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General
837
NCPDP
Facets Tables
Application Tables
100
Market owners need to review this every week to monitor pends and rejects for their market(s).
What is the aging report?
100
Required on all professional lines when then procedure code begins with a 'J'.
What is an NDC and related drug info, such as quantity and unit of measure?
100
Segments and fields
What is how the file is comprised? (no loops)
100
This table holds the data from the claim header.
What is FAC_CMC_CLCL_CLAIM?
100
All pends for all markets are in this table
What is the AGP.PendDetail table?
200
This report must be run two times in every batch.
What is the HIPAA check?
200
LIN and CPT
What two segments are required if sending drug info?
200
In an NCPDP file, overpunch signs are used to indicate this type of value.
What is monetary?
200
This table hold the basic provider information.
What is FAC_CMC_PRPR_PROV?
200
Join on this table to get the pend codes and descriptions.
What is Config.ScrubConfig?
300
The first place you're likely to identify an issue with a paid date range batch.
What is the Batch Reconciliation?
300
Indentifies the referring provider.
What is NM1*DN?
300
Indicates a void transaction on the NCPDP file.
What is B2?
300
In this table you can locate the description for Ex Codes.
What is FAC_CMC_EXCD_EXPL_CD?
300
This table has all the current rejects for all markets.
What is AGP.RejectDetail
400
Research should be done to determine why the dollar amount on this report is greater than 0.
What is the DNS by Batch?
400
The HIPAA standard for 837 transactions.
What is the TR3?
400
The "5010" version of the NCPDP.
What is D.0?
400
You can find member eligibility spans here.
What is FAC_CMC_MEPE_PRCS_ELIG?
400
Use this table to get reject codes and descriptions
What is Config.ClaimStatusCodes
500
In a perfect world we would never see ____ on the batch certification.
What is a variance?
500
On the 837P, this is used to indicate which diagnosis code applies to a specific service line.
What is the Diagnosis Pointer?
500
Prescriptions dispensed by 340b providers.
When are prescritions not eligible for rebate?
500
Where you can find the subscriber ID.
What is the FAC_CMC_SBSB_SUBSC table?
500
Use this table to determine if an encounter has been accepted, rejected, or voided by the state.
What is History.Submissions?