RECORD FORMAT NAME |
WBDCCCB1 |
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: 34
- NCPDP FIELD NUMBER: 301
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 35
- NCPDP FIELD NUMBER: 303
- 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: 442
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 56
- NCPDP FIELD NUMBER: 403
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 57
- NCPDP FIELD NUMBER: 405
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 58
- NCPDP FIELD NUMBER: 406
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 59
- NCPDP FIELD NUMBER: 408
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 61
- NCPDP FIELD NUMBER: 308
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 63
- NCPDP FIELD NUMBER: 461
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 66
- NCPDP FIELD NUMBER: 462
- PROCESSING MODE: STANDARD
|
PRESCRIBER SEGMENT |
-
- PRESCRIBER SEGMENT ORDER: 77
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- PRESCRIBER SEGMENT ORDER: 79
- NCPDP FIELD NUMBER: 466
- PROCESSING MODE: STANDARD
-
- PRESCRIBER SEGMENT ORDER: 81
- NCPDP FIELD NUMBER: 411
- PROCESSING MODE: STANDARD
|
DUR PPS SEGMENT |
-
- DUR PPS SEGMENT ORDER: 101
- NCPDP FIELD NUMBER: 475
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 103
- NCPDP FIELD NUMBER: 476
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 89
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 91
- NCPDP FIELD NUMBER: 473
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 93
- NCPDP FIELD NUMBER: 439
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 95
- NCPDP FIELD NUMBER: 440
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 97
- NCPDP FIELD NUMBER: 441
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 99
- NCPDP FIELD NUMBER: 474
- PROCESSING MODE: STANDARD
|
PRICING SEGMENT |
-
- PRICING SEGMENT ORDER: 111
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 113
- NCPDP FIELD NUMBER: 409
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 115
- NCPDP FIELD NUMBER: 412
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 117
- NCPDP FIELD NUMBER: 481
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 120
- NCPDP FIELD NUMBER: 482
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 123
- NCPDP FIELD NUMBER: 483
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 126
- NCPDP FIELD NUMBER: 484
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 129
- NCPDP FIELD NUMBER: 426
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 132
- NCPDP FIELD NUMBER: 430
- PROCESSING MODE: STANDARD
|