ClaimHeader__x

Name	Label	Type	Description
Id	ID	ID
ExternalId	External ID	TEXT(1000)
DisplayUrl	Display URL	URL
AcceptedOn__c	Accepted On	DATE
AdjudicatedAmount__c	Adjudicated Amount	CURRENCY(10,8)
AdjudicatedOn__c	Adjudicated On	DATE
BilledDRGCode__c	Billed DRG Code	TEXT(64)
ClaimAmount__c	Claim Amount	CURRENCY(18,0)
ClaimNumber__c	Claim Number	TEXT(64)
ClaimStatus__c	Claim Status	TEXT(64)
DrugName__c	Drug Name	TEXT(255)
DrugQuantity__c	Drug Quantity	TEXT(64)
DrugSupplyDays__c	Drug Supply Days	NUMBER(10,8)
EDIMessage__c	Raw EDI Message	TEXT AREA (LONG)(131072)
FillDate__c	Fill Date	DATE
FormularyTier__c	Formulary Tier	TEXT(64)
HIC3ClassCode__c	HIC3 Class Code	TEXT(64)
IsFormulaStatus__c	Is Formula Status	TEXT(8)
IsGeneric__c	Is Generic	TEXT(8)
IsRefillAuthorized__c	Is Refill Authorized	TEXT(8)
MemberPlanId__c	Member Plan	LOOKUP
NDC__c	NDC	TEXT(64)
Name__c	Name	TEXT(64)
PartBorPartD__c	Part B or Part D	TEXT(64)
PayerId__c	Payer	LOOKUP
PaymentDate__c	Payment Date	DATE
PreauthNumber__c	Preauth Number	TEXT(64)
ReferralNumber__c	Referral Number	TEXT(64)
SourceSystemIdentifier__c	Source System Identifier	TEXT(255)
SourceSystemModified__c	Source System Modified	DATETIME
SourceSystem__c	Source System	TEXT(64)
StandardGenericTherapeuticClass__c	Standard Generic Therapeutic Class	TEXT(64)
StandardTherapeuticClassDescription__c	Standard Therapeutic Class Description	TEXT(255)
SubmittedOn__c	Submitted On	DATE
Type__c	Type	TEXT(255)

Name	Id
Label	ID
Type	ID
Required	Yes

Name	ExternalId
Label	External ID
Type	TEXT(1000)

Name	DisplayUrl
Label	Display URL
Type	URL

Name	AcceptedOn__c
Label	Accepted On
Type	DATE
Help Text	Date on which the claim was accepted.

Name	AdjudicatedAmount__c
Label	Adjudicated Amount
Type	CURRENCY(10,8)
Help Text	Amount paid for the service by primary payer.

Name	AdjudicatedOn__c
Label	Adjudicated On
Type	DATE
Help Text	Date on which adjudicated amount was paid by the primary payer.

Name	BilledDRGCode__c
Label	Billed DRG Code
Type	TEXT(64)
Help Text	Diagnosis-related group (DRG) code.

Name	ClaimAmount__c
Label	Claim Amount
Type	CURRENCY(18,0)
Help Text	Amount submitted with the original claim.

Name	ClaimNumber__c
Label	Claim Number
Type	TEXT(64)
Help Text	ID of the claim.

Name	ClaimStatus__c
Label	Claim Status
Type	TEXT(64)
Help Text	Current status of the claim.

Name	DrugName__c
Label	Drug Name
Type	TEXT(255)
Help Text	Name of the drug.

Name	DrugQuantity__c
Label	Drug Quantity
Type	TEXT(64)
Help Text	Authorized quantity per refill.

Name	DrugSupplyDays__c
Label	Drug Supply Days
Type	NUMBER(10,8)
Help Text	Number of days the supply is authorized.

Name	EDIMessage__c
Label	Raw EDI Message
Type	TEXT AREA (LONG)(131072)
Help Text	Text of the original EDI message.

Name	FillDate__c
Label	Fill Date
Type	DATE
Help Text	Date on which the drug was filled by the pharmacy.

Name	FormularyTier__c
Label	Formulary Tier
Type	TEXT(64)
Help Text	The formulary tier level for the drug.

Name	HIC3ClassCode__c
Label	HIC3 Class Code
Type	TEXT(64)
Help Text	Hierarchical Specific Therapeutic (HIC3) class code assigned to the service.

Name	IsFormulaStatus__c
Label	Is Formula Status
Type	TEXT(8)
Help Text	Indicates whether the drug is approved for coverage by the payer.

Name	IsGeneric__c
Label	Is Generic
Type	TEXT(8)
Help Text	Indicates whether the drug is generic.

Name	IsRefillAuthorized__c
Label	Is Refill Authorized
Type	TEXT(8)
Help Text	Indicates whether refills for the drug are authorized.

Name	MemberPlanId__c
Label	Member Plan
Type	LOOKUP
Foreign key	Yes
Help Text	ID of member plan that this claim is related to.

Name	NDC__c
Label	NDC
Type	TEXT(64)
Help Text	National Drug Code (NDC) identification number for the drug associated with the claim.

Name	Name__c
Label	Name
Type	TEXT(64)
Help Text	Name of the claim record.

Name	PartBorPartD__c
Label	Part B or Part D
Type	TEXT(64)
Help Text	Indicates whether the drug has Medicare Part B or Part D coverage. For example, enter "Type B" when the drug is covered under Medicare Part B.

Name	PayerId__c
Label	Payer
Type	LOOKUP
Foreign key	Yes
Help Text	ID of the payer that this claim is related to.

Name	PaymentDate__c
Label	Payment Date
Type	DATE
Help Text	Date on which claim was paid out.

Name	PreauthNumber__c
Label	Preauth Number
Type	TEXT(64)
Help Text	Preauthorization number for the service.

Name	ReferralNumber__c
Label	Referral Number
Type	TEXT(64)
Help Text	ID of the referral for the service.

Name	SourceSystemIdentifier__c
Label	Source System Identifier
Type	TEXT(255)
Help Text	Identifer of the system where this claim was sourced from.

Name	SourceSystemModified__c
Label	Source System Modified
Type	DATETIME
Help Text	Timestamp of the most recent update from the source system.

Name	SourceSystem__c
Label	Source System
Type	TEXT(64)
Help Text	Name of the system where this claim originated.

Name	StandardGenericTherapeuticClass__c
Label	Standard Generic Therapeutic Class
Type	TEXT(64)
Help Text	Therapeutic drug category according to the American Hospital Formulary Service (AHFS) classification system.

Name	StandardTherapeuticClassDescription__c
Label	Standard Therapeutic Class Description
Type	TEXT(255)
Help Text	Description of the therapeutic category of drug according to the American Hospital Formulary Service (AHFS) classification system.

Name	SubmittedOn__c
Label	Submitted On
Type	DATE
Help Text	Claim submission date.

Name	Type__c
Label	Type
Type	TEXT(255)
Help Text	Type of claim.

Name	Parent object	Child object	Parent object field	Child object field
FirstPublishLocation	ClaimHeader__x	ContentVersion	Id	FirstPublishLocationId

Name	Parent object	Child object	Parent object field	Child object field
MemberPlanId__r	MemberPlan	ClaimHeader__x	Id	MemberPlanId__c
PayerId__r	Account	ClaimHeader__x	Id	PayerId__c

Label	Value