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.