Parent File | Name | Number | Package |
---|---|---|---|
PRESCRIPTION(#52) | REJECT INFO | 52.25 | Outpatient Pharmacy |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | NCPDP REJECT CODE | 0;1 | FREE TEXT | ************************REQUIRED FIELD************************
|
1 | DATE/TIME DETECTED | 0;2 | DATE |
|
2 | PAYER MESSAGE | 1;1 | FREE TEXT |
|
3 | REASON | 1;2 | FREE TEXT |
|
4 | PHARMACIST | 0;3 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
5 | FILL NUMBER | 0;4 | NUMBER |
|
6 | GROUP NAME | 2;1 | FREE TEXT |
|
7 | PLAN CONTACT | 2;2 | FREE TEXT |
|
8 | PLAN PREVIOUS FILL DATE | 2;3 | DATE |
|
9 | STATUS | 0;5 | SET |
|
10 | CLOSED DATE/TIME | 0;6 | DATE |
|
11 | CLOSED BY | 0;7 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
12 | CLOSE REASON | 0;8 | SET |
|
13 | CLOSE COMMENTS | 3;1 | FREE TEXT |
|
14 | REASON FOR SERVICE CODE | 0;9 | FREE TEXT |
|
15 | PROFESSIONAL SERVICE CODE | 0;10 | FREE TEXT |
|
16 | RESPONSE ID | 0;11 | NUMBER |
|
17 | OTHER REJECTS | 0;12 | FREE TEXT |
|
18 | DUR TEXT | 4;1 | FREE TEXT |
|
19 | RESULT OF SERVICE CODE | 0;13 | FREE TEXT |
|
20 | INSURANCE NAME | 2;4 | FREE TEXT |
|
21 | GROUP NUMBER | 2;5 | FREE TEXT |
|
22 | CARDHOLDER ID | 2;6 | FREE TEXT |
|
23 | RE-OPENED | 0;14 | SET |
|
24 | CLARIFICATION CODE | 0;15 | FREE TEXT |
|
25 | PRIOR AUTHORIZATION TYPE | 0;16 | NUMBER |
|
26 | PRIOR AUTHORIZATION NUMBER | 0;17 | NUMBER |
|
27 | COORDINATION OF BENEFITS | 2;7 | SET |
|
28 | DUR ADD MSG TEXT | 5;1 | FREE TEXT |
|
29 | BIN | 2;8 | FREE TEXT |
|
30 | RRR FLAG | 0;18 | SET |
|
31 | RRR DOLLAR THRESHOLD | 0;19 | NUMBER |
|
32 | RRR GROSS AMOUNT DUE | 0;20 | NUMBER |
|
33 | INSURANCE COMPANY | 2;9 | NUMBER |
|
34 | PCN | 2;10 | FREE TEXT |
|
51 | COMMENTS | COM;0 | DATE Multiple #52.2551 | 52.2551 |