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Data Elements

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Admission Date MC018 Vermont Medical Claims File Submission
Admission Hour MC019 Vermont Medical Claims File Submission
Admission Source MC021 Vermont Medical Claims File Submission
Admission Type MC020 Vermont Medical Claims File Submission
Admitting Diagnosis MC039 Vermont Medical Claims File Submission
APC MC073 Vermont Medical Claims File Submission
APC Version MC074 Vermont Medical Claims File Submission
Billing Provider Last Name MC078 Vermont Medical Claims File Submission
Billing Provider Number MC076 Vermont Medical Claims File Submission
Charge Amount MC062 Vermont Medical Claims File Submission
Charge Amount PC035 Vermont Pharmacy Claims File Submission
Claim Status MC038 Vermont Medical Claims File Submission
Claim Status PC025 Vermont Pharmacy Claims File Submission
Coinsurance Amount MC066 Vermont Medical Claims File Submission
Coinsurance Amount PC041 Vermont Pharmacy Claims File Submission
Comments HD008 Vermont Medical Eligibility File Submission
Comments HD008 Vermont Medical Claims File Submission
Comments HD008 Vermont Pharmacy Claims File Submission
Compound Drug Indicator PC031 Vermont Pharmacy Claims File Submission
Copay Amount MC065 Vermont Medical Claims File Submission
Copay Amount PC040 Vermont Pharmacy Claims File Submission
Coverage Level Code ME007 Vermont Medical Eligibility File Submission
Coverage Type ME029 Vermont Medical Eligibility File Submission
Date of Service - From MC059 Vermont Medical Claims File Submission
Date of Service - Thru MC060 Vermont Medical Claims File Submission
Date Prescription Filled PC032 Vermont Pharmacy Claims File Submission
Date Processed TR007 Vermont Medical Eligibility File Submission
Date Processed TR007 Vermont Medical Claims File Submission
Date Processed TR007 Vermont Pharmacy Claims File Submission
Date Service Approved (AP Date) MC017 Vermont Medical Claims File Submission
Date Service Approved (AP Date) PC017 Vermont Pharmacy Claims File Submission
Days Supply PC034 Vermont Pharmacy Claims File Submission
Deductible Amount MC067 Vermont Medical Claims File Submission
Deductible Amount PC042 Vermont Pharmacy Claims File Submission
Dental Coverage ME020 Vermont Medical Eligibility File Submission
Discharge Date MC069 Vermont Medical Claims File Submission
Discharge Hour MC022 Vermont Medical Claims File Submission
Discharge Status MC023 Vermont Medical Claims File Submission
Dispense as Written Code PC030 Vermont Pharmacy Claims File Submission
Dispensing Fee PC039 Vermont Pharmacy Claims File Submission
DRG MC071 Vermont Medical Claims File Submission
DRG Version MC072 Vermont Medical Claims File Submission
Drug Code MC075 Vermont Medical Claims File Submission
Drug Code PC026 Vermont Pharmacy Claims File Submission
Drug Name PC027 Vermont Pharmacy Claims File Submission
E-Code MC040 Vermont Medical Claims File Submission
Encrypted Member First Name ME105 Vermont Medical Eligibility File Submission
Encrypted Member First Name MC105 Vermont Medical Claims File Submission
Encrypted Member First Name PC105 Vermont Pharmacy Claims File Submission
Encrypted Member Last Name ME104 Vermont Medical Eligibility File Submission
Results 1 - 50 of 223
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