CareMetx

direct_sales__v

Details of product shipments, payer-plan funding the transaction and copay details for SP direct referrals as reported by Specialty Pharmacy.

Field Type Description
drug_name__v varchar(50) Value will be the name of the drug or product dispensed.
sp_providerid__v varchar(30) SP’s Unique ID associated with a Provider
sp_patientid__v varchar(36) SP’s unique ID associated with a patient
sp_id__v varchar(30) Pharmacy ID to represent the SP of where the sales came from
order_number__v varchar(30) The order number that CareMetx received from SP
hub_order_number__v number(10) The Order number assigned by the CareMetx system for tracking orders sent by the SP’s. This will be a unique identifier in this table
transaction_type__v varchar(30) This field should indicate if the transaction is a sale or return. Indicate ‘S’ for Sale and ‘R’ for Return
referred_by__v varchar(30) Value: ‘Provider’
provider_npi__v varchar(20) Provider NPI number
provider_first_]name__v varchar(50) First name of a provider
provider_last_name__v varchar(50) Last name of a provider
provider_address_1__v varchar(100) Address line 1 of a provider
provider_address_2__v varchar(100) Address line 2 of a provider
provider_city__v varchar(50) City
provider_state__v varchar(2) State
provider_zip__v varchar(10) Zip code. The format should be 00000-0000, with the four digit add-on being optional.
patient_year_of_birth__v varchar(4) Year of the DOB
ndc__v varchar(11) NDC Code of the Product:
ship_date__v date Date when the product was shipped. The date format should be YYYYMMDD .
quantity__v integer(10) Number of units dispensed
days_supply__v integer(5) Number of days supplied for this prescription.
fill_number__v integer(5) Cumulative fill for therapy; 0 indicates first fill, then 1, 2, etc.
refills_remaining__v integer(5) Number of refills remaining for this prescription.
medical_plan_name__v varchar(100) Medical Plan Name from the SP
pbm_name__v varchar(50) Name of Pharmacy Benefit Manager from the SP
copay_amount_paid__v integer(10,2) Amount patient is required to pay for dispense
bin_no__v varchar(30) BIN Number
group_no__v varchar(30) Group Number
pcn__v varchar(30) PCN (processor control number)
nwk_custom_key_value__v varchar(500) Value used to load custom key table in network
raw_filename__v varchar(500) Name of file where this record was loaded from caremetX
date_loaded__v timestamp

Datetime when this record was loaded into Nitro

dispense_details__v

Details of product shipments, payer-plan funding the transaction and copay details for Hub referred Patients as reported by Specialty Pharmacy.

Field Type Description
drug_name__v varchar(50) The name of the drug or product dispensed.
provider_id__v varchar(30) CareMetx generated provider ID associated with this dispense
patient_id__v varchar(30) CareMetx generated unique patient ID associated with this dispense.
sp_id__v varchar(30) ID of the specialty pharmacy
sp_patient_id__v varchar(36) The ID that SP assigned to the patient.
entity_id__v varchar(30) The dispense associated Organization ID that SP sent to hub, if any.
order_number__v varchar(30) Unique transaction number assigned in SP internal system in identifying shipment
order_type__v varchar(30) Values: PAP, Copay or Regular
hub_order_number__v number(10) The Order number assigned by the CareMetx system for tracking orders sent by the SP’s. This will a unique identifier for this table
referred_by__v varchar(30) Value: ‘CareMetx’
provider_npi__v varchar(20) Provider NPI number – Provided by the SP in the Dispense record
provider_first_]name__v varchar(50) First name of a provider – Provided by the SP in the dispense record
provider_last_name__v varchar(50) Last name of a provider - Provided by the SP in the dispense record
provider_address_1__v varchar(100) Address line 1 of a provider - Provided by the SP in the dispense record
provider_address_2__v varchar(100) Address line 2 of a provider - Provided by the SP in the dispense record
provider_city__v varchar(50) City - Provided by the SP in the dispense record
provider_state__v varchar(2) State - Provided by the SP in the dispense record
provider_zip__v varchar(10) Zip code. The format should be 00000-0000, with the four digit add-on being optional.
ndc__v varchar(11) NDC Code of the Product – (###########)
ship_date__v date Date when the product was shipped. The date format should be YYYYMMDD.
quantity__v integer(10) Number of units dispensed (Pills)
days_supply__v integer(5) Number of days supplied for this prescription.
fill_number__v integer(5) Cumulative fill for therapy; 0 indicates first fill, then 1, 2, etc.
refills_remaining__v integer(5) Number of refills remaining for this prescription.
medical_plan_name__v varchar(100) Medical Plan Name
pbm_name__v varchar(50) Name of the Pharmacy Benefit Manager
patient_copay__v decimal(10,2) This is the total copay amount of this dispense.
patient_pay_amount decimal(10,2) The actual copay amount collected from the patient.
copay_card_id__v varchar (20) Copay Card ID
copay_card_amount_used__v decimal(10,2) The amount that the copay program covers for this dispense if known.
bin_no__v varchar(30) BIN Number
group_no__v varchar(30) Group Number
pcn__v varchar(30) PCN (processor control number)
nwk_custom_key_value__v varchar(500) Value used to load custom key table in network
raw_filename__v varchar(500) Name of file where this record was loaded from caremetX
date_loaded__v timestamp Datetime when this record was loaded into Nitro

entity__v

Records of Hospitals, Practices or other Facilities

Field Type Description
entity_id__v varchar(30) Entity ID for the Organization
entity_type__v varchar(30) Value: “Facility”
npi__v varchar(20) National Provider Identification Number
name__v varchar(50) Name of an entity
email_address__v varchar(100) Email address of an entity
raw_filename__v varchar(500) Name of file where this record was loaded from caremetX
date_loaded__v timestamp Datetime when this record was loaded into Nitro

entity_location__v

Locations of the entity

Field Type Description
entity_location_id__v varchar(30) Unique ID for the record
entity_id__v varchar(30) Entity ID for the Organization
entity_type__v varchar(30) Value: “Facility”
address_1__v varchar(50) Address line 1
address_2__V varchar(50) Address line 2
city__v varchar (30) City
state__v varchar(2) State
zip__v varchar(10) Zip code. The format should be 00000-0000, with the four digit add-on being optional.
phone_1__v varchar(20) Phone number Format: 3016861080 or 3016861080 ext. 01
phone_2__v varchar(20) Additional Phone number
fax__v varchar(10) Format: 3016861080
is_primary_location__v varchar (1) Y or N
raw_filename__v varchar(500) Name of file where this record was loaded from caremetX
date_loaded__v timestamp Datetime when this record was loaded into Nitro

first_fill__v

First Fill Information

Field Type Description
sp_id__v varchar(30) ID of the specialty pharmacy
sp_name__v varchar(100) Name of specialty pharmacy
provider_id__v varchar(30) CareMetx generated provider ID associated with this dispense
provider_name__V varchar(150) Name of provider
provider_location_id__v varchar(30)  
provider_city__v varchar(50) City
provider_state__v varchar(2) State
referral_date__v varchar(30) Date of referral
fill_date__v date Date of fill
item_name__v varchar(100) Name of item
ndc__v varchar(11) NDC Code of the Product:
quantity__v numeric(15) Quantity of fill
refill_remaining__v numeric(15) Number of refills remaining for this prescription.
raw_filename__v varchar(500) Name of file where this record was loaded from caremetX
date_loaded__v timestamp Datetime when this record was loaded into Nitro

patient__v

De-identified demographics about the patient

Field Type Description
patient_id__v varchar(30) CareMetx generated unique Patient ID
age__v integer(3) Age of a patient at the time when the file is sent
gender__v varchar(1) Gender of a patient (M/F)
state__v varchar (2) Two digit US State Code of the Patient
diagnosis_code__v varchar(20) ICD9 Code
raw_filename__v varchar(500) Name of file where this record was loaded from caremetX
date_loaded__v timestamp Datetime when this record was loaded into Nitro

patient_status__v

Various statuses that the patient went through. Includes both statuses from Specialty Pharmacy and CareMetx.

Field Type Description
patient_id__v varchar(30) Patient ID of the patient
status_date__v date Date when the patient was changed to this status. The date format should be “YYYYMMDD HH:mm:SS”.
status_code__v varchar(2) Status Codes are defined in Status Lookup File
status_reason_code__v varchar(10) Status Reason Codes are defined in Status Lookup File
raw_filename__v varchar(500) Name of file where this record was loaded from caremetX
date_loaded__v timestamp Datetime when this record was loaded into Nitro

patient_status_lookup__v

Patient Statuses used in CareMetx or provided by Specialty Pharmacy

Field Type Description
status_type__v varchar(20) CareMetx Connect status or SP status. Values: “Hub” or “SP”
status_code__v varchar(2) P/A/C/D
status__v varchar(30) Pending, Active, Cancelled, Discontinued
status_reason_code__v varchar(10) Reason for the status change
status_reason__v varchar(100) e.g. New referral, Processing Benefit Investigation
raw_filename__v varchar(500) Name of file where this record was loaded from caremetX
date_loaded__v timestamp Datetime when this record was loaded into Nitro

provder_location__v

Locations of the provider

Field Type Description
provider_location_id__v varchar(30) Unique ID for the record
provider_id__v varchar(30) CareMetx generated unique Provider ID
address_1__v varchar(50) Address line 1
address_2__v varchar(50) Address line 2
city__v varchar (30) City
state__v varchar(2) State
zip__v varchar(10) Zip code. The format should be 00000-0000, with the four digit add-on being optional.
raw_filename__v varchar(500) Name of file where this record was loaded from caremetX
date_loaded__v timestamp Datetime when this record was loaded into Nitro

provider__v

Profile of the provider

Field Type Description
provider_id__v varchar(30) CareMetx generated unique Provider ID
npi__v varchar(20) National Provider Identification Number
prefix__v varchar(10) Prefix such as Dr, Mr., etc.
first_name__v varchar(50) First name of a provider
last_name__v varchar(50) Last name of a provider
middle_name__v varchar(50) Middle name of a provider
suffix__v varchar(10) Jr, Sr, I, II, III, IV, V, VI
specialty__v varchar(60) Specialty of a provider
email_address__v varchar(100) Email address of a provider
nwk_custom_key_value__v varchar(5000) Value to be used in network's custom key table
raw_filename__v varchar(500) Name of file where this record was loaded from caremetX
date_loaded__v timestamp Datetime when this record was loaded into Nitro

sp_details__v

Profile and address of the Specialty Pharmacy

Field Type Description
sp_id__v varchar(30) Unique identification code of a specialty pharmacy
sp_npi__v varchar(20) Specialty pharmacy NPI number
sp_name__v varchar(100) Name of the specialty pharmacy
address_1__v varchar(50) Primary address of a specialty pharmacy
address_2__v varchar(50) Address of a specialty pharmacy
city__v varchar(30) City of specialty pharmacy
state__v varchar(2) State
zip__v varchar(10) Zip code. The format should be 00000-0000, with the four digit add-on being optional.
raw_filename__v varchar(500) Name of file where this record was loaded from caremetX
date_loaded__v timestamp Datetime when this record was loaded into Nitro