STANDARD DATA DICTIONARY #366.15 -- IB NCPDP PRESCRIPTION FILE                                                    9/29/25    PAGE 1
STORED IN ^IBCNR(366.15,  *** NO DATA STORED YET ***   SITE: WWW.BMIRWIN.COM   UCI: VISTA,VISTA                    (VERSION 2.0)   

DATA          NAME                  GLOBAL        DATA
ELEMENT       TITLE                 LOCATION      TYPE
-----------------------------------------------------------------------------------------------------------------------------------
DO NOT delete entries in this file.  DO NOT edit data in this file with VA File Manager.  
 
This file is used to support NCPDP billing for multiple Rate Types.  Entries are created in this file based on the prescription and 
fill/refill number.  The Rate Type determined at time of Billing Determination is stored in this file so it can be utilized when
bill creation occurs.  This file is also used to store the associated copayment reference number if a non-veteran copayment charge
is created to allow easy lookup if the copayment charge needs to be cancelled.  
 
 
Per VHA Directive 2004-038, this file definition should not be modified.  


              DD ACCESS: @
              RD ACCESS: @
              WR ACCESS: @
             DEL ACCESS: @
           LAYGO ACCESS: @
           AUDIT ACCESS: @

CROSS
REFERENCED BY: PRESCRIPTION REFERENCE(B)



366.15,.01    PRESCRIPTION REFERENCE 0;1 FREE TEXT (Required)

              INPUT TRANSFORM:  K:$L(X)>30!($L(X)<3)!'(X'?1P.E) X
              LAST EDITED:      OCT 16, 2007 
              HELP-PROMPT:      Enter the prescription reference 
              DESCRIPTION:      This prescription reference consists of two semi-colon pieces.  The first piece is the ien from
                                file 52.  The second piece is the fill/refill number, with 0 being the initial fill.  

              CROSS-REFERENCE:  366.15^B 
                                1)= S ^IBCNR(366.15,"B",$E(X,1,30),DA)=""
                                2)= K ^IBCNR(366.15,"B",$E(X,1,30),DA)


366.15,.02    RATE ELIGIBILITY DETERMINED 0;2 FREE TEXT

              INPUT TRANSFORM:  K:$L(X)>1!($L(X)<1) X
              LAST EDITED:      OCT 16, 2007 
              HELP-PROMPT:      Enter the Eligibility Determination for this Rx/Patient 
              DESCRIPTION:      This is the Patient Rx/Eligibility determination indicator.  This is the flag returned back to
                                ECME/Pharmacy to indicate what eligibility was determined for this prescription.  This may effect
                                if a medication can be dispensed to the patient if they are not returned as a V (veteran).  


366.15,.03    RATE TYPE DETERMINED   0;3 POINTER TO RATE TYPE FILE (#399.3)

              LAST EDITED:      OCT 16, 2007 
              HELP-PROMPT:      Enter the Rate Type determined 
              DESCRIPTION:      This is the Rate Type that was determined at the time of the billable check to be used on the bill
                                when the bill is created.  


366.15,.04    COPAYMENT CHARGE       0;4 POINTER TO INTEGRATED BILLING ACTION FILE (#350)

              LAST EDITED:      OCT 16, 2007 
              HELP-PROMPT:      Enter the copayment charge associated with this NCPDP event 
              DESCRIPTION:      This is the copayment charge that was created in association with this billing event. This is used
                                to reverse previously billed copayment charges.  



      FILES POINTED TO                      FIELDS

INTEGRATED BILLING ACTION 
                   (#350)         COPAYMENT CHARGE (#.04)

RATE TYPE (#399.3)                RATE TYPE DETERMINED (#.03)



INPUT TEMPLATE(S):

PRINT TEMPLATE(S):

SORT TEMPLATE(S):

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