Microsoft Access Script to Create Tables
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CREATE TABLE edi_claims (
ID INT NOT NULL AUTO_INCREMENT KEY,
ClaimNo varchar (50) NOT NULL ,
HIPAAsuiteID varchar (9) NULL ,
TradingPartnerIDType char (2) NULL ,
TradingPartnerID varchar (15) NOT NULL ,
SubmitterName varchar (35) NULL ,
SubmitterID varchar (30) NULL ,
SubmitterContact varchar (60) NULL ,
SubmitterTel varchar (20) NULL ,
SubmitterTelExt varchar (10) NULL ,
SubmitterFax varchar (20) NULL ,
SubmitterEmail varchar (80) NULL ,
ReceiverName varchar (35) NULL ,
BillProvIDType char (2) NULL ,
BillProvID varchar (80) NULL ,
BillProvLast varchar (35) NULL ,
BillProvFirst varchar (25) NULL ,
BillProvMiddle varchar (25) NULL ,
BillProvSuffix varchar (10) NULL ,
BillProvSpecialty varchar (10) NULL ,
BillProvAddress varchar (55) NULL ,
BillProvAddress2 varchar (55) NULL ,
BillProvCity varchar (30) NULL ,
BillProvState char (2) NULL ,
BillProvZip varchar (15) NULL ,
BillProvContact varchar (60) NULL ,
BillProvTel varchar (80) NULL ,
BillProvTelExt varchar (80) NULL ,
BillProvFax varchar (80) NULL ,
BillProvEmail varchar (80) NULL ,
PayToProvIDType char (2) NULL ,
PaytoProvID varchar (80) NULL ,
PaytoProvLast varchar (35) NULL ,
PaytoProvFirst varchar (25) NULL ,
PayToProvMiddle varchar (25) NULL ,
PayToProvSuffix varchar (10) NULL ,
PayToProvSpecialty varchar (10) NULL ,
PaytoProvAddress varchar (55) NULL ,
PayToProvAddress2 varchar (55) NULL ,
PaytoProvCity varchar (30) NULL ,
PaytoProvState char (2) NULL ,
PaytoProvZip varchar (15) NULL ,
RendProvIDType char (2) NULL ,
RendProvID varchar (80) NULL ,
RendProvLast varchar (35) NULL ,
RendProvFirst varchar (25) NULL ,
RendProvMiddle varchar (25) NULL ,
RendProvSuffix varchar (10) NULL ,
RendProvSpecialty varchar (10) NULL ,
AttendProvLast varchar (35) NULL ,
AttendProvFirst varchar (25) NULL ,
AttendProvMiddle varchar (25) NULL ,
AttendProvSuffix varchar (10) NULL ,
AttendProvIDType char (2) NULL ,
AttendProvID varchar (80) NULL ,
AttendProvSpecialty varchar (10) NULL ,
OperatingProvLast varchar (35) NULL ,
OperatingProvFirst varchar (25) NULL ,
OperatingProvMiddle varchar (25) NULL ,
OperatingProvSuffix varchar (10) NULL ,
OperatingProvIDType char (2) NULL ,
OperatingProvID varchar (80) NULL ,
OperatingProvSpecialty varchar (10) NULL ,
OtherProvLast varchar (35) NULL ,
OtherProvFirst varchar (25) NULL ,
OtherProvMiddle varchar (25) NULL ,
OtherProvSuffix varchar (10) NULL ,
OtherProvIDType varchar (100) NULL ,
OtherProvID varchar (100) NULL ,
OtherProvSpecialty varchar (100) NULL ,
FacilityType char (2) NULL ,
FacilityIDType char (2) NULL ,
FacilityID varchar (80) NULL ,
FacilityName varchar (80) NULL ,
FacilityAddress varchar (55) NULL ,
FacilityAddress2 varchar (55) NULL ,
FacilityCity varchar (30) NULL ,
FacilitySpecialty varchar (100) NULL ,
FacilityState char (2) NULL ,
FacilityZip varchar (15) NULL ,
OutsideLab char (1) NULL ,
LabCharge varchar (10) NULL ,
SubscriberLast varchar (35) NULL ,
SubscriberFirst varchar (25) NULL ,
SubscriberMiddle varchar (25) NULL ,
SubscriberSuffix varchar (10) NULL ,
SubscriberAddress varchar (55) NULL ,
SubscriberAddress2 varchar (55) NULL ,
SubscriberCity varchar (30) NULL ,
SubscriberState char (2) NULL ,
SubscriberZip varchar (15) NULL ,
SubscriberIDType char (2) NULL ,
SubscriberID varchar (80) NULL ,
SubscriberDOB varchar (10) NULL ,
SubscriberSex char (1) NULL ,
InsuranceType char (2) NULL ,
GroupNo varchar (50) NULL ,
GroupName varchar (60) NULL ,
FilingIndicator char (2) NULL ,
PatientLast varchar (35) NULL ,
PatientFirst varchar (25) NULL ,
PatientMiddle varchar (25) NULL ,
PatientSuffix varchar (10) NULL ,
PatientAddress varchar (55) NULL ,
PatientAddress2 varchar (55) NULL ,
PatientCity varchar (30) NULL ,
PatientState char (2) NULL ,
PatientZip varchar (15) NULL ,
PatientIDType char (2) NULL ,
PatientID varchar (80) NULL ,
PatientDOB varchar (50) NULL ,
PatientSex char (1) NULL ,
PatientRelationship char (2) NULL ,
PatientPaid varchar (10) NULL ,
PregnancyIndicator char (1) NULL ,
OtherInsuredLast varchar (35) NULL ,
OtherInsuredFirst varchar (25) NULL ,
OtherInsuredMiddle varchar (25) NULL ,
OtherInsuredSuffix varchar (10) NULL ,
OtherInsuredPolicy varchar (50) NULL ,
OtherInsuredDOB varchar (10) NULL ,
OtherInsuredSex char (1) NULL ,
OtherInsuredRelationship char (2) NULL ,
OtherPayerName varchar (35) NULL ,
OtherPayerID varchar (80) NULL ,
OtherPayerPaid varchar (10) NULL ,
OtherPayerGroupName varchar (100) NULL ,
OtherPayerGroupNo varchar (100) NULL ,
PayerName varchar (35) NULL ,
PayerIDType char (2) NULL ,
PayerID varchar (80) NULL ,
PayerAddress varchar (55) NULL ,
PayerAddress2 varchar (55) NULL ,
PayerCity varchar (30) NULL ,
PayerState char (2) NULL ,
PayerZip varchar (15) NULL ,
Amount varchar (50) NULL ,
EstimatedAmountDue varchar (10) NULL ,
PlaceOfService char (2) NULL ,
SubmitReason char (1) NULL ,
ProviderSignature char (1) NULL ,
ProviderAcceptsAssignment char (1) NULL ,
BenefitAssignment char (1) NULL ,
InfoReleaseCode char (1) NULL ,
PatientSignatureCode char (1) NULL ,
RelatedCauses char (2) NULL ,
RelatedCausesState char (2) NULL ,
SpecialProgramCode char (3) NULL ,
ProviderParticipation char (1) NULL ,
ServiceDateFrom varchar (15) NULL ,
ServiceDateTo varchar (15) NULL ,
OnsetDate varchar (15) NULL ,
SimilarSymptomsDate varchar (10) NULL ,
DisabilityBegin varchar (10) NULL ,
DisabilityEnd varchar (10) NULL ,
HospitalizationBegin varchar (20) NULL ,
HospitalizationEnd varchar (10) NULL ,
AccidentDate varchar (20) NULL ,
AdmissionDate varchar (15) NULL ,
AdmissionHour varchar (10) NULL ,
AdmissionType char (1) NULL ,
AdmissionSource char (1) NULL ,
DischargeHour varchar (10) NULL ,
PatientStatus char (2) NULL ,
MedicalRecordNumber varchar (50) NULL ,
CoveredDays varchar (4) NULL ,
NonCoveredDays varchar (4) NULL ,
COBDays varchar (4) NULL ,
LifeTimeReserveDays varchar (4) NULL ,
PriorAuthorization varchar (50) NULL ,
OrigRefNo varchar (50) NULL ,
RefProvLast varchar (35) NULL ,
RefProvFirst varchar (25) NULL ,
RefProvMiddle varchar (25) NULL ,
RefProvSuffix varchar (10) NULL ,
RefProvIDType char (2) NULL ,
RefProvID varchar (80) NULL ,
RefProvSpecialty varchar (10) NULL ,
AdmitDiagnosis varchar (10) NULL ,
ECode varchar (100) NULL ,
PrincipalDiagnosis varchar (10) NULL ,
Diag2 varchar (10) NULL ,
Diag3 varchar (10) NULL ,
Diag4 varchar (10) NULL ,
Diag5 varchar (10) NULL ,
Diag6 varchar (10) NULL ,
Diag7 varchar (10) NULL ,
Diag8 varchar (10) NULL ,
Diag9 varchar (10) NULL ,
PrincipalProcedure varchar (10) NULL ,
PrincipalProcedureDate varchar (10) NULL ,
Proc2 varchar (50) NULL ,
Proc2Date varchar (10) NULL ,
Proc3 varchar (10) NULL ,
Proc3Date varchar (10) NULL ,
Proc4 varchar (10) NULL ,
Proc4Date varchar (10) NULL ,
Proc5 varchar (10) NULL ,
Proc5Date varchar (10) NULL ,
Proc6 varchar (10) NULL ,
Proc6Date varchar (10) NULL ,
DRG varchar (15) NULL ,
ValueCode1 char (3) NULL ,
ValueAmount1 varchar (10) NULL ,
ValueCode2 char (3) NULL ,
ValueAmount2 varchar (10) NULL ,
ValueCode3 char (3) NULL ,
ValueAmount3 varchar (10) NULL ,
ValueCode4 char (3) NULL ,
ValueAmount4 varchar (10) NULL ,
ValueCode5 char (3) NULL ,
ValueAmount5 varchar (10) NULL ,
ValueCode6 char (3) NULL ,
ValueAmount6 varchar (10) NULL ,
ValueCode7 varchar (10) NULL ,
ValueAmount7 varchar (10) NULL ,
ValueCode8 char (3) NULL ,
ValueAmount8 varchar (10) NULL ,
ValueCode9 char (3) NULL ,
ValueAmount9 varchar (10) NULL ,
ValueCode10 char (3) NULL ,
ValueAmount10 varchar (10) NULL ,
ValueCode11 char (3) NULL ,
ValueAmount11 varchar (10) NULL ,
ValueCode12 char (3) NULL ,
ValueAmount12 varchar (10) NULL ,
ConditionCode1 varchar (30) NULL ,
ConditionCode2 varchar (30) NULL ,
ConditionCode3 varchar (30) NULL ,
ConditionCode4 varchar (30) NULL ,
ConditionCode5 varchar (30) NULL ,
ConditionCode6 varchar (30) NULL ,
ConditionCode7 varchar (30) NULL ,
ConditionCode8 varchar (30) NULL ,
FileName varchar (100) NULL ,
OccurranceCode1 char (3) NULL ,
OccurranceDate1 varchar (10) NULL ,
OccurranceCode2 char (3) NULL ,
OccurranceDate2 varchar (10) NULL ,
OccurranceCode3 char (3) NULL ,
OccurranceDate3 varchar (10) NULL ,
OccurranceCode4 char (3) NULL ,
OccurranceDate4 varchar (10) NULL ,
OccurranceCode5 char (3) NULL ,
OccurranceDate5 varchar (10) NULL ,
OccurranceCode6 char (3) NULL ,
OccurranceDate6 varchar (10) NULL ,
OccurranceCode7 char (3) NULL ,
OccurranceDate7 varchar (10) NULL ,
OccurranceCode8 char (3) NULL ,
OccurranceDate8 varchar (10) NULL ,
OccurranceSpanCode1 char (3) NULL ,
OccurranceSpanFrom1 varchar (10) NULL ,
OccurranceSpanTo1 varchar (10) NULL ,
OccurranceSpanCode2 char (3) NULL ,
OccurranceSpanFrom2 varchar (10) NULL ,
OccurranceSpanTo2 varchar (10) NULL ,
Test_Prod char (1) NULL ,
ClaimType char (1) NULL ,
TypeofBill varchar (20) NULL ,
Remark1 varchar (90) NULL ,
Remark2 varchar (90) NULL ,
Remark3 varchar (90) NULL ,
Remark4 varchar (90) NULL ,
Claim_status char (1) NULL ,
TargetTP varchar (30) NULL ,
ClearingHouseID varchar (100) NULL,
RepricedClaimNumber varchar (100) NULL,
RepricingMethodology varchar (3) NULL,
RepricedAmount varchar (15) NULL,
SavingsAmount varchar (15) NULL,
RepricerID varchar (30) NULL,
RejectReason varchar (3) NULL
) ;
CREATE TABLE edi_claimdetail (
ID INT NOT NULL AUTO_INCREMENT KEY,
ClaimID varchar (50) NOT NULL ,
HIPAAsuiteID varchar (10) NULL ,
LineNumber decimal(18, 0) NOT NULL ,
LineID varchar (50) NULL ,
ServiceDateFrom varchar (50) NULL ,
ServiceDateTo varchar (50) NULL ,
FacilityCode varchar (50) NULL ,
RevenueCode varchar (50) NULL ,
ProcedureCode varchar (50) NULL ,
Description varchar (100) NULL,
Amount varchar (50) NULL ,
Unit varchar (50) NULL ,
Quantity varchar (50) NULL ,
UnitRate varchar (50) NULL ,
NonCovered varchar (50) NULL ,
Paid varchar (50) NULL ,
PlaceOfService char (3) NULL ,
Modifier1 char (3) NULL ,
Modifier2 char (3) NULL ,
Modifier3 char (3) NULL ,
Modifier4 char (3) NULL ,
DiagPointer1 char (1) NULL ,
DiagPointer2 char (1) NULL ,
DiagPointer3 char (1) NULL ,
DiagPointer4 char (1) NULL ,
ToothNumber char (2) NULL ,
Surface varchar (10) NULL ,
EmergencyIndicator char (1) NULL,
RepricingMethodology varchar (3) NULL,
RepricedAmount varchar (15) NULL,
SavingsAmount varchar (15) NULL,
RepricerID varchar (30) NULL,
RejectReason varchar (3) NULL
) ;
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