| FileMan FileNo | FileMan Filename | Package |
|---|---|---|
| 366.03 | PLAN | Integrated Billing |
| Package | Total | FileMan Files |
|---|---|---|
| Integrated Billing | 1 | GROUP INSURANCE PLAN(#355.3)[6.01] |
| Package | Total | FileMan Files |
|---|---|---|
| Integrated Billing | 3 | NCPDP PROCESSOR(#366.01)[10.04] PHARMACY BENEFITS MANAGER (PBM)(#366.02)[10.01] PLAN APPLICATION(#366.13)[#366.033(.01)] |
| E Claims Management Engine | 1 | BPS NCPDP FORMATS(#9002313.92)[10.07, 10.08, 10.09, 10.11, 10.12, 10.13, 10.14, 10.15] |
| Kernel | 1 | NEW PERSON(#200)[#366.033(.04)] |
| Field # | Name | Loc | Type | Details |
|---|---|---|---|---|
| .01 | ID | 0;1 | FREE TEXT | ************************REQUIRED FIELD************************
|
| .02 | NAME | 0;2 | FREE TEXT | ************************REQUIRED FIELD************************
|
| .04 | NAME - SHORT | 0;4 | FREE TEXT |
|
| .05 | TYPE | 0;5 | SET |
|
| .06 | REGION | 0;6 | FREE TEXT |
|
| .07 | DATE/TIME CREATED | 0;7 | DATE | ************************REQUIRED FIELD************************
|
| 1.01 | PRIMARY CONTACT NAME | 1;1 | FREE TEXT |
|
| 1.02 | PRIMARY CONTACT PREFIX | 1;2 | FREE TEXT |
|
| 1.03 | PRIMARY CONTACT DEGREE | 1;3 | FREE TEXT |
|
| 1.04 | ALTERNATE CONTACT NAME | 1;4 | FREE TEXT |
|
| 1.05 | ALTERNATE CONTACT PREFIX | 1;5 | FREE TEXT |
|
| 1.06 | ALTERNATE CONTACT DEGREE | 1;6 | FREE TEXT |
|
| 2 | CONTACT MEANS | 2;0 | Multiple #366.032 | 366.032
|
| 3 | APPLICATION | 3;0 | POINTER Multiple #366.033 | 366.033
|
| 10.01 | PHARMACY BENEFITS MANAGER NAME | 10;1 | POINTER TO PHARMACY BENEFITS MANAGER (PBM) FILE (#366.02) | PHARMACY BENEFITS MANAGER (PBM)(#366.02)
|
| 10.02 | BANKING IDENTIFICATION NUMBER | 10;2 | FREE TEXT |
|
| 10.03 | PROCESSOR CONTROL NUMBER (PCN) | 10;3 | FREE TEXT |
|
| 10.04 | NCPDP PROCESSOR NAME | 10;4 | POINTER TO NCPDP PROCESSOR FILE (#366.01) | NCPDP PROCESSOR(#366.01)
|
| 10.05 | ENABLED? | 10;5 | SET |
|
| 10.06 | SOFTWARE VENDOR ID | 10;6 | FREE TEXT |
|
| 10.07 | BILLING PAYER SHEET NAME | 10;7 | POINTER TO BPS NCPDP FORMATS FILE (#9002313.92) | BPS NCPDP FORMATS(#9002313.92)
|
| 10.08 | REVERSAL PAYER SHEET NAME | 10;8 | POINTER TO BPS NCPDP FORMATS FILE (#9002313.92) | BPS NCPDP FORMATS(#9002313.92)
|
| 10.09 | REBILL PAYER SHEET NAME | 10;9 | POINTER TO BPS NCPDP FORMATS FILE (#9002313.92) | BPS NCPDP FORMATS(#9002313.92)
|
| 10.1 | MAXIMUM NCPDP TRANSACTIONS | 10;10 | NUMBER |
|
| 10.11 | TEST BILLING PAYER SHEET | 10;11 | POINTER TO BPS NCPDP FORMATS FILE (#9002313.92) | BPS NCPDP FORMATS(#9002313.92)
|
| 10.12 | TEST REVERSAL PAYER SHEET NAME | 10;12 | POINTER TO BPS NCPDP FORMATS FILE (#9002313.92) | BPS NCPDP FORMATS(#9002313.92)
|
| 10.13 | TEST REBILL PAYER SHEET NAME | 10;13 | POINTER TO BPS NCPDP FORMATS FILE (#9002313.92) | BPS NCPDP FORMATS(#9002313.92)
|
| 10.14 | TEST ELIGIBILITY SHEET NAME | 10;14 | POINTER TO BPS NCPDP FORMATS FILE (#9002313.92) | BPS NCPDP FORMATS(#9002313.92)
|
| 10.15 | ELIGIBILITY PAYER SHEET NAME | 10;15 | POINTER TO BPS NCPDP FORMATS FILE (#9002313.92) | BPS NCPDP FORMATS(#9002313.92)
|
| 11.01 | RX PRIMARY CONTACT NAME | 11;1 | FREE TEXT |
|
| 11.02 | RX PRIMARY CONTACT PREFIX | 11;2 | FREE TEXT |
|
| 11.03 | RX PRIMARY CONTACT DEGREE | 11;3 | FREE TEXT |
|
| 11.04 | RX ALTERNATE CONTACT NAME | 11;4 | FREE TEXT |
|
| 11.05 | RX ALTERNATE CONTACT PREFIX | 11;5 | FREE TEXT |
|
| 11.06 | RX ALTERNATE CONTACT DEGREE | 11;6 | FREE TEXT |
|
| 12 | RX CONTACT MEANS | 12;0 | Multiple #366.0312 | 366.0312
|
| Name | Field # of Occurrence |
|---|---|
| ^%DT | .07+1 |
| Name | Field # of Occurrence |
|---|---|
| ^(0 | ID.02+1 |
| ^(10 | ID10.02+1, ID10.03+1 |
| >> | Not killed explicitly |
| * | Changed |
| ! | Killed |
| ~ | Newed |
| Name | Field # of Occurrence |
|---|---|
| >> %DT | .07+1* |
| >> DA | IXFSL+1, IXFKL+1, .01(XREF 1S), .01(XREF 1K), .02(XREF 1S), .02(XREF 1K), 10.02(XREF 1S), 10.02(XREF 1K), 10.03(XREF 1S), 10.03(XREF 1K) |
| U | ID.02+1, ID10.02+1, ID10.03+1 |
| X | .01+1!, .01(XREF 1S), .01(XREF 1K), .02+1!, .02(XREF 1S), .02(XREF 1K), .04+1!, .06+1!, .07+1*!, 1.01+1! , 1.02+1!, 1.03+1!, 1.04+1!, 1.05+1!, 1.06+1!, 10.02+1!, 10.02(XREF 1S), 10.02(XREF 1K), 10.03+1!, 10.03(XREF 1S) , 10.03(XREF 1K), 10.06+1!, 10.1+1!, 11.01+1!, 11.02+1!, 11.03+1!, 11.04+1!, 11.05+1!, 11.06+1! |
| X(1 | IXFSL+1, IXFKL+1 |
| X(2 | IXFSL+1, IXFKL+1 |
| >> Y | .07+1 |