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Data Elements

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Admission Date MC018 Minnesota Medical Claims File Submission
Admission Source MC021 Minnesota Medical Claims File Submission
Admission Type MC020 Minnesota Medical Claims File Submission
Admitting Diagnosis MC039 Minnesota Medical Claims File Submission
Billing Provider Last Name MC078 Minnesota Medical Claims File Submission
Billing Provider Number MC076 Minnesota Medical Claims File Submission
Charge Amount MC062 Minnesota Medical Claims File Submission
Check Issue or EFT Effective Date MC017 Minnesota Medical Claims File Submission
Claim Status PC025 Minnesota Pharmacy Claims File Submission
Claim Submitter's Identifier MC004A Minnesota Medical Claims File Submission
Comments HD008 Minnesota Medical Eligibility File Submission
Comments HD008 Minnesota Medical Claims File Submission
Comments HD008 Minnesota Pharmacy Claims File Submission
Compound Drug Indicator PC031 Minnesota Pharmacy Claims File Submission
Copay / Co-insurance Amount MC065 Minnesota Medical Claims File Submission
Copay / Co- insurance Amount PC040 Minnesota Pharmacy Claims File Submission
Date of Service - From MC059 Minnesota Medical Claims File Submission
Date of Service - Thru MC060 Minnesota Medical Claims File Submission
Date Prescription Filled PC032 Minnesota Pharmacy Claims File Submission
Date Processed TR007 Minnesota Medical Eligibility File Submission
Date Processed TR007 Minnesota Medical Claims File Submission
Date Processed TR007 Minnesota Pharmacy Claims File Submission
Date Service Approved (AP Date) PC017 Minnesota Pharmacy Claims File Submission
Days Supply PC034 Minnesota Pharmacy Claims File Submission
Deductible Amount MC067 Minnesota Medical Claims File Submission
Deductible Amount PC042 Minnesota Pharmacy Claims File Submission
Diagnosis Code Pointer -1 MC079 Minnesota Medical Claims File Submission
Diagnosis Code Pointer -2 MC080 Minnesota Medical Claims File Submission
Diagnosis Code Pointer -3 MC081 Minnesota Medical Claims File Submission
Diagnosis Code Pointer -4 MC082 Minnesota Medical Claims File Submission
Discharge Status MC023 Minnesota Medical Claims File Submission
Dispense as Written Code PC030 Minnesota Pharmacy Claims File Submission
Dispensing Fee Paid PC039 Minnesota Pharmacy Claims File Submission
Drug Code PC026 Minnesota Pharmacy Claims File Submission
Drug Name PC027 Minnesota Pharmacy Claims File Submission
E-Code MC040 Minnesota Medical Claims File Submission
Generic Drug Indicator PC029 Minnesota Pharmacy Claims File Submission
Gross Amount Due PC035 Minnesota Pharmacy Claims File Submission
Header/ Line Payment Indicator MC063A Minnesota Medical Claims File Submission
Health Care Home Assigned Flag ME032 Minnesota Medical Eligibility File Submission
Health Care Home Name ME036 Minnesota Medical Eligibility File Submission
Health Care Home National Provider ID ME035 Minnesota Medical Eligibility File Submission
Health Care Home Number ME033 Minnesota Medical Eligibility File Submission
Health Care Home Tax ID Number ME034 Minnesota Medical Eligibility File Submission
Individual Relationship Code ME012 Minnesota Medical Eligibility File Submission
Individual Relationship Code MC011 Minnesota Medical Claims File Submission
Individual Relationship Code PC011 Minnesota Pharmacy Claims File Submission
Ingredient Cost/List Price PC037 Minnesota Pharmacy Claims File Submission
Insurance Type/ Product Code PC003 Minnesota Pharmacy Claims File Submission
Insurance Type / Product Code ME003 Minnesota Medical Eligibility File Submission
Results 1 - 50 of 192
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