Master Data Element Dictionary, version 20240608: NCMMIS 3501 - 4000

Master Data Element Dictionary, version 20240608: NCMMIS 3501 - 4000

Fragment Sequence Number

NCMMIS Number: 3501

Description: fragment sequence number

Data Type: CHARACTER

Size: X(18)

Functional Area Owner: Reference

Valid Values:

Last Update: 2/10/2010 8:11:11 PM

 

Row Sequence Number

NCMMIS Number: 3502

Description: row sequence number

Data Type: SMALLINT

Size: S9(4)

Functional Area Owner: Reference

Valid Values:

Last Update: 2/10/2010 8:11:13 PM

 

Rule Condition Text

NCMMIS Number: 3503

Description: rule condition text

Data Type: CHARACTER

Size: X(50)

Functional Area Owner: Reference

Valid Values:

Last Update: 2/10/2010 8:11:15 PM

 

Claim History Edit Action

NCMMIS Number: 3504

Description: claim history edit action

Data Type: CHARACTER

Size: X(1)

Functional Area Owner: Reference

Valid Values:

Last Update: 2/10/2010 8:11:17 PM

 

Claim History Edit Accumulator

NCMMIS Number: 3505

Description: claim history edit accumulator

Data Type: CHARACTER

Size: X(1)

Functional Area Owner: Reference

Valid Values:

Last Update: 2/10/2010 8:11:19 PM

 

Claim History Edit Accumulator Amount

NCMMIS Number: 3506

Description: claim history edit accumulator amount

Data Type: DECIMAL

Size: S9(9)V99

Functional Area Owner: Reference

Valid Values:

Last Update: 2/10/2010 8:11:22 PM

 

Claim History Edit Accumulator Days

NCMMIS Number: 3507

Description: claim history edit accumulator days

Data Type: CHARACTER

Size: X(4)

Functional Area Owner: Reference

Valid Values:

Last Update: 2/10/2010 8:11:24 PM

 

Drug Brand Name

NCMMIS Number: 3508

Description: Product description name that appears on the package label provided by the manufacturer

Data Type: CHARACTER

Size: X(30)

Functional Area Owner: Reference

Valid Values:

Last Update: 2/22/2010 1:43:16 PM

 

Medication Identifier

NCMMIS Number: 3509

Description: Identifies the unique combination of product or generic name, route of administration, dosage form, strength, and strength unit-of-measure.

Data Type: CHARACTER

Size: X(8)

Functional Area Owner: Reference

Valid Values:

Last Update: 10/13/2010 1:49:56 PM

 

Enhanced Therapeutic Class Description

NCMMIS Number: 3510

Description: Enhanced Therapeutic Class Description

Data Type: CHARACTER

Size: X(70)

Functional Area Owner: Reference

Valid Values:

Last Update: 2/16/2010 6:06:15 PM

 

GC4 Description

NCMMIS Number: 3511

Description: GC4 Description

Data Type: CHARACTER

Size: X(50)

Functional Area Owner: Reference

Valid Values:

Last Update: 2/16/2010 6:06:17 PM

 

CMS Drug Category Indicator

NCMMIS Number: 3512

Description: Identifies single source, multi-source, or innovator status.

Data Type: CHARACTER

Size: X(01)

Functional Area Owner: Reference

Valid Values:

From Value

Thru Value

Short Description

Long Description

From Value

Thru Value

Short Description

Long Description

Blank

Blank

UNSPEC

Unspecified

I

I

INNOVMS

Innovator Mult-Source

N

N

NONINNOVMS

Non-Innovator Multi-Source

S

S

SINGLESRC

Single Source

 

Last Update: 3/12/2021 2:16:02 PM

 

Reference Health Check Screening Indicator

NCMMIS Number: 3513

Description: Reference Health Check Screening Indicator

Data Type: CHARACTER

Size: X(1)

Functional Area Owner: Reference

Valid Values:

From Value

Thru Value

Short Description

Long Description

From Value

Thru Value

Short Description

Long Description

N

N

NOT HLTH C

DRUG NOT APPLICABLE TO HEALTH CHECK

Y

Y

HEALTH CHK

DRUG APPLICABLE TO HEALTH CHECK

 

Last Update: 3/12/2021 2:16:03 PM

 

TPL - Start Date

NCMMIS Number: 3514

Description: Start Date

Data Type: DATE

Size: X(10)

Functional Area Owner: Third Party Liability

Valid Values:

Last Update: 3/12/2021 1:33:43 PM

 

CheckWrite Status Code

NCMMIS Number: 3515

Description: Status of the CheckWrite Cycle

Data Type: CHARACTER

Size: X(1)

Functional Area Owner: Financial

Valid Values:

From Value

Thru Value

Short Description

Long Description

From Value

Thru Value

Short Description

Long Description

1

1

To-be-Pros

To-be-Processed

2

2

In-Process

In-Process

3

3

Processed

Processed

4

4

Cancelled

Cancelled

 

Last Update: 3/12/2021 1:56:37 PM

 

Claim Exclusion Code

NCMMIS Number: 3516

Description: Reason for excluding the claim in Checkwrite

Data Type: CHARACTER

Size: X(1)

Functional Area Owner: Financial

Valid Values:

From Value

Thru Value

Short Description

Long Description

From Value

Thru Value

Short Description

Long Description

A

A

STATE REQA

STATE REQUESTED NOT TO PROCESS - AFTER REQUEST

B

B

INVBNFTPLN

INVALID BENEFIT PLAN

C

C

CLM EDIT

CLAIM HAS EDIT CODE ''00046'', ''00300'' OR ''00628''

D

D

DB ISSUE

FS10001 HAD A DB ISSUE WITH THE CLAIM

E

E

INVRC CLM

BAD RETURN FROM CLAIMS PROCESS

F

F

FIX RCYCLE

FIXED AND READY TO RECYCLE

G

G

NO CMS64

CAN NOT DETERMINE CMS64 FED COST CODE

H

H

INVHLTHPLN

INVALID HEALTH PLAN

I

I

INV PROV

INVALID PROVIDER

J

J

INVCAPSTAT

INVALID CAPITATION CLAIM STATUS

K

K

NO MCCTOS

CAN NOT DETERMINE MCC TOS CODE

L

L

NO CAC

CAN NOT DETERMINE CAC CODE

M

M

PROVMISSNG

PROVIDER IS NOT ON FILE

N

N

NO COS

CAN NOT DETERMINE COS CODE

O

O

NO SHARES

CAN NOT DETERMINE CAC SHARES

P

P

PAYR MSNG

PAYER ID IS MISSING

Q

Q

HMO EDIT

HMO SUBMITTING MEDICAL SERVICES FOR PAYMENT, EDIT CODE: '07026'

R

R

NO COSADJ

COS NOT FOUND FOR DHB ADJUSTMENTS

S

S

STATE REQ

STATE REQUESTED NOT TO PROCESS

T

T

THRSLD AMT

THRESHOLD AMOUNT EXCEEDED

U

U

NO FUNDS

INSUFFICIENT FUNDS FOR DPH PHARMACY

V

V

EXCL DPHRX

EXCLUDE DPH PHARMACY CLAIMS

W

W

NO CACADJ

CAC NOT FOUND FOR ADJUSTMENTS

X

X

COS 6263

ISSUE WITH COS 62/63 PROCESS

Y

Y

INVRC MARS

BAD RETURN FROM MARS PROCESS

Z

Z

INVRC TPL

BAD RETURN FROM TPL PROCESS

0

0

CAP$LIMIT

PAYMENT AMT UPPER LIMIT EXCEEDED - CAPITATION CLAIMS

1

1

NPI CHANGE

TCN EXCLUDED DUE TO NPI DELETION

2

2

CSR1794

ORIG CLM NOT PRCSD FOR ITS ADJ

3

3

REG$LIMIT

PAYMENT AMT UPPER LIMIT EXCEEDED - NON CAPITATION CLAIMS

4

4

CAP CLAIM

CAP CLM WILL NOT BE PROCESSED IN SAME CHKWRT

5

5

NON CAPCLM

NONCAP CLM WILL NOT BE PROCESSED IN SAME CHKWRT

6

6

NO FRC MCH

NO FRC MATCH FOUND IN THE LIST 2060