Data Dictionary Report Template
|Name: Participant is locked in to a pharmacy on the date of | | | |
|service, but not the pharmacy on the claim. | | | |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |
|Name: A Clinical segment was received with an eligibility, a reversal, a prior| | | |
|authorization reversal, or a prior authorization inquiry request. | | | |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |
|Name: M/I OTHER COVERAGE CODE | | | |
|Conditions |
|Name: Missing/Invalid DUR/PPS Segment | | | |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Field Name |Copybook |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |
|Name: Plan Limits Exceeded on Intended Partial Fill Values | | | |
|Conditions |
|Name: Other Amount Claimed Submitted Count Does Not Match Number Of | | | |
|Repetitions | | | |
|Conditions |Field Name |Copybook |1 |
|Conditions |Column |Table |1 |
|Conditions |Field name |Copybook |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |
|Name: Claim not processed | | | |
|Conditions |
|Name: Claim not processed | | | |
|Conditions |
|Name: Claim not processed | | | |
|Conditions |
|Name: Claim not processed | | | |
|Conditions |
|Name: Cannot adjust a credit of adjustment history claim | | | |
|Conditions |Column |Table |1 |
|Conditions |Column |Table |1 |
|Conditions |
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