GLOBAL MAP DATA DICTIONARY #9002313.57 -- BPS LOG OF TRANSACTIONS FILE 3/24/25 PAGE 1
STORED IN ^BPSTL( *** NO DATA STORED YET *** SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 1.0)
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A copy of 9002313.59. As each transaction completes, a snapshot of 9002313.59 entry is placed here in 9002313.57.
Per VHA Directive 2004-038, this file definition should not be modified.
CROSS
REFERENCED BY: PATIENT(AC), CLAIM(AE), PRESCRIPTION NUMBER(AEC), REVERSAL CLAIM(AER), RESPONSE(AF), REVERSAL RESPONSE(AFR),
USER(AG), LAST UPDATE(AH), SUBMIT REQUEST DATE TIME(AS), ENTRY NUMBER(B)
INDEXED BY: MCCF EDI TAS PROGRESS (C)
^BPSTL(D0,0)= (#.01) ENTRY NUMBER [1F] ^ (#1) STATUS [2N] ^ (#2) HL7 MESSAGE ID [3F] ^ (#3) CLAIM [4P:9002313.02] ^ (#4) RESPONSE
==>[5P:9002313.03] ^ (#5) PATIENT [6P:2] ^ (#6) SUBMIT DATE [7D] ^ (#7) LAST UPDATE [8D] ^ (#14) POSITION IN CLAIM
==>[9N] ^ (#13) USER [10P:200] ^ (#15) START TIME [11D] ^ (#16) SUBMIT REQUEST [12P:9002313.77] ^ (#17) SUBMIT REQUEST
==>DATE TIME [13D] ^ (#18) COB INDICATOR [14S] ^ (#19) TRANSACTION TYPE [15S] ^
^BPSTL(D0,1)= (#9) FILL NUMBER [1N] ^ (#10) NDC [2F] ^ ^ (#11) PHARMACY DIVISION [4P:59] ^ (#1.05) POLICY NUMBER [5N] ^ ^
==>(#1.07) PHARMACY [7P:9002313.56] ^ (#1.08) PINS PIECE [8N] ^ (#1.09) PRIOR AUTHORIZATION NUMBER [9F] ^ ^ (#1.11)
==>PRESCRIPTION NUMBER [11P:52] ^ (#1.12) RESUBMIT AFTER REVERSAL [12S] ^ (#1.13) NCPDP OVERRIDES [13P:9002313.511] ^
==>^ (#1.15) PRIOR AUTHORIZATION TYPE CODE [15F] ^
^BPSTL(D0,2)= (#201) RESULT CODE [1N] ^ (#202) RESULT TEXT [2F] ^
^BPSTL(D0,3)= (#301) NON-BILLABLE REASON [1F] ^ (#302) NON-BILLABLE CLOSED [2S] ^ (#303) NON-BILLABLE DATE CLOSED [3D] ^ (#304)
==>NON-BILLABLE CLOSED BY [4P:200] ^ (#305) NON-BILLABLE CLOSED COMMENT [5F] ^ (#306) NON-BILLABLE DATE RE-OPENED [6D]
==>^ (#307) NON-BILLABLE RE-OPENED BY [7P:200] ^ (#308) NON-BILLABLE RE-OPENED COMMENT [8F] ^
^BPSTL(D0,4)= (#401) REVERSAL CLAIM [1P:9002313.02] ^ (#402) REVERSAL RESPONSE [2P:9002313.03] ^ ^ (#404) REVERSAL REASON [4F] ^
==>(#405) REVERSAL REQUEST [5P:9002313.77] ^ (#406) REVERSAL REQUEST DATE TIME [6D] ^
^BPSTL(D0,5)= (#501) QUANTITY [1N] ^ (#502) UNIT PRICE [2N] ^ (#503) SUBTOTAL [3N] ^ (#504) DISPENSING FEE [4N] ^ (#505) TOTAL
==>PRICE [5N] ^ ^ (#507) ADMINISTRATIVE FEE [7F] ^ (#508) UNIT OF MEASURE [8F] ^ (#509) BILLING QUANTITY [9N] ^
==>(#510) BILLING UNIT [10F] ^
^BPSTL(D0,8)= (#801) ASLEEP PAYER [1P:9002313.15] ^
^BPSTL(D0,9)= (#901) CURRENT VA INSURER [1F] ^ ^ ^ (#901.04) ELIGIBILITY [4S] ^
^BPSTL(D0,10,0)=^9002313.57902PA^^ (#902) PATIENT INSURANCE MULTIPLE
^BPSTL(D0,10,D1,0)= (#.01) PLAN ID [1P:355.3] ^ (#902.02) B1 PAYER SHEET [2P:9002313.92] ^ (#902.19) B2 PAYER SHEET
==>[3P:9002313.92] ^ (#902.21) B3 PAYER SHEET [4P:9002313.92] ^ (#902.22) CERTIFY MODE [5S] ^ (#902.23)
==>CERTIFICATION [6P:9002313.31] ^ (#902.24) INSURANCE NAME [7F] ^ (#902.29) RATE TYPE [8P:399.3] ^ (#902.34) E1
==>PAYER SHEET [9P:9002313.92] ^ ^ ^ (#902.35) POLICY NUMBER [12N] ^
^BPSTL(D0,10,D1,1)= (#902.03) BIN [1F] ^ (#902.04) PCN [2F] ^ (#902.05) GROUP ID [3F] ^ (#902.06) CARDHOLDER ID [4F] ^ (#902.07)
==>PATIENT RELATIONSHIP CODE [5S] ^ (#902.08) CARDHOLDER FIRST NAME [6F] ^ (#902.09) CARDHOLDER LAST NAME [7F] ^
==>(#902.11) HOME PLAN STATE [8F] ^ (#902.36) MAXIMUM NCPDP TRANSACTIONS [9N] ^ (#902.1) PERSON CODE [10F] ^
^BPSTL(D0,10,D1,2)= (#902.12) DISPENSING FEE SUBMITTED [1N] ^ (#902.13) BASIS OF COST DETERMINATION [2F] ^ (#902.14) USUAL
==>CUSTOMARY CHARGE [3N] ^ (#902.15) GROSS AMOUNT DUE [4N] ^ (#902.16) ADMINISTRATIVE FEE [5N] ^ (#902.17) VA
==>FILL NUMBER [6N] ^ (#902.18) SOFTWARE VENDOR CERT ID [7F] ^ (#902.3) PRIMARY PAYER BILL [8P:399] ^ (#902.31)
==>PRIOR PAYMENT [9N] ^ (#902.2) INGREDIENT COST [10N] ^
^BPSTL(D0,10,D1,3)= (#902.25) GROUP NAME [1F] ^ (#902.26) INSURANCE CO PHONE [2F] ^ (#902.27) PHARMACY PLAN ID [3F] ^ (#902.28)
==>ELIGIBILITY [4S] ^ (#902.33) INSURANCE COMPANY [5P:36] ^ (#902.32) PLAN COB [6S] ^
^BPSTL(D0,11,0)=^9002313.57111DA^^ (#111) COMMENT MULTIPLE
^BPSTL(D0,11,D1,0)= (#.01) DATE [1D] ^ (#.02) USER [2P:200] ^ (#.03) COMMENT [3F] ^ (#.04) PHARMACY [4S] ^
^BPSTL(D0,12)= (#1201) RX ACTION [1F] ^ (#1202) DATE OF SERVICE [2D] ^ (#1203) SUBMISSION CLARIFICATION CODE [3F] ^ (#1204) COB
==>OTHER PAYMENTS COUNT [4N] ^ (#1205) OTHER COVERAGE CODE [5S] ^
^BPSTL(D0,13,0)=^9002313.5713^^ (#1300) DUR DATA
^BPSTL(D0,13,D1,0)= (#.01) DUR COUNTER [1N] ^ (#1) DUR PROFESSIONAL SERVICE CODE [2F] ^ (#2) DUR REASON FOR SERVICE CODE [3F] ^
==>(#3) DUR RESULT OF SERVICE CODE [4F] ^
^BPSTL(D0,14,0)=^9002313.5714A^^ (#1400) COB OTHER PAYERS
^BPSTL(D0,14,D1,0)= (#.01) OTHER PAYER COUNTER [1N] ^ (#.02) OTHER PAYER COVERAGE TYPE [2S] ^ (#.03) OTHER PAYER ID QUALIFIER
==>[3S] ^ (#.04) OTHER PAYER ID [4F] ^ (#.05) OTHER PAYER DATE [5D] ^ (#.06) OTHER PAYER AMOUNT PAID COUNT [6N]
==>^ (#.07) OTHER PAYER REJECT COUNT [7N] ^
^BPSTL(D0,14,D1,1,0)=^9002313.57141A^^ (#1) OTHER PAYER AMT PAID MULTIPLE
^BPSTL(D0,14,D1,1,D2,0)= (#.01) OTHER PAYER AMOUNT PAID [1N] ^ (#.02) OTHER PAYER AMT PAID QUALIFIER [2P:9002313.2] ^
^BPSTL(D0,14,D1,2,0)=^9002313.57142A^^ (#2) OTHER PAYER REJECT MULTIPLE
^BPSTL(D0,14,D1,2,D2,0)= (#.01) OTHER PAYER REJECT CODE [1F] ^
^BPSTL(D0,15)= (#20) MCCF EDI TAS PROGRESS [1S] ^
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