BPSNCPD3    ICR (4560)

Prescription IEN (Pointer to the PRESCRIPTION File
(#52))

Fill number (0 for Original, 1 for 1st refill, 2 for
the 2nd refill, etc.)

Array of DUR information in the following format:

DUR(INSN,"BILLED") - 1 for processed through
ECME, 0 for not processed
DUR(INSN,"CARDHOLDER ID") - Patient's cardholder
ID
DUR(INSN,"ELIGBLT") - Eligibility indicator
(V for VA, T for TRICARE and C for CHAMPVA)
determined by Integrated Billing
DUR(INSN,"GROUP NAME") - Insurance group name
DUR(INSN,"GROUP NUMBER") - Insurance group
number
DUR(INSN,"INSURANCE NAME") - Insurance company
name
DUR(INSN,"INSURANCE POINTER") - Insurance
company IEN
DUR(INSN,"PLAN CONTACT") - Patient's Insurance
Plan Contact telephone number

Note: Where INSN is the Payer Sequence.

Note: Applicable DUR related data returned from
the DURRESP component described in this IA
is also returned in the DUR array. Refer
to the DURRESP component for details.

Optional. Returns error information about the call.

(Optional) The Payer Sequence:
1 - Primary (default)
2 - Secondary

Array of DUR related information for a
specific claim response in the BPS RESPONSES
file in the following format:
DUR(INSN,"RESPONSE IEN") - Pointer to the
RESPONSE file (#9002313.03) for the claim
submission
DUR(INSN,"MESSAGE") - The Transmission level
specific data, or Message field 504
DUR(INSN,"PAYER MESSAGE") - Message returned
from the payer in the Transaction level
DUR(INSN,"STATUS") - Status of the claim
(i.e. REJECTED CLAIM, PAYABLE)
DUR(INSN,"BIN") - BIN number associated with
the payer.

The following four fields are redundant with
the fields in the DUR PPS array but are provided
for backwards compatibility.
DUR(INSN,"REASON") - Reason for Service Code
pointer to BPS NCPDP REASON FOR SERVICE CODE
file (#9002313.23)
DUR(INSN,"PREV FILL DATE") - Plan's Previous
Fill Date
DUR(INSN,"DUR FREE TEXT DESC") - Drug
Utilization Review (DUR) description
and/or claims rejection free text
information from the payer
DUR(INSN,"DUR ADD MSG TEXT") - Drug Utilization
Review (DUR) additional free text information
from the payer

The following fields are from the DUR PPS
RESPONSE multiple.
DUR(INSN,"DUR PPS",SEQ,"DUR PPS RESPONSE") -
Total number of DUR PPS responses from the
payer
DUR(INSN,"DUR PPS",SEQ,"REASON FOR SERVICE
CODE") - Code identifying the type of
utilization conflict detected or the reason
for the pharmacist's professional service
DUR(INSN,"DUR PPS",SEQ,"CLINICAL SIGNIFICANCE
CODE") - Code identifying the significance or
severity level of a clinical event as
contained in the originating data base
DUR(INSN,"DUR PPS",SEQ,"OTHER PHARMACY
INDICATOR") - Code for the type of pharmacy
dispensing the conflicting drug
DUR(INSN,"DUR PPS",SEQ,"PREVIOUS DATE OF FILL")
- Date prescription was previously filled
DUR(INSN,"DUR PPS",SEQ,"QUANTITY OF PREVIOUS
FILL") - Amount expressed in metric decimal
units of the conflicting agent that was
previously filled
DUR(INSN,"DUR PPS",SEQ,"DATABASE INDICATOR")
- Code identifying the source of drug
information used for DUR processing
DUR(INSN,"DUR PPS",SEQ,"OTHER PRESCRIBER
INDICATOR") - Code comparing the prescriber of
the current prescription to the prescriber of
the previously filled conflicting prescription
DUR(INSN,"DUR PPS",SEQ,"DUR FREE TEXT MESSAGE")
- Text that provides additional detail
regarding a DUR conflict
DUR(INSN,"DUR PPS",SEQ,"DUR ADDITIONAL TEXT")
- Descriptive information that further defines
the referenced DUR alert

DUR(INSN,"REJ CODE LST") - List of rejection
code(s) returned by the payer separated by
commas (i.e. 79,14).
DUR(INSN,"REJ CODES",SEQ,REJ CODE) - Array of
rejection code descriptions where REJ CODE
correlates to DUR(INSN,"REJ CODE LST")
value(s) and SEQ equals a sequential number

Note: Where INSN is the Payer Sequence

Claim Response IEN (Pointer to the BPS RESPONSES File
(#9002313.03))

(Optional) The Payer Sequence:
1 - Primary (default)
2 - Secondary