{"text_format":"1","workbook":"xlsx","n_sheets":16,"sheets":["Cover","Table Matrix","Table Summary","pivot input","Request Sheet","eligibility","eligibility_supplemental","medical","medical_claim_header","medical_supplemental","medical_claim_diagnosis","medical_claim_icd_procedure","pharmacy","pharmacy_supplemental","provider","Claim Type Refernce"],"not_rendered":{"charts":0,"images":0,"macros":1,"external_links":0,"defined_names":3,"comments":0,"pivot_tables":1},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900"}

{"sheet":"Cover","index":0,"n_rows":18,"n_cols":1,"rows_kept":18,"cut":false,"hidden":false,"merged":[]}
[]
[]
[]
[]
["Connecticut All Payer Claims Database"]
["Data Release Dictionary V2.2 "]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
[]
["Last Updated 7/15/2021"]

{"sheet":"Table Matrix","index":1,"n_rows":15,"n_cols":12,"rows_kept":15,"cut":false,"hidden":false,"merged":[[0,0,0,11],[2,0,3,0],[2,1,2,11]]}
["CT APCD Data Release -  Field Classification Matrix"]
["Count of Variables By Table and Classification"]
["Table Name","Field Classifications"]
[null,"Administrative","Enrollee Coverage Information","Enrollee Demographics","Claim Information","Diagnosis Information","Procedure Coding & Detail","Financial Information","Provider Information","Payer Information","Safe Harbor Variable","Grand Total"]
["Eligibility",2,11,1,null,null,null,1,1,1,4,{"$f":"SUM(B5:K5)","v":21}]
["Eligibility Supplemental",2,13,9,null,null,null,4,null,null,null,{"$f":"SUM(B6:K6)","v":28}]
["Medical",2,3,null,13,2,7,8,4,1,6,46]
["Medical Claim Header",4,null,null,6,3,null,11,null,1,6,31]
["Medical Supplemental",2,null,null,14,null,5,4,1,null,null,26]
["Medical Claim Diagnosis",2,null,null,null,5,null,null,null,null,null,7]
["Medical Claim Icd Procedure",1,null,null,3,null,1,null,null,null,null,5]
["Pharmacy",3,3,null,11,null,2,9,2,1,3,34]
["Pharmacy Supplemental",2,null,null,8,null,null,4,null,null,1,15]
["Provider",3,null,null,null,null,null,null,2,1,null,6]
["Grand Total",{"$f":"SUM(B5:B14)","v":23},{"$f":"SUM(C5:C14)","v":30},10,55,10,15,41,10,5,20,219]

{"sheet":"Table Summary","index":2,"n_rows":15,"n_cols":12,"rows_kept":15,"cut":false,"hidden":true,"merged":[]}
[]
[]
["Count of ID","Column Labels"]
["Row Labels","Administrative","Enrollee Coverage Information","Enrollee Demographics","Claim Information","Diagnosis Information","Procedure Coding & Detail","Financial Information","Provider Information","Payer Information","Safe Harbor Variable","Grand Total"]
["Eligibility  ",2,11,1,null,null,null,1,1,1,4,21]
["Eligibility Supplemental",2,13,9,null,null,null,4,null,null,null,28]
["Medical",2,3,null,13,2,7,8,4,1,6,46]
["Medical Claim Diagnosis",2,null,null,null,5,null,null,null,null,null,7]
["Medical Claim Header",4,null,null,6,3,null,11,null,1,6,31]
["Medical Claim Icd Procedure",1,null,null,3,null,1,null,null,null,null,5]
["Medical Supplemental",2,null,null,14,null,5,4,1,null,null,26]
["Pharmacy",3,3,null,11,null,2,9,2,1,3,34]
["Pharmacy Supplemental",2,null,null,8,null,null,4,null,null,1,15]
["Provider",3,null,null,null,null,null,null,2,1,null,6]
["Grand Total",23,30,10,55,10,15,41,10,5,20,219]

{"sheet":"pivot input","index":3,"n_rows":243,"n_cols":11,"rows_kept":243,"cut":false,"hidden":true,"merged":[]}
["Table ","Classification","ID","Warehouse Name"]
["Member Month","Administrative","MEM-MON001","internal_member_id",null,null,"Classification","ID","Warehouse Name","Descrip","Table"]
["Member Month","Administrative","MEM-MON002","extract_id",null,null,"Administrative","EL-CORE001","eligibility_id ",null,"eligibility"]
["Member Month","Administrative","MEM-MON0014","medical_eligibility_id",null,null,"Administrative","EL-CORE002","extract_id",null,"eligibility"]
["Member Month","Enrollee Coverage Information","MEM-MON003","year_month",null,null,"Enrollee Coverage Information","EL-CORE005","coverage_class",null,"eligibility"]
["Member Month","Enrollee Coverage Information","MEM-MON004","medical_product_code_id",null,null,"Enrollee Coverage Information","EL-CORE007","internal_member_id ",null,"eligibility"]
["Member Month","Enrollee Coverage Information","MEM-MON006","medical_commercial_eligibility_id",null,null,"Enrollee Coverage Information","EL-CORE009","subscriber_relationship_code",null,"eligibility"]
["Member Month","Enrollee Coverage Information","MEM-MON007","medical_medicare_eligibility_id",null,null,"Payer Information","EL-CORE003","submitter_id ",null,"eligibility"]
["Member Month","Enrollee Coverage Information","MEM-MON008","medical_medicaid_eligibility_id",null,null,"Enrollee Coverage Information","EL-CORE011","product_code",null,"eligibility"]
["Member Month","Enrollee Coverage Information","MEM-MON009","pharmacy_product_code_id",null,null,"Enrollee Coverage Information","EL-CORE013","primary_insurance_ind_code",null,"eligibility"]
["Member Month","Administrative","MEM-MON0014","pharmacy_eligibility_id",null,null,"Safe Harbor Variable","EL-CORE018","eligibility_start_dt ",null,"eligibility"]
["Member Month","Enrollee Coverage Information","MEM-MON011","pharmacy_commercial_eligibility_id",null,null,"Safe Harbor Variable","EL-CORE019","eligibility_end_dt ",null,"eligibility"]
["Member Month","Enrollee Coverage Information","MEM-MON012","pharmacy_medicare_eligibility_id",null,null,"Enrollee Coverage Information","EL-CORE020","full_medicaid_coverage_flag",null,"eligibility"]
["Member Month","Enrollee Coverage Information","MEM-MON013","pharmacy_medicaid_eligibility_id",null,null,"Enrollee Coverage Information","EL-CORE022","aid_category_code",null,"eligibility"]
["Eligibility","Administrative","EL-CORE001","eligibility_id ",null,null,"Enrollee Coverage Information","EL-CORE028","dual_eligibility_code",null,"eligibility"]
["Eligibility","Administrative","EL-CORE002","extract_id",null,null,"Enrollee Coverage Information","EL-CORE032","coverage_level_code",null,"eligibility"]
["Eligibility","Enrollee Coverage Information","EL-CORE005","coverage_class",null,null,"Enrollee Coverage Information","EL-CORE034","coverage_type_code",null,"eligibility"]
["Eligibility","Enrollee Coverage Information","EL-CORE007","internal_member_id ",null,null,"Financial Information","EL-CORE035","member_deductible_amt",null,"eligibility"]
["Eligibility","Enrollee Coverage Information","EL-CORE009","subscriber_relationship_code",null,null,"Safe Harbor Variable","MEM-CORE006","zip",null,"eligibility"]
["Eligibility","Enrollee Coverage Information","EL-CORE011","product_code",null,null,"Safe Harbor Variable","MEM-CORE008","birth_dt",null,"eligibility"]
["Eligibility","Enrollee Coverage Information","EL-CORE013","primary_insurance_ind_code",null,null,"Enrollee Demographics","EL-CORE014","gender_code",null,"eligibility"]
["Eligibility","Enrollee Coverage Information","EL-CORE018","eligibility_start_dt ",null,null,"Enrollee Coverage Information","MEM-CORE012","subscriber_internal_member_id",null,"eligibility"]
["Eligibility","Enrollee Coverage Information","EL-CORE019","eligibility_end_dt ",null,null,"Provider Information","EL-PRV003","pcp_provider_id",null,"eligibility"]
["Eligibility","Enrollee Coverage Information","EL-CORE020","full_medicaid_coverage_flag",null,null,"Administrative","EL-SUP001","eligibility_id  ","Eligibility Record ID","Eligibility Supplemental"]
["Eligibility","Enrollee Coverage Information","EL-CORE022","aid_category_code",null,null,"Administrative","EL-SUP002","extract_id","Extract ID","Eligibility Supplemental"]
["Eligibility","Enrollee Coverage Information","EL-CORE028","dual_eligibility_code",null,null,"Enrollee Coverage Information","EL-SUP007","health_care_home_assigned_flag","PCMH Assigned Flag","Eligibility Supplemental"]
["Eligibility","Enrollee Coverage Information","EL-CORE032","coverage_level_code",null,null,"Enrollee Coverage Information","EL-SUP008","purchased_through_exchange","Purchased Through Exchange Indicator Description","Eligibility Supplemental"]
["Eligibility","Enrollee Coverage Information","EL-CORE034","coverage_type_code",null,null,"Enrollee Coverage Information","EL-SUP010","exchange_metallic_tier_code","Exchange Metallic Tier Code","Eligibility Supplemental"]
["Eligibility","Financial Information","EL-CORE035","member_deductible_amt",null,null,"Enrollee Coverage Information","EL-SUP012","market_category_code","Market Category Code ","Eligibility Supplemental"]
["Eligibility","Safe Harbor Variable","MEM-CORE006","zip",null,null,"Financial Information","EL-SUP015","dental_deductible_amt","Dental Deductible Amount","Eligibility Supplemental"]
["Eligibility","Safe Harbor Variable","MEM-CORE008","birth_dt",null,null,"Financial Information","EL-SUP016","vision_deductible_amt","Vision Deductible Amount","Eligibility Supplemental"]
["Eligibility","Enrollee Demographics","MEM-CORE009","gender_code",null,null,"Financial Information","EL-SUP017","total_monthly_premium_amt","Total Monthly Premium Amount","Eligibility Supplemental"]
["Eligibility","Enrollee Coverage Information","MEM-CORE012","subscriber_internal_member_id",null,null,"Enrollee Coverage Information","EL-SUP019","disease_management_ind_code","Disease Management Indicator Code","Eligibility Supplemental"]
["Eligibility","Provider Information","EL-PRV004","pcp_internal_provider_id",null,null,"Enrollee Coverage Information","EL-SUP021","business_type_code","Business Type Code","Eligibility Supplemental"]
["Eligibility Supplemental","Administrative","EL-SUP001","eligibility_id  ",null,null,"Enrollee Demographics","EL-SUP022","disability_indicator_code","Disability Indicator Code","Eligibility Supplemental"]
["Eligibility Supplemental","Administrative","EL-SUP002","extract_id",null,null,"Enrollee Demographics","EL-SUP024","employment_status_code","Employment Status Code","Eligibility Supplemental"]
["Eligibility Supplemental","Enrollee Coverage Information","EL-SUP007","health_care_home_assigned_flag",null,null,"Enrollee Demographics","EL-SUP025","student_status_ind_code","Student Status Indicator Code","Eligibility Supplemental"]
["Eligibility Supplemental","Enrollee Coverage Information","EL-SUP008","purchased_through_exchange",null,null,"Enrollee Demographics","EL-SUP027","marital_status_code","Marital Status Code","Eligibility Supplemental"]
["Eligibility Supplemental","Enrollee Coverage Information","EL-SUP010","exchange_metallic_tier_code",null,null,"Enrollee Coverage Information","EL-SUP029","benefit_status_code","Benefit Status Code","Eligibility Supplemental"]
["Eligibility Supplemental","Enrollee Coverage Information","EL-SUP012","market_category_code",null,null,"Enrollee Demographics","EL-SUP031","employee_type_code","Employee Type Code","Eligibility Supplemental"]
["Eligibility Supplemental","Financial Information","EL-SUP014","member_deductible_amt",null,null,"Enrollee Coverage Information","EL-SUP032","cobra_status_ind_code","COBRA Status Indicator Code","Eligibility Supplemental"]
["Eligibility Supplemental","Financial Information","EL-SUP015","dental_deductible_amt",null,null,"Enrollee Demographics","EL-SUP034","pool_indicator_code","Pool Indicator Code","Eligibility Supplemental"]
["Eligibility Supplemental","Financial Information","EL-SUP016","vision_deductible_amt",null,null,"Enrollee Coverage Information","EL-SUP035","full_coverage_code","Full Coverage Code","Eligibility Supplemental"]
["Eligibility Supplemental","Financial Information","EL-SUP017","total_monthly_premium_amt",null,null,"Enrollee Demographics","EL-SUP036","interpreter_indicator_code","Interpreter Indicator Code","Eligibility Supplemental"]
["Eligibility Supplemental","Enrollee Coverage Information","EL-SUP019","disease_management_ind_code",null,null,"Enrollee Coverage Information","EL-SUP038","medicare_plan_code","Medicare Plan Code","Eligibility Supplemental"]
["Eligibility Supplemental","Enrollee Coverage Information","EL-SUP021","business_type_code",null,null,"Enrollee Coverage Information","EL-SUP039","actuarial_value","Actuarial Value","Eligibility Supplemental"]
["Eligibility Supplemental","Enrollee Demographics","EL-SUP022","disability_indicator_code",null,null,"Enrollee Coverage Information","EL-SUP040","vision_benefit_ind_code","Vision Benefit Indicator Code","Eligibility Supplemental"]
["Eligibility Supplemental","Enrollee Demographics","EL-SUP024","employment_status_code",null,null,"Enrollee Coverage Information","EL-SUP041","risk_adjustment_plan_ind_code","Risk-Adjustment Plan Indicator Code","Eligibility Supplemental"]
["Eligibility Supplemental","Enrollee Demographics","EL-SUP025","student_status_ind_code",null,null,"Financial Information","EL-SUP042","billable_member_ind_code","Billable Member Indicator Code","Eligibility Supplemental"]
["Eligibility Supplemental","Enrollee Demographics","EL-SUP027","marital_status_code",null,null,"Enrollee Demographics","EL-SUP044","apcd_id_code","APCD ID Code","Eligibility Supplemental"]
["Eligibility Supplemental","Enrollee Coverage Information","EL-SUP029","benefit_status_code",null,null,"Enrollee Demographics","EL-SUP045","naics_code","Member NAICS Code","Eligibility Supplemental"]
["Eligibility Supplemental","Enrollee Demographics","EL-SUP031","employee_type_code",null,null,"Administrative","MC-CORE001","medical_claim_service_line_id","Medical Claim Service-Line Record ID","Medical"]
["Eligibility Supplemental","Enrollee Coverage Information","EL-SUP032","cobra_status_ind_code",null,null,"Administrative","MC-CORE002","extract_id","Extract ID","Medical"]
["Eligibility Supplemental","Enrollee Demographics","EL-SUP034","pool_indicator_code",null,null,"Payer Information","MC-CORE003","submitter_id ","Submitter ID","Medical"]
["Eligibility Supplemental","Enrollee Coverage Information","EL-SUP035","full_coverage_code",null,null,"Enrollee Coverage Information","MC-CORE005","product_code","Insurance Type / Product Code","Medical"]
["Eligibility Supplemental","Enrollee Demographics","EL-SUP036","interpreter_indicator_code",null,null,"Claim Information","MC-CORE007","line_counter","Line Counter","Medical"]
["Eligibility Supplemental","Enrollee Coverage Information","EL-SUP038","medicare_plan_code",null,null,"Claim Information","MC-CORE009","internal_member_id ","Internal Member ID","Medical"]
["Eligibility Supplemental","Enrollee Coverage Information","EL-SUP039","actuarial_value",null,null,"Enrollee Coverage Information","MC-CORE011","subscriber_relationship_code","Member’s Relationship Code","Medical"]
["Eligibility Supplemental","Enrollee Coverage Information","EL-SUP040","vision_benefit_ind_code",null,null,"Safe Harbor Variable","MC-CORE016","first_paid_dt","First Paid Date","Medical"]
["Eligibility Supplemental","Enrollee Coverage Information","EL-SUP041","risk_adjustment_plan_ind_code",null,null,"Safe Harbor Variable","MC-CORE017","last_paid_dt","Last Paid Date","Medical"]
["Eligibility Supplemental","Financial Information","EL-SUP042","billable_member_ind_code",null,null,"Safe Harbor Variable","MC-CORE018","first_service_dt","Date of Service (From)","Medical"]
["Eligibility Supplemental","Enrollee Demographics","EL-SUP044","apcd_id_code",null,null,"Safe Harbor Variable","MC-CORE019","last_service_dt","Date of Service (Through)","Medical"]
["Eligibility Supplemental","Enrollee Demographics","EL-SUP045","naics_code",null,null,"Safe Harbor Variable","MC-CORE020","admission_dt ","Admission Date","Medical"]
["Medical","Administrative","MC-CORE001","medical_claim_service_line_id",null,null,"Safe Harbor Variable","MC-CORE021","discharge_dt ","Discharge Date","Medical"]
["Medical","Administrative","MC-CORE002","extract_id",null,null,"Claim Information","MC-CORE023","place_of_service_code","Place of Service Code","Medical"]
["Medical","Enrollee Coverage Information","MC-CORE004","product_code_id ",null,null,"Claim Information","MC-CORE025","type_of_bill_code","Type of Bill Code","Medical"]
["Medical","Enrollee Coverage Information","MC-CORE005","product_code",null,null,"Claim Information","MC-CORE026","claim_type_id","Claim Type ID","Medical"]
["Medical","Claim Information","MC-CORE007","line_counter",null,null,"Claim Information","MC-CORE027","type_of_setting_id","Type of Setting ID","Medical"]
["Medical","Claim Information","MC-CORE009","internal_member_id ",null,null,"Claim Information","MC-CORE028","place_of_setting_id","Place of Setting ID","Medical"]
["Medical","Enrollee Coverage Information","MC-CORE011","subscriber_relationship_code",null,null,"Financial Information","MC-CORE030","quantity","Quantity","Medical"]
["Medical","Safe Harbor Variable","MC-CORE016","first_paid_dt",null,null,"Financial Information","MC-CORE031","charge_amt","Charge Amount","Medical"]
["Medical","Safe Harbor Variable","MC-CORE017","last_paid_dt",null,null,"Financial Information","MC-CORE032","paid_amt","Paid Amount","Medical"]
["Medical","Safe Harbor Variable","MC-CORE018","first_service_dt",null,null,"Financial Information","MC-CORE033","copay_amt","Copay Amount","Medical"]
["Medical","Safe Harbor Variable","MC-CORE019","last_service_dt",null,null,"Financial Information","MC-CORE034","coinsurance_amt","Coinsurance Amount","Medical"]
["Medical","Safe Harbor Variable","MC-CORE020","admission_dt ",null,null,"Financial Information","MC-CORE035","deductible_amt","Deductible Amount","Medical"]
["Medical","Safe Harbor Variable","MC-CORE021","discharge_dt ",null,null,"Financial Information","MC-CORE037","payment_arrangement_ind_code","Payment Arrangement Indicator Code","Medical"]
["Medical","Claim Information","MC-CORE023","place_of_service_code",null,null,"Financial Information","MC-CORE039","prepaid_amt","Prepaid Amount","Medical"]
["Medical","Claim Information","MC-CORE025","type_of_bill_code",null,null,"Claim Information","MC-CORE041","claim_status_code","Claim Status Code","Medical"]
["Medical","Claim Information","MC-CORE026","claim_type_id",null,null,"Procedure Coding & Detail","MC-CORE043","procedure_code","Procedure Code","Medical"]
["Medical","Claim Information","MC-CORE027","type_of_setting_id",null,null,"Procedure Coding & Detail","MC-CORE045","procedure_modifier_code_1","Procedure Modifier Code (1)","Medical"]
["Medical","Claim Information","MC-CORE028","place_of_setting_id",null,null,"Procedure Coding & Detail","MC-CORE047","procedure_modifier_code_2","Procedure Modifier Code (2)","Medical"]
["Medical","Financial Information","MC-CORE030","quantity",null,null,"Procedure Coding & Detail","MC-CORE049","procedure_modifier_code_3","Procedure Modifier Code (3)","Medical"]
["Medical","Financial Information","MC-CORE031","charge_amt",null,null,"Procedure Coding & Detail","MC-CORE051","procedure_modifier_code_4","Procedure Modifier Code (4)","Medical"]
["Medical","Financial Information","MC-CORE032","paid_amt",null,null,"Procedure Coding & Detail","MC-CORE053","revenue_code","Revenue Code","Medical"]
["Medical","Financial Information","MC-CORE033","copay_amt",null,null,"Diagnosis Information","MC-CORE054","icd_version_ind","ICD Version Indicator","Medical"]
["Medical","Financial Information","MC-CORE034","coinsurance_amt",null,null,"Diagnosis Information","MC-CORE056","diagnosis_code","Diagnosis Code","Medical"]
["Medical","Financial Information","MC-CORE035","deductible_amt",null,null,"Procedure Coding & Detail","MC-CORE058","icd_procedure_code","ICD Procedure Code ","Medical"]
["Medical","Financial Information","MC-CORE036","payment_arrangement_ind_id",null,null,"Enrollee Coverage Information","MC-CORE060","aid_category_code","Aid Category Code","Medical"]
["Medical","Financial Information","MC-CORE037","payment_arrangement_ind_code",null,null,"Claim Information","MC-CORE062","discharge_status_code","Discharge Status Code","Medical"]
["Medical","Financial Information","MC-CORE039","prepaid_amt",null,null,"Claim Information","MC-CORE063","orphaned_adjustment_flag","Orphaned Adjustment Flag","Medical"]
["Medical","Claim Information","MC-CORE041","claim_status_code",null,null,"Claim Information","MC-CORE064","denied_claim_flag","Denied Claim Flag","Medical"]
["Medical","Procedure Coding & Detail","MC-CORE043","procedure_code",null,null,"Claim Information","MC-CORE065","emergency_room_flag","Emergency Room Flag","Medical"]
["Medical","Procedure Coding & Detail","MC-CORE044","procedure_modifier_code_id_1",null,null,"Claim Information","MC-XWLK004","medical_claim_header_id","Medical Claim Header Record ID","Medical"]
["Medical","Procedure Coding & Detail","MC-CORE045","procedure_modifier_code_1",null,null,"Provider Information","MC-PRV003","rendering_provider_id","Rendering Provider ID","Medical"]
["Medical","Procedure Coding & Detail","MC-CORE046","procedure_modifier_code_id_2",null,null,"Provider Information","MC-PRV005","billing_provider_id","Billing Provider Provider ID","Medical"]
["Medical","Procedure Coding & Detail","MC-CORE047","procedure_modifier_code_2",null,null,"Provider Information","MC-PRV007","attending_provider_id","Attending Provider Provider ID","Medical"]
["Medical","Procedure Coding & Detail","MC-CORE048","procedure_modifier_code_id_3",null,null,"Provider Information","MC-PRV011","referring_provider_id","Referring Provider ID","Medical"]
["Medical","Procedure Coding & Detail","MC-CORE049","procedure_modifier_code_3",null,null,"Administrative","MH-CORE001","medical_claim_header_id","Medical Claim Header Record ID","Medical Claim Header"]
["Medical","Procedure Coding & Detail","MC-CORE050","procedure_modifier_code_id_4",null,null,"Administrative","MH-CORE002","extract_id","Extract ID","Medical Claim Header"]
["Medical","Procedure Coding & Detail","MC-CORE051","procedure_modifier_code_4",null,null,"Payer Information","MH-CORE003","submitter_id ","Submitter ID","Medical Claim Header"]
["Medical","Procedure Coding & Detail","MC-CORE052","revenue_code_id",null,null,"Administrative","MH-CORE004","internal_member_id","Internal Member ID","Medical Claim Header"]
["Medical","Procedure Coding & Detail","MC-CORE053","revenue_code",null,null,"Safe Harbor Variable","MH-CORE007","first_service_dt","Date of Service (From)","Medical Claim Header"]
["Medical","Diagnosis Information","MC-CORE054","icd_version_ind",null,null,"Safe Harbor Variable","MH-CORE008","last_service_dt","Date of Service (Through)","Medical Claim Header"]
["Medical","Diagnosis Information","MC-CORE056","diagnosis_code",null,null,"Safe Harbor Variable","MH-CORE009","first_paid_dt","First Paid Date","Medical Claim Header"]
["Medical","Procedure Coding & Detail","MC-CORE058","icd_procedure_code",null,null,"Safe Harbor Variable","MH-CORE010","last_paid_dt","Last Paid Date","Medical Claim Header"]
["Medical","Enrollee Coverage Information","MC-CORE060","aid_category_code",null,null,"Financial Information","MH-CORE011","charge_amt_sum","Charge Amount","Medical Claim Header"]
["Medical","Claim Information","MC-CORE062","discharge_status_code",null,null,"Financial Information","MH-CORE012","paid_amt_sum","Paid Amount","Medical Claim Header"]
["Medical","Claim Information","MC-CORE063","orphaned_adjustment_flag",null,null,"Financial Information","MH-CORE013","prepaid_amt_sum","Prepaid Amount","Medical Claim Header"]
["Medical","Claim Information","MC-CORE064","denied_claim_flag",null,null,"Financial Information","MH-CORE014","copay_amt_sum","Copay Amount","Medical Claim Header"]
["Medical","Claim Information","MC-CORE065","emergency_room_flag",null,null,"Financial Information","MH-CORE015","coinsurance_amt_sum","Coinsurance Amount","Medical Claim Header"]
["Medical","Provider Information","MC-CORE066","provider_claim_identifier",null,null,"Financial Information","MH-CORE016","deductible_amt_sum","Deductible Amount","Medical Claim Header"]
["Medical","Claim Information","MC-XWLK004","medical_claim_header_id",null,null,"Financial Information","MH-CORE017","allowed_amt_total","Allowed Amount","Medical Claim Header"]
["Medical","Provider Information","MC-PRV004","rendering_internal_provider_id",null,null,"Financial Information","MH-CORE018","insurer_paid_amt_total","Insurer Paid Amount","Medical Claim Header"]
["Medical","Provider Information","MC-PRV008","attending_internal_provider_id",null,null,"Diagnosis Information","MH-CORE020","diagnosis_code","ICD Diagnosis Code","Medical Claim Header"]
["Medical","Provider Information","MC-PRV012","referring_internal_provider_id",null,null,"Diagnosis Information","MH-CORE021","icd_version_ind","ICD Version Indicator","Medical Claim Header"]
["Medical","Provider Information","MC-PRV006","billing_internal_provider_id",null,null,"Financial Information","MH-CORE022","header_status","Claim Status Code","Medical Claim Header"]
["Medical Claim Header","Administrative","MH-CORE001","medical_claim_header_id",null,null,"Financial Information","MH-CORE023","denied_header_flag","Denied Claim Flag","Medical Claim Header"]
["Medical Claim Header","Administrative","MH-CORE002","extract_id",null,null,"Financial Information","MH-CORE024","orphaned_header_flag","Orphaned Adjustment Flag","Medical Claim Header"]
["Medical Claim Header","Administrative","MH-CORE004","internal_member_id",null,null,"Claim Information","MH-CORE025","claim_type_id","Claim Type ID","Medical Claim Header"]
["Medical Claim Header","Provider Information","MH-CORE005","internal_provider_id",null,null,"Claim Information","MH-CORE026","type_of_setting_id","Type of Setting ID","Medical Claim Header"]
["Medical Claim Header","Safe Harbor Variable","MH-CORE007","first_service_dt",null,null,"Claim Information","MH-CORE027","place_of_setting_id","Place of Setting ID","Medical Claim Header"]
["Medical Claim Header","Safe Harbor Variable","MH-CORE008","last_service_dt",null,null,"Claim Information","MH-CORE028","type_of_bill_code","Type of Bill Code","Medical Claim Header"]
["Medical Claim Header","Safe Harbor Variable","MH-CORE009","first_paid_dt",null,null,"Administrative","IPDIS001","inpatient_discharge_id ","Inpatient Discharge Record ID","Medical Claim Header"]
["Medical Claim Header","Safe Harbor Variable","MH-CORE010","last_paid_dt",null,null,"Safe Harbor Variable","IPDIS007","admission_dt ","Admission Date","Medical Claim Header"]
["Medical Claim Header","Financial Information","MH-CORE011","charge_amt",null,null,"Safe Harbor Variable","IPDIS008","discharge_dt ","Discharge Date","Medical Claim Header"]
["Medical Claim Header","Financial Information","MH-CORE012","paid_amt",null,null,"Claim Information","IPDIS010","discharge_status_code","Discharge Status Code","Medical Claim Header"]
["Medical Claim Header","Financial Information","MH-CORE013","prepaid_amt",null,null,"Claim Information","IPDIS011","length_of_stay","Length of Stay","Medical Claim Header"]
["Medical Claim Header","Financial Information","MH-CORE014","copay_amt",null,null,"Diagnosis Information","IPDIS814","admit_diagnosis ","ICD Diagnosis Code ID Number – Admitting","Medical Claim Header"]
["Medical Claim Header","Financial Information","MH-CORE015","coinsurance_amt",null,null,"Administrative","MC-SUP001","medical_claim_service_line_id","Medical Claim Service-Line Record ID","Medical Supplemental"]
["Medical Claim Header","Financial Information","MH-CORE016","deductible_amt",null,null,"Administrative","MC-SUP002","extract_id","Extract ID","Medical Supplemental"]
["Medical Claim Header","Financial Information","MH-CORE017","allowed_amt",null,null,"Claim Information","MC-SUP005","admission_point_of_origin_code","Admission Point of Origin Code","Medical Supplemental"]
["Medical Claim Header","Financial Information","MH-CORE018","insurer_paid_amt",null,null,"Claim Information","MC-SUP007","admission_type","Admission Type Code","Medical Supplemental"]
["Medical Claim Header","Diagnosis Information","MH-CORE020","diagnosis_code",null,null,"Procedure Coding & Detail","MC-SUP010","national_drug_code","National Drug Code","Medical Supplemental"]
["Medical Claim Header","Diagnosis Information","MH-CORE021","icd_version_ind",null,null,"Financial Information","MC-SUP013","patient_total_out_pocket_amt","Patient Total Out-of-Pocket Amount","Medical Supplemental"]
["Medical Claim Header","Financial Information","MH-CORE022","header_status",null,null,"Financial Information","MC-SUP015","other_ins_paid_amt","Other Insurance Paid Amount","Medical Supplemental"]
["Medical Claim Header","Financial Information","MH-CORE023","denied_header_flag",null,null,"Financial Information","MC-SUP016","medicare_paid_amt","Medicare Paid Amount","Medical Supplemental"]
["Medical Claim Header","Financial Information","MH-CORE024","orphaned_header_flag",null,null,"Financial Information","MC-SUP018","excluded_expenses","Excluded Expenses","Medical Supplemental"]
["Medical Claim Header","Claim Information","MH-CORE026","type_of_setting_id",null,null,"Claim Information","MC-SUP025","claim_line_type_code","Claim Line Type Code","Medical Supplemental"]
["Medical Claim Header","Claim Information","MH-CORE027","place_of_setting_id",null,null,"Claim Information","MC-SUP026","capitated_encounter_flag","Capitated Encounter Indicator","Medical Supplemental"]
["Medical Claim Header","Claim Information","MH-CORE028","type_of_bill_code",null,null,"Claim Information","MC-SUP027","global_payment_ind_code","Global Payment Indicator Code","Medical Supplemental"]
["Medical Claim Header","Safe Harbor Variable","IPDIS007","admission_dt ",null,null,"Claim Information","MC-SUP028","medicare_indicator_code","Medicare Indicator Code","Medical Supplemental"]
["Medical Claim Header","Safe Harbor Variable","IPDIS008","discharge_dt ",null,null,"Claim Information","MC-SUP029","authorization_needed_code","Authorization Needed Code","Medical Supplemental"]
["Medical Claim Header","Claim Information","IPDIS010","discharge_status_code",null,null,"Claim Information","MC-SUP030","referral_indicator_code","Referral Indicator Code","Medical Supplemental"]
["Medical Claim Header","Claim Information","IPDIS011","length_of_stay",null,null,"Claim Information","MC-SUP031","accident_related_ind_code","Accident-Related Indicator Code","Medical Supplemental"]
["Medical Claim Header","Diagnosis Information","IPDIS014","admit_diagnosis_id ",null,null,"Claim Information","MC-SUP032","family_planning_ind_code","Family Planning Indicator Code","Medical Supplemental"]
["Medical Supplemental","Administrative","MC-SUP001","medical_claim_service_line_id",null,null,"Claim Information","MC-SUP033","employment_related_ind_code","Employment-Related Indicator Code","Medical Supplemental"]
["Medical Supplemental","Administrative","MC-SUP002","extract_id",null,null,"Claim Information","MC-SUP034","network_indicator_code","Network Indicator Code","Medical Supplemental"]
["Medical Supplemental","Claim Information","MC-SUP003","claim_version",null,null,"Provider Information","MC-SUP035","pcp_indicator_code","PCP Indicator Code","Medical Supplemental"]
["Medical Supplemental","Claim Information","MC-SUP005","admission_point_of_origin_code",null,null,"Claim Information","MC-SUP037","epsdt_indicator_code","EPSDT Indicator Code","Medical Supplemental"]
["Medical Supplemental","Claim Information","MC-SUP007","admission_type",null,null,"Claim Information","MC-SUP042","apcd_id_code","APCD ID Code","Medical Supplemental"]
["Medical Supplemental","Procedure Coding & Detail","MC-SUP010","national_drug_code",null,null,"Procedure Coding & Detail","MC-SUP047","apc","APC","Medical Supplemental"]
["Medical Supplemental","Financial Information","MC-SUP013","patient_total_out_pocket_amt",null,null,"Procedure Coding & Detail","MC-SUP048","apc_version","APC Version","Medical Supplemental"]
["Medical Supplemental","Financial Information","MC-SUP015","other_ins_paid_amt",null,null,"Procedure Coding & Detail","MC-SUP049","drg_payer_submitted","DRG","Medical Supplemental"]
["Medical Supplemental","Financial Information","MC-SUP016","medicare_paid_amt",null,null,"Procedure Coding & Detail","MC-SUP050","drg_payer_submitted_version","DRG Version","Medical Supplemental"]
["Medical Supplemental","Financial Information","MC-SUP018","excluded_expenses",null,null,"Administrative","MC-DIAG001","medical_claim_service_line_id","Medical Claim Service-Line Record ID","Medical Claim Diagnosis"]
["Medical Supplemental","Claim Information","MC-SUP021","denied_claim_line_ind_code",null,null,"Diagnosis Information","MC-DIAG002","medical_claim_diagnosis_order","Diagnosis Code - Reported Order","Medical Claim Diagnosis"]
["Medical Supplemental","Claim Information","MC-SUP025","claim_line_type_code",null,null,"Diagnosis Information","MC-DIAG003","diagnosis_type_id","Diagnosis Type ID","Medical Claim Diagnosis"]
["Medical Supplemental","Claim Information","MC-SUP026","capitated_encounter_flag",null,null,"Administrative","MC-DIAG004","extract_id","Extract ID","Medical Claim Diagnosis"]
["Medical Supplemental","Claim Information","MC-SUP027","global_payment_ind_code",null,null,"Diagnosis Information","MC-DIAG005","icd_version_ind","ICD Version Indicator","Medical Claim Diagnosis"]
["Medical Supplemental","Claim Information","MC-SUP028","medicare_indicator_code",null,null,"Diagnosis Information","MC-DIAG007","diagnosis_code","Diagnosis Code","Medical Claim Diagnosis"]
["Medical Supplemental","Claim Information","MC-SUP029","authorization_needed_code",null,null,"Diagnosis Information","MC-DIAG009","poa_diagnosis_ind_code","Present on Admission (POA) Indicator Code","Medical Claim Diagnosis"]
["Medical Supplemental","Claim Information","MC-SUP030","referral_indicator_code",null,null,"Administrative","MC-PROC001","medical_claim_service_line_id","Medical Claim Service-Line Record ID","Medical Claim Icd Procedure"]
["Medical Supplemental","Claim Information","MC-SUP031","accident_related_ind_code",null,null,"Procedure Coding & Detail","MC-PROC002","medical_claim_icd_proc_order","ICD Procedure Code - Reported Order","Medical Claim Icd Procedure"]
["Medical Supplemental","Claim Information","MC-SUP032","family_planning_ind_code",null,null,"Claim Information","MC-PROC003","extract_id","Extract ID","Medical Claim Icd Procedure"]
["Medical Supplemental","Claim Information","MC-SUP033","employment_related_ind_code",null,null,"Claim Information","MC-PROC004","icd_version_ind","ICD Version Indicator","Medical Claim Icd Procedure"]
["Medical Supplemental","Claim Information","MC-SUP034","network_indicator_code",null,null,"Claim Information","MC-PROC006","icd_procedure_code","ICD Procedure Code ","Medical Claim Icd Procedure"]
["Medical Supplemental","Provider Information","MC-SUP035","pcp_indicator_code",null,null,"Administrative","PC-CORE001","pharmacy_claim_service_line_id","Pharmacy Claim Record ID","Pharmacy"]
["Medical Supplemental","Claim Information","MC-SUP037","epsdt_indicator_code",null,null,"Administrative","PC-CORE002","extract_id","Extract ID","Pharmacy"]
["Medical Supplemental","Claim Information","MC-SUP042","apcd_id_code",null,null,"Claim Information","PC-CORE005","line_counter","Line Counter","Pharmacy"]
["Medical Supplemental","Procedure Coding & Detail","MC-SUP047","apc",null,null,"Administrative","PC-CORE007","internal_member_id ","Internal Member ID","Pharmacy"]
["Medical Supplemental","Procedure Coding & Detail","MC-SUP048","apc_version",null,null,"Payer Information","PC-CORE003","submitter_id ","Submitter ID","Pharmacy"]
["Medical Supplemental","Procedure Coding & Detail","MC-SUP049","drg_payer_submitted",null,null,"Enrollee Coverage Information","PC-CORE009","product_code","Insurance Type / Product Code","Pharmacy"]
["Medical Supplemental","Procedure Coding & Detail","MC-SUP050","drg_payer_submitted_version",null,null,"Enrollee Coverage Information","PC-CORE015","subscriber_relationship_code","Member’s Relationship Code","Pharmacy"]
["Medical Claim Diagnosis","Administrative","MC-DIAG001","medical_claim_service_line_id",null,null,"Enrollee Coverage Information","PC-CORE017","aid_category_code","Aid Category Code","Pharmacy"]
["Medical Claim Diagnosis","Diagnosis Information","MC-DIAG002","medical_claim_diagnosis_order",null,null,"Safe Harbor Variable","PC-CORE018","prescription_filled_dt ","Date Prescription Filled","Pharmacy"]
["Medical Claim Diagnosis","Diagnosis Information","MC-DIAG003","diagnosis_type_id",null,null,"Safe Harbor Variable","PC-CORE019","first_paid_dt ","First Paid Date","Pharmacy"]
["Medical Claim Diagnosis","Administrative","MC-DIAG004","extract_id",null,null,"Safe Harbor Variable","PC-CORE020","last_paid_dt ","Last Paid Date","Pharmacy"]
["Medical Claim Diagnosis","Diagnosis Information","MC-DIAG005","icd_version_ind",null,null,"Procedure Coding & Detail","PC-CORE021","national_drug_code","National Drug Code","Pharmacy"]
["Medical Claim Diagnosis","Diagnosis Information","MC-DIAG007","diagnosis_code",null,null,"Procedure Coding & Detail","PC-CORE022","drug_name","Drug Name","Pharmacy"]
["Medical Claim Diagnosis","Diagnosis Information","MC-DIAG009","poa_diagnosis_ind_code",null,null,"Claim Information","PC-CORE023","refill_number","New Prescription or Refill","Pharmacy"]
["Medical Claim Icd Procedure","Administrative","MC-PROC001","medical_claim_service_line_id",null,null,"Claim Information","PC-CORE024","quantity","Quantity Dispensed","Pharmacy"]
["Medical Claim Icd Procedure","Procedure Coding & Detail","MC-PROC002","medical_claim_icd_proc_order",null,null,"Claim Information","PC-CORE025","days_supply","Days’ Supply","Pharmacy"]
["Medical Claim Icd Procedure","Claim Information","MC-PROC003","extract_id",null,null,"Claim Information","PC-CORE026","thirty_day_equivalent","Thirty-Day Equivalency","Pharmacy"]
["Medical Claim Icd Procedure","Claim Information","MC-PROC004","icd_version_ind",null,null,"Financial Information","PC-CORE027","charge_amt","Charge Amount","Pharmacy"]
["Medical Claim Icd Procedure","Claim Information","MC-PROC006","icd_procedure_code",null,null,"Financial Information","PC-CORE028","paid_amt","Paid Amount","Pharmacy"]
["Pharmacy","Administrative","PC-CORE001","pharmacy_claim_service_line_id",null,null,"Financial Information","PC-CORE029","copay_amt","Copay Amount","Pharmacy"]
["Pharmacy","Administrative","PC-CORE002","extract_id",null,null,"Financial Information","PC-CORE030","coinsurance_amt","Coinsurance Amount","Pharmacy"]
["Pharmacy","Claim Information","PC-CORE005","line_counter",null,null,"Financial Information","PC-CORE031","deductible_amt","Deductible Amount","Pharmacy"]
["Pharmacy","Administrative","PC-CORE007","internal_member_id ",null,null,"Financial Information","PC-CORE032","dispensing_fee","Dispensing Fee","Pharmacy"]
["Pharmacy","Enrollee Coverage Information","PC-CORE009","product_code",null,null,"Financial Information","PC-CORE033","ingredient_cost","Ingredient Cost / List Price","Pharmacy"]
["Pharmacy","Enrollee Coverage Information","PC-CORE015","subscriber_relationship_code",null,null,"Financial Information","PC-CORE034","postage_cost","Postage Amount Claimed","Pharmacy"]
["Pharmacy","Enrollee Coverage Information","PC-CORE017","aid_category_code",null,null,"Financial Information","PC-CORE036","claim_status_code","Claim Status Code","Pharmacy"]
["Pharmacy","Safe Harbor Variable","PC-CORE018","prescription_filled_dt ",null,null,"Claim Information","PC-CORE037","denied_claim_flag","Denied Claim Flag","Pharmacy"]
["Pharmacy","Safe Harbor Variable","PC-CORE019","first_paid_dt ",null,null,"Claim Information","PC-CORE039","generic_drug_ind_code","Generic Drug Indicator Code","Pharmacy"]
["Pharmacy","Safe Harbor Variable","PC-CORE020","last_paid_dt ",null,null,"Claim Information","PC-CORE041","compound_drug_code","Compound Drug Indicator Code","Pharmacy"]
["Pharmacy","Procedure Coding & Detail","PC-CORE021","national_drug_code",null,null,"Claim Information","PC-CORE043","dispense_as_written_code","Dispense as Written Code","Pharmacy"]
["Pharmacy","Procedure Coding & Detail","PC-CORE022","drug_name",null,null,"Claim Information","PC-CORE044","orphaned_adjustment_flag","Orphaned Adjustment Flag","Pharmacy"]
["Pharmacy","Claim Information","PC-CORE023","refill_number",null,null,"Claim Information","PC-CORE045","medicare_part_d_duplicate_flag","Medicare Part D Duplicate Flag","Pharmacy"]
["Pharmacy","Claim Information","PC-CORE024","quantity",null,null,"Provider Information","PC-PRV003","pharmacy_provider_id","Pharmacy Provider ID","Pharmacy"]
["Pharmacy","Claim Information","PC-CORE025","days_supply",null,null,"Provider Information","PC-PRV006","prscrbing_provider_id","Prescribing Provider ID","Pharmacy"]
["Pharmacy","Claim Information","PC-CORE026","thirty_day_equivalent",null,null,"Administrative","PC-SUP001","pharmacy_claim_service_line_id","Pharmacy Claim Record ID","Pharmacy Supplemental"]
["Pharmacy","Financial Information","PC-CORE027","charge_amt",null,null,"Administrative","PC-SUP002","extract_id","Extract ID","Pharmacy Supplemental"]
["Pharmacy","Financial Information","PC-CORE028","paid_amt",null,null,"Claim Information","PC-SUP005","drug_source_ind_code","Drug Source Indicator Code","Pharmacy Supplemental"]
["Pharmacy","Financial Information","PC-CORE029","copay_amt",null,null,"Safe Harbor Variable","PC-SUP006","prescription_written_dt","Prescription Written Date","Pharmacy Supplemental"]
["Pharmacy","Financial Information","PC-CORE030","coinsurance_amt",null,null,"Financial Information","PC-SUP009","medicare_paid_amt","Medicare Paid Amount","Pharmacy Supplemental"]
["Pharmacy","Financial Information","PC-CORE031","deductible_amt",null,null,"Financial Information","PC-SUP010","patient_pay_amt","Patient Pay Amount","Pharmacy Supplemental"]
["Pharmacy","Financial Information","PC-CORE032","dispensing_fee",null,null,"Financial Information","PC-SUP012","state_sales_tax","State Sales Tax","Pharmacy Supplemental"]
["Pharmacy","Financial Information","PC-CORE033","ingredient_cost",null,null,"Financial Information","PC-SUP013","rebate_indicator_code","Rebate Indicator Code","Pharmacy Supplemental"]
["Pharmacy","Financial Information","PC-CORE034","postage_cost",null,null,"Claim Information","PC-SUP014","formulary_code","Formulary Code","Pharmacy Supplemental"]
["Pharmacy","Financial Information","PC-CORE036","claim_status_code",null,null,"Claim Information","PC-SUP016","drug_administration_route_code","Drug Administration Route Code","Pharmacy Supplemental"]
["Pharmacy","Claim Information","PC-CORE037","denied_claim_flag",null,null,"Claim Information","PC-SUP018","drug_unit_of_measure","Drug Unit of Measurement","Pharmacy Supplemental"]
["Pharmacy","Claim Information","PC-CORE039","generic_drug_ind_code",null,null,"Claim Information","PC-SUP022","medicare_pmt_applied_ind_code","Medicare Payment Applied Indicator Code","Pharmacy Supplemental"]
["Pharmacy","Claim Information","PC-CORE041","compound_drug_code",null,null,"Claim Information","PC-SUP023","pregnancy_indicator_code","Pregnancy Indicator Code","Pharmacy Supplemental"]
["Pharmacy","Claim Information","PC-CORE043","dispense_as_written_code",null,null,"Claim Information","PC-SUP028","apcd_id_code","APCD ID Code","Pharmacy Supplemental"]
["Pharmacy","Claim Information","PC-CORE044","orphaned_adjustment_flag",null,null,"Claim Information","PC-SUP030","pharmacy_mail_order_code","Mail-Order Pharmacy Code","Pharmacy Supplemental"]
["Pharmacy","Claim Information","PC-CORE045","medicare_part_d_duplicate_flag",null,null,"Administrative","PRV-CORE001","provider_id ","Provider ID","Provider"]
["Pharmacy","Provider Information","PC-PRV004","pharmacy_internal_provider_id",null,null,"Administrative","PRV-MAST001","internal_provider_id ","Internal Provider ID","Provider"]
["Pharmacy","Provider Information","PC-PRV006","prscrbing_internal_provider_id",null,null,"Payer Information","PRV-CORE003","submitter_id ","Submitter ID","Provider"]
["Pharmacy Supplemental","Administrative","PC-SUP001","pharmacy_claim_service_line_id",null,null,"Administrative","PRV-MAST002","extract_id","Extract ID","Provider"]
["Pharmacy Supplemental","Administrative","PC-SUP002","extract_id",null,null,"Provider Information","PRV-CORE014","orig_npi","Provider NPI","Provider"]
["Pharmacy Supplemental","Claim Information","PC-SUP003","prescription_id",null,null,"Provider Information","PRV-MAST017","npi","Provider NPI","Provider"]
["Pharmacy Supplemental","Claim Information","PC-SUP005","drug_source_ind_code"]
["Pharmacy Supplemental","Safe Harbor Variable","PC-SUP006","prescription_written_dt"]
["Pharmacy Supplemental","Financial Information","PC-SUP008","other_insurance_paid_amt"]
["Pharmacy Supplemental","Financial Information","PC-SUP009","medicare_paid_amt"]
["Pharmacy Supplemental","Financial Information","PC-SUP010","patient_pay_amt"]
["Pharmacy Supplemental","Financial Information","PC-SUP011","allowed_amt"]
["Pharmacy Supplemental","Financial Information","PC-SUP012","state_sales_tax"]
["Pharmacy Supplemental","Financial Information","PC-SUP013","rebate_indicator_code"]
["Pharmacy Supplemental","Claim Information","PC-SUP014","formulary_code"]
["Pharmacy Supplemental","Claim Information","PC-SUP016","drug_administration_route_code"]
["Pharmacy Supplemental","Claim Information","PC-SUP017","drug_unit_of_measure_id"]
["Pharmacy Supplemental","Claim Information","PC-SUP018","drug_unit_of_measure"]
["Pharmacy Supplemental","Claim Information","PC-SUP020","claim_line_type_code"]
["Pharmacy Supplemental","Claim Information","PC-SUP022","medicare_pmt_applied_ind_code"]
["Pharmacy Supplemental","Claim Information","PC-SUP023","pregnancy_indicator_code"]
["Pharmacy Supplemental","Claim Information","PC-SUP024","denied_claim_line_ind_code"]
["Pharmacy Supplemental","Claim Information","PC-SUP026","denied_claim_line_reason_code"]
["Pharmacy Supplemental","Claim Information","PC-SUP028","apcd_id_code"]
["Pharmacy Supplemental","Claim Information","PC-SUP030","pharmacy_mail_order_code"]
["Provider","Administrative","PRV-MAST001","internal_provider_id "]
["Provider","Administrative","PRV-MAST002","extract_id"]
["Provider","Provider Information","PRV-MAST017","npi"]

{"sheet":"Request Sheet","index":4,"n_rows":50,"n_cols":3,"rows_kept":50,"cut":false,"hidden":false,"merged":[[0,0,0,10],[25,2,25,10],[2,2,2,10],[3,2,3,10],[4,2,4,10],[5,2,5,10],[18,2,18,10],[19,2,19,10],[20,2,20,10],[21,2,21,10],[22,2,22,10],[23,2,23,10],[12,2,12,10],[17,2,17,10],[16,2,16,10],[15,2,15,10],[11,2,11,10],[6,2,6,10],[7,2,7,10],[8,2,8,10],[9,2,9,10],[10,2,10,10],[30,2,30,10],[31,2,31,10],[32,2,32,10],[33,2,33,10],[24,2,24,10],[45,2,45,10],[46,2,46,10],[28,0,28,10],[48,2,48,10],[49,2,49,10],[39,2,39,10],[41,2,41,10],[42,2,42,10],[43,2,43,10],[44,2,44,10],[34,2,34,10],[35,2,35,10],[36,2,36,10],[37,2,37,10],[38,2,38,10],[29,2,29,10]]}
["CT APCD Data Release -  Table & Field Requests"]
[]
["Table Name","1) Please Indicate Which Tables Will Be Needed","Reason"]
["Eligibility"]
["Eligibility Supplemental"]
["Medical"]
["Medical Claim Header"]
["Medical Supplemental"]
["Medical Claim Diagnosis"]
["Medical Claim Icd Procedure"]
["Pharmacy"]
["Pharmacy Supplemental"]
["Provider"]
[]
[]
["Variable Classes","2) Please Indicate Which Variable Classes Will Be Needed","Reason"]
["Administrative"]
["Enrollee Coverage Information"]
["Enrollee Demographics"]
["Claim Information"]
["Diagnosis Information"]
["Procedure Coding & Detail"]
["Financial Information"]
["Provider Information"]
["Payer Information"]
["Safe Harbor Variable"]
[]
[]
["Data sets & Filters  – each type of data set will have one standard format unless the requestor wants to customize it further at additional cost "]
["Dataset/Common Filters","3) Data Set/Filter","Indicate Data set and/or Filter For Data Extract (Provide as much detail as possible)"]
["Eligibility","Data Set"]
["Medical Claims","Data Set"]
["Pharmacy Claims","Data Set"]
["Inpatient Discharge","Data Set"]
["ED Visits","Data Set"]
["Outpatient ","Data Set"]
["Professional ","Data Set"]
[]
["Eligibility Dates","Eligibility"]
["Members’ Age","Eligibility"]
["Members' Gender","Eligibility"]
["Zip Codes","Eligibility"]
["Inpatient Admissions","Medical"]
["Procedures Codes (ICD/CPT/HCPCS)","Medical"]
["Service Dates","Medical"]
["Diagnoses Codes (ICD)","Medical"]
["Medications (NDCs)","Pharmacy"]
["Prescription Filled Date","Pharmacy"]
["Taxonomy codes","Provider"]
["Add rows for others"]

{"sheet":"eligibility","index":5,"n_rows":22,"n_cols":9,"rows_kept":22,"cut":false,"hidden":false,"merged":[]}
["Classification","ID","Warehouse Name","Common Name","Type","Length","Description","Origin","Notes"]
["Administrative","EL-CORE001","eligibility_id ","Eligibility Record ID","Number","38,0","This field contains an ID that identifies a unique eligibility record.","This is a value-added field created by Onpoint. "]
["Administrative","EL-CORE002","extract_id","Extract ID","Number","38,0","This field contains an ID that identifies the unique consolidated data set.","This is a value-added field created by Onpoint. "]
["Enrollee Coverage Information","EL-CORE005","coverage_class","Coverage Class","Varchar2",10,"This field identifies the type of coverage for the member during the reported period. ","This field is supplied as reported to Onpoint by the submitter."]
["Enrollee Coverage Information","EL-CORE007","internal_member_id ","Internal Member ID","Number","38,0","This field contains an ID that represents a unique member.","This is a value-added field created by Onpoint. ","This field can be used to aggregate all records associated with a member."]
["Enrollee Coverage Information","EL-CORE009","subscriber_relationship_code","Member’s Relationship Code","Varchar2",10,"This field contains a code that indicates the member’s relationship to the subscriber or the insured.","This field is supplied as reported to Onpoint by the submitter.","Valid codes and descriptions are maintained by the Accredited Standards Committee (ASC)."]
["Payer Information","EL-CORE003","submitter_id ","Submitter ID","Number","38,0","This field contains an ID that uniquely identifies a submitter.","This is a value-added field created by Onpoint."]
["Enrollee Coverage Information","EL-CORE011","product_code","Insurance Type / Product Code","Varchar2",20,"This field contains a code that identifies the member’s type of insurance or insurance product.","This field is supplied as reported to Onpoint by the submitter.","Valid codes and descriptions are maintained by the Accredited Standards Committee (ASC). Client-defined codes and descriptions, if submitted, are supplied to Onpoint for supplementary reporting."]
["Enrollee Coverage Information","EL-CORE013","primary_insurance_ind_code","Primary Insurance Indicator Code","Varchar2",20,"This field contains a code that indicates if the member has primary coverage or instead has secondary/tertiary coverage. ","This field is supplied as reported to Onpoint by the submitter."]
["Safe Harbor Variable","EL-CORE018","eligibility_start_dt ","Member Coverage Start Date","Date",8,"This field identifies the first date of the member’s insurance coverage within this reporting period.","This is a value-added field created by Onpoint. ","Masking applied to prevent disclosure of actual date."]
["Safe Harbor Variable","EL-CORE019","eligibility_end_dt ","Member Coverage End Date","Date",8,"This field identifies the last date of the member’s insurance coverage.","This is a value-added field created by Onpoint. ","Masking applied to prevent disclosure of actual date."]
["Enrollee Coverage Information","EL-CORE020","full_medicaid_coverage_flag","Full Medicaid Coverage Flag","Varchar2",1,"This field contains a code that identifies whether or not a member had full Medicaid coverage for the reported membership month. ","This field is supplied as reported to Onpoint by the submitter."]
["Enrollee Coverage Information","EL-CORE022","aid_category_code","Aid Category Code","Varchar2",20,"This field contains a code that identifies the member’s Medicaid aid category based on eligibility date.","This field is supplied as reported to Onpoint by the submitter."]
["Enrollee Coverage Information","EL-CORE028","dual_eligibility_code","Dual-Eligibility Code","Varchar2",10,"This field contains a code that identifies the member’s dual coverage based on eligibility date.","This field is supplied as reported to Onpoint by the submitter.","This field is currently null; however, with the collection of Medicare it will be populated. "]
["Enrollee Coverage Information","EL-CORE032","coverage_level_code","Coverage Level Code","Varchar2",20,"This field contains a code that identifies the member’s coverage level based on eligibility date.","This field is supplied as reported to Onpoint by the submitter."]
["Enrollee Coverage Information","EL-CORE034","coverage_type_code","Coverage Type Code","Varchar2",20,"This field contains a code that identifies the member’s coverage type based on eligibility date.","This field is supplied as reported to Onpoint by the submitter."]
["Financial Information","EL-CORE035","member_deductible_amt","Member Deductible Amount","Number","38,2","This field contains the member's annual deductible amount.","This field is supplied as reported to Onpoint by the submitter."]
["Safe Harbor Variable","MEM-CORE006","zip","Member ZIP/Postal Code","Varchar2",20,"This field identifies the ZIP/postal code associated with the member’s residence.","This field is supplied as reported to Onpoint by the submitter.","First three digits of zip codes only if the geographic area covered by all zip codes beginning with those three digits has a population greater than 20,000 or the zip codes for those areas are changed to 000 in the data set. \n"]
["Safe Harbor Variable","MEM-CORE008","birth_dt","Member's Date of Birth","Number",6,"This field contains the member's date of birth in 'YYYY' format.","This field is supplied as reported to Onpoint by the submitter.","Month and day of birthdate not available. Any birth dates less than 1 year or greater than 89 years will be assigned a default year. "]
["Enrollee Demographics","EL-CORE014","gender_code","Gender Code","Varchar2",1,"This field contains a code that indicates the member’s gender.","This field is supplied as reported to Onpoint by the submitter."]
["Enrollee Coverage Information","MEM-CORE012","subscriber_internal_member_id","Subscriber Internal Member ID","Number","38,0","This field contains an ID that represents a unique subscriber.","This is a value-added field created by Onpoint. ","This field can be used to aggregate all records associated with a subscriber."]
["Provider Information","EL-PRV003","pcp_provider_id","Provider Information","Number","38,0","This field contains an ID that identifies a unique combination of reported information for a primary care provider (PCP).","This is a value-added field created by Onpoint. ","When using this field to link between tables, your query must set pcp_provider_id equal to provider_id."]

{"sheet":"eligibility_supplemental","index":6,"n_rows":29,"n_cols":9,"rows_kept":29,"cut":false,"hidden":false,"merged":[]}
["Classification","ID","Warehouse Name","Common Name","Type","Length","Description","Origin","Notes"]
["Administrative","EL-SUP001","eligibility_id  ","Eligibility Record ID","Number","38,0","This field contains an ID that identifies a unique eligibility record.","This is a value-added field created by Onpoint. "]
["Administrative","EL-SUP002","extract_id","Extract ID","Number","38,0","This field contains an ID for the consolidated data set.","This is a value-added field created by Onpoint. "]
["Enrollee Coverage Information","EL-SUP007","health_care_home_assigned_flag","PCMH Assigned Flag","Varchar2",10,"This field contains a code that indicates whether or not the member had an approved medical home for the reported coverage period.\nValid codes include: \n\n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint by the submitter using collection field ME035 (Medical Home Indicator)."]
["Enrollee Coverage Information","EL-SUP008","purchased_through_exchange","Purchased Through Exchange Indicator Description","Varchar2",100,"This field indicate whether or not the member’s product was purchased through the state’s health insurance exchange.\n\nValid codes include: \n\n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint by the submitter using collection field ME045 (Purchased Through Access Health CT Indicator). "]
["Enrollee Coverage Information","EL-SUP010","exchange_metallic_tier_code","Exchange Metallic Tier Code","Varchar2",20,"This field contains a code that indicates the level of the member’s Exchange product.","This field is supplied as reported to Onpoint by the submitter using collection field ME121 (Metal Level)."]
["Enrollee Coverage Information","EL-SUP012","market_category_code","Market Category Code ","Varchar2",4,"This field contains a code that indicates the type of policy sold by the insurer.","This field is supplied as reported to Onpoint by the submitter using collection field ME030 (Market Category Code)."]
["Financial Information","EL-SUP015","dental_deductible_amt","Dental Deductible Amount","Decimal","10,2","This field identifies the maximum amount of the member’s deductible that is applied to dental services before dental services are covered","This field is supplied as reported to Onpoint using collection field ME115 (Dental Deductible)."]
["Financial Information","EL-SUP016","vision_deductible_amt","Vision Deductible Amount","Decimal","10,2","This field identifies the maximum amount of the member’s deductible that is applied to vision services before vision services are covered","This field is supplied as reported to Onpoint using collection field ME116 (Vision Deductible)."]
["Financial Information","EL-SUP017","total_monthly_premium_amt","Total Monthly Premium Amount","Decimal","10,2","This field identifies the total monthly premium at the subscriber level. ","This field is supplied as reported to Onpoint using collection field ME132 (Total Monthly Premium)."]
["Enrollee Coverage Information","EL-SUP019","disease_management_ind_code","Disease Management Indicator Code","Varchar2",10,"This field contains a code that indicates whether or not the member was enrolled in a disease management program.\n \nValid codes include: \n\n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint using collection field ME053 (Disease Management Enrollee Indicator)."]
["Enrollee Coverage Information","EL-SUP021","business_type_code","Business Type Code","Varchar2",10,"This field contains a code that defines the submitter’s line of business for this line of eligibility. ","This field is supplied as reported to Onpoint using collection field ME055 (Business Type Code)."]
["Enrollee Demographics","EL-SUP022","disability_indicator_code","Disability Indicator Code","Varchar2",10,"This field contains a code that indicates whether or not disability applied to this record. \n\nValid codes include: \n\n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint using collection field ME059 (Disability Indicator)."]
["Enrollee Demographics","EL-SUP024","employment_status_code","Employment Status Code","Varchar2",10,"This field contains a code that defines the employment status of the subscriber. ","This field is supplied as reported to Onpoint using collection field ME060 (Employment Status)."]
["Enrollee Demographics","EL-SUP025","student_status_ind_code","Student Status Indicator Code","Varchar2",10,"This field contains a code that indicates whether or not the member was a student. \n\nValid codes include: \n\n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint using collection field ME061 (Student Status Flag)."]
["Enrollee Demographics","EL-SUP027","marital_status_code","Marital Status Code","Varchar2",10,"This field contains a code that indicates the member's marital status. ","This field is supplied as reported to Onpoint using collection field ME062 (Marital Status)."]
["Enrollee Coverage Information","EL-SUP029","benefit_status_code","Benefit Status Code","Varchar2",10,"This field contains a code that indicates the status of the benefits for the member. ","This field is supplied as reported to Onpoint using collection field ME063 (Benefit Status)."]
["Enrollee Demographics","EL-SUP031","employee_type_code","Employee Type Code","Varchar2",10,"This field contains a code that defines the subscriber’s type of employment. ","This field is supplied as reported to Onpoint using collection field ME064 (Employee Type)."]
["Enrollee Coverage Information","EL-SUP032","cobra_status_ind_code","COBRA Status Indicator Code","Varchar2",10,"This field contains a code that indicates whether or not the member was covered using COBRA benefits. \n\nValid codes include: \n\n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint using collection field ME066 (COBRA Status Indicator)."]
["Enrollee Demographics","EL-SUP034","pool_indicator_code","Pool Indicator Code","Varchar2",10,"This field contains a code that defines an employee attribute. ","This field is supplied as reported to Onpoint using collection field ME071 (Pool Indicator Code)."]
["Enrollee Coverage Information","EL-SUP035","full_coverage_code","Full Coverage Code","Varchar2",10,"This field contains a code that indicates whether or not the member was fully insured. \n\nValid codes include: \n\n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint using collection field ME073 (Fully Insured Member Indicator)."]
["Enrollee Demographics","EL-SUP036","interpreter_indicator_code","Interpreter Indicator Code","Varchar2",10,"This field contains a code that indicates whether or not the member required the assistance of an interpreter. \n\nValid codes include: \n\n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint using collection field ME074 (Interpreter Indicator)."]
["Enrollee Coverage Information","EL-SUP038","medicare_plan_code","Medicare Plan Code","Varchar2",10,"This field contains a code that indicates what type of Medicare coverage applied to this line of eligibility (if applicable). ","This field is supplied as reported to Onpoint using collection field ME001 (Medicare Code)."]
["Enrollee Coverage Information","EL-SUP039","actuarial_value","Actuarial Value","Varchar2",10,"This field identifies the actuarial value for the member’s coverage for the time period indicated by enrollment start and end dates. Note that this field contains a number with a decimal point, but is stored as a Varchar2 to preserve any leading zeros.","This field is supplied as reported to Onpoint using collection field ME120 (Actuarial Value)."]
["Enrollee Coverage Information","EL-SUP040","vision_benefit_ind_code","Vision Benefit Indicator Code","Varchar2",10,"This field contains a code that indicates whether or not the member’s plan included vision coverage.\n\nValid codes include: \n\n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint using collection field ME118 (Vision Benefit Indicator)."]
["Enrollee Coverage Information","EL-SUP041","risk_adjustment_plan_ind_code","Risk-Adjustment Plan Indicator Code","Varchar2",10,"This field contains a code that indicates whether or not the subscriber was enrolled with a non-grandfathered individual or small group plan underwritten and filed in the State of Connecticut as of the 15th of the month. Note that large group plans, self-insured plans, and plans underwritten and filed in states other than Connecticut are not subject to risk-adjustment algorithms.\n\nValid codes include: \n\n1 = Yes\n2 = No","This field is supplied as reported to Onpoint using collection field ME126 (Risk-Adjustment Covered Plan (RACP))."]
["Financial Information","EL-SUP042","billable_member_ind_code","Billable Member Indicator Code","Varchar2",10,"This field contains a code that indicates whether or not the member was billable. \n\nValid codes include: \n\n1 = Yes\n2 = No","This field is supplied as reported to Onpoint using collection field ME127 (Billable Member Flag)."]
["Enrollee Demographics","EL-SUP044","apcd_id_code","APCD ID Code","Varchar2",10,"This field contains a code that describes the subscriber’s/member’s enrollment as one of multiple predefined categories, aligning enrollment to appropriate validations and thresholds. ","This field is supplied as reported to Onpoint using collection field ME134 (APCD ID Code)."]
["Enrollee Demographics","EL-SUP045","naics_code","Member NAICS Code","Varchar2",6,"This field contains the North American Industry Classification System (NAICS) code that describes the industry of the subscriber and/or member.","This field is supplied as reported to Onpoint using collection field ME077 (NAICS Code)."]

{"sheet":"medical","index":7,"n_rows":47,"n_cols":9,"rows_kept":47,"cut":false,"hidden":false,"merged":[]}
["Classification","ID","Warehouse Name","Common Name","Type","Length","Description","Origin","Notes"]
["Administrative","MC-CORE001","medical_claim_service_line_id","Medical Claim Service-Line Record ID","Number","38,0","This field contains an ID that identifies a unique service line of a submitted claim record.","This is a value-added field created by Onpoint. "]
["Administrative","MC-CORE002","extract_id","Extract ID","Number","38,0","This field contains an ID that identifies the unique consolidated data set.","This is a value-added field created by Onpoint. "]
["Payer Information","MC-CORE003","submitter_id ","Submitter ID","Number","38,0","This field contains an ID that uniquely identifies a submitter.","This is a value-added field created by Onpoint."]
["Enrollee Coverage Information","MC-CORE005","product_code","Insurance Type / Product Code","Varchar2",20,"This field contains a code that identifies the member’s type of insurance or insurance product.","This field is supplied as reported to Onpoint by the submitter.","Valid codes and descriptions are maintained by the Accredited Standards Committee (ASC). Client-defined codes and descriptions, if submitted, are supplied to Onpoint for supplementary reporting."]
["Claim Information","MC-CORE007","line_counter","Line Counter","Number","38,0","This field contains the line number for this service.","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","MC-CORE009","internal_member_id ","Internal Member ID","Number","38,0","This field contains an ID that represents a unique member.","This is a value-added field created by Onpoint. ","This field can be used to aggregate all records associated with a member."]
["Enrollee Coverage Information","MC-CORE011","subscriber_relationship_code","Member’s Relationship Code","Varchar2",10,"This field contains a code that indicates the member’s relationship to the subscriber or the insured.","This field is supplied as reported to Onpoint by the submitter.","Valid codes and descriptions are maintained by the Accredited Standards Committee (ASC)."]
["Safe Harbor Variable","MC-CORE016","first_paid_dt","First Paid Date","Date",8,"This field identifies the first payment date for the rendered service.","This is a value-added field created by Onpoint. ","Masking applied to prevent disclosure of actual date."]
["Safe Harbor Variable","MC-CORE017","last_paid_dt","Last Paid Date","Date",8,"This field identifies the last payment date for the rendered service.","This is a value-added field created by Onpoint. ","Masking applied to prevent disclosure of actual date."]
["Safe Harbor Variable","MC-CORE018","first_service_dt","Date of Service (From)","Date",8,"This field identifies the first date of service for this service line.","This field is supplied as reported to Onpoint by the submitter.","Masking applied to prevent disclosure of actual date."]
["Safe Harbor Variable","MC-CORE019","last_service_dt","Date of Service (Through)","Date",8,"This field identifies the last date of service for this service line.","This field is supplied as reported to Onpoint by the submitter.","Masking applied to prevent disclosure of actual date."]
["Safe Harbor Variable","MC-CORE020","admission_dt ","Admission Date","Date",8,"This field provides the date of the inpatient admission.","This field is supplied as reported to Onpoint by the submitter.","Masking applied to prevent disclosure of actual date."]
["Safe Harbor Variable","MC-CORE021","discharge_dt ","Discharge Date","Date",8,"This field identifies the discharge date of the patient from inpatient care.","This field is supplied as reported to Onpoint by the submitter.","Masking applied to prevent disclosure of actual date."]
["Claim Information","MC-CORE023","place_of_service_code","Place of Service Code","Varchar2",2,"This field contains a code that indicates the type of site where the service was performed.","This field is supplied as reported to Onpoint by the submitter.","This field is required for professional claims but set to null for institutional claims."]
["Claim Information","MC-CORE025","type_of_bill_code","Type of Bill Code","Varchar2",4,"This field contains a code that identifies the reported type of bill.","This field is supplied as reported to Onpoint by the submitter.","Valid codes and descriptions are maintained by the National Uniform Billing Committee (NUBC). This field is required for institutional claims but set to null for professional claims."]
["Claim Information","MC-CORE026","claim_type_id","Claim Type ID","Number","38,0","This field identifies an ID for the type of claim (e.g., facility, professional, etc.) used to report this service line.","This is a value-added field created by Onpoint.","See Reference Tables"]
["Claim Information","MC-CORE027","type_of_setting_id","Type of Setting ID","Number","38,0","This field provides additional granularity regarding the type of claim (e.g., inpatient, outpatient, provider, lab, etc.).","This is a value-added field created by Onpoint.","See Reference Tables"]
["Claim Information","MC-CORE028","place_of_setting_id","Place of Setting ID","Number","38,0","This field identifies the setting in which the care was rendered (e.g., hospital, swing bed, skilled nursing facility, etc.).","This is a value-added field created by Onpoint. ","This field is based on the reported Type of Bill Code (type_of_bill_code) in the medical claims data. This field is applicable only to facility claims. See Reference Tables."]
["Financial Information","MC-CORE030","quantity","Quantity","Decimal","38,2","This field contains a count of performed services.","This field is supplied as reported to Onpoint by the submitter.","This field may be negative. This field must be used with caution because the type of units may vary based upon the service performed. For example, one anesthesia unit may equal 10 minutes, while one ambulance transportation unit may equal one mile."]
["Financial Information","MC-CORE031","charge_amt","Charge Amount","Decimal","38,2","This field identifies the total charges for the service.","This field is supplied as reported to Onpoint by the submitter.","This is a money field containing dollars and cents. This field may contain a negative value."]
["Financial Information","MC-CORE032","paid_amt","Paid Amount","Decimal","38,2","This field identifies the total dollar amount paid to the provider, including all health plan payments and excluding all member payments and withholds from providers.","This field is supplied as reported to Onpoint by the submitter.","This is a money field containing dollars and cents. This field may contain a negative value."]
["Financial Information","MC-CORE033","copay_amt","Copay Amount","Decimal","38,2","This field identifies the preset, fixed dollar amount payable by a member, often on a per visit/service basis.","This field is supplied as reported to Onpoint by the submitter.","This is a money field containing dollars and cents. This field may contain a negative value."]
["Financial Information","MC-CORE034","coinsurance_amt","Coinsurance Amount","Decimal","38,2","This field identifies the dollar amount that a member must pay toward the cost of a covered service, which is often a percentage of total cost.","This field is supplied as reported to Onpoint by the submitter."]
["Financial Information","MC-CORE035","deductible_amt","Deductible Amount","Decimal","38,2","This field identifies the dollar amount that a member must pay before the health plan benefits will begin to reimburse for services.","This field is supplied as reported to Onpoint by the submitter.","This is a money field containing dollars and cents. This field may contain a negative value."]
["Financial Information","MC-CORE037","payment_arrangement_ind_code","Payment Arrangement Indicator Code","Varchar2",20,"This field contains a code that identifies the payment arrangement under which this service line was processed.","This field is supplied as reported to Onpoint by the submitter."]
["Financial Information","MC-CORE039","prepaid_amt","Prepaid Amount","Decimal","38,2","This field identifies the fee-for-service equivalent that would have been paid by the healthcare claims processor for a specific service if the service had not been capitated. ","This field is supplied as reported to Onpoint by the submitter.","This is a money field containing dollars and cents. This field may contain a negative value."]
["Claim Information","MC-CORE041","claim_status_code","Claim Status Code","Varchar2",20,"This field contains a code that identifies the status of the claim line — whether paid as primary, paid as secondary, denied, etc.","This field is supplied as reported to Onpoint by the submitter.","Valid codes and descriptions are maintained by the Accredited Standards Committee (ASC)."]
["Procedure Coding & Detail","MC-CORE043","procedure_code","Procedure Code","Varchar2",20,"This field contains the reported procedure code for the service rendered.","This field is supplied as reported to Onpoint by the submitter."]
["Procedure Coding & Detail","MC-CORE045","procedure_modifier_code_1","Procedure Modifier Code (1)","Varchar2",20,"This field identifies a CPT procedure modifier, which is used to indicate that a service or procedure has been altered by some specific circumstance but has not changed in its definition or code. ","This field is supplied as reported to Onpoint by the submitter."]
["Procedure Coding & Detail","MC-CORE047","procedure_modifier_code_2","Procedure Modifier Code (2)","Varchar2",20,"This field identifies a CPT procedure modifier, which is used to indicate that a service or procedure has been altered by some specific circumstance but has not changed in its definition or code. ","This field is supplied as reported to Onpoint by the submitter."]
["Procedure Coding & Detail","MC-CORE049","procedure_modifier_code_3","Procedure Modifier Code (3)","Varchar2",20,"This field identifies a CPT procedure modifier, which is used to indicate that a service or procedure has been altered by some specific circumstance but has not changed in its definition or code. ","This field is supplied as reported to Onpoint by the submitter."]
["Procedure Coding & Detail","MC-CORE051","procedure_modifier_code_4","Procedure Modifier Code (4)","Varchar2",20,"This field identifies a CPT procedure modifier, which is used to indicate that a service or procedure has been altered by some specific circumstance but has not changed in its definition or code. ","This field is supplied as reported to Onpoint by the submitter."]
["Procedure Coding & Detail","MC-CORE053","revenue_code","Revenue Code","Varchar2",20,"This field contains a code that identifies the revenue category for the rendered service.","This field is supplied as reported to Onpoint by the submitter.","Valid codes and descriptions are maintained by the National Uniform Billing Committee (NUBC). This field is required for institutional claims but reported as null for professional claims."]
["Diagnosis Information","MC-CORE054","icd_version_ind","ICD Version Indicator","Varchar2",2,"This field contains a code that identifies the version of ICD used to report this service line.","This field is supplied as reported to Onpoint by the submitter."]
["Diagnosis Information","MC-CORE056","diagnosis_code","Diagnosis Code","Varchar2",20,"This field contains a code that identifies a distinct diagnosis.","This field is supplied as reported to Onpoint by the submitter."]
["Procedure Coding & Detail","MC-CORE058","icd_procedure_code","ICD Procedure Code ","Varchar2",10,"This field contains the principal ICD procedure code for the service rendered.","This field is supplied as reported to Onpoint by the submitter."]
["Enrollee Coverage Information","MC-CORE060","aid_category_code","Aid Category Code","Varchar2",20,"This field contains a code that identifies the member’s Medicaid aid category based on service date.","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","MC-CORE062","discharge_status_code","Discharge Status Code","Varchar2",20,"This field contains a code that indicates the status for the patient discharged from an inpatient stay.","This field is supplied as reported to Onpoint by the submitter.","Valid codes and descriptions are maintained by the National Uniform Billing Committee (NUBC)."]
["Claim Information","MC-CORE063","orphaned_adjustment_flag","Orphaned Adjustment Flag","Varchar2",1,"This field contains a flag that identifies a reported adjustment record for which the original claim was not submitted.","This is a value-added field created by Onpoint."]
["Claim Information","MC-CORE064","denied_claim_flag","Denied Claim Flag","Varchar2",1,"This field contains a flag that identifies a claim that was denied.","This is a value-added field created by Onpoint."]
["Claim Information","MC-CORE065","emergency_room_flag","Emergency Room Flag","Varchar2",1,"This field contains a code that is used to identify specific emergency room (ER) revenue or procedure codes within a claim. ","This is a value-added field created by Onpoint.","This field is set only on the specific claim line where an ER-related revenue, procedure code, or place of service code was found. To find true outpatient ER visits, select claim lines where this field is Y."]
["Claim Information","MC-XWLK004","medical_claim_header_id","Medical Claim Header Record ID","Number","38,0","This field contains an ID that identifies a unique claim.","This is a value-added field created by Onpoint. "]
["Provider Information","MC-PRV003","rendering_provider_id","Rendering Provider ID","Number","38,0","This field contains an ID that identifies a unique combination of a rendering provider’s reported information.","This is a value-added field created by Onpoint. ","This field can be used to aggregate all records associated with a provider. When using this field to link between tables, your query must set rendering_provider_id equal to provider_id."]
["Provider Information","MC-PRV005","billing_provider_id","Billing Provider Provider ID","Number","38,0","This field contains an ID that represents a unique provider.","This is a value-added field created by Onpoint. ","This field can be used to aggregate all records associated with a provider. When using this field to link between tables, your query must set billing_provider_id equal to provider_id."]
["Provider Information","MC-PRV007","attending_provider_id","Attending Provider Provider ID","Number","38,0","This field contains an ID that represents a unique provider.","This is a value-added field created by Onpoint. ","This field can be used to aggregate all records associated with a provider. When using this field to link between tables, your query must set attending_provider_id equal to provider_id."]
["Provider Information","MC-PRV011","referring_provider_id","Referring Provider ID","Number","38,0","This field contains an ID that represents a unique provider.","This is a value-added field created by Onpoint. ","This field can be used to aggregate all records associated with a provider. When using this field to link between tables, your query must set referring_provider_id equal to provider_id."]

{"sheet":"medical_claim_header","index":8,"n_rows":32,"n_cols":9,"rows_kept":32,"cut":false,"hidden":false,"merged":[]}
["Classification","ID","Warehouse Name","Common Name","Type","Length","Description","Origin","Notes"]
["Administrative","MH-CORE001","medical_claim_header_id","Medical Claim Header Record ID","Number","38,0","This field contains an ID that identifies a unique claim.","This is a value-added field created by Onpoint. "]
["Administrative","MH-CORE002","extract_id","Extract ID","Number","38,0","This field contains an ID that identifies the unique consolidated data set.","This is a value-added field created by Onpoint. "]
["Payer Information","MH-CORE003","submitter_id ","Submitter ID","Number","38,0","This field contains an ID that uniquely identifies a submitter.","This is a value-added field created by Onpoint."]
["Administrative","MH-CORE004","internal_member_id","Internal Member ID","Number","38,0","This field contains an ID that represents a unique member.","This is a value-added field created by Onpoint. ","This field can be used to aggregate all records associated with a member."]
["Safe Harbor Variable","MH-CORE007","first_service_dt","Date of Service (From)","Date",8,"This field identifies the first date of service for this service line.","This field is supplied as reported to Onpoint by the submitter.","Masking applied to prevent disclosure of actual date."]
["Safe Harbor Variable","MH-CORE008","last_service_dt","Date of Service (Through)","Date",8,"This field identifies the last date of service for this service line.","This field is supplied as reported to Onpoint by the submitter.","Masking applied to prevent disclosure of actual date."]
["Safe Harbor Variable","MH-CORE009","first_paid_dt","First Paid Date","Date",8,"This field identifies the first payment date for the rendered service.","This is a value-added field created by Onpoint. ","Masking applied to prevent disclosure of actual date."]
["Safe Harbor Variable","MH-CORE010","last_paid_dt","Last Paid Date","Date",8,"This field identifies the last payment date for the rendered service.","This is a value-added field created by Onpoint. ","Masking applied to prevent disclosure of actual date."]
["Financial Information","MH-CORE011","charge_amt","Charge Amount","Decimal","38,2","This field identifies the total charges for the service.","This is a value-added field created by Onpoint. ","This is a money field containing dollars and cents. This field may contain a negative value."]
["Financial Information","MH-CORE012","paid_amt","Paid Amount","Decimal","38,2","This field identifies the total dollar amount paid to the provider, including all health plan payments and excluding all member payments and withholds from providers.","This is a value-added field created by Onpoint. ","This is a money field containing dollars and cents. This field may contain a negative value."]
["Financial Information","MH-CORE013","prepaid_amt","Prepaid Amount","Decimal","38,2","This field identifies the fee-for-service equivalent that would have been paid by the healthcare claims processor for a specific service if the service had not been capitated. ","This is a value-added field created by Onpoint. ","This is a money field containing dollars and cents. This field may contain a negative value."]
["Financial Information","MH-CORE014","copay_amt","Copay Amount","Decimal","38,2","This field identifies the preset, fixed dollar amount payable by a member, often on a per visit/service basis.","This is a value-added field created by Onpoint. ","This is a money field containing dollars and cents. This field may contain a negative value."]
["Financial Information","MH-CORE015","coinsurance_amt","Coinsurance Amount","Decimal","38,2","This field identifies the dollar amount that a member must pay toward the cost of a covered service, which is often a percentage of total cost.","This is a value-added field created by Onpoint. ","This is a money field containing dollars and cents. This field may contain a negative value."]
["Financial Information","MH-CORE016","deductible_amt","Deductible Amount","Decimal","38,2","This field identifies the dollar amount that a member must pay before the health plan benefits will begin to reimburse for services.","This is a value-added field created by Onpoint. ","This is a money field containing dollars and cents. This field may contain a negative value."]
["Financial Information","MH-CORE017","allowed_amt","Allowed Amount","Decimal","38,2","This field identifies the sum of the insurer and member paid dollar amounts","This is a value-added field created by Onpoint. ","This is a money field containing dollars and cents. This field may contain a negative value."]
["Financial Information","MH-CORE018","insurer_paid_amt","Insurer Paid Amount","Decimal","38,2","This field identifies the sum of the insurer paid dollar amounts","This is a value-added field created by Onpoint. ","This is a money field containing dollars and cents. This field may contain a negative value."]
["Diagnosis Information","MH-CORE020","diagnosis_code","ICD Diagnosis Code","Varchar2",20,"This field contains a code that identifies the principal diagnosis.","This field is supplied as reported to Onpoint by the submitter."]
["Diagnosis Information","MH-CORE021","icd_version_ind","ICD Version Indicator","Varchar2",2,"This field contains a code that identifies the version of ICD used to report this service line.","This field is supplied as reported to Onpoint by the submitter using collection field (Principal Diagnosis | ICD Version Indicator)."]
["Financial Information","MH-CORE022","header_status","Claim Status Code","Varchar2",2,"This field contains a code that identifies the status of the claim line - whether paid as primary, paid as secondary, denied, etc.","This is a value-added field created by Onpoint.","Valid codes and descriptions are maintained by the Accredited Standards Committee (ASC)."]
["Financial Information","MH-CORE023","denied_header_flag","Denied Claim Flag","Varchar2",1,"This field contains a flag that identifies a claim that was denied.","This is a value-added field created by Onpoint."]
["Financial Information","MH-CORE024","orphaned_header_flag","Orphaned Adjustment Flag","Varchar2",1,"This field contains a flag that identifies a reported adjustment record for which the original claim was not submitted.","This is a value-added field created by Onpoint."]
["Claim Information","MH-CORE025","claim_type_id","Claim Type ID","Number","38,0","This field identifies an ID that identifies the type of claim (e.g., facility, professional, etc.) used to report this service line.","This is a value-added field created by Onpoint.","See Reference Tables"]
["Claim Information","MH-CORE026","type_of_setting_id","Type of Setting ID","Number","38,0","This field provides additional granularity regarding the type of claim (e.g., inpatient, outpatient, provider, lab, etc.).","This is a value-added field created by Onpoint.","See Reference Tables"]
["Claim Information","MH-CORE027","place_of_setting_id","Place of Setting ID","Number","38,0","This field identifies the setting in which the care was rendered (e.g., hospital, swing bed, skilled nursing facility, etc.).","This is a value-added field created by Onpoint. ","This field is based on the reported Type of Bill Code (type_of_bill_code) in the medical claims data. This field is applicable only to facility claims. See Reference Tables."]
["Claim Information","MH-CORE028","type_of_bill_code","Type of Bill Code","Varchar2",4,"This field contains a code that identifies the reported type of bill.","This field is supplied as reported to Onpoint by the submitter.","Valid codes and descriptions are maintained by the National Uniform Billing Committee (NUBC). This field is required for institutional claims but set to null for professional claims."]
["Administrative","IPDIS001","inpatient_discharge_id ","Inpatient Discharge Record ID","Number","38,0","This field contains an ID that identifies a unique inpatient discharge record.","This is a value-added field created by Onpoint."]
["Safe Harbor Variable","IPDIS007","admit_dt ","Admission Date","Date",8,"This field identifies the date of the inpatient admission.","This field is supplied as reported to Onpoint by the submitter.","Masking applied to prevent disclosure of actual date."]
["Safe Harbor Variable","IPDIS008","discharge_dt ","Discharge Date","Date",8,"This field identifies the discharge date of the patient from inpatient care.","This field is supplied as reported to Onpoint by the submitter.","Masking applied to prevent disclosure of actual date."]
["Claim Information","IPDIS010","discharge_status_code","Discharge Status Code","Varchar2",20,"This field contains a code that identifies the status of the patient discharged from an inpatient stay.","This field is supplied as reported to Onpoint by the submitter.","Valid codes and descriptions are maintained by the National Uniform Billing Committee (NUBC)."]
["Claim Information","IPDIS011","length_of_stay","Length of Stay","Number","10,0","This field identifies the length of stay (in days) for an inpatient claim.","This is a value-added field created by Onpoint. ","This field is calculated based on the reported Admission Date (admission_dt) and Discharge Date (discharge_dt). A one-day length of stay is reported if the patient was admitted and discharged on the same day or if the patient was admitted on one day and discharged on the following day. "]
["Diagnosis Information","IPDIS814","admit_diagnosis_ID","ICD Diagnosis Code ID Number – Admitting","Varchar2",20,"This field contains an ID number that identifies a unique combination of information designating an ICD diagnosis code used to report the member’s diagnosis at the time of admission.","This is a value-added field created by Onpoint. "]

{"sheet":"medical_supplemental","index":9,"n_rows":27,"n_cols":9,"rows_kept":27,"cut":false,"hidden":false,"merged":[]}
["Classification","ID","Warehouse Name","Common Name","Type","Length","Description","Origin","Notes"]
["Administrative","MC-SUP001","medical_claim_service_line_id","Medical Claim Service-Line Record ID","Number","38,0","This field contains an ID that identifies a unique service line of a submitted claim record.","This is a value-added field created by Onpoint. "]
["Administrative","MC-SUP002","extract_id","Extract ID","Number","38,0","This field contains an ID for the consolidated data set.","This is a value-added field created by Onpoint. "]
["Claim Information","MC-SUP005","admission_point_of_origin_code","Admission Point of Origin Code","Varchar2",2,"This field contains a code that indicates the source of admission.","This field is supplied as reported to Onpoint by the submitter.","Valid codes and descriptions are maintained by the National Uniform Billing Committee (NUBC)."]
["Claim Information","MC-SUP007","admission_type","Admission Type Code","Varchar2",2,"This field contains a code that indicates the type of admission for the inpatient hospital claim.","This field is supplied as reported to Onpoint by the submitter.","Valid codes and descriptions are maintained by the National Uniform Billing Committee (NUBC)."]
["Procedure Coding & Detail","MC-SUP010","national_drug_code","National Drug Code","Varchar2",11,"This field contains the National Drug Code (NDC) reported for this service line.","This field is supplied as reported to Onpoint by the submitter."]
["Financial Information","MC-SUP013","patient_total_out_pocket_amt","Patient Total Out-of-Pocket Amount","Decimal","38,2","This field identifies the total dollar amount for which the patient is responsible for the reported service.","This field is supplied as reported to Onpoint by the submitter.","This is a money field containing dollars and cents. This field may contain a negative value."]
["Financial Information","MC-SUP015","other_ins_paid_amt","Other Insurance Paid Amount","Decimal","38,2","This field identifies the amount that a prior payer paid for this claim line. Indicates the submitting payer is secondary to the prior payer.","This field is supplied as reported to Onpoint by the submitter."]
["Financial Information","MC-SUP016","medicare_paid_amt","Medicare Paid Amount","Decimal","38,2","This field identifies the amount for which another payer is liable after the submitting payer has processed this claim line. ","This field is supplied as reported to Onpoint by the submitter."]
["Financial Information","MC-SUP018","excluded_expenses","Excluded Expenses","Decimal","38,2","This field identifies the amount that the member incurred toward covered but over-utilized services.","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","MC-SUP025","claim_line_type_code","Claim Line Type Code","Varchar2",10,"This field contains a code that defines the claim line status in terms of adjudication. ","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","MC-SUP026","capitated_encounter_flag","Capitated Encounter Indicator","Varchar2",10,"This field contains a code that indicates whether or not the service was covered under a capitated arrangement. \n\nValid codes include: \n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","MC-SUP027","global_payment_ind_code","Global Payment Indicator Code","Varchar2",10,"This field contains a code that indicates whether or not the claim line was paid under a global payment arrangement.\n\nValid codes include: \n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","MC-SUP028","medicare_indicator_code","Medicare Indicator Code","Varchar2",10,"This field contains a code that indicates whether or not Medicare paid for part or all of the services. \n\nValid codes include: \n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","MC-SUP029","authorization_needed_code","Authorization Needed Code","Varchar2",10,"This field contains a code that indicates whether or not the service required a pre-authorization. \n\nValid codes include: \n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","MC-SUP030","referral_indicator_code","Referral Indicator Code","Varchar2",10,"This field contains a code that indicates whether or not the service was preceded by a referral. \n\nValid codes include: \n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","MC-SUP031","accident_related_ind_code","Accident-Related Indicator Code","Varchar2",10,"This field contains a code that indicates whether or not the claim was accident related. \n\nValid codes include: \n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","MC-SUP032","family_planning_ind_code","Family Planning Indicator Code","Varchar2",10,"This field contains a code that indicates whether or not this claim was for services related to family planning. \n\nValid codes include: \n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","MC-SUP033","employment_related_ind_code","Employment-Related Indicator Code","Varchar2",10,"This field contains a code that indicates whether or not the rendered service was for an employment-related claim. \n\nValid codes include: \n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","MC-SUP034","network_indicator_code","Network Indicator Code","Varchar2",10,"This field contains a code that indicates whether or not the claim line was paid at an in-network rate.\n\nValid codes include: \n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint by the submitter."]
["Provider Information","MC-SUP035","pcp_indicator_code","PCP Indicator Code","Varchar2",10,"This field contains a code that indicates whether or not the rendering provider is the member's PCP.\n\nValid codes include: \n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","MC-SUP037","epsdt_indicator_code","EPSDT Indicator Code","Varchar2",10,"This field contains a code that identifies whether or not the service was related to Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefits and the type of EPSDT service. \n\nValid codes include: \n1 = EPSDT Screening\n2 = EPSDT Treatment\n3 = EPSDT Referral\n0 = Unknown / Not Applicable","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","MC-SUP042","apcd_id_code","APCD ID Code","Varchar2",10,"This field contains a code that describes the subscriber’s/member’s enrollment as one of multiple predefined categories, aligning enrollment to appropriate validations and thresholds.","This field is supplied as reported to Onpoint by the submitter."]
["Procedure Coding & Detail","MC-SUP047","apc","APC","Varchar2",5,"This field identifies the Ambulatory Payment Classification (APC) when reported.","This field is supplied as reported to Onpoint by the submitter."]
["Procedure Coding & Detail","MC-SUP048","apc_version","APC Version","Varchar2",2,"This field identifies the version of the Ambulatory Payment Classification (APC) reported in the APC field (apc; MC073).","This field is supplied as reported to Onpoint by the submitter."]
["Procedure Coding & Detail","MC-SUP049","drg_payer_submitted","DRG","Varchar2",10,"This field identifies the Diagnosis Related Group (DRG) when reported.","This field is supplied as reported to Onpoint by the submitter."]
["Procedure Coding & Detail","MC-SUP050","drg_payer_submitted_version","DRG Version","Varchar2",10,"This field identifies the version of the Diagnosis Related Group (DRG) reported in the DRG field (drg_payer_submitted; MC071).","This field is supplied as reported to Onpoint by the submitter."]

{"sheet":"medical_claim_diagnosis","index":10,"n_rows":8,"n_cols":9,"rows_kept":8,"cut":false,"hidden":false,"merged":[]}
["Classification","ID","Warehouse Name","Common Name","Type","Length","Description","Origin","Notes"]
["Administrative","MC-DIAG001","medical_claim_service_line_id","Medical Claim Service-Line Record ID","Number","38,0","This field contains an ID that identifies a unique service line of a submitted claim record.","This is a value-added field created by Onpoint. "]
["Diagnosis Information","MC-DIAG002","medical_claim_diagnosis_order","Diagnosis Code - Reported Order","Number","38,0","This field identifies the order in which the diagnosis code was reported within the context of its specific diagnosis category.","This is a value-added field created by Onpoint. "]
["Diagnosis Information","MC-DIAG003","diagnosis_type_id","Diagnosis Type ID","Number","38,0","This field identifies the type of reported Diagnosis Code (diagnosis_code) (e.g., admitting, principal, other, etc.).","This field is supplied as reported to Onpoint by the submitter.","Descriptions are based solely on the field used to report the diagnosis in the submitted medical claims data. For example, a diagnosis reported using the Admitting Diagnosis field is flagged with a code/description that identifies it as admitting. See Reference Table."]
["Administrative","MC-DIAG004","extract_id","Extract ID","Number","38,0","This field contains an ID that identifies the unique consolidated data set.","This is a value-added field created by Onpoint. "]
["Diagnosis Information","MC-DIAG005","icd_version_ind","ICD Version Indicator","Varchar2",2,"This field contains a code that identifies the version of ICD used to report this service line.","This field is supplied as reported to Onpoint by the submitter."]
["Diagnosis Information","MC-DIAG007","diagnosis_code","Diagnosis Code","Varchar2",20,"This field contains a code that identifies a distinct diagnosis.","This field is supplied as reported to Onpoint by the submitter."]
["Diagnosis Information","MC-DIAG009","poa_diagnosis_ind_code","Present on Admission (POA) Indicator Code","Varchar2",20,"This field contains a code that indicates whether or not the reported diagnosis or external cause of injury (ECI) was identified as present on admission.","This field is supplied as reported to Onpoint by the submitter.","Valid codes and descriptions are maintained by the National Uniform Billing Committee (NUBC)."]

{"sheet":"medical_claim_icd_procedure","index":11,"n_rows":6,"n_cols":9,"rows_kept":6,"cut":false,"hidden":false,"merged":[]}
["Classification","ID","Warehouse Name","Common Name","Type","Length","Description","Origin","Notes"]
["Administrative","MC-PROC001","medical_claim_service_line_id","Medical Claim Service-Line Record ID","Number","38,0","This field contains an ID that identifies a unique service line of a submitted claim record.","This is a value-added field created by Onpoint. "]
["Procedure Coding & Detail","MC-PROC002","medical_claim_icd_proc_order","ICD Procedure Code - Reported Order","Number","38,0","This field identifies the order in which the ICD procedure code was reported within the context of its specific code category.","This is a value-added field created by Onpoint. "]
["Claim Information","MC-PROC003","extract_id","Extract ID","Number","38,0","This field contains an ID that identifies the unique consolidated data set."]
["Claim Information","MC-PROC004","icd_version_ind","ICD Version Indicator","Varchar2",2,"This field contains a code that identifies the version of ICD used to report this service line.","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","MC-PROC006","icd_procedure_code","ICD Procedure Code ","Varchar2",10,"This field contains the principal ICD procedure code for the service rendered.","This field is supplied as reported to Onpoint by the submitter."]

{"sheet":"pharmacy","index":12,"n_rows":35,"n_cols":9,"rows_kept":35,"cut":false,"hidden":false,"merged":[]}
["Classification","ID","Warehouse Name","Common Name","Type","Length","Description","Origin","Notes"]
["Administrative","PC-CORE001","pharmacy_claim_service_line_id","Pharmacy Claim Record ID","Number","38,0","This field contains an ID that identifies a unique pharmacy claim record.","This is a value-added field created by Onpoint."]
["Administrative","PC-CORE002","extract_id","Extract ID","Number","38,0","This field contains an ID that identifies the unique consolidated data set.","This is a value-added field created by Onpoint. "]
["Claim Information","PC-CORE005","line_counter","Line Counter","Number","38,0","This field contains the line number for this service.","This field is supplied as reported to Onpoint by the submitter."]
["Administrative","PC-CORE007","internal_member_id ","Internal Member ID","Number","38,0","This field contains an ID that represents a unique member.","This is a value-added field created by Onpoint. ","This field can be used to aggregate all records associated with a member."]
["Payer Information","PC-CORE003","submitter_id ","Submitter ID","Number","38,0","This field contains an ID that uniquely identifies a submitter.","This is a value-added field created by Onpoint."]
["Enrollee Coverage Information","PC-CORE009","product_code","Insurance Type / Product Code","Varchar2",20,"This field contains a code that identifies the member’s type of insurance or insurance product.","This field is supplied as reported to Onpoint by the submitter.","Valid codes and descriptions are maintained by the Accredited Standards Committee (ASC)."]
["Enrollee Coverage Information","PC-CORE015","subscriber_relationship_code","Member’s Relationship Code","Varchar2",10,"This field contains a code that indicates the member’s relationship to the subscriber or the insured.","This field is supplied as reported to Onpoint by the submitter."]
["Enrollee Coverage Information","PC-CORE017","aid_category_code","Aid Category Code","Varchar2",20,"This field contains a code that identifies the member’s Medicaid aid category based on eligibility date.","This field is supplied as reported to Onpoint by the submitter."]
["Safe Harbor Variable","PC-CORE018","prescription_filled_dt ","Date Prescription Filled","Date",8,"This field identifies the date on which the prescription was filled.","This field is supplied as reported to Onpoint by the submitter.","Masking applied to prevent disclosure of actual date."]
["Safe Harbor Variable","PC-CORE019","first_paid_dt ","First Paid Date","Date",8,"This field contains the first paid date associated with the claim.","This is a value-added field created by Onpoint. ","This field is based on the reported Date Prescription Filled field. While multiple paid dates may occur for the same claim as part of the adjudication process, this field contains the first paid date associated with the claim. For claims that were not adjusted, this is the actual paid date."]
["Safe Harbor Variable","PC-CORE020","last_paid_dt ","Last Paid Date","Date",8,"This field contains the last paid date associated with the claim. ","This is a value-added field created by Onpoint. ","Masking applied to prevent disclosure of actual date."]
["Procedure Coding & Detail","PC-CORE021","national_drug_code","National Drug Code","Varchar2",11,"This field contains the National Drug Code (NDC) reported for this claim.","This field is supplied as reported to Onpoint by the submitter."]
["Procedure Coding & Detail","PC-CORE022","drug_name","Drug Name","Varchar2",80,"This field contains the text name of the dispensed drug.","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","PC-CORE023","refill_number","New Prescription or Refill","Number","38,0","This field contains a code that identifies whether this was a new prescription or a refill.","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","PC-CORE024","quantity","Quantity Dispensed","Decimal","38,2","This field identifies the total unit dosage in metric units.","This field is supplied as reported to Onpoint by the submitter.","This field may contain a negative value."]
["Claim Information","PC-CORE025","days_supply","Days’ Supply","Decimal","38,0","This field identifies the days’ supply for the prescription based on the metric quantity dispensed.","This field is supplied as reported to Onpoint by the submitter.","This field may contain a negative value."]
["Claim Information","PC-CORE026","thirty_day_equivalent","Thirty-Day Equivalency","Decimal","38,0","This field reports the number of thirty-day equivalencies associated with this prescription.","This is a value-added field created by Onpoint.","This field is based on the reported Days’ Supply."]
["Financial Information","PC-CORE027","charge_amt","Charge Amount","Decimal","38,2","This field identifies the total charges for the service.","This field is supplied as reported to Onpoint by the submitter.","This is a money field containing dollars and cents. This field may contain a negative value."]
["Financial Information","PC-CORE028","paid_amt","Paid Amount","Decimal","38,2","This field identifies the total dollar amount paid to the provider, including all health plan payments and excluding all member payments and withholds from providers.","This field is supplied as reported to Onpoint by the submitter.","This is a money field containing dollars and cents. This field may contain a negative value."]
["Financial Information","PC-CORE029","copay_amt","Copay Amount","Decimal","38,2","This field identifies the preset, fixed dollar amount payable by a member, often on a per visit/service basis.","This field is supplied as reported to Onpoint by the submitter.","Not all carriers can distinguish between the mutually exclusive fields of Copay Amount and Coinsurance Amount. This is a money field containing dollars and cents. This field may contain a negative value."]
["Financial Information","PC-CORE030","coinsurance_amt","Coinsurance Amount","Decimal","38,2","This field identifies the dollar amount that a member must pay toward the cost of a covered service, which is often a percentage of total cost.","This field is supplied as reported to Onpoint by the submitter.","Not all carriers can distinguish between the mutually exclusive fields of Copay Amount and Coinsurance Amount. This is a money field containing dollars and cents. This field may contain a negative value."]
["Financial Information","PC-CORE031","deductible_amt","Deductible Amount","Decimal","38,2","This field identifies the dollar amount that a member must pay before the health plan benefits will begin to reimburse for services.","This field is supplied as reported to Onpoint by the submitter.","To determine the total out-of-pocket/member responsibility for this service, you must sum this field with both Copay Amount and Coinsurance Amount . This is a money field containing dollars and cents. This field may contain a negative value."]
["Financial Information","PC-CORE032","dispensing_fee","Dispensing Fee","Decimal","38,2","This field reports the amount charged for dispensing the prescription.","This field is supplied as reported to Onpoint by the submitter.","This is a money field containing dollars and cents. This field may contain a negative value."]
["Financial Information","PC-CORE033","ingredient_cost","Ingredient Cost / List Price","Decimal","38,2","This field reports the cost of the drug that was dispensed.","This field is supplied as reported to Onpoint by the submitter.","This is a money field containing dollars and cents. This field may contain a negative value."]
["Financial Information","PC-CORE034","postage_cost","Postage Amount Claimed","Decimal","38,2","This field reports the cost of postage included in the Paid Amount field.","This field is supplied as reported to Onpoint by the submitter."]
["Financial Information","PC-CORE036","claim_status_code","Claim Status Code","Varchar2",20,"This field contains a code that identifies the status of the claim — whether paid as primary, paid as secondary, denied, etc.","This field is supplied as reported to Onpoint by the submitter.","Valid codes and descriptions are maintained by the Accredited Standards Committee (ASC)."]
["Claim Information","PC-CORE037","denied_claim_flag","Denied Claim Flag","Varchar2",1,"This field contains a flag that identifies a claim that was denied.","This is a value-added field created by Onpoint."]
["Claim Information","PC-CORE039","generic_drug_ind_code","Generic Drug Indicator Code","Varchar2",10,"This field contains a code that identifies whether the dispensed drug was a branded drug or a generic drug.","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","PC-CORE041","compound_drug_code","Compound Drug Indicator Code","Varchar2",10,"This field contains a code that indicates whether or not the dispensed drug was a compound drug.","This field is supplied as reported to Onpoint by the submitter.","Valid codes and descriptions are maintained by the National Council for Prescription Drug Programs (NCPDP)."]
["Claim Information","PC-CORE043","dispense_as_written_code","Dispense as Written Code","Varchar2",20,"This field contains a code that identifies the instructions given to the pharmacist for filling the prescription.","This field is supplied as reported to Onpoint by the submitter.","Valid codes and descriptions are maintained by the National Council for Prescription Drug Programs (NCPDP)."]
["Claim Information","PC-CORE044","orphaned_adjustment_flag","Orphaned Adjustment Flag","Varchar2",1,"This field contains a flag that identifies a reported adjustment record for which the original claim was not submitted.","This is a value-added field created by Onpoint."]
["Claim Information","PC-CORE045","medicare_part_d_duplicate_flag","Medicare Part D Duplicate Flag","Varchar2",1,"This field designates if this is a duplicate Part D record reported by both Medicare and a commercial part D plan.","This is a value-added field created by Onpoint."]
["Provider Information","PC-PRV003","pharmacy_provider_id","Pharmacy Provider ID","Number","38,0","This field contains an ID that identifies a unique combination of a pharmacy’s reported information.","This is a value-added field created by Onpoint. ","This field can be used to aggregate all records associated with a provider. When using this field to link between tables, your query must set pharmacy_provider_id equal to provider_id."]
["Provider Information","PC-PRV006","prscrbing_provider_id","Prescribing Provider ID","Number","38,0","This field contains an ID that represents a unique provider.","This is a value-added field created by Onpoint. ","This field can be used to aggregate all records associated with a provider. When using this field to link between tables, your query must set prscrbing_provider_id equal to provider_id."]

{"sheet":"pharmacy_supplemental","index":13,"n_rows":16,"n_cols":9,"rows_kept":16,"cut":false,"hidden":false,"merged":[]}
["Classification","ID","Warehouse Name","Common Name","Type","Length","Description","Origin","Notes"]
["Administrative","PC-SUP001","pharmacy_claim_service_line_id","Pharmacy Claim Record ID","Number","38,0","This field contains an ID that identifies a unique pharmacy claim record.","This is a value-added field created by Onpoint."]
["Administrative","PC-SUP002","extract_id","Extract ID","Number","38,0","This field contains an ID for the consolidated data set.","This is a value-added field created by Onpoint. "]
["Claim Information","PC-SUP005","drug_source_ind_code","Drug Source Indicator Code","Varchar2",10,"This field contains a code that defines the availability of the pharmaceutical. ","This field is supplied as reported to Onpoint by the submitter."]
["Safe Harbor Variable","PC-SUP006","prescription_written_dt","Prescription Written Date","Date",8,"This field identifies the date that was written on the prescription or called in by the prescribing physician’s office.","This field is supplied as reported to Onpoint by the submitter.","Masking applied to prevent disclosure of actual date."]
["Financial Information","PC-SUP009","medicare_paid_amt","Medicare Paid Amount","Decimal","38,2","This field identifies the amount for which another payer is liable after the submitting payer has processed this claim line. ","This field is supplied as reported to Onpoint by the submitter."]
["Financial Information","PC-SUP010","patient_pay_amt","Patient Pay Amount","Decimal","38,2","This field identifies the dollar amount for which the patient is responsible.","This field is supplied as reported to Onpoint by the submitter.","This is a money field containing dollars and cents. This field may contain a negative value."]
["Financial Information","PC-SUP012","state_sales_tax","State Sales Tax","Decimal","38,2","This field identifies the amount of state sales tax applied to this claim line. ","This field is supplied as reported to Onpoint by the submitter."]
["Financial Information","PC-SUP013","rebate_indicator_code","Rebate Indicator Code","Varchar2",10,"This field contains a code that indicates whether or not the prescribed drug was eligible for rebate. \n\nValid codes include: \n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","PC-SUP014","formulary_code","Formulary Code","Varchar2",10,"This field contains a code that indicates whether or not the prescribed drug was on the carrier’s formulary list. \n\nValid codes include: \n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","PC-SUP016","drug_administration_route_code","Drug Administration Route Code","Varchar2",10,"This field identifies the pharmaceutical route of administration that defines the method of drug administration.","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","PC-SUP018","drug_unit_of_measure","Drug Unit of Measurement","Varchar2",10,"This field contains a code that defines the unit of measure for the drug dispensed. ","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","PC-SUP022","medicare_pmt_applied_ind_code","Medicare Payment Applied Indicator Code","Varchar2",10,"This field contains a code that indicates whether or not Medicare paid for part or all of the services.\n\nValid codes include:\n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","PC-SUP023","pregnancy_indicator_code","Pregnancy Indicator Code","Varchar2",10,"This field contains a code that indicates whether or not the member was pregnant.\n\nValid codes include: \n1 = Yes\n2 = No\n3 = Unknown\n4 = Other\n5 = Not Applicable","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","PC-SUP028","apcd_id_code","APCD ID Code","Varchar2",10,"This field contains a code that describes the subscriber’s/member’s enrollment as one of multiple predefined categories, aligning enrollment to appropriate validations and thresholds. ","This field is supplied as reported to Onpoint by the submitter."]
["Claim Information","PC-SUP030","pharmacy_mail_order_code","Mail-Order Pharmacy Code","Varchar2",20,"This field contains a code that indicates whether or not the dispensing pharmacy was a mail-order pharmacy.","This field is supplied as reported to Onpoint by the submitter.","Valid codes and descriptions are supplied in specifications provided to submitters."]

{"sheet":"provider","index":14,"n_rows":7,"n_cols":9,"rows_kept":7,"cut":false,"hidden":false,"merged":[]}
["Classification","ID","Warehouse Name","Common Name","Type","Length","Description","Origin","Notes"]
["Administrative","PRV-CORE001","provider_id ","Provider ID","Number","38,0","This field contains an ID that identifies a unique combination of a provider’s reported information.","This is a value-added field created by Onpoint.","This field can be used to link all records associated with a provider."]
["Administrative","PRV-MAST001","internal_provider_id ","Internal Provider ID","Number","38,0","This field contains an ID that represents a unique provider.","This is a value-added field created by Onpoint. ","This field can be used to aggregate all records associated with a provider."]
["Payer Information","PRV-CORE003","submitter_id ","Submitter ID","Number","38,0","This field contains an ID that uniquely identifies a submitter.","This is a value-added field created by Onpoint."]
["Administrative","PRV-MAST002","extract_id","Extract ID","Number","38,0","This field contains an ID that identifies the unique consolidated data set.","This is a value-added field created by Onpoint. "]
["Provider Information","PRV-CORE014","orig_npi","Provider NPI","Number",10,"This field contains the provider’s National Provider Identification Number used by the U.S. Centers for Medicare & Medicaid Services (CMS).","This field is supplied based on a crosswalk between submitter-supplied information and external sources (e.g., NPPES)."]
["Provider Information","PRV-MAST017","npi","Provider NPI","Number",10,"This field contains the provider’s National Provider Identification Number used by the U.S. Centers for Medicare & Medicaid Services (CMS).","This field is supplied based on a crosswalk between submitter-supplied information and external sources (e.g., NPPES)."]

{"sheet":"Claim Type Refernce","index":15,"n_rows":23,"n_cols":6,"rows_kept":23,"cut":false,"hidden":true,"merged":[]}
["claim_type_id","claim_type_desc","type_of_setting_id","type_of_setting_desc","place_of_setting_id","place_of_setting_desc"]
[1,"Facility",1,"Inpatient",1,"Acute inpatient or hospital"]
[1,"Facility",1,"Inpatient",2,"Swing Beds"]
[1,"Facility",1,"Inpatient",3,"SNF"]
[1,"Facility",1,"Inpatient",4,"ICF"]
[1,"Facility",1,"Inpatient",5,"Residential"]
[1,"Facility",1,"Inpatient",6,"Other"]
[1,"Facility",2,"Outpatient",7,"Hospital"]
[1,"Facility",2,"Outpatient",8,"Free-Standing Ambulatory Surgery"]
[1,"Facility",2,"Outpatient",9,"FQHC"]
[1,"Facility",2,"Outpatient",10,"Rural Health Clinic"]
[1,"Facility",2,"Outpatient",11,"Mental health Clinics"]
[1,"Facility",2,"Outpatient",3,"SNF"]
[1,"Facility",2,"Outpatient",6,"Other"]
[2,"Professional",3,"Provider",12,"Not Applicable"]
[2,"Professional",4,"Independent Labs",12,"Not Applicable"]
[2,"Professional",6,"Dental",12,"Not Applicable"]
[2,"Professional",5,"Ambulance",12,"Not Applicable"]
[3,"Other services",8,"DME (Durable Medical Equipment)",12,"Not Applicable"]
[3,"Other services",12,"Hospice",12,"Not Applicable"]
[3,"Other services",9,"Home Health",12,"Not Applicable"]
[3,"Other services",7,"Pharmacy",12,"Not Applicable"]
[3,"Other services",10,"Unclassified/other",12,"Not Applicable"]