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DBIA434 ICR (434)

DBIA434    ICR (434)

Name Value
NUMBER 434
IA # 434
FILE NUMBER 408.31
GLOBAL ROOT DGMT(408.31,
DATE CREATED 1994/04/05
CUSTODIAL PACKAGE REGISTRATION
CUSTODIAL ISC Albany
USAGE Controlled Subscription
TYPE File
DBIC APPROVAL STATUS APPROVED
NAME DBIA434
ORIGINAL NUMBER 434
GLOBAL REFERENCE
GLOBAL REFERENCE FIELD NUMBER
DGMT(408.31,D0,0)
FIELD NUMBER ACCESS FIELD DESCRIPTION FIELD NAME LOCATION
.01 Direct Global Read & w/Fileman
The date/time is needed to determine the date/time of the
RX copay exemption.
DATE OF TEST 0;1
.019 Direct Global Read & w/Fileman
The type is used to determine if the test is a copay
test.
TYPE OF TEST 0;19
.02 Direct Global Read & w/Fileman
This field is used to determine the patient ofr the copay
test.
PATIENT 0;2
.03 Direct Global Read & w/Fileman
The status of the copay test is used to determine RX
copay exemption status.
STATUS 0;3
.04 Direct Global Read & w/Fileman
The income is used to determine RX copay exemption
status.
INCOME 0;4
.05 Direct Global Read & w/Fileman
The net worth is used to determine RX copay exemption
status
NET WORTH 0;5
.1 Direct Global Read & w/Fileman
The adjudication date/time is used to determine RX copay
exemption hardships.
ADJUDICATION DATE/TIME 0;10
.14 Direct Global Read & w/Fileman
This field is used to determine is not exempt from rx
copay based on no available income.
DECLINES TO GIVE INCOME INFO 0;14
.15 Direct Global Read & w/Fileman
Deductible expenses is used to determine rx copay
exemption status.
DEDUCTIBLE EXPENSES 0;15
.18 Direct Global Read & w/Fileman
Total Dependents is used to determine the appropriate
pension threshold level for rx copay exemptions.
TOTAL DEPENDENTS 0;18
STATUS Active
DURATION Till Otherwise Agreed
ID DGMT(408.31,
SUBSCRIBING PACKAGE
SUBSCRIBING PACKAGE ISC
INTEGRATED BILLING Albany
BENEFICIARY TRAVEL
ACCOUNTS RECEIVABLE