RXA_ADJUD_MESSAG_3

Description:

Adjudication fields for D.0.

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	O_BIN_NUMBER	VARCHAR	No
	Card Issuer ID or Bank ID Number used for network routing.
5	O_VERSION_NUMBER	VARCHAR	No
	Code uniquely identifying the transmission syntax and corresponding Data Dictionary.
6	O_TRANS_CODE_ID	NUMERIC	No
	NCPDP code identifying the type of transaction.
7	O_TRANS_CODE_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
8	O_PRCSR_CTRL_NUM	VARCHAR	No
	Processor control number assigned by the processor.
9	O_SERV_PROV_QUAL_ID	NUMERIC	No
	NCPDP code qualifying the 'Service Provider ID' (201-B1).
10	O_SERV_PROV_QUAL_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
11	O_SERV_PROV_ID	VARCHAR	No
	The unique identifier for the pharmacy or provider
12	O_DATE_OF_SERV_DT	DATETIME	No
	Identifies date the prescription was filled or professional service rendered or subsequent payer began coverage following Part A expiration in a long-term care setting only.
13	O_SOFTWARE_VENDOR	VARCHAR	No
	Code indicating the type of dispensing dose.
14	O_CARDHOLDER_ID	VARCHAR	No
	Insurance ID assigned to the cardholder or identification number used by the plan.
15	O_CARDHOLDER_FIRST	VARCHAR	No
	The insurance cardholder's first name used by the plan (312-CC)
16	O_CARDHOLDER_LAST	VARCHAR	No
	The insurance cardholder's last name used by the plan (313-CD)
17	O_HOME_PLAN	VARCHAR	No
	The code identifying the Blue Cross or Blue Shield plan ID which shows where the member's coverage has been designated. Usually where the member lives or purchased their coverage.
18	O_PLAN_ID	VARCHAR	No
	Plan ID assigned by the processor to identify a set of parameters, benefit, or coverage criteria used to adjudicate a claim.
19	O_ELIG_CLAR_CODE_ID	NUMERIC	No
	NCPDP code indicating that the pharmacy is clarifying eligibility for a patient.
20	O_ELIG_CLAR_CODE_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
21	O_GROUP_ID	VARCHAR	No
	Unique ID assigned to cardholder group or employer group.
22	O_PERSON_CODE	VARCHAR	No
	NCPDP code assigned to a specific person within a family.
23	O_PAT_RELAT_CODE_ID	NUMERIC	No
	NCPDP code indicating the gender of the individual.
24	O_PAT_RELAT_CODE_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
25	O_OTH_PAY_BIN_NUM	VARCHAR	No
	The secondary, tertiary, etc. card issuer or bank ID number used for network routing.
26	O_OTH_PAY_PRCSR_NUM	VARCHAR	No
	The unique identifier of the secondary, tertiary, etc. payer to the processor.
27	O_OTH_PAY_CARD_ID	VARCHAR	No
	Unique cardholder ID for the member associated with the designated Payor
28	O_OTH_PAY_GROUP_ID	VARCHAR	No
	ID assigned to the cardholder group or employer group by the secondary, tertiary, etc. payer.
29	O_MEDIGAP_ID	VARCHAR	No
	Patient's ID assigned by the Medigap insurer.
30	O_MEDICAID_IND_ID	NUMERIC	No
	Two character State abbreviation indicating the state where Medicaid coverage exists
31	O_MEDICAID_IND_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
32	O_PROV_ASGN_IND_ID	NUMERIC	No
	NCPDP code indicating whether the provider accepts assignment.
33	O_PROV_ASGN_IND_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
34	O_PARTD_QUAL_FAC_ID	NUMERIC	No
	ID that indicates the patient resides in a facility that qualifies for the CMS Part D benefit.
35	O_PARTD_QUAL_FAC_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
36	O_MEDICAID_ID_NUM	VARCHAR	No
	A unique member identification number assigned by the Medicaid Agency.
37	O_MEDICAID_ASGN_NUM	VARCHAR	No
	Number assigned by processor to identify the individual Medicaid Agency or representative.
38	O_PAT_ID_QUAL_ID	NUMERIC	No
	NCPDP code qualifying the 'Patient ID' (332-CY).
39	O_PAT_ID_QUAL_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
40	O_PAT_ID	VARCHAR	No
	The unique identifier assigned to the patient
41	O_PAT_DOB_DT	DATETIME	No
	The birth date of the patient.
42	O_PAT_SEX_CODE_ID	NUMERIC	No
	NCPDP code indicating the gender of the individual.
43	O_PAT_SEX_CODE_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
44	O_PAT_FIRST_NAME	VARCHAR	No
	Patient's first name sent to the payer (310-CA)
45	O_PAT_LAST_NAME	VARCHAR	No
	Patient's last name sent to the payer (311-CB)
46	O_PAT_STREET	VARCHAR	No
	Patient free text street address (322-CM)
47	O_PAT_CITY	VARCHAR	No
	Free-form text for city name.
48	O_PAT_STATE_ID	NUMERIC	No
	Standard State/Province Code as defined by appropriate government agency.
49	O_PAT_STATE_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
50	O_PAT_ZIP	VARCHAR	No
	Patient postal code zone excluding punctuation and blanks (zip code for US) (325-CF)
51	O_PAT_PHONE_NUM	VARCHAR	No
	Ten-digit phone number of patient.
52	O_PLACE_OF_SERV_ID	NUMERIC	No
	NCPDP code identifying the place where a drug or service is dispensed or administered.
53	O_PLACE_OF_SERV_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
54	O_EMPLOYER_ID	VARCHAR	No
	Unique ID assigned to employer.
55	O_SMOKER_CODE_ID	NUMERIC	No
	NCPDP code indicating the patient as a smoker or non-smoker.
56	O_SMOKER_CODE_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
57	O_PREG_INDICATOR_ID	NUMERIC	No
	NCPDP code indicating the patient as pregnant or non-pregnant.
58	O_PREG_INDICATOR_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
59	O_PAT_EMAIL_ADDRESS	VARCHAR	No
	The E-Mail address of the patient (member).
60	O_PAT_RESIDENCE_ID	NUMERIC	No
	NCPDP code identifying the patient's place of residence.
61	O_PAT_RESIDENCE_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
62	O_RX_REF_NUM_QL_ID	NUMERIC	No
	This ID indicates the type of bill submitted.
63	O_RX_REF_NUM_QL_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
64	O_RX_REF_NUM	VARCHAR	No
	Reference number assigned by the provider for the dispensed product or service provided.
65	O_PROD_ID_QUAL_ID	NUMERIC	No
	NCPDP code qualifying the value in 'Product/Service ID' (407-D7).
66	O_PROD_ID_QUAL_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
67	O_PROD_ID	VARCHAR	No
	Code indicating whether the provider accepts assignment.
68	O_ASC_RX_REF_NUM	VARCHAR	No
	Associated 'Prescription/Service Reference Number' (402-D2) for particular service.
69	O_ASC_RX_SERV_DT	DATETIME	No
	Date of the 'Associated Prescription/Service Reference Number' (456-EN).
70	O_QUANTITY_DISP	NUMERIC	No
	Quantity dispensed in metric decimal units.
71	O_FILL_NUM	INTEGER	No
	The code indicating whether the prescription is an original or a refill.
72	O_DAYS_SUPPLY	NUMERIC	No
	Estimated number of days the prescription will last.
73	O_COMPOUND_CODE_ID	NUMERIC	No
	NCPDP code indicating whether or not the prescription is a compound.
74	O_COMPOUND_CODE_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
75	O_DAW_ID	NUMERIC	No
	Code indicating whether or not the prescriber's instructions regarding generic substitution were followed.
76	O_DAW_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
77	O_DATE_WRITTEN_DT	DATETIME	No
	Date prescription was written.
78	O_NUM_REFILLS_AUTH	INTEGER	No
	Number of refills authorized by the prescriber.
79	O_RX_ORIGIN_CODE_ID	NUMERIC	No
	NCPDP code indicating the origin of the prescription.
80	O_RX_ORIGIN_CODE_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
81	O_QTY_PRESCRIBED	NUMERIC	No
	Amount prescribed in metric decimal units.
82	O_OTH_CVG_CODE_ID	NUMERIC	No
	Code indicating whether or not the patient has other insurance coverage.
83	O_OTH_CVG_CODE_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
84	O_SPEC_PACK_IND_ID	NUMERIC	No
	NCPDP code identifying the type of transaction.
85	O_SPEC_PACK_IND_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
86	O_ORIG_PRD_ID_QL_ID	NUMERIC	No
	NCPDP code qualifying the value in 'Originally Prescribed Product/Service Code' (Field 445-EA).
87	O_ORIG_PRD_ID_QL_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
88	O_ORIG_RX_PROD	VARCHAR	No
	NCPDP code of the initially prescribed product or service.
89	O_ORIG_RX_QUANTITY	NUMERIC	No
	Initial prescribed amount in metric decimal units
90	O_ALT_ID	VARCHAR	No
	Unique personal ID used for controlled product reporting. ID can be that of the patient or the person picking up the prescription as required by the state.
91	O_SCHED_RX_ID_NUM	VARCHAR	No
	The serial number of the prescription form.
92	O_UNIT_OF_MEAS_ID	NUMERIC	No
	NCPDP standard product billing codes.
93	O_UNIT_OF_MEAS_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
94	O_LEVEL_OF_SERV_ID	NUMERIC	No
	Code indicating the type of service the provider supplied
95	O_LEVEL_OF_SERV_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
96	O_PRIOR_AUTH_TYP_ID	NUMERIC	No
	NCPDP code qualifying the value in 'Product/Service ID' (407-D7).
97	O_PRIOR_AUTH_TYP_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
98	O_PRIOR_AUTH_NUM	VARCHAR	No
	Code clarifying the 'Prior Authorization Number Submitted' (462-EV) or benefit/plan exemption.
99	O_INT_AUTH_TYP_ID	NUMERIC	No
	ID indicating that authorization occurred for intermediary processing.
100	O_INT_AUTH_TYP_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
101	O_INT_AUTH_ID	VARCHAR	No
	ID indicating intermediary authorization occurred.
102	O_DISP_STATUS_ID	NUMERIC	No
	Code indicating the quantity dispensed is a partial fill or the completion of a partial fill. Used only in situations where inventory shortages do not allow the full quantity to be dispensed.
103	O_DISP_STATUS_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
104	O_QTY_INT_TO_DISP	NUMERIC	No
	Metric decimal quantity of medication that would be dispensed on original filling if inventory were available. Used in association with a 'P' or 'C' in 'Dispensing Status' (343-HD).
105	O_DAYS_INT_TO_DISP	NUMERIC	No
	Days supply for metric decimal quantity of medication that would be dispensed on original dispensing if inventory were available. Used in association with a 'P' or 'C' in 'Dispensing Status' (343-HD).
106	O_DELAY_RSN_CODE_ID	NUMERIC	No
	NCPDP code to specify the reason that submission of the transactions has been delayed.
107	O_DELAY_RSN_CODE_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
108	O_TX_REF_NUMBER	VARCHAR	No
	A reference number assigned by the provider to each of the data records in the batch or real-time transactions. The purpose of this number is to facilitate the process of matching the transaction response to the transaction. The transaction reference number assigned should be returned in the response.
109	O_PAT_ASGN_IND_ID	NUMERIC	No
	Code which indicates a patient's choice on assignment of benefits.
110	O_PAT_ASGN_IND_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
111	O_ROUTE_ADMIN_ID	NUMERIC	No
	This is an override to the "default" route referenced for the product. For a multi-ingredient compound, it is the route of the complete compound mixture.
112	O_ROUTE_ADMIN_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
113	O_COMPOUND_TYPE_ID	NUMERIC	No
	Unique ID used to clarify the type of compound.
114	O_COMPOUND_TYPE_ID_EXT_CODE_LST_NAME	VARCHAR	No
	The name of the list value.
115	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.