| RECORD FORMAT NAME |
COMLHCB2 |
| 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: 331
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 35
- NCPDP FIELD NUMBER: 332
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 36
- NCPDP FIELD NUMBER: 304
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 37
- NCPDP FIELD NUMBER: 305
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 39
- NCPDP FIELD NUMBER: 310
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 41
- NCPDP FIELD NUMBER: 311
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 43
- NCPDP FIELD NUMBER: 322
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 45
- NCPDP FIELD NUMBER: 323
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 47
- NCPDP FIELD NUMBER: 324
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 50
- NCPDP FIELD NUMBER: 325
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 52
- NCPDP FIELD NUMBER: 326
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 54
- NCPDP FIELD NUMBER: 307
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 55
- NCPDP FIELD NUMBER: 333
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 56
- NCPDP FIELD NUMBER: 334
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 58
- NCPDP FIELD NUMBER: 335
- PROCESSING MODE: STANDARD
|
| CLAIM SEGMENT |
-
- CLAIM SEGMENT ORDER: 67
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 69
- NCPDP FIELD NUMBER: 455
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 72
- NCPDP FIELD NUMBER: 402
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 74
- NCPDP FIELD NUMBER: 436
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 76
- NCPDP FIELD NUMBER: 407
- PROCESSING MODE: STANDARD
|
