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Fieldname

Code

Description

Active Ind

Sort Order

ACTION_TYPE_CD

01

Full team screening

Y

1

ACTION_TYPE_CD

02

Annual review

Y

2

ACTION_TYPE_CD

03

Service change or start

Y

3

ACTION_TYPE_CD

04

Waiver In date

Y

4

ACTION_TYPE_CD

05

Waiver Out date

Y

5

ACTION_TYPE_CD

06

Exit - change county of financial responsibility

Y

6

ACTION_TYPE_CD

07

Exit - relocation out of state

Y

7

ACTION_TYPE_CD

08

Exit - death

Y

8

ACTION_TYPE_CD

09

Exit - no longer financially eligible

Y

9

ACTION_TYPE_CD

10

Exit - other

Y

10

CASE_RELATION_CD

01

Self

Y

1

CASE_RELATION_CD

02

Spouse

Y

2

CASE_RELATION_CD

03

Child

Y

3

CASE_RELATION_CD

04

Parent

Y

4

CASE_RELATION_CD

05

Sibling

Y

5

CASE_RELATION_CD

06

Step sibling

Y

6

CASE_RELATION_CD

07

Half sibling

Y

7

CASE_RELATION_CD

08

Step child

Y

8

CASE_RELATION_CD

09

Step parent

Y

9

CASE_RELATION_CD

10

Aunt

Y

10

CASE_RELATION_CD

11

Uncle

Y

11

CASE_RELATION_CD

12

Niece

Y

12

CASE_RELATION_CD

13

Nephew

Y

13

CASE_RELATION_CD

14

Cousin

Y

14

CASE_RELATION_CD

15

Grandparent

Y

15

CASE_RELATION_CD

16

Grandchild

Y

16

CASE_RELATION_CD

17

Other Relative

Y

17

CASE_RELATION_CD

18

Legal guardian

Y

18

CASE_RELATION_CD

20

Foster child; not IV-E

Y

19

CASE_RELATION_CD

21

IV-E foster child

Y

20

CASE_RELATION_CD

22

Foster adult

Y

21

CASE_RELATION_CD

24

Not related

Y

22

CASE_RELATION_CD

25

Live in attendant

Y

23

CASE_RELATION_CD

26

Roomer

Y

24

CASE_RELATION_CD

27

Boarder

Y

25

CASE_STATUS_CD

A

Active

Y

1

CASE_STATUS_CD

C

Closed

Y

2

CASE_STATUS_CD

D

Denied

Y

3

CASE_STATUS_CD

P

Pending

Y

4

CASE_STATUS_CD

Z

Purged

Y

5

CASE_TYPE_CD

A

Alternative Care

Y

2

CASE_TYPE_CD

B

CHP/SCH combination

Y

3

CASE_TYPE_CD

C

Children's health plan

Y

4

CASE_TYPE_CD

D

County administered

Y

1

CASE_TYPE_CD

E

DMIE

Y

14

CASE_TYPE_CD

F

Family planning program

Y

5

CASE_TYPE_CD

H

HIV program

Y

12

CASE_TYPE_CD

M

Healthmatch

Y

13

CASE_TYPE_CD

O

Client option spend down

Y

6

CASE_TYPE_CD

S

SCH evaluation or treatment

Y

7

CASE_TYPE_CD

T

Consolidated treatment fund

Y

8

CASE_TYPE_CD

U

Unknown

Y

9

CASE_TYPE_CD

X

MinnesotaCare

Y

10

CASE_TYPE_CD

Y

Minnesota/SCH combination

Y

11

CLM_EXCEPTION_CD

1

EXCEPTION CODE: 1

Y

 

CLM_EXCEPTION_CD

10

EXCEPTION CODE: 10

Y

 

CLM_EXCEPTION_CD

101

EXCEPTION CODE: 101

Y

 

CLM_EXCEPTION_CD

102

EXCEPTION CODE: 102

Y

 

CLM_EXCEPTION_CD

103

EXCEPTION CODE: 103

Y

 

CLM_EXCEPTION_CD

104

EXCEPTION CODE: 104

Y

 

CLM_EXCEPTION_CD

105

EXCEPTION CODE: 105

Y

 

CLM_EXCEPTION_CD

106

EXCEPTION CODE: 106

Y

 

CLM_EXCEPTION_CD

107

EXCEPTION CODE: 107

Y

 

CLM_EXCEPTION_CD

108

EXCEPTION CODE: 108

Y

 

CLM_EXCEPTION_CD

109

EXCEPTION CODE: 109

Y

 

CLM_EXCEPTION_CD

11

EXCEPTION CODE: 11

Y

 

CLM_EXCEPTION_CD

110

EXCEPTION CODE: 110

Y

 

CLM_EXCEPTION_CD

111

EXCEPTION CODE: 111

Y

 

CLM_EXCEPTION_CD

112

EXCEPTION CODE: 112

Y

 

CLM_EXCEPTION_CD

113

EXCEPTION CODE: 113

Y

 

CLM_EXCEPTION_CD

114

EXCEPTION CODE: 114

Y

 

CLM_EXCEPTION_CD

115

EXCEPTION CODE: 115

Y

 

CLM_EXCEPTION_CD

116

EXCEPTION CODE: 116

Y

 

CLM_EXCEPTION_CD

117

EXCEPTION CODE: 117

Y

 

CLM_EXCEPTION_CD

118

EXCEPTION CODE: 118

Y

 

CLM_EXCEPTION_CD

119

EXCEPTION CODE: 119

Y

 

CLM_EXCEPTION_CD

12

EXCEPTION CODE: 12

Y

 

CLM_EXCEPTION_CD

120

EXCEPTION CODE: 120

Y

 

CLM_EXCEPTION_CD

121

EXCEPTION CODE: 121

Y

 

CLM_EXCEPTION_CD

122

EXCEPTION CODE: 122

Y

 

CLM_EXCEPTION_CD

123

EXCEPTION CODE: 123

Y

 

CLM_EXCEPTION_CD

124

EXCEPTION CODE: 124

Y

 

CLM_EXCEPTION_CD

125

EXCEPTION CODE: 125

Y

 

CLM_EXCEPTION_CD

126

EXCEPTION CODE: 126

Y

 

CLM_EXCEPTION_CD

127

EXCEPTION CODE: 127

Y

 

CLM_EXCEPTION_CD

128

EXCEPTION CODE: 128

Y

 

CLM_EXCEPTION_CD

129

EXCEPTION CODE: 129

Y

 

CLM_EXCEPTION_CD

13

EXCEPTION CODE: 13

Y

 

CLM_EXCEPTION_CD

130

EXCEPTION CODE: 130

Y

 

CLM_EXCEPTION_CD

131

EXCEPTION CODE: 131

Y

 

CLM_EXCEPTION_CD

132

EXCEPTION CODE: 132

Y

 

CLM_EXCEPTION_CD

133

EXCEPTION CODE: 133

Y

 

CLM_EXCEPTION_CD

134

EXCEPTION CODE: 134

Y

 

CLM_EXCEPTION_CD

135

EXCEPTION CODE: 135

Y

 

CLM_EXCEPTION_CD

136

EXCEPTION CODE: 136

Y

 

CLM_EXCEPTION_CD

137

EXCEPTION CODE: 137

Y

 

CLM_EXCEPTION_CD

138

EXCEPTION CODE: 138

Y

 

CLM_EXCEPTION_CD

139

EXCEPTION CODE: 139

Y

 

CLM_EXCEPTION_CD

14

EXCEPTION CODE: 14

Y

 

CLM_EXCEPTION_CD

140

EXCEPTION CODE: 140

Y

 

CLM_EXCEPTION_CD

141

EXCEPTION CODE: 141

Y

 

CLM_EXCEPTION_CD

142

EXCEPTION CODE: 142

Y

 

CLM_EXCEPTION_CD

143

EXCEPTION CODE: 143

Y

 

CLM_EXCEPTION_CD

144

EXCEPTION CODE: 144

Y

 

CLM_EXCEPTION_CD

145

EXCEPTION CODE: 145

Y

 

CLM_EXCEPTION_CD

146

EXCEPTION CODE: 146

Y

 

CLM_EXCEPTION_CD

147

EXCEPTION CODE: 147

Y

 

CLM_EXCEPTION_CD

148

EXCEPTION CODE: 148

Y

 

CLM_EXCEPTION_CD

149

EXCEPTION CODE: 149

Y

 

CLM_EXCEPTION_CD

15

EXCEPTION CODE: 15

Y

 

CLM_EXCEPTION_CD

150

EXCEPTION CODE: 150

Y

 

CLM_EXCEPTION_CD

151

EXCEPTION CODE: 151

Y

 

CLM_EXCEPTION_CD

152

EXCEPTION CODE: 152

Y

 

CLM_EXCEPTION_CD

153

EXCEPTION CODE: 153

Y

 

CLM_EXCEPTION_CD

154

EXCEPTION CODE: 154

Y

 

CLM_EXCEPTION_CD

155

EXCEPTION CODE: 155

Y

 

CLM_EXCEPTION_CD

156

EXCEPTION CODE: 156

Y

 

CLM_EXCEPTION_CD

157

EXCEPTION CODE: 157

Y

 

CLM_EXCEPTION_CD

158

EXCEPTION CODE: 158

Y

 

CLM_EXCEPTION_CD

159

EXCEPTION CODE: 159

Y

 

CLM_EXCEPTION_CD

16

EXCEPTION CODE: 16

Y

 

CLM_EXCEPTION_CD

160

EXCEPTION CODE: 160

Y

 

CLM_EXCEPTION_CD

161

EXCEPTION CODE: 161

Y

 

CLM_EXCEPTION_CD

162

EXCEPTION CODE: 162

Y

 

CLM_EXCEPTION_CD

163

EXCEPTION CODE: 163

Y

 

CLM_EXCEPTION_CD

164

EXCEPTION CODE: 164

Y

 

CLM_EXCEPTION_CD

165

EXCEPTION CODE: 165

Y

 

CLM_EXCEPTION_CD

166

EXCEPTION CODE: 166

Y

 

CLM_EXCEPTION_CD

167

EXCEPTION CODE: 167

Y

 

CLM_EXCEPTION_CD

168

EXCEPTION CODE: 168

Y

 

CLM_EXCEPTION_CD

169

EXCEPTION CODE: 169

Y

 

CLM_EXCEPTION_CD

17

EXCEPTION CODE: 17

Y

 

CLM_EXCEPTION_CD

170

EXCEPTION CODE: 170

Y

 

CLM_EXCEPTION_CD

171

EXCEPTION CODE: 171

Y

 

CLM_EXCEPTION_CD

172

EXCEPTION CODE: 172

Y

 

CLM_EXCEPTION_CD

173

EXCEPTION CODE: 173

Y

 

CLM_EXCEPTION_CD

174

EXCEPTION CODE: 174

Y

 

CLM_EXCEPTION_CD

175

EXCEPTION CODE: 175

Y

 

CLM_EXCEPTION_CD

176

EXCEPTION CODE: 176

Y

 

CLM_EXCEPTION_CD

177

EXCEPTION CODE: 177

Y

 

CLM_EXCEPTION_CD

178

EXCEPTION CODE: 178

Y

 

CLM_EXCEPTION_CD

179

EXCEPTION CODE: 179

Y

 

CLM_EXCEPTION_CD

18

EXCEPTION CODE: 18

Y

 

CLM_EXCEPTION_CD

180

EXCEPTION CODE: 180

Y

 

CLM_EXCEPTION_CD

181

EXCEPTION CODE: 181

Y

 

CLM_EXCEPTION_CD

182

EXCEPTION CODE: 182

Y

 

CLM_EXCEPTION_CD

183

EXCEPTION CODE: 183

Y

 

CLM_EXCEPTION_CD

184

EXCEPTION CODE: 184

Y

 

CLM_EXCEPTION_CD

185

EXCEPTION CODE: 185

Y

 

CLM_EXCEPTION_CD

186

EXCEPTION CODE: 186

Y

 

CLM_EXCEPTION_CD

187

EXCEPTION CODE: 187

Y

 

CLM_EXCEPTION_CD

188

EXCEPTION CODE: 188

Y

 

CLM_EXCEPTION_CD

189

EXCEPTION CODE: 189

Y

 

CLM_EXCEPTION_CD

19

EXCEPTION CODE: 19

Y

 

CLM_EXCEPTION_CD

190

EXCEPTION CODE: 190

Y

 

CLM_EXCEPTION_CD

192

EXCEPTION CODE: 192

Y

 

CLM_EXCEPTION_CD

195

EXCEPTION CODE: 195

Y

 

CLM_EXCEPTION_CD

196

EXCEPTION CODE: 196

Y

 

CLM_EXCEPTION_CD

197

EXCEPTION CODE: 197

Y

 

CLM_EXCEPTION_CD

198

EXCEPTION CODE: 198

Y

 

CLM_EXCEPTION_CD

199

EXCEPTION CODE: 199

Y

 

CLM_EXCEPTION_CD

2

EXCEPTION CODE: 2

Y

 

CLM_EXCEPTION_CD

20

EXCEPTION CODE: 20

Y

 

CLM_EXCEPTION_CD

200

EXCEPTION CODE: 200

Y

 

CLM_EXCEPTION_CD

201

EXCEPTION CODE: 201

Y

 

CLM_EXCEPTION_CD

202

EXCEPTION CODE: 202

Y

 

CLM_EXCEPTION_CD

203

EXCEPTION CODE: 203

Y

 

CLM_EXCEPTION_CD

204

EXCEPTION CODE: 204

Y

 

CLM_EXCEPTION_CD

205

EXCEPTION CODE: 205

Y

 

CLM_EXCEPTION_CD

206

EXCEPTION CODE: 206

Y

 

CLM_EXCEPTION_CD

207

EXCEPTION CODE: 207

Y

 

CLM_EXCEPTION_CD

208

EXCEPTION CODE: 208

Y

 

CLM_EXCEPTION_CD

209

EXCEPTION CODE: 209

Y

 

CLM_EXCEPTION_CD

21

EXCEPTION CODE: 21

Y

 

CLM_EXCEPTION_CD

210

EXCEPTION CODE: 210

Y

 

CLM_EXCEPTION_CD

211

EXCEPTION CODE: 211

Y

 

CLM_EXCEPTION_CD

212

EXCEPTION CODE: 212

Y

 

CLM_EXCEPTION_CD

213

EXCEPTION CODE: 213

Y

 

CLM_EXCEPTION_CD

214

EXCEPTION CODE: 214

Y

 

CLM_EXCEPTION_CD

215

EXCEPTION CODE: 215

Y

 

CLM_EXCEPTION_CD

216

EXCEPTION CODE: 216

Y

 

CLM_EXCEPTION_CD

217

EXCEPTION CODE: 217

Y

 

CLM_EXCEPTION_CD

22

EXCEPTION CODE: 22

Y

 

CLM_EXCEPTION_CD

220

EXCEPTION CODE: 220

Y

 

CLM_EXCEPTION_CD

221

EXCEPTION CODE: 221

Y

 

CLM_EXCEPTION_CD

222

EXCEPTION CODE: 222

Y

 

CLM_EXCEPTION_CD

223

EXCEPTION CODE: 223

Y

 

CLM_EXCEPTION_CD

224

EXCEPTION CODE: 224

Y

 

CLM_EXCEPTION_CD

225

EXCEPTION CODE: 225

Y

 

CLM_EXCEPTION_CD

226

EXCEPTION CODE: 226

Y

 

CLM_EXCEPTION_CD

227

EXCEPTION CODE: 227

Y

 

CLM_EXCEPTION_CD

229

EXCEPTION CODE: 229

Y

 

CLM_EXCEPTION_CD

23

EXCEPTION CODE: 23

Y

 

CLM_EXCEPTION_CD

230

EXCEPTION CODE: 230

Y

 

CLM_EXCEPTION_CD

231

EXCEPTION CODE: 231

Y

 

CLM_EXCEPTION_CD

232

EXCEPTION CODE: 232

Y

 

CLM_EXCEPTION_CD

233

EXCEPTION CODE: 233

Y

 

CLM_EXCEPTION_CD

234

EXCEPTION CODE: 234

Y

 

CLM_EXCEPTION_CD

235

EXCEPTION CODE: 235

Y

 

CLM_EXCEPTION_CD

236

EXCEPTION CODE: 236

Y

 

CLM_EXCEPTION_CD

237

EXCEPTION CODE: 237

Y

 

CLM_EXCEPTION_CD

238

EXCEPTION CODE: 238

Y

 

CLM_EXCEPTION_CD

239

EXCEPTION CODE: 239

Y

 

CLM_EXCEPTION_CD

24

EXCEPTION CODE: 24

Y

 

CLM_EXCEPTION_CD

240

EXCEPTION CODE: 240

Y

 

CLM_EXCEPTION_CD

241

EXCEPTION CODE: 241

Y

 

CLM_EXCEPTION_CD

242

EXCEPTION CODE: 242

Y

 

CLM_EXCEPTION_CD

243

EXCEPTION CODE: 243

Y

 

CLM_EXCEPTION_CD

244

EXCEPTION CODE: 244

Y

 

CLM_EXCEPTION_CD

245

EXCEPTION CODE: 245

Y

 

CLM_EXCEPTION_CD

246

EXCEPTION CODE: 246

Y

 

CLM_EXCEPTION_CD

247

EXCEPTION CODE: 247

Y

 

CLM_EXCEPTION_CD

248

EXCEPTION CODE: 248

Y

 

CLM_EXCEPTION_CD

249

EXCEPTION CODE: 249

Y

 

CLM_EXCEPTION_CD

25

EXCEPTION CODE: 25

Y

 

CLM_EXCEPTION_CD

250

EXCEPTION CODE: 250

Y

 

CLM_EXCEPTION_CD

251

EXCEPTION CODE: 251

Y

 

CLM_EXCEPTION_CD

252

EXCEPTION CODE: 252

Y

 

CLM_EXCEPTION_CD

253

EXCEPTION CODE: 253

Y

 

CLM_EXCEPTION_CD

254

EXCEPTION CODE: 254

Y

 

CLM_EXCEPTION_CD

255

EXCEPTION CODE: 255

Y

 

CLM_EXCEPTION_CD

256

EXCEPTION CODE: 256

Y

 

CLM_EXCEPTION_CD

257

EXCEPTION CODE: 257

Y

 

CLM_EXCEPTION_CD

258

EXCEPTION CODE: 258

Y

 

CLM_EXCEPTION_CD

259

EXCEPTION CODE: 259

Y

 

CLM_EXCEPTION_CD

26

EXCEPTION CODE: 26

Y

 

CLM_EXCEPTION_CD

260

EXCEPTION CODE: 260

Y

 

CLM_EXCEPTION_CD

261

EXCEPTION CODE: 261

Y

 

CLM_EXCEPTION_CD

262

EXCEPTION CODE: 262

Y

 

CLM_EXCEPTION_CD

263

EXCEPTION CODE: 263

Y

 

CLM_EXCEPTION_CD

264

EXCEPTION CODE: 264

Y

 

CLM_EXCEPTION_CD

265

EXCEPTION CODE: 265

Y

 

CLM_EXCEPTION_CD

266

EXCEPTION CODE: 266

Y

 

CLM_EXCEPTION_CD

267

EXCEPTION CODE: 267

Y

 

CLM_EXCEPTION_CD

268

EXCEPTION CODE: 268

Y

 

CLM_EXCEPTION_CD

269

EXCEPTION CODE: 269

Y

 

CLM_EXCEPTION_CD

27

EXCEPTION CODE: 27

Y

 

CLM_EXCEPTION_CD

270

EXCEPTION CODE: 270

Y

 

CLM_EXCEPTION_CD

271

EXCEPTION CODE: 271

Y

 

CLM_EXCEPTION_CD

272

EXCEPTION CODE: 272

Y

 

CLM_EXCEPTION_CD

273

EXCEPTION CODE: 273

Y

 

CLM_EXCEPTION_CD

274

EXCEPTION CODE: 274

Y

 

CLM_EXCEPTION_CD

275

EXCEPTION CODE: 275

Y

 

CLM_EXCEPTION_CD

276

EXCEPTION CODE: 276

Y

 

CLM_EXCEPTION_CD

277

EXCEPTION CODE: 277

Y

 

CLM_EXCEPTION_CD

278

EXCEPTION CODE: 278

Y

 

CLM_EXCEPTION_CD

279

EXCEPTION CODE: 279

Y

 

CLM_EXCEPTION_CD

28

EXCEPTION CODE: 28

Y

 

CLM_EXCEPTION_CD

280

EXCEPTION CODE: 280

Y

 

CLM_EXCEPTION_CD

281

EXCEPTION CODE: 281

Y

 

CLM_EXCEPTION_CD

282

EXCEPTION CODE: 282

Y

 

CLM_EXCEPTION_CD

283

EXCEPTION CODE: 283

Y

 

CLM_EXCEPTION_CD

284

EXCEPTION CODE: 284

Y

 

CLM_EXCEPTION_CD

285

EXCEPTION CODE: 285

Y

 

CLM_EXCEPTION_CD

286

EXCEPTION CODE: 286

Y

 

CLM_EXCEPTION_CD

287

EXCEPTION CODE: 287

Y

 

CLM_EXCEPTION_CD

288

EXCEPTION CODE: 288

Y

 

CLM_EXCEPTION_CD

289

EXCEPTION CODE: 289

Y

 

CLM_EXCEPTION_CD

29

EXCEPTION CODE: 29

Y

 

CLM_EXCEPTION_CD

290

EXCEPTION CODE: 290

Y

 

CLM_EXCEPTION_CD

291

EXCEPTION CODE: 291

Y

 

CLM_EXCEPTION_CD

292

EXCEPTION CODE: 292

Y

 

CLM_EXCEPTION_CD

293

EXCEPTION CODE: 293

Y

 

CLM_EXCEPTION_CD

294

EXCEPTION CODE: 294

Y

 

CLM_EXCEPTION_CD

295

EXCEPTION CODE: 295

Y

 

CLM_EXCEPTION_CD

296

EXCEPTION CODE: 296

Y

 

CLM_EXCEPTION_CD

297

EXCEPTION CODE: 297

Y

 

CLM_EXCEPTION_CD

298

EXCEPTION CODE: 298

Y

 

CLM_EXCEPTION_CD

299

EXCEPTION CODE: 299

Y

 

CLM_EXCEPTION_CD

3

EXCEPTION CODE: 3

Y

 

CLM_EXCEPTION_CD

30

EXCEPTION CODE: 30

Y

 

CLM_EXCEPTION_CD

300

EXCEPTION CODE: 300

Y

 

CLM_EXCEPTION_CD

301

EXCEPTION CODE: 301

Y

 

CLM_EXCEPTION_CD

302

EXCEPTION CODE: 302

Y

 

CLM_EXCEPTION_CD

303

EXCEPTION CODE: 303

Y

 

CLM_EXCEPTION_CD

304

EXCEPTION CODE: 304

Y

 

CLM_EXCEPTION_CD

305

EXCEPTION CODE: 305

Y

 

CLM_EXCEPTION_CD

306

EXCEPTION CODE: 306

Y

 

CLM_EXCEPTION_CD

307

EXCEPTION CODE: 307

Y

 

CLM_EXCEPTION_CD

308

EXCEPTION CODE: 308

Y

 

CLM_EXCEPTION_CD

309

EXCEPTION CODE: 309

Y

 

CLM_EXCEPTION_CD

31

EXCEPTION CODE: 31

Y

 

CLM_EXCEPTION_CD

310

EXCEPTION CODE: 310

Y

 

CLM_EXCEPTION_CD

311

EXCEPTION CODE: 311

Y

 

CLM_EXCEPTION_CD

312

EXCEPTION CODE: 312

Y

 

CLM_EXCEPTION_CD

313

EXCEPTION CODE: 313

Y

 

CLM_EXCEPTION_CD

314

EXCEPTION CODE: 314

Y

 

CLM_EXCEPTION_CD

315

EXCEPTION CODE: 315

Y

 

CLM_EXCEPTION_CD

316

EXCEPTION CODE: 316

Y

 

CLM_EXCEPTION_CD

317

EXCEPTION CODE: 317

Y

 

CLM_EXCEPTION_CD

318

EXCEPTION CODE: 318

Y

 

CLM_EXCEPTION_CD

319

EXCEPTION CODE: 319

Y

 

CLM_EXCEPTION_CD

32

EXCEPTION CODE: 32

Y

 

CLM_EXCEPTION_CD

320

EXCEPTION CODE: 320

Y

 

CLM_EXCEPTION_CD

321

EXCEPTION CODE: 321

Y

 

CLM_EXCEPTION_CD

322

EXCEPTION CODE: 322

Y

 

CLM_EXCEPTION_CD

323

EXCEPTION CODE: 323

Y

 

CLM_EXCEPTION_CD

324

EXCEPTION CODE: 324

Y

 

CLM_EXCEPTION_CD

325

EXCEPTION CODE: 325

Y

 

CLM_EXCEPTION_CD

326

EXCEPTION CODE: 326

Y

 

CLM_EXCEPTION_CD

327

EXCEPTION CODE: 327

Y

 

CLM_EXCEPTION_CD

328

EXCEPTION CODE: 328

Y

 

CLM_EXCEPTION_CD

329

EXCEPTION CODE: 329

Y

 

CLM_EXCEPTION_CD

33

EXCEPTION CODE: 33

Y

 

CLM_EXCEPTION_CD

330

EXCEPTION CODE: 330

Y

 

CLM_EXCEPTION_CD

331

EXCEPTION CODE: 331

Y

 

CLM_EXCEPTION_CD

332

EXCEPTION CODE: 332

Y

 

CLM_EXCEPTION_CD

333

EXCEPTION CODE: 333

Y

 

CLM_EXCEPTION_CD

334

EXCEPTION CODE: 334

Y

 

CLM_EXCEPTION_CD

335

EXCEPTION CODE: 335

Y

 

CLM_EXCEPTION_CD

336

EXCEPTION CODE: 336

Y

 

CLM_EXCEPTION_CD

337

EXCEPTION CODE: 337

Y

 

CLM_EXCEPTION_CD

338

EXCEPTION CODE: 338

Y

 

CLM_EXCEPTION_CD

339

EXCEPTION CODE: 339

Y

 

CLM_EXCEPTION_CD

34

EXCEPTION CODE: 34

Y

 

CLM_EXCEPTION_CD

340

EXCEPTION CODE: 340

Y

 

CLM_EXCEPTION_CD

341

EXCEPTION CODE: 341

Y

 

CLM_EXCEPTION_CD

342

EXCEPTION CODE: 342

Y

 

CLM_EXCEPTION_CD

343

EXCEPTION CODE: 343

Y

 

CLM_EXCEPTION_CD

344

EXCEPTION CODE: 344

Y

 

CLM_EXCEPTION_CD

345

EXCEPTION CODE: 345

Y

 

CLM_EXCEPTION_CD

346

EXCEPTION CODE: 346

Y

 

CLM_EXCEPTION_CD

347

EXCEPTION CODE: 347

Y

 

CLM_EXCEPTION_CD

348

EXCEPTION CODE: 348

Y

 

CLM_EXCEPTION_CD

349

EXCEPTION CODE: 349

Y

 

CLM_EXCEPTION_CD

35

EXCEPTION CODE: 35

Y

 

CLM_EXCEPTION_CD

350

EXCEPTION CODE: 350

Y

 

CLM_EXCEPTION_CD

351

EXCEPTION CODE: 351

Y

 

CLM_EXCEPTION_CD

352

EXCEPTION CODE: 352

Y

 

CLM_EXCEPTION_CD

353

EXCEPTION CODE: 353

Y

 

CLM_EXCEPTION_CD

354

EXCEPTION CODE: 354

Y

 

CLM_EXCEPTION_CD

355

EXCEPTION CODE: 355

Y

 

CLM_EXCEPTION_CD

356

EXCEPTION CODE: 356

Y

 

CLM_EXCEPTION_CD

357

EXCEPTION CODE: 357

Y

 

CLM_EXCEPTION_CD

358

EXCEPTION CODE: 358

Y

 

CLM_EXCEPTION_CD

359

EXCEPTION CODE: 359

Y

 

CLM_EXCEPTION_CD

36

EXCEPTION CODE: 36

Y

 

CLM_EXCEPTION_CD

360

EXCEPTION CODE: 360

Y

 

CLM_EXCEPTION_CD

361

EXCEPTION CODE: 361

Y

 

CLM_EXCEPTION_CD

362

EXCEPTION CODE: 362

Y

 

CLM_EXCEPTION_CD

363

EXCEPTION CODE: 363

Y

 

CLM_EXCEPTION_CD

364

EXCEPTION CODE: 364

Y

 

CLM_EXCEPTION_CD

365

EXCEPTION CODE: 365

Y

 

CLM_EXCEPTION_CD

366

EXCEPTION CODE: 366

Y

 

CLM_EXCEPTION_CD

367

EXCEPTION CODE: 367

Y

 

CLM_EXCEPTION_CD

368

EXCEPTION CODE: 368

Y

 

CLM_EXCEPTION_CD

369

EXCEPTION CODE: 369

Y

 

CLM_EXCEPTION_CD

37

EXCEPTION CODE: 37

Y

 

CLM_EXCEPTION_CD

370

EXCEPTION CODE: 370

Y

 

CLM_EXCEPTION_CD

372

EXCEPTION CODE: 372

Y

 

CLM_EXCEPTION_CD

373

EXCEPTION CODE: 373

Y

 

CLM_EXCEPTION_CD

374

EXCEPTION CODE: 374

Y

 

CLM_EXCEPTION_CD

375

EXCEPTION CODE: 375

Y

 

CLM_EXCEPTION_CD

376

EXCEPTION CODE: 376

Y

 

CLM_EXCEPTION_CD

377

EXCEPTION CODE: 377

Y

 

CLM_EXCEPTION_CD

378

EXCEPTION CODE: 378

Y

 

CLM_EXCEPTION_CD

379

EXCEPTION CODE: 379

Y

 

CLM_EXCEPTION_CD

38

EXCEPTION CODE: 38

Y

 

CLM_EXCEPTION_CD

380

EXCEPTION CODE: 380

Y

 

CLM_EXCEPTION_CD

381

EXCEPTION CODE: 381

Y

 

CLM_EXCEPTION_CD

382

EXCEPTION CODE: 382

Y

 

CLM_EXCEPTION_CD

383

EXCEPTION CODE: 383

Y

 

CLM_EXCEPTION_CD

384

EXCEPTION CODE: 384

Y

 

CLM_EXCEPTION_CD

385

EXCEPTION CODE: 385

Y

 

CLM_EXCEPTION_CD

386

EXCEPTION CODE: 386

Y

 

CLM_EXCEPTION_CD

387

EXCEPTION CODE: 387

Y

 

CLM_EXCEPTION_CD

388

EXCEPTION CODE: 388

Y

 

CLM_EXCEPTION_CD

389

EXCEPTION CODE: 389

Y

 

CLM_EXCEPTION_CD

39

EXCEPTION CODE: 39

Y

 

CLM_EXCEPTION_CD

390

EXCEPTION CODE: 390

Y

 

CLM_EXCEPTION_CD

391

EXCEPTION CODE: 391

Y

 

CLM_EXCEPTION_CD

392

EXCEPTION CODE: 392

Y

 

CLM_EXCEPTION_CD

393

EXCEPTION CODE: 393

Y

 

CLM_EXCEPTION_CD

394

EXCEPTION CODE: 394

Y

 

CLM_EXCEPTION_CD

395

EXCEPTION CODE: 395

Y

 

CLM_EXCEPTION_CD

396

EXCEPTION CODE: 396

Y

 

CLM_EXCEPTION_CD

397

EXCEPTION CODE: 397

Y

 

CLM_EXCEPTION_CD

398

EXCEPTION CODE: 398

Y

 

CLM_EXCEPTION_CD

399

EXCEPTION CODE: 399

Y

 

CLM_EXCEPTION_CD

4

EXCEPTION CODE: 4

Y

 

CLM_EXCEPTION_CD

40

EXCEPTION CODE: 40

Y

 

CLM_EXCEPTION_CD

400

EXCEPTION CODE: 400

Y

 

CLM_EXCEPTION_CD

401

EXCEPTION CODE: 401

Y

 

CLM_EXCEPTION_CD

402

EXCEPTION CODE: 402

Y

 

CLM_EXCEPTION_CD

403

EXCEPTION CODE: 403

Y

 

CLM_EXCEPTION_CD

404

EXCEPTION CODE: 404

Y

 

CLM_EXCEPTION_CD

405

EXCEPTION CODE: 405

Y

 

CLM_EXCEPTION_CD

406

EXCEPTION CODE: 406

Y

 

CLM_EXCEPTION_CD

407

EXCEPTION CODE: 407

Y

 

CLM_EXCEPTION_CD

408

EXCEPTION CODE: 408

Y

 

CLM_EXCEPTION_CD

409

EXCEPTION CODE: 409

Y

 

CLM_EXCEPTION_CD

41

EXCEPTION CODE: 41

Y

 

CLM_EXCEPTION_CD

410

EXCEPTION CODE: 410

Y

 

CLM_EXCEPTION_CD

411

EXCEPTION CODE: 411

Y

 

CLM_EXCEPTION_CD

412

EXCEPTION CODE: 412

Y

 

CLM_EXCEPTION_CD

413

EXCEPTION CODE: 413

Y

 

CLM_EXCEPTION_CD

414

EXCEPTION CODE: 414

Y

 

CLM_EXCEPTION_CD

415

EXCEPTION CODE: 415

Y

 

CLM_EXCEPTION_CD

416

EXCEPTION CODE: 416

Y

 

CLM_EXCEPTION_CD

417

EXCEPTION CODE: 417

Y

 

CLM_EXCEPTION_CD

418

EXCEPTION CODE: 418

Y

 

CLM_EXCEPTION_CD

419

EXCEPTION CODE: 419

Y

 

CLM_EXCEPTION_CD

42

EXCEPTION CODE: 42

Y

 

CLM_EXCEPTION_CD

420

EXCEPTION CODE: 420

Y

 

CLM_EXCEPTION_CD

421

EXCEPTION CODE: 421

Y

 

CLM_EXCEPTION_CD

422

EXCEPTION CODE: 422

Y

 

CLM_EXCEPTION_CD

423

EXCEPTION CODE: 423

Y

 

CLM_EXCEPTION_CD

424

EXCEPTION CODE: 424

Y

 

CLM_EXCEPTION_CD

425

EXCEPTION CODE: 425

Y

 

CLM_EXCEPTION_CD

426

EXCEPTION CODE: 426

Y

 

CLM_EXCEPTION_CD

427

EXCEPTION CODE: 427

Y

 

CLM_EXCEPTION_CD

428

EXCEPTION CODE: 428

Y

 

CLM_EXCEPTION_CD

429

EXCEPTION CODE: 429

Y

 

CLM_EXCEPTION_CD

43

EXCEPTION CODE: 43

Y

 

CLM_EXCEPTION_CD

430

EXCEPTION CODE: 430

Y

 

CLM_EXCEPTION_CD

431

EXCEPTION CODE: 431

Y

 

CLM_EXCEPTION_CD

432

EXCEPTION CODE: 432

Y

 

CLM_EXCEPTION_CD

433

EXCEPTION CODE: 433

Y

 

CLM_EXCEPTION_CD

434

EXCEPTION CODE: 434

Y

 

CLM_EXCEPTION_CD

435

EXCEPTION CODE: 435

Y

 

CLM_EXCEPTION_CD

436

EXCEPTION CODE: 436

Y

 

CLM_EXCEPTION_CD

437

EXCEPTION CODE: 437

Y

 

CLM_EXCEPTION_CD

438

EXCEPTION CODE: 438

Y

 

CLM_EXCEPTION_CD

439

EXCEPTION CODE: 439

Y

 

CLM_EXCEPTION_CD

44

EXCEPTION CODE: 44

Y

 

CLM_EXCEPTION_CD

440

EXCEPTION CODE: 440

Y

 

CLM_EXCEPTION_CD

441

EXCEPTION CODE: 441

Y

 

CLM_EXCEPTION_CD

443

EXCEPTION CODE: 443

Y

 

CLM_EXCEPTION_CD

445

EXCEPTION CODE: 445

Y

 

CLM_EXCEPTION_CD

446

EXCEPTION CODE: 446

Y

 

CLM_EXCEPTION_CD

447

EXCEPTION CODE: 447

Y

 

CLM_EXCEPTION_CD

45

EXCEPTION CODE: 45

Y

 

CLM_EXCEPTION_CD

450

EXCEPTION CODE: 450

Y

 

CLM_EXCEPTION_CD

451

EXCEPTION CODE: 451

Y

 

CLM_EXCEPTION_CD

452

EXCEPTION CODE: 452

Y

 

CLM_EXCEPTION_CD

453

EXCEPTION CODE: 453

Y

 

CLM_EXCEPTION_CD

454

EXCEPTION CODE: 454

Y

 

CLM_EXCEPTION_CD

455

EXCEPTION CODE: 455

Y

 

CLM_EXCEPTION_CD

456

EXCEPTION CODE: 456

Y

 

CLM_EXCEPTION_CD

457

EXCEPTION CODE: 457

Y

 

CLM_EXCEPTION_CD

46

EXCEPTION CODE: 46

Y

 

CLM_EXCEPTION_CD

47

EXCEPTION CODE: 47

Y

 

CLM_EXCEPTION_CD

48

EXCEPTION CODE: 48

Y

 

CLM_EXCEPTION_CD

488

EXCEPTION CODE: 488

Y

 

CLM_EXCEPTION_CD

489

EXCEPTION CODE: 489

Y

 

CLM_EXCEPTION_CD

49

EXCEPTION CODE: 49

Y

 

CLM_EXCEPTION_CD

492

EXCEPTION CODE: 492

Y

 

CLM_EXCEPTION_CD

497

EXCEPTION CODE: 497

Y

 

CLM_EXCEPTION_CD

498

EXCEPTION CODE: 498

Y

 

CLM_EXCEPTION_CD

499

EXCEPTION CODE: 499

Y

 

CLM_EXCEPTION_CD

5

EXCEPTION CODE: 5

Y

 

CLM_EXCEPTION_CD

50

EXCEPTION CODE: 50

Y

 

CLM_EXCEPTION_CD

500

EXCEPTION CODE: 500

Y

 

CLM_EXCEPTION_CD

501

EXCEPTION CODE: 501

Y

 

CLM_EXCEPTION_CD

502

EXCEPTION CODE: 502

Y

 

CLM_EXCEPTION_CD

503

EXCEPTION CODE: 503

Y

 

CLM_EXCEPTION_CD

504

EXCEPTION CODE: 504

Y

 

CLM_EXCEPTION_CD

505

EXCEPTION CODE: 505

Y

 

CLM_EXCEPTION_CD

506

EXCEPTION CODE: 506

Y

 

CLM_EXCEPTION_CD

51

EXCEPTION CODE: 51

Y

 

CLM_EXCEPTION_CD

510

EXCEPTION CODE: 510

Y

 

CLM_EXCEPTION_CD

511

EXCEPTION CODE: 511

Y

 

CLM_EXCEPTION_CD

512

EXCEPTION CODE: 512

Y

 

CLM_EXCEPTION_CD

513

EXCEPTION CODE: 513

Y

 

CLM_EXCEPTION_CD

514

EXCEPTION CODE: 514

Y

 

CLM_EXCEPTION_CD

515

EXCEPTION CODE: 515

Y

 

CLM_EXCEPTION_CD

516

EXCEPTION CODE: 516

Y

 

CLM_EXCEPTION_CD

517

EXCEPTION CODE: 517

Y

 

CLM_EXCEPTION_CD

518

EXCEPTION CODE: 518

Y

 

CLM_EXCEPTION_CD

519

EXCEPTION CODE: 519

Y

 

CLM_EXCEPTION_CD

52

EXCEPTION CODE: 52

Y

 

CLM_EXCEPTION_CD

520

EXCEPTION CODE: 520

Y

 

CLM_EXCEPTION_CD

523

EXCEPTION CODE: 523

Y

 

CLM_EXCEPTION_CD

524

EXCEPTION CODE: 524

Y

 

CLM_EXCEPTION_CD

525

EXCEPTION CODE: 525

Y

 

CLM_EXCEPTION_CD

527

EXCEPTION CODE: 527

Y

 

CLM_EXCEPTION_CD

528

EXCEPTION CODE: 528

Y

 

CLM_EXCEPTION_CD

53

EXCEPTION CODE: 53

Y

 

CLM_EXCEPTION_CD

531

EXCEPTION CODE: 531

Y

 

CLM_EXCEPTION_CD

532

EXCEPTION CODE: 532

Y

 

CLM_EXCEPTION_CD

533

EXCEPTION CODE: 533

Y

 

CLM_EXCEPTION_CD

535

EXCEPTION CODE: 535

Y

 

CLM_EXCEPTION_CD

536

EXCEPTION CODE: 536

Y

 

CLM_EXCEPTION_CD

538

EXCEPTION CODE: 538

Y

 

CLM_EXCEPTION_CD

539

EXCEPTION CODE: 539

Y

 

CLM_EXCEPTION_CD

54

EXCEPTION CODE: 54

Y

 

CLM_EXCEPTION_CD

540

EXCEPTION CODE: 540

Y

 

CLM_EXCEPTION_CD

541

EXCEPTION CODE: 541

Y

 

CLM_EXCEPTION_CD

542

EXCEPTION CODE: 542

Y

 

CLM_EXCEPTION_CD

543

EXCEPTION CODE: 543

Y

 

CLM_EXCEPTION_CD

544

EXCEPTION CODE: 544

Y

 

CLM_EXCEPTION_CD

545

EXCEPTION CODE: 545

Y

 

CLM_EXCEPTION_CD

546

EXCEPTION CODE: 546

Y

 

CLM_EXCEPTION_CD

547

EXCEPTION CODE: 547

Y

 

CLM_EXCEPTION_CD

548

EXCEPTION CODE: 548

Y

 

CLM_EXCEPTION_CD

549

EXCEPTION CODE: 549

Y

 

CLM_EXCEPTION_CD

55

EXCEPTION CODE: 55

Y

 

CLM_EXCEPTION_CD

550

EXCEPTION CODE: 550

Y

 

CLM_EXCEPTION_CD

551

EXCEPTION CODE: 551

Y

 

CLM_EXCEPTION_CD

553

EXCEPTION CODE: 553

Y

 

CLM_EXCEPTION_CD

554

EXCEPTION CODE: 554

Y

 

CLM_EXCEPTION_CD

555

EXCEPTION CODE: 555

Y

 

CLM_EXCEPTION_CD

556

EXCEPTION CODE: 556

Y

 

CLM_EXCEPTION_CD

56

EXCEPTION CODE: 56

Y

 

CLM_EXCEPTION_CD

560

EXCEPTION CODE: 560

Y

 

CLM_EXCEPTION_CD

57

EXCEPTION CODE: 57

Y

 

CLM_EXCEPTION_CD

572

EXCEPTION CODE: 572

Y

 

CLM_EXCEPTION_CD

576

EXCEPTION CODE: 576

Y

 

CLM_EXCEPTION_CD

577

EXCEPTION CODE: 577

Y

 

CLM_EXCEPTION_CD

578

EXCEPTION CODE: 578

Y

 

CLM_EXCEPTION_CD

58

EXCEPTION CODE: 58

Y

 

CLM_EXCEPTION_CD

580

EXCEPTION CODE: 580

Y

 

CLM_EXCEPTION_CD

581

EXCEPTION CODE: 581

Y

 

CLM_EXCEPTION_CD

582

EXCEPTION CODE: 582

Y

 

CLM_EXCEPTION_CD

583

EXCEPTION CODE: 583

Y

 

CLM_EXCEPTION_CD

584

EXCEPTION CODE: 584

Y

 

CLM_EXCEPTION_CD

585

EXCEPTION CODE: 585

Y

 

CLM_EXCEPTION_CD

586

EXCEPTION CODE: 586

Y

 

CLM_EXCEPTION_CD

587

EXCEPTION CODE: 587

Y

 

CLM_EXCEPTION_CD

588

EXCEPTION CODE: 588

Y

 

CLM_EXCEPTION_CD

589

EXCEPTION CODE: 589

Y

 

CLM_EXCEPTION_CD

59

EXCEPTION CODE: 59

Y

 

CLM_EXCEPTION_CD

590

EXCEPTION CODE: 590

Y

 

CLM_EXCEPTION_CD

591

EXCEPTION CODE: 591

Y

 

CLM_EXCEPTION_CD

592

EXCEPTION CODE: 592

Y

 

CLM_EXCEPTION_CD

593

EXCEPTION CODE: 593

Y

 

CLM_EXCEPTION_CD

594

EXCEPTION CODE: 594

Y

 

CLM_EXCEPTION_CD

595

EXCEPTION CODE: 595

Y

 

CLM_EXCEPTION_CD

596

EXCEPTION CODE: 596

Y

 

CLM_EXCEPTION_CD

597

EXCEPTION CODE: 597

Y

 

CLM_EXCEPTION_CD

598

EXCEPTION CODE: 598

Y

 

CLM_EXCEPTION_CD

599

EXCEPTION CODE: 599

Y

 

CLM_EXCEPTION_CD

6

EXCEPTION CODE: 6

Y

 

CLM_EXCEPTION_CD

60

EXCEPTION CODE: 60

Y

 

CLM_EXCEPTION_CD

600

EXCEPTION CODE: 600

Y

 

CLM_EXCEPTION_CD

601

EXCEPTION CODE: 601

Y

 

CLM_EXCEPTION_CD

602

EXCEPTION CODE: 602

Y

 

CLM_EXCEPTION_CD

603

EXCEPTION CODE: 603

Y

 

CLM_EXCEPTION_CD

604

EXCEPTION CODE: 604

Y

 

CLM_EXCEPTION_CD

605

EXCEPTION CODE: 605

Y

 

CLM_EXCEPTION_CD

606

EXCEPTION CODE: 606

Y

 

CLM_EXCEPTION_CD

607

EXCEPTION CODE: 607

Y

 

CLM_EXCEPTION_CD

608

EXCEPTION CODE: 608

Y

 

CLM_EXCEPTION_CD

609

EXCEPTION CODE: 609

Y

 

CLM_EXCEPTION_CD

61

EXCEPTION CODE: 61

Y

 

CLM_EXCEPTION_CD

610

EXCEPTION CODE: 610

Y

 

CLM_EXCEPTION_CD

611

EXCEPTION CODE: 611

Y

 

CLM_EXCEPTION_CD

612

EXCEPTION CODE: 612

Y

 

CLM_EXCEPTION_CD

613

EXCEPTION CODE: 613

Y

 

CLM_EXCEPTION_CD

614

EXCEPTION CODE: 614

Y

 

CLM_EXCEPTION_CD

615

EXCEPTION CODE: 615

Y

 

CLM_EXCEPTION_CD

616

EXCEPTION CODE: 616

Y

 

CLM_EXCEPTION_CD

617

EXCEPTION CODE: 617

Y

 

CLM_EXCEPTION_CD

618

EXCEPTION CODE: 618

Y

 

CLM_EXCEPTION_CD

619

EXCEPTION CODE: 619

Y

 

CLM_EXCEPTION_CD

62

EXCEPTION CODE: 62

Y

 

CLM_EXCEPTION_CD

620

EXCEPTION CODE: 620

Y

 

CLM_EXCEPTION_CD

621

EXCEPTION CODE: 621

Y

 

CLM_EXCEPTION_CD

622

EXCEPTION CODE: 622

Y

 

CLM_EXCEPTION_CD

623

EXCEPTION CODE: 623

Y

 

CLM_EXCEPTION_CD

624

EXCEPTION CODE: 624

Y

 

CLM_EXCEPTION_CD

625

EXCEPTION CODE: 625

Y

 

CLM_EXCEPTION_CD

626

EXCEPTION CODE: 626

Y

 

CLM_EXCEPTION_CD

627

EXCEPTION CODE: 627

Y

 

CLM_EXCEPTION_CD

628

EXCEPTION CODE: 628

Y

 

CLM_EXCEPTION_CD

629

EXCEPTION CODE: 629

Y

 

CLM_EXCEPTION_CD

63

EXCEPTION CODE: 63

Y

 

CLM_EXCEPTION_CD

630

EXCEPTION CODE: 630

Y

 

CLM_EXCEPTION_CD

631

EXCEPTION CODE: 631

Y

 

CLM_EXCEPTION_CD

632

EXCEPTION CODE: 632

Y

 

CLM_EXCEPTION_CD

633

EXCEPTION CODE: 633

Y

 

CLM_EXCEPTION_CD

634

EXCEPTION CODE: 634

Y

 

CLM_EXCEPTION_CD

635

EXCEPTION CODE: 635

Y

 

CLM_EXCEPTION_CD

636

EXCEPTION CODE: 636

Y

 

CLM_EXCEPTION_CD

637

EXCEPTION CODE: 637

Y

 

CLM_EXCEPTION_CD

639

EXCEPTION CODE: 639

Y

 

CLM_EXCEPTION_CD

64

EXCEPTION CODE: 64

Y

 

CLM_EXCEPTION_CD

640

EXCEPTION CODE: 640

Y

 

CLM_EXCEPTION_CD

641

EXCEPTION CODE: 641

Y

 

CLM_EXCEPTION_CD

642

EXCEPTION CODE: 642

Y

 

CLM_EXCEPTION_CD

643

EXCEPTION CODE: 643

Y

 

CLM_EXCEPTION_CD

644

EXCEPTION CODE: 644

Y

 

CLM_EXCEPTION_CD

645

EXCEPTION CODE: 645

Y

 

CLM_EXCEPTION_CD

646

EXCEPTION CODE: 646

Y

 

CLM_EXCEPTION_CD

647

EXCEPTION CODE: 647

Y

 

CLM_EXCEPTION_CD

648

EXCEPTION CODE: 648

Y

 

CLM_EXCEPTION_CD

649

EXCEPTION CODE: 649

Y

 

CLM_EXCEPTION_CD

65

EXCEPTION CODE: 65

Y

 

CLM_EXCEPTION_CD

650

EXCEPTION CODE: 650

Y

 

CLM_EXCEPTION_CD

651

EXCEPTION CODE: 651

Y

 

CLM_EXCEPTION_CD

652

EXCEPTION CODE: 652

Y

 

CLM_EXCEPTION_CD

653

EXCEPTION CODE: 653

Y

 

CLM_EXCEPTION_CD

654

EXCEPTION CODE: 654

Y

 

CLM_EXCEPTION_CD

655

EXCEPTION CODE: 655

Y

 

CLM_EXCEPTION_CD

656

EXCEPTION CODE: 656

Y

 

CLM_EXCEPTION_CD

657

EXCEPTION CODE: 657

Y

 

CLM_EXCEPTION_CD

658

EXCEPTION CODE: 658

Y

 

CLM_EXCEPTION_CD

659

EXCEPTION CODE: 659

Y

 

CLM_EXCEPTION_CD

66

EXCEPTION CODE: 66

Y

 

CLM_EXCEPTION_CD

660

EXCEPTION CODE: 660

Y

 

CLM_EXCEPTION_CD

661

EXCEPTION CODE: 661

Y

 

CLM_EXCEPTION_CD

662

EXCEPTION CODE: 662

Y

 

CLM_EXCEPTION_CD

663

EXCEPTION CODE: 663

Y

 

CLM_EXCEPTION_CD

664

EXCEPTION CODE: 664

Y

 

CLM_EXCEPTION_CD

665

EXCEPTION CODE: 665

Y

 

CLM_EXCEPTION_CD

666

EXCEPTION CODE: 666

Y

 

CLM_EXCEPTION_CD

667

EXCEPTION CODE: 667

Y

 

CLM_EXCEPTION_CD

668

EXCEPTION CODE: 668

Y

 

CLM_EXCEPTION_CD

669

EXCEPTION CODE: 669

Y

 

CLM_EXCEPTION_CD

67

EXCEPTION CODE: 67

Y

 

CLM_EXCEPTION_CD

670

EXCEPTION CODE: 670

Y

 

CLM_EXCEPTION_CD

671

EXCEPTION CODE: 671

Y

 

CLM_EXCEPTION_CD

672

EXCEPTION CODE: 672

Y

 

CLM_EXCEPTION_CD

673

EXCEPTION CODE: 673

Y

 

CLM_EXCEPTION_CD

674

EXCEPTION CODE: 674

Y

 

CLM_EXCEPTION_CD

675

EXCEPTION CODE: 675

Y

 

CLM_EXCEPTION_CD

676

EXCEPTION CODE: 676

Y

 

CLM_EXCEPTION_CD

677

EXCEPTION CODE: 677

Y

 

CLM_EXCEPTION_CD

678

EXCEPTION CODE: 678

Y

 

CLM_EXCEPTION_CD

679

EXCEPTION CODE: 679

Y

 

CLM_EXCEPTION_CD

68

EXCEPTION CODE: 68

Y

 

CLM_EXCEPTION_CD

680

EXCEPTION CODE: 680

Y

 

CLM_EXCEPTION_CD

681

EXCEPTION CODE: 681

Y

 

CLM_EXCEPTION_CD

682

EXCEPTION CODE: 682

Y

 

CLM_EXCEPTION_CD

683

EXCEPTION CODE: 683

Y

 

CLM_EXCEPTION_CD

684

EXCEPTION CODE: 684

Y

 

CLM_EXCEPTION_CD

685

EXCEPTION CODE: 685

Y

 

CLM_EXCEPTION_CD

686

EXCEPTION CODE: 686

Y

 

CLM_EXCEPTION_CD

687

EXCEPTION CODE: 687

Y

 

CLM_EXCEPTION_CD

688

EXCEPTION CODE: 688

Y

 

CLM_EXCEPTION_CD

689

EXCEPTION CODE: 689

Y

 

CLM_EXCEPTION_CD

69

EXCEPTION CODE: 69

Y

 

CLM_EXCEPTION_CD

690

EXCEPTION CODE: 690

Y

 

CLM_EXCEPTION_CD

691

EXCEPTION CODE: 691

Y

 

CLM_EXCEPTION_CD

692

EXCEPTION CODE: 692

Y

 

CLM_EXCEPTION_CD

693

EXCEPTION CODE: 693

Y

 

CLM_EXCEPTION_CD

694

EXCEPTION CODE: 694

Y

 

CLM_EXCEPTION_CD

695

EXCEPTION CODE: 695

Y

 

CLM_EXCEPTION_CD

696

EXCEPTION CODE: 696

Y

 

CLM_EXCEPTION_CD

697

EXCEPTION CODE: 697

Y

 

CLM_EXCEPTION_CD

698

EXCEPTION CODE: 698

Y

 

CLM_EXCEPTION_CD

699

EXCEPTION CODE: 699

Y

 

CLM_EXCEPTION_CD

7

EXCEPTION CODE: 7

Y

 

CLM_EXCEPTION_CD

70

EXCEPTION CODE: 70

Y

 

CLM_EXCEPTION_CD

700

EXCEPTION CODE: 700

Y

 

CLM_EXCEPTION_CD

701

EXCEPTION CODE: 701

Y

 

CLM_EXCEPTION_CD

702

EXCEPTION CODE: 702

Y

 

CLM_EXCEPTION_CD

705

EXCEPTION CODE: 705

Y

 

CLM_EXCEPTION_CD

707

EXCEPTION CODE: 707

Y

 

CLM_EXCEPTION_CD

708

EXCEPTION CODE: 708

Y

 

CLM_EXCEPTION_CD

709

EXCEPTION CODE: 709

Y

 

CLM_EXCEPTION_CD

71

EXCEPTION CODE: 71

Y

 

CLM_EXCEPTION_CD

711

EXCEPTION CODE: 711

Y

 

CLM_EXCEPTION_CD

712

EXCEPTION CODE: 712

Y

 

CLM_EXCEPTION_CD

713

EXCEPTION CODE: 713

Y

 

CLM_EXCEPTION_CD

714

EXCEPTION CODE: 714

Y

 

CLM_EXCEPTION_CD

715

EXCEPTION CODE: 715

Y

 

CLM_EXCEPTION_CD

716

EXCEPTION CODE: 716

Y

 

CLM_EXCEPTION_CD

717

EXCEPTION CODE: 717

Y

 

CLM_EXCEPTION_CD

718

EXCEPTION CODE: 718

Y

 

CLM_EXCEPTION_CD

719

EXCEPTION CODE: 719

Y

 

CLM_EXCEPTION_CD

72

EXCEPTION CODE: 72

Y

 

CLM_EXCEPTION_CD

720

EXCEPTION CODE: 720

Y

 

CLM_EXCEPTION_CD

721

EXCEPTION CODE: 721

Y

 

CLM_EXCEPTION_CD

722

EXCEPTION CODE: 722

Y

 

CLM_EXCEPTION_CD

723

EXCEPTION CODE: 723

Y

 

CLM_EXCEPTION_CD

724

EXCEPTION CODE: 724

Y

 

CLM_EXCEPTION_CD

725

EXCEPTION CODE: 725

Y

 

CLM_EXCEPTION_CD

726

EXCEPTION CODE: 726

Y

 

CLM_EXCEPTION_CD

727

EXCEPTION CODE: 727

Y

 

CLM_EXCEPTION_CD

728

EXCEPTION CODE: 728

Y

 

CLM_EXCEPTION_CD

729

EXCEPTION CODE: 729

Y

 

CLM_EXCEPTION_CD

73

EXCEPTION CODE: 73

Y

 

CLM_EXCEPTION_CD

731

EXCEPTION CODE: 731

Y

 

CLM_EXCEPTION_CD

737

EXCEPTION CODE: 737

Y

 

CLM_EXCEPTION_CD

739

EXCEPTION CODE: 739

Y

 

CLM_EXCEPTION_CD

74

EXCEPTION CODE: 74

Y

 

CLM_EXCEPTION_CD

740

EXCEPTION CODE: 740

Y

 

CLM_EXCEPTION_CD

741

EXCEPTION CODE: 741

Y

 

CLM_EXCEPTION_CD

743

EXCEPTION CODE: 743

Y

 

CLM_EXCEPTION_CD

744

EXCEPTION CODE: 744

Y

 

CLM_EXCEPTION_CD

745

EXCEPTION CODE: 745

Y

 

CLM_EXCEPTION_CD

746

EXCEPTION CODE: 746

Y

 

CLM_EXCEPTION_CD

747

EXCEPTION CODE: 747

Y

 

CLM_EXCEPTION_CD

75

EXCEPTION CODE: 75

Y

 

CLM_EXCEPTION_CD

750

EXCEPTION CODE: 750

Y

 

CLM_EXCEPTION_CD

758

EXCEPTION CODE: 758

Y

 

CLM_EXCEPTION_CD

76

EXCEPTION CODE: 76

Y

 

CLM_EXCEPTION_CD

763

EXCEPTION CODE: 763

Y

 

CLM_EXCEPTION_CD

764

EXCEPTION CODE: 764

Y

 

CLM_EXCEPTION_CD

765

EXCEPTION CODE: 765

Y

 

CLM_EXCEPTION_CD

766

EXCEPTION CODE: 766

Y

 

CLM_EXCEPTION_CD

767

EXCEPTION CODE: 767

Y

 

CLM_EXCEPTION_CD

768

EXCEPTION CODE: 768

Y

 

CLM_EXCEPTION_CD

769

EXCEPTION CODE: 769

Y

 

CLM_EXCEPTION_CD

77

EXCEPTION CODE: 77

Y

 

CLM_EXCEPTION_CD

770

EXCEPTION CODE: 770

Y

 

CLM_EXCEPTION_CD

771

EXCEPTION CODE: 771

Y

 

CLM_EXCEPTION_CD

772

EXCEPTION CODE: 772

Y

 

CLM_EXCEPTION_CD

773

EXCEPTION CODE: 773

Y

 

CLM_EXCEPTION_CD

774

EXCEPTION CODE: 774

Y

 

CLM_EXCEPTION_CD

775

EXCEPTION CODE: 775

Y

 

CLM_EXCEPTION_CD

776

EXCEPTION CODE: 776

Y

 

CLM_EXCEPTION_CD

777

EXCEPTION CODE: 777

Y

 

CLM_EXCEPTION_CD

778

EXCEPTION CODE: 778

Y

 

CLM_EXCEPTION_CD

779

EXCEPTION CODE: 779

Y

 

CLM_EXCEPTION_CD

78

EXCEPTION CODE: 78

Y

 

CLM_EXCEPTION_CD

780

EXCEPTION CODE: 780

Y

 

CLM_EXCEPTION_CD

781

EXCEPTION CODE: 781

Y

 

CLM_EXCEPTION_CD

782

EXCEPTION CODE: 782

Y

 

CLM_EXCEPTION_CD

783

EXCEPTION CODE: 783

Y

 

CLM_EXCEPTION_CD

784

EXCEPTION CODE: 784

Y

 

CLM_EXCEPTION_CD

785

EXCEPTION CODE: 785

Y

 

CLM_EXCEPTION_CD

786

EXCEPTION CODE: 786

Y

 

CLM_EXCEPTION_CD

787

EXCEPTION CODE: 787

Y

 

CLM_EXCEPTION_CD

788

EXCEPTION CODE: 788

Y

 

CLM_EXCEPTION_CD

789

EXCEPTION CODE: 789

Y

 

CLM_EXCEPTION_CD

79

EXCEPTION CODE: 79

Y

 

CLM_EXCEPTION_CD

790

EXCEPTION CODE: 790

Y

 

CLM_EXCEPTION_CD

791

EXCEPTION CODE: 791

Y

 

CLM_EXCEPTION_CD

792

EXCEPTION CODE: 792

Y

 

CLM_EXCEPTION_CD

793

EXCEPTION CODE: 793

Y

 

CLM_EXCEPTION_CD

794

EXCEPTION CODE: 794

Y

 

CLM_EXCEPTION_CD

795

EXCEPTION CODE: 795

Y

 

CLM_EXCEPTION_CD

796

EXCEPTION CODE: 796

Y

 

CLM_EXCEPTION_CD

797

EXCEPTION CODE: 797

Y

 

CLM_EXCEPTION_CD

798

EXCEPTION CODE: 798

Y

 

CLM_EXCEPTION_CD

799

EXCEPTION CODE: 799

Y

 

CLM_EXCEPTION_CD

8

EXCEPTION CODE: 8

Y

 

CLM_EXCEPTION_CD

80

EXCEPTION CODE: 80

Y

 

CLM_EXCEPTION_CD

800

EXCEPTION CODE: 800

Y

 

CLM_EXCEPTION_CD

801

EXCEPTION CODE: 801

Y

 

CLM_EXCEPTION_CD

81

EXCEPTION CODE: 81

Y

 

CLM_EXCEPTION_CD

812

EXCEPTION CODE: 812

Y

 

CLM_EXCEPTION_CD

813

EXCEPTION CODE: 813

Y

 

CLM_EXCEPTION_CD

82

EXCEPTION CODE: 82

Y

 

CLM_EXCEPTION_CD

820

EXCEPTION CODE: 820

Y

 

CLM_EXCEPTION_CD

823

EXCEPTION CODE: 823

Y

 

CLM_EXCEPTION_CD

824

EXCEPTION CODE: 824

Y

 

CLM_EXCEPTION_CD

825

EXCEPTION CODE: 825

Y

 

CLM_EXCEPTION_CD

826

EXCEPTION CODE: 826

Y

 

CLM_EXCEPTION_CD

827

EXCEPTION CODE: 827

Y

 

CLM_EXCEPTION_CD

828

EXCEPTION CODE: 828

Y

 

CLM_EXCEPTION_CD

829

EXCEPTION CODE: 829

Y

 

CLM_EXCEPTION_CD

83

EXCEPTION CODE: 83

Y

 

CLM_EXCEPTION_CD

830

EXCEPTION CODE: 830

Y

 

CLM_EXCEPTION_CD

831

EXCEPTION CODE: 831

Y

 

CLM_EXCEPTION_CD

833

EXCEPTION CODE: 833

Y

 

CLM_EXCEPTION_CD

834

EXCEPTION CODE: 834

Y

 

CLM_EXCEPTION_CD

835

EXCEPTION CODE: 835

Y

 

CLM_EXCEPTION_CD

836

EXCEPTION CODE: 836

Y

 

CLM_EXCEPTION_CD

837

EXCEPTION CODE: 837

Y

 

CLM_EXCEPTION_CD

838

EXCEPTION CODE: 838

Y

 

CLM_EXCEPTION_CD

839

EXCEPTION CODE: 839

Y

 

CLM_EXCEPTION_CD

84

EXCEPTION CODE: 84

Y

 

CLM_EXCEPTION_CD

840

EXCEPTION CODE: 840

Y

 

CLM_EXCEPTION_CD

842

EXCEPTION CODE: 842

Y

 

CLM_EXCEPTION_CD

843

EXCEPTION CODE: 843

Y

 

CLM_EXCEPTION_CD

844

EXCEPTION CODE: 844

Y

 

CLM_EXCEPTION_CD

845

EXCEPTION CODE: 845

Y

 

CLM_EXCEPTION_CD

846

EXCEPTION CODE: 846

Y

 

CLM_EXCEPTION_CD

847

EXCEPTION CODE: 847

Y

 

CLM_EXCEPTION_CD

848

EXCEPTION CODE: 848

Y

 

CLM_EXCEPTION_CD

85

EXCEPTION CODE: 85

Y

 

CLM_EXCEPTION_CD

850

EXCEPTION CODE: 850

Y

 

CLM_EXCEPTION_CD

853

EXCEPTION CODE: 853

Y

 

CLM_EXCEPTION_CD

854

EXCEPTION CODE: 854

Y

 

CLM_EXCEPTION_CD

855

EXCEPTION CODE: 855

Y

 

CLM_EXCEPTION_CD

856

EXCEPTION CODE: 856

Y

 

CLM_EXCEPTION_CD

857

EXCEPTION CODE: 857

Y

 

CLM_EXCEPTION_CD

858

EXCEPTION CODE: 858

Y

 

CLM_EXCEPTION_CD

859

EXCEPTION CODE: 859

Y

 

CLM_EXCEPTION_CD

86

EXCEPTION CODE: 86

Y

 

CLM_EXCEPTION_CD

866

EXCEPTION CODE: 866

Y

 

CLM_EXCEPTION_CD

867

EXCEPTION CODE: 867

Y

 

CLM_EXCEPTION_CD

868

EXCEPTION CODE: 868

Y

 

CLM_EXCEPTION_CD

87

EXCEPTION CODE: 87

Y

 

CLM_EXCEPTION_CD

870

EXCEPTION CODE: 870

Y

 

CLM_EXCEPTION_CD

871

EXCEPTION CODE: 871

Y

 

CLM_EXCEPTION_CD

872

EXCEPTION CODE: 872

Y

 

CLM_EXCEPTION_CD

873

EXCEPTION CODE: 873

Y

 

CLM_EXCEPTION_CD

874

EXCEPTION CODE: 874

Y

 

CLM_EXCEPTION_CD

875

EXCEPTION CODE: 875

Y

 

CLM_EXCEPTION_CD

876

EXCEPTION CODE: 876

Y

 

CLM_EXCEPTION_CD

877

EXCEPTION CODE: 877

Y

 

CLM_EXCEPTION_CD

878

EXCEPTION CODE: 878

Y

 

CLM_EXCEPTION_CD

879

EXCEPTION CODE: 879

Y

 

CLM_EXCEPTION_CD

88

EXCEPTION CODE: 88

Y

 

CLM_EXCEPTION_CD

880

EXCEPTION CODE: 880

Y

 

CLM_EXCEPTION_CD

881

EXCEPTION CODE: 881

Y

 

CLM_EXCEPTION_CD

882

EXCEPTION CODE: 882

Y

 

CLM_EXCEPTION_CD

886

EXCEPTION CODE: 886

Y

 

CLM_EXCEPTION_CD

887

EXCEPTION CODE: 887

Y

 

CLM_EXCEPTION_CD

888

EXCEPTION CODE: 888

Y

 

CLM_EXCEPTION_CD

889

EXCEPTION CODE: 889

Y

 

CLM_EXCEPTION_CD

89

EXCEPTION CODE: 89

Y

 

CLM_EXCEPTION_CD

890

EXCEPTION CODE: 890

Y

 

CLM_EXCEPTION_CD

891

EXCEPTION CODE: 891

Y

 

CLM_EXCEPTION_CD

892

EXCEPTION CODE: 892

Y

 

CLM_EXCEPTION_CD

895

EXCEPTION CODE: 895

Y

 

CLM_EXCEPTION_CD

896

EXCEPTION CODE: 896

Y

 

CLM_EXCEPTION_CD

898

EXCEPTION CODE: 898

Y

 

CLM_EXCEPTION_CD

899

EXCEPTION CODE: 899

Y

 

CLM_EXCEPTION_CD

9

EXCEPTION CODE: 9

Y

 

CLM_EXCEPTION_CD

90

EXCEPTION CODE: 90

Y

 

CLM_EXCEPTION_CD

900

EXCEPTION CODE: 900

Y

 

CLM_EXCEPTION_CD

91

EXCEPTION CODE: 91

Y

 

CLM_EXCEPTION_CD

92

EXCEPTION CODE: 92

Y

 

CLM_EXCEPTION_CD

93

EXCEPTION CODE: 93

Y

 

CLM_EXCEPTION_CD

94

EXCEPTION CODE: 94

Y

 

CLM_EXCEPTION_CD

95

EXCEPTION CODE: 95

Y

 

CLM_EXCEPTION_CD

96

EXCEPTION CODE: 96

Y

 

CLM_EXCEPTION_CD

97

EXCEPTION CODE: 97

Y

 

CLM_RATE_ADJ_RSN_CD

##

NO REASON INDICATED CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

01

SPENDDOWN CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

02

MINNESOTA CARE COPAYMENT

Y

 

CLM_RATE_ADJ_RSN_CD

03

PROV-SUBMITTED TPL CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

04

DHS-COLLECTED TPL CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

05

AUTH LIMIT EXCEEDED CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

06

TPL DRUG COPAYMENT CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

07

OTHER LTC PROCESSING CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

08

C&TC OUTREACH LIMIT CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

09

SURS CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

10

SURS ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

11

REBASING AMOUNT ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

12

FINAL REBASING PAYMT ADJ

Y

 

CLM_RATE_ADJ_RSN_CD

13

RECIPIENT CO-PAYMENT

Y

 

CLM_RATE_ADJ_RSN_CD

14

CALC REIMB VS PAID AMT CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

15

SENIOR PRESCRIPTION DRUG ADD ON

Y

 

CLM_RATE_ADJ_RSN_CD

16

SENIOR PRESCRIPTION DRUG DEDUCTIBLE

Y

 

CLM_RATE_ADJ_RSN_CD

17

AC CAP REDUCTION

Y

 

CLM_RATE_ADJ_RSN_CD

18

EW SPECIAL INCOME STANDARD CUT

Y

 

CLM_RATE_ADJ_RSN_CD

19

CCDTF ADD ON FOR SPENDDOWN

Y

 

CLM_RATE_ADJ_RSN_CD

1W

SPECIAL FUNDING RATE CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

2R

Inpatient transition cutback

Y

 

CLM_RATE_ADJ_RSN_CD

71

PAT RESP WITH TPL CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

72

AC DIS CAP REDUCTION

Y

 

CLM_RATE_ADJ_RSN_CD

73

MCARE RATE ADJUSTMENT CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

74

GAMC REFORM PAY ZERO

Y

 

CLM_RATE_ADJ_RSN_CD

75

RCP COPAY REDUCED INCOME LIMIT

Y

 

CLM_RATE_ADJ_RSN_CD

76

FQHC ENCOUNTER LIMIT CUT

Y

 

CLM_RATE_ADJ_RSN_CD

77

RHC ENCOUNTER LIMIT CUT

Y

 

CLM_RATE_ADJ_RSN_CD

78

PHARM OBLIG CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

79

HEALTH CARE SCHOLARSHIP LEGISLATION ADD ON

Y

 

CLM_RATE_ADJ_RSN_CD

80

PROVIDER REDUCTION/COPAY

Y

 

CLM_RATE_ADJ_RSN_CD

81

GA 06 REDUCED 2ND CLAIM

Y

 

CLM_RATE_ADJ_RSN_CD

82

GA 06 REDUCED REIMB AMT

Y

 

CLM_RATE_ADJ_RSN_CD

83

GA06 REDUCED ADD FROM OTHER LINE

Y

 

CLM_RATE_ADJ_RSN_CD

84

GA 06 REDUCED 82 AND 83

Y

 

CLM_RATE_ADJ_RSN_CD

86

INPATIENT J PAYER MCARE-B REIMB

Y

 

CLM_RATE_ADJ_RSN_CD

87

RCP PHARM COPAY CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

88

COMPOUND DRUG DISP FEE

Y

 

CLM_RATE_ADJ_RSN_CD

89

FQHC RHC PHARMACY CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

90

CONVERSION DHS TPL ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

91

CONVERSION BALANCING CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

92

CONVERSION BALANCING ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

93

INDIAN HLTH ENCOUNTER LIM CUT

Y

 

CLM_RATE_ADJ_RSN_CD

94

RECIPIENT COPAY REDUCED 2ND CLAIM

Y

 

CLM_RATE_ADJ_RSN_CD

95

RECIPIENT COPAY REDUCED REIMB AMT

Y

 

CLM_RATE_ADJ_RSN_CD

96

COPAY ADD FROM OTHER LINE

Y

 

CLM_RATE_ADJ_RSN_CD

97

COPAY REDUCED 94 AND 95

Y

 

CLM_RATE_ADJ_RSN_CD

98

MNCARE TAX TWO PERCENT ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

99

FAMILY DEDUCTIBLE

Y

 

CLM_RATE_ADJ_RSN_CD

AA

PA LIMIT EXCEEDED CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

AB

BILLABLE BUT NOT PAYABLE CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

AC

ASC SECONDARY LINE CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

AE

PROCEDURE NOT ALLOWED CUT

Y

 

CLM_RATE_ADJ_RSN_CD

AL

ASSESSMENT LATE CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

AN

BUNDLED OR PKGD PROC CUT

Y

 

CLM_RATE_ADJ_RSN_CD

AS

ASC PRIMARY ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

AV

VISIT NOT ALLOWED CUT

Y

 

CLM_RATE_ADJ_RSN_CD

BB

BEN LIMIT EXCEEDED CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

BC

ATS ADMIN FEE CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

CA

CAPITATION NF ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

CB

CAPITATION EW ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

CC

CAPITATION RISK ADJ ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

CD

CAPITATION OTHER ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

CE

CAPITATION MED ED RES CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

CG

CAPITATION MH ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

CH

HH CASE MANAG PROV MAX CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

CM

CRITICAL ACC MENT HLTH ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

CR

HOSPITAL PAYMENT ADJUSTMENT

Y

 

CLM_RATE_ADJ_RSN_CD

CS

COMPLICATED C-SECTION

Y

 

CLM_RATE_ADJ_RSN_CD

CT

COMPUTED TOMOGRAPHY TECH CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

CW

IHS CWTCM ADMIN FEE CUT

Y

 

CLM_RATE_ADJ_RSN_CD

DA

CRITICAL ACCESS DENTAL ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

DB

DME PURCH REDUCTION

Y

 

CLM_RATE_ADJ_RSN_CD

DC

DENTAL COPAY

Y

 

CLM_RATE_ADJ_RSN_CD

DD

PEDIATRICS ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

DE

DME LEGISLATIVE INCREASE

Y

 

CLM_RATE_ADJ_RSN_CD

DI

LEGISLATIVE DENTAL INCREASE 2014

Y

 

CLM_RATE_ADJ_RSN_CD

DL

DENTAL INCREASE OUTSIDE 7 METRO CO

Y

 

CLM_RATE_ADJ_RSN_CD

DP

DPA ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

DS

Inpatient dsh add-on

Y

 

CLM_RATE_ADJ_RSN_CD

EA

EARLY INT BEHAV INTERV 20% CUT

Y

 

CLM_RATE_ADJ_RSN_CD

EB

EARLY INT BEHAV INTERV 50% CUT

Y

 

CLM_RATE_ADJ_RSN_CD

EC

OXYGEN WITH QH MODIFIER ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

EE

CCDTF MEDICARE COVERED CUT

Y

 

CLM_RATE_ADJ_RSN_CD

EP

ENDOSCOPIC PRICING

Y

 

CLM_RATE_ADJ_RSN_CD

ES

ESSURE MEDICAL DEVICE ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

FA

LTC 1ST 30 DAY ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

FB

LTC DAY 31-90 ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

FC

PAY PRIVATE ROOM

Y

 

CLM_RATE_ADJ_RSN_CD

FD

LTC LEAVE

Y

 

CLM_RATE_ADJ_RSN_CD

FF

COURAGE CENTER ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

FI

FQHC FAMILY PLAN ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

FM

FAMILY PLANNING 20% ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

FP

FAMILY PLANNING ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

FR

FQHC FAMILY PLAN CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

FT

FLOURIDE VARNISH ADD ON

Y

 

CLM_RATE_ADJ_RSN_CD

GF

CAH NONPHYSICIAN CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

GG

OBSTETRICS ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

HF

HIT MULTIPLE INFUS CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

HH

COMM/PUBLIC HEALTH ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

HL

GILLETTE INCREASE PAY TO PROV COS

Y

 

CLM_RATE_ADJ_RSN_CD

IA

INDIAN HEALTH SERVICE ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

IC

IMMUNIZATION CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

ID

INDIAN HEALTH SERVICE CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

IH

ADD INDIAN HLTH ANCILLARY ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

II

OUTPATIENT AS OFFICE CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

JJ

DENTAL PREV HEALTH ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

JK

DENTAL NON-PREV HEALTH ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

KA

CORE HOSPITAL INCREASE

Y

 

CLM_RATE_ADJ_RSN_CD

KK

SMALL HOSPITAL INCREASE

Y

 

CLM_RATE_ADJ_RSN_CD

LB

CLINICAL CHEMISTRY CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

LC

LEGISLATIVE RATE CUT 03

Y

 

CLM_RATE_ADJ_RSN_CD

LD

LEGISLATIVE RATE CUT 05

Y

 

CLM_RATE_ADJ_RSN_CD

LE

LEGISLATIVE RATE CUT 08 09 10

Y

 

CLM_RATE_ADJ_RSN_CD

LF

LEGISLATIVE BASIC CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

LG

LEGISLATIVE RATE CUT 08

Y

 

CLM_RATE_ADJ_RSN_CD

LH

LEGISLATIVE PHYS PROF CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

LI

1% INPATIENT CLAIMS REDUCTION

Y

 

CLM_RATE_ADJ_RSN_CD

LJ

GAMC LEGISLATIVE PAY 37%

Y

 

CLM_RATE_ADJ_RSN_CD

LK

LEGISLATIVE INPT REDUCT 2011

Y

 

CLM_RATE_ADJ_RSN_CD

LL

COST OUTLIER ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

LM

DPA OUTLIER ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

LN

LEGISLATIVE PHYS PROF 2011

Y

 

CLM_RATE_ADJ_RSN_CD

LO

LEGISLATIVE DENT REDUCT 2011

Y

 

CLM_RATE_ADJ_RSN_CD

LP

CAP LEGISLATIVE RATE CUT

Y

 

CLM_RATE_ADJ_RSN_CD

LQ

LEGISLATIVE INPT REDUCT 09-11

Y

 

CLM_RATE_ADJ_RSN_CD

LR

LEGISLATIVE RATABLE REDUCTION

Y

 

CLM_RATE_ADJ_RSN_CD

LS

LEGISLATIVE BASIC CUTBACK 2011

Y

 

CLM_RATE_ADJ_RSN_CD

LT

LEGISLATIVE RATE REDUCTION TRANSPORT

N

 

CLM_RATE_ADJ_RSN_CD

LU

LEGISLATIVE 20% CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

LW

LEGISLATIVE BASIC INCREASE

Y

 

CLM_RATE_ADJ_RSN_CD

LX

LEGISLATIVE PHYSICIAN PROF ADD ON

Y

 

CLM_RATE_ADJ_RSN_CD

LY

LEGISLATIVE DME REDUCTION 2014

Y

 

CLM_RATE_ADJ_RSN_CD

MB

MCARE BLOOD DEDUCTIBLE ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

MC

MCARE COINSURANCE ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

MD

MCARE CASH DEDUCTIBLE ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

MG

MENTAL HLTH 2 PERCENT ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

MI

MENTAL HEALTH 2 PLUS 2 ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

MJ

PAYER CODE J MCARE-B REIMB

Y

 

CLM_RATE_ADJ_RSN_CD

MK

MEDICARE LIMIT

Y

 

CLM_RATE_ADJ_RSN_CD

ML

MEDICARE PAYMENT

Y

 

CLM_RATE_ADJ_RSN_CD

MM

DAY OUTLIER ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

MN

Inpatient cost outlier add-on

Y

 

CLM_RATE_ADJ_RSN_CD

MP

MCARE PSYCH ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

MR

2% SEQUESTRATION CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

MX

ENH SERVICE GREATER THAN SUBMITTED CHARGE CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

NA

INTERIM REBASING PAYMT ADJ

Y

 

CLM_RATE_ADJ_RSN_CD

NB

INDIGENT CARE PAYMENT

Y

 

CLM_RATE_ADJ_RSN_CD

NE

NON EMERGENCY ER CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

NH

NEWBORN HEARING ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

NN

NEWBORN ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

NS

CLINICAL NURSE SPECIALIST CUT

Y

 

CLM_RATE_ADJ_RSN_CD

PA

PHSYCIAN ASSISTANT CUT

Y

 

CLM_RATE_ADJ_RSN_CD

PB

340B DISCOUNT ALLOWABLE CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

PC

PCA RELATIVE CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

PD

PROVIDER RESPONSIBILITY CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

PE

PRIMARY CARE ENHANCED ADD ON

Y

 

CLM_RATE_ADJ_RSN_CD

PP

SOLE COMMUNITY PROVIDER ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

PR

PRACTITIONER-REDUCTION

Y

 

CLM_RATE_ADJ_RSN_CD

PT

POSTAGE/TAX

Y

 

CLM_RATE_ADJ_RSN_CD

PU

PARTIAL UNITS CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

QQ

PMT GREATER CHARGES OVER YR

Y

 

CLM_RATE_ADJ_RSN_CD

RD

RHC FAMILY PLAN CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

RI

RHC FAMILY PLAN ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

RL

PROVIDER REDUCTION

Y

 

CLM_RATE_ADJ_RSN_CD

RM

PROV REDUCED 2ND CLAIM

Y

 

CLM_RATE_ADJ_RSN_CD

RN

PROV REDUCED REIMB AMOUNT

Y

 

CLM_RATE_ADJ_RSN_CD

RO

PROV REDUCE ADD FROM OTHER

Y

 

CLM_RATE_ADJ_RSN_CD

RP

REDUCED RN AND RO

Y

 

CLM_RATE_ADJ_RSN_CD

RR

TRANS MULTI RIDER CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

SD

ESRD PROV TEACHS SELF DIAL ADD

Y

 

CLM_RATE_ADJ_RSN_CD

SS

SEC SURGERY PROC ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

T1

NDC DRUG CODE MISSING APC/ASC

Y

 

CLM_RATE_ADJ_RSN_CD

T2

NDC DRUG QTY MISSING APC/ASC

Y

 

CLM_RATE_ADJ_RSN_CD

T3

NDC DRUG NOT ON FILE APC/ASC

Y

 

CLM_RATE_ADJ_RSN_CD

T4

NDC DRUG CODE EXPIRED APC/ASC

Y

 

CLM_RATE_ADJ_RSN_CD

T5

NDC DRUG DATE RANGE APC/ASC

Y

 

CLM_RATE_ADJ_RSN_CD

T6

NDC DRUG NO REBATE APC/ASC

Y

 

CLM_RATE_ADJ_RSN_CD

TI

Inpatient transition add-on

Y

 

CLM_RATE_ADJ_RSN_CD

TM

TRANSPORTATION TRIP TO 50 MILES

Y

 

CLM_RATE_ADJ_RSN_CD

TN

Inpatient ten percent add-on

Y

 

CLM_RATE_ADJ_RSN_CD

TP

PRIMARY MCARE PAYER TPL AMT

Y

 

CLM_RATE_ADJ_RSN_CD

TR

TRANSPORTATION RURAL ADD ON

Y

 

CLM_RATE_ADJ_RSN_CD

TS

TRANSPORTATION TRIP TO 17 MILES

Y

 

CLM_RATE_ADJ_RSN_CD

TT

SEC SURGERY PROC CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

UU

PDDD MAX UNITS CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

VE

VACCINE ENHANCED SVCS ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

VV

NURSE PRACTITIONER CUTBACK

Y

 

CLM_RATE_ADJ_RSN_CD

WA

Inpatient mental health drg add-on

Y

 

CLM_RATE_ADJ_RSN_CD

WB

Inpatient neonate add-on

Y

 

CLM_RATE_ADJ_RSN_CD

WC

Inpatient normal newborn add-on

Y

 

CLM_RATE_ADJ_RSN_CD

WD

Inpatient ob vag deliv metro add-on

Y

 

CLM_RATE_ADJ_RSN_CD

WE

Inpatient ob vag delv nonmetro add-on

Y

 

CLM_RATE_ADJ_RSN_CD

WF

Inpatient ob cesarean drg add-on

Y

 

CLM_RATE_ADJ_RSN_CD

WG

Inpatient oth obstetric drg add-on

Y

 

CLM_RATE_ADJ_RSN_CD

WH

Inpatient transplant drg add-on

Y

 

CLM_RATE_ADJ_RSN_CD

WI

Inpatient trauma drg add-on

Y

 

CLM_RATE_ADJ_RSN_CD

WJ

Inpatient oth drg child hosp add-on

Y

 

CLM_RATE_ADJ_RSN_CD

WK

Inpatient oth drg non-child hsp add-on

Y

 

CLM_RATE_ADJ_RSN_CD

WL

Inpatient other drg adult add-on

Y

 

CLM_RATE_ADJ_RSN_CD

XX

UNIT DOSE ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

YY

PHARM DISPENSING FEE ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

Z1

ENH 100 PCT FED SHARE

Y

 

CLM_RATE_ADJ_RSN_CD

Z2

100 PCT FED SHARE OFFSET

Y

 

CLM_RATE_ADJ_RSN_CD

ZM

MINNESOTA CARE DENTAL ADD-ON

Y

 

CLM_RATE_ADJ_RSN_CD

ZX

SED RATE ADD

Y

 

CLM_RATE_ADJ_RSN_CD

ZY

GAMC RATE CUT

Y

 

CLM_RATE_ADJ_RSN_CD

ZZ

MASTERS LEVEL PSYCH CUTBACK

Y

 

CLM_RA_ADJ_GRP_CD

CO

Other adjustment

Y

3

CLM_RA_ADJ_GRP_CD

CR

Replacement or reversal

Y

4

CLM_RA_ADJ_GRP_CD

OA

Adjustment during warrant processing

Y

1

CLM_RA_ADJ_GRP_CD

PI

Adjustment to balance claim

Y

2

CLM_RA_ADJ_GRP_CD

PR

Spenddown or co-pay

Y

5

CLM_RA_ADJ_REASON_CD

1

RA Adjustment Reason: 1

Y

 

CLM_RA_ADJ_REASON_CD

10

RA Adjustment Reason: 10

Y

 

CLM_RA_ADJ_REASON_CD

100

RA Adjustment Reason: 100

Y

 

CLM_RA_ADJ_REASON_CD

101

RA Adjustment Reason: 101

Y

 

CLM_RA_ADJ_REASON_CD

102

RA Adjustment Reason: 102

Y

 

CLM_RA_ADJ_REASON_CD

103

RA Adjustment Reason: 103

Y

 

CLM_RA_ADJ_REASON_CD

104

RA Adjustment Reason: 104

Y

 

CLM_RA_ADJ_REASON_CD

105

RA Adjustment Reason: 105

Y

 

CLM_RA_ADJ_REASON_CD

106

RA Adjustment Reason: 106

Y

 

CLM_RA_ADJ_REASON_CD

107

RA Adjustment Reason: 107

Y

 

CLM_RA_ADJ_REASON_CD

108

RA Adjustment Reason: 108

Y

 

CLM_RA_ADJ_REASON_CD

109

RA Adjustment Reason: 109

Y

 

CLM_RA_ADJ_REASON_CD

11

RA Adjustment Reason: 11

Y

 

CLM_RA_ADJ_REASON_CD

110

RA Adjustment Reason: 110

Y

 

CLM_RA_ADJ_REASON_CD

111

RA Adjustment Reason: 111

Y

 

CLM_RA_ADJ_REASON_CD

112

RA Adjustment Reason: 112

Y

 

CLM_RA_ADJ_REASON_CD

113

RA Adjustment Reason: 113

N

 

CLM_RA_ADJ_REASON_CD

114

RA Adjustment Reason: 114

Y

 

CLM_RA_ADJ_REASON_CD

115

RA Adjustment Reason: 115

Y

 

CLM_RA_ADJ_REASON_CD

116

RA Adjustment Reason: 116

Y

 

CLM_RA_ADJ_REASON_CD

117

RA Adjustment Reason: 117

Y

 

CLM_RA_ADJ_REASON_CD

118

RA Adjustment Reason: 118

Y

 

CLM_RA_ADJ_REASON_CD

119

RA Adjustment Reason: 119

Y

 

CLM_RA_ADJ_REASON_CD

12

RA Adjustment Reason: 12

Y

 

CLM_RA_ADJ_REASON_CD

120

RA Adjustment Reason: 120

N

 

CLM_RA_ADJ_REASON_CD

121

RA Adjustment Reason: 121

Y

 

CLM_RA_ADJ_REASON_CD

122

RA Adjustment Reason: 122

Y

 

CLM_RA_ADJ_REASON_CD

123

RA Adjustment Reason: 123

N

 

CLM_RA_ADJ_REASON_CD

124

RA Adjustment Reason: 124

N

 

CLM_RA_ADJ_REASON_CD

125

RA Adjustment Reason: 125

N

 

CLM_RA_ADJ_REASON_CD

126

RA Adjustment Reason: 126

N

 

CLM_RA_ADJ_REASON_CD

127

RA Adjustment Reason: 127

N

 

CLM_RA_ADJ_REASON_CD

128

RA Adjustment Reason: 128

Y

 

CLM_RA_ADJ_REASON_CD

129

RA Adjustment Reason: 129

Y

 

CLM_RA_ADJ_REASON_CD

13

RA Adjustment Reason: 13

Y

 

CLM_RA_ADJ_REASON_CD

130

RA Adjustment Reason: 130

Y

 

CLM_RA_ADJ_REASON_CD

131

RA Adjustment Reason: 131

Y

 

CLM_RA_ADJ_REASON_CD

132

RA Adjustment Reason: 132

Y

 

CLM_RA_ADJ_REASON_CD

133

RA Adjustment Reason: 133

Y

 

CLM_RA_ADJ_REASON_CD

134

RA Adjustment Reason: 134

Y

 

CLM_RA_ADJ_REASON_CD

135

RA Adjustment Reason: 135

Y

 

CLM_RA_ADJ_REASON_CD

136

RA Adjustment Reason: 136

Y

 

CLM_RA_ADJ_REASON_CD

137

RA Adjustment Reason: 137

Y

 

CLM_RA_ADJ_REASON_CD

138

RA Adjustment Reason: 138

N

 

CLM_RA_ADJ_REASON_CD

139

RA Adjustment Reason: 139

Y

 

CLM_RA_ADJ_REASON_CD

14

RA Adjustment Reason: 14

Y

 

CLM_RA_ADJ_REASON_CD

140

RA Adjustment Reason: 140

Y

 

CLM_RA_ADJ_REASON_CD

141

RA Adjustment Reason: 141

N

 

CLM_RA_ADJ_REASON_CD

142

RA Adjustment Reason: 142

Y

 

CLM_RA_ADJ_REASON_CD

143

RA Adjustment Reason: 143

Y

 

CLM_RA_ADJ_REASON_CD

144

RA Adjustment Reason: 144

Y

 

CLM_RA_ADJ_REASON_CD

145

RA Adjustment Reason: 145

N

 

CLM_RA_ADJ_REASON_CD

146

RA Adjustment Reason: 146

Y

 

CLM_RA_ADJ_REASON_CD

147

RA Adjustment Reason: 147

Y

 

CLM_RA_ADJ_REASON_CD

148

RA Adjustment Reason: 148

Y

 

CLM_RA_ADJ_REASON_CD

149

RA Adjustment Reason: 149

Y

 

CLM_RA_ADJ_REASON_CD

15

RA Adjustment Reason: 15

N

 

CLM_RA_ADJ_REASON_CD

150

RA Adjustment Reason: 150

Y

 

CLM_RA_ADJ_REASON_CD

151

RA Adjustment Reason: 151

Y

 

CLM_RA_ADJ_REASON_CD

152

RA Adjustment Reason: 152

Y

 

CLM_RA_ADJ_REASON_CD

153

RA Adjustment Reason: 153

Y

 

CLM_RA_ADJ_REASON_CD

154

RA Adjustment Reason: 154

Y

 

CLM_RA_ADJ_REASON_CD

155

RA Adjustment Reason: 155

Y

 

CLM_RA_ADJ_REASON_CD

156

RA Adjustment Reason: 156

N

 

CLM_RA_ADJ_REASON_CD

157

RA Adjustment Reason: 157

Y

 

CLM_RA_ADJ_REASON_CD

158

RA Adjustment Reason: 158

Y

 

CLM_RA_ADJ_REASON_CD

159

RA Adjustment Reason: 159

Y

 

CLM_RA_ADJ_REASON_CD

16

RA Adjustment Reason: 16

Y

 

CLM_RA_ADJ_REASON_CD

160

RA Adjustment Reason: 160

Y

 

CLM_RA_ADJ_REASON_CD

161

RA Adjustment Reason: 161

Y

 

CLM_RA_ADJ_REASON_CD

162

RA Adjustment Reason: 162

N

 

CLM_RA_ADJ_REASON_CD

163

RA Adjustment Reason: 163

Y

 

CLM_RA_ADJ_REASON_CD

164

RA Adjustment Reason: 164

Y

 

CLM_RA_ADJ_REASON_CD

165

RA Adjustment Reason: 165

N

 

CLM_RA_ADJ_REASON_CD

166

RA Adjustment Reason: 166

Y

 

CLM_RA_ADJ_REASON_CD

167

RA Adjustment Reason: 167

Y

 

CLM_RA_ADJ_REASON_CD

168

RA Adjustment Reason: 168

N

 

CLM_RA_ADJ_REASON_CD

169

RA Adjustment Reason: 169

Y

 

CLM_RA_ADJ_REASON_CD

17

RA Adjustment Reason: 17

N

 

CLM_RA_ADJ_REASON_CD

170

RA Adjustment Reason: 170

Y

 

CLM_RA_ADJ_REASON_CD

171

RA Adjustment Reason: 171

Y

 

CLM_RA_ADJ_REASON_CD

172

RA Adjustment Reason: 172

Y

 

CLM_RA_ADJ_REASON_CD

173

RA Adjustment Reason: 173

Y

 

CLM_RA_ADJ_REASON_CD

174

RA Adjustment Reason: 174

Y

 

CLM_RA_ADJ_REASON_CD

175

RA Adjustment Reason: 175

Y

 

CLM_RA_ADJ_REASON_CD

176

RA Adjustment Reason: 176

Y

 

CLM_RA_ADJ_REASON_CD

177

RA Adjustment Reason: 177

Y

 

CLM_RA_ADJ_REASON_CD

178

RA Adjustment Reason: 178

Y

 

CLM_RA_ADJ_REASON_CD

179

RA Adjustment Reason: 179

Y

 

CLM_RA_ADJ_REASON_CD

18

RA Adjustment Reason: 18

Y

 

CLM_RA_ADJ_REASON_CD

180

RA Adjustment Reason: 180

Y

 

CLM_RA_ADJ_REASON_CD

181

RA Adjustment Reason: 181

Y

 

CLM_RA_ADJ_REASON_CD

182

RA Adjustment Reason: 182

Y

 

CLM_RA_ADJ_REASON_CD

183

RA Adjustment Reason: 183

Y

 

CLM_RA_ADJ_REASON_CD

184

RA Adjustment Reason: 184

Y

 

CLM_RA_ADJ_REASON_CD

185

RA Adjustment Reason: 185

Y

 

CLM_RA_ADJ_REASON_CD

186

RA Adjustment Reason: 186

Y

 

CLM_RA_ADJ_REASON_CD

187

RA Adjustment Reason: 187

Y

 

CLM_RA_ADJ_REASON_CD

188

RA Adjustment Reason: 188

Y

 

CLM_RA_ADJ_REASON_CD

189

RA Adjustment Reason: 189

Y

 

CLM_RA_ADJ_REASON_CD

19

RA Adjustment Reason: 19

Y

 

CLM_RA_ADJ_REASON_CD

190

RA Adjustment Reason: 190

Y

 

CLM_RA_ADJ_REASON_CD

191

RA Adjustment Reason: 191

N

 

CLM_RA_ADJ_REASON_CD

192

RA Adjustment Reason: 192

Y

 

CLM_RA_ADJ_REASON_CD

193

RA Adjustment Reason: 193

Y

 

CLM_RA_ADJ_REASON_CD

194

RA Adjustment Reason: 194

Y

 

CLM_RA_ADJ_REASON_CD

195

RA Adjustment Reason: 195

Y

 

CLM_RA_ADJ_REASON_CD

196

RA Adjustment Reason: 196

N

 

CLM_RA_ADJ_REASON_CD

197

RA Adjustment Reason: 197

Y

 

CLM_RA_ADJ_REASON_CD

198

RA Adjustment Reason: 198

Y

 

CLM_RA_ADJ_REASON_CD

199

RA Adjustment Reason: 199

Y

 

CLM_RA_ADJ_REASON_CD

2

RA Adjustment Reason: 2

Y

 

CLM_RA_ADJ_REASON_CD

20

RA Adjustment Reason: 20

Y

 

CLM_RA_ADJ_REASON_CD

200

RA Adjustment Reason: 200

Y

 

CLM_RA_ADJ_REASON_CD

201

RA Adjustment Reason: 201

Y

 

CLM_RA_ADJ_REASON_CD

202

RA Adjustment Reason: 202

Y

 

CLM_RA_ADJ_REASON_CD

203

RA Adjustment Reason: 203

Y

 

CLM_RA_ADJ_REASON_CD

204

RA Adjustment Reason: 204

Y

 

CLM_RA_ADJ_REASON_CD

205

RA Adjustment Reason: 205

Y

 

CLM_RA_ADJ_REASON_CD

206

RA Adjustment Reason: 206

Y

 

CLM_RA_ADJ_REASON_CD

207

RA Adjustment Reason: 207

Y

 

CLM_RA_ADJ_REASON_CD

208

RA Adjustment Reason: 208

Y

 

CLM_RA_ADJ_REASON_CD

209

RA Adjustment Reason: 209

Y

 

CLM_RA_ADJ_REASON_CD

21

RA Adjustment Reason: 21

Y

 

CLM_RA_ADJ_REASON_CD

210

RA Adjustment Reason: 210

Y

 

CLM_RA_ADJ_REASON_CD

211

RA Adjustment Reason: 211

Y

 

CLM_RA_ADJ_REASON_CD

212

RA Adjustment Reason: 212

Y

 

CLM_RA_ADJ_REASON_CD

213

RA Adjustment Reason: 213

Y

 

CLM_RA_ADJ_REASON_CD

214

RA Adjustment Reason: 214

N

 

CLM_RA_ADJ_REASON_CD

215

RA Adjustment Reason: 215

Y

 

CLM_RA_ADJ_REASON_CD

216

RA Adjustment Reason: 216

Y

 

CLM_RA_ADJ_REASON_CD

217

RA Adjustment Reason: 217

N

 

CLM_RA_ADJ_REASON_CD

218

RA Adjustment Reason: 218

N

 

CLM_RA_ADJ_REASON_CD

219

RA Adjustment Reason: 219

Y

 

CLM_RA_ADJ_REASON_CD

22

RA Adjustment Reason: 22

Y

 

CLM_RA_ADJ_REASON_CD

220

RA Adjustment Reason: 220

N

 

CLM_RA_ADJ_REASON_CD

221

RA Adjustment Reason: 221

N

 

CLM_RA_ADJ_REASON_CD

222

RA Adjustment Reason: 222

Y

 

CLM_RA_ADJ_REASON_CD

223

RA Adjustment Reason: 223

Y

 

CLM_RA_ADJ_REASON_CD

224

RA Adjustment Reason: 224

Y

 

CLM_RA_ADJ_REASON_CD

225

RA Adjustment Reason: 225

Y

 

CLM_RA_ADJ_REASON_CD

226

RA Adjustment Reason: 226

Y

 

CLM_RA_ADJ_REASON_CD

227

RA Adjustment Reason: 227

Y

 

CLM_RA_ADJ_REASON_CD

228

RA Adjustment Reason: 228

Y

 

CLM_RA_ADJ_REASON_CD

229

RA Adjustment Reason: 229

Y

 

CLM_RA_ADJ_REASON_CD

23

RA Adjustment Reason: 23

Y

 

CLM_RA_ADJ_REASON_CD

230

RA Adjustment Reason: 230

N

 

CLM_RA_ADJ_REASON_CD

231

RA Adjustment Reason: 231

Y

 

CLM_RA_ADJ_REASON_CD

232

RA Adjustment Reason: 232

Y

 

CLM_RA_ADJ_REASON_CD

233

RA Adjustment Reason: 233

Y

 

CLM_RA_ADJ_REASON_CD

234

RA Adjustment Reason: 234

Y

 

CLM_RA_ADJ_REASON_CD

235

RA Adjustment Reason: 235

Y

 

CLM_RA_ADJ_REASON_CD

236

RA Adjustment Reason: 236

Y

 

CLM_RA_ADJ_REASON_CD

237

RA Adjustment Reason: 237

Y

 

CLM_RA_ADJ_REASON_CD

238

RA Adjustment Reason: 238

Y

 

CLM_RA_ADJ_REASON_CD

239

RA Adjustment Reason: 239

Y

 

CLM_RA_ADJ_REASON_CD

24

RA Adjustment Reason: 24

Y

 

CLM_RA_ADJ_REASON_CD

240

RA Adjustment Reason: 240

Y

 

CLM_RA_ADJ_REASON_CD

241

RA Adjustment Reason: 241

Y

 

CLM_RA_ADJ_REASON_CD

242

RA Adjustment Reason: 242

Y

 

CLM_RA_ADJ_REASON_CD

243

RA Adjustment Reason: 243

Y

 

CLM_RA_ADJ_REASON_CD

245

RA Adjustment Reason: 245

Y

 

CLM_RA_ADJ_REASON_CD

246

RA Adjustment Reason: 246

Y

 

CLM_RA_ADJ_REASON_CD

249

RA Adjustment Reason: 249

Y

 

CLM_RA_ADJ_REASON_CD

25

RA Adjustment Reason: 25

N

 

CLM_RA_ADJ_REASON_CD

250

RA Adjustment Reason: 250

Y

 

CLM_RA_ADJ_REASON_CD

251

RA Adjustment Reason: 251

Y

 

CLM_RA_ADJ_REASON_CD

252

RA Adjustment Reason: 252

Y

 

CLM_RA_ADJ_REASON_CD

253

RA Adjustment Reason: 253

Y

 

CLM_RA_ADJ_REASON_CD

254

RA Adjustment Reason: 254

Y

 

CLM_RA_ADJ_REASON_CD

256

RA Adjustment Reason: 256

Y

 

CLM_RA_ADJ_REASON_CD

257

RA Adjustment Reason: 257

Y

 

CLM_RA_ADJ_REASON_CD

258

RA Adjustment Reason: 258

Y

 

CLM_RA_ADJ_REASON_CD

259

RA Adjustment Reason: 259

Y

 

CLM_RA_ADJ_REASON_CD

26

RA Adjustment Reason: 26

Y

 

CLM_RA_ADJ_REASON_CD

260

RA Adjustment Reason: 260

Y

 

CLM_RA_ADJ_REASON_CD

261

RA Adjustment Reason: 261

Y

 

CLM_RA_ADJ_REASON_CD

262

RA Adjustment Reason: 262

Y

 

CLM_RA_ADJ_REASON_CD

263

RA Adjustment Reason: 263

Y

 

CLM_RA_ADJ_REASON_CD

264

RA Adjustment Reason: 264

Y

 

CLM_RA_ADJ_REASON_CD

265

RA Adjustment Reason: 265

Y

 

CLM_RA_ADJ_REASON_CD

266

RA Adjustment Reason: 266

Y

 

CLM_RA_ADJ_REASON_CD

267

RA Adjustment Reason: 267

Y

 

CLM_RA_ADJ_REASON_CD

268

RA Adjustment Reason: 268

Y

 

CLM_RA_ADJ_REASON_CD

269

RA Adjustment Reason: 269

Y

 

CLM_RA_ADJ_REASON_CD

27

RA Adjustment Reason: 27

Y

 

CLM_RA_ADJ_REASON_CD

270

RA Adjustment Reason: 270

Y

 

CLM_RA_ADJ_REASON_CD

271

RA Adjustment Reason: 271

Y

 

CLM_RA_ADJ_REASON_CD

272

RA Adjustment Reason: 272

Y

 

CLM_RA_ADJ_REASON_CD

273

RA Adjustment Reason: 273

Y

 

CLM_RA_ADJ_REASON_CD

274

RA Adjustment Reason: 274

Y

 

CLM_RA_ADJ_REASON_CD

275

RA Adjustment Reason: 275

Y

 

CLM_RA_ADJ_REASON_CD

276

RA Adjustment Reason: 276

Y

 

CLM_RA_ADJ_REASON_CD

277

RA Adjustment Reason: 277

Y

 

CLM_RA_ADJ_REASON_CD

278

RA Adjustment Reason: 278

Y

 

CLM_RA_ADJ_REASON_CD

279

RA Adjustment Reason: 279

Y

 

CLM_RA_ADJ_REASON_CD

28

RA Adjustment Reason: 28

N

 

CLM_RA_ADJ_REASON_CD

280

RA Adjustment Reason: 280

Y

 

CLM_RA_ADJ_REASON_CD

281

RA Adjustment Reason: 281

Y

 

CLM_RA_ADJ_REASON_CD

282

RA Adjustment Reason: 282

Y

 

CLM_RA_ADJ_REASON_CD

283

RA Adjustment Reason: 283

Y

 

CLM_RA_ADJ_REASON_CD

284

RA Adjustment Reason: 284

Y

 

CLM_RA_ADJ_REASON_CD

285

RA Adjustment Reason: 285

Y

 

CLM_RA_ADJ_REASON_CD

286

RA Adjustment Reason: 286

Y

 

CLM_RA_ADJ_REASON_CD

287

RA Adjustment Reason: 287

Y

 

CLM_RA_ADJ_REASON_CD

288

RA Adjustment Reason: 288

Y

 

CLM_RA_ADJ_REASON_CD

289

RA Adjustment Reason: 289

Y

 

CLM_RA_ADJ_REASON_CD

29

RA Adjustment Reason: 29

Y

 

CLM_RA_ADJ_REASON_CD

290

RA Adjustment Reason: 290

Y

 

CLM_RA_ADJ_REASON_CD

291

RA Adjustment Reason: 291

Y

 

CLM_RA_ADJ_REASON_CD

292

RA Adjustment Reason: 292

Y

 

CLM_RA_ADJ_REASON_CD

293

RA Adjustment Reason: 293

Y

 

CLM_RA_ADJ_REASON_CD

294

RA Adjustment Reason: 294

Y

 

CLM_RA_ADJ_REASON_CD

295

RA Adjustment Reason: 295

Y

 

CLM_RA_ADJ_REASON_CD

296

RA Adjustment Reason: 296

Y

 

CLM_RA_ADJ_REASON_CD

297

RA Adjustment Reason: 297

Y

 

CLM_RA_ADJ_REASON_CD

298

RA Adjustment Reason: 298

Y

 

CLM_RA_ADJ_REASON_CD

299

RA Adjustment Reason: 299

Y

 

CLM_RA_ADJ_REASON_CD

3

RA Adjustment Reason: 3

Y

 

CLM_RA_ADJ_REASON_CD

30

RA Adjustment Reason: 30

N

 

CLM_RA_ADJ_REASON_CD

300

RA Adjustment Reason: 300

Y

 

CLM_RA_ADJ_REASON_CD

301

RA Adjustment Reason: 301

Y

 

CLM_RA_ADJ_REASON_CD

302

RA Adjustment Reason: 302

Y

 

CLM_RA_ADJ_REASON_CD

303

RA Adjustment Reason: 303

Y

 

CLM_RA_ADJ_REASON_CD

304

RA Adjustment Reason: 304

Y

 

CLM_RA_ADJ_REASON_CD

305

RA Adjustment Reason: 305

Y

 

CLM_RA_ADJ_REASON_CD

31

RA Adjustment Reason: 31

Y

 

CLM_RA_ADJ_REASON_CD

32

RA Adjustment Reason: 32

Y

 

CLM_RA_ADJ_REASON_CD

33

RA Adjustment Reason: 33

Y

 

CLM_RA_ADJ_REASON_CD

34

RA Adjustment Reason: 34

Y

 

CLM_RA_ADJ_REASON_CD

35

RA Adjustment Reason: 35

Y

 

CLM_RA_ADJ_REASON_CD

36

RA Adjustment Reason: 36

N

 

CLM_RA_ADJ_REASON_CD

37

RA Adjustment Reason: 37

N

 

CLM_RA_ADJ_REASON_CD

38

RA Adjustment Reason: 38

N

 

CLM_RA_ADJ_REASON_CD

39

RA Adjustment Reason: 39

Y

 

CLM_RA_ADJ_REASON_CD

4

RA Adjustment Reason: 4

Y

 

CLM_RA_ADJ_REASON_CD

40

RA Adjustment Reason: 40

Y

 

CLM_RA_ADJ_REASON_CD

41

RA Adjustment Reason: 41

N

 

CLM_RA_ADJ_REASON_CD

42

RA Adjustment Reason: 42

N

 

CLM_RA_ADJ_REASON_CD

43

RA Adjustment Reason: 43

N

 

CLM_RA_ADJ_REASON_CD

44

RA Adjustment Reason: 44

Y

 

CLM_RA_ADJ_REASON_CD

45

RA Adjustment Reason: 45

Y

 

CLM_RA_ADJ_REASON_CD

46

RA Adjustment Reason: 46

N

 

CLM_RA_ADJ_REASON_CD

47

RA Adjustment Reason: 47

N

 

CLM_RA_ADJ_REASON_CD

48

RA Adjustment Reason: 48

N

 

CLM_RA_ADJ_REASON_CD

49

RA Adjustment Reason: 49

Y

 

CLM_RA_ADJ_REASON_CD

5

RA Adjustment Reason: 5

Y

 

CLM_RA_ADJ_REASON_CD

50

RA Adjustment Reason: 50

Y

 

CLM_RA_ADJ_REASON_CD

51

RA Adjustment Reason: 51

Y

 

CLM_RA_ADJ_REASON_CD

52

RA Adjustment Reason: 52

N

 

CLM_RA_ADJ_REASON_CD

53

RA Adjustment Reason: 53

Y

 

CLM_RA_ADJ_REASON_CD

54

RA Adjustment Reason: 54

Y

 

CLM_RA_ADJ_REASON_CD

55

RA Adjustment Reason: 55

Y

 

CLM_RA_ADJ_REASON_CD

56

RA Adjustment Reason: 56

Y

 

CLM_RA_ADJ_REASON_CD

57

RA Adjustment Reason: 57

N

 

CLM_RA_ADJ_REASON_CD

58

RA Adjustment Reason: 58

Y

 

CLM_RA_ADJ_REASON_CD

59

RA Adjustment Reason: 59

Y

 

CLM_RA_ADJ_REASON_CD

6

RA Adjustment Reason: 6

Y

 

CLM_RA_ADJ_REASON_CD

60

RA Adjustment Reason: 60

Y

 

CLM_RA_ADJ_REASON_CD

61

RA Adjustment Reason: 61

Y

 

CLM_RA_ADJ_REASON_CD

62

RA Adjustment Reason: 62

N

 

CLM_RA_ADJ_REASON_CD

63

RA Adjustment Reason: 63

N

 

CLM_RA_ADJ_REASON_CD

64

RA Adjustment Reason: 64

N

 

CLM_RA_ADJ_REASON_CD

65

RA Adjustment Reason: 65

N

 

CLM_RA_ADJ_REASON_CD

66

RA Adjustment Reason: 66

Y

 

CLM_RA_ADJ_REASON_CD

67

RA Adjustment Reason: 67

N

 

CLM_RA_ADJ_REASON_CD

68

RA Adjustment Reason: 68

N

 

CLM_RA_ADJ_REASON_CD

69

RA Adjustment Reason: 69

Y

 

CLM_RA_ADJ_REASON_CD

7

RA Adjustment Reason: 7

Y

 

CLM_RA_ADJ_REASON_CD

70

RA Adjustment Reason: 70

Y

 

CLM_RA_ADJ_REASON_CD

71

RA Adjustment Reason: 71

N

 

CLM_RA_ADJ_REASON_CD

72

RA Adjustment Reason: 72

N

 

CLM_RA_ADJ_REASON_CD

73

RA Adjustment Reason: 73

N

 

CLM_RA_ADJ_REASON_CD

74

RA Adjustment Reason: 74

Y

 

CLM_RA_ADJ_REASON_CD

75

RA Adjustment Reason: 75

Y

 

CLM_RA_ADJ_REASON_CD

76

RA Adjustment Reason: 76

Y

 

CLM_RA_ADJ_REASON_CD

77

RA Adjustment Reason: 77

N

 

CLM_RA_ADJ_REASON_CD

78

RA Adjustment Reason: 78

Y

 

CLM_RA_ADJ_REASON_CD

79

RA Adjustment Reason: 79

N

 

CLM_RA_ADJ_REASON_CD

8

RA Adjustment Reason: 8

Y

 

CLM_RA_ADJ_REASON_CD

80

RA Adjustment Reason: 80

N

 

CLM_RA_ADJ_REASON_CD

81

RA Adjustment Reason: 81

N

 

CLM_RA_ADJ_REASON_CD

82

RA Adjustment Reason: 82

N

 

CLM_RA_ADJ_REASON_CD

83

RA Adjustment Reason: 83

N

 

CLM_RA_ADJ_REASON_CD

84

RA Adjustment Reason: 84

N

 

CLM_RA_ADJ_REASON_CD

85

RA Adjustment Reason: 85

Y

 

CLM_RA_ADJ_REASON_CD

86

RA Adjustment Reason: 86

N

 

CLM_RA_ADJ_REASON_CD

87

RA Adjustment Reason: 87

N

 

CLM_RA_ADJ_REASON_CD

88

RA Adjustment Reason: 88

N

 

CLM_RA_ADJ_REASON_CD

89

RA Adjustment Reason: 89

Y

 

CLM_RA_ADJ_REASON_CD

9

RA Adjustment Reason: 9

Y

 

CLM_RA_ADJ_REASON_CD

90

RA Adjustment Reason: 90

Y

 

CLM_RA_ADJ_REASON_CD

91

RA Adjustment Reason: 91

Y

 

CLM_RA_ADJ_REASON_CD

92

RA Adjustment Reason: 92

N

 

CLM_RA_ADJ_REASON_CD

93

RA Adjustment Reason: 93

N

 

CLM_RA_ADJ_REASON_CD

94

RA Adjustment Reason: 94

Y

 

CLM_RA_ADJ_REASON_CD

95

RA Adjustment Reason: 95

Y

 

CLM_RA_ADJ_REASON_CD

96

RA Adjustment Reason: 96

Y

 

CLM_RA_ADJ_REASON_CD

97

RA Adjustment Reason: 97

Y

 

CLM_RA_ADJ_REASON_CD

98

RA Adjustment Reason: 98

N

 

CLM_RA_ADJ_REASON_CD

99

RA Adjustment Reason: 99

N

 

CLM_RA_ADJ_REASON_CD

A0

RA Adjustment Reason: A0

Y

 

CLM_RA_ADJ_REASON_CD

A1

RA Adjustment Reason: A1

Y

 

CLM_RA_ADJ_REASON_CD

A2

RA Adjustment Reason: A2

N

 

CLM_RA_ADJ_REASON_CD

A3

RA Adjustment Reason: A3

N

 

CLM_RA_ADJ_REASON_CD

A4

RA Adjustment Reason: A4

N

 

CLM_RA_ADJ_REASON_CD

A5

RA Adjustment Reason: A5

Y

 

CLM_RA_ADJ_REASON_CD

A6

RA Adjustment Reason: A6

Y

 

CLM_RA_ADJ_REASON_CD

A7

RA Adjustment Reason: A7

Y

 

CLM_RA_ADJ_REASON_CD

A8

RA Adjustment Reason: A8

Y

 

CLM_RA_ADJ_REASON_CD

B1

RA Adjustment Reason: B1

Y

 

CLM_RA_ADJ_REASON_CD

B10

RA Adjustment Reason: B10

Y

 

CLM_RA_ADJ_REASON_CD

B11

RA Adjustment Reason: B11

Y

 

CLM_RA_ADJ_REASON_CD

B12

RA Adjustment Reason: B12

Y

 

CLM_RA_ADJ_REASON_CD

B13

RA Adjustment Reason: B13

Y

 

CLM_RA_ADJ_REASON_CD

B14

RA Adjustment Reason: B14

Y

 

CLM_RA_ADJ_REASON_CD

B15

RA Adjustment Reason: B15

Y

 

CLM_RA_ADJ_REASON_CD

B16

RA Adjustment Reason: B16

Y

 

CLM_RA_ADJ_REASON_CD

B17

RA Adjustment Reason: B17

N

 

CLM_RA_ADJ_REASON_CD

B18

RA Adjustment Reason: B18

N

 

CLM_RA_ADJ_REASON_CD

B19

RA Adjustment Reason: B19

N

 

CLM_RA_ADJ_REASON_CD

B2

RA Adjustment Reason: B2

N

 

CLM_RA_ADJ_REASON_CD

B20

RA Adjustment Reason: B20

Y

 

CLM_RA_ADJ_REASON_CD

B21

RA Adjustment Reason: B21

N

 

CLM_RA_ADJ_REASON_CD

B22

RA Adjustment Reason: B22

Y

 

CLM_RA_ADJ_REASON_CD

B23

RA Adjustment Reason: B23

Y

 

CLM_RA_ADJ_REASON_CD

B3

RA Adjustment Reason: B3

N

 

CLM_RA_ADJ_REASON_CD

B4

RA Adjustment Reason: B4

Y

 

CLM_RA_ADJ_REASON_CD

B5

RA Adjustment Reason: B5

N

 

CLM_RA_ADJ_REASON_CD

B6

RA Adjustment Reason: B6

N

 

CLM_RA_ADJ_REASON_CD

B7

RA Adjustment Reason: B7

Y

 

CLM_RA_ADJ_REASON_CD

B8

RA Adjustment Reason: B8

Y

 

CLM_RA_ADJ_REASON_CD

B9

RA Adjustment Reason: B9

Y

 

CLM_RA_ADJ_REASON_CD

D1

RA Adjustment Reason: D1

N

 

CLM_RA_ADJ_REASON_CD

D10

RA Adjustment Reason: D10

N

 

CLM_RA_ADJ_REASON_CD

D11

RA Adjustment Reason: D11

N

 

CLM_RA_ADJ_REASON_CD

D12

RA Adjustment Reason: D12

N

 

CLM_RA_ADJ_REASON_CD

D13

RA Adjustment Reason: D13

N

 

CLM_RA_ADJ_REASON_CD

D14

RA Adjustment Reason: D14

N

 

CLM_RA_ADJ_REASON_CD

D15

RA Adjustment Reason: D15

N

 

CLM_RA_ADJ_REASON_CD

D16

RA Adjustment Reason: D16

N

 

CLM_RA_ADJ_REASON_CD

D17

RA Adjustment Reason: D17

N

 

CLM_RA_ADJ_REASON_CD

D18

RA Adjustment Reason: D18

N

 

CLM_RA_ADJ_REASON_CD

D19

RA Adjustment Reason: D19

N

 

CLM_RA_ADJ_REASON_CD

D2

RA Adjustment Reason: D2

N

 

CLM_RA_ADJ_REASON_CD

D20

RA Adjustment Reason: D20

N

 

CLM_RA_ADJ_REASON_CD

D21

RA Adjustment Reason: D21

N

 

CLM_RA_ADJ_REASON_CD

D22

RA Adjustment Reason: D22

N

 

CLM_RA_ADJ_REASON_CD

D23

RA Adjustment Reason: D23

N

 

CLM_RA_ADJ_REASON_CD

D3

RA Adjustment Reason: D3

N

 

CLM_RA_ADJ_REASON_CD

D4

RA Adjustment Reason: D4

N

 

CLM_RA_ADJ_REASON_CD

D5

RA Adjustment Reason: D5

N

 

CLM_RA_ADJ_REASON_CD

D6

RA Adjustment Reason: D6

N

 

CLM_RA_ADJ_REASON_CD

D7

RA Adjustment Reason: D7

N

 

CLM_RA_ADJ_REASON_CD

D8

RA Adjustment Reason: D8

N

 

CLM_RA_ADJ_REASON_CD

D9

RA Adjustment Reason: D9

N

 

CLM_RA_ADJ_REASON_CD

P2

RA Adjustment Reason: P2

Y

 

CLM_RA_ADJ_REASON_CD

W1

RA Adjustment Reason: W1

N

 

CLM_RA_ADJ_REASON_CD

W2

RA Adjustment Reason: W2

N

 

COST_EFF_STATUS_CD

A

Approved

Y

1

COST_EFF_STATUS_CD

D

Denied

Y

2

COST_EFF_STATUS_CD

P

Pending

Y

3

COST_EFF_STATUS_CD

SP

Pending

Y

4

DTH_SERVICE_CD

1

High service level

Y

1

DTH_SERVICE_CD

2

Medium service level

Y

2

DTH_SERVICE_CD

3

Low service level

Y

3

ELIG_TYPE_CD

02

Refugee Cash

Y

102

ELIG_TYPE_CD

06

GA with GAMC

N

44

ELIG_TYPE_CD

07

FG with GAMC

N

42

ELIG_TYPE_CD

09

IV-E Adoption Assistance

Y

62

ELIG_TYPE_CD

10

Minnesota Adoption Assistance

Y

71

ELIG_TYPE_CD

11

Automatic Newborn Eligibility

Y

18

ELIG_TYPE_CD

12

1 Month Extended Medical

N

1

ELIG_TYPE_CD

13

4 Month Extended Medical

Y

4

ELIG_TYPE_CD

14

6 to 12 Month Extended Medical

Y

5

ELIG_TYPE_CD

15

1619A

Y

2

ELIG_TYPE_CD

16

1619B

Y

3

ELIG_TYPE_CD

1A

AFDC Piggyback Continued Absence

N

9

ELIG_TYPE_CD

1B

Qualifying Individual 1 Blind

Y

99

ELIG_TYPE_CD

1D

Qualifying Individual 1 Disabled

Y

100

ELIG_TYPE_CD

1E

Qualifying Individual 1 Elderly

Y

101

ELIG_TYPE_CD

1P

AFDC Piggyback Incapacitated Parent

N

10

ELIG_TYPE_CD

1U

AFDC Piggyback Unemployed Parent

N

11

ELIG_TYPE_CD

21

Refugee Extended Medical

N

103

ELIG_TYPE_CD

25

AFDC Foster Care IV-E with Cash

Y

8

ELIG_TYPE_CD

26

AFDC Foster Care IV-E w/o Cash

N

7

ELIG_TYPE_CD

2A

PE Adult/Parent

Y

91

ELIG_TYPE_CD

2C

PE Child

Y

92

ELIG_TYPE_CD

2F

PE Former Foster Care to Age 26

Y

94

ELIG_TYPE_CD

2P

PE Pregnant Woman

Y

95

ELIG_TYPE_CD

2X

PE CHIP Pregnant Woman

Y

93

ELIG_TYPE_CD

A1

MinnesotaCare FFP Group 1

N

75

ELIG_TYPE_CD

A2

MinnesotaCare FFP Group 2

Y

76

ELIG_TYPE_CD

A4

MinnesotaCare S-Chip-A4

Y

84

ELIG_TYPE_CD

AA

AFDC Related Absent Parent

Y

12

ELIG_TYPE_CD

AC

Alternative Care

Y

15

ELIG_TYPE_CD

AE

Absent Parent Essential Person

N

6

ELIG_TYPE_CD

AF

Application for MFPP Only

Y

17

ELIG_TYPE_CD

AH

MFPP Applicant for Health Care

Y

69

ELIG_TYPE_CD

AN

MinnesotaCare Auto Newborn

Y

72

ELIG_TYPE_CD

AP

AFDC Related Incapacitated Parent

N

13

ELIG_TYPE_CD

AU

AFDC Related Unemployed Parent

N

14

ELIG_TYPE_CD

AX

MA Adults without children

Y

63

ELIG_TYPE_CD

AZ

Appl for MFPP Opted Out TPL

Y

16

ELIG_TYPE_CD

BC

BCC

Y

20

ELIG_TYPE_CD

BD

Blind Rx

Y

24

ELIG_TYPE_CD

BQ

Blind QMB Only

Y

22

ELIG_TYPE_CD

BS

Blind SLMB

Y

25

ELIG_TYPE_CD

BT

Blind TEFRA

Y

26

ELIG_TYPE_CD

BW

Blind QWD

Y

23

ELIG_TYPE_CD

BX

Blind No Sub-Type

Y

21

ELIG_TYPE_CD

C1

MinnesotaCare Children Group 1

Y

73

ELIG_TYPE_CD

C2

MinnesotaCare Children Group 2

Y

74

ELIG_TYPE_CD

CB

Infants

Y

61

ELIG_TYPE_CD

CH

Children's Health Plan

N

29

ELIG_TYPE_CD

CK

Children Ages 2 thru 18

Y

27

ELIG_TYPE_CD

CM

IMD Resident 21 Years Old

Y

58

ELIG_TYPE_CD

CS

CHP/SCH Combined

N

30

ELIG_TYPE_CD

CV

State Funded Victim of Torture

Y

109

ELIG_TYPE_CD

CX

Children Ages 19 and 20

Y

28

ELIG_TYPE_CD

DC

Disabled Child Ages 18 thru 20

Y

32

ELIG_TYPE_CD

DD

HIV Drugs and Dental

N

52

ELIG_TYPE_CD

DE

HIV Dental Only

N

51

ELIG_TYPE_CD

DI

MA EPD without MA Premium

N

65

ELIG_TYPE_CD

DM

DMIE

Y

38

ELIG_TYPE_CD

DN

HIV Dental and Nutrition

Y

50

ELIG_TYPE_CD

DP

MA EPD with MA Premium

Y

64

ELIG_TYPE_CD

DQ

Disabled QMB Only

Y

34

ELIG_TYPE_CD

DS

Disabled SLMB

Y

36

ELIG_TYPE_CD

DT

Disabled TEFRA

Y

37

ELIG_TYPE_CD

DW

Disabled QWD

Y

35

ELIG_TYPE_CD

DX

Disabled No Sub-Type

Y

33

ELIG_TYPE_CD

EC

Essential Community Supports

Y

41

ELIG_TYPE_CD

EE

MFPP Auto Enrolled Exiter

Y

70

ELIG_TYPE_CD

EP

Eligibility Presumed for MFPP

Y

40

ELIG_TYPE_CD

EQ

Over 65 QMB Only

Y

89

ELIG_TYPE_CD

ES

Elderly SLMB

Y

39

ELIG_TYPE_CD

EX

Over Age 65 No Sub-Type

Y

90

ELIG_TYPE_CD

EZ

Presumptive Elig MFPP No TPL

Y

98

ELIG_TYPE_CD

FC

Fomerly Foster Care

Y

43

ELIG_TYPE_CD

GF

GAMC Adults With Children

Y

45

ELIG_TYPE_CD

GH

GAMC Hospital Only

Y

47

ELIG_TYPE_CD

GR

Group Residential Housing/Supplemental Service Rate

Y

49

ELIG_TYPE_CD

GS

GAMC Adults Without Children

Y

46

ELIG_TYPE_CD

HI

HIV Drugs, Dental, and Nutrition

Y

54

ELIG_TYPE_CD

I1

MinnesotaCare Infant Group 1

Y

82

ELIG_TYPE_CD

I2

MinnesotaCare Infant Group 2

Y

83

ELIG_TYPE_CD

ID

Incapacitated Prescription

Y

60

ELIG_TYPE_CD

IN

HIV Insurance

Y

55

ELIG_TYPE_CD

M1

MinnesotaCare Group 1

Y

79

ELIG_TYPE_CD

M2

MinnesotaCare Group 2

Y

80

ELIG_TYPE_CD

M3

MinnesotaCare Group 3

Y

81

ELIG_TYPE_CD

M4

MinnesotaCare S-CHIP-M4

Y

85

ELIG_TYPE_CD

M5

MinnesotaCare FFP Group 5

Y

77

ELIG_TYPE_CD

M6

MinnesotaCare FFP Group 6

Y

78

ELIG_TYPE_CD

M7

Basic Help Plan - Group VII

Y

19

ELIG_TYPE_CD

MC

GAMC to MinnesotaCare

Y

48

ELIG_TYPE_CD

NA

MA Expansion Not Newly Eligible

Y

66

ELIG_TYPE_CD

NR

HIV Nutrition and Drugs

N

56

ELIG_TYPE_CD

NT

HIV Nutrition Only

Y

57

ELIG_TYPE_CD

P1

MCRE Pregnant Group 1

Y

67

ELIG_TYPE_CD

P2

MCRE Pregnant Group 2

Y

68

ELIG_TYPE_CD

PC

Pregnant S-CHIP

Y

96

ELIG_TYPE_CD

PE

Incapacitated Parent Essential Person

N

59

ELIG_TYPE_CD

PX

Pregnant Woman

Y

97

ELIG_TYPE_CD

RM

Refugee Medical

Y

104

ELIG_TYPE_CD

RU

Unaccompanied Minor Refugee

Y

110

ELIG_TYPE_CD

RX

HIV Drugs Only

Y

53

ELIG_TYPE_CD

S1

MinnesotaCare/SCH Group 1

N

86

ELIG_TYPE_CD

S2

MinnesotaCare/SCH Group 2

N

87

ELIG_TYPE_CD

S3

MinnesotaCare/SCH Group 3

N

88

ELIG_TYPE_CD

SA

Consolidated Treatment Fund

Y

31

ELIG_TYPE_CD

SC

SCH Care Plan

N

105

ELIG_TYPE_CD

SD

Senior Prescription

Y

108

ELIG_TYPE_CD

SE

SCH Evaluation

N

106

ELIG_TYPE_CD

SG

SCH General Care

N

107

ELIG_TYPE_CD

UE

Unemployed Parent Essential Person

N

111

ELIG_TYPE_CD

UN

Unknown

Y

112

EXCL_REASON_CD

AA

Adoption assistance

Y

1

EXCL_REASON_CD

AB

Part A or Part B Only

Y

23

EXCL_REASON_CD

BB

Blind/Disabled under 65 years old

Y

2

EXCL_REASON_CD

CC

Child protection case

Y

7

EXCL_REASON_CD

CD

Chemical dependent pilot

Y

5

EXCL_REASON_CD

CS

Consumer Support Grant

Y

9

EXCL_REASON_CD

CV

Center for victims of torture

Y

4

EXCL_REASON_CD

DD

Communicable disease

Y

8

EXCL_REASON_CD

DO

Disability opt out

Y

12

EXCL_REASON_CD

EE

SED/SPMI

Y

30

EXCL_REASON_CD

FF

Child in foster care

Y

6

EXCL_REASON_CD

GG

Geographic exclusion

Y

15

EXCL_REASON_CD

HH

Private HMO coverage

Y

26

EXCL_REASON_CD

II

Breast/Cervical cancer

Y

3

EXCL_REASON_CD

JJ

GAMC Special exclusions / incarcerations

Y

14

EXCL_REASON_CD

KK

Elderly waiver

Y

13

EXCL_REASON_CD

LL

Personal care attendant

Y

25

EXCL_REASON_CD

MD

MA Delay

Y

18

EXCL_REASON_CD

MM

Native American on reservation

Y

21

EXCL_REASON_CD

MS

MNSure tracking

Y

20

EXCL_REASON_CD

NN

Nursing homes

Y

22

EXCL_REASON_CD

PC

Payment county

Y

24

EXCL_REASON_CD

QQ

QMB/SLMB eligibility

Y

27

EXCL_REASON_CD

RR

Refugee/EMA/EGA

Y

28

EXCL_REASON_CD

SS

Medical spend down

Y

19

EXCL_REASON_CD

TT

Terminal illness

Y

31

EXCL_REASON_CD

UU

Limited disability

Y

17

EXCL_REASON_CD

VV

Hurricane Katrina Survivors

N

16

EXCL_REASON_CD

WW

Delayed nursing home

Y

11

EXCL_REASON_CD

YY

Delayed decision

Y

10

EXCL_REASON_CD

ZZ

RTZ/IMD resident

Y

29

LIVE_ARR_CD

41

Nursing Facility I - Medicare certified

Y

15

LIVE_ARR_CD

42

Nursing Facility II - Non-Medicare certified

Y

16

LIVE_ARR_CD

43

ICF/MR - Public or private

Y

6

LIVE_ARR_CD

44

NF I - Short term stay <30 days

Y

12

LIVE_ARR_CD

45

NF II - Short term stay <30 days

Y

13

LIVE_ARR_CD

46

ICF/MR - Short term stay <30 days

Y

7

LIVE_ARR_CD

47

RTC/ICF-MR - Not IMD

N

28

LIVE_ARR_CD

48

Medical hospital >29 days

Y

11

LIVE_ARR_CD

49

State sex offender and forensic programs - IMD

Y

34

LIVE_ARR_CD

50

RTC - MI psychiatric inpatient hospital - IMD

Y

27

LIVE_ARR_CD

51

Rule 31 CD - IMD

Y

30

LIVE_ARR_CD

52

Rule 36 MI - IMD

Y

32

LIVE_ARR_CD

53

Private psychiatric inpatient hospital - IMD

Y

19

LIVE_ARR_CD

54

Rehab option facility for children

Y

25

LIVE_ARR_CD

55

Rule 203 - Adult foster home

Y

29

LIVE_ARR_CD

56

GRH (not foster care or Rule 36)

Y

5

LIVE_ARR_CD

57

Rule 36 MI - Not IMD

Y

33

LIVE_ARR_CD

58

RTC - CD psychiatric inpatient hospital - IMD

Y

26

LIVE_ARR_CD

59

Out-of-state SED res. trtmt. facility for children - IMD

Y

17

LIVE_ARR_CD

60

Non-negotiated rate facility

Y

14

LIVE_ARR_CD

61

Rule 31 CD - Not IMD

Y

31

LIVE_ARR_CD

67

Battered women's shelter

Y

3

LIVE_ARR_CD

68

Adult - city or county jail

Y

1

LIVE_ARR_CD

69

Adult - other correctional facility

Y

2

LIVE_ARR_CD

70

Juvenile - state correctional facility

Y

9

LIVE_ARR_CD

71

Public/private juvenile secure detention facility or bed

Y

22

LIVE_ARR_CD

72

Public juv. res. facility/grp. fost. hm. IV-E <26 non-secure beds

Y

21

LIVE_ARR_CD

73

Public juv. res. facility/grp. fost. hm. >25 beds

Y

20

LIVE_ARR_CD

74

Private juv. res. facility or group home - non-secure facility

Y

18

LIVE_ARR_CD

75

Juvenile foster home (DOC licensed)

Y

10

LIVE_ARR_CD

76

Public/private juvenile temporary holdover - secure facility

Y

24

LIVE_ARR_CD

77

Public/private juvenile temporary holdover - non-secure facility

Y

23

LIVE_ARR_CD

78

IMD nursing home

Y

8

LIVE_ARR_CD

80

Community

Y

4

LTC_ASSES_EXIT_CD

01

Community with services

Y

12

LTC_ASSES_EXIT_CD

02

Community no AC or waiver services

Y

10

LTC_ASSES_EXIT_CD

03

Community no services

Y

11

LTC_ASSES_EXIT_CD

04

Nursing Facility or CBC

Y

36

LTC_ASSES_EXIT_CD

05

Non-certified board and care

Y

34

LTC_ASSES_EXIT_CD

06

ICF/MR

Y

27

LTC_ASSES_EXIT_CD

07

Short term NF from hospital

Y

44

LTC_ASSES_EXIT_CD

08

Long term NF from hospital

Y

29

LTC_ASSES_EXIT_CD

09

Long term hospitalization

Y

28

LTC_ASSES_EXIT_CD

10

Changing to a different program

Y

8

LTC_ASSES_EXIT_CD

11

Reopening to same program

Y

43

LTC_ASSES_EXIT_CD

12

Case management service change

Y

7

LTC_ASSES_EXIT_CD

13

Reassessment visit

Y

40

LTC_ASSES_EXIT_CD

18

Transition planning

Y

45

LTC_ASSES_EXIT_CD

19

Exit, EW AC financial elig. change

Y

23

LTC_ASSES_EXIT_CD

20

Exit, does not meet needs

Y

22

LTC_ASSES_EXIT_CD

21

Exit, not at risk

Y

25

LTC_ASSES_EXIT_CD

22

Exit, does not meet criteria

Y

21

LTC_ASSES_EXIT_CD

23

Exit, client choice

Y

20

LTC_ASSES_EXIT_CD

24

Exit, other reasons

Y

26

LTC_ASSES_EXIT_CD

25

Exit, never used services

Y

24

LTC_ASSES_EXIT_CD

26

Exit, change county of service

Y

19

LTC_ASSES_EXIT_CD

27

Placed on CAC, CADI, or BI waiting list

Y

39

LTC_ASSES_EXIT_CD

28

Open to program from waiting list

Y

37

LTC_ASSES_EXIT_CD

29

Undecided

N

46

LTC_ASSES_EXIT_CD

30

Death

Y

13

LTC_ASSES_EXIT_CD

31

Exit AC, fee not paid

Y

17

LTC_ASSES_EXIT_CD

32

Updating AC financial eligibility info

Y

47

LTC_ASSES_EXIT_CD

33

Exit AC, estate recoveries

Y

16

LTC_ASSES_EXIT_CD

34

Exit AC, premium changes

Y

18

LTC_ASSES_EXIT_CD

35

MSHO, MSC+, and SNBC Health Risk Assessments

Y

32

LTC_ASSES_EXIT_CD

36

Elected Elderly CDCS services

Y

14

LTC_ASSES_EXIT_CD

37

Elected non-CDCS services

Y

15

LTC_ASSES_EXIT_CD

38

MNDHO rate cell change

Y

30

LTC_ASSES_EXIT_CD

39

Refusal of Health Risk Assessment

Y

41

LTC_ASSES_EXIT_CD

40

CAC waiting list

Y

4

LTC_ASSES_EXIT_CD

41

CADI waiting list

Y

6

LTC_ASSES_EXIT_CD

42

BI-NF waiting list

Y

3

LTC_ASSES_EXIT_CD

43

NF visit every 3 years

Y

33

LTC_ASSES_EXIT_CD

44

BI-NB waiting list

Y

2

LTC_ASSES_EXIT_CD

45

CADI MNDHO waiting list

Y

5

LTC_ASSES_EXIT_CD

46

BI-MNDHO waiting list

Y

1

LTC_ASSES_EXIT_CD

47

Removed from waiting list

Y

42

LTC_ASSES_EXIT_CD

48

MNDHO slot for 60 days

Y

31

LTC_ASSES_EXIT_CD

49

Citizenship verified

Y

9

LTC_ASSES_EXIT_CD

98

Other

Y

38

LTC_ASSES_EXIT_CD

99

Not applicable

Y

35

LTC_WAIVER_TYPE_CD

00

None

Y

26

LTC_WAIVER_TYPE_CD

01

BI Nursing Facility Diversion

Y

9

LTC_WAIVER_TYPE_CD

02

BI Nursing Facility Conversion

Y

8

LTC_WAIVER_TYPE_CD

03

Elderly Diversion

Y

19

LTC_WAIVER_TYPE_CD

04

Elderly Conversion

Y

18

LTC_WAIVER_TYPE_CD

05

CADI Diversion

Y

13

LTC_WAIVER_TYPE_CD

06

CADI Conversion

Y

12

LTC_WAIVER_TYPE_CD

07

CAC Diversion

Y

11

LTC_WAIVER_TYPE_CD

08

CAC Conversion

Y

10

LTC_WAIVER_TYPE_CD

09

AC Diversion

Y

3

LTC_WAIVER_TYPE_CD

10

AC Conversion

Y

2

LTC_WAIVER_TYPE_CD

11

BI NB Diversion

Y

7

LTC_WAIVER_TYPE_CD

12

BI NB Conversion

Y

6

LTC_WAIVER_TYPE_CD

13

CSG Diversion

Y

15

LTC_WAIVER_TYPE_CD

14

CSG Conversion

Y

14

LTC_WAIVER_TYPE_CD

18

MSHO, no program

Y

25

LTC_WAIVER_TYPE_CD

19

MSHO NF resident

Y

24

LTC_WAIVER_TYPE_CD

21

MNDHO CADI

Y

20

LTC_WAIVER_TYPE_CD

22

90 day temporary AC

Y

1

LTC_WAIVER_TYPE_CD

23

MNDHO Home Care Diversion

Y

22

LTC_WAIVER_TYPE_CD

24

BI - NF

Y

5

LTC_WAIVER_TYPE_CD

25

MNDHO NF

Y

23

LTC_WAIVER_TYPE_CD

26

MNDHO Community Other

Y

21

LTC_WAIVER_TYPE_CD

27

BI - NB

Y

4

LTC_WAIVER_TYPE_CD

28

SNBC

Y

27

LTC_WAIVER_TYPE_CD

29

Essential Community Supports

Y

16

LTC_WAIVER_TYPE_CD

30

ECS Transitions

Y

17

MAJOR_PROG_CD

AC

Alternative Care

Y

1

MAJOR_PROG_CD

BB

MinnesotaCare Adults =<200% FPG

Y

14

MAJOR_PROG_CD

CC

Children's Health Plan

N

3

MAJOR_PROG_CD

DD

CHP/SCH Combined

N

2

MAJOR_PROG_CD

DM

Demonstration to Maintain Indep. & Employment (DMIE)

N

5

MAJOR_PROG_CD

EC

State-Paid Emergency General Assistance Medical

N

29

MAJOR_PROG_CD

EE

MCSHN Evaluation (Health Dept.)

N

12

MAJOR_PROG_CD

EH

Federally-Paid Emergency Medicaid

N

7

MAJOR_PROG_CD

FF

MinnesotaCare Parents =<275% FPG

Y

19

MAJOR_PROG_CD

FP

Family Planning

Y

6

MAJOR_PROG_CD

GM

General Assistance Medical Care (GAMC)

N

9

MAJOR_PROG_CD

HH

Ins. Extension Program (State Adm.)

Y

11

MAJOR_PROG_CD

IM

IMD - Inst. for Mental Disease

Y

10

MAJOR_PROG_CD

JJ

MinnesotaCare Noncitizen Parents =<275% FPG

Y

18

MAJOR_PROG_CD

KK

MinnesotaCare Noncitizen Kids/PWS

Y

17

MAJOR_PROG_CD

LL

MinnesotaCare Citizen Kids/PWS

Y

16

MAJOR_PROG_CD

MA

Federally-Paid Medical Assistance

Y

8

MAJOR_PROG_CD

NM

State-Paid Medical Assistance

Y

30

MAJOR_PROG_CD

OO

Consolidated Treatment Fund

Y

4

MAJOR_PROG_CD

P

Prepaid Health Plan - MA

N

23

MAJOR_PROG_CD

QM

Qualified Medicare Beneficiary

Y

25

MAJOR_PROG_CD

RM

Refugee

Y

27

MAJOR_PROG_CD

SL

Part B Premiums Only (SLMB)

Y

21

MAJOR_PROG_CD

TT

MCSHN Treatment (Health Dept.)

N

13

MAJOR_PROG_CD

UN

Screened - not Placed on Waiver/AC

Y

28

MAJOR_PROG_CD

VV

Prescription Drug Program

N

24

MAJOR_PROG_CD

WD

Qualified Working Disabled

Y

26

MAJOR_PROG_CD

XX

MinnesotaCare Adults >200% FPG

N

15

MAJOR_PROG_CD

YY

MinnesotaCare/SCH Combination

N

20

MAJOR_PROG_CD

Z

Prepaid Health Plan - GAMC

N

22

MEDICARE_SOURCE_CD

B

BENDEX

Y

1

MEDICARE_SOURCE_CD

E

Entered online

Y

4

MEDICARE_SOURCE_CD

F

CMS EDB file

Y

3

MEDICARE_SOURCE_CD

L

LTC AC screening

Y

6

MEDICARE_SOURCE_CD

M

MAXIS

Y

7

MEDICARE_SOURCE_CD

N

Not verified

Y

8

MEDICARE_SOURCE_CD

S

CMS buy-in file

Y

2

MEDICARE_SOURCE_CD

T

HCSTAT tape

Y

5

MEDICARE_TYPE_CD

A

Medicare Part A

Y

1

MEDICARE_TYPE_CD

B

Medicare Part B

Y

2

MEDICARE_TYPE_CD

D

Medicare Part D

Y

3

MMIS_DIAG_TYPE_CD

2

ICD-9-CM

Y

1

MMIS_DIAG_TYPE_CD

4

ICD-10-CM

Y

2

PA_SCRNG_STATUS_CD

A

Approved

Y

1

PA_SCRNG_STATUS_CD

D

Denied

Y

2

PA_SCRNG_STATUS_CD

R

Replaced

Y

3

PA_SCRNG_STATUS_CD

S

Suspended

Y

4

PA_STATUS_REASON_CD

001

Reason Code: 001

Y

 

PA_STATUS_REASON_CD

002

Reason Code: 002

Y

 

PA_STATUS_REASON_CD

003

Reason Code: 003

Y

 

PA_STATUS_REASON_CD

004

Reason Code: 004

Y

 

PA_STATUS_REASON_CD

005

Reason Code: 005

Y

 

PA_STATUS_REASON_CD

006

Reason Code: 006

Y

 

PA_STATUS_REASON_CD

007

Reason Code: 007

Y

 

PA_STATUS_REASON_CD

008

Reason Code: 008

Y

 

PA_STATUS_REASON_CD

009

Reason Code: 009

Y

 

PA_STATUS_REASON_CD

010

Reason Code: 010

Y

 

PA_STATUS_REASON_CD

011

Reason Code: 011

Y

 

PA_STATUS_REASON_CD

012

Reason Code: 012

Y

 

PA_STATUS_REASON_CD

014

Reason Code: 014

Y

 

PA_STATUS_REASON_CD

015

Reason Code: 015

Y

 

PA_STATUS_REASON_CD

017

Reason Code: 017

Y

 

PA_STATUS_REASON_CD

018

Reason Code: 018

Y

 

PA_STATUS_REASON_CD

020

Reason Code: 020

Y

 

PA_STATUS_REASON_CD

022

Reason Code: 022

Y

 

PA_STATUS_REASON_CD

023

Reason Code: 023

Y

 

PA_STATUS_REASON_CD

024

Reason Code: 024

Y

 

PA_STATUS_REASON_CD

027

Reason Code: 027

Y

 

PA_STATUS_REASON_CD

028

Reason Code: 028

Y

 

PA_STATUS_REASON_CD

034

Reason Code: 034

Y

 

PA_STATUS_REASON_CD

039

Reason Code: 039

Y

 

PA_STATUS_REASON_CD

040

Reason Code: 040

Y

 

PA_STATUS_REASON_CD

041

Reason Code: 041

Y

 

PA_STATUS_REASON_CD

042

Reason Code: 042

Y

 

PA_STATUS_REASON_CD

044

Reason Code: 044

Y

 

PA_STATUS_REASON_CD

045

Reason Code: 045

Y

 

PA_STATUS_REASON_CD

049

Reason Code: 049

Y

 

PA_STATUS_REASON_CD

050

Reason Code: 050

Y

 

PA_STATUS_REASON_CD

051

Reason Code: 051

Y

 

PA_STATUS_REASON_CD

052

Reason Code: 052

Y

 

PA_STATUS_REASON_CD

053

Reason Code: 053

Y

 

PA_STATUS_REASON_CD

054

Reason Code: 054

Y

 

PA_STATUS_REASON_CD

055

Reason Code: 055

Y

 

PA_STATUS_REASON_CD

059

Reason Code: 059

Y

 

PA_STATUS_REASON_CD

061

Reason Code: 061

Y

 

PA_STATUS_REASON_CD

075

Reason Code: 075

Y

 

PA_STATUS_REASON_CD

078

Reason Code: 078

Y

 

PA_STATUS_REASON_CD

079

Reason Code: 079

Y

 

PA_STATUS_REASON_CD

080

Reason Code: 080

Y

 

PA_STATUS_REASON_CD

081

Reason Code: 081

Y

 

PA_STATUS_REASON_CD

085

Reason Code: 085

Y

 

PA_STATUS_REASON_CD

086

Reason Code: 086

Y

 

PA_STATUS_REASON_CD

087

Reason Code: 087

Y

 

PA_STATUS_REASON_CD

088

Reason Code: 088

Y

 

PA_STATUS_REASON_CD

095

Reason Code: 095

Y

 

PA_STATUS_REASON_CD

102

Reason Code: 102

Y

 

PA_STATUS_REASON_CD

104

Reason Code: 104

Y

 

PA_STATUS_REASON_CD

105

Reason Code: 105

Y

 

PA_STATUS_REASON_CD

106

Reason Code: 106

Y

 

PA_STATUS_REASON_CD

108

Reason Code: 108

Y

 

PA_STATUS_REASON_CD

110

Reason Code: 110

Y

 

PA_STATUS_REASON_CD

111

Reason Code: 111

Y

 

PA_STATUS_REASON_CD

114

Reason Code: 114

Y

 

PA_STATUS_REASON_CD

115

Reason Code: 115

Y

 

PA_STATUS_REASON_CD

118

Reason Code: 118

Y

 

PA_STATUS_REASON_CD

119

Reason Code: 119

Y

 

PA_STATUS_REASON_CD

120

Reason Code: 120

Y

 

PA_STATUS_REASON_CD

121

Reason Code: 121

Y

 

PA_STATUS_REASON_CD

127

Reason Code: 127

Y

 

PA_STATUS_REASON_CD

128

Reason Code: 128

Y

 

PA_STATUS_REASON_CD

129

Reason Code: 129

Y

 

PA_STATUS_REASON_CD

130

Reason Code: 130

Y

 

PA_STATUS_REASON_CD

131

Reason Code: 131

Y

 

PA_STATUS_REASON_CD

132

Reason Code: 132

Y

 

PA_STATUS_REASON_CD

133

Reason Code: 133

Y

 

PA_STATUS_REASON_CD

134

Reason Code: 134

Y

 

PA_STATUS_REASON_CD

135

Reason Code: 135

Y

 

PA_STATUS_REASON_CD

136

Reason Code: 136

Y

 

PA_STATUS_REASON_CD

137

Reason Code: 137

Y

 

PA_STATUS_REASON_CD

139

Reason Code: 139

Y

 

PA_STATUS_REASON_CD

145

Reason Code: 145

Y

 

PA_STATUS_REASON_CD

146

Reason Code: 146

Y

 

PA_STATUS_REASON_CD

147

Reason Code: 147

Y

 

PA_STATUS_REASON_CD

149

Reason Code: 149

Y

 

PA_STATUS_REASON_CD

151

Reason Code: 151

Y

 

PA_STATUS_REASON_CD

152

Reason Code: 152

Y

 

PA_STATUS_REASON_CD

154

Reason Code: 154

Y

 

PA_STATUS_REASON_CD

161

Reason Code: 161

Y

 

PA_STATUS_REASON_CD

162

Reason Code: 162

Y

 

PA_STATUS_REASON_CD

164

Reason Code: 164

Y

 

PA_STATUS_REASON_CD

165

Reason Code: 165

Y

 

PA_STATUS_REASON_CD

166

Reason Code: 166

Y

 

PA_STATUS_REASON_CD

171

Reason Code: 171

Y

 

PA_STATUS_REASON_CD

172

Reason Code: 172

Y

 

PA_STATUS_REASON_CD

176

Reason Code: 176

Y

 

PA_STATUS_REASON_CD

181

Reason Code: 181

Y

 

PA_STATUS_REASON_CD

182

Reason Code: 182

Y

 

PA_STATUS_REASON_CD

190

Reason Code: 190

Y

 

PA_STATUS_REASON_CD

193

Reason Code: 193

Y

 

PA_STATUS_REASON_CD

194

Reason Code: 194

Y

 

PA_STATUS_REASON_CD

195

Reason Code: 195

Y

 

PA_STATUS_REASON_CD

196

Reason Code: 196

Y

 

PA_STATUS_REASON_CD

197

Reason Code: 197

Y

 

PA_STATUS_REASON_CD

198

Reason Code: 198

Y

 

PA_STATUS_REASON_CD

199

Reason Code: 199

Y

 

PA_STATUS_REASON_CD

200

Reason Code: 200

Y

 

PA_STATUS_REASON_CD

201

Reason Code: 201

Y

 

PA_STATUS_REASON_CD

202

Reason Code: 202

Y

 

PA_STATUS_REASON_CD

203

Reason Code: 203

Y

 

PA_STATUS_REASON_CD

204

Reason Code: 204

Y

 

PA_STATUS_REASON_CD

205

Reason Code: 205

Y

 

PA_STATUS_REASON_CD

206

Reason Code: 206

Y

 

PA_STATUS_REASON_CD

207

Reason Code: 207

Y

 

PA_STATUS_REASON_CD

208

Reason Code: 208

Y

 

PA_STATUS_REASON_CD

209

Reason Code: 209

Y

 

PA_STATUS_REASON_CD

210

Reason Code: 210

Y

 

PA_STATUS_REASON_CD

211

Reason Code: 211

Y

 

PA_STATUS_REASON_CD

212

Reason Code: 212

Y

 

PA_STATUS_REASON_CD

300

Reason Code: 300

Y

 

PA_STATUS_REASON_CD

301

Reason Code: 301

Y

 

PA_STATUS_REASON_CD

388

Reason Code: 388

Y

 

PA_STATUS_REASON_CD

390

Reason Code: 390

Y

 

PA_STATUS_REASON_CD

391

Reason Code: 391

Y

 

PA_STATUS_REASON_CD

392

Reason Code: 392

Y

 

PA_STATUS_REASON_CD

393

Reason Code: 393

Y

 

PA_STATUS_REASON_CD

394

Reason Code: 394

Y

 

PA_STATUS_REASON_CD

400

Reason Code: 400

Y

 

PA_STATUS_REASON_CD

401

Reason Code: 401

Y

 

PA_STATUS_REASON_CD

402

Reason Code: 402

Y

 

PA_STATUS_REASON_CD

403

Reason Code: 403

Y

 

PA_STATUS_REASON_CD

404

Reason Code: 404

Y

 

PA_STATUS_REASON_CD

405

Reason Code: 405

Y

 

PA_STATUS_REASON_CD

406

Reason Code: 406

Y

 

PA_STATUS_REASON_CD

407

Reason Code: 407

Y

 

PA_STATUS_REASON_CD

408

Reason Code: 408

Y

 

PA_STATUS_REASON_CD

409

Reason Code: 409

Y

 

PA_STATUS_REASON_CD

410

Reason Code: 410

Y

 

PA_STATUS_REASON_CD

411

Reason Code: 411

Y

 

PA_STATUS_REASON_CD

412

Reason Code: 412

Y

 

PA_STATUS_REASON_CD

413

Reason Code: 413

Y

 

PA_STATUS_REASON_CD

414

Reason Code: 414

Y

 

PA_STATUS_REASON_CD

415

Reason Code: 415

Y

 

PA_STATUS_REASON_CD

416

Reason Code: 416

Y

 

PA_STATUS_REASON_CD

417

Reason Code: 417

Y

 

PA_STATUS_REASON_CD

418

Reason Code: 418

Y

 

PA_STATUS_REASON_CD

419

Reason Code: 419

Y

 

PA_STATUS_REASON_CD

420

Reason Code: 420

Y

 

PA_STATUS_REASON_CD

421

Reason Code: 421

Y

 

PA_STATUS_REASON_CD

422

Reason Code: 422

Y

 

PA_STATUS_REASON_CD

423

Reason Code: 423

Y

 

PA_STATUS_REASON_CD

424

Reason Code: 424

Y

 

PA_STATUS_REASON_CD

425

Reason Code: 425

Y

 

PA_STATUS_REASON_CD

426

Reason Code: 426

Y

 

PA_STATUS_REASON_CD

427

Reason Code: 427

Y

 

PA_STATUS_REASON_CD

428

Reason Code: 428

Y

 

PA_STATUS_REASON_CD

429

Reason Code: 429

Y

 

PA_STATUS_REASON_CD

430

Reason Code: 430

Y

 

PA_STATUS_REASON_CD

431

Reason Code: 431

Y

 

PA_STATUS_REASON_CD

432

Reason Code: 432

Y

 

PA_STATUS_REASON_CD

433

Reason Code: 433

Y

 

PA_STATUS_REASON_CD

434

Reason Code: 434

Y

 

PA_STATUS_REASON_CD

435

Reason Code: 435

Y

 

PA_STATUS_REASON_CD

436

Reason Code: 436

Y

 

PA_STATUS_REASON_CD

437

Reason Code: 437

Y

 

PA_STATUS_REASON_CD

438

Reason Code: 438

Y

 

PA_STATUS_REASON_CD

439

Reason Code: 439

Y

 

PA_STATUS_REASON_CD

440

Reason Code: 440

Y

 

PA_STATUS_REASON_CD

441

Reason Code: 441

Y

 

PA_STATUS_REASON_CD

442

Reason Code: 442

Y

 

PA_STATUS_REASON_CD

443

Reason Code: 443

Y

 

PA_STATUS_REASON_CD

444

Reason Code: 444

Y

 

PA_STATUS_REASON_CD

445

Reason Code: 445

Y

 

PA_STATUS_REASON_CD

446

Reason Code: 446

Y

 

PA_STATUS_REASON_CD

447

Reason Code: 447

Y

 

PA_STATUS_REASON_CD

448

Reason Code: 448

Y

 

PA_STATUS_REASON_CD

449

Reason Code: 449

Y

 

PA_STATUS_REASON_CD

450

Reason Code: 450

Y

 

PA_STATUS_REASON_CD

451

Reason Code: 451

Y

 

PA_STATUS_REASON_CD

452

Reason Code: 452

Y

 

PA_STATUS_REASON_CD

453

Reason Code: 453

Y

 

PA_STATUS_REASON_CD

454

Reason Code: 454

Y

 

PA_STATUS_REASON_CD

455

Reason Code: 455

Y

 

PA_STATUS_REASON_CD

456

Reason Code: 456

Y

 

PA_STATUS_REASON_CD

457

Reason Code: 457

Y

 

PA_STATUS_REASON_CD

458

Reason Code: 458

Y

 

PA_STATUS_REASON_CD

459

Reason Code: 459

Y

 

PA_STATUS_REASON_CD

460

Reason Code: 460

Y

 

PA_STATUS_REASON_CD

461

Reason Code: 461

Y

 

PA_STATUS_REASON_CD

462

Reason Code: 462

Y

 

PA_STATUS_REASON_CD

463

Reason Code: 463

Y

 

PA_STATUS_REASON_CD

464

Reason Code: 464

Y

 

PA_STATUS_REASON_CD

465

Reason Code: 465

Y

 

PA_STATUS_REASON_CD

466

Reason Code: 466

Y

 

PA_STATUS_REASON_CD

467

Reason Code: 467

Y

 

PA_STATUS_REASON_CD

468

Reason Code: 468

Y

 

PA_STATUS_REASON_CD

469

Reason Code: 469

Y

 

PA_STATUS_REASON_CD

470

Reason Code: 470

Y

 

PA_STATUS_REASON_CD

471

Reason Code: 471

Y

 

PA_STATUS_REASON_CD

472

Reason Code: 472

Y

 

PA_STATUS_REASON_CD

473

Reason Code: 473

Y

 

PA_STATUS_REASON_CD

474

Reason Code: 474

Y

 

PA_STATUS_REASON_CD

475

Reason Code: 475

Y

 

PA_STATUS_REASON_CD

476

Reason Code: 476

Y

 

PA_STATUS_REASON_CD

477

Reason Code: 477

Y

 

PA_STATUS_REASON_CD

478

Reason Code: 478

Y

 

PA_STATUS_REASON_CD

479

Reason Code: 479

Y

 

PA_STATUS_REASON_CD

480

Reason Code: 480

Y

 

PA_STATUS_REASON_CD

481

Reason Code: 481

Y

 

PA_STATUS_REASON_CD

482

Reason Code: 482

Y

 

PA_STATUS_REASON_CD

483

Reason Code: 483

Y

 

PA_STATUS_REASON_CD

484

Reason Code: 484

Y

 

PA_STATUS_REASON_CD

485

Reason Code: 485

Y

 

PA_STATUS_REASON_CD

486

Reason Code: 486

Y

 

PA_STATUS_REASON_CD

487

Reason Code: 487

Y

 

PA_STATUS_REASON_CD

488

Reason Code: 488

Y

 

PA_STATUS_REASON_CD

489

Reason Code: 489

Y

 

PA_STATUS_REASON_CD

490

Reason Code: 490

Y

 

PA_STATUS_REASON_CD

491

Reason Code: 491

Y

 

PA_STATUS_REASON_CD

492

Reason Code: 492

Y

 

PA_STATUS_REASON_CD

493

Reason Code: 493

Y

 

PA_STATUS_REASON_CD

494

Reason Code: 494

Y

 

PA_STATUS_REASON_CD

495

Reason Code: 495

Y

 

PA_STATUS_REASON_CD

496

Reason Code: 496

Y

 

PA_STATUS_REASON_CD

497

Reason Code: 497

Y

 

PA_STATUS_REASON_CD

498

Reason Code: 498

Y

 

PA_STATUS_REASON_CD

499

Reason Code: 499

Y

 

PA_STATUS_REASON_CD

500

Reason Code: 500

Y

 

PA_STATUS_REASON_CD

501

Reason Code: 501

Y

 

PA_STATUS_REASON_CD

502

Reason Code: 502

Y

 

PA_STATUS_REASON_CD

503

Reason Code: 503

Y

 

PA_STATUS_REASON_CD

504

Reason Code: 504

Y

 

PA_STATUS_REASON_CD

505

Reason Code: 505

Y

 

PA_STATUS_REASON_CD

506

Reason Code: 506

Y

 

PA_STATUS_REASON_CD

507

Reason Code: 507

Y

 

PA_STATUS_REASON_CD

508

Reason Code: 508

Y

 

PA_STATUS_REASON_CD

509

Reason Code: 509

Y

 

PA_STATUS_REASON_CD

510

Reason Code: 510

Y

 

PA_STATUS_REASON_CD

511

Reason Code: 511

Y

 

PA_STATUS_REASON_CD

512

Reason Code: 512

Y

 

PA_STATUS_REASON_CD

513

Reason Code: 513

Y

 

PA_STATUS_REASON_CD

514

Reason Code: 514

Y

 

PA_STATUS_REASON_CD

515

Reason Code: 515

Y

 

PA_STATUS_REASON_CD

516

Reason Code: 516

Y

 

PA_STATUS_REASON_CD

517

Reason Code: 517

Y

 

PA_STATUS_REASON_CD

518

Reason Code: 518

Y

 

PA_STATUS_REASON_CD

519

Reason Code: 519

Y

 

PA_STATUS_REASON_CD

520

Reason Code: 520

Y

 

PA_STATUS_REASON_CD

521

Reason Code: 521

Y

 

PA_STATUS_REASON_CD

522

Reason Code: 522

Y

 

PA_STATUS_REASON_CD

523

Reason Code: 523

Y

 

PA_STATUS_REASON_CD

524

Reason Code: 524

Y

 

PA_STATUS_REASON_CD

525

Reason Code: 525

Y

 

PA_STATUS_REASON_CD

526

Reason Code: 526

Y

 

PA_STATUS_REASON_CD

527

Reason Code: 527

Y

 

PA_STATUS_REASON_CD

528

Reason Code: 528

Y

 

PA_STATUS_REASON_CD

529

Reason Code: 529

Y

 

PA_STATUS_REASON_CD

530

Reason Code: 530

Y

 

PA_STATUS_REASON_CD

531

Reason Code: 531

Y

 

PA_STATUS_REASON_CD

532

Reason Code: 532

Y

 

PA_STATUS_REASON_CD

533

Reason Code: 533

Y

 

PA_STATUS_REASON_CD

534

Reason Code: 534

Y

 

PA_STATUS_REASON_CD

535

Reason Code: 535

Y

 

PA_STATUS_REASON_CD

536

Reason Code: 536

Y

 

PA_STATUS_REASON_CD

537

Reason Code: 537

Y

 

PA_STATUS_REASON_CD

538

Reason Code: 538

Y

 

PA_STATUS_REASON_CD

539

Reason Code: 539

Y

 

PA_STATUS_REASON_CD

540

Reason Code: 540

Y

 

PA_STATUS_REASON_CD

541

Reason Code: 541

Y

 

PA_STATUS_REASON_CD

542

Reason Code: 542

Y

 

PA_STATUS_REASON_CD

543

Reason Code: 543

Y

 

PA_STATUS_REASON_CD

544

Reason Code: 544

Y

 

PA_STATUS_REASON_CD

545

Reason Code: 545

Y

 

PA_STATUS_REASON_CD

546

Reason Code: 546

Y

 

PA_STATUS_REASON_CD

547

Reason Code: 547

Y

 

PA_STATUS_REASON_CD

548

Reason Code: 548

Y

 

PA_STATUS_REASON_CD

549

Reason Code: 549

Y

 

PA_STATUS_REASON_CD

550

Reason Code: 550

Y

 

PA_STATUS_REASON_CD

551

Reason Code: 551

Y

 

PA_STATUS_REASON_CD

552

Reason Code: 552

Y

 

PA_STATUS_REASON_CD

553

Reason Code: 553

Y

 

PA_STATUS_REASON_CD

554

Reason Code: 554

Y

 

PA_STATUS_REASON_CD

555

Reason Code: 555

Y

 

PA_STATUS_REASON_CD

556

Reason Code: 556

Y

 

PA_STATUS_REASON_CD

557

Reason Code: 557

Y

 

PA_STATUS_REASON_CD

558

Reason Code: 558

Y

 

PA_STATUS_REASON_CD

559

Reason Code: 559

Y

 

PA_STATUS_REASON_CD

560

Reason Code: 560

Y

 

PA_STATUS_REASON_CD

561

Reason Code: 561

Y

 

PA_STATUS_REASON_CD

562

Reason Code: 562

Y

 

PA_STATUS_REASON_CD

563

Reason Code: 563

Y

 

PA_STATUS_REASON_CD

564

Reason Code: 564

Y

 

PA_STATUS_REASON_CD

565

Reason Code: 565

Y

 

PA_STATUS_REASON_CD

566

Reason Code: 566

Y

 

PA_STATUS_REASON_CD

567

Reason Code: 567

Y

 

PA_STATUS_REASON_CD

568

Reason Code: 568

Y

 

PA_STATUS_REASON_CD

569

Reason Code: 569

Y

 

PA_STATUS_REASON_CD

570

Reason Code: 570

Y

 

PA_STATUS_REASON_CD

571

Reason Code: 571

Y

 

PA_STATUS_REASON_CD

572

Reason Code: 572

Y

 

PA_STATUS_REASON_CD

573

Reason Code: 573

Y

 

PA_STATUS_REASON_CD

574

Reason Code: 574

Y

 

PA_STATUS_REASON_CD

575

Reason Code: 575

Y

 

PA_STATUS_REASON_CD

576

Reason Code: 576

Y

 

PA_STATUS_REASON_CD

577

Reason Code: 577

Y

 

PA_STATUS_REASON_CD

578

Reason Code: 578

Y

 

PA_STATUS_REASON_CD

579

Reason Code: 579

Y

 

PA_STATUS_REASON_CD

580

Reason Code: 580

Y

 

PA_STATUS_REASON_CD

581

Reason Code: 581

Y

 

PA_STATUS_REASON_CD

582

Reason Code: 582

Y

 

PA_STATUS_REASON_CD

811

Reason Code: 811

Y

 

PA_STATUS_REASON_CD

812

Reason Code: 812

Y

 

PA_STATUS_REASON_CD

813

Reason Code: 813

Y

 

PA_STATUS_REASON_CD

814

Reason Code: 814

Y

 

PA_STATUS_REASON_CD

815

Reason Code: 815

Y

 

PA_STATUS_REASON_CD

816

Reason Code: 816

Y

 

PA_STATUS_REASON_CD

817

Reason Code: 817

Y

 

PA_STATUS_REASON_CD

818

Reason Code: 818

Y

 

PA_STATUS_REASON_CD

819

Reason Code: 819

Y

 

PA_STATUS_REASON_CD

820

Reason Code: 820

Y

 

PA_STATUS_REASON_CD

821

Reason Code: 821

Y

 

PA_STATUS_REASON_CD

822

Reason Code: 822

Y

 

PA_STATUS_REASON_CD

823

Reason Code: 823

Y

 

PA_STATUS_REASON_CD

824

Reason Code: 824

Y

 

PA_STATUS_REASON_CD

825

Reason Code: 825

Y

 

PA_STATUS_REASON_CD

826

Reason Code: 826

Y

 

PA_STATUS_REASON_CD

827

Reason Code: 827

Y

 

PA_STATUS_REASON_CD

828

Reason Code: 828

Y

 

PA_STATUS_REASON_CD

829

Reason Code: 829

Y

 

PA_STATUS_REASON_CD

830

Reason Code: 830

Y

 

PA_STATUS_REASON_CD

831

Reason Code: 831

Y

 

PA_STATUS_REASON_CD

832

Reason Code: 832

Y

 

PA_STATUS_REASON_CD

833

Reason Code: 833

Y

 

PA_STATUS_REASON_CD

834

Reason Code: 834

Y

 

PA_STATUS_REASON_CD

835

Reason Code: 835

Y

 

PA_STATUS_REASON_CD

836

Reason Code: 836

Y

 

PA_STATUS_REASON_CD

837

Reason Code: 837

Y

 

PA_STATUS_REASON_CD

838

Reason Code: 838

Y

 

PA_STATUS_REASON_CD

839

Reason Code: 839

Y

 

PA_STATUS_REASON_CD

840

Reason Code: 840

Y

 

PA_STATUS_REASON_CD

841

Reason Code: 841

Y

 

PA_STATUS_REASON_CD

842

Reason Code: 842

Y

 

PA_STATUS_REASON_CD

843

Reason Code: 843

Y

 

PA_STATUS_REASON_CD

844

Reason Code: 844

Y

 

PA_STATUS_REASON_CD

845

Reason Code: 845

Y

 

PA_STATUS_REASON_CD

846

Reason Code: 846

Y

 

PA_STATUS_REASON_CD

847

Reason Code: 847

Y

 

PA_STATUS_REASON_CD

848

Reason Code: 848

Y

 

PA_STATUS_REASON_CD

849

Reason Code: 849

Y

 

PA_STATUS_REASON_CD

850

Reason Code: 850

Y

 

PA_STATUS_REASON_CD

851

Reason Code: 851

Y

 

PA_STATUS_REASON_CD

852

Reason Code: 852

Y

 

PA_STATUS_REASON_CD

853

Reason Code: 853

Y

 

PA_STATUS_REASON_CD

854

Reason Code: 854

Y

 

PA_STATUS_REASON_CD

855

Reason Code: 855

Y

 

PA_STATUS_REASON_CD

856

Reason Code: 856

Y

 

PA_STATUS_REASON_CD

857

Reason Code: 857

Y

 

PA_STATUS_REASON_CD

858

Reason Code: 858

Y

 

PA_STATUS_REASON_CD

859

Reason Code: 859

Y

 

PA_STATUS_REASON_CD

860

Reason Code: 860

Y

 

PA_STATUS_REASON_CD

861

Reason Code: 861

Y

 

PA_STATUS_REASON_CD

862

Reason Code: 862

Y

 

PA_STATUS_REASON_CD

863

Reason Code: 863

Y

 

PA_STATUS_REASON_CD

864

Reason Code: 864

Y

 

PA_STATUS_REASON_CD

961

Reason Code: 961

Y

 

PA_STATUS_REASON_CD

983

Reason Code: 983

Y

 

PA_STATUS_REASON_CD

984

Reason Code: 984

Y

 

PA_STATUS_REASON_CD

985

Reason Code: 985

Y

 

PA_STATUS_REASON_CD

986

Reason Code: 986

Y

 

PA_STATUS_REASON_CD

987

Reason Code: 987

Y

 

PA_STATUS_REASON_CD

988

Reason Code: 988

Y

 

PPHP_CHG_REASON_CD

AP

Appeal

Y

1

PPHP_CHG_REASON_CD

EL

Eligibility Ended

Y

2

PPHP_CHG_REASON_CD

FY

First year change

Y

3

PPHP_CHG_REASON_CD

HP

Health plan end

Y

4

PPHP_CHG_REASON_CD

IN

Initial assignment

Y

5

PPHP_CHG_REASON_CD

MV

Move

Y

6

PPHP_CHG_REASON_CD

NT

Ninety day change option

Y

7

PPHP_CHG_REASON_CD

OE

Open enrollment

Y

8

PPHP_CHG_REASON_CD

OT

Other

Y

9

PPHP_CHG_REASON_CD

PM

PMI merge

Y

10

PPHP_CHG_REASON_CD

RE

Re-enrollment

Y

11

PPHP_CHG_REASON_CD

RS

Reinstatement

Y

12

PPHP_CHG_REASON_CD

SE

Service ending

Y

13

PPHP_CHG_REASON_CD

VL

Voluntary

Y

14

PPHP_DISENRL_RSN_CD

AP

Appeal

Y

1

PPHP_DISENRL_RSN_CD

CP

Capitation error

Y

2

PPHP_DISENRL_RSN_CD

CV

Healthmatch conversion

Y

9

PPHP_DISENRL_RSN_CD

DT

Death

Y

4

PPHP_DISENRL_RSN_CD

EE

Eligibility ended

Y

5

PPHP_DISENRL_RSN_CD

EX

Exclusion

Y

6

PPHP_DISENRL_RSN_CD

FY

First year change option

Y

7

PPHP_DISENRL_RSN_CD

HP

Health plan contract end

Y

8

PPHP_DISENRL_RSN_CD

JL

Jail incarceration

Y

10

PPHP_DISENRL_RSN_CD

MV

Move

Y

15

PPHP_DISENRL_RSN_CD

ND

Loss disability

Y

11

PPHP_DISENRL_RSN_CD

NT

Ninety day change option

Y

16

PPHP_DISENRL_RSN_CD

OE

Open enrollment

Y

18

PPHP_DISENRL_RSN_CD

OT

Other

Y

19

PPHP_DISENRL_RSN_CD

PA

Loss of Part A

Y

12

PPHP_DISENRL_RSN_CD

PB

Loss of Part B

Y

13

PPHP_DISENRL_RSN_CD

PD

Loss of Part D

Y

14

PPHP_DISENRL_RSN_CD

PM

PMI merge

Y

20

PPHP_DISENRL_RSN_CD

RC

Retro change

Y

21

PPHP_DISENRL_RSN_CD

SE

Service ending

Y

22

PPHP_DISENRL_RSN_CD

SP

Non-payment of spenddown

Y

17

PPHP_DISENRL_RSN_CD

TC

Change/Select different plan

Y

3

PPHP_DISENRL_RSN_CD

VL

Voluntary

Y

23

PPHP_TRACK_CD

A

Auto assigned

Y

1

PPHP_TRACK_CD

H

Health plan assigned

Y

2

PPHP_TRACK_CD

R

Re-enrollment

Y

3

PPHP_TRACK_CD

S

Recipient selected

Y

4

PROV_CNTY_CD

001

Aitkin

Y

1

PROV_CNTY_CD

002

Anoka

Y

2

PROV_CNTY_CD

003

Becker

Y

3

PROV_CNTY_CD

004

Beltrami

Y

4

PROV_CNTY_CD

005

Benton

Y

5

PROV_CNTY_CD

006

Big Stone

Y

6

PROV_CNTY_CD

007

Blue Earth

Y

7

PROV_CNTY_CD

008

Brown

Y

8

PROV_CNTY_CD

009

Carlton

Y

9

PROV_CNTY_CD

010

Carver

Y

10

PROV_CNTY_CD

011

Cass

Y

11

PROV_CNTY_CD

012

Chippewa

Y

12

PROV_CNTY_CD

013

Chisago

Y

13

PROV_CNTY_CD

014

Clay

Y

14

PROV_CNTY_CD

015

Clearwater

Y

15

PROV_CNTY_CD

016

Cook

Y

16

PROV_CNTY_CD

017

Cottonwood

Y

17

PROV_CNTY_CD

018

Crow Wing

Y

18

PROV_CNTY_CD

019

Dakota

Y

19

PROV_CNTY_CD

020

Dodge

Y

20

PROV_CNTY_CD

021

Douglas

Y

21

PROV_CNTY_CD

022

Faribault

Y

22

PROV_CNTY_CD

023

Fillmore

Y

23

PROV_CNTY_CD

024

Freeborn

Y

24

PROV_CNTY_CD

025

Goodhue

Y

25

PROV_CNTY_CD

026

Grant

Y

26

PROV_CNTY_CD

027

Hennepin

Y

27

PROV_CNTY_CD

028

Houston

Y

28

PROV_CNTY_CD

029

Hubbard

Y

29

PROV_CNTY_CD

030

Isanti

Y

30

PROV_CNTY_CD

031

Itasca

Y

31

PROV_CNTY_CD

032

Jackson

Y

32

PROV_CNTY_CD

033

Kanabec

Y

33

PROV_CNTY_CD

034

Kandiyohi

Y

34

PROV_CNTY_CD

035

Kittson

Y

35

PROV_CNTY_CD

036

Koochiching

Y

36

PROV_CNTY_CD

037

Lac qui Parle

Y

37

PROV_CNTY_CD

038

Lake

Y

38

PROV_CNTY_CD

039

Lake of the Woods

Y

39

PROV_CNTY_CD

040

LeSueur

Y

40

PROV_CNTY_CD

041

Lincoln

Y

41

PROV_CNTY_CD

042

Lyon

Y

42

PROV_CNTY_CD

043

McLeod

Y

43

PROV_CNTY_CD

044

Mahnomen

Y

44

PROV_CNTY_CD

045

Marshall

Y

45

PROV_CNTY_CD

046

Martin

Y

46

PROV_CNTY_CD

047

Meeker

Y

47

PROV_CNTY_CD

048

Mille Lacs

Y

48

PROV_CNTY_CD

049

Morrison

Y

49

PROV_CNTY_CD

050

Mower

Y

50

PROV_CNTY_CD

051

Murray

Y

51

PROV_CNTY_CD

052

Nicollet

Y

52

PROV_CNTY_CD

053

Nobles

Y

53

PROV_CNTY_CD

054

Norman

Y

54

PROV_CNTY_CD

055

Olmsted

Y

55

PROV_CNTY_CD

056

Otter Tail

Y

56

PROV_CNTY_CD

057

Pennington

Y

57

PROV_CNTY_CD

058

Pine

Y

58

PROV_CNTY_CD

059

Pipestone

Y

59

PROV_CNTY_CD

060

Polk

Y

60

PROV_CNTY_CD

061

Pope

Y

61

PROV_CNTY_CD

062

Ramsey

Y

62

PROV_CNTY_CD

063

Red Lake

Y

63

PROV_CNTY_CD

064

Redwood

Y

64

PROV_CNTY_CD

065

Renville

Y

65

PROV_CNTY_CD

066

Rice

Y

66

PROV_CNTY_CD

067

Rock

Y

67

PROV_CNTY_CD

068

Roseau

Y

68

PROV_CNTY_CD

069

St. Louis

Y

69

PROV_CNTY_CD

070

Scott

Y

70

PROV_CNTY_CD

071

Sherburne

Y

71

PROV_CNTY_CD

072

Sibley

Y

72

PROV_CNTY_CD

073

Stearns

Y

73

PROV_CNTY_CD

074

Steele

Y

74

PROV_CNTY_CD

075

Stevens

Y

75

PROV_CNTY_CD

076

Swift

Y

76

PROV_CNTY_CD

077

Todd

Y

77

PROV_CNTY_CD

078

Traverse

Y

78

PROV_CNTY_CD

079

Wabasha

Y

79

PROV_CNTY_CD

080

Wadena

Y

80

PROV_CNTY_CD

081

Waseca

Y

81

PROV_CNTY_CD

082

Washington

Y

82

PROV_CNTY_CD

083

Watonwan

Y

83

PROV_CNTY_CD

084

Wilkin

Y

84

PROV_CNTY_CD

085

Winona

Y

85

PROV_CNTY_CD

086

Wright

Y

86

PROV_CNTY_CD

087

Yellow Medicine

Y

87

PROV_CNTY_CD

090

North Dakota

Y

88

PROV_CNTY_CD

091

South Dakota

Y

89

PROV_CNTY_CD

092

Iowa

Y

90

PROV_CNTY_CD

093

Wisconsin

Y

91

PROV_CNTY_CD

094

East of the Mississippi

Y

92

PROV_CNTY_CD

095

West of the Mississippi

Y

93

PROV_CNTY_CD

096

Canada

Y

94

PROV_CNTY_CD

097

Outside of the United States

Y

95

PROV_CNTY_CD

102

Red Lake Indian Reservation

Y

96

PROV_CNTY_CD

103

White Earth Indian Reservation

Y

97

PROV_CNTY_CD

104

Leech Lake Forest Indian Reservation

Y

98

PROV_CNTY_CD

105

Nett Lake Indian Reservation

Y

99

PROV_CNTY_CD

106

Fond du Lac Indian Reservation

Y

100

PROV_CNTY_CD

107

Mille Lacs Indian Reservation

Y

101

PROV_CNTY_CD

108

Upper Sioux Indian Reservation

Y

102

PROV_CNTY_CD

109

Grand Portage Indian Reservation

Y

103

PROV_CNTY_CD

110

Shakopee Mdewakanton Sioux Community

Y

104

RCP_ELIG_STATUS_CD

A

Active

Y

1

RCP_ELIG_STATUS_CD

C

Closed

Y

2

RCP_ELIG_STATUS_CD

D

Denied

Y

3

RCP_ELIG_STATUS_CD

P

Pending

Y

4

RCP_GENDER_CD

F

Female

Y

1

RCP_GENDER_CD

M

Male

Y

2

RCP_GENDER_CD

U

Unknown

Y

3

SA_HDR_STATUS_CD

A

Approved

Y

1

SA_HDR_STATUS_CD

D

Denied

Y

2

SA_HDR_STATUS_CD

P

Pended

Y

3

SA_HDR_STATUS_CD

S

Suspended

Y

4

SA_HDR_STATUS_CD

T

Partially suspended

Y

5

SA_LINE_STATUS_CD

A

Approved

Y

1

SA_LINE_STATUS_CD

D

Denied

Y

2

SA_LINE_STATUS_CD

P

Pended

Y

3

SA_LINE_STATUS_CD

S

Suspended

Y

4

SA_TYPE_CD

A

Agreement - SCH

Y

1

SA_TYPE_CD

B

Agreement - Home Care

Y

2

SA_TYPE_CD

C

Agreement - RSL

Y

3

SA_TYPE_CD

D

Agreement - Special Needs

Y

4

SA_TYPE_CD

E

Agreement - Day Training/Hab

Y

5

SA_TYPE_CD

F

Agreement - CADI Conversion

Y

6

SA_TYPE_CD

G

Agreement - CADI Diversion

Y

7

SA_TYPE_CD

H

Agreement - CAC Conversion

Y

8

SA_TYPE_CD

I

Agreement - CAC Diversion

Y

9

SA_TYPE_CD

J

Agreement - EW Conversion

Y

10

SA_TYPE_CD

K

Agreement - EW Diversion

Y

11

SA_TYPE_CD

L

Agreement - BI NF Conversion

Y

12

SA_TYPE_CD

M

Agreement - BI NF Diversion

Y

13

SA_TYPE_CD

N

Agreement - AC Conversion

Y

14

SA_TYPE_CD

O

Agreement - AC Diversion

Y

15

SA_TYPE_CD

P

Agreement - BI Neuro Behaviorial Conversion

Y

16

SA_TYPE_CD

Q

Agreement - BI Neuro Behavioral Diversion

Y

17

SA_TYPE_CD

R

Agreement - DD Conversion

Y

18

SA_TYPE_CD

S

Agreement - DD Diversion

Y

19

SA_TYPE_CD

T

Agreement - EF Conversion

Y

20

SA_TYPE_CD

U

Agreement - FCO Diversion

Y

21

SA_TYPE_CD

V

Agreement - Consolidated Treatment Fund

Y

22

SA_TYPE_CD

W

Agreement - SILS Diversion

Y

23

SA_TYPE_CD

X

Agreement - ACS Diversion

Y

24

SA_TYPE_CD

Y

Agreement - Essential Comm Support

Y

25

SA_TYPE_CD

Z

Agreement - Moving Home MN

Y

26

SCRNG_ACT_TYPE_CD

01

Telephone screen

Y

9

SCRNG_ACT_TYPE_CD

02

Person to person assessment

Y

6

SCRNG_ACT_TYPE_CD

03

Visit/early intervention

Y

10

SCRNG_ACT_TYPE_CD

04

Relocation/transition assessment

Y

8

SCRNG_ACT_TYPE_CD

05

Document change only

Y

4

SCRNG_ACT_TYPE_CD

06

Reassessment

Y

7

SCRNG_ACT_TYPE_CD

07

Administrative activity

Y

1

SCRNG_ACT_TYPE_CD

08

CAC/CADI/BI reassessment 65th birthday

Y

2

SCRNG_ACT_TYPE_CD

09

Eligibility update

Y

5

SCRNG_ACT_TYPE_CD

10

Case management service change

Y

3

SERVICE_FREQ_CD

1

Daily

Y

1

SERVICE_FREQ_CD

2

Weekly

Y

2

SERVICE_FREQ_CD

3

Monthly

Y

3

SERVICE_FREQ_CD

4

Semi-annual

Y

4

SERVICE_FREQ_CD

5

Yearly

Y

5

SERVICE_FREQ_CD

6

Hour

Y

6

SERVICE_FREQ_CD

7

Episode

Y

7

SERVICE_FREQ_CD

8

Visit

Y

8

WAIVER_TYPE_CD

F

LTC - CADI Conversion

Y

1

WAIVER_TYPE_CD

G

LTC - CADI Diversion

Y

2

WAIVER_TYPE_CD

H

LTC - CAC Conversion

Y

3

WAIVER_TYPE_CD

I

LTC - CAC Diversion

Y

4

WAIVER_TYPE_CD

J

LTC - EW Conversion

Y

5

WAIVER_TYPE_CD

K

LTC - EW Diversion

Y

6

WAIVER_TYPE_CD

L

LTC - BI NF Conversion

Y

7

WAIVER_TYPE_CD

M

LTC - BI NF Diversion

Y

8

WAIVER_TYPE_CD

P

LTC - BI-NB Conversion

Y

9

WAIVER_TYPE_CD

Q

LTC - BI-NB Diversion

Y

10

WAIVER_TYPE_CD

R

DD - Conversion

Y

11

WAIVER_TYPE_CD

S

DD - Diversion

Y

12

WAIVER_TYPE_CD

Y

LTC - Essential Comm Support

Y

13

WAIVER_TYPE_CD

Z

LTC - CSG Diversion

N

14

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