PB_DTL_TX
Description:
The PB_DTL_TX table contains the coverage-level detailed transactions associated with a premium billing account transaction.

Primary Key
Column Name Ordinal Position
PB_TX_ID 1

Column Information
Name Type Discontinued?
1 PB_TX_ID VARCHAR No
The unique ID of the premium billing detailed transaction.
2 PDX_TX_TYPE_C_NAME VARCHAR No
Indicates the type of the transaction (i.e. premium billing, payment, etc.)
May contain organization-specific values: No
Category Entries:
New
Billing
Payment
Ad Hoc Adjustment
Balance Forward
Overpost
Write Off
Information
Payment Reversal
Previously Closed
Refund
Suspense
3 PDX_TX_SENSE_C_NAME VARCHAR No
Indicates whether the transaction is a credit or debit.
May contain organization-specific values: No
Category Entries:
Credit
Debit
4 TX_DATE DATETIME No
Date that the transaction was created in the system.
5 EFF_DATE DATETIME No
Effective date of the transaction. This date represents the first day of the coverage period being billed for the transaction.
6 REAL_DATE DATETIME No
Realization date of the transaction. This date represents the cycle date of the premium billing batch that computed this transaction.
7 PB_ACCT_ID VARCHAR No
The unique ID of the premium billing account associated with the detailed transaction.
8 AMT NUMERIC No
Amount of the transaction.
9 PB_ACT_TX_ID VARCHAR No
The unique ID of the premium billing account transaction to which the detailed transaction is associated.
10 ACCT_POST_DATE DATETIME No
Account posting date of the detailed transaction. This date represents the day that the detailed transaction was posted to the premium billing account.
11 COVERAGE_ID NUMERIC No
The unique ID assigned to the coverage record.
12 BENEFIT_PLAN_ID_BENEFIT_PLAN_NAME VARCHAR No
The name of the benefit plan record.
13 RIDER_BEN_PLAN_ID_BENEFIT_PLAN_NAME VARCHAR No
The name of the benefit plan record.
14 SUB_PAT_ID VARCHAR No
The unique ID of the patient associated with the detailed transaction.
15 NUM_MEMS INTEGER No
Number of members on the coverage associated with the detailed transaction.
16 CVG_ATTR_C_NAME VARCHAR No
Coverage attributes associated with the detailed transaction.
May contain organization-specific values: Yes
17 PRORATE_YN VARCHAR No
Indicates whether premium is being pro-rated for the detailed transaction.
May contain organization-specific values: No
Category Entries:
Yes
No
18 PDX_PRORATE_C_NAME VARCHAR No
Indicates the method used for pro-rating premium.
May contain organization-specific values: No
Category Entries:
Test Date Prorating
Daily Prorating
Full Monthly Rate
19 CVG_RATE_YN VARCHAR No
Indicates whether coverage rates are being used on the detailed transaction.
The category values for this column were already listed for column: PRORATE_YN
20 RETRO_YN VARCHAR No
Indicates whether this detailed transaction is a retroactive premium adjustments.
The category values for this column were already listed for column: PRORATE_YN
21 RET_RVSL_PB_TX_ID VARCHAR No
The unique ID of detailed transaction that reversed this detailed transaction.
22 RET_ADJ_PB_TX_ID VARCHAR No
The unique ID of the adjustment detailed transaction if the detailed transaction has been reversed and adjusted.
23 RET_ORIG_PB_TX_ID VARCHAR No
The unique ID of the original detailed transaction if the detailed transaction is an adjustment.
24 CANCELS_PB_TX_ID VARCHAR No
The unique ID of detailed transaction which this detailed transaction voids out.
25 OUTSTAND_AMT NUMERIC No
Outstanding amount for the detailed transaction.
26 INIT_PB_INVC_ID VARCHAR No
The unique ID of initial invoice on which the detailed transaction is included.
27 ORG_OVPST_PB_TX_ID VARCHAR No
If this detail transaction is an overpost originating from the overpayment of an existing detail transaction, then this field stores the The unique ID of the original detail transaction.
28 PDX_CLOSE_RSN_C_NAME VARCHAR No
Indicates the reason the detailed transaction was closed (paid in full or balance forward).
May contain organization-specific values: No
Category Entries:
Paid In Full
Balance Forward
29 CHNG_TYPE_C_NAME VARCHAR No
Indicates the type of change associated with the detailed transaction (add, delete, or change tiers).
May contain organization-specific values: No
Category Entries:
Change - Tier/Income Category
Add
DELETES
Amount Change
30 NUMBER_OF_ADULT INTEGER No
For income level billing, this field stores the number of additional adult dependents
31 NUMBER_OF_CHILD INTEGER No
For income level billing, this field stores the number of child dependents
32 NUMBER_OF_LTJOINER INTEGER No
For income level billing, this field stores the number of members identified as late joiners.
33 PREM_SAVINGS NUMERIC No
Amount of this detailed transaction that is considered savings premium.
34 REVCLOSED_PB_TX_ID VARCHAR No
When using a previously closed type of exception in payment posting, this field stores the unique ID of the detailed transaction that this transaction reverses.
35 CLSDREVBY_PB_TX_ID VARCHAR No
When using a previously closed type of exception in payment posting, this field stores the unique ID of the detailed transaction that reversed this transaction.
36 PAIDBY_PB_TXSET_ID VARCHAR No
The unique ID of the transaction set that was last used to post a payment against this transaction.
37 SAVINGS_PDX_YN VARCHAR No
Whether savings premium is included in this detailed transaction.
The category values for this column were already listed for column: PRORATE_YN
38 OLD_CVG_ATTR_C_NAME VARCHAR No
Old coverage attributes associated with the detailed transaction.
The category values for this column were already listed for column: CVG_ATTR_C_NAME
39 OLD_PDX_AMOUNT INTEGER No
Old amount associated with the detailed transaction.
40 LEP_YN VARCHAR No
This flag indicates if a PDX represent a Medicare Part D Late Enrollment Penalty.
May contain organization-specific values: No
Category Entries:
No
Yes
41 AR_TX_TYPE_C_NAME VARCHAR No
The type of transaction. This indicates if the transaction is a charge, a payment, or an adjustment.
May contain organization-specific values: No
Category Entries:
Charge
Payment
Debit Adjustment
Credit Adjustment
42 AR_TX_CODE_PROC_ID_PROC_NAME VARCHAR No
The name of each procedure.
43 AR_TX_AMOUNT NUMERIC No
The dollar amount for a transaction.
44 AR_TX_ACCT_PB_ACCT_ID VARCHAR No
The account that this transaction is posting to.
45 AR_TX_COVERAGE_ID NUMERIC No
The coverage that this transaction applies to.
46 AR_TX_EFF_DATE DATETIME No
The effective date that this transaction applies to.
47 AR_TX_MEMBER_PAT_ID VARCHAR No
The member that this transaction applies to. This applies only to per-member accounts.
48 AR_TX_SUBSCRIBER_PAT_ID VARCHAR No
The subscriber that this transaction applies to.
49 AR_TX_STATUS_C_NAME VARCHAR No
The current status for a transaction.
May contain organization-specific values: No
Category Entries:
New
Waiting to file
Filing
In Review
Filed
Voided
50 AR_TX_FILED_DATE DATETIME No
The date that a transaction has filed to the system.
51 AR_TX_REVERSED_TRANSACTION_ID VARCHAR No
The transaction ID that is being reversed by a given transaction.
52 AR_TX_CORRECTED_TRANSACTION_ID VARCHAR No
The transaction ID that is being corrected by a given transaction.
53 MEDICARE_LIS_AMOUNT NUMERIC No
Amount of the part D premium that was reduced for Low Income Subsidy (LIS).
54 PREMIUM_TYPE_C_NAME VARCHAR No
Premium type of the PDX. This is used to specify specific parts of the member premium such as Medicare Part C vs Medicare Part D.
May contain organization-specific values: No
Category Entries:
Medicare Advantage Part C
Medicare Advantage Part D
55 WRITE_OFF_FOR_PB_ACT_TX_ID VARCHAR No
Stores what account transaction (PAX) the write off is for.
56 PB_REFUND_STATUS_C_NAME VARCHAR No
This item is used to track how far along through the refunding process a certain transaction is. Approved - the refund has been created in Epic but has not been distributed to the member. Ready for Check - a check for this refund is being written manually. Refund Sent - the refund has either been processed automatically or an end user has confirmed that the refund has been sent to the member via check. Canceled - the refund was approved and has since been canceled and reversed (before being set to Refund Sent).
May contain organization-specific values: No
Category Entries:
Approved
Ready for Check
Refund Sent
Canceled
Requested
Refund Reversal
57 REFUNDED_PAYMENT_ID VARCHAR No
This row tracks which payment should be refunded by the refund transaction it is associated with. This is determined by looking for the payment that was used to pay off the transaction being refunded. In the case of a refund for an ad hoc adjustment this value will not be set since no original payment will be found.