RECORD FORMAT NAME |
NDCAPCB1 |
VERSION |
Version 5.1 |
PRODUCTION STATUS |
PRODUCTION |
PAYER SHEET VERSION |
3 |
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
|
PATIENT SEGMENT |
-
- PATIENT SEGMENT ORDER: 31
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 33
- NCPDP FIELD NUMBER: 304
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 34
- NCPDP FIELD NUMBER: 305
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 36
- NCPDP FIELD NUMBER: 310
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 38
- NCPDP FIELD NUMBER: 311
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 40
- NCPDP FIELD NUMBER: 307
- PROCESSING MODE: STANDARD
|
INSURANCE SEGMENT |
-
- INSURANCE SEGMENT ORDER: 48
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 50
- NCPDP FIELD NUMBER: 302
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 51
- NCPDP FIELD NUMBER: 301
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 52
- NCPDP FIELD NUMBER: 303
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 53
- NCPDP FIELD NUMBER: 306
- PROCESSING MODE: STANDARD
|
CLAIM SEGMENT |
-
- CLAIM SEGMENT ORDER: 63
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 65
- NCPDP FIELD NUMBER: 455
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 68
- NCPDP FIELD NUMBER: 402
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 70
- NCPDP FIELD NUMBER: 436
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 72
- NCPDP FIELD NUMBER: 407
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 74
- NCPDP FIELD NUMBER: 442
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 76
- NCPDP FIELD NUMBER: 403
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 77
- NCPDP FIELD NUMBER: 405
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 78
- NCPDP FIELD NUMBER: 406
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 79
- NCPDP FIELD NUMBER: 408
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 81
- NCPDP FIELD NUMBER: 414
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 84
- NCPDP FIELD NUMBER: 415
- PROCESSING MODE: STANDARD
|
PRESCRIBER SEGMENT |
-
- PRESCRIBER SEGMENT ORDER: 94
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- PRESCRIBER SEGMENT ORDER: 96
- NCPDP FIELD NUMBER: 466
- PROCESSING MODE: STANDARD
-
- PRESCRIBER SEGMENT ORDER: 98
- NCPDP FIELD NUMBER: 411
- PROCESSING MODE: STANDARD
|
DUR PPS SEGMENT |
-
- DUR PPS SEGMENT ORDER: 106
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 108
- NCPDP FIELD NUMBER: 473
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 110
- NCPDP FIELD NUMBER: 439
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 112
- NCPDP FIELD NUMBER: 440
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 114
- NCPDP FIELD NUMBER: 441
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 116
- NCPDP FIELD NUMBER: 474
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 118
- NCPDP FIELD NUMBER: 475
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 120
- NCPDP FIELD NUMBER: 476
- PROCESSING MODE: STANDARD
|
PRICING SEGMENT |
-
- PRICING SEGMENT ORDER: 128
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 130
- NCPDP FIELD NUMBER: 409
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 132
- NCPDP FIELD NUMBER: 412
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 134
- NCPDP FIELD NUMBER: 433
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 137
- NCPDP FIELD NUMBER: 481
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 140
- NCPDP FIELD NUMBER: 426
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 143
- NCPDP FIELD NUMBER: 430
- PROCESSING MODE: STANDARD
|