RECORD FORMAT NAME |
MEGHRXB1 |
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: 14
- NCPDP FIELD NUMBER: 104
- PROCESSING MODE: STANDARD
-
- TRANSACTION HEADER ORDER: 16
- NCPDP FIELD NUMBER: 109
- PROCESSING MODE: STANDARD
-
- TRANSACTION HEADER ORDER: 18
- NCPDP FIELD NUMBER: 202
- PROCESSING MODE: STANDARD
-
- TRANSACTION HEADER ORDER: 20
- NCPDP FIELD NUMBER: 201
- PROCESSING MODE: STANDARD
-
- TRANSACTION HEADER ORDER: 22
- NCPDP FIELD NUMBER: 401
- PROCESSING MODE: STANDARD
-
- TRANSACTION HEADER ORDER: 23
- NCPDP FIELD NUMBER: 110
- PROCESSING MODE: STANDARD
-
- TRANSACTION HEADER ORDER: 9
- NCPDP FIELD NUMBER: 101
- PROCESSING MODE: STANDARD
|
PATIENT SEGMENT |
-
- PATIENT SEGMENT ORDER: 32
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 34
- NCPDP FIELD NUMBER: 331
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 36
- NCPDP FIELD NUMBER: 332
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 37
- NCPDP FIELD NUMBER: 304
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 38
- NCPDP FIELD NUMBER: 305
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 40
- NCPDP FIELD NUMBER: 310
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 42
- NCPDP FIELD NUMBER: 311
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 44
- NCPDP FIELD NUMBER: 323
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 46
- NCPDP FIELD NUMBER: 324
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 49
- NCPDP FIELD NUMBER: 325
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 51
- NCPDP FIELD NUMBER: 326
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 53
- NCPDP FIELD NUMBER: 307
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 54
- NCPDP FIELD NUMBER: 333
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 55
- NCPDP FIELD NUMBER: 334
- PROCESSING MODE: STANDARD
-
- PATIENT SEGMENT ORDER: 57
- NCPDP FIELD NUMBER: 335
- PROCESSING MODE: STANDARD
|
INSURANCE SEGMENT |
-
- INSURANCE SEGMENT ORDER: 66
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 68
- NCPDP FIELD NUMBER: 302
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 69
- NCPDP FIELD NUMBER: 312
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 71
- NCPDP FIELD NUMBER: 313
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 73
- NCPDP FIELD NUMBER: 314
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 74
- NCPDP FIELD NUMBER: 524
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 75
- NCPDP FIELD NUMBER: 309
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 78
- NCPDP FIELD NUMBER: 336
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 79
- NCPDP FIELD NUMBER: 301
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 80
- NCPDP FIELD NUMBER: 303
- PROCESSING MODE: STANDARD
-
- INSURANCE SEGMENT ORDER: 81
- NCPDP FIELD NUMBER: 306
- PROCESSING MODE: STANDARD
|
CLAIM SEGMENT |
-
- CLAIM SEGMENT ORDER: 100
- NCPDP FIELD NUMBER: 407
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 102
- NCPDP FIELD NUMBER: 456
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 105
- NCPDP FIELD NUMBER: 457
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 108
- NCPDP FIELD NUMBER: 458
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 111
- NCPDP FIELD NUMBER: 459
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 113
- NCPDP FIELD NUMBER: 442
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 116
- NCPDP FIELD NUMBER: 403
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 117
- NCPDP FIELD NUMBER: 405
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 118
- NCPDP FIELD NUMBER: 406
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 119
- NCPDP FIELD NUMBER: 408
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 121
- NCPDP FIELD NUMBER: 414
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 124
- NCPDP FIELD NUMBER: 415
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 127
- NCPDP FIELD NUMBER: 419
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 129
- NCPDP FIELD NUMBER: 420
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 132
- NCPDP FIELD NUMBER: 460
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 134
- NCPDP FIELD NUMBER: 308
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 136
- NCPDP FIELD NUMBER: 429
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 138
- NCPDP FIELD NUMBER: 453
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 141
- NCPDP FIELD NUMBER: 445
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 144
- NCPDP FIELD NUMBER: 446
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 146
- NCPDP FIELD NUMBER: 330
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 147
- NCPDP FIELD NUMBER: 454
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 150
- NCPDP FIELD NUMBER: 600
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 151
- NCPDP FIELD NUMBER: 418
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 152
- NCPDP FIELD NUMBER: 461
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 155
- NCPDP FIELD NUMBER: 462
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 159
- NCPDP FIELD NUMBER: 463
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 162
- NCPDP FIELD NUMBER: 464
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 165
- NCPDP FIELD NUMBER: 343
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 167
- NCPDP FIELD NUMBER: 344
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 170
- NCPDP FIELD NUMBER: 345
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 91
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 93
- NCPDP FIELD NUMBER: 455
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 96
- NCPDP FIELD NUMBER: 402
- PROCESSING MODE: STANDARD
-
- CLAIM SEGMENT ORDER: 98
- NCPDP FIELD NUMBER: 436
- PROCESSING MODE: STANDARD
|
PRESCRIBER SEGMENT |
-
- PRESCRIBER SEGMENT ORDER: 180
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- PRESCRIBER SEGMENT ORDER: 182
- NCPDP FIELD NUMBER: 466
- PROCESSING MODE: STANDARD
-
- PRESCRIBER SEGMENT ORDER: 184
- NCPDP FIELD NUMBER: 411
- PROCESSING MODE: STANDARD
-
- PRESCRIBER SEGMENT ORDER: 185
- NCPDP FIELD NUMBER: 467
- PROCESSING MODE: STANDARD
-
- PRESCRIBER SEGMENT ORDER: 187
- NCPDP FIELD NUMBER: 427
- PROCESSING MODE: STANDARD
-
- PRESCRIBER SEGMENT ORDER: 189
- NCPDP FIELD NUMBER: 498
- PROCESSING MODE: STANDARD
-
- PRESCRIBER SEGMENT ORDER: 191
- NCPDP FIELD NUMBER: 468
- PROCESSING MODE: STANDARD
-
- PRESCRIBER SEGMENT ORDER: 194
- NCPDP FIELD NUMBER: 421
- PROCESSING MODE: STANDARD
-
- PRESCRIBER SEGMENT ORDER: 196
- NCPDP FIELD NUMBER: 469
- PROCESSING MODE: STANDARD
-
- PRESCRIBER SEGMENT ORDER: 199
- NCPDP FIELD NUMBER: 470
- PROCESSING MODE: STANDARD
|
COB OTHER PAYMENTS SEGMENT |
-
- COB OTHER PAYMENTS ORDER: 209
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- COB OTHER PAYMENTS ORDER: 211
- NCPDP FIELD NUMBER: 337
- PROCESSING MODE: STANDARD
-
- COB OTHER PAYMENTS ORDER: 213
- NCPDP FIELD NUMBER: 338
- PROCESSING MODE: STANDARD
-
- COB OTHER PAYMENTS ORDER: 215
- NCPDP FIELD NUMBER: 339
- PROCESSING MODE: STANDARD
-
- COB OTHER PAYMENTS ORDER: 217
- NCPDP FIELD NUMBER: 340
- PROCESSING MODE: STANDARD
-
- COB OTHER PAYMENTS ORDER: 219
- NCPDP FIELD NUMBER: 443
- PROCESSING MODE: STANDARD
-
- COB OTHER PAYMENTS ORDER: 221
- NCPDP FIELD NUMBER: 341
- PROCESSING MODE: STANDARD
-
- COB OTHER PAYMENTS ORDER: 224
- NCPDP FIELD NUMBER: 342
- PROCESSING MODE: STANDARD
-
- COB OTHER PAYMENTS ORDER: 227
- NCPDP FIELD NUMBER: 431
- PROCESSING MODE: STANDARD
-
- COB OTHER PAYMENTS ORDER: 230
- NCPDP FIELD NUMBER: 471
- PROCESSING MODE: STANDARD
-
- COB OTHER PAYMENTS ORDER: 232
- NCPDP FIELD NUMBER: 472
- PROCESSING MODE: STANDARD
|
DUR PPS SEGMENT |
-
- DUR PPS SEGMENT ORDER: 241
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 243
- NCPDP FIELD NUMBER: 473
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 245
- NCPDP FIELD NUMBER: 439
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 247
- NCPDP FIELD NUMBER: 440
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 249
- NCPDP FIELD NUMBER: 441
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 251
- NCPDP FIELD NUMBER: 474
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 253
- NCPDP FIELD NUMBER: 475
- PROCESSING MODE: STANDARD
-
- DUR PPS SEGMENT ORDER: 255
- NCPDP FIELD NUMBER: 476
- PROCESSING MODE: STANDARD
|
PRICING SEGMENT |
-
- PRICING SEGMENT ORDER: 264
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 266
- NCPDP FIELD NUMBER: 409
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 268
- NCPDP FIELD NUMBER: 412
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 270
- NCPDP FIELD NUMBER: 477
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 273
- NCPDP FIELD NUMBER: 433
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 276
- NCPDP FIELD NUMBER: 438
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 278
- NCPDP FIELD NUMBER: 478
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 281
- NCPDP FIELD NUMBER: 479
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 285
- NCPDP FIELD NUMBER: 480
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 288
- NCPDP FIELD NUMBER: 481
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 291
- NCPDP FIELD NUMBER: 482
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 294
- NCPDP FIELD NUMBER: 483
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 297
- NCPDP FIELD NUMBER: 484
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 300
- NCPDP FIELD NUMBER: 426
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 303
- NCPDP FIELD NUMBER: 430
- PROCESSING MODE: STANDARD
-
- PRICING SEGMENT ORDER: 304
- NCPDP FIELD NUMBER: 423
- PROCESSING MODE: STANDARD
|
COUPON SEGMENT |
-
- COUPON SEGMENT ORDER: 313
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- COUPON SEGMENT ORDER: 315
- NCPDP FIELD NUMBER: 485
- PROCESSING MODE: STANDARD
-
- COUPON SEGMENT ORDER: 316
- NCPDP FIELD NUMBER: 486
- PROCESSING MODE: STANDARD
-
- COUPON SEGMENT ORDER: 317
- NCPDP FIELD NUMBER: 487
- PROCESSING MODE: STANDARD
|
COMPOUND SEGMENT |
-
- COMPOUND SEGMENT ORDER: 326
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- COMPOUND SEGMENT ORDER: 328
- NCPDP FIELD NUMBER: 450
- PROCESSING MODE: STANDARD
-
- COMPOUND SEGMENT ORDER: 331
- NCPDP FIELD NUMBER: 451
- PROCESSING MODE: STANDARD
-
- COMPOUND SEGMENT ORDER: 333
- NCPDP FIELD NUMBER: 452
- PROCESSING MODE: STANDARD
-
- COMPOUND SEGMENT ORDER: 335
- NCPDP FIELD NUMBER: 447
- PROCESSING MODE: STANDARD
-
- COMPOUND SEGMENT ORDER: 337
- NCPDP FIELD NUMBER: 488
- PROCESSING MODE: STANDARD
-
- COMPOUND SEGMENT ORDER: 339
- NCPDP FIELD NUMBER: 489
- PROCESSING MODE: STANDARD
-
- COMPOUND SEGMENT ORDER: 340
- NCPDP FIELD NUMBER: 448
- PROCESSING MODE: STANDARD
-
- COMPOUND SEGMENT ORDER: 342
- NCPDP FIELD NUMBER: 449
- PROCESSING MODE: STANDARD
-
- COMPOUND SEGMENT ORDER: 344
- NCPDP FIELD NUMBER: 490
- PROCESSING MODE: STANDARD
|
CLINICAL SEGMENT |
-
- CLINICAL SEGMENT ORDER: 354
- NCPDP FIELD NUMBER: 111
- PROCESSING MODE: STANDARD
-
- CLINICAL SEGMENT ORDER: 356
- NCPDP FIELD NUMBER: 491
- PROCESSING MODE: STANDARD
-
- CLINICAL SEGMENT ORDER: 358
- NCPDP FIELD NUMBER: 492
- PROCESSING MODE: STANDARD
-
- CLINICAL SEGMENT ORDER: 360
- NCPDP FIELD NUMBER: 424
- PROCESSING MODE: STANDARD
-
- CLINICAL SEGMENT ORDER: 361
- NCPDP FIELD NUMBER: 493
- PROCESSING MODE: STANDARD
-
- CLINICAL SEGMENT ORDER: 364
- NCPDP FIELD NUMBER: 494
- PROCESSING MODE: STANDARD
-
- CLINICAL SEGMENT ORDER: 366
- NCPDP FIELD NUMBER: 495
- PROCESSING MODE: STANDARD
-
- CLINICAL SEGMENT ORDER: 368
- NCPDP FIELD NUMBER: 496
- PROCESSING MODE: STANDARD
-
- CLINICAL SEGMENT ORDER: 370
- NCPDP FIELD NUMBER: 497
- PROCESSING MODE: STANDARD
-
- CLINICAL SEGMENT ORDER: 372
- NCPDP FIELD NUMBER: 499
- PROCESSING MODE: STANDARD
|