United States Health Information Knowledgebase


Action Code

Name:Action Code
Definition:Processing action requested.
Type:Data Element
Representation Format:M
Registration Authority:National Council for Prescription Drug Programs
Source:National Council for Prescription Drug Programs
Minimum Size:1
Maximum Size:1
Permissible Values:
Code / Value Meaning Meaning Definition Text
A Member is being added as new member to the group and/or processor control number. If the member was previously in a different group and changes to a new one, this would be an add with a new effective date. Not Provided
R The member, within the group, was previously terminated. This transaction makes the member eligible again. Not Provided
S Suspend eligibility of Group or Member until Reinstate is received. Not Provided
T The last day of coverage for the member, within the group. If the member is changing groups, the records are provided: (1) Terminate in previous group (2) Add in new group with or without lapse in coverage Not Provided
U Acts as Change if the record exists and an Add if it does not. Not Provided
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There are no Conceptual Domains linked to Action Code.

Relationship Organization Item
utilizes NCPDP Action Code Value Set   
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