GLOBAL MAP DATA DICTIONARY #9002313.92 -- BPS NCPDP FORMATS FILE 3/24/25 PAGE 1
STORED IN ^BPSF(9002313.92, (305 ENTRIES) SITE: WWW.BMIRWIN.COM UCI: VISTA,VISTA (VERSION 1.0)
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The formats for sending claims. As derived from NDC Payer Sheets and Envoy Plan Sheets. Never modify locally, except in
cooperation with development.
Per VHA Directive 2004-038, this file definition should not be modified.
CROSS
REFERENCED BY: RECORD FORMAT NAME(B)
^BPSF(9002313.92,D0,0)= (#.01) RECORD FORMAT NAME [1F] ^
^BPSF(9002313.92,D0,1)= ^ (#1.02) VERSION [2S] ^ ^ ^ ^ (#1.06) PRODUCTION STATUS [6S] ^ ^ ^ ^ (#1.1) TOTAL EXCLUSIVE
==>PATIENT AMOUNT [10S] ^ (#1.11) ASLEEP PROBER [11P:9002313.59] ^ (#1.12) ASLEEP RETRY TIME [12D] ^ ^
==>(#1.14) PAYER SHEET VERSION [14N] ^
^BPSF(9002313.92,D0,100,0)=^9002313.9205A^^ (#100) TRANSACTION HEADER SEGMENT
^BPSF(9002313.92,D0,100,D1,0)= (#.01) TRANSACTION HEADER ORDER [1N] ^ (#.02) NCPDP FIELD NUMBER [2P:9002313.91] ^ (#.03)
==>PROCESSING MODE [3S] ^
^BPSF(9002313.92,D0,100,D1,1,0)=^9002313.92051^^ (#1) SPECIAL CODE
^BPSF(9002313.92,D0,100,D1,1,D2,0)= (#.01) SPECIAL CODE [1W] ^
^BPSF(9002313.92,D0,100,D1,2,0)=^9002313.92052^^ (#2) PROGRAMMING NOTES
^BPSF(9002313.92,D0,100,D1,2,D2,0)= (#.01) PROGRAMMING NOTES [1W] ^
^BPSF(9002313.92,D0,110,0)=^9002313.9206A^^ (#110) PATIENT SEGMENT
^BPSF(9002313.92,D0,110,D1,0)= (#.01) PATIENT SEGMENT ORDER [1N] ^ (#.02) NCPDP FIELD NUMBER [2P:9002313.91] ^ (#.03) PROCESSING
==>MODE [3S] ^
^BPSF(9002313.92,D0,110,D1,1,0)=^9002313.92061^^ (#1) SPECIAL CODE
^BPSF(9002313.92,D0,110,D1,1,D2,0)= (#.01) SPECIAL CODE [1W] ^
^BPSF(9002313.92,D0,110,D1,2,0)=^9002313.92062^^ (#2) PROGRAMMING NOTES
^BPSF(9002313.92,D0,110,D1,2,D2,0)= (#.01) PROGRAMMING NOTES [1W] ^
^BPSF(9002313.92,D0,120,0)=^9002313.9207A^^ (#120) INSURANCE SEGMENT
^BPSF(9002313.92,D0,120,D1,0)= (#.01) INSURANCE SEGMENT ORDER [1N] ^ (#.02) NCPDP FIELD NUMBER [2P:9002313.91] ^ (#.03)
==>PROCESSING MODE [3S] ^
^BPSF(9002313.92,D0,120,D1,1,0)=^9002313.92071^^ (#1) SPECIAL CODE
^BPSF(9002313.92,D0,120,D1,1,D2,0)= (#.01) SPECIAL CODE [1W] ^
^BPSF(9002313.92,D0,120,D1,2,0)=^9002313.92072^^ (#2) PROGRAMMING NOTES
^BPSF(9002313.92,D0,120,D1,2,D2,0)= (#.01) PROGRAMMING NOTES [1W] ^
^BPSF(9002313.92,D0,130,0)=^9002313.9208A^^ (#130) CLAIM SEGMENT
^BPSF(9002313.92,D0,130,D1,0)= (#.01) CLAIM SEGMENT ORDER [1N] ^ (#.02) NCPDP FIELD NUMBER [2P:9002313.91] ^ (#.03) PROCESSING
==>MODE [3S] ^
^BPSF(9002313.92,D0,130,D1,1,0)=^9002313.92081^^ (#1) SPECIAL CODE
^BPSF(9002313.92,D0,130,D1,1,D2,0)= (#.01) SPECIAL CODE [1W] ^
^BPSF(9002313.92,D0,130,D1,2,0)=^9002313.92082^^ (#2) PROGRAMMING NOTES
^BPSF(9002313.92,D0,130,D1,2,D2,0)= (#.01) PROGRAMMING NOTES [1W] ^
^BPSF(9002313.92,D0,140,0)=^9002313.9209A^^ (#140) PHARMACY PROVIDER SEGMENT
^BPSF(9002313.92,D0,140,D1,0)= (#.01) PHARMACY PROVIDER ORDER [1N] ^ (#.02) NCPDP FIELD NUMBER [2P:9002313.91] ^ (#.03)
==>PROCESSING MODE [3S] ^
^BPSF(9002313.92,D0,140,D1,1,0)=^9002313.92091^^ (#1) SPECIAL CODE
^BPSF(9002313.92,D0,140,D1,1,D2,0)= (#.01) SPECIAL CODE [1W] ^
^BPSF(9002313.92,D0,140,D1,2,0)=^9002313.92092^^ (#2) PROGRAMMING NOTES
^BPSF(9002313.92,D0,140,D1,2,D2,0)= (#.01) PROGRAMMING NOTES [1W] ^
^BPSF(9002313.92,D0,150,0)=^9002313.921A^^ (#150) PRESCRIBER SEGMENT
^BPSF(9002313.92,D0,150,D1,0)= (#.01) PRESCRIBER SEGMENT ORDER [1N] ^ (#.02) NCPDP FIELD NUMBER [2P:9002313.91] ^ (#.03)
==>PROCESSING MODE [3S] ^
^BPSF(9002313.92,D0,150,D1,1,0)=^9002313.9211^^ (#1) SPECIAL CODE
^BPSF(9002313.92,D0,150,D1,1,D2,0)= (#.01) SPECIAL CODE [1W] ^
^BPSF(9002313.92,D0,150,D1,2,0)=^9002313.9212^^ (#2) PROGRAMMING NOTES
^BPSF(9002313.92,D0,150,D1,2,D2,0)= (#.01) PROGRAMMING NOTES [1W] ^
^BPSF(9002313.92,D0,160,0)=^9002313.9213A^^ (#160) COB OTHER PAYMENTS SEGMENT
^BPSF(9002313.92,D0,160,D1,0)= (#.01) COB OTHER PAYMENTS ORDER [1N] ^ (#.02) NCPDP FIELD NUMBER [2P:9002313.91] ^ (#.03)
==>PROCESSING MODE [3S] ^
^BPSF(9002313.92,D0,160,D1,1,0)=^9002313.92131^^ (#1) SPECIAL CODE
^BPSF(9002313.92,D0,160,D1,1,D2,0)= (#.01) SPECIAL CODE [1W] ^
^BPSF(9002313.92,D0,160,D1,2,0)=^9002313.92132^^ (#2) PROGRAMMING NOTES
^BPSF(9002313.92,D0,160,D1,2,D2,0)= (#.01) PROGRAMMING NOTES [1W] ^
^BPSF(9002313.92,D0,170,0)=^9002313.9214A^^ (#170) WORKERS COMP SEGMENT
^BPSF(9002313.92,D0,170,D1,0)= (#.01) WORKERS COMP SEGMENT ORDER [1N] ^ (#.02) NCPDP FIELD NUMBER [2P:9002313.91] ^ (#.03)
==>PROCESSING MODE [3S] ^
^BPSF(9002313.92,D0,170,D1,1,0)=^9002313.92141^^ (#1) SPECIAL CODE
^BPSF(9002313.92,D0,170,D1,1,D2,0)= (#.01) SPECIAL CODE [1W] ^
^BPSF(9002313.92,D0,170,D1,2,0)=^9002313.92142^^ (#2) PROGRAMMING NOTES
^BPSF(9002313.92,D0,170,D1,2,D2,0)= (#.01) PROGRAMMING NOTES [1W] ^
^BPSF(9002313.92,D0,180,0)=^9002313.9215A^^ (#180) DUR PPS SEGMENT
^BPSF(9002313.92,D0,180,D1,0)= (#.01) DUR PPS SEGMENT ORDER [1N] ^ (#.02) NCPDP FIELD NUMBER [2P:9002313.91] ^ (#.03) PROCESSING
==>MODE [3S] ^
^BPSF(9002313.92,D0,180,D1,1,0)=^9002313.92151^^ (#1) SPECIAL CODE
^BPSF(9002313.92,D0,180,D1,1,D2,0)= (#.01) SPECIAL CODE [1W] ^
^BPSF(9002313.92,D0,180,D1,2,0)=^9002313.92152^^ (#2) PROGRAMMING NOTES
^BPSF(9002313.92,D0,180,D1,2,D2,0)= (#.01) PROGRAMMING NOTES [1W] ^
^BPSF(9002313.92,D0,190,0)=^9002313.9216A^^ (#190) PRICING SEGMENT
^BPSF(9002313.92,D0,190,D1,0)= (#.01) PRICING SEGMENT ORDER [1N] ^ (#.02) NCPDP FIELD NUMBER [2P:9002313.91] ^ (#.03) PROCESSING
==>MODE [3S] ^
^BPSF(9002313.92,D0,190,D1,1,0)=^9002313.92161^^ (#1) SPECIAL CODE
^BPSF(9002313.92,D0,190,D1,1,D2,0)= (#.01) SPECIAL CODE [1W] ^
^BPSF(9002313.92,D0,190,D1,2,0)=^9002313.92162^^ (#2) PROGRAMMING NOTES
^BPSF(9002313.92,D0,190,D1,2,D2,0)= (#.01) PROGRAMMING NOTES [1W] ^
^BPSF(9002313.92,D0,200,0)=^9002313.9217A^^ (#200) COUPON SEGMENT
^BPSF(9002313.92,D0,200,D1,0)= (#.01) COUPON SEGMENT ORDER [1N] ^ (#.02) NCPDP FIELD NUMBER [2P:9002313.91] ^ (#.03) PROCESSING
==>MODE [3S] ^
^BPSF(9002313.92,D0,200,D1,1,0)=^9002313.92171^^ (#1) SPECIAL CODE
^BPSF(9002313.92,D0,200,D1,1,D2,0)= (#.01) SPECIAL CODE [1W] ^
^BPSF(9002313.92,D0,200,D1,2,0)=^9002313.92172^^ (#2) PROGRAMMING NOTES
^BPSF(9002313.92,D0,200,D1,2,D2,0)= (#.01) PROGRAMMING NOTES [1W] ^
^BPSF(9002313.92,D0,210,0)=^9002313.9218A^^ (#210) COMPOUND SEGMENT
^BPSF(9002313.92,D0,210,D1,0)= (#.01) COMPOUND SEGMENT ORDER [1N] ^ (#.02) NCPDP FIELD NUMBER [2P:9002313.91] ^ (#.03) PROCESSING
==>MODE [3S] ^
^BPSF(9002313.92,D0,210,D1,1,0)=^9002313.92181^^ (#1) SPECIAL CODE
^BPSF(9002313.92,D0,210,D1,1,D2,0)= (#.01) SPECIAL CODE [1W] ^
^BPSF(9002313.92,D0,210,D1,2,0)=^9002313.92182^^ (#2) PROGRAMMING NOTES
^BPSF(9002313.92,D0,210,D1,2,D2,0)= (#.01) PROGRAMMING NOTES [1W] ^
^BPSF(9002313.92,D0,220,0)=^9002313.9219A^^ (#220) PRIOR AUTH SEGMENT
^BPSF(9002313.92,D0,220,D1,0)= (#.01) PRIOR AUTH SEGMENT ORDER [1N] ^ (#.02) NCPDP FIELD NUMBER [2P:9002313.91] ^ (#.03)
==>PROCESSING MODE [3S] ^
^BPSF(9002313.92,D0,220,D1,1,0)=^9002313.92191^^ (#1) SPECIAL CODE
^BPSF(9002313.92,D0,220,D1,1,D2,0)= (#.01) SPECIAL CODE [1W] ^
^BPSF(9002313.92,D0,220,D1,2,0)=^9002313.92192^^ (#2) PROGRAMMING NOTES
^BPSF(9002313.92,D0,220,D1,2,D2,0)= (#.01) PROGRAMMING NOTES [1W] ^
^BPSF(9002313.92,D0,230,0)=^9002313.922A^^ (#230) CLINICAL SEGMENT
^BPSF(9002313.92,D0,230,D1,0)= (#.01) CLINICAL SEGMENT ORDER [1N] ^ (#.02) NCPDP FIELD NUMBER [2P:9002313.91] ^ (#.03) PROCESSING
==>MODE [3S] ^
^BPSF(9002313.92,D0,230,D1,1,0)=^9002313.9221^^ (#1) SPECIAL CODE
^BPSF(9002313.92,D0,230,D1,1,D2,0)= (#.01) SPECIAL CODE [1W] ^
^BPSF(9002313.92,D0,230,D1,2,0)=^9002313.9222^^ (#2) PROGRAMMING NOTES
^BPSF(9002313.92,D0,230,D1,2,D2,0)= (#.01) PROGRAMMING NOTES [1W] ^
^BPSF(9002313.92,D0,240,0)=^9002313.9223A^^ (#240) ADDL DOC SEGMENT
^BPSF(9002313.92,D0,240,D1,0)= (#.01) ADDL DOCUMENTATION ORDER [1N] ^ (#.02) NCPDP FIELD NUMBER [2P:9002313.91] ^ (#.03)
==>PROCESSING MODE [3S] ^
^BPSF(9002313.92,D0,240,D1,1,0)=^9002313.92231^^ (#1) SPECIAL CODE
^BPSF(9002313.92,D0,240,D1,1,D2,0)= (#.01) SPECIAL CODE [1W] ^
^BPSF(9002313.92,D0,240,D1,2,0)=^9002313.92232^^ (#2) PROGRAMMING NOTES
^BPSF(9002313.92,D0,240,D1,2,D2,0)= (#.01) PROGRAMMING NOTES [1W] ^
^BPSF(9002313.92,D0,250,0)=^9002313.9224A^^ (#250) FACILITY SEGMENT
^BPSF(9002313.92,D0,250,D1,0)= (#.01) FACILITY SEGMENT ORDER [1N] ^ (#.02) NCPDP FIELD NUMBER [2P:9002313.91] ^ (#.03) PROCESSING
==>MODE [3S] ^
^BPSF(9002313.92,D0,250,D1,1,0)=^9002313.92241^^ (#1) SPECIAL CODE
^BPSF(9002313.92,D0,250,D1,1,D2,0)= (#.01) SPECIAL CODE [1W] ^
^BPSF(9002313.92,D0,250,D1,2,0)=^9002313.92242^^ (#2) PROGRAMMING NOTES
^BPSF(9002313.92,D0,250,D1,2,D2,0)= (#.01) PROGRAMMING NOTES [1W] ^
^BPSF(9002313.92,D0,260,0)=^9002313.9225A^^ (#260) NARRATIVE SEGMENT
^BPSF(9002313.92,D0,260,D1,0)= (#.01) NARRATIVE SEGMENT ORDER [1N] ^ (#.02) NCPDP FIELD NUMBER [2P:9002313.91] ^ (#.03)
==>PROCESSING MODE [3S] ^
^BPSF(9002313.92,D0,260,D1,1,0)=^9002313.92251^^ (#1) SPECIAL CODE
^BPSF(9002313.92,D0,260,D1,1,D2,0)= (#.01) SPECIAL CODE [1W] ^
^BPSF(9002313.92,D0,260,D1,2,0)=^9002313.92252^^ (#2) PROGRAMMING NOTES
^BPSF(9002313.92,D0,260,D1,2,D2,0)= (#.01) PROGRAMMING NOTES [1W] ^
^BPSF(9002313.92,D0,270,0)=^9002313.9227A^^ (#270) PURCHASER SEGMENT
^BPSF(9002313.92,D0,270,D1,0)= (#.01) PURCHASER SEGMENT ORDER [1N] ^ (#.02) NCPDP FIELD NUMBER [2P:9002313.91] ^ (#.03)
==>PROCESSING MODE [3S] ^
^BPSF(9002313.92,D0,270,D1,1,0)=^9002313.92271^^ (#1) SPECIAL CODE
^BPSF(9002313.92,D0,270,D1,1,D2,0)= (#.01) SPECIAL CODE [1W] ^
^BPSF(9002313.92,D0,270,D1,2,0)=^9002313.92272^^ (#2) PROGRAMMING NOTES
^BPSF(9002313.92,D0,270,D1,2,D2,0)= (#.01) PROGRAMMING NOTES [1W] ^
^BPSF(9002313.92,D0,280,0)=^9002313.9228A^^ (#280) SERVICE PROVIDER SEGMENT
^BPSF(9002313.92,D0,280,D1,0)= (#.01) SERVICE PROVIDER SEG ORDER [1N] ^ (#.02) NCPDP FIELD NUMBER [2P:9002313.91] ^ (#.03)
==>PROCESSING MODE [3S] ^
^BPSF(9002313.92,D0,280,D1,1,0)=^9002313.92281^^ (#1) SPECIAL CODE
^BPSF(9002313.92,D0,280,D1,1,D2,0)= (#.01) SPECIAL CODE [1W] ^
^BPSF(9002313.92,D0,280,D1,2,0)=^9002313.92282^^ (#2) PROGRAMMING NOTES
^BPSF(9002313.92,D0,280,D1,2,D2,0)= (#.01) PROGRAMMING NOTES [1W] ^
^BPSF(9002313.92,D0,290,0)=^9002313.9229^^ (#290) INTERMEDIARY SEGMENT
^BPSF(9002313.92,D0,290,D1,0)= (#.01) INTERMEDIARY SEGMENT ORDER [1N] ^ (#.02) NCPDP FIELD NUMBER [2P:9002313.91] ^ (#.03)
==>PROCESSING MODE [3S] ^
^BPSF(9002313.92,D0,290,D1,1,0)=^9002313.92291^^ (#1) SPECIAL CODE
^BPSF(9002313.92,D0,290,D1,1,D2,0)= (#.01) SPECIAL CODE [1W] ^
^BPSF(9002313.92,D0,290,D1,2,0)=^9002313.92292^^ (#2) PROGRAMMING NOTES
^BPSF(9002313.92,D0,290,D1,2,D2,0)= (#.01) PROGRAMMING NOTES [1W] ^
^BPSF(9002313.92,D0,300,0)=^9002313.923^^ (#300) LAST KNOWN 4RX SEGMENT
^BPSF(9002313.92,D0,300,D1,0)= (#.01) LAST KNOWN 4RX SEGMENT ORDER [1N] ^ (#.02) NCPDP FIELD NUMBER [2P:9002313.91] ^ (#.03)
==>PROCESSING MODE [3S] ^
^BPSF(9002313.92,D0,300,D1,1,0)=^9002313.9231^^ (#1) SPECIAL CODE
^BPSF(9002313.92,D0,300,D1,1,D2,0)= (#.01) SPECIAL CODE [1W] ^
^BPSF(9002313.92,D0,300,D1,2,0)=^9002313.9232^^ (#2) PROGRAMMING NOTES
^BPSF(9002313.92,D0,300,D1,2,D2,0)= (#.01) PROGRAMMING NOTES [1W] ^
^BPSF(9002313.92,D0,DEVELOPER'S REMARKS,0)=^9002313.921901^^ (#1901) DEVELOPMENT REMARKS
^BPSF(9002313.92,D0,DEVELOPER'S REMARKS,D1,0)= (#.01) DEVELOPMENT REMARKS [1W] ^
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