Parent File | Name | Number | Package |
---|---|---|---|
IB NCPDP EVENT LOG(#366.14) | EVENT | 366.141 | Integrated Billing |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | EVENT TYPE | 0;1 | SET | ************************REQUIRED FIELD************************
|
.02 | NON-BILLABLE REASON | 0;2 | POINTER TO IB NCPDP NON-BILLABLE REASONS FILE (#366.17) | IB NCPDP NON-BILLABLE REASONS(#366.17)
|
.03 | PATIENT | 0;3 | POINTER TO PATIENT FILE (#2) | PATIENT(#2)
|
.04 | JOB | 0;4 | NUMBER |
|
.05 | TIME | 0;5 | DATE |
|
.06 | ePHARMACY USER | 0;6 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
.07 | RESULT | 0;7 | NUMBER |
|
.08 | RESULT MESSAGE | 0;8 | FREE TEXT |
|
.09 | E-PHARMACY DIVISION | 0;9 | POINTER TO BPS PHARMACIES FILE (#9002313.56) | BPS PHARMACIES(#9002313.56)
|
.11 | AUTH # | 1;1 | FREE TEXT |
|
.12 | BCID | 1;2 | FREE TEXT |
|
.13 | CLAIMID | 1;3 | FREE TEXT |
|
.14 | PATIENT IN IBD | 1;4 | POINTER TO PATIENT FILE (#2) | PATIENT(#2)
|
.15 | MEDICAL CENTER DIVISION | 1;5 | POINTER TO MEDICAL CENTER DIVISION FILE (#40.8) | MEDICAL CENTER DIVISION(#40.8)
|
.16 | RESPONSE | 1;6 | FREE TEXT |
|
.17 | REVERSAL REASON | 1;7 | FREE TEXT |
|
.18 | RTS-DEL | 1;8 | NUMBER |
|
.19 | STATUS | 1;9 | FREE TEXT |
|
.201 | PRESCRIPTION | 2;1 | POINTER TO PRESCRIPTION FILE (#52) | PRESCRIPTION(#52)
|
.202 | RX NO | 2;2 | FREE TEXT |
|
.203 | FILL NUMBER | 2;3 | NUMBER |
|
.204 | DRUG | 2;4 | FREE TEXT |
|
.205 | NDC | 2;5 | FREE TEXT |
|
.206 | DATE OF SERVICE | 2;6 | DATE |
|
.207 | RELEASE DATE | 2;7 | DATE |
|
.208 | QTY | 2;8 | NUMBER |
|
.209 | DAYS SUPPLY | 2;9 | NUMBER |
|
.21 | DEA | 2;10 | FREE TEXT |
|
.211 | FILLED BY | 2;11 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
.212 | RX # | 2;12 | POINTER TO PRESCRIPTION FILE (#52) | PRESCRIPTION(#52)
|
.213 | BILLING UNITS | 2;13 | FREE TEXT |
|
.214 | NCPDP QTY | 2;14 | NUMBER |
|
.215 | NCPDP UNITS | 2;15 | FREE TEXT |
|
.301 | BILL | 3;1 | POINTER TO BILL/CLAIMS FILE (#399) | BILL/CLAIMS(#399)
|
.302 | BILLED | 3;2 | NUMBER |
|
.303 | PLAN | 3;3 | POINTER TO GROUP INSURANCE PLAN FILE (#355.3) | GROUP INSURANCE PLAN(#355.3)
|
.304 | COST | 3;4 | NUMBER |
|
.305 | PAID BY INSURANCE | 3;5 | NUMBER |
|
.306 | CLOSE/REOPEN COMMENT | 3;6 | FREE TEXT |
|
.307 | CLOSE REASON | 3;7 | POINTER TO CLAIMS TRACKING NON-BILLABLE REASONS FILE (#356.8) | CLAIMS TRACKING NON-BILLABLE REASONS(#356.8)
|
.308 | DROP TO PAPER | 3;8 | NUMBER |
|
.309 | RELEASE COPAY | 3;9 | NUMBER |
|
.31 | ECME USER IN IBD | 3;10 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
.311 | COPAY AMOUNT | 3;11 | NUMBER |
|
.312 | INGREDIENT COST PAID | 3;12 | NUMBER |
|
.313 | DISPENSING FEE PAID | 3;13 | NUMBER |
|
.314 | PATIENT RESPONSIBILITY (INS) | 3;14 | NUMBER |
|
.401 | AO | 4;1 | SET |
|
.402 | CV | 4;2 | SET |
|
.403 | SWA | 4;3 | SET |
|
.404 | IR | 4;4 | SET |
|
.405 | MST | 4;5 | SET |
|
.406 | HNC | 4;6 | SET |
|
.407 | SC | 4;7 | SET |
|
.408 | SHAD | 4;8 | SET |
|
.409 | ADO | 4;9 | SET |
|
2 | INSURANCE | 5;0 | Multiple #366.1412 | 366.1412
|
7.01 | RX COB | 7;1 | SET |
|
7.02 | PRIMARY BILL | 7;2 | POINTER TO BILL/CLAIMS FILE (#399) | BILL/CLAIMS(#399)
|
7.03 | PRIOR PAYMENT | 7;3 | NUMBER |
|
7.04 | RATE TYPE SELECTED BY USER | 7;4 | POINTER TO RATE TYPE FILE (#399.3) | RATE TYPE(#399.3)
|
7.05 | ELIGIBILITY | 7;5 | SET |
|
7.06 | DRUG ECME BILLABLE | 7;6 | SET |
|
7.07 | DRUG ECME BILLABLE TRICARE | 7;7 | SET |
|
7.08 | DRUG ECME BILLABLE CHAMPVA | 7;8 | SET |
|
7.09 | DRUG SENSITIVE DIAGNOSIS | 7;9 | SET |
|