Professional Documents
Culture Documents
EDGE Server Production and Test Schema Data Dictionary March Release
Version
Date
Author/Owner
Description of Change
1.0
10/19/2014
Accenture / CCIIO
Initial Version
2.0
1/27/2015
Accenture / CCIIO
3.0
2/15/2015
Accenture/CCIIO
Number
3/10/2015
Accenture/CCIIO
5.0
4/17/2015
Accenture/CCIIO
6.0
5/26/2015
Accenture/CCIIO
7.0
10/23/2015
Accenture/CCIIO
Changed the data type from BIT(1) to VARCHAR(1) in the column RA_FLAG
of table MEDICAL_CLAIM.
Deleted the columns: RA_FLAG and RA_REASON_CODE in table
SUPPLEMENTAL_CLAIM.
8.0
1/29/2016
Accenture/CCIIO
2/26/2016
Accenture/CCIIO
10.0
3/17/2016
Accenture/CCIIO
EDGE Server Production and Test Schema Data Dictionary March Release
Contents
1.
INTRODUCTION ..................................................................................................................................................1
2.
DATABASECHANGELOG ......................................................................................................................................2
3.
DATABASECHANGELOGLOCK .............................................................................................................................3
4.
EDGE_ERROR_LOG .............................................................................................................................................4
5.
EDGE_EVENT_LOG..............................................................................................................................................6
6.
INSRD_MMBR .....................................................................................................................................................7
7.
MDCL_CLM_DGNS_CD_ASCTN ..........................................................................................................................8
8.
MEDICAL_CLAIM.................................................................................................................................................9
9.
MEDICAL_CLAIM_SRVC_LINE .......................................................................................................................... 11
10.
MEDICAL_CLAIM_SRVC_MDFR_ASCTN....................................................................................................... 13
11.
MMBR_INSRNC_PLCY_CVRG ....................................................................................................................... 14
12.
MMBR_INSRNC_PLCY_CVRG_CRSS_YR_HSTY............................................................................................. 16
13.
MMBR_INSRNC_PLCY_CVRG_PROFILE_ASCTN........................................................................................... 18
14.
PHARMACY_CLAIM ...................................................................................................................................... 19
15.
PRM_STBLZN_SUBMSN_STUS ..................................................................................................................... 21
16.
RECORD_LEVEL_HIER .................................................................................................................................. 22
17.
RISKSCORE ................................................................................................................................................... 23
18.
RISKSCORE_REMOTE ................................................................................................................................... 25
19.
STNG_ENRLMT_SUBMSN ............................................................................................................................ 27
20.
STNG_INSRD_MMBR_CC_ASSOC ................................................................................................................ 29
21.
STNG_INSRD_MMBR_DGNS_ASSOC_ACCEP .............................................................................................. 30
22.
STNG_INSRD_MMBR_DGNS_UTI_ASSOC ................................................................................................... 31
23.
STNG_INSRD_MMBR_DROP_HCC_ASSOC .................................................................................................. 32
24.
STNG_INSRD_MMBR_HCC_ASSOC.............................................................................................................. 33
25.
STNG_INSRD_MMBR_HCC_GROUP_ASSOC................................................................................................ 34
26.
STNG_MDCL_SUBMSN ................................................................................................................................ 35
27.
STNG_MMBR_INSRNC_PLCY_CVRG_CRSS_YR ............................................................................................ 37
28.
STNG_MMBR_INSRNC_PLCY_CVRG_PROFILE_ASCTN ................................................................................ 39
29.
STNG_PHRMCY_SUBMSN............................................................................................................................ 40
30.
STNG_RADV_POPULATION.......................................................................................................................... 42
ii
EDGE Server Production and Test Schema Data Dictionary March Release
31.
STNG_REINSURANCE ................................................................................................................................... 43
32.
STNG_SPLMNTL_SUBMSN........................................................................................................................... 44
33.
SUB_PLCY..................................................................................................................................................... 46
34.
SUPPLEMENTAL_CLAIM............................................................................................................................... 47
35.
SUB_PLCY_CLM_ASSOC ............................................................................................................................... 49
36.
SUB_CLM_DGNS_CD_ASCTN....................................................................................................................... 50
iii
EDGE Server Production and Test Schema Data Dictionary March Release
1. INTRODUCTION
This data dictionary documents the External Data Gathering Environment (EDGE) Server Production
and Test schemas. Two (2) schemas are utilized by the EDGE server application. The production and
test schemas are identical data models. The test schema can be used to test and validate inbound
eXtensible Markup Language (XML) files. Summary reports generated from the test schema are not
sent to the Centers for Medicare & Medicaid Services (CMS). Both detailed and error reports are
available to the issuer to facilitate remediation of inbound XML issues that may be encountered.
The EDGE Server Production schema is used by the issuer to process production files. Summary
reports generated from the production schema are sent to CMS. Both detailed and error reports are
available to the issuer to review.
EDGE Server Production and Test Schema Data Dictionary March Release
2. DATABASECHANGELOG
Table Name: DATABASECHANGELOG
Group: Tracking Error Liquibase Table
Category: DB change log System Table (for system internal use only)
Table Definition: This is a system level table to track database changes. Should not be modified.
Column Name
Data Type
Column Definition
ID
VARCHAR(255)
Not Null
AUTHOR
VARCHAR(255)
Not Null
FILENAME
VARCHAR(255)
Not Null
DATEEXECUTED
DATETIME
Not Null
ORDEREXECUTED
DATETIME
Not Null
EXECTYPE
VARCHAR(10)
Not Null
Execution type.
MD5SUM
VARCHAR(35)
Null
DESCRIPTION
VARCHAR(255)
Null
Description.
COMMENTS
VARCHAR(255)
Null
Comments.
TAG
VARCHAR(255)
Null
LIQUIBASE
VARCHAR(20)
Null
Liquibase version.
EDGE Server Production and Test Schema Data Dictionary March Release
3. DATABASECHANGELOGLOCK
Table Name: DATABASECHANGELOGLOCK
Group: Tracking Error Liquibase Table
Category: DB change lock System Table (for system internal use only)
Table Definition: This is a system level table to track database changes. Should not be modified.
Column Name
Data Type
Column Definition
ID
INT(11)
Not Null
Unique ID.
LOCKED
BIT(1)
Not Null
LOCKGRANTED
DATETIME
Null
LOCKEDBY
VARCHAR(255)
Null
EDGE Server Production and Test Schema Data Dictionary March Release
4. EDGE_ERROR_LOG
Table Name : EDGE_ERROR_LOG
Group: Staging & Reporting Table
Category: Staging Table
Table Definition: The table logs business validation errors, inline validation errors into this table, and it will be used for generating
the outbound reports.
Column Name
Data Type
Column Definition
UID
INT(10)
Not Null
RECORDID
BIGINT(19)
Not Null
RECORDLEVEL
VARCHAR(45)
Not Null
ELEMENTNAME
VARCHAR(100)
Null
ELEMENTVALUE
VARCHAR(100)
Null
ERRORSPECIFICTYPE
VARCHAR(200)
Null
ERRORCODE
VARCHAR(45)
Null
ERRORDETAIL
VARCHAR(500)
Null
ERRORMESSAGE
VARCHAR(500)
Null
JOBID
BIGINT(19)
Not Null
Null
M Medical Claim
P Pharmacy Claim
E Enrollment
S Supplemental Diagnosis
SUBMISSIONTYPE
VARCHAR(80)
ERROR_TYPE
VARCHAR(50)
Null
ERRORLEVELNO
BIGINT(19)
Null
ERRORTYPENO
BIGINT(19)
Null
1 For required/situational
3 Reference
4 Logical
5 Business
6 System
The Error Code consists of three (3) digits. The first digit
represents the Error Level.
Error type number. Valid values are:
1 For required/situational
3 Reference
4 Logical
5 Business
6 System
EDGE Server Production and Test Schema Data Dictionary March Release
Table Name : EDGE_ERROR_LOG (Cont.)
Group: Staging & Reporting Table
Category: Staging Table
Table Definition: The table logs business validation errors, inline validation errors into this table, and it will be used for generating
the outbound reports.
Column Name
Data Type
Column Definition
STATUS_TYPE
CHAR(1)
Null
A Accept
R Reject
I Informational (Accepted
with warning message)
CLAIM_IDENTIFIER
VARCHAR(80)
Null
MEDICAL_SRVC_LINE_NUM
VARCHAR(20)
Null
EDGE Server Production and Test Schema Data Dictionary March Release
5. EDGE_EVENT_LOG
Table Name : EDGE_EVENT_LOG
Group: Tracking Error Liquibase Table
Category: Transaction table
Table Definition: The table logs each event that happens on edge application into this table.
Column Name
Data Type
Column Definition
UID
BIGINT(19)
NOT NULL
JOB_ID
BIGINT(19)
NULL
JOB_TYPE
VARCHAR(25)
NULL
JOB_COND
VARCHAR(100)
NULL
Pre
Post
EVENT_ID
VARCHAR(100)
NULL
EVENT_VAL
VARCHAR(100)
NULL
Deprecated.
EVENT_MSG
VARCHAR(1000)
NULL
EVENT_RESULT
VARCHAR(10)
NULL
EVENT_ORDER
INT(10)
NULL
CREATN_DT
DATETIME
NULL
CREATD_BY
VARCHAR(50)
NULL
Deprecated.
LAST_MDFYD_DT
DATETIME
NULL
Deprecated.
MDFYD_BY
VARCHAR(50)
NULL
Deprecated.
EDGE Server Production and Test Schema Data Dictionary March Release
6. INSRD_MMBR
Table Name : INSRD_MMBR
Group: Member Table
Category: Ingested Data Table
Table Definition: This table has the ingested enrollee/member information.
Column Name
Data Type
Column Definition
INSRD_MMBR_ID
INT(10)
Not Null
RCVD_SUBMSN_ID
BIGINT(19)
Not Null
DOB
DATE
Not Null
CREATN_DT
DATETIME
Null
INACTIVATION_DT
DATETIME
Null
LAST_CNFRMED_DT
DATETIME
Null
CREATD_BY
VARCHAR(255)
Null
Deprecated.
LAST_MDFYD_DT
DATETIME
Null
MDFYD_BY
VARCHAR(255)
Null
Deprecated.
ISSR_ORG_ID
VARCHAR(5)
Not Null
GNDR_CD
VARCHAR(1)
Not Null
INSRD_MMBR_STUS_CD
BIT(1)
Not Null
RCVD_INSRD_MMBR_ID
VARCHAR(80)
Not Null
RCRD_IDNTFR
BIGINT(19)
Not Null
F Female
M Male
0 inactive
1 active
EDGE Server Production and Test Schema Data Dictionary March Release
7. MDCL_CLM_DGNS_CD_ASCTN
Table Name: MDCL_CLM_DGNS_CD_ASCTN
Group: Claim Table
Category: Ingested Data Table
Table Definition: This table has the ingested Diagnosis Codes from the medical claims.
Column Name
Data Type
Column Definition
UID
BIGINT(19)
Not Null
MEDICAL_CLAIM_UID_FK
BIGINT(19)
Null
CREATN_DT
DATETIME
Null
CREATD_BY
VARCHAR(255)
Null
Deprecated.
LAST_MDFYD_DT
DATETIME
Null
MDFYD_BY
VARCHAR(255)
Null
Deprecated.
ACTV_IND
VARCHAR(1)
Null
Deprecated.
Null
Null
DGNS_CD
DGNS_QLFYR_CD
CHAR(30)
CHAR(2)
EDGE Server Production and Test Schema Data Dictionary March Release
8. MEDICAL_CLAIM
Table Name: MEDICAL_CLAIM
Group: Claim Table
Category: Ingest Data Table
Table Definition: This table has the ingested data for medical claims.
Column Name
Data Type
Column Definition
UID
BIGINT(19)
Not Null
BENEFIT_YEAR
VARCHAR(4)
Not Null
STATEMENT_COVERS_TO_DATE
DATE
Null
STATEMENT_COVERS_FROM_DATE
DATE
Null
ADMISSION_DATE
DATE
Null
Deprecated.
DISCHARGE_DATE
DATE
Null
Deprecated.
ORIGINAL_CLAIM_ID
VARCHAR(50)
Null
CLAIM_ALLOWED_TOTAL_AMOUNT
DECIMAL(18,2)
Null
CLAIM_PAID_TOTAL_AMOUNT
DECIMAL(18,2)
Null
CLAIM_STATUS_UPDATE_DATE
DATE
Null
The date the medical claim status was changed, from active to
inactive.
RECEIVED_INSURED_MEMBER_ID
VARCHAR(80)
Null
BILLING_PROVIDER_ID
CHAR(15)
Null
MEDICAL_CLAIM_ID
VARCHAR(50)
Null
INACTIVATION_DT
DATETIME
Null
CREATION_DATE
DATETIME
Null
System date when the claim was first inserted into the
database.
CREATD_BY
VARCHAR(255)
Null
Deprecated.
LAST_MODIFIED_DATE
DATETIME
Null
MODIFIED_BY
VARCHAR(255)
Null
Deprecated.
INSURANCE_PLAN_ID
VARCHAR(16)
Null
ISSR_ORG_ID
VARCHAR(5)
Not Null
TRANSACTION_TYPE
CHAR(2)
Not Null
O Original
R Replace
V Void
CLAIM_STATUS
VARCHAR(30)
Null
0 inactive
1 active
CLAIM_FILTERING_STATUS
CHAR(1)
Null
Deprecated.
EDGE Server Production and Test Schema Data Dictionary March Release
Table Name: MEDICAL_CLAIM (Cont.)
Group: Claim Table
Category: Ingest Data Table
Table Definition: This table has the ingested data for medical claims.
Column Name
Data Type
Column Definition
CLAIM_FORM_TYPE
CHAR(1)
Null
P Professional
I Institutional
CLAIM_BILL_TYPE
CHAR(3)
Null
DISCHARGE_STATUS
CHAR(2)
Null
CLAIM_TYPE
CHAR(2)
Null
M Medical Claim
P Pharmacy Claim
E Enrollment
S Supplemental Diagnosis
CLAIM_PROCESSED_DATETIME
DATETIME
Null
DERIVED_SERVICE_CLAIM_IND
CHAR(1)
Null
Indicator used to distinguish between fee-forservice claims and claims covered under
capitation.
BILLING_PROVIDER_QLFYR_CODE
CHAR(2)
Null
JOB_ID
BIGINT(19)
Null
DERIVED_BENEFIT_MONTH
VARCHAR(2)
Null
Deprecated.
RECORD_ID
BIGINT(19)
Null
SERVICE_PAID_DATE
DATE
Null
LAST_CONFIRMED_DATE
DATETIME
Null
RA_FLAG
VARCHAR(1)
Null
CLAIM_FAMILY_ID
BIGINT(19)
Not Null
RA_REASON_CODE
VARCHAR(3)
Null
RI_FLAG
VARCHAR(1)
Null
RA_USED
VARCHAR(1)
Null
10
EDGE Server Production and Test Schema Data Dictionary March Release
9. MEDICAL_CLAIM_SRVC_LINE
Table Name: MEDICAL_CLAIM_SRVC_LINE
Group: Claim Table
Category: Ingest Data Table
Table Definition: This table has the ingested data for medical claim service lines.
Column Name
Data Type
Column Definition
MEDICAL_SRVC_LINE_NUM
INT(10)
Not Null
SRVC_FROM_DT
DATE
Null
SRVC_TO_DT
DATE
Null
ALOWD_AMT
DECIMAL(18,2)
Null
PLCY_PD_AMT
DECIMAL(18,2)
Null
MEDICAL_CLAIM_UID_FK
BIGINT(19)
Not Null
UID
BIGINT(19)
Not Null
RNDRNG_PRVDR_ID
CHAR(15)
Null
CREATN_DT
DATETIME
Null
CREATD_BY
VARCHAR(255)
Null
Deprecated.
LAST_MDFYD_DT
DATETIME
Null
MDFYD_BY
VARCHAR(255)
Null
Deprecated.
SRVC_PLACE_CD
CHAR(2)
Null
REV_CD
CHAR(4)
Null
SRVC_CD
CHAR(48)
Null
CLAIM_FLTRING_STUS_CD
CHAR(1)
Null
Deprecated.
Null
SRVC_TYPE_CD
11
CHAR(2)
EDGE Server Production and Test Schema Data Dictionary March Release
Table Name: MEDICAL_CLAIM_SRVC_LINE (Cont.)
Group: Claim Table
Category: Ingest Data Table
Table Definition: This table has the ingested data for medical claim service lines.
Column Name
DRVD_SRVC_CLM_CD
Data Type
CHAR(1)
Column Definition
Null
Indicator used to distinguish between fee-forservice claims and claims covered under
capitation. Valid values are:
N Actual (Fee-For-Service)
RNDRNG_PRVDR_QLFYR_CD
CHAR(2)
Null
RECORD_ID
BIGINT(19)
Null
JOB_ID
BIGINT(19)
Null
12
EDGE Server Production and Test Schema Data Dictionary March Release
10.
MEDICAL_CLAIM_SRVC_MDFR_ASCTN
Column Name
Data Type
Column Definition
SRVC_MDFR_CD
CHAR(2)
Not Null
MEDICAL_CLAIM_SRVC_LINE_UID_FK
BIGINT(19)
Not Null
13
EDGE Server Production and Test Schema Data Dictionary March Release
11.
MMBR_INSRNC_PLCY_CVRG
Column Name
Data Type
Column Definition
MMBR_INSRNC_PLCY_CVRG_ID
BIGINT(19)
Not Null
RCVD_SUBMSN_ID
BIGINT(19)
Not Null
INSRNC_PLAN_ID
VARCHAR(16)
Not Null
CVRG_EFCTV_STRT_DT
DATE
Null
CVRG_EFCTV_END_DT
DATE
Null
INSRNC_PLAN_PRM_AMT
DECIMAL(18,2)
Null
CREATN_DT
DATETIME
Null
Date and time when this row was created in the database.
INACTIVATION_DT
DATETIME
Null
LAST_CNFRMED_DT
DATETIME
Null
Date and time the policy data on this row was last updated.
It is the generation date and time from inbound XML file.
LAST_MDFYD_DT
DATETIME
Null
Date and time when this row was modified in the database.
MDFYD_BY
VARCHAR(255)
Null
Deprecated.
ISSR_ORG_ID
VARCHAR(5)
Not Null
ENRLMT_MNT_TYPE_CD
VARCHAR(6)
Not Null
PLCY_RATG_AREA_CD
VARCHAR(15)
Not Null
INSRD_MMBR_STUS_CD
CHAR(2)
Not Null
0 inactive
1 active
CREATD_BY
VARCHAR(255)
Null
Deprecated.
14
EDGE Server Production and Test Schema Data Dictionary March Release
Table Name : MMBR_INSRNC_PLCY_CVRG (Cont.)
Group: Member Table
Category: Ingested Data Table
Table Definition: This table has the ingested enrollee policy/enrollment period information.
Column Name
Data Type
Column Definition
INSRD_MMBR_ID
INT(10)
Not Null
S Subscriber
SBSCBR_IND
CHAR(1)
Null
SBSCBR_ID
CHAR(80)
Null
RCRD_IDNTFR
BIGINT(19)
Not Null
RI_FLAG
VARCHAR(1)
Null
15
EDGE Server Production and Test Schema Data Dictionary March Release
12.
MMBR_INSRNC_PLCY_CVRG_CRSS_YR_HSTY
Column Name
Data Type
Column Definition
UID
BIGINT(19)
Not Null
The UID.
MMBR_INSRNC_PLCY_CVRG_ID
BIGINT(19)
Not Null
MEDICAL_CLAIM_UID
BIGINT(19)
Null
RCVD_SUBMSN_ID
BIGINT(19)
Not Null
INSRNC_PLAN_ID
VARCHAR(16)
Not Null
CVRG_EFCTV_STRT_DT
DATE
Null
CVRG_EFCTV_END_DT
DATE
Null
INSRNC_PLAN_PRM_AMT
DECIMAL(18,2)
Null
CREATN_DT
DATETIME
Null
Date and time when this row was created in the database.
INACTIVATION_DT
DATETIME
Null
LAST_CNFRMED_DT
DATETIME
Null
Date and time the policy data on this row was last updated.
It is the generation date and time from inbound XML file.
LAST_MDFYD_DT
DATETIME
Null
Date and time when this row was modified in the database.
MDFYD_BY
VARCHAR(255)
Null
Deprecated.
ISSR_ORG_ID
VARCHAR(5)
Not Null
ENRLMT_MNT_TYPE_CD
VARCHAR(6)
Not Null
PLCY_RATG_AREA_CD
VARCHAR(15)
Not Null
16
EDGE Server Production and Test Schema Data Dictionary March Release
Table Name : MMBR_INSRNC_PLCY_CVRG_CRSS_YR_HSTY (Cont.)
Group: Member Table
Category: Association Table
Table Definition: This table hosts the system generated cross-year enrollment periods for each RA run.
Column Name
Data Type
Column Definition
INSRD_MMBR_STUS_CD
CHAR(2)
Not Null
0 inactive
1 active
CREATD_BY
VARCHAR(255)
Null
Deprecated.
INSRD_MMBR_ID
INT(10)
Not Null
S Subscriber
SBSCBR_IND
CHAR(1)
Null
SBSCBR_ID
CHAR(80)
Null
RCRD_IDNTFR
BIGINT(19)
Not Null
RI_FLAG
VARCHAR(1)
Null
17
EDGE Server Production and Test Schema Data Dictionary March Release
13.
MMBR_INSRNC_PLCY_CVRG_PROFILE_ASCTN
Column Name
Data Type
Column Definition
MMBR_INSRNC_PLCY_CVRG_ID_PK_FK
BIGINT(19)
NOT NULL
POLICY_ID
BIGINT(19)
NOT NULL
18
EDGE Server Production and Test Schema Data Dictionary March Release
14.
PHARMACY_CLAIM
Column Name
Data Type
Column Definition
ID
INT(10)
Not Null
JOBID
BIGINT(19)
Not Null
RECEIVED_INSURED_MEMBER_ID
VARCHAR(80)
Null
CLAIM_IDENTIFIER
VARCHAR(50)
Null
CLAIM_PROCESSED_DATETIME
DATETIME
Null
PRESCRIPTION_FILL_DATE
DATE
Not Null
ISSUER_CLAIM_PAID_DATE
DATE
Null
PRESCRIPTION_FILL_NUMBER
INT(10)
Null
PRESCRIPTION_SERVICE_REFEREN
CE_NUMBER
VARCHAR(255)
Null
NATIONAL_DRUG_CODE
VARCHAR(255)
Null
DISPENSING_PROVIDER
_IDENTIFIER
VARCHAR(255)
Null
DISPENSING_PROVIDER_ID_QUALIFI
ER
VARCHAR(255)
Null
DISPENSING_STATUS_CODE
VARCHAR(1)
Null
P Partial fill
POLICY_PAID_AMOUNT
DECIMAL(18,2)
Null
DERIVED_SERVICE_CLAIM_INDICAT
OR
VARCHAR(1)
Null
Y Capitated
N Fee-for-Service
INSURANCE_PLAN_IDENTIFIER
VARCHAR(80)
Null
19
EDGE Server Production and Test Schema Data Dictionary March Release
Table Name : PHARMACY_CLAIM (Cont.)
Group: Claim Table
Category: Ingested Data Table
Table Definition: This table has the ingested pharmacy claim data.
Column Name
Data Type
Column Definition
ISSUER_IDENTIFIER
VARCHAR(80)
Null
VOID_REPLACE_CODE
VARCHAR(1)
Null
V Void
R Replace
ALLOWED_TOTAL_COST_AMOUNT
DECIMAL(18,2)
Null
CREATION_DATE
DATETIME
Null
LAST_MODIFIED_DATE
DATETIME
Null
CREATED_BY
VARCHAR(255)
Null
MODIFIED_BY
VARCHAR(255)
Null
LAST_CONFIRMED_DATE
DATETIME
Null
INACTIVATION_DATE
DATETIME
Null
CLAIM_TRANSACTION_TYPE
VARCHAR(1)
Not Null
V Void
R Replace
O Original
BENEFIT_YEAR
VARCHAR(4)
Not Null
RI_FLAG
VARCHAR(1)
Null
20
EDGE Server Production and Test Schema Data Dictionary March Release
15.
PRM_STBLZN_SUBMSN_STUS
Column Name
Data Type
Column Definition
RCVD_SUBMSN_ID
BIGINT(19)
Not Null
RCVD_SUBMSN_DT_TIME
DATETIME
Null
ISSR_PROCD_RUN_DT
DATETIME
Null
CREATN_DT
DATETIME
Null
FIL_ID
VARCHAR(12)
Null
SBMTTING_ORG_ID
VARCHAR(5)
Null
ZN_CD
VARCHAR(1)
Null
T Test
P Production
SUBMSN_STUS_CD
VARCHAR(1)
Null
Deprecated.
SUBMSN_TYPE_CD
VARCHAR(1)
Null
M Medical Claim
P Pharmacy Claim
E Enrollment
S Supplemental Diagnosis
EXCTN_STUS_CD
VARCHAR(2)
Null
Deprecated.
PRCSG_STUS_CD
VARCHAR(2)
Null
01 In Progress
02 Failed
03 Completed successfully
FIL_STUS_CD
VARCHAR(2)
Null
05 File accepted
06 File rejected
FIL_NM
VARCHAR(34)
Null
GENERIC_INFO
BLOB
Null
Deprecated.
VERSION
VARCHAR(25)
Null
INBOUND_FILE_HASH
VARCHAR(100)
Null
DETAIL_REPORT_HASH
VARCHAR(100)
Null
JOB_END_DT
DATETIME
Null
RA_PROCESSED
BIT(1)
TRUE
21
EDGE Server Production and Test Schema Data Dictionary March Release
16.
RECORD_LEVEL_HIER
Column Name
Data Type
Column Definition
UID
INT(10)
Not Null
JOBID
BIGINT(19)
Not Null
RECORDID
BIGINT(19)
Not Null
PARENT_RECORDID
BIGINT(19)
Null
RECORDLEVEL
VARCHAR(45)
Not Null
CURRENT_ELEMENTID
VARCHAR(100)
Null
Null
M Medical Claim
P Pharmacy Claim
E Enrollment
S Supplemental Diagnosis
Not Null
A Accept
R Reject
SUBMISSIONTYPE
STATUS_TYPE
VARCHAR(80)
CHAR(2)
CLAIM_FORM_TYPE
CHAR(1)
Null
I Institutional
P Professional
CLAIM_REFDATE
VARCHAR(80)
Null
22
EDGE Server Production and Test Schema Data Dictionary March Release
17.
RISKSCORE
Column Name
Data Type
Null Option
Type
Column Definition
MMBR_INSRNC_PLCY_CVRG_ID
BIGINT(19)
Not Null
JOB_ID
BIGINT(19)
Not Null
MODEL_SCORE
DECIMAL(33,15)
Not Null
Model score.
CSR_SCORE
DECIMAL(33,15)
Not Null
DEMOGRAPHIC_SCORE
DECIMAL(33,15)
Not Null
RA_SCORE
DECIMAL(33,15)
Not Null
CC_FLAG
VARCHAR(1)
Not Null
MODEL_TYPE
VARCHAR(20)
Not Null
Adult
Child
Infant
MAX_PERIOD_DATE
DATETIME
Not Null
RA_CLAIM_COUNT
INT(10)
Not Null
TOTAL_PLAN_PAID
VARCHAR(33)
Not Null
DX_TO_CC_UNIQUE_COUNT
INT(10)
Not Null
DX_TO_CC_COUNT
INT(10)
Not Null
DX_UNIQUE_COUNT
INT(10)
Not Null
DX_COUNT
INT(10)
Not Null
CC_UNIQUE_COUNT
INT(10)
Not Null
HCC_UNIQUE_COUNT
INT(10)
Not Null
V3_INDICATOR
VARCHAR(10)
Not Null
SEVERITY_INTER_GRP
VARCHAR(10)
Not Null
INSRNC_PLAN_ID_REP
VARCHAR(14)
Not Null
PLCY_RATG_AREA_CD
VARCHAR(15)
Not Null
INSRD_MMBR_ID
INT(10)
Not Null
MMBR_MNTHS
DECIMAL(33,15)
Null
UTILIZER_IND
VARCHAR(1)
Null
CROSS_YEAR_CLAIM_UID
BIGINT(19)
Null
Null
F Female
M Male
GNDR_CD
23
VARCHAR(1)
EDGE Server Production and Test Schema Data Dictionary March Release
Table Name : RISKSCORE (Cont.)
Group: Member Table
Category: Risk Score Report Table
Table Definition: This table stores data from risk score report.
Column Name
Data Type
Null Option
Type
Column Definition
ARF_AGE
INT(10)
Null
LAST_AGE
INT(10)
Null
INFANT_HCC_SEVERITY
VARCHAR(3)
Null
INFANT_HCC_MATURITY
VARCHAR(3)
Null
RCVD_INSRD_MMBR_ID
VARCHAR(80)
Not Null
CVRG_EFCTV_STRT_DT
DATE
Not Null
CVRG_EFCTV_END_DT
DATE
Not Null
MTL_LVL
VARCHAR(2)
Not Null
EXCHANGE_TYPE
VARCHAR(25)
Not Null
MARKET_TYPE
VARCHAR(20)
Not Null
24
On the exchange
'1' Individual
EDGE Server Production and Test Schema Data Dictionary March Release
18.
RISKSCORE_REMOTE
Column Name
Data Type
Null Option
Type
Column Definition
MMBR_INSRNC_PLCY_CVRG_ID
BIGINT(19)
Not Null
JOB_ID
BIGINT(19)
Not Null
MODEL_SCORE
DECIMAL(33,15)
Not Null
Model score.
CSR_SCORE
DECIMAL(33,15)
Not Null
DEMOGRAPHIC_SCORE
DECIMAL(33,15)
Not Null
RA_SCORE
DECIMAL(33,15)
Not Null
CC_FLAG
VARCHAR(1)
Not Null
MODEL_TYPE
VARCHAR(20)
Not Null
Adult
Child
Infant
MAX_PERIOD_DATE
DATETIME
Not Null
RA_CLAIM_COUNT
INT(10)
Not Null
TOTAL_PLAN_PAID
VARCHAR(33)
Not Null
DX_TO_CC_UNIQUE_COUNT
INT(10)
Not Null
DX_TO_CC_COUNT
INT(10)
Not Null
DX_UNIQUE_COUNT
INT(10)
Not Null
DX_COUNT
INT(10)
Not Null
CC_UNIQUE_COUNT
INT(10)
Not Null
HCC_UNIQUE_COUNT
INT(10)
Not Null
V3_INDICATOR
VARCHAR(10)
Not Null
SEVERITY_INTER_GRP
VARCHAR(10)
Not Null
INSRNC_PLAN_ID_REP
VARCHAR(14)
Not Null
PLCY_RATG_AREA_CD
VARCHAR(15)
Not Null
INSRD_MMBR_ID
INT(10)
Not Null
MMBR_MNTHS
DECIMAL(33,15)
Null
UTILIZER_IND
VARCHAR(1)
Null
CROSS_YEAR_CLAIM_UID
BIGINT(19)
Null
GNDR_CD
VARCHAR(1)
Null
F Female
M Male
ARF_AGE
INT(10)
Null
25
EDGE Server Production and Test Schema Data Dictionary March Release
Table Name : RISKSCORE_REMOTE (Cont.)
Group: Member Table
Category: Risk Score Report Table
Table Definition: This table stores data from risk score report. It is prepared for RADV 15.0.
Column Name
Data Type
Null Option
Type
Column Definition
LAST_AGE
INT(10)
Null
INFANT_HCC_SEVERITY
VARCHAR(3)
Null
INFANT_HCC_MATURITY
VARCHAR(3)
Null
RCVD_INSRD_MMBR_ID
VARCHAR(80)
Not Null
CVRG_EFCTV_STRT_DT
DATE
Not Null
CVRG_EFCTV_END_DT
DATE
Not Null
MTL_LVL
VARCHAR(2)
Not Null
EXCHANGE_TYPE
VARCHAR(25)
Not Null
MARKET_TYPE
VARCHAR(20)
Not Null
26
On the exchange
'1' Individual
EDGE Server Production and Test Schema Data Dictionary March Release
19.
STNG_ENRLMT_SUBMSN
Column Name
Data Type
Column Definition
RCVD_SUBMSN_ID
BIGINT(19)
Not Null
UID
BIGINT(19)
Not Null
FILEIDENTIFIER
VARCHAR(80)
Not Null
EXECUTIONZONECODE
VARCHAR(80)
Not Null
T Test
P Production
GENERATIONDATETIME
VARCHAR(80)
Not Null
SUBMISSIONTYPECODE
VARCHAR(80)
Not Null
M Medical Claim
P Pharmacy Claim
E Enrollment
S Supplemental Diagnosis
INSUREDMEMBERTOTALQUA
NTITY
VARCHAR(80)
Not Null
INSUREDMEMBERPROFILETO
TALQUANTITY
VARCHAR(80)
Not Null
ISSUERRECORDIDENTIFIER
VARCHAR(80)
Null
ISSUERIDENTIFIER
VARCHAR(80)
Null
ISSUERINSUREDMEMBERTOT
ALQUANTITY
VARCHAR(80)
Null
ISSUERINSUREDMEMBERPR
OFILETOTALQUANTITY
VARCHAR(80)
Null
ENROLLEEREOCRDIDENTIFIE
R
VARCHAR(80)
Null
INSUREDMEMBERIDENTIFIER
VARCHAR(80)
Null
INSUREDMEMBERBIRTHDATE
VARCHAR(80)
Null
VARCHAR(80)
Null
Gender of enrollee.
VARCHAR(80)
Null
SUBSCRIBERINDICATOR
VARCHAR(80)
Null
SUBSCRIBERIDENTIFIER
VARCHAR(80)
Null
INSURANCEPLANIDENTIFIER
VARCHAR(80)
Null
COVERAGESTARTDATE
VARCHAR(80)
Null
INSUREDMEMBERGENDERCO
DE
ENROLLMENTPERIODRECOR
DIDENTIFIER
27
EDGE Server Production and Test Schema Data Dictionary March Release
Table Name : STNG_ENRLMT_SUBMSN (Cont.)
Group: Staging & Reporting Table
Category: Transitional Data Table (for application internal use only)
Table Definition: This is a table used by the application to internally stage the enrollment submission files. It should not be
modified.
Column Name
Data Type
Null
Option
Type
Column Definition
COVERAGEENDDATE
VARCHAR(80)
Null
INSURANCEPLANPREMIUMAMOUNT
VARCHAR(80)
Null
RATEAREAIDENTIFIER
VARCHAR(80)
Null
PRCSG_STUS
CHAR(1)
Null
VALIDATIONFLAG
CHAR(1)
Not Null
INTERFACECONTROLRELEASENUMBER
VARCHAR(80)
Null
ENROLLMENTMAINTENANCETYPECODE
VARCHAR(80)
Null
VALIDATIONDATE
VARCHAR(80)
Null
POLICYID
VARCHAR(80)
Null
Policy ID.
POLICYSTARTDATE
VARCHAR(80)
Null
POLICYENDDATE
VARCHAR(80)
Null
28
EDGE Server Production and Test Schema Data Dictionary March Release
20.
STNG_INSRD_MMBR_CC_ASSOC
Column Name
Data Type
Column Definition
UID
INT(10)
Not Null
INSRD_MMBR
INT(10)
Not Null
CC
VARCHAR(30)
Not Null
29
EDGE Server Production and Test Schema Data Dictionary March Release
21.
STNG_INSRD_MMBR_DGNS_ASSOC_ACCEP
Column Name
Data Type
Column Definition
UID
INT(10)
Not Null
INSRD_MMBR
INT(10)
Not Null
DGNS
VARCHAR(30)
Not Null
MEDICAL_CLAIM_UID
VARCHAR(50)
Not Null
30
EDGE Server Production and Test Schema Data Dictionary March Release
22.
STNG_INSRD_MMBR_DGNS_UTI_ASSOC
Column Name
Data Type
Column Definition
UID
INT(10)
Not Null
INSRD_MMBR
INT(10)
Not Null
DGNS
VARCHAR(30)
Not Null
MEDICAL_CLAIM_UID
VARCHAR(50)
Not Null
31
EDGE Server Production and Test Schema Data Dictionary March Release
23.
STNG_INSRD_MMBR_DROP_HCC_ASSOC
Column Name
Data Type
Column Definition
UID
INT(10)
Not Null
INSRD_MMBR_ID
INT(10)
Not Null
DROPPED_HCC_CD
VARCHAR(30)
Not Null
32
EDGE Server Production and Test Schema Data Dictionary March Release
24.
STNG_INSRD_MMBR_HCC_ASSOC
Column Name
Data Type
Column Definition
UID
INT(10)
Not Null
INSRD_MMBR
INT(10)
Not Null
HCC
VARCHAR(30)
Not Null
33
EDGE Server Production and Test Schema Data Dictionary March Release
25.
STNG_INSRD_MMBR_HCC_GROUP_ASSOC
Column Name
Data Type
Column Definition
UID
INT(10)
Not Null
INSRD_MMBR
INT(10)
Not Null
HCC_GROUP
VARCHAR(45)
Not Null
34
EDGE Server Production and Test Schema Data Dictionary March Release
26.
STNG_MDCL_SUBMSN
Column Name
Data Type
Null
Option
Type
Column Definition
RCVD_SUBMSN_ID
BIGINT(19)
Not Null
UID
BIGINT(19)
Not Null
FILEIDENTIFIER
VARCHAR(80)
Not Null
EXECUTIONZONECODE
VARCHAR(80)
Not Null
T Test
P Production
GENERATIONDATETIME
VARCHAR(80)
Not Null
SUBMISSIONTYPECODE
VARCHAR(80)
Not Null
M Medical Claim
P Pharmacy Claim
E Enrollment
S Supplemental Diagnosis
CLAIMDETAILTOTALQUANTITY
VARCHAR(80)
Not Null
CLAIMSERVICELINETOTALQUANTITY
VARCHAR(80)
Not Null
INSURANCEPLANPAIDONFILETOTALAMOUNT
VARCHAR(80)
Not Null
ISSUERRECORDIDENTIFIER
VARCHAR(80)
Null
ISSUERIDENTIFIER
VARCHAR(80)
Null
ISSUERCLAIMDETAILTOTALQUANTITY
VARCHAR(80)
Null
ISSUERCLAIMSERVICELINETOTALQUANTITY
VARCHAR(80)
Null
Total count of claim lines for all claims for the issuer.
ISSUERPLANPAIDTOTALAMOUNT
VARCHAR(80)
Null
PLANRECORDIDENTIFIER
VARCHAR(80)
Null
INSURANCEPLANIDENTIFIER
VARCHAR(80)
Null
INSURANCEPLANCLAIMDETAILTOTALQUANTI
TY
VARCHAR(80)
Null
INSURANCEPLANCLAIMSERVICELINETOTALQ
UANTITY
VARCHAR(80)
Null
Total count of claim lines for all claims for the plan.
INSURANCEPLANPAIDTOTALAMOUNT
VARCHAR(80)
Null
MEDICALHEADERRECORDIDENTIFIER
VARCHAR(80)
Null
Null
INSUREDMEMBERIDENTIFIER
35
VARCHAR(80)
EDGE Server Production and Test Schema Data Dictionary March Release
Table Name : STNG_MDCL_SUBMSN (Cont.)
Group: Staging & Reporting Table
Category: Transitional Data Table (for application internal use only)
Table Definition: This is a table used for application to internally stage the medical submission data. It should not be modified.
Column Name
Data Type
Null
Option
Type
Column Definition
FORMTYPECODE
VARCHAR(80)
Null
CLAIMDIDENTIFIER
VARCHAR(80)
Null
ORIGINALCLAIMIDENTIFIER
VARCHAR(80)
Null
CLAIMPROCESSEDDATETIME
VARCHAR(80)
Null
The date and time when the claim was adjudicated and
resulted in a paid amount or reported encounter.
BILLTYPECODE
VARCHAR(80)
Null
VOIDREPLACECODE
VARCHAR(80)
Null
DIAGNOSISTYPECODE
VARCHAR(80)
Null
DIAGNOSISCODE
BLOB
Null
ADMISSIONDATE
VARCHAR(80)
Null
DISCHARGEDATE
VARCHAR(80)
Null
DISCHARGESTATUSCODE
VARCHAR(80)
Null
STATEMENTCOVERFROMDATE
VARCHAR(80)
Null
STATEMENTCOVERTODATE
VARCHAR(80)
Null
BILLINGPROVIDERIDQUALIFIER
VARCHAR(2)
Null
BILLINGPROVIDERIDENTIFIER
VARCHAR(80)
Null
ALLOWEDTOTALAMOUNT
VARCHAR(80)
Null
POLICYPAIDTOTALAMOUNT
VARCHAR(80)
Null
SERVICELINES
BLOB
Null
SERVICELINECOUNT
INT(10)
Not Null
PRCSG_STUS
CHAR(1)
Null
VALIDATIONFLAG
INT(10)
Not Null
SERVICEPAIDDATE
VARCHAR(80)
Not Null
DERIVEDSERVICECLAIMINDICATOR
CHAR(1)
Not Null
36
EDGE Server Production and Test Schema Data Dictionary March Release
27.
STNG_MMBR_INSRNC_PLCY_CVRG_CRSS_YR
Column Name
Data Type
Column Definition
MMBR_INSRNC_PLCY_CVRG_ID
BIGINT(19)
Not Null
MEDICAL_CLAIM_UID
BIGINT(19)
Null
RCVD_SUBMSN_ID
BIGINT(19)
Not Null
INSRNC_PLAN_ID
VARCHAR(16)
Not Null
CVRG_EFCTV_STRT_DT
DATE
Null
CVRG_EFCTV_END_DT
DATE
Null
INSRNC_PLAN_PRM_AMT
DECIMAL(18,2)
Null
CREATN_DT
DATETIME
Null
Date and time when this row was created in the database.
INACTIVATION_DT
DATETIME
Null
LAST_CNFRMED_DT
DATETIME
Null
Date and time the policy data on this row was last updated.
It is the generation date and time from inbound XML file.
LAST_MDFYD_DT
DATETIME
Null
Date and time when this row was modified in the database.
MDFYD_BY
VARCHAR(255)
Null
Deprecated.
ISSR_ORG_ID
VARCHAR(5)
Not Null
ENRLMT_MNT_TYPE_CD
VARCHAR(6)
Not Null
PLCY_RATG_AREA_CD
VARCHAR(15)
Not Null
37
EDGE Server Production and Test Schema Data Dictionary March Release
Table Name : STNG_MMBR_INSRNC_PLCY_CVRG_CRSS_YR (Cont.)
Group: Staging & Reporting Table
Category: Transitional Data Table (for application internal use)
Table Definition: This is a table used by the application to internally stage the cross-year enrollment submission files. It should not
be modified.
Column Name
Data Type
Column Definition
INSRD_MMBR_STUS_CD
CHAR(2)
Not Null
0 inactive
1 active
CREATD_BY
VARCHAR(255)
Null
Deprecated.
INSRD_MMBR_ID
INT(10)
Not Null
Null
S Subscriber
SBSCBR_IND
CHAR(1)
SBSCBR_ID
CHAR(80)
Null
RCRD_IDNTFR
BIGINT(19)
Not Null
RI_FLAG
VARCHAR(1)
Null
INSRNC_PLAN_ID_REP
VARCHAR(14)
Not Null
38
EDGE Server Production and Test Schema Data Dictionary March Release
28.
STNG_MMBR_INSRNC_PLCY_CVRG_PROFILE_ASCTN
Column Name
Data Type
Column Definition
MMBR_INSRNC_PLCY_CVRG_ID_PK_FK
BIGINT(19)
NOT NULL
POLICY_ID
BIGINT(19)
NOT NULL
39
EDGE Server Production and Test Schema Data Dictionary March Release
29.
STNG_PHRMCY_SUBMSN
Column Name
Data Type
Null
Option
Type
Column Definition
RCVD_SUBMSN_ID
BIGINT(19)
Not Null
UID
BIGINT(19)
Not Null
FILEIDENTIFIER
VARCHAR(80)
Not Null
EXECUTIONZONECODE
VARCHAR(80)
Not Null
T Test
P Production
INTERFACECONTROLRELEASENUMBER
VARCHAR(80)
Null
GENERATIONDATETIME
VARCHAR(80)
Not Null
SUBMISSIONTYPECODE
VARCHAR(80)
Not Null
M Medical Claim
P Pharmacy Claim
E Enrollment
S Supplemental Diagnosis
CLAIMDETAILTOTALQUANTITY
VARCHAR(80)
Not Null
INSURANCEPLANPAIDONFILETOTALAMOUNT
VARCHAR(80)
Not Null
ISSUERRECORDIDENTIFIER
VARCHAR(80)
Null
ISSUERIDENTIFIER
VARCHAR(80)
Null
ISSUERCLAIMDETAILTOTALQUANTITY
VARCHAR(80)
Null
ISSUERPLANPAIDTOTALAMOUNT
VARCHAR(80)
Null
PLANRECORDIDENTIFIER
VARCHAR(80)
Null
INSURANCEPLANIDENTIFIER
VARCHAR(80)
Null
INSURANCEPLANCLAIMDETAILTOTALQUANTITY
VARCHAR(80)
Null
POLICYPAIDTOTALAMOUNT
VARCHAR(80)
Null
PHARMACYDETAILRECORDIDENTIFIER
VARCHAR(80)
Null
INSUREDMEMBERIDENTIFIER
VARCHAR(80)
Null
40
EDGE Server Production and Test Schema Data Dictionary March Release
Table Name : STNG_PHRMCY_SUBMSN (Cont.)
Group: Staging & Reporting Table
Category: Transitional Data Table (for application internal use only)
Table Definition: This is a table used by the application to internally stage the pharmacy submission data. It should not be
modified.
Column Name
Data Type
Null
Option
Type
Column Definition
CLAIMIDENTIFIER
VARCHAR(80)
Null
CLAIMPROCESSEDDATETIME
VARCHAR(80)
Null
PRESCRIPTIONFILLDATE
VARCHAR(80)
Null
ISSUERCLAIMPAIDDATE
VARCHAR(80)
Null
INSUREDMEMBERCLAIMPAIDDATE
VARCHAR(80)
Null
PRESCRIPTIONSERVICEREFERENCENUMBER
VARCHAR(80)
Null
NATIONALDRUGCODE
VARCHAR(80)
Null
DISPENSINGPROVIDERIDQUALIFIER
VARCHAR(80)
Null
DISPENSINGPROVIDERIDENTIFIER
VARCHAR(80)
Null
PRESCRIPTIONFILLNUMBER
VARCHAR(80)
Null
DISPENSINGSTATUSCODE
VARCHAR(80)
Null
VOIDREPLACECODE
VARCHAR(80)
Null
ALLOWEDTOTALCOSTAMOUNT
VARCHAR(80)
Null
POLICYPAIDAMOUNT
VARCHAR(80)
Null
DERIVEDSERVICECLAIMINDICATOR
VARCHAR(80)
Null
PRCSG_STUS
CHAR(1)
Null
VALIDATIONFLAG
BIGINT(19)
Null
41
EDGE Server Production and Test Schema Data Dictionary March Release
30.
STNG_RADV_POPULATION
Column Name
Data Type
Column Definition
INSRD_MMBR_ID
INT(10)
Not Null
RISK_SCORE_AVG
DECIMAL(65,30)
Not Null
MODEL_TYPE
VARCHAR(20)
Not Null
Model type.
CC_FLAG
VARCHAR(1)
Not Null
STRATUM
VARCHAR(45)
Null
MAX_PERIOD_DATE
VARCHAR(45)
Not Null
RA_CLAIM_COUNT
INT(10)
Not Null
TOTAL_PLAN_PAID
VARCHAR(45)
Not Null
DX_TO_CC_UNIQUE_COUNT
INT(10)
Not Null
DX_TO_CC_COUNT
INT(10)
Not Null
DX_UNIQUE_COUNT
INT(10)
Not Null
DX_COUNT
INT(10)
Not Null
CC_UNIQUE_COUNT
INT(10)
Not Null
TOTAL_PREMIUM_AMT
VARCHAR(100)
Null
42
EDGE Server Production and Test Schema Data Dictionary March Release
31.
STNG_REINSURANCE
Column Name
Data Type
Column Definition
UID
INT(10)
Not Null
Unique ID.
INSRD_MMBR_ID
VARCHAR(80)
Null
MEMBER_MONTHS
VARCHAR(80)
Null
Member months.
CSR_MOOP_ADJ
VARCHAR(80)
Null
COINSURANCE_ADJ_TOTAL_RI_PAY
MENT
VARCHAR(80)
Null
INSRNC_PLAN_ID
VARCHAR(16)
Not Null
CLAIM_ID
VARCHAR(50)
Null
Claim ID.
CLAIM_PAID_AMOUNT
VARCHAR(80)
Null
CLAIM_ALLOWED_AMOUNT
VARCHAR(80)
Null
PERIOD_START_DATE
DATETIME
Null
PERIOD_END_DATE
DATETIME
Null
SUB_POLICY_ID
BIGINT(19)
Null
CLAIM_TYPE
VARCHAR(1)
Null
CLAIM_FROM_DATE
DATETIME
Null
43
EDGE Server Production and Test Schema Data Dictionary March Release
32.
STNG_SPLMNTL_SUBMSN
Column Name
Data Type
Null
Option
Type
Column Definition
RCVD_SUBMSN_ID
BIGINT(19)
Not Null
UID
BIGINT(19)
Not Null
FILEIDENTIFIER
VARCHAR(80)
Not Null
EXECUTIONZONECODE
VARCHAR(80)
Not Null
T Test
P Production
INTERFACECONTROLRELEASENUMBER
VARCHAR(80)
Null
GENERATIONDATETIME
VARCHAR(80)
Not Null
SUBMISSIONTYPECODE
VARCHAR(80)
Not Null
M Medical Claim
P Pharmacy Claim
E Enrollment
S Supplemental Diagnosis
FILEDETAILTOTALQUANTITY
VARCHAR(80)
Not Null
ISSUERRECORDIDENTIFIER
VARCHAR(80)
Null
ISSUERIDENTIFIER
VARCHAR(80)
Null
ISSUERFILEDETAILTOTALQUANTITY
VARCHAR(80)
Null
PLANRECORDIDENTIFIER
VARCHAR(80)
Null
INSURANCEPLANIDENTIFIER
VARCHAR(80)
Null
INSURANCEPLANFILEDETAILTOTALQUANTITY
VARCHAR(80)
Null
DETAILRECORDIDENTIFIER
VARCHAR(80)
Null
INSUREDMEMBERIDENTIFIER
VARCHAR(80)
Null
VARCHAR(80)
Null
VARCHAR(80)
Null
SUPPLEMENTALDIAGNOSISDETAILRECORDIDENTI
FIER
ORIGINALCLAIMIDENTIFIER
44
EDGE Server Production and Test Schema Data Dictionary March Release
Table Name : STNG_SPLMNTL_SUBMSN (Cont.)
Group: Staging & Reporting Table
Category: Transitional Data Table (for application internal use only)
Table Definition: This is a table used by the application to internally stage the supplemental submission data. It should not be
modified.
Column Name
Data Type
Null
Option
Type
Column Definition
DETAILRECORDPROCESSEDDATETIME
VARCHAR(80)
Null
ADDDELETEVOIDCODE
VARCHAR(80)
Null
ORIGINALSUPPLEMENTALDETAILID
VARCHAR(80)
Null
SERVICEFROMDATE
VARCHAR(80)
Null
SERVICETODATE
VARCHAR(80)
Null
DIAGNOSISTYPECODE
VARCHAR(80)
Null
SOURCECODE
VARCHAR(80)
Null
MR Medical record
PRCSG_STUS
CHAR(1)
Null
VALIDATIONFLAG
INT(10)
Null
SUPPLEMENTALDIAGNOSISCODE
VARCHAR(80)
Null
45
EDGE Server Production and Test Schema Data Dictionary March Release
33.
SUB_PLCY
Column Name
Data Type
Column Definition
UID
BIGINT(19)
NOT NULL
Unique ID.
MMBR_INSRNC_PLCY_CVRG_ID_FK
BIGINT(19)
NOT NULL
SUB_PLCY_STRT_DT
DATETIME
NOT NULL
SUB_PLCY_END_DT
DATETIME
NOT NULL
SUB_PLCY_ID
BIGINT(19)
NOT NULL
POLICY_ID_FK
BIGINT(19)
NOT NULL
46
EDGE Server Production and Test Schema Data Dictionary March Release
34.
SUPPLEMENTAL_CLAIM
Column Name
Data Type
Column Definition
UID
INT(10)
NOT NULL
BENEFIT_YEAR
VARCHAR(4)
NOT NULL
SUPPLEMENTAL_DETAIL_ID
VARCHAR(50)
NULL
JOB_ID
BIGINT(19)
NOT NULL
DETAIL_RECORD_PROCESSED_DATET
IME
DATETIME
NULL
SERVICE_FROM_DATE
DATE
NULL
SERVICE_TO_DATE
DATE
NULL
ISSUER_IDENTIFIER
VARCHAR(80)
NULL
RECEIVED_INSURED_MEMBER_ID
VARCHAR(80)
NULL
ORIGINAL_CLAIM_IDENTIFIER
VARCHAR(50)
NULL
ORIGINAL_SUPPLEMENTAL_DETAIL_ID
VARCHAR(50)
NULL
NULL
A Add
D Delete
V Void
ADD_DELETE_VOID
47
VARCHAR(1)
EDGE Server Production and Test Schema Data Dictionary March Release
Table Name: SUPPLEMENTAL_CLAIM (Cont.)
Group: Claim Table
Column Name
Data Type
Column Definition
Indicates if the Diagnosis Code is
International Classification of Diseases 9CM (ICD 9-CM) or International
Classification of Diseases 10-CM (ICD 10CM).
Code value for the Diagnosis Code as
determined by classification of
International Classification of Diseases.
Refer to the DGNS_CD_TYPE for valid
values.
Identifies the source of the supplemental
diagnosis. MR for medical record EDI for
electronic data interchanges. Only one (1)
code per supplemental diagnosis. Valid
values are:
MR Medical record
DIAGNOSIS_TYPE_CODE
VARCHAR(2)
NULL
SUPPLEMENTAL_DIAGNOSIS_CODE
VARCHAR(30)
NULL
SOURCE_CODE
VARCHAR(3)
NULL
CREATION_DATE
DATETIME
NULL
LAST_MODIFIED_DATE
DATETIME
NULL
CREATED_BY
VARCHAR(255)
NULL
Deprecated.
MODIFIED_BY
VARCHAR(255)
NULL
Deprecated.
LAST_CONFIRMED_DATE
DATETIME
NULL
INACTIVATION_DATE
DATETIME
NULL
MEDICAL_CLAIM_FAMILY_ID
BIGINT(19)
NULL
48
EDGE Server Production and Test Schema Data Dictionary March Release
35.
SUB_PLCY_CLM_ASSOC
Column Name
Data Type
Column Definition
UID
BIGINT(19)
NOT NULL
Unique ID.
CLAIM_TYPE
VARCHAR(2)
NOT NULL
Claim type.
CLAIM_UID
BIGINT(19)
NOT NULL
SUB_PLCY_UID_FK
BIGINT(19)
NOT NULL
49
EDGE Server Production and Test Schema Data Dictionary March Release
36.
SUB_CLM_DGNS_CD_ASCTN
Column Name
Data Type
Column Definition
UID
BIGINT(19)
Not Null
SUPPLEMENTAL_CLAIM_UID_FK
INT(10)
Null
CREATN_DT
DATETIME
Null
CREATD_BY
VARCHAR(255)
Null
Deprecated.
LAST_MDFYD_DT
DATETIME
Null
MDFYD_BY
VARCHAR(255)
Null
Deprecated.
ACTV_IND
VARCHAR(1)
Null
Deprecated.
DGNS_CD
VARCHAR(30)
Null
DGNS_QLFYR_CD
VARCHAR(2)
Null
50