Table Detail Report
ORDER_HEALTH_PLAN
| Column Section | Relationship Section | Top of Page |
Table-level Detail
| Description: | Order Health Plan |
| Definition: | Claims related information for a Health Plan of a given Order action |
| Table Type: | ACTIVITY |
Column Detail - ORDER_HEALTH_PLAN
| Column Name | Type | Null? | Definition |
|---|---|---|---|
| ACTION_SEQUENCE | NUMBER | N | A sequence number used to identify the order of the actions. |
| ACTUAL_DAYS_SUPPLY | NUMBER | N | Estimated number of days the prescription will last. |
| ALTERNATE_IDENT | VC2(250) | N | Person identifier to be used for controlled product reporting. Identifier may be that of the patient or the person picking up the prescription as required by the governing body sent in field 330-cw of claim segment (07) |
| ASSOC_PRESCRIP_DT_TM | DATE | Y | Date of the Associated Prescription/ Service Reference Number.Field 457-EP on Claim Segment (07) |
| ASSOC_PRESCRIP_NBR | VC2(200) | N | Related 'Prescription/Service Reference Number' To which the service is associated. Field 456-EN on Claim Segment (07) |
| ASSOC_PRESCRIP_TZ | NUMBER | N | Time zone for the assoc_prescrip_dt_tm |
| AUTH_NBR_TXT | VC2(250) | N | Number assigned by the processor to identify an authorized transaction sent in field 503-f3 of prior auth segment (12) |
| AUTH_REP_CITY | VC2(250) | N | State/Province of the patient's authorized representative sent in field 498-PJ or prior auth segment (12) |
| AUTH_REP_FIRST_NAME | VC2(250) | N | First name of the patient's authorized representative sent in field 498-PE of prior auth segment (12). |
| AUTH_REP_LAST_NAME | VC2(250) | N | Last name of the patient's authorized representative sent in field 498-PE of prior auth segment (12) |
| AUTH_REP_STATE | VC2(250) | N | State/Province of the patient's authorized representative sent in field 498-PJ of prior auth segment (12) |
| AUTH_REP_STREET | VC2(250) | N | Street address of the patient's authorized representative sent in field 498-PG of prior auth segment (12) |
| AUTH_REP_ZIP | VC2(250) | N | Zip code/Postal zone of the patient's authorized representative sent in field 498-PK of prior auth segment (12) |
| CARD_HOLDER_IDENT | VC2(100) | N | The member number of the subscriber to the health plan. |
| COB_OTHER_PAYER_PAY_AMT | FLOAT | N | Amount of any payment known by the pharmacy from other sources (including coupons). Sent in field 431-DV of claim segment. |
| COB_OTHER_PAYER_PAY_TYPE_CD | NUMBER | N | Service type of payment that the Other Payer amount was applied to. Example: Delivery, Drug Benefit. Sent in field 342-HC of claim segment. |
| COB_PAYER_CTRL_IDENT | VC2(30) | Y | Used to identify an adjudicated claim, when supplied, in payer-to-payer coordination of benefits only. Sent in field 993-A7 of claim segment. |
| COMPOUND_FORM_CD | NUMBER | N | Dosage form for the complete compound mixture as prescribed by NDCPD format. |
| CONFLICT_CD | NUMBER | N | DUR Conflict code |
| COUPON_AMT | FLOAT | N | Value of coupon sent in field 487-NE of coupon segment (09) |
| COUPON_NBR_TXT | VC2(250) | N | Unique serial number assigned to the prescription coupons sent in field 486-ME of coupon segment (09) |
| COUPON_TYPE_CD | NUMBER | N | Code Indicating the type of coupon being used sent in field 485-KE of coupon segment (09) |
| DUR_AGENT_QUAL_CD | NUMBER | N | Drug Utilization Review Co-Agent Id Qualifier for Retail Prescription Claims |
| DUR_AGENT_QUAL_IDENT | VC2(30) | N | Drug Utilization Review Co-Agent Id for Retail Prescription Claims |
| DUR_LEVEL_OF_EFFORT_CD | NUMBER | N | Code indicating the level of effort as determined by the complexity of decision making or resources utilized by a pharmacist to perform a professional service sent in field 474-8E of DUR/PPS segment (08). |
| ELIGIBILITY_CD | NUMBER | N | Eligibility Clarification Code |
| EMPLOYER_IDENT | VC2(250) | N | ID assigned to an employer sent in field 333_CZ of patient segment (01) |
| FACILITY_IDENT | VC2(250) | N | ID assigned to the patient's clinic/host party sent in field 336-8C of insurance segment (04) |
| HEALTH_PLAN_ID | NUMBER | N | Identifier assigned for a Health Plan |
| HEALTH_PLAN_SEQ | NUMBER | N | Sequence in which Health Plan is used during claim submission. |
| HOME_PLAN_IDENT | VC2(250) | N | Code identifying the Blue Cross or Blue Shield plan ID which indicates where the member's coverage has been designated. Usually where the member lives or purchased their coverage. Sent in field 314-CE of the insurance segment (04). |
| INTERVENTION_CD | NUMBER | N | DUR Intervention Code |
| INTER_AUTH_IDENT | VC2(250) | N | Value indicating intermediary authorization occurred sent in field 464-EX of claim segment (07) |
| INTER_AUTH_TYPE_ID_CD | NUMBER | N | Value indicating that authorization occurred for intermediary processing sent in field 463-EW of claim segment (07) |
| LEVEL_OF_SERVICE_CD | NUMBER | N | Code indicating the type of service the provider rendered sent in field 418-DI of claim segment (07) |
| MANUAL_ADJUDICATED_IND | NUMBER | N | Indicates whether the adjudication is manual or electronic for plans that are part of Benefits Coordination. 0 - Electronic, 1 - Manual |
| MANUAL_COPAY_AMT | FLOAT | N | Copay Amount for manually adjudicated plans that are part of Benefits Coordination. |
| ORDER_ID | NUMBER | N | This field contains the unique value assigned to each orderable procedure associated with an order. |
| ORIG_PRESCRIBED_QTY | FLOAT | N | Product initially prescribed amount expressed in metric decimal units sent in field 446-EB of claim segment (07) |
| ORIG_PRESCRIBED_SERV_QUAL_CD | NUMBER | N | Code qualifying the value in the Originally Prescribed Product/Service Code sent . |
| ORIG_PRESCRIBED_SERV_QUAL_TXT | VC2(250) | N | Code of the initially prescribed product of service sent in field 445-EA of claim segment (07) |
| OTHER_COVERAGE_CD | NUMBER | N | Other coverage code accept in Order Entry |
| OUTCOME_CD | NUMBER | N | DUR Outcome code |
| PARTIAL_FILL_TYPE_CD | NUMBER | N | Indicates if a health plan supports NCPDP 51 Partial Fill Submission Process. |
| PATIENT_LOCATION_ID_CD | NUMBER | N | The code identifying the location of the patient when receiving Pharmacy Services sent in field 307-C7 of patient segment (01) |
| PATIENT_PAID_AMT | FLOAT | N | The amount the pharmacy received from the patient for the prescription dispensed sent in field 433-DX of pricing segment (11) |
| PA_REQ_BASIS_CD | NUMBER | N | Prior Authorized Basis of Request for Retail Prescription Claims. |
| PA_REQ_BEG_DT_TM | DATE | Y | Prior Authorized Request Period Begin Date and Time for Retail Prescription claims. |
| PA_REQ_END_DT_TM | DATE | Y | Prior Authorized Request Period End Date and Time for Retail Prescription claims. |
| PA_REQ_TYPE_CD | NUMBER | N | Prior Authorized Request Type for Retail Prescription Claims |
| PA_REQ_TZ | NUMBER | N | Time zone for the pa_req_beg_dt_tm and pa_req_end_dt_tm. |
| PRESCRIPTION_CD | NUMBER | N | Prescription clarification code |
| PRIOR_AUTH_BEG_EFF_DT_TM | DATE | Y | Effective Date from date of prior authorization number |
| PRIOR_AUTH_END_EFF_DT_TM | DATE | Y | Effective To date of prior authorization number |
| PRIOR_AUTH_NBR_ASSIGN_TXT | VC2(250) | N | Unique number identifying the prior authorization assigned by the processor sent field 498-PY of prior auth segment. |
| PRIOR_AUTH_NBR_TXT | VC2(250) | N | Prior authorization number |
| PRIOR_AUTH_SUPPORT_DOC_TXT | VC2(500) | N | Free text message sent in field 498-PP of prior auth segment (12) |
| PRIOR_AUTH_TYPE_CD | NUMBER | N | NCPDP Prior Authorization Type Code |
| PRIOR_AUTH_TZ | NUMBER | N | Time zone for the prior_auth_beg_eff_dt_tm and prior_auth_end_eff_dt_tm. |
| SCHED_PRESCRIPT_ID_NBR_TXT | VC2(250) | N | The serial number of the prescription blank/form sent in field 454-EK of claim segment (07) |
| UPDT_APPLCTX | NUMBER | N | The application context number from the record info block. |
| UPDT_CNT | NUMBER | N | Set to 0 on insert. Incremented by 1 on update. Used to recognize update conflict where data in a row updated by one application is at risk of being lost by a second application attempting to update the row. |
| UPDT_DT_TM | DATE | N | The date and time the row was last inserted or updated. |
| UPDT_ID | NUMBER | N | The person_id of the person from the personnel table (prsnl) that caused the last insert or update of the row in the table. |
| UPDT_TASK | NUMBER | N | The registered (assigned) task number for the process that inserted or updated the row. |
| WORKERS_COMP_FLAG | NUMBER | N | Workers Compensation segment flag indicates whether or not the segment is required to transmit. |
Relationship Detail - ORDER_HEALTH_PLAN
| Child Column in ORDER_HEALTH_PLAN(FK) | Parent Table Name | Parent Column Name | |
|---|---|---|---|
| Parents: | HEALTH_PLAN_ID | HEALTH_PLAN | HEALTH_PLAN_ID |
| ORDER_ID | ORDERS | ORDER_ID |
| Parent Column in ORDER_HEALTH_PLAN (PK) | Child Table Name | Child Column Name | |
|---|---|---|---|
| Children: | ACTION_SEQUENCE | ORDER_HEALTH_PLAN_DETAIL | ACTION_SEQ |
| CARD_HOLDER_IDENT | ORDER_HEALTH_PLAN_DETAIL | CARD_HOLDER_IDENT | |
| HEALTH_PLAN_ID | ORDER_HEALTH_PLAN_DETAIL | HEALTH_PLAN_ID | |
| ORDER_ID | ORDER_HEALTH_PLAN_DETAIL | ORDER_ID | |
| ACTION_SEQUENCE | RX_CLAIM_PENDING | ACTION_SEQUENCE_NBR | |
| CARD_HOLDER_IDENT | RX_CLAIM_PENDING | CARD_HOLDER_IDENT | |
| HEALTH_PLAN_ID | RX_CLAIM_PENDING | HEALTH_PLAN_ID | |
| ORDER_ID | RX_CLAIM_PENDING | ORDER_ID |
ORDER_HEALTH_PLAN_DETAIL
| Column Section | Relationship Section | Top of Page |
Table-level Detail
| Description: | Order Health Plan Detail |
| Definition: | For every action on an order, this table stores the NCPDP Claim related information per health plan used. |
| Table Type: | ACTIVITY |
Column Detail - ORDER_HEALTH_PLAN_DETAIL
| Column Name | Type | Null? | Definition |
|---|---|---|---|
| ACTION_SEQ | NUMBER | N | A sequence number used to identify the order of the actions. |
| CARD_HOLDER_IDENT | VC2(100) | N | The member number of the subscriber to the health plan. |
| DETAIL_FIELD_DT_TM | DATE | Y | Value of the current detail record if source field contains date/time value. |
| DETAIL_FIELD_ID | NUMBER | N | Stores the order entry detail id. Populated only for a Rebill that is valid for all health plans. |
| DETAIL_FIELD_IDENT | NUMBER | N | Field ID for the current detail record |
| DETAIL_FIELD_MEANING | VC2(25) | N | Stores the string meaning of the order_entry_detail. Populated only for a Rebill that is valid for all health plans. |
| DETAIL_FIELD_SEQ | NUMBER | N | The sequence for each occurrence of a given Source Field. |
| DETAIL_FIELD_TXT | VC2(250) | N | The value of the current detail record if source field contains text. |
| DETAIL_FIELD_VALUE | NUMBER | N | The value of the current detail record if source field contains numeric or codified value. |
| DETAIL_TZ | NUMBER | N | Time zone for the detail_field_dt_tm |
| HEALTH_PLAN_ID | NUMBER | N | The identifier assigned for a health plan. |
| ORDER_HEALTH_PLAN_DTL_ID | NUMBER | N | This field contains the unique value assigned to each order health plan detail row. |
| ORDER_ID | NUMBER | N | This field contains the unique value assigned to each orderable procedure associated with an order. |
| UPDT_APPLCTX | NUMBER | N | The application context number from the record info block. |
| UPDT_CNT | NUMBER | N | Set to 0 on insert. Incremented by 1 on update. Used to recognize update conflict where data in a row updated by one application is at risk of being lost by a second application attempting to update the row. |
| UPDT_DT_TM | DATE | N | The date and time the row was last inserted or updated. |
| UPDT_ID | NUMBER | N | The person_id of the person from the personnel table (prsnl) that caused the last insert or update of the row in the table. |
| UPDT_TASK | NUMBER | N | The registered (assigned) task number for the process that inserted or updated the row. |
Relationship Detail - ORDER_HEALTH_PLAN_DETAIL
| Child Column in ORDER_HEALTH_PLAN_DETAIL(FK) | Parent Table Name | Parent Column Name | |
|---|---|---|---|
| Parents: | HEALTH_PLAN_ID | HEALTH_PLAN | HEALTH_PLAN_ID |
| ACTION_SEQ | ORDER_HEALTH_PLAN | ACTION_SEQUENCE | |
| CARD_HOLDER_IDENT | ORDER_HEALTH_PLAN | CARD_HOLDER_IDENT | |
| HEALTH_PLAN_ID | ORDER_HEALTH_PLAN | HEALTH_PLAN_ID | |
| ORDER_ID | ORDER_HEALTH_PLAN | ORDER_ID |
PHARMACY_RANGE
| Column Section | Relationship Section | Top of Page |
Table-level Detail
| Description: | PHARMACY RANGE |
| Definition: | Pharmacy_range - Range of numbers to use for Prescription and Tracking Numbers. |
| Table Type: | REFERENCE |
Column Detail - PHARMACY_RANGE
| Column Name | Type | Null? | Definition |
|---|---|---|---|
| DESCRIPTION | VC2(100) | Y | Description of range |
| FROM_RANGE | FLOAT | Y | Beginning of Range Value |
| NEXT_VALUE | NUMBER | Y | Next range value |
| RANGE_ID | NUMBER | N | Unique ID identifying pharmacy range |
| TO_RANGE | FLOAT | Y | Ending of range value |
| UPDT_APPLCTX | NUMBER | N | The application context number from the record info block. |
| UPDT_CNT | NUMBER | N | Set to 0 on insert. Incremented by 1 on update. Used to recognize update conflict where data in a row updated by one application is at risk of being lost by a second application attempting to update the row. |
| UPDT_DT_TM | DATE | N | The date and time the row was last inserted or updated. |
| UPDT_ID | NUMBER | N | The person_id of the person from the personnel table (prsnl) that caused the last insert or update of the row in the table. |
| UPDT_TASK | NUMBER | N | The registered (assigned) task number for the process that inserted or updated the row. |
Relationship Detail - PHARMACY_RANGE
| Parent Column in PHARMACY_RANGE (PK) | Child Table Name | Child Column Name | |
|---|---|---|---|
| Children: | RANGE_ID | SERV_RES_EXT_PHARM | DOWNTIME_RANGE_ID |
PHA_BATCH_REPORT_ACT
| Column Section | Relationship Section | Top of Page |
Table-level Detail
| Description: | Pharmacy Batch Report Activity |
| Definition: | Track the history of Batch Claims runs. |
| Table Type: | ACTIVITY |
Column Detail - PHA_BATCH_REPORT_ACT
| Column Name | Type | Null? | Definition |
|---|---|---|---|
| BATCH_REPORT_CD | NUMBER | N | The batch report that generated this activity. |
| BATCH_TYPE_CD | NUMBER | Y | Type of report |
| ENCNTR_ID | NUMBER | N | The encounter for which the batch has been run. |
| EXECUTION_END_DT_TM | DATE | Y | The time that this particular execution ended. |
| EXECUTION_START_DT_TM | DATE | N | The time that this execution began. |
| EXECUTION_TYPE_FLAG | NUMBER | N | Flag to indicate if it was executed as part of ops job or manually executed |
| ORD_TYPE_CONT_IND | NUMBER | N | Display/print continuous orders on this report. |
| ORD_TYPE_INT_IND | NUMBER | N | Display intermittent IV orders on the report. |
| ORD_TYPE_MED_IND | NUMBER | N | Display medication orders on the report. |
| OUTPUT_DEVICE_CD | NUMBER | N | Output Deivce (printer) where the report was printedo. |
| OUTPUT_FORMAT_CD | NUMBER | N | Output format associated with this report |
| PHA_BATCH_REPORT_ACT_ID | NUMBER | N | Unique generated number that identifies a single row on the PHA_BATCH_REPORT_ACT table. |
| REPORT_FROM_DT_TM | DATE | Y | The begin date of this report. |
| REPORT_FROM_TZ | NUMBER | N | The time zone associated to the report_from_dt_tm column. |
| REPORT_TO_DT_TM | DATE | Y | The end date/time of this report run. |
| REPORT_TO_TZ | NUMBER | N | The time zone associated to the report_to_dt_tm column. |
| RUNS_TO_PRINT_FLAG | NUMBER | N | Indicates which runs will be part of the report that is printed once the batch is complete. |
| RUN_USER_ID | NUMBER | N | This is the user that ran the batch |
| RX_WORKSTATION_CD | NUMBER | N | The workstation that batch was executed from. |
| STATUSES_TO_PRINT_FLAG | NUMBER | N | Indicates which records, based on the process status of the records, will be part of the report that is printed once batch is complete. |
| STATUS_CD | NUMBER | N | Status of Inpatient to Outpatient Link |
| UPDT_APPLCTX | NUMBER | N | The application context number from the record info block. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
| UPDT_CNT | NUMBER | N | Set to 0 on insert. Incremented by 1 on update. Used to recognize update conflict where data in a row updated by one application is at risk of being lost by a second application attempting to update the row. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
| UPDT_DT_TM | DATE | N | The date and time the row was last inserted or updated. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
| UPDT_ID | NUMBER | N | The person_id of the person from the personnel table (prsnl) that caused the last insert or update of the row in the table. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
| UPDT_TASK | NUMBER | N | The registered (assigned) task number for the process that inserted or updated the row. The UPDT family of columns are typically used for housekeeping and external system process and should never be depended on for solution specific logic. |
Relationship Detail - PHA_BATCH_REPORT_ACT
| Child Column in PHA_BATCH_REPORT_ACT(FK) | Parent Table Name | Parent Column Name | |
|---|---|---|---|
| Parents: | ENCNTR_ID | ENCOUNTER | ENCNTR_ID |
| BATCH_REPORT_CD | PHA_BATCH_REPORT | BATCH_REPORT_CD | |
| RUN_USER_ID | PRSNL | PERSON_ID |
| Parent Column in PHA_BATCH_REPORT_ACT (PK) | Child Table Name | Child Column Name | |
|---|---|---|---|
| Children: | PHA_BATCH_REPORT_ACT_ID | PHA_BATCH_REPORT_ACT_DTL | PHA_BATCH_REPORT_ACT_ID |
| RXS_PHA_REPORT_FILTER_HIST | PHA_BATCH_REPORT_ACT_ID |
PHA_BATCH_REPORT_ACT_DTL
| Column Section | Relationship Section | Top of Page |
Table-level Detail
| Description: | Pharmacy Batch Report Activity Detail |
| Definition: | Stores the records that qualified based on the batch parameters. |
| Table Type: | ACTIVITY |
Column Detail - PHA_BATCH_REPORT_ACT_DTL
| Column Name | Type | Null? | Definition |
|---|---|---|---|
| CHILD_ORDER_ID | NUMBER | N | Identifies a child order associated with an original inpatient order (i.e. pass med orders) |
| DETAIL_PROCESS_STATUS_CD | NUMBER | N | Identifies a more detailed status for the qualified dispense. |
| DISPENSE_HX_ID | NUMBER | N | Identifies a dispense that qualified for the batch. |
| HEALTH_PLAN_ID | NUMBER | N | Identifies the health plan used to qualify the dispense. |
| ORDER_ID | NUMBER | N | Identifies an inpatient order associated to the inpatient dispense. |
| PHA_BATCH_REPORT_ACT_DTL_ID | NUMBER | N | Unique generated number that identifies a single row on the PHA_BATCH_REPORT_ACT_DTL table. |
| PHA_BATCH_REPORT_ACT_ID | NUMBER | N | The particular execution of the batch report that this detail i for. |
| PROCESS_STATUS_CD | NUMBER | N | Identifies the status for the qualified dispense. |
| PROD_CLAIM_QTY | FLOAT | N | Net Dispense Quantity, in terms of Dispensing Package Unit, of the product that is being claimed. |
| PROD_DISPENSE_HX_ID | NUMBER | N | Identifies a product associated with the dispense |
| RX_ADMIN_DISPENSE_HX_ID | NUMBER | N | Identifies a specific administration associated with the dispense. |
| RX_ADMIN_PROD_DISPENSE_HX_ID | NUMBER | N | Identifies a product associated with a specific administration. |
| SERVICE_END_DT_TM | DATE | Y | Identifies the end date of when the service was provided |
| SERVICE_START_DT_TM | DATE | Y | Identifies the start date of when the service was provided. |
| UPDT_APPLCTX | NUMBER | N | The application context number from the record info block. |
| UPDT_CNT | NUMBER | N | Set to 0 on insert. Incremented by 1 on update. Used to recognize update conflict where data in a row updated by one application is at risk of being lost by a second application attempting to update the row. |
| UPDT_DT_TM | DATE | N | The date and time the row was last inserted or updated. |
| UPDT_ID | NUMBER | N | The person_id of the person from the personnel table (prsnl) that caused the last insert or update of the row in the table. |
| UPDT_TASK | NUMBER | N | The registered (assigned) task number for the process that inserted or updated the row. |
Relationship Detail - PHA_BATCH_REPORT_ACT_DTL
| Child Column in PHA_BATCH_REPORT_ACT_DTL(FK) | Parent Table Name | Parent Column Name | |
|---|---|---|---|
| Parents: | DISPENSE_HX_ID | DISPENSE_HX | DISPENSE_HX_ID |
| HEALTH_PLAN_ID | HEALTH_PLAN | HEALTH_PLAN_ID | |
| CHILD_ORDER_ID | ORDERS | ORDER_ID | |
| ORDER_ID | ORDERS | ORDER_ID | |
| PHA_BATCH_REPORT_ACT_ID | PHA_BATCH_REPORT_ACT | PHA_BATCH_REPORT_ACT_ID | |
| RX_ADMIN_DISPENSE_HX_ID | RX_ADMIN_DISPENSE_HX | RX_ADMIN_DISPENSE_HX_ID | |
| RX_ADMIN_PROD_DISPENSE_HX_ID | RX_ADMIN_PROD_DISPENSE_HX | RX_ADMIN_PROD_DISPENSE_HX_ID |