RECORD FORMAT NAME |
CRMKV5B1 |
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
|
INSURANCE SEGMENT |
-
- INSURANCE SEGMENT ORDER: 67
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 69
- NCPDP FIELD NUMBER: 302
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 70
- NCPDP FIELD NUMBER: 312
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 72
- NCPDP FIELD NUMBER: 313
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 74
- NCPDP FIELD NUMBER: 314
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 75
- NCPDP FIELD NUMBER: 524
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 76
- NCPDP FIELD NUMBER: 309
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 79
- NCPDP FIELD NUMBER: 336
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 80
- NCPDP FIELD NUMBER: 301
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 83
- NCPDP FIELD NUMBER: 303
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 84
- NCPDP FIELD NUMBER: 306
- PROCESSING MODE: STANDARD
|
CLAIM SEGMENT |
-
- CLAIM SEGMENT ORDER: 101
- NCPDP FIELD NUMBER: 436
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 103
- NCPDP FIELD NUMBER: 407
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 105
- NCPDP FIELD NUMBER: 456
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 108
- NCPDP FIELD NUMBER: 457
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 111
- NCPDP FIELD NUMBER: 458
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 114
- NCPDP FIELD NUMBER: 459
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 116
- NCPDP FIELD NUMBER: 442
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 118
- NCPDP FIELD NUMBER: 403
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 119
- NCPDP FIELD NUMBER: 405
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 120
- NCPDP FIELD NUMBER: 406
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 121
- NCPDP FIELD NUMBER: 408
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 123
- NCPDP FIELD NUMBER: 414
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 126
- NCPDP FIELD NUMBER: 415
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 129
- NCPDP FIELD NUMBER: 419
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 131
- NCPDP FIELD NUMBER: 420
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 134
- NCPDP FIELD NUMBER: 460
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 136
- NCPDP FIELD NUMBER: 308
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 138
- NCPDP FIELD NUMBER: 429
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 140
- NCPDP FIELD NUMBER: 453
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 143
- NCPDP FIELD NUMBER: 445
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 146
- NCPDP FIELD NUMBER: 446
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 148
- NCPDP FIELD NUMBER: 330
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 149
- NCPDP FIELD NUMBER: 454
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 152
- NCPDP FIELD NUMBER: 600
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 153
- NCPDP FIELD NUMBER: 418
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 154
- NCPDP FIELD NUMBER: 461
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 157
- NCPDP FIELD NUMBER: 462
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 161
- NCPDP FIELD NUMBER: 463
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 164
- NCPDP FIELD NUMBER: 464
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 167
- NCPDP FIELD NUMBER: 343
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 171
- NCPDP FIELD NUMBER: 344
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 174
- NCPDP FIELD NUMBER: 345
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 94
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 96
- NCPDP FIELD NUMBER: 455
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 99
- NCPDP FIELD NUMBER: 402
- PROCESSING MODE: STANDARD
|
PHARMACY PROVIDER SEGMENT |
-
- PHARMACY PROVIDER ORDER: 184
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- PHARMACY PROVIDER ORDER: 186
- NCPDP FIELD NUMBER: 465
- PROCESSING MODE: STANDARD
-
- PHARMACY PROVIDER ORDER: 188
- NCPDP FIELD NUMBER: 444
- PROCESSING MODE: STANDARD
|
PRESCRIBER SEGMENT |
-
- PRESCRIBER SEGMENT ORDER: 196
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- PRESCRIBER SEGMENT ORDER: 198
- NCPDP FIELD NUMBER: 466
- PROCESSING MODE: STANDARD
-
- PRESCRIBER SEGMENT ORDER: 200
- NCPDP FIELD NUMBER: 411
- PROCESSING MODE: STANDARD
|
WORKERS COMP SEGMENT |
-
- WORKERS COMP SEGMENT ORDER: 208
- NCPDP FIELD NUMBER: 435
- PROCESSING MODE: STANDARD
|
DUR PPS SEGMENT |
-
- DUR PPS SEGMENT ORDER: 217
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 219
- NCPDP FIELD NUMBER: 473
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 221
- NCPDP FIELD NUMBER: 439
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 223
- NCPDP FIELD NUMBER: 440
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 225
- NCPDP FIELD NUMBER: 441
- PROCESSING MODE: STANDARD
|
PRICING SEGMENT |
-
- PRICING SEGMENT ORDER: 234
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 236
- NCPDP FIELD NUMBER: 409
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 238
- NCPDP FIELD NUMBER: 412
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 240
- NCPDP FIELD NUMBER: 433
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 243
- NCPDP FIELD NUMBER: 481
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 246
- NCPDP FIELD NUMBER: 482
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 249
- NCPDP FIELD NUMBER: 426
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 252
- NCPDP FIELD NUMBER: 430
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 253
- NCPDP FIELD NUMBER: 423
- PROCESSING MODE: STANDARD
|