STANDARD 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)
DATA NAME GLOBAL DATA
ELEMENT TITLE LOCATION TYPE
-----------------------------------------------------------------------------------------------------------------------------------
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.
DD ACCESS: @
RD ACCESS: Pp
WR ACCESS: @
DEL ACCESS: @
LAYGO ACCESS: @
AUDIT ACCESS: @
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)
LAST MODIFIED: DEC 8,2020@08:27:23
9002313.57,.01ENTRY NUMBER 0;1 FREE TEXT (Required)
INPUT TRANSFORM: K:$L(X)>20!($L(X)<1) X
LAST EDITED: FEB 12, 2008
HELP-PROMPT: Answer must be 1-20 characters in length
DESCRIPTION:
Sequential entry number
CROSS-REFERENCE: 9002313.57^B
1)= S ^BPSTL("B",$E(X,1,30),DA)=""
2)= K ^BPSTL("B",$E(X,1,30),DA)
9002313.57,1 STATUS 0;2 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<0)!(X?.E1"."1N.N) X
LAST EDITED: JUN 13, 2008
HELP-PROMPT: Type a Number between 0 and 99, 0 Decimal Digits
DESCRIPTION: The status of the transaction as a percentage of completion. The text value can be obtained by
running $$STATI^BPSOSU(). Note that 99 indicates complete. Since records are only
copied to BPS Log of Transactions when transactions are complete, all records in this file should
be 99.
9002313.57,1.05POLICY NUMBER 1;5 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9999)!(X<0)!(X?.E1"."1.N) X
LAST EDITED: OCT 18, 2010
HELP-PROMPT: Enter the policy number that will be processed for this request (0-9999).
DESCRIPTION:
This is the policy number that is being processed for this eligibility verification request.
9002313.57,1.07PHARMACY 1;7 POINTER TO BPS PHARMACIES FILE (#9002313.56)
LAST EDITED: FEB 12, 2008
HELP-PROMPT: Select the BPS PHARMACY this Transaction Log relates to.
DESCRIPTION:
Textual description of the Pharmacy involved with this transaction.
9002313.57,1.08PINS PIECE 1;8 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: JUN 13, 2008
HELP-PROMPT: Type a Number between 1 and 9, 0 Decimal Digits
DESCRIPTION: Pointer to which of the PINS pieces in ^(6) is in use for this claim. Use this to keep track of
where you are in billing down the line to various insurers. (Probably won't automatically roll
over to next insurer, but maybe we will have an option to edit insurance info, try next insurance,
etc.)
9002313.57,1.09PRIOR AUTHORIZATION NUMBER 1;9 FREE TEXT
INPUT TRANSFORM: K:$L(X)>11!($L(X)<1) X
LAST EDITED: MAR 19, 2008
HELP-PROMPT: Enter the prior authorization number (1-11 characters)
DESCRIPTION:
Number assigned by the processor to identify a prior authorized transaction.
9002313.57,1.11PRESCRIPTION NUMBER 1;11 POINTER TO PRESCRIPTION FILE (#52)
LAST EDITED: DEC 10, 2013
HELP-PROMPT: Answer with PRESCRIPTION RX #
DESCRIPTION:
Prescription number for this BPS Transactions.
CROSS-REFERENCE: 9002313.57^AEC
1)= S ^BPSTL("AEC",$E(X,1,30),DA)=""
2)= K ^BPSTL("AEC",$E(X,1,30),DA)
This cross-reference is used to locate PRESCRIPTION file (#52) entries related to a transaction.
9002313.57,1.1199RXI INTERNAL ; COMPUTED
MUMPS CODE: S Y(9002313.57,1.1199,1)=$S($D(^BPSTL(D0,1)):^(1),1:"") S X=$P(Y(9002313.57,1.1199,1),U,11),X=X
ALGORITHM: INTERNAL(PRESCRIPTION NUMBER)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Internal ID to the claims file.
9002313.57,1.12RESUBMIT AFTER REVERSAL 1;12 SET
'0' FOR DONE;
'1' FOR RESUBMIT AFTER REVERSAL;
'2' FOR RESUBMITTING;
LAST EDITED: DEC 13, 2005
HELP-PROMPT: Enter the status of the resubmit
DESCRIPTION:
Indicator that a transaction has been resubmitted after being backed out.
9002313.57,1.13NCPDP OVERRIDES 1;13 POINTER TO BPS NCPDP OVERRIDE FILE (#9002313.511)
LAST EDITED: MAR 30, 2001
HELP-PROMPT: Select the BPS NCPDP OVERRIDE (test accounts only).
DESCRIPTION: Pointer to the overrides file for any fields that are not straight forward, but are required by the
payer.
9002313.57,1.15PRIOR AUTHORIZATION TYPE CODE 1;15 FREE TEXT
INPUT TRANSFORM: K:$L(X)>2!($L(X)<1) X
LAST EDITED: MAR 14, 2007
HELP-PROMPT: Enter the prior authorization type (1-2 characters)
DESCRIPTION:
Indicates the type of authorization made before transaction was submitted.
9002313.57,2 HL7 MESSAGE ID 0;3 FREE TEXT
INPUT TRANSFORM: K:$L(X)>60!($L(X)<1) X
LAST EDITED: JUN 27, 2011
HELP-PROMPT: Answer must be 1-60 characters in length.
DESCRIPTION:
This is the unique HL7 message ID used for the NCPDP message created for this transaction.
9002313.57,3 CLAIM 0;4 POINTER TO BPS CLAIMS FILE (#9002313.02)
LAST EDITED: NOV 11, 2000
HELP-PROMPT: Answer with BPS CLAIMS CLAIM ID
DESCRIPTION:
Claim number
CROSS-REFERENCE: 9002313.57^AE
1)= S ^BPSTL("AE",$E(X,1,30),DA)=""
2)= K ^BPSTL("AE",$E(X,1,30),DA)
9002313.57,3.1CLAIM IEN ; COMPUTED
MUMPS CODE: S Y(9002313.57,3.1,1)=$S($D(^BPSTL(D0,0)):^(0),1:"") S X=$P(Y(9002313.57,3.1,1),U,4),X=X
ALGORITHM: INTERNAL(CLAIM)
DESCRIPTION:
Pointer to the BPS claims file - 9002313.02
9002313.57,4 RESPONSE 0;5 POINTER TO BPS RESPONSES FILE (#9002313.03)
LAST EDITED: NOV 11, 2000
HELP-PROMPT: Answer with BPS RESPONSES
DESCRIPTION:
Pointer to the corresponding response in the response file, 9002313.03
CROSS-REFERENCE: 9002313.57^AF
1)= S ^BPSTL("AF",$E(X,1,30),DA)=""
2)= K ^BPSTL("AF",$E(X,1,30),DA)
9002313.57,4.0098RESULT WITH REVERSAL ; COMPUTED
MUMPS CODE: S X=$$CATEG^BPSOSUC(D0,1)
ALGORITHM: S X=$$CATEG^BPSOSUC(D0,1)
DESCRIPTION:
Result if the claim had to be reversed for whatever reason.
9002313.57,4.0099RESULT ; COMPUTED
MUMPS CODE: S X=$$CATEG^BPSOSUC(D0)
ALGORITHM: S X=$$CATEG^BPSOSUC(D0)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Result from the payer - maybe be Paid, rejected, captured or accepted.
9002313.57,4.1RESPONSE IEN ; COMPUTED
MUMPS CODE: S Y(9002313.57,4.1,1)=$S($D(^BPSTL(D0,0)):^(0),1:"") S X=$P(Y(9002313.57,4.1,1),U,5),X=X
ALGORITHM: INTERNAL(RESPONSE)
DESCRIPTION:
Response file record number of any reversals.
9002313.57,5 PATIENT 0;6 POINTER TO PATIENT FILE (#2)
LAST EDITED: DEC 16, 2003
HELP-PROMPT: Answer with PATIENT NAME
DESCRIPTION:
The patient this transaction refers to.
CROSS-REFERENCE: 9002313.57^AC
1)= S ^BPSTL("AC",$E(X,1,30),DA)=""
2)= K ^BPSTL("AC",$E(X,1,30),DA)
9002313.57,6 SUBMIT DATE 0;7 DATE
INPUT TRANSFORM: S %DT="ESTXR" D ^%DT S X=Y K:X<1 X
LAST EDITED: JUN 13, 2008
HELP-PROMPT: Enter the date/time that the claim was submitted
DESCRIPTION:
This is the date/time that the claim was submitted to ECME.
9002313.57,7 LAST UPDATE 0;8 DATE
INPUT TRANSFORM: S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: NOV 11, 2000
HELP-PROMPT: Enter the date/time this Transaction Log was last updated.
DESCRIPTION: Date/time the POS transaction completed processing, as copied from 9002313.59 at the time the .57
record was created.
CROSS-REFERENCE: 9002313.57^AH
1)= S ^BPSTL("AH",$E(X,1,30),DA)=""
2)= K ^BPSTL("AH",$E(X,1,30),DA)
9002313.57,9 FILL NUMBER 1;1 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<0)!(X?.E1"."1.N) X
LAST EDITED: FEB 12, 2008
HELP-PROMPT: Type a number between 0 and 99, 0 Decimal Digits
DESCRIPTION:
Prescription fill/refill number.
9002313.57,10 NDC 1;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>12!($L(X)<1) X
LAST EDITED: FEB 12, 2008
HELP-PROMPT: Answer must be 1-12 characters in length.
DESCRIPTION:
NDC number referenced in this transaction.
9002313.57,10.0099USER NUMBER ; COMPUTED
MUMPS CODE: S Y(9002313.57,10.0099,1)=$S($D(^BPSTL(D0,0)):^(0),1:"") S X=$P(Y(9002313.57,10.0099,1),U,10),X=X
ALGORITHM: INTERNAL(USER)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
IEN of the user generating the transaction
9002313.57,11 PHARMACY DIVISION 1;4 POINTER TO OUTPATIENT SITE FILE (#59)
LAST EDITED: FEB 12, 2008
HELP-PROMPT: Select the division for this transaction.
DESCRIPTION:
Division this transaction is for.
9002313.57,13 USER 0;10 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: NOV 11, 2000
HELP-PROMPT: Answer with NEW PERSON NAME
DESCRIPTION:
Who created the ECME claim
CROSS-REFERENCE: 9002313.57^AG
1)= S ^BPSTL("AG",$E(X,1,30),DA)=""
2)= K ^BPSTL("AG",$E(X,1,30),DA)
9002313.57,14 POSITION IN CLAIM 0;9 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9)!(X<1)!(X?.E1"."1N.N) X
LAST EDITED: APR 18, 2000
HELP-PROMPT: Type a Number between 1 and 9, 0 Decimal Digits
DESCRIPTION:
This is the D1 subscript into 9002313.02 and .03
9002313.57,15 START TIME 0;11 DATE
INPUT TRANSFORM: S %DT="ESTX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: APR 18, 2000
HELP-PROMPT: Enter the start Date/Time for this log entry.
DESCRIPTION:
Time, including the seconds that the transaction was initiated.
9002313.57,16 SUBMIT REQUEST 0;12 POINTER TO BPS REQUESTS FILE (#9002313.77)
LAST EDITED: DEC 12, 2007
HELP-PROMPT: Answer with BPS REQUESTS RX NUMBER
DESCRIPTION:
IEN of the BPS REQUEST file (#9002313.77)
9002313.57,17 SUBMIT REQUEST DATE TIME 0;13 DATE
INPUT TRANSFORM: S %DT="E" D ^%DT S X=Y K:Y<1 X
LAST EDITED: DEC 12, 2007
HELP-PROMPT: Enter the date/time this request was submitted.
DESCRIPTION:
Submit Request Date/Time
CROSS-REFERENCE: 9002313.57^AS
1)= S ^BPSTL("AS",$E(X,1,30),DA)=""
2)= K ^BPSTL("AS",$E(X,1,30),DA)
Submit Request Date/Time cross-reference - when the request was placed to the queue.
9002313.57,18 COB INDICATOR 0;14 SET
'1' FOR PRIMARY;
'2' FOR SECONDARY;
'3' FOR TERTIARY;
LAST EDITED: MAR 19, 2008
HELP-PROMPT: Specify the Coordination of Benefits
DESCRIPTION:
COB indicator.
9002313.57,19 TRANSACTION TYPE 0;15 SET
'C' FOR CLAIM;
'E' FOR ELIGIBILITY;
'U' FOR UNCLAIM;
'N' FOR NON-BILLABLE;
LAST EDITED: MAY 14, 2015
HELP-PROMPT: Answer with the type of transaction that will be processed for this NCPDP request.
DESCRIPTION: This is the type of transaction that is being processed:
CLAIM - An NCPDP billing request.
UNCLAIM - An NCPDP reversal request.
ELIGIBILITY - An eligibility verification request.
NON-BILLABLE - A TRICARE/CHAMPVA non-billable prescription.
TECHNICAL DESCR:
NON-BILLABLE has been added with patch BPS*1*20.
9002313.57,20 MCCF EDI TAS PROGRESS 15;1 SET
'1' FOR READY TO SEND;
'2' FOR SENT;
'3' FOR WRITTEN;
LAST EDITED: FEB 26, 2020
HELP-PROMPT: Enter the status of the MCCF EDI TAS transmission.
DESCRIPTION:
1 - Ready for Transmission to TAS 2 - Transmitted to TAS 3 - Written to TAS
FIELD INDEX: C (#1707) REGULAR IR LOOKUP & SORTING
Short Descr: This is a regular index on the MCCF EDI TAS PROGRESS field
Set Logic: S ^BPSTL("C",X,DA)=""
Kill Logic: K ^BPSTL("C",X,DA)
Whole Kill: K ^BPSTL("C")
X(1): MCCF EDI TAS PROGRESS (9002313.57,20) (Subscr 1) (forwards)
9002313.57,111COMMENT MULTIPLE 11;0 DATE Multiple #9002313.57111 (Add New Entry without Asking)
LAST EDITED: JUN 27, 2005
DESCRIPTION:
User's comment
9002313.57111,.01DATE 0;1 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:Y<1 X
LAST EDITED: MAY 27, 2005
HELP-PROMPT: Enter the Date/Time of this Comment
DESCRIPTION:
To store user's comment date
CROSS-REFERENCE: 9002313.57111^B
1)= S ^BPSTL(DA(1),11,"B",$E(X,1,30),DA)=""
2)= K ^BPSTL(DA(1),11,"B",$E(X,1,30),DA)
9002313.57111,.02USER 0;2 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: MAY 27, 2005
HELP-PROMPT: Enter the New Person entering this Comment
DESCRIPTION:
ECME user
9002313.57111,.03COMMENT 0;3 FREE TEXT
INPUT TRANSFORM: K:$L(X)>74!($L(X)<1) X
LAST EDITED: MAY 27, 2005
HELP-PROMPT: Answer must be 1-74 characters in length.
DESCRIPTION:
Comment text
9002313.57111,.04PHARMACY 0;4 SET
'1' FOR YES;
'0' FOR NO;
LAST EDITED: MAY 18, 2015
HELP-PROMPT: Enter '1' or 'Yes' if this is a pharmacy comment.
DESCRIPTION:
This field is used to determine whether or not this is a pharmacy comment.
9002313.57,201RESULT CODE 2;1 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999.999)!(X<0)!(X?.E1"."8.N) X
LAST EDITED: MAR 19, 2008
HELP-PROMPT: Type a number between 0 and 999.999, 7 Decimal Digits
DESCRIPTION:
Code indicating whether the claim was successfully billed or rejected.
9002313.57,202RESULT TEXT 2;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>222!($L(X)<1) X
LAST EDITED: APR 18, 2000
HELP-PROMPT: Answer must be 1-222 characters in length.
DESCRIPTION:
Textual description of the reason for rejection, if the claim was rejected.
9002313.57,301NON-BILLABLE REASON 3;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>60!($L(X)<1) X
LAST EDITED: AUG 19, 2015
HELP-PROMPT: Answer must be 1-60 characters in length.
DESCRIPTION: This is the reason why this prescription is Non-Billable. It is the free text value as returned by
the IB Billing Determination process. This is only for TRICARE or CHAMPVA prescriptions.
TECHNICAL DESCR: This value comes from piece [2] of the return value of $$RX^IBNCPDP when the prescription is
reported as non-billable. This is only for TRICARE or CHAMPVA prescriptions.
9002313.57,302NON-BILLABLE CLOSED 3;2 SET
'0' FOR NO;
'1' FOR YES;
LAST EDITED: MAY 15, 2015
HELP-PROMPT: Enter Yes if the Non-Billable entry is Closed.
DESCRIPTION: Enter Yes if this Non-Billable entry has been Closed. Enter No if this Non-Billable entry is still
Open. When Non-Billable entries are initially created in the BPS Transaction file, they are
automatically defaulted to Open.
9002313.57,303NON-BILLABLE DATE CLOSED 3;3 DATE
INPUT TRANSFORM: S %DT="ESTXR" D ^%DT S X=Y K:X<1 X
LAST EDITED: MAY 15, 2015
HELP-PROMPT: Enter the date and time when this Non-Billable entry was closed.
DESCRIPTION: This field contains the date and time when this Non-Billable entry was closed. It is set by the
system when a user performs this action on the ECME User Screen.
9002313.57,304NON-BILLABLE CLOSED BY 3;4 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: MAY 15, 2015
HELP-PROMPT: Enter the person who closed this non-billable entry.
DESCRIPTION: This is the person who closed this non-billable entry. It is automatically populated when this
close action happens.
9002313.57,305NON-BILLABLE CLOSED COMMENT 3;5 FREE TEXT
INPUT TRANSFORM: K:$L(X)>40!($L(X)<1) X
LAST EDITED: MAY 15, 2015
HELP-PROMPT: Answer must be 1-40 characters in length.
DESCRIPTION:
This is a free text comment explaining why this non-billable entry is being closed.
9002313.57,306NON-BILLABLE DATE RE-OPENED 3;6 DATE
INPUT TRANSFORM: S %DT="ESTXR" D ^%DT S X=Y K:X<1 X
LAST EDITED: MAY 15, 2015
HELP-PROMPT: Enter the date and time when the non-billable entry was re-opened.
DESCRIPTION:
This is the date and time when the user re-opened the non-billable entry.
9002313.57,307NON-BILLABLE RE-OPENED BY 3;7 POINTER TO NEW PERSON FILE (#200)
LAST EDITED: MAY 15, 2015
HELP-PROMPT: Enter the user who re-opened this non-billable entry.
DESCRIPTION: This is the user who re-opened this non-billable entry. It is set automatically by the system when
this action is performed.
9002313.57,308NON-BILLABLE RE-OPENED COMMENT 3;8 FREE TEXT
INPUT TRANSFORM: K:$L(X)>40!($L(X)<1) X
LAST EDITED: MAY 15, 2015
HELP-PROMPT: Answer must be 1-40 characters in length.
DESCRIPTION: This field holds the free-text comments entered by the user for the reason that this non-billable
entry was re-opened.
9002313.57,401REVERSAL CLAIM 4;1 POINTER TO BPS CLAIMS FILE (#9002313.02)
LAST EDITED: NOV 11, 2000
HELP-PROMPT: Answer with BPS CLAIMS CLAIM ID
DESCRIPTION:
Pointer to file 9002313.02 BPS CLAIMS file for the reversal transaction.
CROSS-REFERENCE: 9002313.57^AER
1)= S ^BPSTL("AER",$E(X,1,30),DA)=""
2)= K ^BPSTL("AER",$E(X,1,30),DA)
9002313.57,402REVERSAL RESPONSE 4;2 POINTER TO BPS RESPONSES FILE (#9002313.03)
LAST EDITED: NOV 11, 2000
HELP-PROMPT: Answer with BPS RESPONSES
DESCRIPTION:
Pointer to the BPS responses file 9002313.03 for the reversal response.
CROSS-REFERENCE: 9002313.57^AFR
1)= S ^BPSTL("AFR",$E(X,1,30),DA)=""
2)= K ^BPSTL("AFR",$E(X,1,30),DA)
9002313.57,404REVERSAL REASON 4;4 FREE TEXT
INPUT TRANSFORM: K:$L(X)>40!($L(X)<1) X
LAST EDITED: MAY 25, 2005
HELP-PROMPT: Answer must be 1-40 characters in length
DESCRIPTION:
Reason for the reversal
9002313.57,405REVERSAL REQUEST 4;5 POINTER TO BPS REQUESTS FILE (#9002313.77)
LAST EDITED: DEC 12, 2007
HELP-PROMPT: Answer with BPS REQUESTS RX NUMBER
DESCRIPTION:
Reversal Request IEN
9002313.57,406REVERSAL REQUEST DATE TIME 4;6 DATE
INPUT TRANSFORM: S %DT="E" D ^%DT S X=Y K:Y<1 X
LAST EDITED: DEC 12, 2007
HELP-PROMPT: Enter the Date/Time of this Reversal
DESCRIPTION:
Reversal Request Date/Time
9002313.57,501QUANTITY 5;1 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9999999)!(X<0)!(X?.E1"."4.N) X
LAST EDITED: JUL 06, 2011
HELP-PROMPT: Type a number between 0 and 9999999, 3 decimal digits.
DESCRIPTION: This is the quantity that will be used for the NCPDP field 442-E7 (QUANTITY DISPENSED) of the NCPDP
submission.
9002313.57,502UNIT PRICE 5;2 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<0)!(X?.E1"."9N.N) X
LAST EDITED: APR 18, 2000
HELP-PROMPT: Type a Number between 0 and 999999999, 8 Decimal Digits
DESCRIPTION:
Price per unit of prescription.
9002313.57,503SUBTOTAL 5;3 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<0)!(X?.E1"."9N.N) X
LAST EDITED: APR 18, 2000
HELP-PROMPT: Type a Number between 0 and 999999999, 8 Decimal Digits
DESCRIPTION: = QUANTITY * UNIT PRICE This is what we want to send as the INGREDIENT COST field in the NCPDP
message.
9002313.57,504DISPENSING FEE 5;4 NUMBER
INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>100)!(X<0) X
LAST EDITED: APR 18, 2000
HELP-PROMPT: Type a Dollar Amount between 0 and 100, 2 Decimal Digits
DESCRIPTION:
Service fee the pharmacy charges for dispensing the drug.
9002313.57,505TOTAL PRICE 5;5 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>999999999)!(X<0)!(X?.E1"."3N.N) X
LAST EDITED: APR 18, 2000
HELP-PROMPT: Type a Number between 0 and 999999999, 2 Decimal Digits
DESCRIPTION:
=SUBTOTAL + DISPENSING FEE
9002313.57,507ADMINISTRATIVE FEE 5;7 FREE TEXT
INPUT TRANSFORM: K:$L(X)>15!($L(X)<1) X
LAST EDITED: FEB 12, 2008
HELP-PROMPT: Answer must be 1-15 characters in length
DESCRIPTION:
Any fee charged for handling of the paperwork.
9002313.57,508UNIT OF MEASURE 5;8 FREE TEXT
INPUT TRANSFORM: K:$L(X)>2!($L(X)<1) X
LAST EDITED: JUN 27, 2007
HELP-PROMPT: Enter the Unit of Measure (1-2 characters)
DESCRIPTION: Enter the Unit of Measure for the drug. This is usually GR (grams), ML (milliliters), or EA
(Each).
9002313.57,509BILLING QUANTITY 5;9 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99999999)!(X<0)!(X?.E1"."4.N) X
LAST EDITED: JUL 06, 2011
HELP-PROMPT: Type a number between 0 and 99999999, 3 decimal digits.
DESCRIPTION: This is the quantity from the prescription and is used to calculate the ingredient cost. It may be
different than the quantity used in the actual NCPDP submission.
9002313.57,510BILLING UNIT 5;10 FREE TEXT
INPUT TRANSFORM: K:$L(X)>10!($L(X)<1) X
LAST EDITED: JUN 03, 2011
HELP-PROMPT: Answer must be 1-10 characters in length.
DESCRIPTION:
This is the billing units associated with the billing quantity.
9002313.57,801ASLEEP PAYER 8;1 POINTER TO BPS ASLEEP PAYERS FILE (#9002313.15)
LAST EDITED: JUN 13, 2008
HELP-PROMPT: Specify a payer that is identified as being asleep.
DESCRIPTION:
This field identifies an asleep payer for this transaction.
9002313.57,901CURRENT VA INSURER 9;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>15!($L(X)<1) X
LAST EDITED: JUN 13, 2008
HELP-PROMPT: Answer must be 1-15 characters in length.
DESCRIPTION: This field is used for the 1st patient insurance for a VA prescription and it points to the payer
sheet to use.
9002313.57,901.04ELIGIBILITY 9;4 SET
'V' FOR VETERAN;
'T' FOR TRICARE;
'C' FOR CHAMPVA;
LAST EDITED: JUN 13, 2008
HELP-PROMPT: Enter (V)eteran, (T)ricare, or (C)hampVA.
DESCRIPTION:
The insurance eligibility type of the claim.
9002313.57,902PATIENT INSURANCE MULTIPLE 10;0 POINTER Multiple #9002313.57902 (Add New Entry without Asking)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
List of VA insurers.
9002313.57902,.01PLAN ID 0;1 POINTER TO GROUP INSURANCE PLAN FILE (#355.3) (Multiply asked)
LAST EDITED: JUN 13, 2008
HELP-PROMPT: Enter the group insurance record
DESCRIPTION:
Insurance plan ID sent from the IB API
CROSS-REFERENCE: 9002313.57902^B
1)= S ^BPSTL(DA(1),10,"B",$E(X,1,30),DA)=""
2)= K ^BPSTL(DA(1),10,"B",$E(X,1,30),DA)
9002313.57902,902.02B1 PAYER SHEET 0;2 POINTER TO BPS NCPDP FORMATS FILE (#9002313.92)
LAST EDITED: OCT 18, 2010
HELP-PROMPT: Answer with a billing payer sheet to be used for this payer.
DESCRIPTION: This the payer sheet used to submit billing request for this particular insurer. Billing request
transmissions will be formatted per the specifications in this payer sheet.
9002313.57902,902.03BIN 1;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>10!($L(X)<1) X
LAST EDITED: JUL 09, 2003
HELP-PROMPT: Answer must be 1-10 characters in length.
DESCRIPTION:
Card Issuer ID or Bank ID Number used for network routing.
9002313.57902,902.04PCN 1;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>10!($L(X)<1) X
LAST EDITED: JUL 09, 2003
HELP-PROMPT: Answer must be 1-10 characters in length.
DESCRIPTION:
Processor control number assigned for the payer sheet.
9002313.57902,902.05GROUP ID 1;3 FREE TEXT
INPUT TRANSFORM: K:$L(X)>17!($L(X)<1) X
LAST EDITED: SEP 13, 2005
HELP-PROMPT: Answer must be 1-17 characters in length
DESCRIPTION:
ID assigned to the cardholder group or employer group.
9002313.57902,902.06CARDHOLDER ID 1;4 FREE TEXT
INPUT TRANSFORM: K:$L(X)>20!($L(X)<1) X
LAST EDITED: JUL 09, 2003
HELP-PROMPT: Answer must be 1-20 characters in length.
DESCRIPTION:
Insured person
9002313.57902,902.07PATIENT RELATIONSHIP CODE 1;5 SET
'0' FOR NOT SPECIFIED;
'1' FOR CARDHOLDER (SELF);
'2' FOR SPOUSE;
'3' FOR CHILD;
'4' FOR OTHER;
LAST EDITED: APR 22, 2011
HELP-PROMPT: Enter the relationship of the patient to the insured.
DESCRIPTION: This stores the relationship of the patient to insurance subscriber and will be used to populate
the NCPDP 306-C6 (PATIENT RELATIONSHIP CODE) field.
9002313.57902,902.08CARDHOLDER FIRST NAME 1;6 FREE TEXT
INPUT TRANSFORM: K:$L(X)>12!($L(X)<1) X
LAST EDITED: JUL 09, 2003
HELP-PROMPT: Answer must be 1-12 characters in length.
DESCRIPTION:
First name of the Cardholder/Subscriber.
9002313.57902,902.09CARDHOLDER LAST NAME 1;7 FREE TEXT
INPUT TRANSFORM: K:$L(X)>15!($L(X)<1) X
LAST EDITED: JUL 09, 2003
HELP-PROMPT: Answer must be 1-15 characters in length.
DESCRIPTION:
Last name of the Cardholder/Subscriber.
9002313.57902,902.1PERSON CODE 1;10 FREE TEXT
INPUT TRANSFORM: K:$L(X)>3!($L(X)<1) X
LAST EDITED: JUL 06, 2011
HELP-PROMPT: Enter the person code for the NCPDP request (1-3 characters).
DESCRIPTION: This is the Person Code that will be placed in NCPDP field 303-C3 (Person Code). This value is
specified by the third-party payer and is found on the patient's insurance card.
9002313.57902,902.11HOME PLAN STATE 1;8 FREE TEXT
INPUT TRANSFORM: K:$L(X)>2!($L(X)<1) X
LAST EDITED: JUL 09, 2003
HELP-PROMPT: Answer must be 1-2 characters in length.
DESCRIPTION:
Usually the state where the member lives or purchased their coverage.
9002313.57902,902.12DISPENSING FEE SUBMITTED 2;1 NUMBER
INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>99999)!(X<0)!(X?.E1"."3.N) X
LAST EDITED: FEB 12, 2008
HELP-PROMPT: Type a Dollar amount between 0 and 99999, 2 Decimal Digits
DESCRIPTION:
Fee amount submitted for the cost associated with dispensing this prescription.
9002313.57902,902.13BASIS OF COST DETERMINATION 2;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>2!($L(X)<1) X
LAST EDITED: JUL 09, 2003
HELP-PROMPT: Answer must be 1-2 characters in length.
DESCRIPTION:
Code indicating the method by which 'Ingredient Cost Submitted' was calculated.
9002313.57902,902.14USUAL CUSTOMARY CHARGE 2;3 NUMBER
INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:X'?.N.1".".4N!(X>99999)!(X<0) X
LAST EDITED: FEB 12, 2008
HELP-PROMPT: Type a number between 0 and 99999, 4 Decimal Digits
DESCRIPTION: Amount charged cash customers for the prescription exclusive of sales tax or other amounts
claimed.
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
9002313.57902,902.15GROSS AMOUNT DUE 2;4 NUMBER
INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:X'?.N.1".".4N!(X>99999)!(X<0) X
LAST EDITED: FEB 12, 2008
HELP-PROMPT: Type a number between 0 and 99999, 4 Decimal Digits
DESCRIPTION: Total price claimed from all sources. For prescription claim request, field represents a sum of
'Ingredient Cost Submitted' (4�9-D9), 'Dispensing Fee Submitted' (412-DC), 'Flat Sales Tax Amount
Submitted'(481-HA), 'Percentage Sales Tax Amount Submitted' (482-GE), 'Incentive Amount
Submitted' (438-E3), 'Other Amount Claimed' (48�-H9). For service claim request, field
represents a sum of 'Professional Services Fee Submitted' (477-BE), 'Flat Sales Tax Amount
Submitted'(481-HA), 'Percentage Sales Tax Amount Submitted'(482-GE), 'Other Amount Claimed'
(48�-H9)
NOTES: XXXX--CAN'T BE ALTERED EXCEPT BY PROGRAMMER
9002313.57902,902.16ADMINISTRATIVE FEE 2;5 NUMBER
INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>99999)!(X<0)!(X?.E1"."3.N) X
LAST EDITED: FEB 12, 2008
HELP-PROMPT: Type a Dollar amount between 0 and 99999, 2 Decimal Digits
DESCRIPTION:
Fee charged for any costs related to preparing the prescription.
9002313.57902,902.17VA FILL NUMBER 2;6 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99)!(X<0)!(X?.E1"."1.N) X
LAST EDITED: FEB 12, 2008
HELP-PROMPT: Type a number between 0 and 99, 0 Decimal Digits
DESCRIPTION:
Which fill/refill this transaction is for.
9002313.57902,902.18SOFTWARE VENDOR CERT ID 2;7 FREE TEXT
INPUT TRANSFORM: K:$L(X)>30!($L(X)<1) X
LAST EDITED: FEB 12, 2008
HELP-PROMPT: Answer must be 1-30 characters in length.
DESCRIPTION:
Certification number assigned by payer to the sending entity, allowing claims to be sent.
9002313.57902,902.19B2 PAYER SHEET 0;3 POINTER TO BPS NCPDP FORMATS FILE (#9002313.92)
LAST EDITED: FEB 12, 2008
HELP-PROMPT: Enter the Reversal payer sheet.
DESCRIPTION:
This is the reversal payer sheet associated with the payer.
9002313.57902,902.2INGREDIENT COST 2;10 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99999999)!(X<0)!(X?.E1"."3.N) X
LAST EDITED: JUL 06, 2011
HELP-PROMPT: Type a number between 0 and 99999999, 2 decimal digits.
DESCRIPTION: This is the INGREDIENT COST that will be placed in the NCPDP field 409-D9 (INGREDIENT COST
SUBMITTED) field of the NCPDP submission.
9002313.57902,902.21B3 PAYER SHEET 0;4 POINTER TO BPS NCPDP FORMATS FILE (#9002313.92)
LAST EDITED: OCT 18, 2010
HELP-PROMPT: Enter the rebill payer sheet used for this payer.
DESCRIPTION: This is the payer sheet to be used for a rebill request for this insurer. Rebill transmission
will be formatted per the specifications in this payer sheet.
9002313.57902,902.22CERTIFY MODE 0;5 SET
'0' FOR CERTIFY MODE ON;
'1' FOR CERTIFY MODE OFF;
LAST EDITED: JUN 13, 2008
HELP-PROMPT: Enter null or 0 for Certify mode off. Enter 1 for Certify mode on.
DESCRIPTION:
This is to specify if the claim was used for certification.
9002313.57902,902.23CERTIFICATION 0;6 POINTER TO BPS CERTIFICATION FILE (#9002313.31)
LAST EDITED: FEB 12, 2008
HELP-PROMPT: Enter the certification record
DESCRIPTION: This field is used during certification testing, and contains the pointer to the Certification
file 9002313.31.
9002313.57902,902.24INSURANCE NAME 0;7 FREE TEXT
INPUT TRANSFORM: K:$L(X)>40!($L(X)<1) X
LAST EDITED: NOV 21, 2007
HELP-PROMPT: Answer must be 1-40 characters in length.
DESCRIPTION:
This field is the Plan Name for the insurance being filed.
9002313.57902,902.25GROUP NAME 3;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>20!($L(X)<2) X
LAST EDITED: SEP 13, 2005
HELP-PROMPT: Answer must be 2-20 characters in length
DESCRIPTION:
This is the Group Name for the Group Insurance file
9002313.57902,902.26INSURANCE CO PHONE 3;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>20!($L(X)<7) X
LAST EDITED: FEB 12, 2008
HELP-PROMPT: Answer must be 7-20 characters in length
DESCRIPTION:
This is the Claims (RX) phone number from the Insurance Company file
9002313.57902,902.27PHARMACY PLAN ID 3;3 FREE TEXT
INPUT TRANSFORM: K:$L(X)>30!($L(X)<1) X
LAST EDITED: JUN 17, 2005
HELP-PROMPT: Answer must be 1-30 characters in length
DESCRIPTION:
This is a ID of the Plan file
9002313.57902,902.28ELIGIBILITY 3;4 SET
'V' FOR VETERAN;
'T' FOR TRICARE;
'C' FOR CHAMPVA;
LAST EDITED: AUG 04, 2011
HELP-PROMPT: Enter eligibility of the claim.
DESCRIPTION:
The insurance eligibility type of the claim.
9002313.57902,902.29RATE TYPE 0;8 POINTER TO RATE TYPE FILE (#399.3)
LAST EDITED: JAN 09, 2009
HELP-PROMPT: Select Rate Type for billing
DESCRIPTION:
The Rate Type selected by the user for billing.
9002313.57902,902.3PRIMARY PAYER BILL 2;8 POINTER TO BILL/CLAIMS FILE (#399)
LAST EDITED: JAN 09, 2009
HELP-PROMPT: Select Primary bill for secondary billing.
DESCRIPTION: Primary bill which should be used to create the secondary bill. This field is used for secondary
billing only.
9002313.57902,902.31PRIOR PAYMENT 2;9 NUMBER
INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999999)!(X<0) X
LAST EDITED: MAR 25, 2009
HELP-PROMPT: Enter a Dollar Amount (between 0 and 999999, 2 Decimal Digits) paid by primary insurer.
DESCRIPTION:
Dollar amount paid by the Primary insurer. This field is used for secondary billing only.
9002313.57902,902.32PLAN COB 3;6 SET
'1' FOR PRIMARY;
'2' FOR SECONDARY;
'3' FOR TERTIARY;
LAST EDITED: MAR 25, 2009
HELP-PROMPT: Enter Coordination Of Benefits indicator for the insurance plan.
DESCRIPTION: The Coordination of Benefits value as it is stored in (#.2) COB field of the (#.3121) Insurance
Type multiple of the Patient file (#2).
9002313.57902,902.33INSURANCE COMPANY 3;5 POINTER TO INSURANCE COMPANY FILE (#36)
LAST EDITED: JAN 16, 2009
HELP-PROMPT: Select the insurance carrier for this claim.
DESCRIPTION:
This is the INSURANCE COMPANY from file #36.
9002313.57902,902.34E1 PAYER SHEET 0;9 POINTER TO BPS NCPDP FORMATS FILE (#9002313.92)
LAST EDITED: OCT 18, 2010
HELP-PROMPT: Enter the eligibility verification payer sheet for the payer.
DESCRIPTION: This is the payer sheet to be used for eligibility verification requests for this insurer.
Eligibility verification transmissions will be formatted per the specifications in this payer
sheet.
9002313.57902,902.35POLICY NUMBER 0;12 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9999)!(X<0)!(X?.E1"."1.N) X
LAST EDITED: OCT 18, 2010
HELP-PROMPT: Enter the policy number for this insurer (0-9999).
DESCRIPTION:
This is the policy number assigned for this particular patient and insurer.
9002313.57902,902.36MAXIMUM NCPDP TRANSACTIONS 1;9 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>99999)!(X<1)!(X?.E1"."1.N) X
LAST EDITED: OCT 18, 2010
HELP-PROMPT: Enter the maximum number of transactions allowed in a request (1-9999).
DESCRIPTION: This is the maximum number of transactions that can be bundled in a transmission. It is
specified by the NCPDP processor.
9002313.57,1201RX ACTION 12;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>4!($L(X)<1) X
LAST EDITED: FEB 10, 2011
HELP-PROMPT: Enter the mnemonic that indicates what type of action should be performed (1-4 characters).
DESCRIPTION: This is the action that is being performed on this request. It is either the BWHERE parameter
passed into BPSNCPDP or 'ELIG' for an eligibility verification request. The list of BWHERE values
are documented at the top of routine BPSNCPD3.
9002313.57,1202DATE OF SERVICE 12;2 DATE
INPUT TRANSFORM: S %DT="E" D ^%DT S X=Y K:X<1 X
LAST EDITED: MAY 25, 2005
HELP-PROMPT: (No range limit on date)
DESCRIPTION:
Date used for the 401-D1 (DATE OF SERVICE) in the NCPDP transaction
9002313.57,1203SUBMISSION CLARIFICATION CODE 12;3 FREE TEXT
INPUT TRANSFORM: K:$L(X)>2!($L(X)<1) X
LAST EDITED: JAN 19, 2007
HELP-PROMPT: Answer must be 1-2 characters in length.
DESCRIPTION:
Submission Clarification Code
9002313.57,1204COB OTHER PAYMENTS COUNT 12;4 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9)!(X<0)!(X?.E1"."1.N) X
LAST EDITED: JUN 17, 2010
HELP-PROMPT: Enter a number between 0 and 9 for a count of other payment occurrences.
DESCRIPTION: NCPDP field 337-4C - Coordination of Benefits/Other Payments Count
This value corresponds to the number of multiple entries in the #1400 multiple field - COB OTHER
PAYERS.
9002313.57,1205OTHER COVERAGE CODE 12;5 SET
'00' FOR NOT SPECIFIED;
'01' FOR NO OTH COVERAGE;
'02' FOR PYMT COLLECT/OTH PAYER;
'03' FOR CLAIM NOT COVER/OTH PAYER;
'04' FOR PYMT NOT COLLECT/OTH PAYER;
'05' FOR PLAN DENIAL;
'06' FOR NONPARTICIPAT PROV/OTH PAYER;
'07' FOR OTH COVER NOT EFFECT ON DOS;
'08' FOR COPAY BILLING;
LAST EDITED: JUN 17, 2010
HELP-PROMPT: Select the Other Coverage Code.
DESCRIPTION:
NCPDP field 308-C8 - code indicating whether or not the patient has other insurance coverage.
9002313.57,1300DUR DATA 13;0 Multiple #9002313.5713
DESCRIPTION: This multiple will track the Drug Utilization Review (DUR) information passed by Outpatient
Pharmacy to ECME and that will eventually be put in the DUR segment of the NCPDP claim.
9002313.5713,.01DUR COUNTER 0;1 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9999)!(X<1)!(X?.E1"."1.N) X
LAST EDITED: JUN 15, 2005
HELP-PROMPT: Type a number between 1 and 9999, 0 Decimal Digits
DESCRIPTION:
This is the field used to populate the 473-7E field of the claim
CROSS-REFERENCE: 9002313.5713^B
1)= S ^BPSTL(DA(1),13,"B",$E(X,1,30),DA)=""
2)= K ^BPSTL(DA(1),13,"B",$E(X,1,30),DA)
9002313.5713,1 DUR PROFESSIONAL SERVICE CODE 0;2 FREE TEXT
INPUT TRANSFORM: K:$L(X)>2!($L(X)<1) X
LAST EDITED: JUN 15, 2005
HELP-PROMPT: Answer must be 1-2 characters in length
DESCRIPTION:
This is the field used to populate the 439-E4 field of the claim
9002313.5713,2 DUR REASON FOR SERVICE CODE 0;3 FREE TEXT
INPUT TRANSFORM: K:$L(X)>2!($L(X)<1) X
LAST EDITED: JUN 15, 2005
HELP-PROMPT: Answer must be 1-2 characters in length
DESCRIPTION:
This is the field used to populate the 440-E5 field of the claim
9002313.5713,3 DUR RESULT OF SERVICE CODE 0;4 FREE TEXT
INPUT TRANSFORM: K:$L(X)>2!($L(X)<1) X
LAST EDITED: JUN 15, 2005
HELP-PROMPT: Answer must be 1-2 characters in length
DESCRIPTION:
This is the field used to populate the 441-E6 field of the claim
9002313.57,1400COB OTHER PAYERS 14;0 Multiple #9002313.5714 (Add New Entry without Asking)
LAST EDITED: JUN 17, 2010
DESCRIPTION: This multiple structure stores information about each of the other payers involved in the payment
or rejection of the claim.
NCPDP has a maximum of 9 occurrences here with a recommendation of less than or equal to 3
occurrences. However, VA only stores data for at most 3 insurance policies for any given claim.
So at most there will only be 2 occurrences of this other payer multiple.
9002313.5714,.01OTHER PAYER COUNTER 0;1 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9)!(X<0)!(X?.E1"."1.N) X
LAST EDITED: JUN 17, 2010
HELP-PROMPT: Type a number between 0 and 9, 0 decimal digits.
DESCRIPTION:
This is a multiple counter field to store the count of the other payers.
CROSS-REFERENCE: 9002313.5714^B
1)= S ^BPSTL(DA(1),14,"B",$E(X,1,30),DA)=""
2)= K ^BPSTL(DA(1),14,"B",$E(X,1,30),DA)
9002313.5714,.02OTHER PAYER COVERAGE TYPE 0;2 SET
'01' FOR PRIMARY;
'02' FOR SECONDARY;
'03' FOR TERTIARY;
'98' FOR COUPON;
'99' FOR COMPOSITE;
LAST EDITED: JUN 17, 2010
HELP-PROMPT: Select other payer coverage type.
DESCRIPTION:
NCPDP field 338-5C - Code identifying the type of 'Other Payer ID'
9002313.5714,.03OTHER PAYER ID QUALIFIER 0;3 SET
'01' FOR STANDARD UNIQUE HEALTH PLAN ID;
'02' FOR HEALTH INDUSTRY NUMBER (HIN);
'03' FOR BANK INFORMATION NUMBER (BIN);
'04' FOR NAT. ASSOC. OF INS. COM.(NAIC);
'05' FOR MEDICARE CARRIER NUMBER;
'09' FOR COUPON;
'99' FOR OTHER;
LAST EDITED: NOV 25, 2014
HELP-PROMPT: Select Other Payer ID Qualifier.
DESCRIPTION:
NCPDP field 339-6C - Code qualifying the 'Other Payer ID' (340-7C).
9002313.5714,.04OTHER PAYER ID 0;4 FREE TEXT
INPUT TRANSFORM: K:$L(X)>10!($L(X)<1) X
LAST EDITED: JUN 17, 2010
HELP-PROMPT: Enter Other Payer ID (1-10 characters).
DESCRIPTION:
NCPDP field 340-7C - ID assigned to the payer.
9002313.5714,.05OTHER PAYER DATE 0;5 DATE
INPUT TRANSFORM: S %DT="EX" D ^%DT S X=Y K:X<1 X
LAST EDITED: JUN 17, 2010
HELP-PROMPT: Enter the payment/denial date of the claim submitted to the other payer.
DESCRIPTION: NCPDP field 443-E8 - Payment or denial date of the claim submitted to the other payer. Used for
coordination of benefits.
9002313.5714,.06OTHER PAYER AMOUNT PAID COUNT 0;6 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>9)!(X<0)!(X?.E1"."1.N) X
LAST EDITED: JUN 17, 2010
HELP-PROMPT: Enter the count (0-9) of the payer amount paid occurrences.
DESCRIPTION:
NCPDP field 341-HB - Count of the payer amount paid occurrences.
9002313.5714,.07OTHER PAYER REJECT COUNT 0;7 NUMBER
INPUT TRANSFORM: K:+X'=X!(X>20)!(X<0)!(X?.E1"."1.N) X
LAST EDITED: JUN 17, 2010
HELP-PROMPT: Enter the count (0-20) of the other payer reject code occurrences.
DESCRIPTION:
NCPDP field 471-5E - Count of 'Other Payer Reject Code' occurrences.
9002313.5714,1 OTHER PAYER AMT PAID MULTIPLE 1;0 Multiple #9002313.57141 (Add New Entry without Asking)
LAST EDITED: JUN 17, 2010
DESCRIPTION: This multiple stores the NCPDP fields:
431-DV - Other Payer Amount Paid
342-HC - Other Payer Amount Paid Qualifier
Up to 9 occurrences are allowed by the NCPDP standard. This limit is dictated by the NCPDP
standard and enforced within the ECME claim building process (i.e. the ECME application
software). There are no such limits built into this data dictionary.
9002313.57141,.01 OTHER PAYER AMOUNT PAID 0;1 NUMBER
INPUT TRANSFORM: S:X["$" X=$P(X,"$",2) K:X'?.N.1".".2N!(X>999999)!(X<0)!(X?.E1"."3.N) X
LAST EDITED: JUN 17, 2010
HELP-PROMPT: Type a dollar amount between 0 and 999999, 2 decimal digits.
DESCRIPTION: NCPDP field 431-DV - Amount of any payment known by the pharmacy from other sources (including
coupons).
CROSS-REFERENCE: 9002313.57141^B
1)= S ^BPSTL(DA(2),14,DA(1),1,"B",$E(X,1,30),DA)=""
2)= K ^BPSTL(DA(2),14,DA(1),1,"B",$E(X,1,30),DA)
9002313.57141,.02 OTHER PAYER AMT PAID QUALIFIER 0;2 POINTER TO BPS NCPDP OTHER PAYER AMT PAID QUAL FILE (#9002313.2)
LAST EDITED: DEC 01, 2014
HELP-PROMPT: Enter the type of Other Payer Amount Paid.
DESCRIPTION:
NCPDP field 342-HC - Code qualifying the 'Other Payer Amount Paid' (431-DV).
9002313.5714,2 OTHER PAYER REJECT MULTIPLE 2;0 Multiple #9002313.57142 (Add New Entry without Asking)
LAST EDITED: JUN 17, 2010
DESCRIPTION: This multiple stores the NCPDP field:
NCPDP field 472-6E - Other Payer Reject Code
Up to 20 occurrences are allowed by the NCPDP standard. This limit is dictated by the NCPDP
standard and enforced within the ECME claim building process (i.e. the ECME application
software). There are no such limits built into this data dictionary.
9002313.57142,.01 OTHER PAYER REJECT CODE 0;1 FREE TEXT
INPUT TRANSFORM: K:$L(X)>3!($L(X)<1) X
LAST EDITED: JUN 17, 2010
HELP-PROMPT: Enter a reject code returned by the Other Payer.
DESCRIPTION: NCPDP field 472-6E - The error encountered by the previous "Other Payer" in 'Reject Code'
(511-FB).
CROSS-REFERENCE: 9002313.57142^B
1)= S ^BPSTL(DA(2),14,DA(1),2,"B",$E(X,1,30),DA)=""
2)= K ^BPSTL(DA(2),14,DA(1),2,"B",$E(X,1,30),DA)
9002313.57,9999.92HRN FAC ; COMPUTED
MUMPS CODE: N IEN57 S IEN57=D0,X=$$HRN^BPSOS57
ALGORITHM: N IEN57 S IEN57=D0,X=$$HRN^BPSOS57
LAST EDITED: FEB 12, 2008
DESCRIPTION: Health record number and facility ID - this is set to the pointer to the patient file and the
division.
9002313.57,9999.93DRUG NAME ; COMPUTED
MUMPS CODE: N IEN57 S IEN57=D0,X=$$DRGNAME^BPSOS57
ALGORITHM: N IEN57 S IEN57=D0,X=$$DRGNAME^BPSOS57
DESCRIPTION:
Drug name from file 50
9002313.57,9999.94DRUG IEN ; COMPUTED
MUMPS CODE: N IEN57 S IEN57=D0,X=$$DRGDFN^BPSOS57
ALGORITHM: N IEN57 S IEN57=D0,X=$$DRGDFN^BPSOS57
DESCRIPTION:
The IEN of the drug from file 50.
9002313.57,9999.95RELEASED DATE ; COMPUTED
MUMPS CODE: N IEN57 S IEN57=D0,X=$$RELDATE^BPSOS57
ALGORITHM: N IEN57 S IEN57=D0,X=$$RELDATE^BPSOS57
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Release date and time from the prescription file, 52.
9002313.57,9999.96NET PAID BY INSURER ; COMPUTED
MUMPS CODE: N RESP,POSITION S X=$G(^BPSTL(D0,0)),RESP=$P(X,U,5),POSITION=$P(X,U,9),X=$S(RESP&POSITION:$$NETPAID
1^BPSOS03(RESP,POSITION),1:"")
ALGORITHM: N RESP,POSITION S X=$G(^BPSTL(D0,0)),RESP=$P(X,U,5),POSITION=$P(X,U,9),X=$S(RESP&POSITION:$$NETPAID
1^BPSOS03(RESP,POSITION),1:"")
LAST EDITED: MAR 31, 2004
DESCRIPTION:
Amount paid after the discounts and deductible have been subtracted.
9002313.57,9999.97ELAPSED TIME PRINTABLE ; COMPUTED
MUMPS CODE: S X=$G(^BPSTL(D0,0)) N X11,X8 S X11=$P(X,U,11),X8=$P(X,U,8),X=$S(X11&X8:$$TIMEDIF^BPSOSUD(X11,X8),1
:"")
ALGORITHM: S X=$G(^BPSTL(D0,0)) N X11,X8 S X11=$P(X,U,11),X8=$P(X,U,8),X=$S(X11&X8:$$TIMEDIF^BPSOSUD(X11,X8),1
:"")
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Elapsed time between submission and response in external format.
9002313.57,9999.98ELAPSED TIME SECONDS ; COMPUTED
MUMPS CODE: S X=$G(^BPSTL(D0,0)) N X11,X8 S X11=$P(X,U,11),X8=$P(X,U,8),X=$S(X11&X8:$$TIMEDIFI^BPSOSUD(X11,X8),
1:"")
ALGORITHM: S X=$G(^BPSTL(D0,0)) N X11,X8 S X11=$P(X,U,11),X8=$P(X,U,8),X=$S(X11&X8:$$TIMEDIFI^BPSOSUD(X11,X8),
1:"")
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Elapsed time between submission and response expressed as a number of seconds.
9002313.57,9999.99RESULT CATEGORY ; COMPUTED
MUMPS CODE: S X=$$CATEG^BPSOSUC(D0)
ALGORITHM: S X=$$CATEG^BPSOSUC(D0)
LAST EDITED: NOV 15, 2000
DESCRIPTION:
The category of the transmission - accepted, payable, rejected, etc.
9002313.57,10101BIN NUMBER ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(101)
ALGORITHM: S X=$$FIELD^BPSOS57(101)
DESCRIPTION:
BIN number from the response file.
9002313.57,10102VERSION RELEASE NUMBER ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(102)
ALGORITHM: S X=$$FIELD^BPSOS57(102)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Version/release number from the BPS claims file.
9002313.57,10103TRANSACTION CODE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(103)
ALGORITHM: S X=$$FIELD^BPSOS57(103)
DESCRIPTION:
Type of transaction from the claim file.
9002313.57,10104PROCESSOR CONTROL NUMBER ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(104)
ALGORITHM: S X=$$FIELD^BPSOS57(104)
DESCRIPTION:
PCN number from the claims file.
9002313.57,10201PHARMACY NUMBER ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(201)
ALGORITHM: S X=$$FIELD^BPSOS57(201)
DESCRIPTION:
The Pharmacy's NABP number from the claims file.
9002313.57,10301GROUP NUMBER ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(301)
ALGORITHM: S X=$$FIELD^BPSOS57(301)
DESCRIPTION:
The group number of the insurance used from the BPS claims file.
9002313.57,10302CARDHOLDER ID NUMBER ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(302)
ALGORITHM: S X=$$FIELD^BPSOS57(302)
LAST EDITED: MAR 22, 2004
DESCRIPTION:
The insured person's cardholder identification number from the claims file.
9002313.57,10303PERSON CODE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(303)
ALGORITHM: S X=$$FIELD^BPSOS57(303)
DESCRIPTION:
The person code from the BPS claims file.
9002313.57,10304DATE OF BIRTH ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(304)
ALGORITHM: S X=$$FIELD^BPSOS57(304)
DESCRIPTION:
Date of birth of the patient from the BPS claims file.
9002313.57,10305SEX CODE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(305)
ALGORITHM: S X=$$FIELD^BPSOS57(305)
DESCRIPTION:
Sex of the patient, "M" or "F"
9002313.57,10306RELATIONSHIP CODE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(306)
ALGORITHM: S X=$$FIELD^BPSOS57(306)
DESCRIPTION:
Relationship of the patient to the insured - from the BPS claims file.
9002313.57,10307CUSTOMER LOCATION ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(307)
ALGORITHM: S X=$$FIELD^BPSOS57(307)
DESCRIPTION: Code identifying the location of the patient when receiving pharmacy services. �=Not Specified
1=Home 2=Inter-Care 3=Nursing Home 4=Long Term/Extended Care 5=Rest Home 6=Boarding Home 7=Skilled
Care Facility 8=Sub-Acute Care Facility 9=Acute Care Facility 1�=Outpatient 11=Hospice
from the BPS claims file
9002313.57,10308OTHER COVERAGE CODE CALCULATED ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(308)
ALGORITHM: S X=$$FIELD^BPSOS57(308)
LAST EDITED: OCT 13, 2010
DESCRIPTION: Code indicating whether or not the patient has other insurance coverage. It returns OTHER COVERAGE
CODE (#308) field of the MEDICATIONS (#9002313.0201) sub-file of the BPS CLAIMS (#900213.02) file.
If the patient has no other insurance coverage an empty string is returned.
9002313.57,10309ELIGIBILITY CLARIFICATION CODE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(309)
ALGORITHM: S X=$$FIELD^BPSOS57(309)
DESCRIPTION: Code indicating that the pharmacy is clarifying eligibility based on receiving a denial. Comes from
the BPS claims file.
9002313.57,10310PATIENT FIRST NAME ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(310)
ALGORITHM: S X=$$FIELD^BPSOS57(310)
DESCRIPTION:
First name of patient receiving the prescription, from the BPS claims file.
9002313.57,10311PATIENT LAST NAME ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(311)
ALGORITHM: S X=$$FIELD^BPSOS57(311)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Last Name of patient receiving the prescription from the BPS claims file.
9002313.57,10312CARDHOLDER FIRST NAME ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(312)
ALGORITHM: S X=$$FIELD^BPSOS57(312)
DESCRIPTION:
First name of the Cardholder/Subscriber from the BPS claims file.
9002313.57,10313CARDHOLDER LAST NAME ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(313)
ALGORITHM: S X=$$FIELD^BPSOS57(313)
DESCRIPTION:
Last name of the Cardholder/Subscriber from the BPS claims file.
9002313.57,10314HOME PLAN ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(314)
ALGORITHM: S X=$$FIELD^BPSOS57(314)
DESCRIPTION: Code identifying the Blue Cross or Blue Shield plan ID which indicates where the member's coverage
has been designated. Usually where the member lives or purchased their coverage from the BPS claims
file.
9002313.57,10315EMPLOYER NAME ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(315)
ALGORITHM: S X=$$FIELD^BPSOS57(315)
DESCRIPTION:
Complete name of employer.
9002313.57,10316EMPLOYER STREET ADDRESS ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(316)
ALGORITHM: S X=$$FIELD^BPSOS57(316)
DESCRIPTION:
Free-form text for address information from the claims file.
9002313.57,10317EMPLOYER CITY ADDRESS ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(317)
ALGORITHM: S X=$$FIELD^BPSOS57(317)
DESCRIPTION:
Free-form text for city name.
9002313.57,10318EMPLOYER STATE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(318)
ALGORITHM: S X=$$FIELD^BPSOS57(318)
DESCRIPTION:
Standard State/Province Code as defined by appropriate government agency.
9002313.57,10319EMPLOYER ZIP CODE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(319)
ALGORITHM: S X=$$FIELD^BPSOS57(319)
DESCRIPTION:
Code defining international postal zone excluding punctuation and blanks (zip code for US).
9002313.57,10320EMPLOYER PHONE NUMBER ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(320)
ALGORITHM: S X=$$FIELD^BPSOS57(320)
DESCRIPTION:
Ten digit phone number of employer.
9002313.57,10321EMPLOYER CONTACT NAME ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(321)
ALGORITHM: S X=$$FIELD^BPSOS57(321)
LAST EDITED: JUN 13, 2008
DESCRIPTION:
Contact person's name of the cardholder's employer.
9002313.57,10322PATIENT STREET ADDRESS ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(322)
ALGORITHM: S X=$$FIELD^BPSOS57(322)
DESCRIPTION:
Free-form text for Patient address information.
9002313.57,10323PATIENT CITY ADDRESS ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(323)
ALGORITHM: S X=$$FIELD^BPSOS57(323)
LAST EDITED: DEC 22, 2003
DESCRIPTION:
Free-form text for city name.
9002313.57,10324PATIENT STATE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(324)
ALGORITHM: S X=$$FIELD^BPSOS57(324)
DESCRIPTION: Standard State/Province Code as defined by appropriate government agency. Comes from the BPS
claims file.
9002313.57,10325PATIENT ZIP CODE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(325)
ALGORITHM: S X=$$FIELD^BPSOS57(325)
DESCRIPTION: Code defining international postal zone excluding punctuation and blanks (zip code for US). From
the BPS claims file.
9002313.57,10326PATIENT PHONE NUMBER ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(326)
ALGORITHM: S X=$$FIELD^BPSOS57(326)
DESCRIPTION:
Ten digit phone number of patient. From the BPS claims file.
9002313.57,10327CARRIER ID NUMBER ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(327)
ALGORITHM: S X=$$FIELD^BPSOS57(327)
DESCRIPTION:
The ID number of the insurance carrier.
9002313.57,10328PATIENT WEIGHT ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(328)
ALGORITHM: S X=$$FIELD^BPSOS57(328)
DESCRIPTION:
Patient's weight from the patient file.
9002313.57,10329PATIENT SSN ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(329)
ALGORITHM: S X=$$FIELD^BPSOS57(329)
DESCRIPTION:
Patient SSN from the claims file.
9002313.57,10401DATE FILLED ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(401)
ALGORITHM: S X=$$FIELD^BPSOS57(401)
DESCRIPTION:
The fill/refill date
9002313.57,10402PRESCRIPTION NUMBER SEVEN ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(402)
ALGORITHM: S X=$$FIELD^BPSOS57(402)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
The first seven digits of the prescription IEN
9002313.57,10403NEW REFILL CODE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(403)
ALGORITHM: S X=$$FIELD^BPSOS57(403)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
The fill/refill number, starting at 0 for the original fill.
9002313.57,10404METRIC QUANTITY ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(404)
ALGORITHM: S X=$$FIELD^BPSOS57(404)
DESCRIPTION:
Metric quantity of the drug.
9002313.57,10405DAYS SUPPLY ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(405)
ALGORITHM: S X=$$FIELD^BPSOS57(405)
DESCRIPTION:
The actual days supply dispensed.
9002313.57,10406COMPOUND CODE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(406)
ALGORITHM: S X=$$FIELD^BPSOS57(406)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Field indicating whether this prescription was a compound (1) or not a compound (0).
9002313.57,10407NDC NUMBER ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(407)
ALGORITHM: S X=$$FIELD^BPSOS57(407)
DESCRIPTION:
NDC code in our case.
9002313.57,10408DISPENSE AS WRITTEN ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(408)
ALGORITHM: S X=$$FIELD^BPSOS57(408)
DESCRIPTION:
Indicator for whether the prescription was to be dispensed only as written.
9002313.57,10409INGREDIENT COST ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(409)
ALGORITHM: S X=$$FIELD^BPSOS57(409)
LAST EDITED: APR 05, 2001
DESCRIPTION:
Cost amount for the ingredients of compounds.
9002313.57,10410SALES TAX ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(410)
ALGORITHM: S X=$$FIELD^BPSOS57(410)
DESCRIPTION:
Sales Tax charged (not applicable for VA)
9002313.57,10411PRESCRIBER ID ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(411)
ALGORITHM: S X=$$FIELD^BPSOS57(411)
DESCRIPTION:
Prescriber identification number.
9002313.57,10412DISPENSING FEE SUBMITTED ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(412)
ALGORITHM: S X=$$FIELD^BPSOS57(412)
DESCRIPTION: Add-on fee charged in a retail setting. This field will probably be used when the Tricare
functionality is added.
9002313.57,10414DATE PRESCRIPTION WRITTEN ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(414)
ALGORITHM: S X=$$FIELD^BPSOS57(414)
DESCRIPTION:
This will be the fill/refill date for local fills, the released date for CMOP.
9002313.57,10415NUMBER OF REFILLS AUTHORIZED ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(415)
ALGORITHM: S X=$$FIELD^BPSOS57(415)
DESCRIPTION:
The number of refills allowed that was entered during order entry.
9002313.57,10416PRIOR AUTH/MC CODE AND NUMBER ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(416)
ALGORITHM: S X=$$FIELD^BPSOS57(416)
DESCRIPTION:
Not used for VA - left in for IHS
9002313.57,10418LEVEL OF SERVICE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(418)
ALGORITHM: S X=$$FIELD^BPSOS57(418)
DESCRIPTION:
Not used for VA - left in for IHS
9002313.57,10419PRESCRIPTION ORIGIN CODE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(419)
ALGORITHM: S X=$$FIELD^BPSOS57(419)
DESCRIPTION:
Not used for VA - left in for IHS
9002313.57,10420PRESCRIPTION CLARIFICATION ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(420)
ALGORITHM: S X=$$FIELD^BPSOS57(420)
DESCRIPTION:
Not used for VA - left in for IHS
9002313.57,10421PRIMARY PRESCRIBER ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(421)
ALGORITHM: S X=$$FIELD^BPSOS57(421)
DESCRIPTION:
Provider ID number
9002313.57,10422CLINIC ID NUMBER ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(422)
ALGORITHM: S X=$$FIELD^BPSOS57(422)
DESCRIPTION:
Clinic ID where the prescription was entered.
9002313.57,10423BASIS OF COST DETERMINATION ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(423)
ALGORITHM: S X=$$FIELD^BPSOS57(423)
DESCRIPTION:
How the amount charged was arrived at.
9002313.57,10424DIAGNOSIS CODE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(424)
ALGORITHM: S X=$$FIELD^BPSOS57(424)
DESCRIPTION: Diagnosis code that applies to this prescription. Not used for third party billing as of this date
- so it is not used, but may be used in the future.
9002313.57,10425DRUG TYPE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(425)
ALGORITHM: S X=$$FIELD^BPSOS57(425)
DESCRIPTION: Code to indicate the type of drug dispensed. �=Not specified 1=Single source brand 2=Branded
generic 3=Generic 4=O.T.C. (over the counter)
9002313.57,10426USUAL AND CUSTOMARY CHARGE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(426)
ALGORITHM: S X=$$FIELD^BPSOS57(426)
LAST EDITED: APR 05, 2001
DESCRIPTION:
Amount charged cash customers for the prescription exclusive of sales tax or other amounts claimed.
9002313.57,10427PRESCRIBER LAST NAME ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(427)
ALGORITHM: S X=$$FIELD^BPSOS57(427)
DESCRIPTION:
Last Name of the Prescriber
9002313.57,10428POSTAGE AMOUNT CLAIMED ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(428)
ALGORITHM: S X=$$FIELD^BPSOS57(428)
DESCRIPTION:
Dollar amount of postage claimed.
9002313.57,10429UNIT DOSE INDICATOR ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(429)
ALGORITHM: S X=$$FIELD^BPSOS57(429)
DESCRIPTION: Code indicating the type of unit dose dispensing. �=Not Specified 1=Not Unit Dose 2=Manufacturer
Unit Dose 3=Pharmacy Unit Dose
9002313.57,10430GROSS AMOUNT DUE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(430)
ALGORITHM: S X=$$FIELD^BPSOS57(430)
DESCRIPTION:
Total amount submitted to the payer.
9002313.57,10431OTHER PAYOR AMOUNT ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(431)
ALGORITHM: S X=$$FIELD^BPSOS57(431)
DESCRIPTION:
Amount of any payment known by the pharmacy from other sources (including coupons).
9002313.57,10432BASIS OF DAYS SUPPLY DET ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(432)
ALGORITHM: S X=$$FIELD^BPSOS57(432)
DESCRIPTION: Code indicating the method by which the days supply was determined. �=Not specified 1=Explicit
directions 2=PRN directions (take as needed pharmacist estimate) 3=As directed by physician
9002313.57,10433PATIENT PAID AMOUNT ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(433)
ALGORITHM: S X=$$FIELD^BPSOS57(433)
DESCRIPTION:
Amount the pharmacy received from the patient for the prescription dispensed.
9002313.57,10434DATE OF INJURY ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(434)
ALGORITHM: S X=$$FIELD^BPSOS57(434)
DESCRIPTION:
Date on which the injury occurred.
9002313.57,10435CLAIM REF ID NUMBER ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(435)
ALGORITHM: S X=$$FIELD^BPSOS57(435)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Identifies the claim number assigned by Workers Compensation Program.
9002313.57,10436ALT PRODUCT TYPE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(436)
ALGORITHM: S X=$$FIELD^BPSOS57(436)
LAST EDITED: FEB 12, 2008
DESCRIPTION: Code qualifying the value in 'Product/Service ID' (4�7-D7) Not Specified Blank Not Specified ��
Universal Product Code (UPC) �1 Health Related Item (HRI) �2 National Drug Code (NDC) �3 Universal
Product Number (UPN) �4 Department of Defense (DOD) �5 Drug Use Review/ Professional Pharmacy
Service (DUR/PPS) �6 Common Procedure Terminology (CPT4) �7 Common Procedure Terminology (CPT5) �8
Health Care Financing Administration Common Procedural Coding System (HCPCS) �9 Pharmacy Practice
Activity Classification (PPAC) 1� National Pharmaceutical Product Interface Code(NAPPI) 11
International Article Numbering System(EAN) 12 Drug Identification Number(DIN) 13 Medi-Span GPI 14
First DataBank GCN 15 Medical Economics GPO 16 Medi-Span DDID 17 First DataBank SmartKey 18 Medical
Economics GM 19 International Classification of Diseases(ICD9) 2� International Classification of
Diseases (ICD10) 21 Medi-Span Diagnosis Code 22 Common Dental Terminology (CDT) 25 American
Psychiatric Association Diagnostic Statistical Manual of Mental Disorders (DSM IV) Other 99
9002313.57,10437ALT PRODUCT CODE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(437)
ALGORITHM: S X=$$FIELD^BPSOS57(437)
LAST EDITED: FEB 12, 2008
DESCRIPTION: This field identifies the actual product code for the item that was dispensed. The type of product
is defined by field 436-E1. This field should only be used if the National Drug Code number is not
available. The code number here is the UPC number or the HRI number
9002313.57,10438INCENTIVE AMOUNT SUBMITTED ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(438)
ALGORITHM: S X=$$FIELD^BPSOS57(438)
DESCRIPTION: Amount represents a fee that is submitted by the pharmacy for contractually agreed upon services.
This amount is included in the 'Gross Amount Due' (43�-DU).
9002313.57,10439DUR CONFLICT CODE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(439)
ALGORITHM: S X=$$FIELD^BPSOS57(439)
LAST EDITED: FEB 12, 2008
DESCRIPTION: Code identifying the type of utilization conflict detected or the reason for the pharmacist's
professional service.
9002313.57,10440DUR INTERVENTION CODE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(440)
ALGORITHM: S X=$$FIELD^BPSOS57(440)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Code to indicate whether an intervention was entered.
9002313.57,10441DUR OUTCOME CODE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(441)
ALGORITHM: S X=$$FIELD^BPSOS57(441)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
The outcome of the DUR - whether the prescription had to be modified.
9002313.57,10442METRIC DECIMAL QUANTITY ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(442)
ALGORITHM: S X=$$FIELD^BPSOS57(442)
DESCRIPTION:
Quantity dispensed expressed in metric decimal units.
9002313.57,10443OTHER PAYOR DATE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(443)
ALGORITHM: S X=$$FIELD^BPSOS57(443)
DESCRIPTION: Payment or denial date of the claim submitted to the other payer. Used for coordination of
benefits.
9002313.57,10444PHARMACIST ID ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(444)
ALGORITHM: S X=$$FIELD^BPSOS57(444)
DESCRIPTION: Unique ID assigned to the person responsible for the dispensing of the prescription or provision of
the service.
9002313.57,10501RESPONSE STATUS ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(501)
ALGORITHM: S X=$$FIELD^BPSOS57(501)
DESCRIPTION:
Status flag indicating whether the transaction was "P"aid, "R"ejected, "A"ccepted, or "C"aptured.
9002313.57,10503AUTHORIZATION NUMBER ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(503)
ALGORITHM: S X=$$FIELD^BPSOS57(503)
DESCRIPTION:
Authorization number for pre-authorization requests.
9002313.57,10504MESSAGE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(504)
ALGORITHM: S X=$$FIELD^BPSOS57(504)
DESCRIPTION:
Free form Message.
9002313.57,10505PATIENT PAY AMOUNT ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(505)
ALGORITHM: S X=$$FIELD^BPSOS57(505)
LAST EDITED: APR 05, 2001
DESCRIPTION:
Amount the patient pays (copay).
9002313.57,10506INGREDIENT COST PAID ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(506)
ALGORITHM: S X=$$FIELD^BPSOS57(506)
DESCRIPTION:
Drug ingredient cost paid included in the 'Total Amount Paid' (5�9).
9002313.57,10507CONTRACT FEE PAID ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(507)
ALGORITHM: S X=$$FIELD^BPSOS57(507)
DESCRIPTION:
Dispensing fee paid included in the 'Total Amount Paid' (5�9).
9002313.57,10508SALES TAX PAID ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(508)
ALGORITHM: S X=$$FIELD^BPSOS57(508)
DESCRIPTION:
The amount of sales tax paid for the prescription dispensed.
9002313.57,10509TOTAL AMOUNT PAID ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(509)
ALGORITHM: S X=$$FIELD^BPSOS57(509)
DESCRIPTION: Total amount to be paid by the claims processor (i.e. pharmacy receivable). Represents a sum of
'Ingredient Cost Paid' (5�6), 'Dispensing Fee Paid' (5�7), 'Flat Sales Tax Amount Paid' (558),
'Percentage Sales Tax Amount Paid' (559), 'Incentive Amount Paid' (521), 'Professional Service Fee
Paid' (562), 'Other Amount Paid' (565), less 'Patient Pay Amount' (5�5) and 'Other Payer Amount
Recognized' (566).
9002313.57,10510REJECT COUNT ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(510)
ALGORITHM: S X=$$FIELD^BPSOS57(510)
DESCRIPTION:
Count of 'Reject Code' (511) occurrences.
9002313.57,10511REJECT CODES ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(511)
ALGORITHM: S X=$$FIELD^BPSOS57(511)
DESCRIPTION:
Multiple rejection codes.
9002313.57,10511.01REJECT CODE 1 ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(511.01)
ALGORITHM: S X=$$FIELD^BPSOS57(511.01)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reject code #1 returned in the response by the payer.
9002313.57,10511.02REJECT CODE 2 ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(511.02)
ALGORITHM: S X=$$FIELD^BPSOS57(511.02)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reject code #2 returned in the response by the payer.
9002313.57,10511.03REJECT CODE 3 ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(511.03)
ALGORITHM: S X=$$FIELD^BPSOS57(511.03)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reject code #3 returned in the response by the payer.
9002313.57,10511.04REJECT CODE 4 ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(511.04)
ALGORITHM: S X=$$FIELD^BPSOS57(511.04)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reject code #4 returned in the response by the payer.
9002313.57,10511.05REJECT CODE 5 ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(511.05)
ALGORITHM: S X=$$FIELD^BPSOS57(511.05)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reject code #5 returned in the response by the payer.
9002313.57,10511.06REJECT CODE 6 ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(511.06)
ALGORITHM: S X=$$FIELD^BPSOS57(511.06)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reject code #6 returned in the response by the payer.
9002313.57,10511.07REJECT CODE 7 ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(511.07)
ALGORITHM: S X=$$FIELD^BPSOS57(511.07)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reject code #7 returned in the response by the payer.
9002313.57,10511.08REJECT CODE 8 ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(511.08)
ALGORITHM: S X=$$FIELD^BPSOS57(511.08)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reject code #8 returned in the response by the payer.
9002313.57,10511.09REJECT CODE 9 ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(511.09)
ALGORITHM: S X=$$FIELD^BPSOS57(511.09)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reject code #9 returned in the response by the payer.
9002313.57,10511.1REJECT CODE 10 ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(511.1)
ALGORITHM: S X=$$FIELD^BPSOS57(511.1)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reject code #10 returned in the response by the payer.
9002313.57,10511.11REJECT CODE 11 ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(511.11)
ALGORITHM: S X=$$FIELD^BPSOS57(511.11)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reject code #11 returned in the response by the payer.
9002313.57,10511.12REJECT CODE 12 ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(511.12)
ALGORITHM: S X=$$FIELD^BPSOS57(511.12)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reject code #12 returned in the response by the payer.
9002313.57,10511.13REJECT CODE 13 ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(511.13)
ALGORITHM: S X=$$FIELD^BPSOS57(511.13)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reject code #13 returned in the response by the payer.
9002313.57,10511.14REJECT CODE 14 ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(511.14)
ALGORITHM: S X=$$FIELD^BPSOS57(511.14)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reject code #14 returned in the response by the payer.
9002313.57,10511.15REJECT CODE 15 ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(511.15)
ALGORITHM: S X=$$FIELD^BPSOS57(511.15)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reject code #15 returned in the response by the payer.
9002313.57,10511.16REJECT CODE 16 ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(511.16)
ALGORITHM: S X=$$FIELD^BPSOS57(511.16)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reject code #16 returned in the response by the payer.
9002313.57,10511.17REJECT CODE 17 ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(511.17)
ALGORITHM: S X=$$FIELD^BPSOS57(511.17)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reject code #17 returned in the response by the payer.
9002313.57,10511.18REJECT CODE 18 ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(511.18)
ALGORITHM: S X=$$FIELD^BPSOS57(511.18)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reject code #18 returned in the response by the payer.
9002313.57,10511.19REJECT CODE 19 ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(511.19)
ALGORITHM: S X=$$FIELD^BPSOS57(511.19)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reject code #19 returned in the response by the payer.
9002313.57,10511.2REJECT CODE 20 ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(511.2)
ALGORITHM: S X=$$FIELD^BPSOS57(511.2)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reject code #20 returned in the response by the payer.
9002313.57,10512ACCUMULATED DEDUCTIBLE AMOUNT ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(512)
ALGORITHM: S X=$$FIELD^BPSOS57(512)
DESCRIPTION:
Amount in dollars met by the patient/family in a deductible plan.
9002313.57,10513REMAINING DEDUCTIBLE AMOUNT ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(513)
ALGORITHM: S X=$$FIELD^BPSOS57(513)
DESCRIPTION:
Amount not met by the patient/family in the deductible plan.
9002313.57,10514REMAINING BENEFIT AMOUNT ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(514)
ALGORITHM: S X=$$FIELD^BPSOS57(514)
DESCRIPTION:
Amount remaining in a patient/family plan with a periodic maximum benefit.
9002313.57,10515POSTAGE AMOUNT PAID ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(515)
ALGORITHM: S X=$$FIELD^BPSOS57(515)
DESCRIPTION:
Not applicable to the VA.
9002313.57,10516DRUG DESCRIPTION ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(516)
ALGORITHM: S X=$$FIELD^BPSOS57(516)
DESCRIPTION:
Text description for the drug from the drug file 50.
9002313.57,10517AMOUNT APP TO PER DEDUCTIBLE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(517)
ALGORITHM: S X=$$FIELD^BPSOS57(517)
DESCRIPTION: Amount to be collected from a patient that is included in 'Patient Pay Amount' (5�5) that is
applied to a periodic deductible.
9002313.57,10518AMOUNT OF COPAY COINSURANCE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(518)
ALGORITHM: S X=$$FIELD^BPSOS57(518)
LAST EDITED: FEB 12, 2008
DESCRIPTION: Amount to be collected from the patient that is included in 'Patient Pay Amount' (5�5) that is due
to a per prescription copay/coinsurance.
9002313.57,10519AMOUNT ATTR TO PRODUCT SELECT ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(519)
ALGORITHM: S X=$$FIELD^BPSOS57(519)
DESCRIPTION: Amount to be collected from the patient that is included in 'Patient Pay Amount' (5�5) that is due
to the patient's selection of drug product.
9002313.57,10520AMOUNT EXCEED PER BENEFIT MAX ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(520)
ALGORITHM: S X=$$FIELD^BPSOS57(520)
DESCRIPTION: Amount to be collected from the patient that is included in 'Patient Pay Amount' (5�5) that is due
to the patient exceeding a periodic benefit maximum.
9002313.57,10521INCENTIVE FEE PAID ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(521)
ALGORITHM: S X=$$FIELD^BPSOS57(521)
LAST EDITED: APR 05, 2001
DESCRIPTION: Amount represents the contractually agreed upon incentive fee paid for specific services rendered.
Amount is included in the 'Total Amount Paid' (5�9).
9002313.57,10522BASIS OF REIMBURSEMENT DET ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(522)
ALGORITHM: S X=$$FIELD^BPSOS57(522)
DESCRIPTION:
Code identifying how the reimbursement amount was calculated for 'Ingredient Cost Paid' (5�6).
9002313.57,10523AMOUNT ATTRIBUTED TO SALES TAX ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(523)
ALGORITHM: S X=$$FIELD^BPSOS57(523)
DESCRIPTION: Amount to be collected from the patient that is included in 'Patient Pay Amount' (5�5) that is due
to sales tax paid.
9002313.57,10524PLAN ID ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(524)
ALGORITHM: S X=$$FIELD^BPSOS57(524)
DESCRIPTION:
Plan Identification Number.
9002313.57,10525DUR RESPONSE DATA ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(525)
ALGORITHM: S X=$$FIELD^BPSOS57(525)
DESCRIPTION:
Text that provides additional detail regarding a DUR conflict.
9002313.57,10525.01DUR COUNT ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.01,9.6) S X=$S(Y(9002313.57,10525.01,2):Y(9002313.57,10525.01,3),Y(9002313.5
7,10525.01,5):Y(9002313.57,10525.01,6),Y(9002313.57,10525.01,8):Y(9002313.57,10525.01,9),Y(9002313.
57,10525.01,10):X)
9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.1,0),U,5,99) S Y(9002313.57,10525.01,1)=X X "N I,Y "_$P(^D
D(9002313.57,10525.2,0),U,5,99) S Y(9002313.57,10525.01,4)=X
9.3 = X ^DD(9002313.57,10525.01,9.2) X "N I,Y "_$P(^DD(9002313.57,10525.3,0),U,5,99) S Y(9002313.57
,10525.01,7)=X S X=Y(9002313.57,10525.01,1)=""
9.4 = X ^DD(9002313.57,10525.01,9.3) S Y(9002313.57,10525.01,2)=$G(X) S X=0,Y(9002313.57,10525.01,3
)=$G(X) S X=Y(9002313.57,10525.01,4)=""
9.5 = X ^DD(9002313.57,10525.01,9.4) S Y(9002313.57,10525.01,5)=$G(X) S X=1,Y(9002313.57,10525.01,6
)=$G(X) S X=Y(9002313.57,10525.01,7)=""
9.6 = X ^DD(9002313.57,10525.01,9.5) S Y(9002313.57,10525.01,8)=$G(X) S X=2,Y(9002313.57,10525.01,9
)=$G(X) S X=1,Y(9002313.57,10525.01,10)=$G(X) S X=3
ALGORITHM: $S(DUR 1 RAW DATA="":0,DUR 2 RAW DATA="":1,DUR 3 RAW DATA="":2,1:3)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Number of DUR messages to be displayed.
9002313.57,10525.1DUR 1 RAW DATA ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.1,9.5) S X=$S(Y(9002313.57,10525.1,4):Y(9002313.57,10525.1,5),Y(9002313.57,1
0525.1,6):X)
9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.1,1)=X S X=Y(9002313.57,10525.1,1),
Y(9002313.57,10525.1,2)=X S X=1,Y(9002313.57,10525.1,3)=X S X=2
9.3 = X ^DD(9002313.57,10525.1,9.2) S X=$E(Y(9002313.57,10525.1,2),Y(9002313.57,10525.1,3),X)=" ",
Y(9002313.57,10525.1,4)=X S X="",Y(9002313.57,10525.1,5)=X S X=1
9.4 = X ^DD(9002313.57,10525.1,9.3) S Y(9002313.57,10525.1,6)=X,Y(9002313.57,10525.1,7)=X S X=Y(900
2313.57,10525.1,1),Y(9002313.57,10525.1,8)=X S X=1
9.5 = X ^DD(9002313.57,10525.1,9.4) S Y(9002313.57,10525.1,9)=X S X=53,X=$E(Y(9002313.57,10525.1,8)
,Y(9002313.57,10525.1,9),X)
ALGORITHM: $S($E(DUR RESPONSE DATA,1,2)=" ":"",1:$E(DUR RESPONSE DATA,1,53))
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Raw Data DUR message sent from the payer and stored in the response file.
9002313.57,10525.1439DUR 1 DRUG CONFLICT CODE ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.1439,9.2) S Y(9002313.57,10525.1439,3)=X S X=2,X=$E(Y(9002313.57,10525.1439,
2),Y(9002313.57,10525.1439,3),X)
9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.1439,1)=X S X=Y(9002313.57,10525.14
39,1),Y(9002313.57,10525.1439,2)=X S X=1
ALGORITHM: $E(DUR RESPONSE DATA,1,2)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Severity level code for the first DUR.
9002313.57,10525.1528DUR 1 SEVERITY INDEX CODE ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.1528,9.2) S X=$E(Y(9002313.57,10525.1528,2),X)
9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.1528,1)=X S X=Y(9002313.57,10525.15
28,1),Y(9002313.57,10525.1528,2)=X S X=3
ALGORITHM: $E(DUR RESPONSE DATA,3)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Blank=Not Specified 1=Major 2=Moderate 3=Minor
9002313.57,10525.1529DUR 1 OTHER PHARMACY INDIC ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.1529,9.2) S X=$E(Y(9002313.57,10525.1529,2),X)
9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.1529,1)=X S X=Y(9002313.57,10525.15
29,1),Y(9002313.57,10525.1529,2)=X S X=4
ALGORITHM: $E(DUR RESPONSE DATA,4)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
�=Not Specified 1=Your Pharmacy 2=Other Pharmacy in Same Chain 3=Other Pharmacy
9002313.57,10525.153DUR 1 PREVIOUS DATE OF FILL ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.153,9.2) S Y(9002313.57,10525.153,3)=X S X=12,X=$E(Y(9002313.57,10525.153,2)
,Y(9002313.57,10525.153,3),X)
9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.153,1)=X S X=Y(9002313.57,10525.153
,1),Y(9002313.57,10525.153,2)=X S X=5
ALGORITHM: $E(DUR RESPONSE DATA,5,12)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Previous fill date
9002313.57,10525.1531DUR 1 QTY OF PREVIOUS FILL ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.1531,9.2) S Y(9002313.57,10525.1531,3)=X S X=17,X=$E(Y(9002313.57,10525.1531
,2),Y(9002313.57,10525.1531,3),X)
9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.1531,1)=X S X=Y(9002313.57,10525.15
31,1),Y(9002313.57,10525.1531,2)=X S X=13
ALGORITHM: $E(DUR RESPONSE DATA,13,17)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
The quantity of the previous fill that caused the DUR to be triggered.
9002313.57,10525.1532DUR 1 DATABASE INDICATOR ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.1532,9.2) S X=$E(Y(9002313.57,10525.1532,2),X)
9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.1532,1)=X S X=Y(9002313.57,10525.15
32,1),Y(9002313.57,10525.1532,2)=X S X=18
ALGORITHM: $E(DUR RESPONSE DATA,18)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Blank=Not Specified 1=First Databank 2=Medi-Span 3=Redbook 4=Processor Developed 5=Other
9002313.57,10525.1533DUR 1 OTHER PRESCRIBER INDIC ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.1533,9.2) S X=$E(Y(9002313.57,10525.1533,2),X)
9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.1533,1)=X S X=Y(9002313.57,10525.15
33,1),Y(9002313.57,10525.1533,2)=X S X=19
ALGORITHM: $E(DUR RESPONSE DATA,19)
LAST EDITED: FEB 12, 2008
DESCRIPTION: Code that indicates the prescriber of the current fill relationship to the prescriber of the
conflicting prescription.
�=Not Specified 1=Same Prescriber 2=Other Prescriber
9002313.57,10525.1544DUR 1 FREE TEXT ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.1544,9.2) S Y(9002313.57,10525.1544,3)=X S X=49,X=$E(Y(9002313.57,10525.1544
,2),Y(9002313.57,10525.1544,3),X)
9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.1544,1)=X S X=Y(9002313.57,10525.15
44,1),Y(9002313.57,10525.1544,2)=X S X=20
ALGORITHM: $E(DUR RESPONSE DATA,20,49)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Actual DUR text
9002313.57,10525.1999DUR 1 RESERVE SPACE ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.1999,9.2) S Y(9002313.57,10525.1999,3)=X S X=53,X=$E(Y(9002313.57,10525.1999
,2),Y(9002313.57,10525.1999,3),X)
9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.1999,1)=X S X=Y(9002313.57,10525.19
99,1),Y(9002313.57,10525.1999,2)=X S X=50
ALGORITHM: $E(DUR RESPONSE DATA,50,53)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reserved space for additional information.
9002313.57,10525.2DUR 2 RAW DATA ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.2,9.5) S X=$S(Y(9002313.57,10525.2,4):Y(9002313.57,10525.2,5),Y(9002313.57,1
0525.2,6):X)
9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.2,1)=X S X=Y(9002313.57,10525.2,1),
Y(9002313.57,10525.2,2)=X S X=54,Y(9002313.57,10525.2,3)=X S X=55
9.3 = X ^DD(9002313.57,10525.2,9.2) S X=$E(Y(9002313.57,10525.2,2),Y(9002313.57,10525.2,3),X)=" ",
Y(9002313.57,10525.2,4)=X S X="",Y(9002313.57,10525.2,5)=X S X=1
9.4 = X ^DD(9002313.57,10525.2,9.3) S Y(9002313.57,10525.2,6)=X,Y(9002313.57,10525.2,7)=X S X=Y(900
2313.57,10525.2,1),Y(9002313.57,10525.2,8)=X S X=54
9.5 = X ^DD(9002313.57,10525.2,9.4) S Y(9002313.57,10525.2,9)=X S X=106,X=$E(Y(9002313.57,10525.2,8
),Y(9002313.57,10525.2,9),X)
ALGORITHM: $S($E(DUR RESPONSE DATA,54,55)=" ":"",1:$E(DUR RESPONSE DATA,54,106))
LAST EDITED: FEB 12, 2008
DESCRIPTION:
DUR information returned by the payer that has not been formatted yet.
9002313.57,10525.2439DUR 2 DRUG CONFLICT CODE ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.2439,9.2) S Y(9002313.57,10525.2439,3)=$G(X) S X=2,X=$E(Y(9002313.57,10525.2
439,2),Y(9002313.57,10525.2439,3),X)
9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.2,0),U,5,99) S Y(9002313.57,10525.2439,1)=X S X=Y(9002313.
57,10525.2439,1),Y(9002313.57,10525.2439,2)=$G(X) S X=1
ALGORITHM: $E(DUR 2 RAW DATA,1,2)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
�=Not Specified 1=Your Pharmacy 2=Other Pharmacy in Same Chain 3=Other Pharmacy
9002313.57,10525.2528DUR 2 SEVERITY INDEX CODE ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.2528,9.2) S X=$E(Y(9002313.57,10525.2528,2),X)
9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.2,0),U,5,99) S Y(9002313.57,10525.2528,1)=X S X=Y(9002313.
57,10525.2528,1),Y(9002313.57,10525.2528,2)=$G(X) S X=3
ALGORITHM: $E(DUR 2 RAW DATA,3)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Blank=Not Specified 1=Major 2=Moderate 3=Minor
9002313.57,10525.2529DUR 2 OTHER PHARMACY INDIC ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.2529,9.2) S X=$E(Y(9002313.57,10525.2529,2),X)
9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.2,0),U,5,99) S Y(9002313.57,10525.2529,1)=X S X=Y(9002313.
57,10525.2529,1),Y(9002313.57,10525.2529,2)=$G(X) S X=4
ALGORITHM: $E(DUR 2 RAW DATA,4)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
�=Not Specified 1=Your Pharmacy 2=Other Pharmacy in Same Chain 3=Other Pharmacy
9002313.57,10525.253DUR 2 PREVIOUS DATE OF FILL ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.253,9.2) S Y(9002313.57,10525.253,3)=$G(X) S X=12,X=$E(Y(9002313.57,10525.25
3,2),Y(9002313.57,10525.253,3),X)
9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.2,0),U,5,99) S Y(9002313.57,10525.253,1)=X S X=Y(9002313.5
7,10525.253,1),Y(9002313.57,10525.253,2)=$G(X) S X=5
ALGORITHM: $E(DUR 2 RAW DATA,5,12)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Fill date of the previous fill that is causing the DUR conflict.
9002313.57,10525.2531DUR 2 QTY OF PREVIOUS FILL ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.2531,9.2) S Y(9002313.57,10525.2531,3)=$G(X) S X=17,X=$E(Y(9002313.57,10525.
2531,2),Y(9002313.57,10525.2531,3),X)
9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.2,0),U,5,99) S Y(9002313.57,10525.2531,1)=X S X=Y(9002313.
57,10525.2531,1),Y(9002313.57,10525.2531,2)=$G(X) S X=13
ALGORITHM: $E(DUR 2 RAW DATA,13,17)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Quantity of the fill that is causing the conflict.
9002313.57,10525.2532DUR 2 DATABASE INDICATOR ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.2532,9.2) S X=$E(Y(9002313.57,10525.2532,2),X)
9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.2,0),U,5,99) S Y(9002313.57,10525.2532,1)=X S X=Y(9002313.
57,10525.2532,1),Y(9002313.57,10525.2532,2)=$G(X) S X=18
ALGORITHM: $E(DUR 2 RAW DATA,18)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Blank=Not Specified 1=First Databank 2=Medi-Span 3=Redbook 4=Processor Developed 5=Other
9002313.57,10525.2533DUR 2 OTHER PRESCRIBER INDIC ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.2533,9.2) S X=$E(Y(9002313.57,10525.2533,2),X)
9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.2,0),U,5,99) S Y(9002313.57,10525.2533,1)=X S X=Y(9002313.
57,10525.2533,1),Y(9002313.57,10525.2533,2)=$G(X) S X=19
ALGORITHM: $E(DUR 2 RAW DATA,19)
LAST EDITED: FEB 12, 2008
DESCRIPTION: Code that indicates the prescriber of the current fill relationship to the prescriber of the
conflicting prescription.
�=Not Specified 1=Same Prescriber 2=Other Prescriber
9002313.57,10525.2544DUR 2 FREE TEXT ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.2544,9.2) S Y(9002313.57,10525.2544,3)=$G(X) S X=49,X=$E(Y(9002313.57,10525.
2544,2),Y(9002313.57,10525.2544,3),X)
9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.2,0),U,5,99) S Y(9002313.57,10525.2544,1)=X S X=Y(9002313.
57,10525.2544,1),Y(9002313.57,10525.2544,2)=$G(X) S X=20
ALGORITHM: $E(DUR 2 RAW DATA,20,49)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Actual DUR text
9002313.57,10525.2999DUR 2 RESERVE SPACE ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.2999,9.2) S Y(9002313.57,10525.2999,3)=$G(X) S X=53,X=$E(Y(9002313.57,10525.
2999,2),Y(9002313.57,10525.2999,3),X)
9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.2,0),U,5,99) S Y(9002313.57,10525.2999,1)=X S X=Y(9002313.
57,10525.2999,1),Y(9002313.57,10525.2999,2)=$G(X) S X=50
ALGORITHM: $E(DUR 2 RAW DATA,50,53)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reserved space for additional information.
9002313.57,10525.3DUR 3 RAW DATA ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.3,9.5) S X=$S(Y(9002313.57,10525.3,4):Y(9002313.57,10525.3,5),Y(9002313.57,1
0525.3,6):X)
9.2 = X $P(^DD(9002313.57,10525,0),U,5,99) S Y(9002313.57,10525.3,1)=X S X=Y(9002313.57,10525.3,1),
Y(9002313.57,10525.3,2)=X S X=107,Y(9002313.57,10525.3,3)=X S X=108
9.3 = X ^DD(9002313.57,10525.3,9.2) S X=$E(Y(9002313.57,10525.3,2),Y(9002313.57,10525.3,3),X)=" ",
Y(9002313.57,10525.3,4)=X S X="",Y(9002313.57,10525.3,5)=X S X=1
9.4 = X ^DD(9002313.57,10525.3,9.3) S Y(9002313.57,10525.3,6)=X,Y(9002313.57,10525.3,7)=X S X=Y(900
2313.57,10525.3,1),Y(9002313.57,10525.3,8)=X S X=107
9.5 = X ^DD(9002313.57,10525.3,9.4) S Y(9002313.57,10525.3,9)=X S X=159,X=$E(Y(9002313.57,10525.3,8
),Y(9002313.57,10525.3,9),X)
ALGORITHM: $S($E(DUR RESPONSE DATA,107,108)=" ":"",1:$E(DUR RESPONSE DATA,107,159))
LAST EDITED: FEB 12, 2008
DESCRIPTION:
DUR information returned by the payer that has not been formatted yet.
9002313.57,10525.3439DUR 3 DRUG CONFLICT CODE ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.3439,9.2) S Y(9002313.57,10525.3439,3)=$G(X) S X=2,X=$E(Y(9002313.57,10525.3
439,2),Y(9002313.57,10525.3439,3),X)
9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.3,0),U,5,99) S Y(9002313.57,10525.3439,1)=X S X=Y(9002313.
57,10525.3439,1),Y(9002313.57,10525.3439,2)=$G(X) S X=1
ALGORITHM: $E(DUR 3 RAW DATA,1,2)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
�=Not Specified 1=Your Pharmacy 2=Other Pharmacy in Same Chain 3=Other Pharmacy
9002313.57,10525.3528DUR 3 SEVERITY INDEX CODE ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.3528,9.2) S X=$E(Y(9002313.57,10525.3528,2),X)
9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.3,0),U,5,99) S Y(9002313.57,10525.3528,1)=X S X=Y(9002313.
57,10525.3528,1),Y(9002313.57,10525.3528,2)=$G(X) S X=3
ALGORITHM: $E(DUR 3 RAW DATA,3)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Blank=Not Specified 1=Major 2=Moderate 3=Minor
9002313.57,10525.3529DUR 3 OTHER PHARMACY INDIC ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.3529,9.2) S X=$E(Y(9002313.57,10525.3529,2),X)
9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.3,0),U,5,99) S Y(9002313.57,10525.3529,1)=X S X=Y(9002313.
57,10525.3529,1),Y(9002313.57,10525.3529,2)=$G(X) S X=4
ALGORITHM: $E(DUR 3 RAW DATA,4)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
�=Not Specified 1=Your Pharmacy 2=Other Pharmacy in Same Chain 3=Other Pharmacy
9002313.57,10525.353DUR 3 PREVIOUS DATE OF FILL ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.353,9.2) S Y(9002313.57,10525.353,3)=$G(X) S X=12,X=$E(Y(9002313.57,10525.35
3,2),Y(9002313.57,10525.353,3),X)
9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.3,0),U,5,99) S Y(9002313.57,10525.353,1)=X S X=Y(9002313.5
7,10525.353,1),Y(9002313.57,10525.353,2)=$G(X) S X=5
ALGORITHM: $E(DUR 3 RAW DATA,5,12)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Fill date of the previous fill that is causing the DUR conflict.
9002313.57,10525.3531DUR 3 QTY OF PREVIOUS FILL ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.3531,9.2) S Y(9002313.57,10525.3531,3)=$G(X) S X=17,X=$E(Y(9002313.57,10525.
3531,2),Y(9002313.57,10525.3531,3),X)
9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.3,0),U,5,99) S Y(9002313.57,10525.3531,1)=X S X=Y(9002313.
57,10525.3531,1),Y(9002313.57,10525.3531,2)=$G(X) S X=13
ALGORITHM: $E(DUR 3 RAW DATA,13,17)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Quantity of the fill that is causing the conflict.
9002313.57,10525.3532DUR 3 DATABASE INDICATOR ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.3532,9.2) S X=$E(Y(9002313.57,10525.3532,2),X)
9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.3,0),U,5,99) S Y(9002313.57,10525.3532,1)=X S X=Y(9002313.
57,10525.3532,1),Y(9002313.57,10525.3532,2)=$G(X) S X=18
ALGORITHM: $E(DUR 3 RAW DATA,18)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Blank=Not Specified 1=First Databank 2=Medi-Span 3=Redbook 4=Processor Developed 5=Other
9002313.57,10525.3533DUR 3 OTHER PRESCRIBER INDIC ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.3533,9.2) S X=$E(Y(9002313.57,10525.3533,2),X)
9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.3,0),U,5,99) S Y(9002313.57,10525.3533,1)=X S X=Y(9002313.
57,10525.3533,1),Y(9002313.57,10525.3533,2)=$G(X) S X=19
ALGORITHM: $E(DUR 3 RAW DATA,19)
LAST EDITED: FEB 12, 2008
DESCRIPTION: Code that indicates the prescriber of the current fill relationship to the prescriber of the
conflicting prescription.
�=Not Specified 1=Same Prescriber 2=Other Prescriber
9002313.57,10525.3544DUR 3 FREE TEXT ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.3544,9.2) S Y(9002313.57,10525.3544,3)=$G(X) S X=49,X=$E(Y(9002313.57,10525.
3544,2),Y(9002313.57,10525.3544,3),X)
9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.3,0),U,5,99) S Y(9002313.57,10525.3544,1)=X S X=Y(9002313.
57,10525.3544,1),Y(9002313.57,10525.3544,2)=$G(X) S X=20
ALGORITHM: $E(DUR 3 RAW DATA,20,49)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Actual DUR text
9002313.57,10525.3999DUR 3 RESERVE SPACE ; COMPUTED
MUMPS CODE: X ^DD(9002313.57,10525.3999,9.2) S Y(9002313.57,10525.3999,3)=$G(X) S X=53,X=$E(Y(9002313.57,10525.
3999,2),Y(9002313.57,10525.3999,3),X)
9.2 = X "N I,Y "_$P(^DD(9002313.57,10525.3,0),U,5,99) S Y(9002313.57,10525.3999,1)=X S X=Y(9002313.
57,10525.3999,1),Y(9002313.57,10525.3999,2)=$G(X) S X=50
ALGORITHM: $E(DUR 3 RAW DATA,50,53)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Reserved space for additional information.
9002313.57,10526ADDITIONAL MESSAGE INFORMATION ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(526)
ALGORITHM: S X=$$FIELD^BPSOS57(526)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Free text, additional information from the payer.
9002313.57,10528CLINICAL SIGNIFICANCE CODE ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(528)
ALGORITHM: S X=$$FIELD^BPSOS57(528)
DESCRIPTION:
Blank=Not Specified 1=Major 2=Moderate 3=Minor
9002313.57,10529OTHER PHARMACY INDICATOR ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(529)
ALGORITHM: S X=$$FIELD^BPSOS57(529)
DESCRIPTION:
�=Not Specified 1=Your Pharmacy 2=Other Pharmacy in Same Chain 3=Other Pharmacy
9002313.57,10530PREVIOUS DATE OF FILL ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(530)
ALGORITHM: S X=$$FIELD^BPSOS57(530)
DESCRIPTION:
Fill date of the prescription causing the DUR conflict.
9002313.57,10531QUANTITY OF PREVIOUS FILL ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(531)
ALGORITHM: S X=$$FIELD^BPSOS57(531)
DESCRIPTION:
Quantity of the prescription causing the conflict.
9002313.57,10532DATABASE INDICATOR ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(532)
ALGORITHM: S X=$$FIELD^BPSOS57(532)
DESCRIPTION:
Blank=Not Specified 1=First Databank 2=Medi-Span 3=Redbook 4=Processor Developed 5=Other
9002313.57,10533OTHER PRESCRIBER INDICATOR ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(533)
ALGORITHM: S X=$$FIELD^BPSOS57(533)
DESCRIPTION:
�=Not Specified 1=Same Prescriber 2=Other Prescriber
9002313.57,10535DUR OVERFLOW ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(535)
ALGORITHM: S X=$$FIELD^BPSOS57(535)
LAST EDITED: FEB 12, 2008
DESCRIPTION:
Additional DUR information that did not fit in the other fields provided.
9002313.57,10544FREE TEXT ; COMPUTED
MUMPS CODE: S X=$$FIELD^BPSOS57(544)
ALGORITHM: S X=$$FIELD^BPSOS57(544)
DESCRIPTION:
Even more room for additional free text DUR information.
FILES POINTED TO FIELDS
BILL/CLAIMS (#399) PATIENT INSURANCE MULTIPLE:PRIMARY PAYER BILL (#902.3)
BPS ASLEEP PAYERS (#9002313.15) ASLEEP PAYER (#801)
BPS CERTIFICATION (#9002313.31) PATIENT INSURANCE MULTIPLE:CERTIFICATION (#902.23)
BPS CLAIMS (#9002313.02) CLAIM (#3)
REVERSAL CLAIM (#401)
BPS NCPDP FORMATS (#9002313.92) PATIENT INSURANCE MULTIPLE:B1 PAYER SHEET (#902.02)
B2 PAYER SHEET (#902.19)
B3 PAYER SHEET (#902.21)
E1 PAYER SHEET (#902.34)
BPS NCPDP OTHER PAYER AMT PAID
(#9002313.2) OTHER PAYER AMT PAID MULTIPLE:OTHER PAYER AMT PAID QUALIFIER (#.02)
BPS NCPDP OVERRIDE (#9002313.511) NCPDP OVERRIDES (#1.13)
BPS PHARMACIES (#9002313.56) PHARMACY (#1.07)
BPS REQUESTS (#9002313.77) SUBMIT REQUEST (#16)
REVERSAL REQUEST (#405)
BPS RESPONSES (#9002313.03) RESPONSE (#4)
REVERSAL RESPONSE (#402)
GROUP INSURANCE PLAN (#355.3) PATIENT INSURANCE MULTIPLE:PLAN ID (#.01)
INSURANCE COMPANY (#36) PATIENT INSURANCE MULTIPLE:INSURANCE COMPANY (#902.33)
NEW PERSON (#200) USER (#13)
NON-BILLABLE CLOSED BY (#304)
NON-BILLABLE RE-OPENED BY (#307)
COMMENT MULTIPLE:USER (#.02)
OUTPATIENT SITE (#59) PHARMACY DIVISION (#11)
PATIENT (#2) PATIENT (#5)
PRESCRIPTION (#52) PRESCRIPTION NUMBER (#1.11)
RATE TYPE (#399.3) PATIENT INSURANCE MULTIPLE:RATE TYPE (#902.29)
INPUT TEMPLATE(S):
PRINT TEMPLATE(S):
SORT TEMPLATE(S):
FORM(S)/BLOCK(S):