Parent File | Name | Number | Package |
---|---|---|---|
PRESCRIPTION(#52) | REFILL | 52.1 | Outpatient Pharmacy |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | REFILL DATE | 0;1 | DATE |
|
1 | QTY | 0;4 | NUMBER | ************************REQUIRED FIELD************************
|
1.1 | DAYS SUPPLY | 0;10 | NUMBER | ************************REQUIRED FIELD************************
|
1.2 | CURRENT UNIT PRICE OF DRUG | 0;11 | NUMBER |
|
2 | MAIL/WINDOW/PARK | 0;2 | SET | ************************REQUIRED FIELD************************
|
3 | REMARKS | 0;3 | FREE TEXT |
|
4 | PHARMACIST NAME | 0;5 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
5 | LOT # | 0;6 | FREE TEXT |
|
6 | CLERK CODE | 0;7 | POINTER TO NEW PERSON FILE (#200) | ************************REQUIRED FIELD************************ NEW PERSON(#200)
|
7 | LOGIN DATE | 0;8 | DATE |
|
8 | DIVISION | 0;9 | POINTER TO OUTPATIENT SITE FILE (#59) | ************************REQUIRED FIELD************************ OUTPATIENT SITE(#59)
|
9 | IB NUMBER | IB;1 | POINTER TO INTEGRATED BILLING ACTION FILE (#350) | INTEGRATED BILLING ACTION(#350)
|
9.1 | COPAY EXCEEDING CAP | IB;2 | POINTER TO IB COPAY TRANSACTIONS FILE (#354.71) | IB COPAY TRANSACTIONS(#354.71)
|
10.1 | DISPENSED DATE | 0;19 | DATE | ************************REQUIRED FIELD************************
|
11 | NDC | 1;3 | FREE TEXT |
|
12 | MANUFACTURER | 0;14 | FREE TEXT |
|
13 | DRUG EXPIRATION DATE | 0;15 | DATE |
|
14 | RETURNED TO STOCK | 0;16 | DATE |
|
15 | PROVIDER | 0;17 | POINTER TO NEW PERSON FILE (#200) | ************************REQUIRED FIELD************************ NEW PERSON(#200)
|
16 | GENERIC PROVIDER | 1;1 | FREE TEXT |
|
17 | RELEASED DATE/TIME | 0;18 | DATE |
|
18 | BINGO WAIT TIME | 1;2 | NUMBER |
|
19 | FILLING PERSON | 1;4 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
20 | CHECKING PHARMACIST | 1;5 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
21 | PFSS ACCOUNT REFERENCE | PFS;1 | POINTER TO PFSS ACCOUNT FILE (#375) | PFSS ACCOUNT(#375)
|
22 | PFSS CHARGE ID | PFS;2 | NUMBER |
|
23 | ADMINISTERED IN CLINIC | 0;20 | SET |
|
24 | ACTIVE DUTY OVERRIDE | 1;6 | SET |
|
81 | DAW CODE | EPH;1 | FREE TEXT |
|
82 | RE-TRANSMIT FLAG | EPH;2 | SET |
|
83 | DATE NDC VALIDATED | EPH;3 | DATE |
|
84 | NDC VALIDATED BY | EPH;4 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
85 | BILLING ELIGIBILITY INDICATOR | EPH;5 | SET |
|
86 | EPHARMACY SUSPENSE HOLD DATE | EPH;6 | DATE |
|
91 | REMOTE FILL SITE | RF;1 | FREE TEXT |
|
92 | REMOTE PHARMACIST | RF;2 | FREE TEXT |
|
93 | REMOTE PHARMACIST PHONE | RF;3 | FREE TEXT |
|
94 | REFILL SOURCE | RF1;1 | FREE TEXT |
|
95 | PERSON REQUESTING REFILL | RF1;2 | FREE TEXT |
|
96 | REMOTE FILLING PERSON | RF;6 | FREE TEXT |
|
97 | REMOTE CHECKING PHARMACIST | RF;5 | FREE TEXT |
|
98 | BYPASS 3/4 DAY SUPPLY LOGIC | 1;7 | SET (BOOLEAN Data Type) |
|