Tables [dbo].[Patient_PBM]
Patient Rx Benefit plan information
KeyNameData TypeMax Length (Bytes)NullabilityDefaultDescription
Cluster Primary Key PK_CIX_Patient_PBM_PatientID_PBMDE_Org_Pat_ID: PatientID\PBMDE\Org_Pat_IDIndexes TWstat_Patient_PBM_GroupNumber_PatientID, TWstat_Patient_PBM_InsOrgID_PatientID, TWstat_Patient_PBM_Last_Elig_Check_PatientID, TWstat_Patient_PBM_Mail_Ord_NABP_PatientID, TWstat_Patient_PBM_MailServiceFLAG_PatientID, TWstat_Patient_PBM_MemberNumber_PatientID, TWstat_Patient_PBM_PBMDE_PatientID, TWstat_Patient_PBM_PBMProviderID_PatientID, TWstat_Patient_PBM_RelationshipDE_PatientID(9)Foreign Keys FK_Patient_PBM_PatientID_Person_ID: [dbo].[Person].PatientIDPatientID[dbo].[uniqueid]9NOT NULLPatient. Link to Person.ID
Cluster Primary Key PK_CIX_Patient_PBM_PatientID_PBMDE_Org_Pat_ID: PatientID\PBMDE\Org_Pat_IDIndexes TWstat_Patient_PBM_PBMDE_PatientIDForeign Keys FK_Patient_PBM_PBMDE_PBM_DE_ID: [dbo].[PBM_DE].PBMDEPBMDE[dbo].[dict_id]5NOT NULLPBM. Link to PBM_DE.ID
Indexes TWstat_Patient_PBM_PBMProviderID_PatientIDPBMProviderID[dbo].[uniqueid]9NOT NULLRx Benefit plan provider ID
Indexes TWstat_Patient_PBM_GroupNumber_PatientIDGroupNumbervarchar(50)50NULL allowedGroup policy identification number
Indexes TWstat_Patient_PBM_InsOrgID_PatientIDInsOrgIDvarchar(20)20NOT NULLInsurance Organization ID
Indexes NIX_Patient_PBM_MemberNumber_RelationshipDE, TWstat_Patient_PBM_MemberNumber_PatientID(2)MemberNumbervarchar(50)50NULL allowedMember Number of Insurance policy
Indexes NIX_Patient_PBM_MemberNumber_RelationshipDE, TWstat_Patient_PBM_RelationshipDE_PatientID(2)Foreign Keys FK_Patient_PBM_RelationshipDE_Relationship_DE_ID: [dbo].[Relationship_DE].RelationshipDERelationshipDE[dbo].[dict_id]5NOT NULLRelationship. Link to Relationship_DE.ID
Indexes TWstat_Patient_PBM_MailServiceFLAG_PatientIDMailServiceFLAGchar(1)1NULL allowedFlag to indicate Mail Service
PBMConsentDTdatetime8NULL allowedConcent Date for PBM
Indexes NIX_Patient_PBM_PBMLastUpdateDTTM_SourcePBMLastUpdateDTTMdatetime8NULL allowedLast Updated Date and Time
Check Constraints EligibilityState : ([EligibilityState]='F' OR [EligibilityState]='N' OR [EligibilityState]='Y')EligibilityStatechar(1)1NOT NULL('N')Flag for Eligibility State
Cluster Primary Key PK_CIX_Patient_PBM_PatientID_PBMDE_Org_Pat_ID: PatientID\PBMDE\Org_Pat_IDOrg_Pat_IDvarchar(80)80NOT NULLComposite PK with PBMDE and PatientID
Formu_IDvarchar(80)80NULL allowedFormulary ID of the insurance plan for the patient
Alt_IDvarchar(80)80NULL allowedAlternative ID
Indexes TWstat_Patient_PBM_Mail_Ord_NABP_PatientIDMail_Ord_NABPchar(7)7NULL allowedMail Order NABP Detail
Indexes TWstat_Patient_PBM_Last_Elig_Check_PatientIDLast_Elig_Checkdatetime8NULL allowedLast Eligibility Check on date
Indexes NIX_Patient_PBM_PBMLastUpdateDTTM_SourceSourcevarchar(30)30NOT NULL('')Data source which updated the record.  Ex : Touchworks , Registration Interface, Eligibility Check etc.
CreateDTTMdatetime8NOT NULL(getdate())Record created date time.
Indexes TWstat_Patient_PBM_DefaultFLAGCheck Constraints CK_Patient_PBM_DefaultFLAG_Yes_Or_No : ([DefaultFLAG]='N' OR [DefaultFLAG]='Y')DefaultFLAG[dbo].[BOOL]1NOT NULL('Y')Defalut PBM for the patient indicator
Indexes TWstat_Patient_PBM_LastDefaultedDTTMLastDefaultedDTTMdatetime8NOT NULL(getdate())Last Updated Date and Time
RetailBenefitFlagchar(1)1NULL allowedFlag to indicate Retail Benefit
CoverageIDvarchar(80)80NULL allowedCoverage ID of the policy
BINvarchar(50)50NULL allowedBIN
PCNvarchar(30)30NULL allowedPCN
CoPayIDvarchar(80)80NULL allowedCo Pay Policy ID
InsTypPharmchar(3)3NULL allowedInsurance Type Pharmacy
PlanDescPharmvarchar(50)50NULL allowedPlan Description
OOPPharmvarchar(18)18NULL allowedOut of Pocket Pharmacy
InsTypMOBchar(3)3NULL allowedMail Order Benefit Insurance Type
PlanDescMOBvarchar(50)50NULL allowedMail Order Benefit Plan Description
OOPMOBvarchar(18)18NULL allowedOut of Pocket Mail Order Benefit
PayerIdentCdchar(3)3NULL allowedPayer Identification Code
PayerIdentCdDescvarchar(35)35NULL allowedPayer Identification Code Description
BenefitSpecialtychar(1)1NULL allowedSpecialty Benefit
PlanNameSpecialtyvarchar(50)50NULL allowedSpecialty Plan Name
BenefitLTCchar(1)1NULL allowedLong Term Care Benefit
PlanNameLTCvarchar(50)50NULL allowedLong Term Care Plan Name