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 |
