/day |
IR/m2/day |
BAU/m2/day |
Million Int'l Units/m2/day |
Kilo Int'l Units/m2/day |
IR/1.7m2/day |
BAU/1.7m2/day |
Million Int'l Units/1.7m2/day |
Kilo Int'l Units/1.7m2/day |
IR/oz/day |
BAU/oz/day |
Million Int'l Units/oz/day |
Kilo Int'l Units/oz/day |
kJ/30 mL |
kcal/30 mL |
Gy-cm2 |
mL/cm2 |
mg/cm2 |
mOsmol |
each |
tablet |
capsule |
drop |
tsp |
puff |
suppository |
spray |
Squirt |
inch |
patch |
Act |
ampule |
Bar |
Bottle |
Can |
Device |
enema |
Gallon |
Inhaler |
kit |
lb |
lozenge |
oz |
packet |
Stick |
strip |
Tbsp |
Tube |
vial |
Wafer |
Container |
Syringe |
Package |
applicator |
cm |
Applicatorful |
Troche |
millicurie |
Intra Uterine Device |
Part |
m |
Film |
Million Cells |
Dose |
mm |
IR |
BAU |
kg |
cm2 |
Imperial Gallon |
kJ |
PFU |
Piece |
Million PFU |
Doses/Fill |
Cartridge |
Thousand Units |
Lipoprotein Lipase Releasing Unit |
Scoop |
Million Int'l Units |
mm2 |
Pump |
fluid ounce |
Product |
Bag |
mcmol |
1e12 Vector Genomes |
Vector Genomes |
millicurie/kg |
millicurie/m2 |
millicurie/1.7m2 |
microcurie |
microcurie/kg |
microcurie/m2 |
microcurie/1.7m2 |
Canister |
mcg DFE |
Billion Cells |
Application |
Box |
Capful |
Inhalation |
Lancet |
Needle |
Pad |
Pen |
Piece of gum |
Ring |
Swab |
Sachet |
Implant |
Insert |
Pools |
Kilo Int'l Units |
Kilo Int'l Units/kg/day |
1e11 Vector Genomes |
1e13 Vector Genomes |
1e14 Vector Genomes |
1e15 Vector Genomes |
Cells |
EIN |
Million EIN |
EIN/kg/day |
None / Other |
|
|
9 |
DAYS_SUPPLY |
INTEGER |
No |
|
|
|
Holds the days supply priced. |
|
|
10 |
PLAN_PAY_AMT |
NUMERIC |
No |
|
|
|
Holds the plan pay amount. |
|
|
11 |
PAT_PAY_AMT |
NUMERIC |
No |
|
|
|
Holds the estimated patient pay amount. |
|
|
12 |
OOP_APPLIED_AMT |
NUMERIC |
No |
|
|
|
Holds the out of pocket applied amount. |
|
|
13 |
OOP_REMAIN_AMT |
NUMERIC |
No |
|
|
|
Holds the out of pocket remaining amount. |
|
|
14 |
DEDUCT_APPLY_AMT |
NUMERIC |
No |
|
|
|
Holds the deductible applied amount. |
|
|
15 |
DEDUCT_REMAIN_AMT |
NUMERIC |
No |
|
|
|
Holds the deductible remaining amount. |
|
|
16 |
FORM_STATUS |
VARCHAR |
No |
|
|
|
Holds the formulary status. |
|
|
17 |
PA_REQ_C_NAME |
VARCHAR |
No |
|
|
|
Holds whether prior authorization is required for this medication. This is the effective prior authorization flag after considering system overrides. The actual value returned in the RTPB response is in item LME 322. |
May contain organization-specific values: No |
Category Entries: |
Yes |
No |
Unknown |
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18 |
PHARMACY_ID |
NUMERIC |
No |
|
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|
This item holds a pointer to the pharmacy (PHR) that was used for generating this estimate. |
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19 |
PHARMACY_ID_PHARMACY_NAME |
VARCHAR |
No |
|
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|
The name of the pharmacy. |
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|
20 |
PRIMARY_CVG_YN |
VARCHAR |
No |
|
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|
This item indicates if this line holds the coverage information that matches what was originally requested. |
May contain organization-specific values: No |
Category Entries: |
No |
Yes |
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21 |
DISPLAYED_BEFORE_SIGN_YN |
VARCHAR |
No |
|
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|
This item indicates if this line of coverage data was displayed to an end-user before the order was signed. |
The category values for this column were already listed for column: PRIMARY_CVG_YN |
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22 |
RTPB_PA_REQ_C_NAME |
VARCHAR |
No |
|
|
|
Holds whether prior authorization is required for this medication. This is the actual value returned in the RTPB response. Item LME 316 holds the effective prior authorization flag after considering system overrides. |
The category values for this column were already listed for column: PA_REQ_C_NAME |
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