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Global: ^BPSTL

Package: E Claims Management Engine

Global: ^BPSTL


Information

FileMan FileNo FileMan Filename Package
9002313.57 BPS LOG OF TRANSACTIONS E Claims Management Engine

Description

Accessed By FileMan Db Calls, Total: 16

Package Total Routines
E Claims Management Engine 14 BPS10P17    BPS27POST    BPS31POST    BPSECMP2    BPSNTR01    BPSOSCC    BPSOSIY    BPSOSU
BPSRCRI    BPSRPC02    BPSRPC03    BPSSCRLG    BPSTASDB    BPSUTIL    
Integrated Billing 1 IBNCPDP1    
Outpatient Pharmacy 1 PSOBPSU3    

Pointer To FileMan Files, Total: 17

Package Total FileMan Files
E Claims Management Engine 9 BPS ASLEEP PAYERS(#9002313.15)[801]    BPS NCPDP OTHER PAYER AMT PAID QUAL(#9002313.2)[#9002313.57141(.02)]    BPS CERTIFICATION(#9002313.31)[#9002313.57902(902.23)]    BPS NCPDP OVERRIDE(#9002313.511)[1.13]    BPS PHARMACIES(#9002313.56)[1.07]    BPS REQUESTS(#9002313.77)[16, 405]    BPS CLAIMS(#9002313.02)[3, 401]    BPS NCPDP FORMATS(#9002313.92)[#9002313.57902(902.02), #9002313.57902(902.19), #9002313.57902(902.21), #9002313.57902(902.34)]    BPS RESPONSES(#9002313.03)[4, 402]    
Integrated Billing 4 BILL/CLAIMS(#399)[#9002313.57902(902.3)]    RATE TYPE(#399.3)[#9002313.57902(902.29)]    INSURANCE COMPANY(#36)[#9002313.57902(902.33)]    GROUP INSURANCE PLAN(#355.3)[#9002313.57902(.01)]    
Outpatient Pharmacy 2 OUTPATIENT SITE(#59)[11]    PRESCRIPTION(#52)[1.11]    
Kernel 1 NEW PERSON(#200)[13, 304, 307, #9002313.57111(.02)]    
Registration 1 PATIENT(#2)[5]    

Fields, Total: 237

Field # Name Loc Type Details
.01 ENTRY NUMBER 0;1 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:$L(X)>20!($L(X)<1) X
  • LAST EDITED:  FEB 12, 2008
  • HELP-PROMPT:  Answer must be 1-20 characters in length
  • DESCRIPTION:  
    Sequential entry number
  • CROSS-REFERENCE:  9002313.57^B
    1)= S ^BPSTL("B",$E(X,1,30),DA)=""
    2)= K ^BPSTL("B",$E(X,1,30),DA)
1 STATUS 0;2 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
  • LAST EDITED:  JUN 13, 2008
  • HELP-PROMPT:  Type a Number between 0 and 99, 0 Decimal Digits
  • DESCRIPTION:  The status of the transaction as a percentage of completion. The text value can be obtained by running $$STATI^BPSOSU(). Note that 99 indicates complete. Since records are only copied to BPS Log of
    Transactions when transactions are complete, all records in this file should be 99.
1.05 POLICY NUMBER 1;5 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9999)!(X<0)!(X?.E1"."1.N) X
  • LAST EDITED:  OCT 18, 2010
  • HELP-PROMPT:  Enter the policy number that will be processed for this request (0-9999).
  • DESCRIPTION:  
    This is the policy number that is being processed for this eligibility verification request.
1.07 PHARMACY 1;7 POINTER TO BPS PHARMACIES FILE (#9002313.56) BPS PHARMACIES(#9002313.56)

  • LAST EDITED:  FEB 12, 2008
  • HELP-PROMPT:  Select the BPS PHARMACY this Transaction Log relates to.
  • DESCRIPTION:  
    Textual description of the Pharmacy involved with this transaction.
1.08 PINS PIECE 1;8 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  JUN 13, 2008
  • HELP-PROMPT:  Type a Number between 1 and 9, 0 Decimal Digits
  • DESCRIPTION:  Pointer to which of the PINS pieces in ^(6) is in use for this claim. Use this to keep track of where you are in billing down the line to various insurers. (Probably won't automatically roll over to next insurer, but
    maybe we will have an option to edit insurance info, try next insurance, etc.)
1.09 PRIOR AUTHORIZATION NUMBER 1;9 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>11!($L(X)<1) X
  • LAST EDITED:  MAR 19, 2008
  • HELP-PROMPT:  Enter the prior authorization number (1-11 characters)
  • DESCRIPTION:  
    Number assigned by the processor to identify a prior authorized transaction.
1.11 PRESCRIPTION NUMBER 1;11 POINTER TO PRESCRIPTION FILE (#52) PRESCRIPTION(#52)

  • LAST EDITED:  DEC 10, 2013
  • HELP-PROMPT:  Answer with PRESCRIPTION RX #
  • DESCRIPTION:  
    Prescription number for this BPS Transactions.
  • CROSS-REFERENCE:  9002313.57^AEC
    1)= S ^BPSTL("AEC",$E(X,1,30),DA)=""
    2)= K ^BPSTL("AEC",$E(X,1,30),DA)
    This cross-reference is used to locate PRESCRIPTION file (#52) entries related to a transaction.
1.1199 RXI INTERNAL COMPUTED

  • MUMPS CODE:  S Y(9002313.57,1.1199,1)=$S($D(^BPSTL(D0,1)):^(1),1:"") S X=$P(Y(9002313.57,1.1199,1),U,11),X=X
  • ALGORITHM:  INTERNAL(PRESCRIPTION NUMBER)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Internal ID to the claims file.
1.12 RESUBMIT AFTER REVERSAL 1;12 SET
  • '0' FOR DONE;
  • '1' FOR RESUBMIT AFTER REVERSAL;
  • '2' FOR RESUBMITTING;

  • LAST EDITED:  DEC 13, 2005
  • HELP-PROMPT:  Enter the status of the resubmit
  • DESCRIPTION:  
    Indicator that a transaction has been resubmitted after being backed out.
1.13 NCPDP OVERRIDES 1;13 POINTER TO BPS NCPDP OVERRIDE FILE (#9002313.511) BPS NCPDP OVERRIDE(#9002313.511)

  • LAST EDITED:  MAR 30, 2001
  • HELP-PROMPT:  Select the BPS NCPDP OVERRIDE (test accounts only).
  • DESCRIPTION:  
    Pointer to the overrides file for any fields that are not straight forward, but are required by the payer.
1.15 PRIOR AUTHORIZATION TYPE CODE 1;15 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>2!($L(X)<1) X
  • LAST EDITED:  MAR 14, 2007
  • HELP-PROMPT:  Enter the prior authorization type (1-2 characters)
  • DESCRIPTION:  
    Indicates the type of authorization made before transaction was submitted.
2 HL7 MESSAGE ID 0;3 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>60!($L(X)<1) X
  • LAST EDITED:  JUN 27, 2011
  • HELP-PROMPT:  Answer must be 1-60 characters in length.
  • DESCRIPTION:  
    This is the unique HL7 message ID used for the NCPDP message created for this transaction.
3 CLAIM 0;4 POINTER TO BPS CLAIMS FILE (#9002313.02) BPS CLAIMS(#9002313.02)

  • LAST EDITED:  NOV 11, 2000
  • HELP-PROMPT:  Answer with BPS CLAIMS CLAIM ID
  • DESCRIPTION:  
    Claim number
  • CROSS-REFERENCE:  9002313.57^AE
    1)= S ^BPSTL("AE",$E(X,1,30),DA)=""
    2)= K ^BPSTL("AE",$E(X,1,30),DA)
3.1 CLAIM IEN COMPUTED

  • MUMPS CODE:  S Y(9002313.57,3.1,1)=$S($D(^BPSTL(D0,0)):^(0),1:"") S X=$P(Y(9002313.57,3.1,1),U,4),X=X
  • ALGORITHM:  INTERNAL(CLAIM)
  • DESCRIPTION:  
    Pointer to the BPS claims file - 9002313.02
4 RESPONSE 0;5 POINTER TO BPS RESPONSES FILE (#9002313.03) BPS RESPONSES(#9002313.03)

  • LAST EDITED:  NOV 11, 2000
  • HELP-PROMPT:  Answer with BPS RESPONSES
  • DESCRIPTION:  
    Pointer to the corresponding response in the response file, 9002313.03
  • CROSS-REFERENCE:  9002313.57^AF
    1)= S ^BPSTL("AF",$E(X,1,30),DA)=""
    2)= K ^BPSTL("AF",$E(X,1,30),DA)
4.0098 RESULT WITH REVERSAL COMPUTED

  • MUMPS CODE:  S X=$$CATEG^BPSOSUC(D0,1)
  • ALGORITHM:  S X=$$CATEG^BPSOSUC(D0,1)
  • DESCRIPTION:  
    Result if the claim had to be reversed for whatever reason.
4.0099 RESULT COMPUTED

  • MUMPS CODE:  S X=$$CATEG^BPSOSUC(D0)
  • ALGORITHM:  S X=$$CATEG^BPSOSUC(D0)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Result from the payer - maybe be Paid, rejected, captured or accepted.
4.1 RESPONSE IEN COMPUTED

  • MUMPS CODE:  S Y(9002313.57,4.1,1)=$S($D(^BPSTL(D0,0)):^(0),1:"") S X=$P(Y(9002313.57,4.1,1),U,5),X=X
  • ALGORITHM:  INTERNAL(RESPONSE)
  • DESCRIPTION:  
    Response file record number of any reversals.
5 PATIENT 0;6 POINTER TO PATIENT FILE (#2) PATIENT(#2)

  • LAST EDITED:  DEC 16, 2003
  • HELP-PROMPT:  Answer with PATIENT NAME
  • DESCRIPTION:  
    The patient this transaction refers to.
  • CROSS-REFERENCE:  9002313.57^AC
    1)= S ^BPSTL("AC",$E(X,1,30),DA)=""
    2)= K ^BPSTL("AC",$E(X,1,30),DA)
6 SUBMIT DATE 0;7 DATE

  • INPUT TRANSFORM:  S %DT="ESTXR" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  JUN 13, 2008
  • HELP-PROMPT:  Enter the date/time that the claim was submitted
  • DESCRIPTION:  
    This is the date/time that the claim was submitted to ECME.
7 LAST UPDATE 0;8 DATE

  • INPUT TRANSFORM:  S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  NOV 11, 2000
  • HELP-PROMPT:  Enter the date/time this Transaction Log was last updated.
  • DESCRIPTION:  
    Date/time the POS transaction completed processing, as copied from 9002313.59 at the time the .57 record was created.
  • CROSS-REFERENCE:  9002313.57^AH
    1)= S ^BPSTL("AH",$E(X,1,30),DA)=""
    2)= K ^BPSTL("AH",$E(X,1,30),DA)
9 FILL NUMBER 1;1 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<0)!(X?.E1"."1.N) X
  • LAST EDITED:  FEB 12, 2008
  • HELP-PROMPT:  Type a number between 0 and 99, 0 Decimal Digits
  • DESCRIPTION:  
    Prescription fill/refill number.
10 NDC 1;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>12!($L(X)<1) X
  • LAST EDITED:  FEB 12, 2008
  • HELP-PROMPT:  Answer must be 1-12 characters in length.
  • DESCRIPTION:  
    NDC number referenced in this transaction.
10.0099 USER NUMBER COMPUTED

  • MUMPS CODE:  S Y(9002313.57,10.0099,1)=$S($D(^BPSTL(D0,0)):^(0),1:"") S X=$P(Y(9002313.57,10.0099,1),U,10),X=X
  • ALGORITHM:  INTERNAL(USER)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    IEN of the user generating the transaction
11 PHARMACY DIVISION 1;4 POINTER TO OUTPATIENT SITE FILE (#59) OUTPATIENT SITE(#59)

  • LAST EDITED:  FEB 12, 2008
  • HELP-PROMPT:  Select the division for this transaction.
  • DESCRIPTION:  
    Division this transaction is for.
13 USER 0;10 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  NOV 11, 2000
  • HELP-PROMPT:  Answer with NEW PERSON NAME
  • DESCRIPTION:  
    Who created the ECME claim
  • CROSS-REFERENCE:  9002313.57^AG
    1)= S ^BPSTL("AG",$E(X,1,30),DA)=""
    2)= K ^BPSTL("AG",$E(X,1,30),DA)
14 POSITION IN CLAIM 0;9 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  APR 18, 2000
  • HELP-PROMPT:  Type a Number between 1 and 9, 0 Decimal Digits
  • DESCRIPTION:  
    This is the D1 subscript into 9002313.02 and .03
15 START TIME 0;11 DATE

  • INPUT TRANSFORM:  S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  APR 18, 2000
  • HELP-PROMPT:  Enter the start Date/Time for this log entry.
  • DESCRIPTION:  
    Time, including the seconds that the transaction was initiated.
16 SUBMIT REQUEST 0;12 POINTER TO BPS REQUESTS FILE (#9002313.77) BPS REQUESTS(#9002313.77)

  • LAST EDITED:  DEC 12, 2007
  • HELP-PROMPT:  Answer with BPS REQUESTS RX NUMBER
  • DESCRIPTION:  
    IEN of the BPS REQUEST file (#9002313.77)
17 SUBMIT REQUEST DATE TIME 0;13 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  DEC 12, 2007
  • HELP-PROMPT:  Enter the date/time this request was submitted.
  • DESCRIPTION:  
    Submit Request Date/Time
  • CROSS-REFERENCE:  9002313.57^AS
    1)= S ^BPSTL("AS",$E(X,1,30),DA)=""
    2)= K ^BPSTL("AS",$E(X,1,30),DA)
    Submit Request Date/Time cross-reference - when the request was placed to the queue.
18 COB INDICATOR 0;14 SET
  • '1' FOR PRIMARY;
  • '2' FOR SECONDARY;
  • '3' FOR TERTIARY;

  • LAST EDITED:  MAR 19, 2008
  • HELP-PROMPT:  Specify the Coordination of Benefits
  • DESCRIPTION:  
    COB indicator.
19 TRANSACTION TYPE 0;15 SET
  • 'C' FOR CLAIM;
  • 'E' FOR ELIGIBILITY;
  • 'U' FOR UNCLAIM;
  • 'N' FOR NON-BILLABLE;

  • LAST EDITED:  MAY 14, 2015
  • HELP-PROMPT:  Answer with the type of transaction that will be processed for this NCPDP request.
  • DESCRIPTION:  This is the type of transaction that is being processed:
    CLAIM - An NCPDP billing request.
    UNCLAIM - An NCPDP reversal request.
    ELIGIBILITY - An eligibility verification request.
    NON-BILLABLE - A TRICARE/CHAMPVA non-billable prescription.
  • TECHNICAL DESCR:  
    NON-BILLABLE has been added with patch BPS*1*20.
20 MCCF EDI TAS PROGRESS 15;1 SET
  • '1' FOR READY TO SEND;
  • '2' FOR SENT;
  • '3' FOR WRITTEN;

  • LAST EDITED:  FEB 26, 2020
  • HELP-PROMPT:  Enter the status of the MCCF EDI TAS transmission.
  • DESCRIPTION:  
    1 - Ready for Transmission to TAS 2 - Transmitted to TAS 3 - Written to TAS
  • FIELD INDEX:  C (#1707) REGULAR IR LOOKUP & SORTING
    Short Descr: This is a regular index on the MCCF EDI TAS PROGRESS field
    Set Logic: S ^BPSTL("C",X,DA)=""
    Kill Logic: K ^BPSTL("C",X,DA)
    Whole Kill: K ^BPSTL("C")
    X(1): MCCF EDI TAS PROGRESS (9002313.57,20) (Subscr 1) (forwards)
111 COMMENT MULTIPLE 11;0 DATE Multiple #9002313.57111 9002313.57111

  • LAST EDITED:  JUN 27, 2005
  • DESCRIPTION:  
    User's comment
201 RESULT CODE 2;1 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999.999)!(X<0)!(X?.E1"."8.N) X
  • LAST EDITED:  MAR 19, 2008
  • HELP-PROMPT:  Type a number between 0 and 999.999, 7 Decimal Digits
  • DESCRIPTION:  
    Code indicating whether the claim was successfully billed or rejected.
202 RESULT TEXT 2;2 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>222!($L(X)<1) X
  • LAST EDITED:  APR 18, 2000
  • HELP-PROMPT:  Answer must be 1-222 characters in length.
  • DESCRIPTION:  
    Textual description of the reason for rejection, if the claim was rejected.
301 NON-BILLABLE REASON 3;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>60!($L(X)<1) X
  • LAST EDITED:  AUG 19, 2015
  • HELP-PROMPT:  Answer must be 1-60 characters in length.
  • DESCRIPTION:  
    This is the reason why this prescription is Non-Billable. It is the free text value as returned by the IB Billing Determination process. This is only for TRICARE or CHAMPVA prescriptions.
  • TECHNICAL DESCR:  
    This value comes from piece [2] of the return value of $$RX^IBNCPDP when the prescription is reported as non-billable. This is only for TRICARE or CHAMPVA prescriptions.
302 NON-BILLABLE CLOSED 3;2 SET
  • '0' FOR NO;
  • '1' FOR YES;

  • LAST EDITED:  MAY 15, 2015
  • HELP-PROMPT:  Enter Yes if the Non-Billable entry is Closed.
  • DESCRIPTION:  Enter Yes if this Non-Billable entry has been Closed. Enter No if this Non-Billable entry is still Open. When Non-Billable entries are initially created in the BPS Transaction file, they are automatically defaulted to
    Open.
303 NON-BILLABLE DATE CLOSED 3;3 DATE

  • INPUT TRANSFORM:  S %DT="ESTXR" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  MAY 15, 2015
  • HELP-PROMPT:  Enter the date and time when this Non-Billable entry was closed.
  • DESCRIPTION:  
    This field contains the date and time when this Non-Billable entry was closed. It is set by the system when a user performs this action on the ECME User Screen.
304 NON-BILLABLE CLOSED BY 3;4 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  MAY 15, 2015
  • HELP-PROMPT:  Enter the person who closed this non-billable entry.
  • DESCRIPTION:  
    This is the person who closed this non-billable entry. It is automatically populated when this close action happens.
305 NON-BILLABLE CLOSED COMMENT 3;5 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>40!($L(X)<1) X
  • LAST EDITED:  MAY 15, 2015
  • HELP-PROMPT:  Answer must be 1-40 characters in length.
  • DESCRIPTION:  
    This is a free text comment explaining why this non-billable entry is being closed.
306 NON-BILLABLE DATE RE-OPENED 3;6 DATE

  • INPUT TRANSFORM:  S %DT="ESTXR" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  MAY 15, 2015
  • HELP-PROMPT:  Enter the date and time when the non-billable entry was re-opened.
  • DESCRIPTION:  
    This is the date and time when the user re-opened the non-billable entry.
307 NON-BILLABLE RE-OPENED BY 3;7 POINTER TO NEW PERSON FILE (#200) NEW PERSON(#200)

  • LAST EDITED:  MAY 15, 2015
  • HELP-PROMPT:  Enter the user who re-opened this non-billable entry.
  • DESCRIPTION:  
    This is the user who re-opened this non-billable entry. It is set automatically by the system when this action is performed.
308 NON-BILLABLE RE-OPENED COMMENT 3;8 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>40!($L(X)<1) X
  • LAST EDITED:  MAY 15, 2015
  • HELP-PROMPT:  Answer must be 1-40 characters in length.
  • DESCRIPTION:  
    This field holds the free-text comments entered by the user for the reason that this non-billable entry was re-opened.
401 REVERSAL CLAIM 4;1 POINTER TO BPS CLAIMS FILE (#9002313.02) BPS CLAIMS(#9002313.02)

  • LAST EDITED:  NOV 11, 2000
  • HELP-PROMPT:  Answer with BPS CLAIMS CLAIM ID
  • DESCRIPTION:  
    Pointer to file 9002313.02 BPS CLAIMS file for the reversal transaction.
  • CROSS-REFERENCE:  9002313.57^AER
    1)= S ^BPSTL("AER",$E(X,1,30),DA)=""
    2)= K ^BPSTL("AER",$E(X,1,30),DA)
402 REVERSAL RESPONSE 4;2 POINTER TO BPS RESPONSES FILE (#9002313.03) BPS RESPONSES(#9002313.03)

  • LAST EDITED:  NOV 11, 2000
  • HELP-PROMPT:  Answer with BPS RESPONSES
  • DESCRIPTION:  
    Pointer to the BPS responses file 9002313.03 for the reversal response.
  • CROSS-REFERENCE:  9002313.57^AFR
    1)= S ^BPSTL("AFR",$E(X,1,30),DA)=""
    2)= K ^BPSTL("AFR",$E(X,1,30),DA)
404 REVERSAL REASON 4;4 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>40!($L(X)<1) X
  • LAST EDITED:  MAY 25, 2005
  • HELP-PROMPT:  Answer must be 1-40 characters in length
  • DESCRIPTION:  
    Reason for the reversal
405 REVERSAL REQUEST 4;5 POINTER TO BPS REQUESTS FILE (#9002313.77) BPS REQUESTS(#9002313.77)

  • LAST EDITED:  DEC 12, 2007
  • HELP-PROMPT:  Answer with BPS REQUESTS RX NUMBER
  • DESCRIPTION:  
    Reversal Request IEN
406 REVERSAL REQUEST DATE TIME 4;6 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:Y<1 X
  • LAST EDITED:  DEC 12, 2007
  • HELP-PROMPT:  Enter the Date/Time of this Reversal
  • DESCRIPTION:  
    Reversal Request Date/Time
501 QUANTITY 5;1 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9999999)!(X<0)!(X?.E1"."4.N) X
  • LAST EDITED:  JUL 06, 2011
  • HELP-PROMPT:  Type a number between 0 and 9999999, 3 decimal digits.
  • DESCRIPTION:  
    This is the quantity that will be used for the NCPDP field 442-E7 (QUANTITY DISPENSED) of the NCPDP submission.
502 UNIT PRICE 5;2 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999999999)!(X<0)!(X?.E1"."9N.N) X
  • LAST EDITED:  APR 18, 2000
  • HELP-PROMPT:  Type a Number between 0 and 999999999, 8 Decimal Digits
  • DESCRIPTION:  
    Price per unit of prescription.
503 SUBTOTAL 5;3 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999999999)!(X<0)!(X?.E1"."9N.N) X
  • LAST EDITED:  APR 18, 2000
  • HELP-PROMPT:  Type a Number between 0 and 999999999, 8 Decimal Digits
  • DESCRIPTION:  
    = QUANTITY * UNIT PRICE This is what we want to send as the INGREDIENT COST field in the NCPDP message.
504 DISPENSING FEE 5;4 NUMBER

  • INPUT TRANSFORM:  S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>100)!(X<0) X
  • LAST EDITED:  APR 18, 2000
  • HELP-PROMPT:  Type a Dollar Amount between 0 and 100, 2 Decimal Digits
  • DESCRIPTION:  
    Service fee the pharmacy charges for dispensing the drug.
505 TOTAL PRICE 5;5 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999999999)!(X<0)!(X?.E1"."3N.N) X
  • LAST EDITED:  APR 18, 2000
  • HELP-PROMPT:  Type a Number between 0 and 999999999, 2 Decimal Digits
  • DESCRIPTION:  
    =SUBTOTAL + DISPENSING FEE
507 ADMINISTRATIVE FEE 5;7 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>15!($L(X)<1) X
  • LAST EDITED:  FEB 12, 2008
  • HELP-PROMPT:  Answer must be 1-15 characters in length
  • DESCRIPTION:  
    Any fee charged for handling of the paperwork.
508 UNIT OF MEASURE 5;8 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>2!($L(X)<1) X
  • LAST EDITED:  JUN 27, 2007
  • HELP-PROMPT:  Enter the Unit of Measure (1-2 characters)
  • DESCRIPTION:  
    Enter the Unit of Measure for the drug. This is usually GR (grams), ML (milliliters), or EA (Each).
509 BILLING QUANTITY 5;9 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99999999)!(X<0)!(X?.E1"."4.N) X
  • LAST EDITED:  JUL 06, 2011
  • HELP-PROMPT:  Type a number between 0 and 99999999, 3 decimal digits.
  • DESCRIPTION:  
    This is the quantity from the prescription and is used to calculate the ingredient cost. It may be different than the quantity used in the actual NCPDP submission.
510 BILLING UNIT 5;10 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<1) X
  • LAST EDITED:  JUN 03, 2011
  • HELP-PROMPT:  Answer must be 1-10 characters in length.
  • DESCRIPTION:  
    This is the billing units associated with the billing quantity.
801 ASLEEP PAYER 8;1 POINTER TO BPS ASLEEP PAYERS FILE (#9002313.15) BPS ASLEEP PAYERS(#9002313.15)

  • LAST EDITED:  JUN 13, 2008
  • HELP-PROMPT:  Specify a payer that is identified as being asleep.
  • DESCRIPTION:  
    This field identifies an asleep payer for this transaction.
901 CURRENT VA INSURER 9;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>15!($L(X)<1) X
  • LAST EDITED:  JUN 13, 2008
  • HELP-PROMPT:  Answer must be 1-15 characters in length.
  • DESCRIPTION:  
    This field is used for the 1st patient insurance for a VA prescription and it points to the payer sheet to use.
901.04 ELIGIBILITY 9;4 SET
  • 'V' FOR VETERAN;
  • 'T' FOR TRICARE;
  • 'C' FOR CHAMPVA;

  • LAST EDITED:  JUN 13, 2008
  • HELP-PROMPT:  Enter (V)eteran, (T)ricare, or (C)hampVA.
  • DESCRIPTION:  
    The insurance eligibility type of the claim.
902 PATIENT INSURANCE MULTIPLE 10;0 POINTER Multiple #9002313.57902 9002313.57902

  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    List of VA insurers.
1201 RX ACTION 12;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>4!($L(X)<1) X
  • LAST EDITED:  FEB 10, 2011
  • HELP-PROMPT:  Enter the mnemonic that indicates what type of action should be performed (1-4 characters).
  • DESCRIPTION:  This is the action that is being performed on this request. It is either the BWHERE parameter passed into BPSNCPDP or 'ELIG' for an eligibility verification request. The list of BWHERE values are documented at the top of
    routine BPSNCPD3.
1202 DATE OF SERVICE 12;2 DATE

  • INPUT TRANSFORM:  S %DT="E" D ^%DT S X=Y K:X<1 X
  • LAST EDITED:  MAY 25, 2005
  • HELP-PROMPT:  (No range limit on date)
  • DESCRIPTION:  
    Date used for the 401-D1 (DATE OF SERVICE) in the NCPDP transaction
1203 SUBMISSION CLARIFICATION CODE 12;3 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>2!($L(X)<1) X
  • LAST EDITED:  JAN 19, 2007
  • HELP-PROMPT:  Answer must be 1-2 characters in length.
  • DESCRIPTION:  
    Submission Clarification Code
1204 COB OTHER PAYMENTS COUNT 12;4 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>9)!(X<0)!(X?.E1"."1.N) X
  • LAST EDITED:  JUN 17, 2010
  • HELP-PROMPT:  Enter a number between 0 and 9 for a count of other payment occurrences.
  • DESCRIPTION:  NCPDP field 337-4C - Coordination of Benefits/Other Payments Count
    This value corresponds to the number of multiple entries in the #1400 multiple field - COB OTHER PAYERS.
1205 OTHER COVERAGE CODE 12;5 SET
  • '00' FOR NOT SPECIFIED;
  • '01' FOR NO OTH COVERAGE;
  • '02' FOR PYMT COLLECT/OTH PAYER;
  • '03' FOR CLAIM NOT COVER/OTH PAYER;
  • '04' FOR PYMT NOT COLLECT/OTH PAYER;
  • '05' FOR PLAN DENIAL;
  • '06' FOR NONPARTICIPAT PROV/OTH PAYER;
  • '07' FOR OTH COVER NOT EFFECT ON DOS;
  • '08' FOR COPAY BILLING;

  • LAST EDITED:  JUN 17, 2010
  • HELP-PROMPT:  Select the Other Coverage Code.
  • DESCRIPTION:  
    NCPDP field 308-C8 - code indicating whether or not the patient has other insurance coverage.
1300 DUR DATA 13;0 Multiple #9002313.5713 9002313.5713

  • DESCRIPTION:  
    This multiple will track the Drug Utilization Review (DUR) information passed by Outpatient Pharmacy to ECME and that will eventually be put in the DUR segment of the NCPDP claim.
1400 COB OTHER PAYERS 14;0 Multiple #9002313.5714 9002313.5714

  • LAST EDITED:  JUN 17, 2010
  • DESCRIPTION:  This multiple structure stores information about each of the other payers involved in the payment or rejection of the claim.
    NCPDP has a maximum of 9 occurrences here with a recommendation of less than or equal to 3 occurrences. However, VA only stores data for at most 3 insurance policies for any given claim. So at most there will only be 2
    occurrences of this other payer multiple.
9999.92 HRN FAC COMPUTED

  • MUMPS CODE:  N IEN57 S IEN57=D0,X=$$HRN^BPSOS57
  • ALGORITHM:  N IEN57 S IEN57=D0,X=$$HRN^BPSOS57
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Health record number and facility ID - this is set to the pointer to the patient file and the division.
9999.93 DRUG NAME COMPUTED

  • MUMPS CODE:  N IEN57 S IEN57=D0,X=$$DRGNAME^BPSOS57
  • ALGORITHM:  N IEN57 S IEN57=D0,X=$$DRGNAME^BPSOS57
  • DESCRIPTION:  
    Drug name from file 50
9999.94 DRUG IEN COMPUTED

  • MUMPS CODE:  N IEN57 S IEN57=D0,X=$$DRGDFN^BPSOS57
  • ALGORITHM:  N IEN57 S IEN57=D0,X=$$DRGDFN^BPSOS57
  • DESCRIPTION:  
    The IEN of the drug from file 50.
9999.95 RELEASED DATE COMPUTED

  • MUMPS CODE:  N IEN57 S IEN57=D0,X=$$RELDATE^BPSOS57
  • ALGORITHM:  N IEN57 S IEN57=D0,X=$$RELDATE^BPSOS57
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Release date and time from the prescription file, 52.
9999.96 NET PAID BY INSURER COMPUTED

  • MUMPS CODE:  N RESP,POSITION S X=$G(^BPSTL(D0,0)),RESP=$P(X,U,5),POSITION=$P(X,U,9),X=$S(RESP&POSITION:$$NETPAID1^BPSOS03(RESP,POSITION),1:"")
  • ALGORITHM:  N RESP,POSITION S X=$G(^BPSTL(D0,0)),RESP=$P(X,U,5),POSITION=$P(X,U,9),X=$S(RESP&POSITION:$$NETPAID1^BPSOS03(RESP,POSITION),1:"")
  • LAST EDITED:  MAR 31, 2004
  • DESCRIPTION:  
    Amount paid after the discounts and deductible have been subtracted.
9999.97 ELAPSED TIME PRINTABLE COMPUTED

  • MUMPS CODE:  S X=$G(^BPSTL(D0,0)) N X11,X8 S X11=$P(X,U,11),X8=$P(X,U,8),X=$S(X11&X8:$$TIMEDIF^BPSOSUD(X11,X8),1:"")
  • ALGORITHM:  S X=$G(^BPSTL(D0,0)) N X11,X8 S X11=$P(X,U,11),X8=$P(X,U,8),X=$S(X11&X8:$$TIMEDIF^BPSOSUD(X11,X8),1:"")
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Elapsed time between submission and response in external format.
9999.98 ELAPSED TIME SECONDS COMPUTED

  • MUMPS CODE:  S X=$G(^BPSTL(D0,0)) N X11,X8 S X11=$P(X,U,11),X8=$P(X,U,8),X=$S(X11&X8:$$TIMEDIFI^BPSOSUD(X11,X8),1:"")
  • ALGORITHM:  S X=$G(^BPSTL(D0,0)) N X11,X8 S X11=$P(X,U,11),X8=$P(X,U,8),X=$S(X11&X8:$$TIMEDIFI^BPSOSUD(X11,X8),1:"")
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Elapsed time between submission and response expressed as a number of seconds.
9999.99 RESULT CATEGORY COMPUTED

  • MUMPS CODE:  S X=$$CATEG^BPSOSUC(D0)
  • ALGORITHM:  S X=$$CATEG^BPSOSUC(D0)
  • LAST EDITED:  NOV 15, 2000
  • DESCRIPTION:  
    The category of the transmission - accepted, payable, rejected, etc.
10101 BIN NUMBER COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(101)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(101)
  • DESCRIPTION:  
    BIN number from the response file.
10102 VERSION RELEASE NUMBER COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(102)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(102)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Version/release number from the BPS claims file.
10103 TRANSACTION CODE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(103)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(103)
  • DESCRIPTION:  
    Type of transaction from the claim file.
10104 PROCESSOR CONTROL NUMBER COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(104)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(104)
  • DESCRIPTION:  
    PCN number from the claims file.
10201 PHARMACY NUMBER COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(201)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(201)
  • DESCRIPTION:  
    The Pharmacy's NABP number from the claims file.
10301 GROUP NUMBER COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(301)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(301)
  • DESCRIPTION:  
    The group number of the insurance used from the BPS claims file.
10302 CARDHOLDER ID NUMBER COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(302)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(302)
  • LAST EDITED:  MAR 22, 2004
  • DESCRIPTION:  
    The insured person's cardholder identification number from the claims file.
10303 PERSON CODE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(303)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(303)
  • DESCRIPTION:  
    The person code from the BPS claims file.
10304 DATE OF BIRTH COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(304)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(304)
  • DESCRIPTION:  
    Date of birth of the patient from the BPS claims file.
10305 SEX CODE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(305)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(305)
  • DESCRIPTION:  
    Sex of the patient, "M" or "F"
10306 RELATIONSHIP CODE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(306)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(306)
  • DESCRIPTION:  
    Relationship of the patient to the insured - from the BPS claims file.
10307 CUSTOMER LOCATION COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(307)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(307)
  • DESCRIPTION:  Code identifying the location of the patient when receiving pharmacy services. Ø=Not Specified 1=Home 2=Inter-Care 3=Nursing Home 4=Long Term/Extended Care 5=Rest Home 6=Boarding Home 7=Skilled Care Facility 8=Sub-Acute
    Care Facility 9=Acute Care Facility 1Ø=Outpatient 11=Hospice
    from the BPS claims file
10308 OTHER COVERAGE CODE CALCULATED COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(308)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(308)
  • LAST EDITED:  OCT 13, 2010
  • DESCRIPTION:  Code indicating whether or not the patient has other insurance coverage. It returns OTHER COVERAGE CODE (#308) field of the MEDICATIONS (#9002313.0201) sub-file of the BPS CLAIMS (#900213.02) file.
    If the patient has no other insurance coverage an empty string is returned.
10309 ELIGIBILITY CLARIFICATION CODE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(309)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(309)
  • DESCRIPTION:  
    Code indicating that the pharmacy is clarifying eligibility based on receiving a denial. Comes from the BPS claims file.
10310 PATIENT FIRST NAME COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(310)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(310)
  • DESCRIPTION:  
    First name of patient receiving the prescription, from the BPS claims file.
10311 PATIENT LAST NAME COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(311)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(311)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Last Name of patient receiving the prescription from the BPS claims file.
10312 CARDHOLDER FIRST NAME COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(312)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(312)
  • DESCRIPTION:  
    First name of the Cardholder/Subscriber from the BPS claims file.
10313 CARDHOLDER LAST NAME COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(313)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(313)
  • DESCRIPTION:  
    Last name of the Cardholder/Subscriber from the BPS claims file.
10314 HOME PLAN COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(314)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(314)
  • DESCRIPTION:  
    Code identifying the Blue Cross or Blue Shield plan ID which indicates where the member's coverage has been designated. Usually where the member lives or purchased their coverage from the BPS claims file.
10315 EMPLOYER NAME COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(315)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(315)
  • DESCRIPTION:  
    Complete name of employer.
10316 EMPLOYER STREET ADDRESS COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(316)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(316)
  • DESCRIPTION:  
    Free-form text for address information from the claims file.
10317 EMPLOYER CITY ADDRESS COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(317)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(317)
  • DESCRIPTION:  
    Free-form text for city name.
10318 EMPLOYER STATE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(318)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(318)
  • DESCRIPTION:  
    Standard State/Province Code as defined by appropriate government agency.
10319 EMPLOYER ZIP CODE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(319)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(319)
  • DESCRIPTION:  
    Code defining international postal zone excluding punctuation and blanks (zip code for US).
10320 EMPLOYER PHONE NUMBER COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(320)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(320)
  • DESCRIPTION:  
    Ten digit phone number of employer.
10321 EMPLOYER CONTACT NAME COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(321)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(321)
  • LAST EDITED:  JUN 13, 2008
  • DESCRIPTION:  
    Contact person's name of the cardholder's employer.
10322 PATIENT STREET ADDRESS COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(322)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(322)
  • DESCRIPTION:  
    Free-form text for Patient address information.
10323 PATIENT CITY ADDRESS COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(323)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(323)
  • LAST EDITED:  DEC 22, 2003
  • DESCRIPTION:  
    Free-form text for city name.
10324 PATIENT STATE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(324)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(324)
  • DESCRIPTION:  
    Standard State/Province Code as defined by appropriate government agency. Comes from the BPS claims file.
10325 PATIENT ZIP CODE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(325)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(325)
  • DESCRIPTION:  
    Code defining international postal zone excluding punctuation and blanks (zip code for US). From the BPS claims file.
10326 PATIENT PHONE NUMBER COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(326)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(326)
  • DESCRIPTION:  
    Ten digit phone number of patient. From the BPS claims file.
10327 CARRIER ID NUMBER COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(327)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(327)
  • DESCRIPTION:  
    The ID number of the insurance carrier.
10328 PATIENT WEIGHT COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(328)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(328)
  • DESCRIPTION:  
    Patient's weight from the patient file.
10329 PATIENT SSN COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(329)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(329)
  • DESCRIPTION:  
    Patient SSN from the claims file.
10401 DATE FILLED COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(401)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(401)
  • DESCRIPTION:  
    The fill/refill date
10402 PRESCRIPTION NUMBER SEVEN COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(402)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(402)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    The first seven digits of the prescription IEN
10403 NEW REFILL CODE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(403)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(403)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    The fill/refill number, starting at 0 for the original fill.
10404 METRIC QUANTITY COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(404)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(404)
  • DESCRIPTION:  
    Metric quantity of the drug.
10405 DAYS SUPPLY COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(405)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(405)
  • DESCRIPTION:  
    The actual days supply dispensed.
10406 COMPOUND CODE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(406)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(406)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Field indicating whether this prescription was a compound (1) or not a compound (0).
10407 NDC NUMBER COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(407)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(407)
  • DESCRIPTION:  
    NDC code in our case.
10408 DISPENSE AS WRITTEN COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(408)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(408)
  • DESCRIPTION:  
    Indicator for whether the prescription was to be dispensed only as written.
10409 INGREDIENT COST COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(409)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(409)
  • LAST EDITED:  APR 05, 2001
  • DESCRIPTION:  
    Cost amount for the ingredients of compounds.
10410 SALES TAX COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(410)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(410)
  • DESCRIPTION:  
    Sales Tax charged (not applicable for VA)
10411 PRESCRIBER ID COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(411)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(411)
  • DESCRIPTION:  
    Prescriber identification number.
10412 DISPENSING FEE SUBMITTED COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(412)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(412)
  • DESCRIPTION:  
    Add-on fee charged in a retail setting. This field will probably be used when the Tricare functionality is added.
10414 DATE PRESCRIPTION WRITTEN COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(414)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(414)
  • DESCRIPTION:  
    This will be the fill/refill date for local fills, the released date for CMOP.
10415 NUMBER OF REFILLS AUTHORIZED COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(415)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(415)
  • DESCRIPTION:  
    The number of refills allowed that was entered during order entry.
10416 PRIOR AUTH/MC CODE AND NUMBER COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(416)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(416)
  • DESCRIPTION:  
    Not used for VA - left in for IHS
10418 LEVEL OF SERVICE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(418)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(418)
  • DESCRIPTION:  
    Not used for VA - left in for IHS
10419 PRESCRIPTION ORIGIN CODE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(419)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(419)
  • DESCRIPTION:  
    Not used for VA - left in for IHS
10420 PRESCRIPTION CLARIFICATION COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(420)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(420)
  • DESCRIPTION:  
    Not used for VA - left in for IHS
10421 PRIMARY PRESCRIBER COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(421)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(421)
  • DESCRIPTION:  
    Provider ID number
10422 CLINIC ID NUMBER COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(422)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(422)
  • DESCRIPTION:  
    Clinic ID where the prescription was entered.
10423 BASIS OF COST DETERMINATION COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(423)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(423)
  • DESCRIPTION:  
    How the amount charged was arrived at.
10424 DIAGNOSIS CODE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(424)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(424)
  • DESCRIPTION:  
    Diagnosis code that applies to this prescription. Not used for third party billing as of this date - so it is not used, but may be used in the future.
10425 DRUG TYPE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(425)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(425)
  • DESCRIPTION:  
    Code to indicate the type of drug dispensed. Ø=Not specified 1=Single source brand 2=Branded generic 3=Generic 4=O.T.C. (over the counter)
10426 USUAL AND CUSTOMARY CHARGE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(426)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(426)
  • LAST EDITED:  APR 05, 2001
  • DESCRIPTION:  
    Amount charged cash customers for the prescription exclusive of sales tax or other amounts claimed.
10427 PRESCRIBER LAST NAME COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(427)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(427)
  • DESCRIPTION:  
    Last Name of the Prescriber
10428 POSTAGE AMOUNT CLAIMED COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(428)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(428)
  • DESCRIPTION:  
    Dollar amount of postage claimed.
10429 UNIT DOSE INDICATOR COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(429)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(429)
  • DESCRIPTION:  
    Code indicating the type of unit dose dispensing. Ø=Not Specified 1=Not Unit Dose 2=Manufacturer Unit Dose 3=Pharmacy Unit Dose
10430 GROSS AMOUNT DUE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(430)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(430)
  • DESCRIPTION:  
    Total amount submitted to the payer.
10431 OTHER PAYOR AMOUNT COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(431)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(431)
  • DESCRIPTION:  
    Amount of any payment known by the pharmacy from other sources (including coupons).
10432 BASIS OF DAYS SUPPLY DET COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(432)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(432)
  • DESCRIPTION:  
    Code indicating the method by which the days supply was determined. Ø=Not specified 1=Explicit directions 2=PRN directions (take as needed pharmacist estimate) 3=As directed by physician
10433 PATIENT PAID AMOUNT COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(433)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(433)
  • DESCRIPTION:  
    Amount the pharmacy received from the patient for the prescription dispensed.
10434 DATE OF INJURY COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(434)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(434)
  • DESCRIPTION:  
    Date on which the injury occurred.
10435 CLAIM REF ID NUMBER COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(435)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(435)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Identifies the claim number assigned by Workers Compensation Program.
10436 ALT PRODUCT TYPE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(436)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(436)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  Code qualifying the value in 'Product/Service ID' (4Ø7-D7) Not Specified Blank Not Specified ØØ Universal Product Code (UPC) Ø1 Health Related Item (HRI) Ø2 National Drug Code (NDC) Ø3 Universal Product Number (UPN) Ø4
    Department of Defense (DOD) Ø5 Drug Use Review/ Professional Pharmacy Service (DUR/PPS) Ø6 Common Procedure Terminology (CPT4) Ø7 Common Procedure Terminology (CPT5) Ø8 Health Care Financing Administration Common
    Procedural Coding System (HCPCS) Ø9 Pharmacy Practice Activity Classification (PPAC) 1Ø National Pharmaceutical Product Interface Code(NAPPI) 11 International Article Numbering System(EAN) 12 Drug Identification
    Number(DIN) 13 Medi-Span GPI 14 First DataBank GCN 15 Medical Economics GPO 16 Medi-Span DDID 17 First DataBank SmartKey 18 Medical Economics GM 19 International Classification of Diseases(ICD9) 2Ø International
    Classification of Diseases (ICD10) 21 Medi-Span Diagnosis Code 22 Common Dental Terminology (CDT) 25 American Psychiatric Association Diagnostic Statistical Manual of Mental Disorders (DSM IV) Other 99
10437 ALT PRODUCT CODE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(437)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(437)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  This field identifies the actual product code for the item that was dispensed. The type of product is defined by field 436-E1. This field should only be used if the National Drug Code number is not available. The code
    number here is the UPC number or the HRI number
10438 INCENTIVE AMOUNT SUBMITTED COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(438)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(438)
  • DESCRIPTION:  
    Amount represents a fee that is submitted by the pharmacy for contractually agreed upon services. This amount is included in the 'Gross Amount Due' (43Ø-DU).
10439 DUR CONFLICT CODE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(439)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(439)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Code identifying the type of utilization conflict detected or the reason for the pharmacist's professional service.
10440 DUR INTERVENTION CODE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(440)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(440)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Code to indicate whether an intervention was entered.
10441 DUR OUTCOME CODE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(441)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(441)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    The outcome of the DUR - whether the prescription had to be modified.
10442 METRIC DECIMAL QUANTITY COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(442)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(442)
  • DESCRIPTION:  
    Quantity dispensed expressed in metric decimal units.
10443 OTHER PAYOR DATE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(443)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(443)
  • DESCRIPTION:  
    Payment or denial date of the claim submitted to the other payer. Used for coordination of benefits.
10444 PHARMACIST ID COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(444)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(444)
  • DESCRIPTION:  
    Unique ID assigned to the person responsible for the dispensing of the prescription or provision of the service.
10501 RESPONSE STATUS COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(501)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(501)
  • DESCRIPTION:  
    Status flag indicating whether the transaction was "P"aid, "R"ejected, "A"ccepted, or "C"aptured.
10503 AUTHORIZATION NUMBER COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(503)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(503)
  • DESCRIPTION:  
    Authorization number for pre-authorization requests.
10504 MESSAGE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(504)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(504)
  • DESCRIPTION:  
    Free form Message.
10505 PATIENT PAY AMOUNT COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(505)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(505)
  • LAST EDITED:  APR 05, 2001
  • DESCRIPTION:  
    Amount the patient pays (copay).
10506 INGREDIENT COST PAID COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(506)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(506)
  • DESCRIPTION:  
    Drug ingredient cost paid included in the 'Total Amount Paid' (5Ø9).
10507 CONTRACT FEE PAID COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(507)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(507)
  • DESCRIPTION:  
    Dispensing fee paid included in the 'Total Amount Paid' (5Ø9).
10508 SALES TAX PAID COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(508)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(508)
  • DESCRIPTION:  
    The amount of sales tax paid for the prescription dispensed.
10509 TOTAL AMOUNT PAID COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(509)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(509)
  • DESCRIPTION:  Total amount to be paid by the claims processor (i.e. pharmacy receivable). Represents a sum of 'Ingredient Cost Paid' (5Ø6), 'Dispensing Fee Paid' (5Ø7), 'Flat Sales Tax Amount Paid' (558), 'Percentage Sales Tax Amount
    Paid' (559), 'Incentive Amount Paid' (521), 'Professional Service Fee Paid' (562), 'Other Amount Paid' (565), less 'Patient Pay Amount' (5Ø5) and 'Other Payer Amount Recognized' (566).
10510 REJECT COUNT COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(510)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(510)
  • DESCRIPTION:  
    Count of 'Reject Code' (511) occurrences.
10511 REJECT CODES COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(511)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(511)
  • DESCRIPTION:  
    Multiple rejection codes.
10511.01 REJECT CODE 1 COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(511.01)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(511.01)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reject code #1 returned in the response by the payer.
10511.02 REJECT CODE 2 COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(511.02)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(511.02)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reject code #2 returned in the response by the payer.
10511.03 REJECT CODE 3 COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(511.03)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(511.03)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reject code #3 returned in the response by the payer.
10511.04 REJECT CODE 4 COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(511.04)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(511.04)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reject code #4 returned in the response by the payer.
10511.05 REJECT CODE 5 COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(511.05)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(511.05)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reject code #5 returned in the response by the payer.
10511.06 REJECT CODE 6 COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(511.06)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(511.06)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reject code #6 returned in the response by the payer.
10511.07 REJECT CODE 7 COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(511.07)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(511.07)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reject code #7 returned in the response by the payer.
10511.08 REJECT CODE 8 COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(511.08)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(511.08)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reject code #8 returned in the response by the payer.
10511.09 REJECT CODE 9 COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(511.09)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(511.09)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reject code #9 returned in the response by the payer.
10511.1 REJECT CODE 10 COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(511.1)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(511.1)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reject code #10 returned in the response by the payer.
10511.11 REJECT CODE 11 COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(511.11)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(511.11)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reject code #11 returned in the response by the payer.
10511.12 REJECT CODE 12 COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(511.12)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(511.12)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reject code #12 returned in the response by the payer.
10511.13 REJECT CODE 13 COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(511.13)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(511.13)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reject code #13 returned in the response by the payer.
10511.14 REJECT CODE 14 COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(511.14)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(511.14)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reject code #14 returned in the response by the payer.
10511.15 REJECT CODE 15 COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(511.15)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(511.15)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reject code #15 returned in the response by the payer.
10511.16 REJECT CODE 16 COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(511.16)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(511.16)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reject code #16 returned in the response by the payer.
10511.17 REJECT CODE 17 COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(511.17)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(511.17)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reject code #17 returned in the response by the payer.
10511.18 REJECT CODE 18 COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(511.18)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(511.18)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reject code #18 returned in the response by the payer.
10511.19 REJECT CODE 19 COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(511.19)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(511.19)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reject code #19 returned in the response by the payer.
10511.2 REJECT CODE 20 COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(511.2)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(511.2)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reject code #20 returned in the response by the payer.
10512 ACCUMULATED DEDUCTIBLE AMOUNT COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(512)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(512)
  • DESCRIPTION:  
    Amount in dollars met by the patient/family in a deductible plan.
10513 REMAINING DEDUCTIBLE AMOUNT COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(513)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(513)
  • DESCRIPTION:  
    Amount not met by the patient/family in the deductible plan.
10514 REMAINING BENEFIT AMOUNT COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(514)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(514)
  • DESCRIPTION:  
    Amount remaining in a patient/family plan with a periodic maximum benefit.
10515 POSTAGE AMOUNT PAID COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(515)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(515)
  • DESCRIPTION:  
    Not applicable to the VA.
10516 DRUG DESCRIPTION COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(516)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(516)
  • DESCRIPTION:  
    Text description for the drug from the drug file 50.
10517 AMOUNT APP TO PER DEDUCTIBLE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(517)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(517)
  • DESCRIPTION:  
    Amount to be collected from a patient that is included in 'Patient Pay Amount' (5Ø5) that is applied to a periodic deductible.
10518 AMOUNT OF COPAY COINSURANCE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(518)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(518)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Amount to be collected from the patient that is included in 'Patient Pay Amount' (5Ø5) that is due to a per prescription copay/coinsurance.
10519 AMOUNT ATTR TO PRODUCT SELECT COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(519)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(519)
  • DESCRIPTION:  
    Amount to be collected from the patient that is included in 'Patient Pay Amount' (5Ø5) that is due to the patient's selection of drug product.
10520 AMOUNT EXCEED PER BENEFIT MAX COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(520)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(520)
  • DESCRIPTION:  
    Amount to be collected from the patient that is included in 'Patient Pay Amount' (5Ø5) that is due to the patient exceeding a periodic benefit maximum.
10521 INCENTIVE FEE PAID COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(521)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(521)
  • LAST EDITED:  APR 05, 2001
  • DESCRIPTION:  
    Amount represents the contractually agreed upon incentive fee paid for specific services rendered. Amount is included in the 'Total Amount Paid' (5Ø9).
10522 BASIS OF REIMBURSEMENT DET COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(522)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(522)
  • DESCRIPTION:  
    Code identifying how the reimbursement amount was calculated for 'Ingredient Cost Paid' (5Ø6).
10523 AMOUNT ATTRIBUTED TO SALES TAX COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(523)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(523)
  • DESCRIPTION:  
    Amount to be collected from the patient that is included in 'Patient Pay Amount' (5Ø5) that is due to sales tax paid.
10524 PLAN ID COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(524)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(524)
  • DESCRIPTION:  
    Plan Identification Number.
10525 DUR RESPONSE DATA COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(525)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(525)
  • DESCRIPTION:  
    Text that provides additional detail regarding a DUR conflict.
10525.01 DUR COUNT COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.01,9.6) S X=$S(Y(9002313.57,10525.01,2):Y(9002313.57,10525.01,3),Y(9002313.57,10525.01,5):Y(9002313.57,10525.01,6),Y(9002313.57,10525.01,8):Y(9002313.57,10525.01,9),Y(9002313.57,10525.01,10):X)
    9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.1,0),U,5,99) S Y(9002313.57,10525.01,1)=X X "N I,Y "_$P(^DD(9002313.57,10525.2,0),U,5,99) S Y(9002313.57,10525.01,4)=X
    9.3 = X ^DD(9002313.57,10525.01,9.2) X "N I,Y "_$P(^DD(9002313.57,10525.3,0),U,5,99) S Y(9002313.57,10525.01,7)=X S X=Y(9002313.57,10525.01,1)=""
    9.4 = X ^DD(9002313.57,10525.01,9.3) S Y(9002313.57,10525.01,2)=$G(X) S X=0,Y(9002313.57,10525.01,3)=$G(X) S X=Y(9002313.57,10525.01,4)=""
    9.5 = X ^DD(9002313.57,10525.01,9.4) S Y(9002313.57,10525.01,5)=$G(X) S X=1,Y(9002313.57,10525.01,6)=$G(X) S X=Y(9002313.57,10525.01,7)=""
    9.6 = X ^DD(9002313.57,10525.01,9.5) S Y(9002313.57,10525.01,8)=$G(X) S X=2,Y(9002313.57,10525.01,9)=$G(X) S X=1,Y(9002313.57,10525.01,10)=$G(X) S X=3
  • ALGORITHM:  $S(DUR 1 RAW DATA="":0,DUR 2 RAW DATA="":1,DUR 3 RAW DATA="":2,1:3)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Number of DUR messages to be displayed.
10525.1 DUR 1 RAW DATA COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.1,9.5) S X=$S(Y(9002313.57,10525.1,4):Y(9002313.57,10525.1,5),Y(9002313.57,10525.1,6):X)
    9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.1,1)=X S X=Y(9002313.57,10525.1,1),Y(9002313.57,10525.1,2)=X S X=1,Y(9002313.57,10525.1,3)=X S X=2
    9.3 = X ^DD(9002313.57,10525.1,9.2) S X=$E(Y(9002313.57,10525.1,2),Y(9002313.57,10525.1,3),X)=" ",Y(9002313.57,10525.1,4)=X S X="",Y(9002313.57,10525.1,5)=X S X=1
    9.4 = X ^DD(9002313.57,10525.1,9.3) S Y(9002313.57,10525.1,6)=X,Y(9002313.57,10525.1,7)=X S X=Y(9002313.57,10525.1,1),Y(9002313.57,10525.1,8)=X S X=1
    9.5 = X ^DD(9002313.57,10525.1,9.4) S Y(9002313.57,10525.1,9)=X S X=53,X=$E(Y(9002313.57,10525.1,8),Y(9002313.57,10525.1,9),X)
  • ALGORITHM:  $S($E(DUR RESPONSE DATA,1,2)=" ":"",1:$E(DUR RESPONSE DATA,1,53))
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Raw Data DUR message sent from the payer and stored in the response file.
10525.1439 DUR 1 DRUG CONFLICT CODE COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.1439,9.2) S Y(9002313.57,10525.1439,3)=X S X=2,X=$E(Y(9002313.57,10525.1439,2),Y(9002313.57,10525.1439,3),X)
    9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.1439,1)=X S X=Y(9002313.57,10525.1439,1),Y(9002313.57,10525.1439,2)=X S X=1
  • ALGORITHM:  $E(DUR RESPONSE DATA,1,2)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Severity level code for the first DUR.
10525.1528 DUR 1 SEVERITY INDEX CODE COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.1528,9.2) S X=$E(Y(9002313.57,10525.1528,2),X)
    9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.1528,1)=X S X=Y(9002313.57,10525.1528,1),Y(9002313.57,10525.1528,2)=X S X=3
  • ALGORITHM:  $E(DUR RESPONSE DATA,3)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Blank=Not Specified 1=Major 2=Moderate 3=Minor
10525.1529 DUR 1 OTHER PHARMACY INDIC COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.1529,9.2) S X=$E(Y(9002313.57,10525.1529,2),X)
    9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.1529,1)=X S X=Y(9002313.57,10525.1529,1),Y(9002313.57,10525.1529,2)=X S X=4
  • ALGORITHM:  $E(DUR RESPONSE DATA,4)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Ø=Not Specified 1=Your Pharmacy 2=Other Pharmacy in Same Chain 3=Other Pharmacy
10525.153 DUR 1 PREVIOUS DATE OF FILL COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.153,9.2) S Y(9002313.57,10525.153,3)=X S X=12,X=$E(Y(9002313.57,10525.153,2),Y(9002313.57,10525.153,3),X)
    9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.153,1)=X S X=Y(9002313.57,10525.153,1),Y(9002313.57,10525.153,2)=X S X=5
  • ALGORITHM:  $E(DUR RESPONSE DATA,5,12)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Previous fill date
10525.1531 DUR 1 QTY OF PREVIOUS FILL COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.1531,9.2) S Y(9002313.57,10525.1531,3)=X S X=17,X=$E(Y(9002313.57,10525.1531,2),Y(9002313.57,10525.1531,3),X)
    9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.1531,1)=X S X=Y(9002313.57,10525.1531,1),Y(9002313.57,10525.1531,2)=X S X=13
  • ALGORITHM:  $E(DUR RESPONSE DATA,13,17)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    The quantity of the previous fill that caused the DUR to be triggered.
10525.1532 DUR 1 DATABASE INDICATOR COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.1532,9.2) S X=$E(Y(9002313.57,10525.1532,2),X)
    9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.1532,1)=X S X=Y(9002313.57,10525.1532,1),Y(9002313.57,10525.1532,2)=X S X=18
  • ALGORITHM:  $E(DUR RESPONSE DATA,18)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Blank=Not Specified 1=First Databank 2=Medi-Span 3=Redbook 4=Processor Developed 5=Other
10525.1533 DUR 1 OTHER PRESCRIBER INDIC COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.1533,9.2) S X=$E(Y(9002313.57,10525.1533,2),X)
    9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.1533,1)=X S X=Y(9002313.57,10525.1533,1),Y(9002313.57,10525.1533,2)=X S X=19
  • ALGORITHM:  $E(DUR RESPONSE DATA,19)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  Code that indicates the prescriber of the current fill relationship to the prescriber of the conflicting prescription.
    Ø=Not Specified 1=Same Prescriber 2=Other Prescriber
10525.1544 DUR 1 FREE TEXT COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.1544,9.2) S Y(9002313.57,10525.1544,3)=X S X=49,X=$E(Y(9002313.57,10525.1544,2),Y(9002313.57,10525.1544,3),X)
    9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.1544,1)=X S X=Y(9002313.57,10525.1544,1),Y(9002313.57,10525.1544,2)=X S X=20
  • ALGORITHM:  $E(DUR RESPONSE DATA,20,49)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Actual DUR text
10525.1999 DUR 1 RESERVE SPACE COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.1999,9.2) S Y(9002313.57,10525.1999,3)=X S X=53,X=$E(Y(9002313.57,10525.1999,2),Y(9002313.57,10525.1999,3),X)
    9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.1999,1)=X S X=Y(9002313.57,10525.1999,1),Y(9002313.57,10525.1999,2)=X S X=50
  • ALGORITHM:  $E(DUR RESPONSE DATA,50,53)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reserved space for additional information.
10525.2 DUR 2 RAW DATA COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.2,9.5) S X=$S(Y(9002313.57,10525.2,4):Y(9002313.57,10525.2,5),Y(9002313.57,10525.2,6):X)
    9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.2,1)=X S X=Y(9002313.57,10525.2,1),Y(9002313.57,10525.2,2)=X S X=54,Y(9002313.57,10525.2,3)=X S X=55
    9.3 = X ^DD(9002313.57,10525.2,9.2) S X=$E(Y(9002313.57,10525.2,2),Y(9002313.57,10525.2,3),X)=" ",Y(9002313.57,10525.2,4)=X S X="",Y(9002313.57,10525.2,5)=X S X=1
    9.4 = X ^DD(9002313.57,10525.2,9.3) S Y(9002313.57,10525.2,6)=X,Y(9002313.57,10525.2,7)=X S X=Y(9002313.57,10525.2,1),Y(9002313.57,10525.2,8)=X S X=54
    9.5 = X ^DD(9002313.57,10525.2,9.4) S Y(9002313.57,10525.2,9)=X S X=106,X=$E(Y(9002313.57,10525.2,8),Y(9002313.57,10525.2,9),X)
  • ALGORITHM:  $S($E(DUR RESPONSE DATA,54,55)=" ":"",1:$E(DUR RESPONSE DATA,54,106))
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    DUR information returned by the payer that has not been formatted yet.
10525.2439 DUR 2 DRUG CONFLICT CODE COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.2439,9.2) S Y(9002313.57,10525.2439,3)=$G(X) S X=2,X=$E(Y(9002313.57,10525.2439,2),Y(9002313.57,10525.2439,3),X)
    9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.2,0),U,5,99) S Y(9002313.57,10525.2439,1)=X S X=Y(9002313.57,10525.2439,1),Y(9002313.57,10525.2439,2)=$G(X) S X=1
  • ALGORITHM:  $E(DUR 2 RAW DATA,1,2)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Ø=Not Specified 1=Your Pharmacy 2=Other Pharmacy in Same Chain 3=Other Pharmacy
10525.2528 DUR 2 SEVERITY INDEX CODE COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.2528,9.2) S X=$E(Y(9002313.57,10525.2528,2),X)
    9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.2,0),U,5,99) S Y(9002313.57,10525.2528,1)=X S X=Y(9002313.57,10525.2528,1),Y(9002313.57,10525.2528,2)=$G(X) S X=3
  • ALGORITHM:  $E(DUR 2 RAW DATA,3)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Blank=Not Specified 1=Major 2=Moderate 3=Minor
10525.2529 DUR 2 OTHER PHARMACY INDIC COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.2529,9.2) S X=$E(Y(9002313.57,10525.2529,2),X)
    9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.2,0),U,5,99) S Y(9002313.57,10525.2529,1)=X S X=Y(9002313.57,10525.2529,1),Y(9002313.57,10525.2529,2)=$G(X) S X=4
  • ALGORITHM:  $E(DUR 2 RAW DATA,4)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Ø=Not Specified 1=Your Pharmacy 2=Other Pharmacy in Same Chain 3=Other Pharmacy
10525.253 DUR 2 PREVIOUS DATE OF FILL COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.253,9.2) S Y(9002313.57,10525.253,3)=$G(X) S X=12,X=$E(Y(9002313.57,10525.253,2),Y(9002313.57,10525.253,3),X)
    9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.2,0),U,5,99) S Y(9002313.57,10525.253,1)=X S X=Y(9002313.57,10525.253,1),Y(9002313.57,10525.253,2)=$G(X) S X=5
  • ALGORITHM:  $E(DUR 2 RAW DATA,5,12)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Fill date of the previous fill that is causing the DUR conflict.
10525.2531 DUR 2 QTY OF PREVIOUS FILL COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.2531,9.2) S Y(9002313.57,10525.2531,3)=$G(X) S X=17,X=$E(Y(9002313.57,10525.2531,2),Y(9002313.57,10525.2531,3),X)
    9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.2,0),U,5,99) S Y(9002313.57,10525.2531,1)=X S X=Y(9002313.57,10525.2531,1),Y(9002313.57,10525.2531,2)=$G(X) S X=13
  • ALGORITHM:  $E(DUR 2 RAW DATA,13,17)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Quantity of the fill that is causing the conflict.
10525.2532 DUR 2 DATABASE INDICATOR COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.2532,9.2) S X=$E(Y(9002313.57,10525.2532,2),X)
    9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.2,0),U,5,99) S Y(9002313.57,10525.2532,1)=X S X=Y(9002313.57,10525.2532,1),Y(9002313.57,10525.2532,2)=$G(X) S X=18
  • ALGORITHM:  $E(DUR 2 RAW DATA,18)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Blank=Not Specified 1=First Databank 2=Medi-Span 3=Redbook 4=Processor Developed 5=Other
10525.2533 DUR 2 OTHER PRESCRIBER INDIC COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.2533,9.2) S X=$E(Y(9002313.57,10525.2533,2),X)
    9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.2,0),U,5,99) S Y(9002313.57,10525.2533,1)=X S X=Y(9002313.57,10525.2533,1),Y(9002313.57,10525.2533,2)=$G(X) S X=19
  • ALGORITHM:  $E(DUR 2 RAW DATA,19)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  Code that indicates the prescriber of the current fill relationship to the prescriber of the conflicting prescription.
    Ø=Not Specified 1=Same Prescriber 2=Other Prescriber
10525.2544 DUR 2 FREE TEXT COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.2544,9.2) S Y(9002313.57,10525.2544,3)=$G(X) S X=49,X=$E(Y(9002313.57,10525.2544,2),Y(9002313.57,10525.2544,3),X)
    9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.2,0),U,5,99) S Y(9002313.57,10525.2544,1)=X S X=Y(9002313.57,10525.2544,1),Y(9002313.57,10525.2544,2)=$G(X) S X=20
  • ALGORITHM:  $E(DUR 2 RAW DATA,20,49)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Actual DUR text
10525.2999 DUR 2 RESERVE SPACE COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.2999,9.2) S Y(9002313.57,10525.2999,3)=$G(X) S X=53,X=$E(Y(9002313.57,10525.2999,2),Y(9002313.57,10525.2999,3),X)
    9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.2,0),U,5,99) S Y(9002313.57,10525.2999,1)=X S X=Y(9002313.57,10525.2999,1),Y(9002313.57,10525.2999,2)=$G(X) S X=50
  • ALGORITHM:  $E(DUR 2 RAW DATA,50,53)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reserved space for additional information.
10525.3 DUR 3 RAW DATA COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.3,9.5) S X=$S(Y(9002313.57,10525.3,4):Y(9002313.57,10525.3,5),Y(9002313.57,10525.3,6):X)
    9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.3,1)=X S X=Y(9002313.57,10525.3,1),Y(9002313.57,10525.3,2)=X S X=107,Y(9002313.57,10525.3,3)=X S X=108
    9.3 = X ^DD(9002313.57,10525.3,9.2) S X=$E(Y(9002313.57,10525.3,2),Y(9002313.57,10525.3,3),X)=" ",Y(9002313.57,10525.3,4)=X S X="",Y(9002313.57,10525.3,5)=X S X=1
    9.4 = X ^DD(9002313.57,10525.3,9.3) S Y(9002313.57,10525.3,6)=X,Y(9002313.57,10525.3,7)=X S X=Y(9002313.57,10525.3,1),Y(9002313.57,10525.3,8)=X S X=107
    9.5 = X ^DD(9002313.57,10525.3,9.4) S Y(9002313.57,10525.3,9)=X S X=159,X=$E(Y(9002313.57,10525.3,8),Y(9002313.57,10525.3,9),X)
  • ALGORITHM:  $S($E(DUR RESPONSE DATA,107,108)=" ":"",1:$E(DUR RESPONSE DATA,107,159))
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    DUR information returned by the payer that has not been formatted yet.
10525.3439 DUR 3 DRUG CONFLICT CODE COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.3439,9.2) S Y(9002313.57,10525.3439,3)=$G(X) S X=2,X=$E(Y(9002313.57,10525.3439,2),Y(9002313.57,10525.3439,3),X)
    9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.3,0),U,5,99) S Y(9002313.57,10525.3439,1)=X S X=Y(9002313.57,10525.3439,1),Y(9002313.57,10525.3439,2)=$G(X) S X=1
  • ALGORITHM:  $E(DUR 3 RAW DATA,1,2)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Ø=Not Specified 1=Your Pharmacy 2=Other Pharmacy in Same Chain 3=Other Pharmacy
10525.3528 DUR 3 SEVERITY INDEX CODE COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.3528,9.2) S X=$E(Y(9002313.57,10525.3528,2),X)
    9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.3,0),U,5,99) S Y(9002313.57,10525.3528,1)=X S X=Y(9002313.57,10525.3528,1),Y(9002313.57,10525.3528,2)=$G(X) S X=3
  • ALGORITHM:  $E(DUR 3 RAW DATA,3)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Blank=Not Specified 1=Major 2=Moderate 3=Minor
10525.3529 DUR 3 OTHER PHARMACY INDIC COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.3529,9.2) S X=$E(Y(9002313.57,10525.3529,2),X)
    9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.3,0),U,5,99) S Y(9002313.57,10525.3529,1)=X S X=Y(9002313.57,10525.3529,1),Y(9002313.57,10525.3529,2)=$G(X) S X=4
  • ALGORITHM:  $E(DUR 3 RAW DATA,4)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Ø=Not Specified 1=Your Pharmacy 2=Other Pharmacy in Same Chain 3=Other Pharmacy
10525.353 DUR 3 PREVIOUS DATE OF FILL COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.353,9.2) S Y(9002313.57,10525.353,3)=$G(X) S X=12,X=$E(Y(9002313.57,10525.353,2),Y(9002313.57,10525.353,3),X)
    9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.3,0),U,5,99) S Y(9002313.57,10525.353,1)=X S X=Y(9002313.57,10525.353,1),Y(9002313.57,10525.353,2)=$G(X) S X=5
  • ALGORITHM:  $E(DUR 3 RAW DATA,5,12)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Fill date of the previous fill that is causing the DUR conflict.
10525.3531 DUR 3 QTY OF PREVIOUS FILL COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.3531,9.2) S Y(9002313.57,10525.3531,3)=$G(X) S X=17,X=$E(Y(9002313.57,10525.3531,2),Y(9002313.57,10525.3531,3),X)
    9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.3,0),U,5,99) S Y(9002313.57,10525.3531,1)=X S X=Y(9002313.57,10525.3531,1),Y(9002313.57,10525.3531,2)=$G(X) S X=13
  • ALGORITHM:  $E(DUR 3 RAW DATA,13,17)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Quantity of the fill that is causing the conflict.
10525.3532 DUR 3 DATABASE INDICATOR COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.3532,9.2) S X=$E(Y(9002313.57,10525.3532,2),X)
    9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.3,0),U,5,99) S Y(9002313.57,10525.3532,1)=X S X=Y(9002313.57,10525.3532,1),Y(9002313.57,10525.3532,2)=$G(X) S X=18
  • ALGORITHM:  $E(DUR 3 RAW DATA,18)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Blank=Not Specified 1=First Databank 2=Medi-Span 3=Redbook 4=Processor Developed 5=Other
10525.3533 DUR 3 OTHER PRESCRIBER INDIC COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.3533,9.2) S X=$E(Y(9002313.57,10525.3533,2),X)
    9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.3,0),U,5,99) S Y(9002313.57,10525.3533,1)=X S X=Y(9002313.57,10525.3533,1),Y(9002313.57,10525.3533,2)=$G(X) S X=19
  • ALGORITHM:  $E(DUR 3 RAW DATA,19)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  Code that indicates the prescriber of the current fill relationship to the prescriber of the conflicting prescription.
    Ø=Not Specified 1=Same Prescriber 2=Other Prescriber
10525.3544 DUR 3 FREE TEXT COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.3544,9.2) S Y(9002313.57,10525.3544,3)=$G(X) S X=49,X=$E(Y(9002313.57,10525.3544,2),Y(9002313.57,10525.3544,3),X)
    9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.3,0),U,5,99) S Y(9002313.57,10525.3544,1)=X S X=Y(9002313.57,10525.3544,1),Y(9002313.57,10525.3544,2)=$G(X) S X=20
  • ALGORITHM:  $E(DUR 3 RAW DATA,20,49)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Actual DUR text
10525.3999 DUR 3 RESERVE SPACE COMPUTED

  • MUMPS CODE:  X ^DD(9002313.57,10525.3999,9.2) S Y(9002313.57,10525.3999,3)=$G(X) S X=53,X=$E(Y(9002313.57,10525.3999,2),Y(9002313.57,10525.3999,3),X)
    9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.3,0),U,5,99) S Y(9002313.57,10525.3999,1)=X S X=Y(9002313.57,10525.3999,1),Y(9002313.57,10525.3999,2)=$G(X) S X=50
  • ALGORITHM:  $E(DUR 3 RAW DATA,50,53)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Reserved space for additional information.
10526 ADDITIONAL MESSAGE INFORMATION COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(526)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(526)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Free text, additional information from the payer.
10528 CLINICAL SIGNIFICANCE CODE COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(528)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(528)
  • DESCRIPTION:  
    Blank=Not Specified 1=Major 2=Moderate 3=Minor
10529 OTHER PHARMACY INDICATOR COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(529)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(529)
  • DESCRIPTION:  
    Ø=Not Specified 1=Your Pharmacy 2=Other Pharmacy in Same Chain 3=Other Pharmacy
10530 PREVIOUS DATE OF FILL COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(530)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(530)
  • DESCRIPTION:  
    Fill date of the prescription causing the DUR conflict.
10531 QUANTITY OF PREVIOUS FILL COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(531)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(531)
  • DESCRIPTION:  
    Quantity of the prescription causing the conflict.
10532 DATABASE INDICATOR COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(532)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(532)
  • DESCRIPTION:  
    Blank=Not Specified 1=First Databank 2=Medi-Span 3=Redbook 4=Processor Developed 5=Other
10533 OTHER PRESCRIBER INDICATOR COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(533)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(533)
  • DESCRIPTION:  
    Ø=Not Specified 1=Same Prescriber 2=Other Prescriber
10535 DUR OVERFLOW COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(535)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(535)
  • LAST EDITED:  FEB 12, 2008
  • DESCRIPTION:  
    Additional DUR information that did not fit in the other fields provided.
10544 FREE TEXT COMPUTED

  • MUMPS CODE:  S X=$$FIELD^BPSOS57(544)
  • ALGORITHM:  S X=$$FIELD^BPSOS57(544)
  • DESCRIPTION:  
    Even more room for additional free text DUR information.
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