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Routine: IBNCPDP1

Package: Integrated Billing

Routine: IBNCPDP1


Information

IBNCPDP1 ;OAK/ELZ - IB BILLING DETERMINATION PROCESSING FOR NEW RX REQUESTS ;5/22/08

Source Information

Source file <IBNCPDP1.m>

Call Graph

Call Graph

Call Graph Total: 24

Package Total Call Graph
Integrated Billing 18 $$NAME^IBCEFG1  STCHK^IBCNRU1  ($$PLCOV,$$PTCOV)^IBCNSU3  $$RATECHG^IBCRCC  $$BICOST^IBCRCI  $$ITPTR^IBCRU2  $$EVNTITM^IBCRU3  $$BILLABLE^IBNCPDP  
LOG^IBNCPDP2  ($$PHONE,START)^IBNCPDP6  ($$ACDUTY,$$RT,CT,RXINS)^IBNCPDPU  $$SENS^IBNCPDR  ($$MACHK,$$ROI,ROICLN)^IBNCPDR4  ($$ERMSG,$$NDC,$$PAPERBIL)^IBNCPNB  $$RXSTATUS^IBNCPRR  GETINDIC^IBNCPUT2  
$$COSTTYP^IBNCPUT3  DATA^IBRXUTL  
VA FileMan 3 ^DIE  $$EXTERNAL^DILFD  ($$GET1,GETS)^DIQ  
E Claims Management Engine 1 ADDCOMM^BPSBUTL  
Outpatient Pharmacy 1 $$MWC^PSOBPSU2  
Scheduling 1 CL^SDCO21  

Caller Graph

Legends:

Legend of Colors

Package Component Superscript legend

action A extended action Ea event driver Ed subscriber Su protocol O limited protocol LP run routine RR broker B edit E server Se print P screenman SM inquire I

Caller Graph

Caller Graph Total: 2

Package Total Caller Graph
Integrated Billing 2 IBNCPDP  IBNCPEV1  

Entry Points

Name Comments DBIA/ICR reference
RX(DFN,IBD) ; pharmacy package call, passing in IBD by ref
; this is called by PSO for all prescriptions issued, return is
; a response to bill ECME or not with array for billing data elements
GETINS ; -- examine the insurance data for a patient
RATEPRIC ; determine rates/prices to use
RXQ ; final processing
; set the 3rd piece of IBRES (default Vet)
CT ; files in claims tracking
SETINSUR(IBADT,IBRT,IBELIG,IBINS,IBD,IBRES) ; build insurance data array
; Input variables:
; IBADT - date of service/identify insurance as of this date
; IBRT - rate type variable - [1] rate type ien, [2] type (A/C/T), [3] eligibility (V/T/C)
; IBELIG - eligibility request flag (1/0)
; IBINS - insurance array as returned by RXINS^IBNCPDPU
; IBD - input/output - array entries passed in and certain array entries returned
; Output variable:
; IBRES - only returned if insurance errors
SETINX ;
RXPCT(IBD,BWHERE) ; Penny drug cost calculation
; Input-IBD array, BWHERE
; Output-return quotient of drug true value with 4 decimal places, or 0
RXPCTQ ;
EXEMPT ; exemption reasons
; variable from SD call ^ variable from PSO ^ reason not billable

External References

Name Field # of Occurrence
ADDCOMM^BPSBUTL RX+72
^DIE RX+128, RX+133, RX+138, RX+143
$$EXTERNAL^DILFD SETINSUR+48
$$GET1^DIQ SETINSUR+76, SETINSUR+81
GETS^DIQ RXPCT+8, RXPCT+18
$$NAME^IBCEFG1 SETINSUR+45
STCHK^IBCNRU1 SETINSUR+39
$$PLCOV^IBCNSU3 SETINSUR+27
$$PTCOV^IBCNSU3 RX+75
$$RATECHG^IBCRCC RATEPRIC+25
$$BICOST^IBCRCI RATEPRIC+15
$$ITPTR^IBCRU2 RATEPRIC+12
$$EVNTITM^IBCRU3 RATEPRIC+3
$$BILLABLE^IBNCPDP RX+95
LOG^IBNCPDP2 RXQ+7
$$PHONE^IBNCPDP6 SETINSUR+75
START^IBNCPDP6 RXQ+6
$$ACDUTY^IBNCPDPU RX+79
$$RT^IBNCPDPU RX+33
CT^IBNCPDPU CT+3
RXINS^IBNCPDPU RX+30
$$SENS^IBNCPDR RX+99
$$MACHK^IBNCPDR4 RX+102
$$ROI^IBNCPDR4 RX+103
ROICLN^IBNCPDR4 RX+111
$$ERMSG^IBNCPNB SETINSUR+40
$$NDC^IBNCPNB RATEPRIC+12
$$PAPERBIL^IBNCPNB RX+68
$$RXSTATUS^IBNCPRR RX+125
GETINDIC^IBNCPUT2 RX+81
$$COSTTYP^IBNCPUT3 RX+38
DATA^IBRXUTL RXPCT+14
$$MWC^PSOBPSU2 RXPCT+24
CL^SDCO21 RX+85

FileMan Files Accessed Via FileMan Db Call

FileNo Call Tags
2.312 EXTERNAL^DILFD
^IBT(356 - [#356] Classic Fileman Calls
^IBCNR(366.03 - [#366.03] GET1^DIQ
^PSDRUG - [#50] GETS^DIQ
50.1 GETS^DIQ

Global Variables Directly Accessed

Name Line Occurrences  (* Changed,  ! Killed)
^BPSF(9002313.92 - [#9002313.92] SETINSUR+54, SETINSUR+61, SETINSUR+62, SETINSUR+65
^DGCR(399.3 - [#399.3] RATEPRIC+19
^DIC(36 - [#36] SETINSUR+44, SETINSUR+60
^IBA(355.3 - [#355.3] SETINSUR+36, SETINSUR+44, SETINSUR+78
^IBE(350.9 - [#350.9] RX+54
^IBE(355.1 - [#355.1] SETINSUR+33
^IBE(356.8 - [#356.8] RX+121
^IBT(356 - [#356] RX+58, RX+120
^TMP($J RXPCT+15, RXPCT+16, RXPCT+29!

Label References

Name Line Occurrences
$$RXPCT RATEPRIC+19
CT RX+75, RX+92, RX+95, RX+114, RATEPRIC+2, RATEPRIC+4, RATEPRIC+7, RATEPRIC+13, RATEPRIC+30, RATEPRIC+53
GETINS RX+65
RXPCTQ RXPCT+6
RXQ RX+24, RX+43, RX+49, RX+50, RX+51, RX+68, RX+75, RX+92, RX+95, RX+114
, RX+149, GETINS+3, RATEPRIC+2, RATEPRIC+4, RATEPRIC+7, RATEPRIC+13, RATEPRIC+30
SETINSUR RX+45, RX+61
SETINX SETINSUR+104

Local Variables

Legend:

>> Not killed explicitly
* Changed
! Killed
~ Newed

Name Field # of Occurrence
BWHERE RATEPRIC+19, RXPCT~, RXPCT+5
DA RX+126~, RX+128*, RX+132~, RX+133*, RX+137~, RX+138*, RX+142~, RX+143*
DFN RX~, RX+24, RX+30, RX+33, RX+75, RX+79, RX+85, RX+103, RX+125, CT+3
DIE RX+126~, RX+128*, RX+132~, RX+133*, RX+137~, RX+138*, RX+142~, RX+143*
DR RX+126~, RX+128*, RX+132~, RX+133*, RX+137~, RX+138*, RX+142~, RX+143*
DT RX+27
IBACDUTY RX+16~, RX+79*, RX+84
IBADMINFEE RX+16~, RATEPRIC+28*, RATEPRIC+41, RATEPRIC+43, RATEPRIC+45
IBADT RX+16~, RX+27*, RX+30, RX+33, RX+38, RX+45, RX+56, RX+61, RX+75, RX+85
, RX+102, RX+103, RATEPRIC+3, RATEPRIC+15, RATEPRIC+25, CT+3, SETINSUR~, SETINSUR+27
IBANY RX+16~, RX+75
IBARR RX+16~, RX+85, RX+86
IBARR( RX+86
IBBI RX+16~, RATEPRIC+3*, RATEPRIC+4, RATEPRIC+11, RATEPRIC+12
IBCHG RX+16~, RATEPRIC+25*, RATEPRIC+26
IBCHNM SETINSUR+23~, SETINSUR+45*, SETINSUR+58, SETINSUR+59
IBCNT SETINSUR+17~, SETINSUR+87*, SETINSUR+91, SETINSUR+98
IBD RX~, RX+45, RX+61, RX+81, RX+95, RX+99, RATEPRIC+19, SETINSUR~, RXPCT~
IBD( RX+87, RX+88
IBD("COST" RATEPRIC+19*, RATEPRIC+25, RATEPRIC+34
IBD("DOS" RX+27
IBD("DRUG" RX+95, RX+99, RX+103, RXPCT+4
IBD("FILL NUM BER" , RX+50, RXPCT+4
IBD("IEN" RX+49, RX+81, RXPCT+4
IBD("INS" RX+14!, RX+99, RX+103, RATEPRIC+48*, SETINSUR+15!, SETINSUR+34, SETINSUR+71*, SETINSUR+82*, SETINSUR+92, SETINSUR+93
, SETINSUR+104, SETINSUR+105
IBD("NDC" RATEPRIC+7, RATEPRIC+12, RXPCT+4
IBD("NO ECME INSURANCE" , RX+62, RX+70*, RX+75*, GETINS+3, SETINSUR+15!, SETINSUR+104*, SETINSUR+105*
IBD("PLAN" RX+36, SETINSUR+28, SETINSUR+34
IBD("QTY" RX+51*, RATEPRIC+15, RATEPRIC+25, RATEPRIC+34
IBD("RELEASE DATE" , RX+131, RATEPRIC+51
IBD("RTYPE" RX+36, RX+37, RX+38
IBD("RX ACTIO N" , RX+22
IBD("RXCOB" RX+65, CT+1, SETINSUR+101
IBD("SC/EI NO ANSW" , RX+14!, RX+90*
IBD("SC/EI OV R" , RX+84
IBDAT SETINSUR+23~, SETINSUR+50*, SETINSUR+51*, SETINSUR+52*, SETINSUR+53*, SETINSUR+54*, SETINSUR+55*, SETINSUR+56*, SETINSUR+57*, SETINSUR+58*
, SETINSUR+59*, SETINSUR+60*, SETINSUR+61*, SETINSUR+62*, SETINSUR+63*, SETINSUR+64*, SETINSUR+65*, SETINSUR+66*, SETINSUR+67*, SETINSUR+68*
, SETINSUR+69*, SETINSUR+70*, SETINSUR+71, SETINSUR+73*, SETINSUR+74*, SETINSUR+75*, SETINSUR+76*, SETINSUR+77*, SETINSUR+78*, SETINSUR+79*
, SETINSUR+80*, SETINSUR+81*, SETINSUR+82
IBDEA RX+16~
IBDIEN RXPCT+3~, RXPCT+4*, RXPCT+24
IBDISPFEE RX+16~, RATEPRIC+27*, RATEPRIC+39, RATEPRIC+41
IBDQUO RXPCT+3~, RXPCT+11*, RXPCT+26
IBDRFL RXPCT+3~, RXPCT+4*, RXPCT+24
IBDRUG RXPCT+3~
IBDRX RXPCT+3~, RXPCT+4*, RXPCT+6, RXPCT+8, RXPCT+9, RXPCT+10, RXPCT+14, RXPCT+15, RXPCT+16, RXPCT+17
IBELIG RX+17~, RX+22*, RX+43, RX+45, RX+61, RXQ+5, SETINSUR~, SETINSUR+39
IBERMSG SETINSUR+17~
IBERMSG( SETINSUR+34*, SETINSUR+37*, SETINSUR+40*, SETINSUR+43*, SETINSUR+104
IBERMSG(0 SETINSUR+93
IBFEE RX+17~, RATEPRIC+25, RATEPRIC+27, RATEPRIC+28
IBFIL RX+17~, RX+50*, RX+58, RX+72, RX+89, RX+111, RXQ+6, CT+3
IBFRM RXPCT+3~, RXPCT+5*, RXPCT+25
IBINGCOST RX+17~, RATEPRIC+34*, RATEPRIC+35*, RATEPRIC+41, RATEPRIC+44
IBINS RX+17~, RX+30, RX+33, RX+45, RX+61, SETINSUR~
IBINS( SETINSUR+24, SETINSUR+33, SETINSUR+46, SETINSUR+55, SETINSUR+70, SETINSUR+74
IBINS("S" SETINSUR+21, SETINSUR+22
IBINSN SETINSUR+23~, SETINSUR+44*, SETINSUR+64
IBINSXRES RX+17~, RX+62*, GETINS+3
IBIT RX+17~, RATEPRIC+12*, RATEPRIC+13, RATEPRIC+15
IBNBR RX+119~, RX+120*, RX+121
IBNBRT RX+119~, RX+121*, RX+125, RX+131, RX+136, RX+141, RX+146
IBNDC RXPCT+3~, RXPCT+4*, RXPCT+16
IBNEEDS RX+17~, RX+83*, RX+89*, RX+91
IBPDISP RXPCT+3~, RXPCT+10*, RXPCT+11, RXPCT+20*, RXPCT+21
IBPIEN SETINSUR+23~, SETINSUR+36*, SETINSUR+37, SETINSUR+39, SETINSUR+76, SETINSUR+81
IBPL SETINSUR+23~, SETINSUR+25*, SETINSUR+26, SETINSUR+27, SETINSUR+28, SETINSUR+36, SETINSUR+44, SETINSUR+51, SETINSUR+78
IBPLNTYP SETINSUR+23~, SETINSUR+33*, SETINSUR+34, SETINSUR+77
IBPORD RXPCT+3~, RXPCT+9*, RXPCT+11, RXPCT+19*, RXPCT+21
IBPRDATA RX+17~, RATEPRIC+38*, RATEPRIC+39*, RATEPRIC+40*, RATEPRIC+41*, RATEPRIC+42*, RATEPRIC+43*, RATEPRIC+44*, RATEPRIC+45*, RATEPRIC+48
IBPRICE RX+18~, RATEPRIC+15*, RATEPRIC+26*, RATEPRIC+30, RATEPRIC+35*, RATEPRIC+41, RATEPRIC+42, RATEPRIC+45
IBPSUF RXPCT+3~, RXPCT+17*, RXPCT+18, RXPCT+19, RXPCT+20
IBPTYP RX+18~, RX+33, RX+39
IBQUO RXPCT+3~, RXPCT+5*, RXPCT+11*, RXPCT+21*, RXPCT+26*, RXPCT+28*, RXPCTQ+1
IBREL SETINSUR+23~, SETINSUR+46*, SETINSUR+48*, SETINSUR+57
IBRES RX+18~, RX+24*, RX+26*, RX+44*, RX+45, RX+49*, RX+50*, RX+51*, RX+61, RX+62
, RX+69*, RX+75*, RX+92*, RX+95*, RX+107*, RX+149*, GETINS+3*, RATEPRIC+2*, RATEPRIC+4*, RATEPRIC+7*
RATEPRIC+13*, RATEPRIC+30*, RATEPRIC+50*, RATEPRIC+51, RXQ+2*, RXQ+6, RXQ+7, RXQ+10, SETINSUR~, SETINSUR+104*
, SETINSUR+105*
IBRMARK RX+18~, RX+75*, RX+88*, RX+91*, RX+92, RX+95, RX+106*, RX+112!, RX+114, RX+146*
, RX+149, RATEPRIC+50, RATEPRIC+51*, CT+3
IBROIMAIBRS RX+18~
>> IBRS RATEPRIC+3, RATEPRIC+11*, RATEPRIC+25
>> IBRS( RATEPRIC+11
IBRT RX+18~, RX+33*, RX+37*, RX+38*, RX+39*, RX+45, RX+61, RX+79, RX+95, RATEPRIC+2
RATEPRIC+3, RATEPRIC+12, RATEPRIC+13, RATEPRIC+15, RATEPRIC+19, RATEPRIC+25, RATEPRIC+26, RATEPRIC+40, RATEPRIC+41, RXQ+2
RXQ+6, SETINSUR~, SETINSUR+34
IBRXN RX+18~, RX+49*, RX+58, RX+72, RX+89, RX+111, RX+125, RXQ+6, CT+3
IBRXPOL SETINSUR+17~
IBRXPOL( SETINSUR+31*, SETINSUR+87
IBSAVE RX+18~
>> IBSCRES( RX+89
IBSYN RXPCT+3~, RXPCT+15*, RXPCT+16, RXPCT+17
IBT RX+18~, RX+86*, RX+87, RX+88, RX+90, SETINSUR+17~, SETINSUR+22*, SETINSUR+24, SETINSUR+31, SETINSUR+33
, SETINSUR+46, SETINSUR+55, SETINSUR+70, SETINSUR+74, SETINSUR+80
IBTRKR RX+19~, RX+54*, RX+56*, RX+75, CT+3
IBTRKRN RX+19~, RX+58*, RX+68, RX+111, RX+118, RX+120, RX+128, RX+133, RX+138, RX+143
IBTRN RX+19~
IBUNIT RXPCT+3~
IBUNIT( RXPCT+19, RXPCT+20
IBUNIT(50 RXPCT+9, RXPCT+10
IBX RX+19~, RX+86*, RATEPRIC+48*, SETINSUR+17~, SETINSUR+21*, SETINSUR+22, SETINSUR+31, SETINSUR+34, SETINSUR+37, SETINSUR+40
, SETINSUR+43, SETINSUR+71, SETINSUR+82, SETINSUR+87*, SETINSUR+92*, SETINSUR+93*, SETINSUR+98*, SETINSUR+101*, SETINSUR+104, SETINSUR+105
IBY SETINSUR+23~, SETINSUR+39!
IBY(1 SETINSUR+40
IBY(2 SETINSUR+52
IBY(3 SETINSUR+53
IBY(4 SETINSUR+63
IBY(5 SETINSUR+54, SETINSUR+61, SETINSUR+62, SETINSUR+65, SETINSUR+66, SETINSUR+67, SETINSUR+68, SETINSUR+69
IBY(6 SETINSUR+40
IBZ SETINSUR+23~, SETINSUR+24*, SETINSUR+25, SETINSUR+45, SETINSUR+48, SETINSUR+56, SETINSUR+60, SETINSUR+75, SETINSUR+79
U RX+37, RX+38, RX+39, RX+56, RX+75, RX+79, RX+87, RX+88, RX+90, RX+95
, RX+103, RX+120, RX+121, RATEPRIC+12, RATEPRIC+13, RATEPRIC+15, RATEPRIC+19, RATEPRIC+25, RATEPRIC+26, RATEPRIC+27
RATEPRIC+28, RATEPRIC+39, RATEPRIC+40, RATEPRIC+41, RATEPRIC+42, RATEPRIC+43, RATEPRIC+44, RATEPRIC+45, RXQ+2, RXQ+6
, SETINSUR+25, SETINSUR+33, SETINSUR+34, SETINSUR+44, SETINSUR+45, SETINSUR+46, SETINSUR+48, SETINSUR+51, SETINSUR+52, SETINSUR+53
, SETINSUR+54, SETINSUR+55, SETINSUR+56, SETINSUR+57, SETINSUR+58, SETINSUR+59, SETINSUR+60, SETINSUR+61, SETINSUR+62, SETINSUR+63
, SETINSUR+64, SETINSUR+65, SETINSUR+66, SETINSUR+67, SETINSUR+68, SETINSUR+69, SETINSUR+70, SETINSUR+74, SETINSUR+75, SETINSUR+76
, SETINSUR+77, SETINSUR+78, SETINSUR+79, SETINSUR+80, SETINSUR+81

Marked Items

Name Field # of Occurrence
$T(EXEMPT+IBX RX+86
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