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Data Elements

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Admission Date MC018 Virginia Medical Claims File Submission
Admission Hour MC019 Virginia Medical Claims File Submission
Admission Source MC021 Virginia Medical Claims File Submission
Admission Type MC020 Virginia Medical Claims File Submission
Admitting Diagnosis MC039 Virginia Medical Claims File Submission
APC MC073 Virginia Medical Claims File Submission
APC Version MC074 Virginia Medical Claims File Submission
Beginning Month HD004 Virginia Member Eligibility File Submission
Beginning Month TR004 Virginia Member Eligibility File Submission
Beginning Month HD004 Virginia Medical Claims File Submission
Beginning Month TR004 Virginia Medical Claims File Submission
Beginning Month HD004 Virginia Pharmacy Claims File Submission
Beginning Month TR004 Virginia Pharmacy Claims File Submission
Beginning Month HD004 Virginia Provider File Submission
Beginning Month TR004 Virginia Provider File Submission
Billing Provider LastName or Organization Name MC078 Virginia Medical Claims File Submission
Billing Provider Number MC076 Virginia Medical Claims File Submission
Carrier Associated with Claim MC207 Virginia Medical Claims File Submission
Carrier Associated with Claim PC203 Virginia Pharmacy Claims File Submission
Carrier Plan Specific Contract Number or Subscriber/Member Social Security Number MC208 Virginia Medical Claims File Submission
Carrier Plan Specific Contract Number or Subscriber/Member Social Security Number PC204 Virginia Pharmacy Claims File Submission
Charge Amount MC062 Virginia Medical Claims File Submission
Charge Amount PC035 Virginia Pharmacy Claims File Submission
Claim Status MC038 Virginia Medical Claims File Submission
Claim Status PC025 Virginia Pharmacy Claims File Submission
Co-pay Amount MC065 Virginia Medical Claims File Submission
Co-pay Amount PC040 Virginia Pharmacy Claims File Submission
Coinsurance Amount MC066 Virginia Medical Claims File Submission
Coinsurance Amount PC041 Virginia Pharmacy Claims File Submission
Compound Drug Indicator PC031 Virginia Pharmacy Claims File Submission
Coverage Level Code ME007 Virginia Member Eligibility File Submission
Coverage Type ME029 Virginia Member Eligibility File Submission
Date of Service - From MC059 Virginia Medical Claims File Submission
Date of Service - Thru MC060 Virginia Medical Claims File Submission
Date Prescription Filled PC032 Virginia Pharmacy Claims File Submission
Date Service Approved/Accounts Payable Date/Actual Paid Date MC017 Virginia Medical Claims File Submission
Date Service Approved (AP Date) PC017 Virginia Pharmacy Claims File Submission
Days Supply PC034 Virginia Pharmacy Claims File Submission
Deductible Amount MC067 Virginia Medical Claims File Submission
Deductible Amount PC042 Virginia Pharmacy Claims File Submission
Dental Coverage ME020 Virginia Member Eligibility File Submission
Discharge Date MC069 Virginia Medical Claims File Submission
Discharge Hour MC022 Virginia Medical Claims File Submission
Discharge Status MC023 Virginia Medical Claims File Submission
Dispensed as Written Code PC030 Virginia Pharmacy Claims File Submission
Dispensing Fee PC039 Virginia Pharmacy Claims File Submission
DRG MC071 Virginia Medical Claims File Submission
DRG Version MC072 Virginia Medical Claims File Submission
Drug Code MC075 Virginia Medical Claims File Submission
Drug Code PC026 Virginia Pharmacy Claims File Submission
Results 1 - 50 of 262
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