|
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 |
Premium Billing |
Payment |
Ad Hoc Adjustment |
Balance Forward |
Overpost |
Writeoff |
Information |
Payment Reversal |
Previously Closed |
|
|
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. |
|
|