Name	Value
RECORD FORMAT NAME	FHTNB2V5
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: 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: 322 PROCESSING MODE: STANDARD PATIENT SEGMENT ORDER: 46 NCPDP FIELD NUMBER: 323 PROCESSING MODE: STANDARD PATIENT SEGMENT ORDER: 48 NCPDP FIELD NUMBER: 324 PROCESSING MODE: STANDARD PATIENT SEGMENT ORDER: 51 NCPDP FIELD NUMBER: 325 PROCESSING MODE: STANDARD PATIENT SEGMENT ORDER: 53 NCPDP FIELD NUMBER: 326 PROCESSING MODE: STANDARD PATIENT SEGMENT ORDER: 55 NCPDP FIELD NUMBER: 307 PROCESSING MODE: STANDARD PATIENT SEGMENT ORDER: 56 NCPDP FIELD NUMBER: 333 PROCESSING MODE: STANDARD PATIENT SEGMENT ORDER: 57 NCPDP FIELD NUMBER: 334 PROCESSING MODE: STANDARD PATIENT SEGMENT ORDER: 59 NCPDP FIELD NUMBER: 335 PROCESSING MODE: STANDARD
INSURANCE SEGMENT	INSURANCE SEGMENT ORDER: 68 NCPDP FIELD NUMBER: 111 PROCESSING MODE: STANDARD INSURANCE SEGMENT ORDER: 70 NCPDP FIELD NUMBER: 302 PROCESSING MODE: STANDARD INSURANCE SEGMENT ORDER: 71 NCPDP FIELD NUMBER: 312 PROCESSING MODE: STANDARD INSURANCE SEGMENT ORDER: 73 NCPDP FIELD NUMBER: 313 PROCESSING MODE: STANDARD INSURANCE SEGMENT ORDER: 75 NCPDP FIELD NUMBER: 314 PROCESSING MODE: STANDARD INSURANCE SEGMENT ORDER: 76 NCPDP FIELD NUMBER: 524 PROCESSING MODE: STANDARD INSURANCE SEGMENT ORDER: 77 NCPDP FIELD NUMBER: 309 PROCESSING MODE: STANDARD INSURANCE SEGMENT ORDER: 80 NCPDP FIELD NUMBER: 336 PROCESSING MODE: STANDARD INSURANCE SEGMENT ORDER: 81 NCPDP FIELD NUMBER: 301 PROCESSING MODE: STANDARD INSURANCE SEGMENT ORDER: 82 NCPDP FIELD NUMBER: 303 PROCESSING MODE: STANDARD INSURANCE SEGMENT ORDER: 83 NCPDP FIELD NUMBER: 306 PROCESSING MODE: STANDARD
CLAIM SEGMENT	CLAIM SEGMENT ORDER: 100 NCPDP FIELD NUMBER: 436 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 102 NCPDP FIELD NUMBER: 407 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 104 NCPDP FIELD NUMBER: 456 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 107 NCPDP FIELD NUMBER: 457 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 110 NCPDP FIELD NUMBER: 458 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 113 NCPDP FIELD NUMBER: 459 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 115 NCPDP FIELD NUMBER: 442 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 117 NCPDP FIELD NUMBER: 403 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 118 NCPDP FIELD NUMBER: 405 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 119 NCPDP FIELD NUMBER: 406 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 120 NCPDP FIELD NUMBER: 408 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 122 NCPDP FIELD NUMBER: 414 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 125 NCPDP FIELD NUMBER: 415 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 128 NCPDP FIELD NUMBER: 419 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 130 NCPDP FIELD NUMBER: 420 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 133 NCPDP FIELD NUMBER: 460 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 135 NCPDP FIELD NUMBER: 308 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 137 NCPDP FIELD NUMBER: 429 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 139 NCPDP FIELD NUMBER: 453 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 142 NCPDP FIELD NUMBER: 445 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 145 NCPDP FIELD NUMBER: 446 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 147 NCPDP FIELD NUMBER: 330 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 148 NCPDP FIELD NUMBER: 454 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 151 NCPDP FIELD NUMBER: 600 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 152 NCPDP FIELD NUMBER: 418 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 153 NCPDP FIELD NUMBER: 461 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 156 NCPDP FIELD NUMBER: 462 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 160 NCPDP FIELD NUMBER: 463 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 163 NCPDP FIELD NUMBER: 464 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 166 NCPDP FIELD NUMBER: 343 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 168 NCPDP FIELD NUMBER: 344 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 171 NCPDP FIELD NUMBER: 345 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 93 NCPDP FIELD NUMBER: 111 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 95 NCPDP FIELD NUMBER: 455 PROCESSING MODE: STANDARD CLAIM SEGMENT ORDER: 98 NCPDP FIELD NUMBER: 402 PROCESSING MODE: STANDARD
DUR PPS SEGMENT	DUR PPS SEGMENT ORDER: 181 NCPDP FIELD NUMBER: 111 PROCESSING MODE: STANDARD DUR PPS SEGMENT ORDER: 183 NCPDP FIELD NUMBER: 473 PROCESSING MODE: STANDARD DUR PPS SEGMENT ORDER: 185 NCPDP FIELD NUMBER: 439 PROCESSING MODE: STANDARD DUR PPS SEGMENT ORDER: 187 NCPDP FIELD NUMBER: 440 PROCESSING MODE: STANDARD DUR PPS SEGMENT ORDER: 189 NCPDP FIELD NUMBER: 441 PROCESSING MODE: STANDARD DUR PPS SEGMENT ORDER: 191 NCPDP FIELD NUMBER: 474 PROCESSING MODE: STANDARD DUR PPS SEGMENT ORDER: 193 NCPDP FIELD NUMBER: 475 PROCESSING MODE: STANDARD DUR PPS SEGMENT ORDER: 195 NCPDP FIELD NUMBER: 476 PROCESSING MODE: STANDARD
PRICING SEGMENT	PRICING SEGMENT ORDER: 203 NCPDP FIELD NUMBER: 111 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 205 NCPDP FIELD NUMBER: 409 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 207 NCPDP FIELD NUMBER: 412 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 209 NCPDP FIELD NUMBER: 477 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 212 NCPDP FIELD NUMBER: 433 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 215 NCPDP FIELD NUMBER: 438 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 217 NCPDP FIELD NUMBER: 478 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 220 NCPDP FIELD NUMBER: 479 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 224 NCPDP FIELD NUMBER: 480 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 227 NCPDP FIELD NUMBER: 481 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 230 NCPDP FIELD NUMBER: 482 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 233 NCPDP FIELD NUMBER: 483 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 236 NCPDP FIELD NUMBER: 484 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 239 NCPDP FIELD NUMBER: 426 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 242 NCPDP FIELD NUMBER: 430 PROCESSING MODE: STANDARD PRICING SEGMENT ORDER: 243 NCPDP FIELD NUMBER: 423 PROCESSING MODE: STANDARD

FHTNB2V5 (294) BPS NCPDP FORMATS (9002313.92)