RECORD FORMAT NAME |
ACSWYB1 |
VERSION |
Version 5.1 |
PRODUCTION STATUS |
PRODUCTION |
PAYER SHEET VERSION |
1 |
TRANSACTION HEADER SEGMENT |
-
- TRANSACTION HEADER ORDER: 10
- NCPDP FIELD NUMBER: 102
- PROCESSING MODE: STANDARD
-
- TRANSACTION HEADER ORDER: 12
- NCPDP FIELD NUMBER: 103
- PROCESSING MODE: STANDARD
-
- TRANSACTION HEADER ORDER: 13
- NCPDP FIELD NUMBER: 104
- PROCESSING MODE: STANDARD
-
- TRANSACTION HEADER ORDER: 15
- NCPDP FIELD NUMBER: 109
- PROCESSING MODE: STANDARD
-
- TRANSACTION HEADER ORDER: 17
- NCPDP FIELD NUMBER: 202
- PROCESSING MODE: STANDARD
-
- TRANSACTION HEADER ORDER: 19
- NCPDP FIELD NUMBER: 201
- PROCESSING MODE: STANDARD
-
- TRANSACTION HEADER ORDER: 21
- NCPDP FIELD NUMBER: 401
- PROCESSING MODE: STANDARD
-
- TRANSACTION HEADER ORDER: 22
- NCPDP FIELD NUMBER: 110
- PROCESSING MODE: STANDARD
-
- TRANSACTION HEADER ORDER: 9
- NCPDP FIELD NUMBER: 101
- PROCESSING MODE: STANDARD
|
INSURANCE SEGMENT |
-
- INSURANCE SEGMENT ORDER: 31
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 33
- NCPDP FIELD NUMBER: 302
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 35
- NCPDP FIELD NUMBER: 301
- PROCESSING MODE: STANDARD
|
CLAIM SEGMENT |
-
- CLAIM SEGMENT ORDER: 43
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 45
- NCPDP FIELD NUMBER: 455
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 48
- NCPDP FIELD NUMBER: 402
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 50
- NCPDP FIELD NUMBER: 436
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 52
- NCPDP FIELD NUMBER: 407
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 54
- NCPDP FIELD NUMBER: 456
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 57
- NCPDP FIELD NUMBER: 457
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 60
- NCPDP FIELD NUMBER: 442
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 62
- NCPDP FIELD NUMBER: 403
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 63
- NCPDP FIELD NUMBER: 405
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 64
- NCPDP FIELD NUMBER: 406
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 65
- NCPDP FIELD NUMBER: 408
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 67
- NCPDP FIELD NUMBER: 414
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 70
- NCPDP FIELD NUMBER: 420
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 73
- NCPDP FIELD NUMBER: 308
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 75
- NCPDP FIELD NUMBER: 461
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 78
- NCPDP FIELD NUMBER: 343
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 80
- NCPDP FIELD NUMBER: 344
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 83
- NCPDP FIELD NUMBER: 345
- PROCESSING MODE: STANDARD
|
PRESCRIBER SEGMENT |
-
- PRESCRIBER SEGMENT ORDER: 93
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- PRESCRIBER SEGMENT ORDER: 95
- NCPDP FIELD NUMBER: 466
- PROCESSING MODE: STANDARD
-
- PRESCRIBER SEGMENT ORDER: 97
- NCPDP FIELD NUMBER: 411
- PROCESSING MODE: STANDARD
|
COB OTHER PAYMENTS SEGMENT |
-
- COB OTHER PAYMENTS ORDER: 105
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- COB OTHER PAYMENTS ORDER: 107
- NCPDP FIELD NUMBER: 337
- PROCESSING MODE: STANDARD
-
- COB OTHER PAYMENTS ORDER: 109
- NCPDP FIELD NUMBER: 338
- PROCESSING MODE: STANDARD
-
- COB OTHER PAYMENTS ORDER: 111
- NCPDP FIELD NUMBER: 339
- PROCESSING MODE: STANDARD
-
- COB OTHER PAYMENTS ORDER: 113
- NCPDP FIELD NUMBER: 340
- PROCESSING MODE: STANDARD
-
- COB OTHER PAYMENTS ORDER: 114
- NCPDP FIELD NUMBER: 443
- PROCESSING MODE: STANDARD
-
- COB OTHER PAYMENTS ORDER: 116
- NCPDP FIELD NUMBER: 341
- PROCESSING MODE: STANDARD
-
- COB OTHER PAYMENTS ORDER: 119
- NCPDP FIELD NUMBER: 342
- PROCESSING MODE: STANDARD
-
- COB OTHER PAYMENTS ORDER: 122
- NCPDP FIELD NUMBER: 431
- PROCESSING MODE: STANDARD
|
DUR PPS SEGMENT |
-
- DUR PPS SEGMENT ORDER: 131
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 133
- NCPDP FIELD NUMBER: 473
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 135
- NCPDP FIELD NUMBER: 439
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 137
- NCPDP FIELD NUMBER: 440
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 139
- NCPDP FIELD NUMBER: 441
- PROCESSING MODE: STANDARD
|
PRICING SEGMENT |
-
- PRICING SEGMENT ORDER: 148
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 150
- NCPDP FIELD NUMBER: 409
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 152
- NCPDP FIELD NUMBER: 426
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 155
- NCPDP FIELD NUMBER: 430
- PROCESSING MODE: STANDARD
|
COMPOUND SEGMENT |
-
- COMPOUND SEGMENT ORDER: 163
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- COMPOUND SEGMENT ORDER: 165
- NCPDP FIELD NUMBER: 450
- PROCESSING MODE: STANDARD
-
- COMPOUND SEGMENT ORDER: 168
- NCPDP FIELD NUMBER: 451
- PROCESSING MODE: STANDARD
-
- COMPOUND SEGMENT ORDER: 170
- NCPDP FIELD NUMBER: 452
- PROCESSING MODE: STANDARD
-
- COMPOUND SEGMENT ORDER: 172
- NCPDP FIELD NUMBER: 447
- PROCESSING MODE: STANDARD
-
- COMPOUND SEGMENT ORDER: 174
- NCPDP FIELD NUMBER: 488
- PROCESSING MODE: STANDARD
-
- COMPOUND SEGMENT ORDER: 176
- NCPDP FIELD NUMBER: 489
- PROCESSING MODE: STANDARD
-
- COMPOUND SEGMENT ORDER: 177
- NCPDP FIELD NUMBER: 448
- PROCESSING MODE: STANDARD
-
- COMPOUND SEGMENT ORDER: 179
- NCPDP FIELD NUMBER: 449
- PROCESSING MODE: STANDARD
|