Master Data Element Dictionary, version 20240608: NCMMIS 9501 - 9999
Payor Adjudication Date
NCMMIS Number: 9501
Description: Payor Adjudication Date as found in Claims Header Coordination of Benefits table
Data Type: CHARACTER
Size: X(10)
Functional Area Owner: Claims
Valid Values:
Last Update: 1/16/2013 10:14:10 AM
Payor Control Number
NCMMIS Number: 9502
Description: Payor Control Number as found in the Claims Header Coordination of Benefits table
Data Type: CHARACTER
Size: X(40)
Functional Area Owner: Claims
Valid Values:
Last Update: 1/16/2013 10:21:53 AM
Payor Covered Days Count
NCMMIS Number: 9503
Description: Payor Covered Days Count as found in Claims Header Coordination of Benefits table
Data Type: SMALLINT
Size: S9()
Functional Area Owner: Claims
Valid Values:
Last Update: 1/16/2013 10:24:25 AM
Payor Identifier
NCMMIS Number: 9504
Description: Payor Identifier as found in Claims Header Coordination of Benefits table
Data Type: CHARACTER
Size: X(40
Functional Area Owner: Claims
Valid Values:
Last Update: 1/16/2013 10:27:29 AM
Payor Not Cover Amount
NCMMIS Number: 9505
Description: Payor Not Cover Amount as found in Claims Header Coordination of Benefits
Data Type: DECIMAL
Size: S9(11)v9(2)
Functional Area Owner: Claims
Valid Values:
Last Update: 1/16/2013 10:29:20 AM
Remaining Patient Amount
NCMMIS Number: 9506
Description: Remaining Patient Amount as found in Claims Header Coordination of Benefits table
Data Type: DECIMAL
Size: S9(11)V9(2)
Functional Area Owner: Claims
Valid Values:
Last Update: 1/16/2013 10:30:41 AM
Initial Drug Code
NCMMIS Number: 9507
Description: Initial Drug Code as found in Claims Header Institutional table
Data Type: CHARACTER
Size: X(4)
Functional Area Owner: Claims
Valid Values:
Last Update: 1/16/2013 10:36:06 AM
IRL IO Code
NCMMIS Number: 9508
Description: IRL IO Code as found in Claims JRE IRL Text
Data Type: CHARACTER
Size: X(1)
Functional Area Owner: Reference
Valid Values:
Last Update: 1/16/2013 10:45:04 AM
IRL Text
NCMMIS Number: 9509
Description: IRL Text as found in Claims JRE IRL Text table
Data Type: CHARACTER
Size: X(32650)
Functional Area Owner: Reference
Valid Values:
Last Update: 1/16/2013 11:11:36 AM
State Memo Edit Notes
NCMMIS Number: 9510
Description: State Memo Edit Notes as found in Edit State Memo Notes table
Data Type: CHARACTER
Size: X(5000)
Functional Area Owner: Reference
Valid Values:
Last Update: 1/16/2013 2:04:02 PM
Data Input Text
NCMMIS Number: 9511
Description: Data Input Text as found in Financial Shares Exceptions
Data Type: CHARACTER
Size: X(500)
Functional Area Owner: E-Commerce
Valid Values:
Last Update: 3/4/2021 2:05:51 PM
Data Output Text
NCMMIS Number: 9512
Description: Data Output Text as found in Financial Shares Exceptions
Data Type: CHARACTER
Size: X(2200)
Functional Area Owner: E-Commerce
Valid Values:
Last Update: 3/4/2021 1:50:46 PM
Default Return Code
NCMMIS Number: 9513
Description: Default Return Code as found in Financial Shares Exceptions
Data Type: INTEGER
Size: S9()
Functional Area Owner: E-Commerce
Valid Values:
Last Update: 3/4/2021 1:58:51 PM
Generic Dispensing Fee Amount
NCMMIS Number: 9514
Description: The generic dispensing fee amount
Data Type: DECIMAL
Size: S9(5)V9(2)
Functional Area Owner: Provider
Valid Values:
Last Update: 1/16/2013 2:23:04 PM
Generic Dispensing Rate Effective Date
NCMMIS Number: 9515
Description: The starting date of the generic prescription rate.
Data Type: DATE
Size: X(10)
Functional Area Owner: Provider
Valid Values:
Last Update: 1/16/2013 2:24:26 PM
Generic Dispensing Rate End Date
NCMMIS Number: 9516
Description: The ending date of the rate
Data Type: DATE
Size: X(10)
Functional Area Owner: Provider
Valid Values:
Last Update: 1/16/2013 2:25:15 PM
Generic Dispensing Rate Quarter Begin Date
NCMMIS Number: 9517
Description: The quarter that the rate is effective for.
Data Type: DATE
Size: X(10)
Functional Area Owner: Provider
Valid Values:
Last Update: 1/16/2013 2:26:19 PM
Generic Dispensing Rate Quarter End Date
NCMMIS Number: 9518
Description: The ending date of the effective quarter.
Data Type: DATE
Size: X(10)
Functional Area Owner: Provider
Valid Values:
Last Update: 1/16/2013 2:27:15 PM
Generic Dispensing Rate Type Code
NCMMIS Number: 9519
Description: Generic Dispensing Rate Type Code
Data Type: CHARACTER
Size: X(2)
Functional Area Owner: Provider
Valid Values:
Last Update: 1/16/2013 2:28:36 PM
Number of Paid Claims
NCMMIS Number: 9520
Description: Number of precriptions that have been paid to the provider
Data Type: SMALLINT
Size: S9()
Functional Area Owner: Provider
Valid Values:
Last Update: 1/16/2013 2:30:35 PM
Number of Paid Generic Claims
NCMMIS Number: 9521
Description: The number of generic prescriptions that have been paid for the provider
Data Type: SMALLINT
Size: S9()
Functional Area Owner: Provider
Valid Values:
Last Update: 1/16/2013 2:31:44 PM
Provider Generic Dispensing Rate
NCMMIS Number: 9522
Description: The rate being given to the provider for the generic prescriptions that have been written
Data Type: DECIMAL
Size: S9(5)V9(2)
Functional Area Owner: Provider
Valid Values:
Last Update: 1/16/2013 2:33:37 PM
Rate Variance
NCMMIS Number: 9523
Description: The variance being allowed for the generic prescription rates.
Data Type: DECIMAL
Size: S9(5)V9(2)
Functional Area Owner: Provider
Valid Values:
Last Update: 1/16/2013 2:35:20 PM
Response Held Data
NCMMIS Number: 9524
Description: Response Held Data as found in HIPAA 278 Temporary Hold
Data Type: SMALLINT
Size: S9()
Functional Area Owner: E-Commerce
Valid Values:
Last Update: 3/4/2021 1:57:03 PM
Data In Text
NCMMIS Number: 9525
Description: Data In Text as found in HIPAA Raw In Transaction Storage
Data Type: CHARACTER
Size: X(32000)
Functional Area Owner: E-Commerce
Valid Values:
Last Update: 3/4/2021 2:02:37 PM
Data Transaction Sequence Number
NCMMIS Number: 9526
Description: Data Transaction Sequence Number as found in MEVS Response
Data Type: SMALLINT
Size: S9()
Functional Area Owner: E-Commerce
Valid Values:
Last Update: 3/4/2021 1:52:15 PM
HD Partition Key
NCMMIS Number: 9527
Description: HD Partition Key as found in HIPAA Raw In Transaction Storage
Data Type: SMALLINT
Size: S9()
Functional Area Owner: E-Commerce
Valid Values:
Last Update: 3/4/2021 1:55:34 PM
Data Out Text
NCMMIS Number: 9528
Description: Data Out Text as found in HIPAA Raw Out Transaction Storage table
Data Type: CHARACTER
Size: X(32000)
Functional Area Owner: E-Commerce
Valid Values:
Last Update: 3/4/2021 2:03:39 PM
Submitting Source Code
NCMMIS Number: 9529
Description: Submitting Source Code as found in HIPAA Raw Out Transaction Storage table
Data Type: CHARACTER
Size: X(1)
Functional Area Owner: E-Commerce
Valid Values:
Last Update: 3/4/2021 1:51:15 PM
Test Case Data Text
NCMMIS Number: 9530
Description: Test Case Data Text as found in HIPAA Test Case table
Data Type: CHARACTER
Size: X(32000)
Functional Area Owner: E-Commerce
Valid Values:
Last Update: 3/4/2021 1:59:15 PM
Test Case Device Type
NCMMIS Number: 9531
Description: Test Case Device Type as found in HIPAA Test Case table
Data Type: CHARACTER
Size: X(8)
Functional Area Owner: E-Commerce
Valid Values:
Last Update: 3/4/2021 2:05:02 PM
Test Case Number
NCMMIS Number: 9532
Description: Test Case Number as found in HIPAA Test Case table
Data Type: CHARACTER
Size: X(25)
Functional Area Owner: E-Commerce
Valid Values:
Last Update: 3/4/2021 1:52:21 PM
Test Case Transaction Code
NCMMIS Number: 9533
Description: Test Case Transaction Code as found in HIPAA Test Case table
Data Type: CHARACTER
Size: X(4)
Functional Area Owner: E-Commerce
Valid Values:
Last Update: 3/4/2021 1:57:32 PM
Hospital Begin date
NCMMIS Number: 9534
Description: Beginning date of the effective date range
Data Type: DATE
Size: X(10)
Functional Area Owner: Provider
Valid Values:
Last Update: 1/16/2013 3:49:43 PM
Hospital End Date
NCMMIS Number: 9535
Description: Ending date of the effective date range
Data Type: DATE
Size: X(10)
Functional Area Owner: Provider
Valid Values:
Last Update: 1/16/2013 3:50:50 PM
PA Letter EPSDT Code Reason
NCMMIS Number: 9536
Description: EPSDT Criteria Reason stores the reviewers explanation of why the PA request did not meet the EPSDT criteria.
Data Type: CHARACTER
Size: X(250)
Functional Area Owner: Prior Authorization
Valid Values:
Last Update: 1/21/2013 12:27:36 PM
PA Maintenance of Service Reason
NCMMIS Number: 9537
Description: A MOS Reason identifies why a new maintenance of services PA detail line is created.
Data Type: CHARACTER
Size: X(2)
Functional Area Owner: Prior Authorization
Valid Values:
Last Update: 1/21/2013 12:33:35 PM
Prior Authorization Auto GCN
NCMMIS Number: 9538
Description: Prior Authorization Auto GCN as found in A_PA_AUTO_GCN_TB
Data Type: CHARACTER
Size: X(5)
Functional Area Owner: Provider
Valid Values:
Last Update: 1/21/2013 12:42:17 PM
COE Code
NCMMIS Number: 9539
Description: COE Code as found in I_TH_CLIENT_TB
Data Type: CHARACTER
Size: X(2)
Functional Area Owner: Provider
Valid Values:
Last Update: 1/21/2013 12:44:18 PM
Other Insurance Coverage Begin Date
NCMMIS Number: 9540
Description: The date other insurance coverage began
Data Type: DATE
Size: X(10)
Functional Area Owner: Recipient
Valid Values:
Last Update: 1/21/2013 1:25:12 PM
Other Insurance Coverage End Date
NCMMIS Number: 9541
Description: The date other insurance coverage ended
Data Type: DATE
Size: X(10)
Functional Area Owner: Recipient
Valid Values:
Last Update: 1/21/2013 1:25:56 PM
Other Insurance Coverage Record Status
NCMMIS Number: 9542
Description: Denotes the status of the other insurance coverage.
Data Type: CHARACTER
Size: X(1)
Functional Area Owner: Recipient