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
	NCPDP code indicating whether a coverage is a Medicare Part D Coverage
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
	The unique identifier for the formular 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
	Code indicating the status of the transaction.
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
	NCPDP code indicating the payer and/or the patient is exempt from taxes.
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
	NCPD code indicating how the reimbursement amount was calculated for 'Flat Sales Tax 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
	NCPDP code indicating how the reimbursement amount was calculated for 'Percentage Sales 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
	The sales tax that has been calculated.
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
	NCPDP code specifying the basis on which the coinsure was calculated.
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 calculated estimated generic savings.
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
	The cost of the ingredient contracted/reimbursable amount.
67	I_DISP_FEE_CNTRCTD	NUMERIC	No
	The dispensible free that was contracted/reimbursable amount
68	I_PCT_TAX_PD_ID	NUMERIC	No
	NCPDP code indicating the percentage sales 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)