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Data ElementAPCD Dervied Pharmacy Claim Match
Description

Flag appended when a pharmacy fill occurred for this member during an active enrollment period for the member.  Methodology:  Date of fill (PC032) is within member enrollment and disenrollment dates (ME162A and ME163A).

Values:  

1 = Pharmacy claim matches member record during the member's  Pharmacy claims were processed during member’s enrollment period

0 = Pharmacy claim does not match member during the member's enrollment period claims were not processed during member’s enrollment period

TypeInteger
FormatTinyint
Length
Threshold100%
RequiredComputed
Tip / NotesThis is a derived field that should be used to supplement the submitting entity required field, ME019.
Rank038


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