Name	Value
RECORD FORMAT NAME	NDCIDSB1
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
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: 322 PROCESSING MODE: STANDARD PATIENT SEGMENT ORDER: 42 NCPDP FIELD NUMBER: 323 PROCESSING MODE: STANDARD PATIENT SEGMENT ORDER: 44 NCPDP FIELD NUMBER: 324 PROCESSING MODE: STANDARD PATIENT SEGMENT ORDER: 47 NCPDP FIELD NUMBER: 325 PROCESSING MODE: STANDARD PATIENT SEGMENT ORDER: 49 NCPDP FIELD NUMBER: 307 PROCESSING MODE: STANDARD
INSURANCE SEGMENT	INSURANCE SEGMENT ORDER: 57 NCPDP FIELD NUMBER: 111 PROCESSING MODE: STANDARD INSURANCE SEGMENT ORDER: 59 NCPDP FIELD NUMBER: 302 PROCESSING MODE: STANDARD INSURANCE SEGMENT ORDER: 60 NCPDP FIELD NUMBER: 314 PROCESSING MODE: STANDARD INSURANCE SEGMENT ORDER: 61 NCPDP FIELD NUMBER: 309 PROCESSING MODE: STANDARD INSURANCE SEGMENT ORDER: 64 NCPDP FIELD NUMBER: 301 PROCESSING MODE: STANDARD INSURANCE SEGMENT ORDER: 65 NCPDP FIELD NUMBER: 303 PROCESSING MODE: STANDARD INSURANCE SEGMENT ORDER: 66 NCPDP FIELD NUMBER: 306 PROCESSING MODE: STANDARD
CLAIM SEGMENT	CLAIM SEGMENT ORDER: 100 NCPDP FIELD NUMBER: 419 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 102 NCPDP FIELD NUMBER: 420 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 105 NCPDP FIELD NUMBER: 308 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 108 NCPDP FIELD NUMBER: 429 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 110 NCPDP FIELD NUMBER: 462 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 76 NCPDP FIELD NUMBER: 111 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 78 NCPDP FIELD NUMBER: 455 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 81 NCPDP FIELD NUMBER: 402 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 83 NCPDP FIELD NUMBER: 436 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 85 NCPDP FIELD NUMBER: 407 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 87 NCPDP FIELD NUMBER: 442 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 89 NCPDP FIELD NUMBER: 403 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 90 NCPDP FIELD NUMBER: 405 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 91 NCPDP FIELD NUMBER: 406 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 92 NCPDP FIELD NUMBER: 408 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 94 NCPDP FIELD NUMBER: 414 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 97 NCPDP FIELD NUMBER: 415 PROCESSING MODE: STANDARD
PRESCRIBER SEGMENT	PRESCRIBER SEGMENT ORDER: 121 NCPDP FIELD NUMBER: 111 PROCESSING MODE: STANDARD PRESCRIBER SEGMENT ORDER: 123 NCPDP FIELD NUMBER: 466 PROCESSING MODE: STANDARD PRESCRIBER SEGMENT ORDER: 125 NCPDP FIELD NUMBER: 411 PROCESSING MODE: STANDARD PRESCRIBER SEGMENT ORDER: 126 NCPDP FIELD NUMBER: 427 PROCESSING MODE: STANDARD
COB OTHER PAYMENTS SEGMENT	COB OTHER PAYMENTS ORDER: 135 NCPDP FIELD NUMBER: 111 PROCESSING MODE: STANDARD COB OTHER PAYMENTS ORDER: 137 NCPDP FIELD NUMBER: 337 PROCESSING MODE: STANDARD COB OTHER PAYMENTS ORDER: 139 NCPDP FIELD NUMBER: 338 PROCESSING MODE: STANDARD COB OTHER PAYMENTS ORDER: 141 NCPDP FIELD NUMBER: 339 PROCESSING MODE: STANDARD COB OTHER PAYMENTS ORDER: 143 NCPDP FIELD NUMBER: 340 PROCESSING MODE: STANDARD COB OTHER PAYMENTS ORDER: 144 NCPDP FIELD NUMBER: 443 PROCESSING MODE: STANDARD COB OTHER PAYMENTS ORDER: 145 NCPDP FIELD NUMBER: 341 PROCESSING MODE: STANDARD COB OTHER PAYMENTS ORDER: 148 NCPDP FIELD NUMBER: 342 PROCESSING MODE: STANDARD COB OTHER PAYMENTS ORDER: 151 NCPDP FIELD NUMBER: 431 PROCESSING MODE: STANDARD COB OTHER PAYMENTS ORDER: 153 NCPDP FIELD NUMBER: 471 PROCESSING MODE: STANDARD COB OTHER PAYMENTS ORDER: 155 NCPDP FIELD NUMBER: 472 PROCESSING MODE: STANDARD
WORKERS COMP SEGMENT	WORKERS COMP SEGMENT ORDER: 164 NCPDP FIELD NUMBER: 111 PROCESSING MODE: STANDARD WORKERS COMP SEGMENT ORDER: 167 NCPDP FIELD NUMBER: 434 PROCESSING MODE: STANDARD WORKERS COMP SEGMENT ORDER: 168 NCPDP FIELD NUMBER: 315 PROCESSING MODE: STANDARD WORKERS COMP SEGMENT ORDER: 169 NCPDP FIELD NUMBER: 316 PROCESSING MODE: STANDARD WORKERS COMP SEGMENT ORDER: 171 NCPDP FIELD NUMBER: 317 PROCESSING MODE: STANDARD WORKERS COMP SEGMENT ORDER: 173 NCPDP FIELD NUMBER: 318 PROCESSING MODE: STANDARD WORKERS COMP SEGMENT ORDER: 176 NCPDP FIELD NUMBER: 319 PROCESSING MODE: STANDARD WORKERS COMP SEGMENT ORDER: 178 NCPDP FIELD NUMBER: 320 PROCESSING MODE: STANDARD WORKERS COMP SEGMENT ORDER: 180 NCPDP FIELD NUMBER: 321 PROCESSING MODE: STANDARD WORKERS COMP SEGMENT ORDER: 182 NCPDP FIELD NUMBER: 327 PROCESSING MODE: STANDARD WORKERS COMP SEGMENT ORDER: 183 NCPDP FIELD NUMBER: 435 PROCESSING MODE: STANDARD
DUR PPS SEGMENT	DUR PPS SEGMENT ORDER: 192 NCPDP FIELD NUMBER: 111 PROCESSING MODE: STANDARD DUR PPS SEGMENT ORDER: 194 NCPDP FIELD NUMBER: 473 PROCESSING MODE: STANDARD DUR PPS SEGMENT ORDER: 196 NCPDP FIELD NUMBER: 439 PROCESSING MODE: STANDARD DUR PPS SEGMENT ORDER: 198 NCPDP FIELD NUMBER: 440 PROCESSING MODE: STANDARD DUR PPS SEGMENT ORDER: 200 NCPDP FIELD NUMBER: 441 PROCESSING MODE: STANDARD DUR PPS SEGMENT ORDER: 202 NCPDP FIELD NUMBER: 474 PROCESSING MODE: STANDARD DUR PPS SEGMENT ORDER: 204 NCPDP FIELD NUMBER: 475 PROCESSING MODE: STANDARD DUR PPS SEGMENT ORDER: 206 NCPDP FIELD NUMBER: 476 PROCESSING MODE: STANDARD
PRICING SEGMENT	PRICING SEGMENT ORDER: 214 NCPDP FIELD NUMBER: 111 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 216 NCPDP FIELD NUMBER: 409 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 218 NCPDP FIELD NUMBER: 412 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 220 NCPDP FIELD NUMBER: 477 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 223 NCPDP FIELD NUMBER: 433 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 226 NCPDP FIELD NUMBER: 438 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 228 NCPDP FIELD NUMBER: 481 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 231 NCPDP FIELD NUMBER: 426 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 234 NCPDP FIELD NUMBER: 430 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 235 NCPDP FIELD NUMBER: 423 PROCESSING MODE: STANDARD
COMPOUND SEGMENT	COMPOUND SEGMENT ORDER: 244 NCPDP FIELD NUMBER: 111 PROCESSING MODE: STANDARD COMPOUND SEGMENT ORDER: 246 NCPDP FIELD NUMBER: 450 PROCESSING MODE: STANDARD COMPOUND SEGMENT ORDER: 249 NCPDP FIELD NUMBER: 451 PROCESSING MODE: STANDARD COMPOUND SEGMENT ORDER: 251 NCPDP FIELD NUMBER: 452 PROCESSING MODE: STANDARD COMPOUND SEGMENT ORDER: 253 NCPDP FIELD NUMBER: 447 PROCESSING MODE: STANDARD COMPOUND SEGMENT ORDER: 255 NCPDP FIELD NUMBER: 488 PROCESSING MODE: STANDARD COMPOUND SEGMENT ORDER: 257 NCPDP FIELD NUMBER: 489 PROCESSING MODE: STANDARD COMPOUND SEGMENT ORDER: 258 NCPDP FIELD NUMBER: 448 PROCESSING MODE: STANDARD COMPOUND SEGMENT ORDER: 260 NCPDP FIELD NUMBER: 449 PROCESSING MODE: STANDARD COMPOUND SEGMENT ORDER: 262 NCPDP FIELD NUMBER: 490 PROCESSING MODE: STANDARD
CLINICAL SEGMENT	CLINICAL SEGMENT ORDER: 272 NCPDP FIELD NUMBER: 111 PROCESSING MODE: STANDARD CLINICAL SEGMENT ORDER: 274 NCPDP FIELD NUMBER: 491 PROCESSING MODE: STANDARD CLINICAL SEGMENT ORDER: 276 NCPDP FIELD NUMBER: 492 PROCESSING MODE: STANDARD CLINICAL SEGMENT ORDER: 278 NCPDP FIELD NUMBER: 424 PROCESSING MODE: STANDARD CLINICAL SEGMENT ORDER: 279 NCPDP FIELD NUMBER: 493 PROCESSING MODE: STANDARD CLINICAL SEGMENT ORDER: 282 NCPDP FIELD NUMBER: 494 PROCESSING MODE: STANDARD CLINICAL SEGMENT ORDER: 283 NCPDP FIELD NUMBER: 495 PROCESSING MODE: STANDARD CLINICAL SEGMENT ORDER: 284 NCPDP FIELD NUMBER: 496 PROCESSING MODE: STANDARD CLINICAL SEGMENT ORDER: 286 NCPDP FIELD NUMBER: 497 PROCESSING MODE: STANDARD CLINICAL SEGMENT ORDER: 287 NCPDP FIELD NUMBER: 499 PROCESSING MODE: STANDARD

NDCIDSB1 (163) BPS NCPDP FORMATS (9002313.92)