Table Detail Report
RX_CLAIM_AUTH_AUDIT
| Column Section | Top of Page |
Table-level Detail
| Description: | Pharmacy Claim Authorization Audit |
| Definition: | Table used to audit asynchronized transactions for Claim Authorization services |
| Table Type: | ACTIVITY |
Column Detail - RX_CLAIM_AUTH_AUDIT
| Column Name | Type | Null? | Definition |
|---|---|---|---|
| ACTION_NAME | VC2(40) | N | Specifies the action for which the audit row is entered. |
| AUTHORIZATION_IDENT_TXT | VC2(100) | N | This column holds the value of pre-generated authorization ID that will be sent for pharmacy prior request transactions. The unique identifier assigned by the health provider to identify the Authorization; must be globally unique and start with EncounterFacilityID followed by a unique identifier assigned by the facility information system, followed by date/time of the transaction. |
| CONTRIBUTOR_SYSTEM_TXT | VC2(5) | N | Identifies the subsystem that entered this row. |
| CREATE_DT_TM | DATE | N | Identifies date & time the row was created. |
| MESSAGE_TXT | VC2(1000) | N | Text indicating success or failure message |
| RX_CLAIM_AUTH_AUDIT_ID | NUMBER | N | Unique generated number that identifies a single row on the claim_authorization_audit table. |
| SUCCESS_IND | NUMBER | N | Indicates if the claim was processed successfully. |
| 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. |
RX_CLAIM_DOWNTIME
| Column Section | Top of Page |
Table-level Detail
| Description: | Retail Claim Downtime |
| Definition: | Rx_Claim_downtime |
| Table Type: | ACTIVITY |
Column Detail - RX_CLAIM_DOWNTIME
| Column Name | Type | Null? | Definition |
|---|---|---|---|
| ACTIVE_IND | NUMBER | N | The table row is active or inactive. A row is generally active unless it is in an inactive state such as logically deleted, combined away, pending purge, etc. |
| BEG_EFFECTIVE_DT_TM | DATE | N | The date and time for which this table row becomes effective. Normally, this will be the date and time the row is added, but could be a past or future date and time. |
| DOWNTIME_TYPE_CD | NUMBER | N | downtime_type_cd |
| END_EFFECTIVE_DT_TM | DATE | N | The date/time after which the row is no longer valid as active current data. This may be valued with the date that the row became inactive. |
| PARENT_ENTITY | VC2(32) | Y | Parent Entity name |
| PARENT_ENTITY_ID | NUMBER | N | The value of the primary identifier of the table to which the address row is related (i.e., person_id, organization_id, etc.) |
| RX_CLAIM_DOWNTIME_ID | NUMBER | N | Rx Claim Downtime |
| 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. |
RX_CLAIM_FIELD
| Column Section | Relationship Section | Top of Page |
Table-level Detail
| Description: | RX CLAIM FIELD |
| Definition: | Rx_claim_field - Defines fields on a Prescription claim format. |
| Table Type: | REFERENCE |
Column Detail - RX_CLAIM_FIELD
| Column Name | Type | Null? | Definition |
|---|---|---|---|
| CLAIM_FIELD_CD | NUMBER | N | Claim Field Code value |
| FIELD_DECIMAL_CNT | NUMBER | Y | Number of digits after decimal to be used. |
| FIELD_LENGTH | NUMBER | Y | Field Length |
| FIELD_TYPE_FLAG | NUMBER | Y | Field_Type Flag (1-Alpha,2-Alpha/Numeric,3-Numeric,4-Decimal) |
| 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 - RX_CLAIM_FIELD
| Parent Column in RX_CLAIM_FIELD (PK) | Child Table Name | Child Column Name | |
|---|---|---|---|
| Children: | CLAIM_FIELD_CD | RX_HEALTH_PLAN_CLAIM | CLAIM_FIELD_CD |
RX_CLAIM_FORMAT
| Column Section | Relationship Section | Top of Page |
Table-level Detail
| Description: | RX CLAIM FORMAT |
| Definition: | Details Prescription claim formats |
| Table Type: | REFERENCE |
Column Detail - RX_CLAIM_FORMAT
| Column Name | Type | Null? | Definition |
|---|---|---|---|
| CLAIM_SEGMENT_CD | NUMBER | N | The code value of the claim segment that contains the claim field. |
| FIELD_BEG_POS | NUMBER | Y | CLAIM FIELD BEGINNING POSITION |
| FIELD_CD | NUMBER | N | CODE VALUE FROM CODE SET 4517 |
| FIELD_DECIMAL_CNT | NUMBER | Y | NUMBER OF DIGITS AFTER DECIMAL TO BE USED |
| FIELD_END_POS | NUMBER | Y | CLAIM FIELD ENDING POSITION |
| FIELD_LENGTH | NUMBER | Y | LENGTH OF CLAIM FIELD |
| FIELD_TYPE_FLAG | NUMBER | Y | Field_Type Flag (1-Alpha,2-Alpha/Numeric,3-Numeric,4-Decimal) |
| FORMAT_CD | NUMBER | N | CODE VALUE FROM CODE SET 4515 |
| FORMAT_ID | NUMBER | N | UNIQUE ID FOR EACH FIELD IN THE FORMAT |
| FORMAT_SEQ | NUMBER | Y | SEQUENCE OF THE FIELDS IN THE FORMAT |
| FORMAT_TYPE_CD | NUMBER | N | CODE VALUE FROM CODE SET 4516 |
| REQUIRED_IND | NUMBER | Y | INDICATOR (0 OR 1). indicates whether or not a the field is required for the format. (1=Required) |
| REVERSAL_REQUIRED_IND | NUMBER | N | Indicates whether the field is required during claim reversal transaction. (1 = required, 0 = not required.) |
| SOURCE_BEG_POS | NUMBER | Y | The position of the character, in the Source value, that is used as the starting point. |
| SOURCE_END_POS | NUMBER | Y | CLAIM SOURCE ENDING POSITION |
| SOURCE_FIELD_CD | NUMBER | N | CODE VALUE FROM CODE SET 4518 |
| SOURCE_STRING | VC2(255) | Y | Value of the Source, if Source is a literal value. |
| STANDARD_IND | NUMBER | Y | INDICATOR (0 OR 1). indicates whether or not the format is modifiable. (1 = Not Modifiable) |
| 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 - RX_CLAIM_FORMAT
| Parent Column in RX_CLAIM_FORMAT (PK) | Child Table Name | Child Column Name | |
|---|---|---|---|
| Children: | FORMAT_ID | RX_HEALTH_PLAN_CLAIM | CLAIM_FORMAT_ID |
RX_CLAIM_OVERRIDE
| Column Section | Relationship Section | Top of Page |
Table-level Detail
| Description: | RX Claim Override |
| Definition: | Stores the values of fields, which are part of claim request message, overridden by the user. |
| Table Type: | ACTIVITY |
Column Detail - RX_CLAIM_OVERRIDE
| Column Name | Type | Null? | Definition |
|---|---|---|---|
| CARD_HOLDER_IDENT | VC2(100) | N | The member number of the subscriber to the health plan. |
| DISPENSE_HX_ID | NUMBER | N | Relates a particular field to a specific row on the Dispense History table. |
| HEALTH_PLAN_ID | NUMBER | N | This column relates a particular field to a specific health plan record. |
| OVERRIDE_FIELD_CD | NUMBER | N | National Council for Prescription Drug Program Code taken from code_value , code_set 4517. |
| OVERRIDE_FIELD_SEQ | NUMBER | N | Sequence that indicates the multiple occurrences of a particular field_cd. |
| OVERRIDE_FIELD_TXT | VC2(255) | N | Value entered by the user for a given field_cd and field_seq combination. |
| RX_CLAIM_OVERRIDE_ID | NUMBER | N | Uniquely identifies a specific override field. |
| 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 - RX_CLAIM_OVERRIDE
| Child Column in RX_CLAIM_OVERRIDE(FK) | Parent Table Name | Parent Column Name | |
|---|---|---|---|
| Parents: | DISPENSE_HX_ID | DISPENSE_HX | DISPENSE_HX_ID |
| HEALTH_PLAN_ID | HEALTH_PLAN | HEALTH_PLAN_ID |