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Data Elements

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Admission Date MC018 New Hampshire Medical Claims File Submission
Admission Hour MC019 New Hampshire Medical Claims File Submission
Admission Source MC021 New Hampshire Medical Claims File Submission
Admission Type MC020 New Hampshire Medical Claims File Submission
Admitting Diagnosis MC039 New Hampshire Medical Claims File Submission
APC MC073 New Hampshire Medical Claims File Submission
APC Version MC074 New Hampshire Medical Claims File Submission
Billing Provider Last Name MC078 New Hampshire Medical Claims File Submission
Billing Provider Last Name DC044 New Hampshire Dental Claims File Submission
Billing Provider Number MC076 New Hampshire Medical Claims File Submission
Billing Provider Number DC042 New Hampshire Dental Claims File Submission
CDT Code DC032 New Hampshire Dental Claims File Submission
Charge Amount MC062 New Hampshire Medical Claims File Submission
Charge Amount PC035 New Hampshire Pharmacy Claims File Submission
Charge Amount DC037 New Hampshire Dental Claims File Submission
Claim Status MC038 New Hampshire Medical Claims File Submission
Claim Status PC025 New Hampshire Pharmacy Claims File Submission
Claim Status DC031 New Hampshire Dental Claims File Submission
Coinsurance Amount MC066 New Hampshire Medical Claims File Submission
Coinsurance Amount PC041 New Hampshire Pharmacy Claims File Submission
Coinsurance Amount DC040 New Hampshire Dental Claims File Submission
Comments HD008 New Hampshire Medical Eligibility File Submission
Comments HD008 New Hampshire Medical Claims File Submission
Comments HD008 New Hampshire Pharmacy Claims File Submission
Comments HD008 New Hampshire Dental Claims File Submission
Compound Drug Indicator PC031 New Hampshire Pharmacy Claims File Submission
Copay Amount MC065 New Hampshire Medical Claims File Submission
Copay Amount PC040 New Hampshire Pharmacy Claims File Submission
Copay Amount DC039 New Hampshire Dental Claims File Submission
Coverage Level Code ME007 New Hampshire Medical Eligibility File Submission
Coverage Type ME029 New Hampshire Medical Eligibility File Submission
Date of Service - From MC059 New Hampshire Medical Claims File Submission
Date of Service - From DC035 New Hampshire Dental Claims File Submission
Date of Service - Thru MC060 New Hampshire Medical Claims File Submission
Date of Service - Thru DC036 New Hampshire Dental Claims File Submission
Date Prescription Filled PC032 New Hampshire Pharmacy Claims File Submission
Date Processed TR007 New Hampshire Medical Eligibility File Submission
Date Processed TR007 New Hampshire Medical Claims File Submission
Date Processed TR007 New Hampshire Pharmacy Claims File Submission
Date Processed TR007 New Hampshire Dental Claims File Submission
Date Service Approved (AP Date) MC017 New Hampshire Medical Claims File Submission
Date Service Approved (AP Date) PC017 New Hampshire Pharmacy Claims File Submission
Date Service Approved (AP Date) DC017 New Hampshire Dental Claims File Submission
Days Supply PC034 New Hampshire Pharmacy Claims File Submission
Deductible Amount MC067 New Hampshire Medical Claims File Submission
Deductible Amount PC042 New Hampshire Pharmacy Claims File Submission
Deductible Amount DC041 New Hampshire Dental Claims File Submission
Dental Coverage ME020 New Hampshire Medical Eligibility File Submission
Discharge Date MC069 New Hampshire Medical Claims File Submission
Discharge Hour MC022 New Hampshire Medical Claims File Submission
Results 1 - 50 of 286
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