United States Health Information Knowledgebase

 

Data Elements Related to Medical Rebate Data Submission Standard

Name: Medical Rebate Data Submission Standard
Definition: Provides a standardized format for health plans' rebate submissions to multiple manufacturers throughout the industry.
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Adjudication DateDate the claim or adjustment is processed.
Allowed AmountAllowable charges for covered services based on the specially negotiated fee between the provider and MCO.
Billed AmountTotal reasonable and customary fee providers charge to provide the type of service received
Claim NumberA unique identifier for a prescription and claim processor
Contracting Organization (PMO) Contract NumberContract number assigned by the contracting organization.
Contracting Organization (PMO) ID CodeID code assigned by the contracting organization.
Contracting Organization (PMO) ID QualifierIndicates the type of data being submitted in the 'Contracting Organization (PMO) ID Code' (600-66) field.
Contracting Organization (PMO) NameThe name of the contracting organization.
Data LevelThe level of data being submitted.
Data Provider ID CodeCode assigned to identify the data provider.
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