| Parent File | Name | Number | Package |
|---|---|---|---|
| PRESCRIPTION(#52) | REJECT INFO | 52.25 | Outpatient Pharmacy |
| Field # | Name | Loc | Type | Details |
|---|---|---|---|---|
| .01 | NCPDP REJECT CODE | 0;1 | FREE TEXT | ************************REQUIRED FIELD************************
|
| 1 | DATE/TIME DETECTED | 0;2 | DATE |
|
| 2 | PAYER MESSAGE | 1;1 | FREE TEXT |
|
| 3 | REASON | 1;2 | FREE TEXT |
|
| 4 | PHARMACIST | 0;3 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
| 5 | FILL NUMBER | 0;4 | NUMBER |
|
| 6 | GROUP NAME | 2;1 | FREE TEXT |
|
| 7 | PLAN CONTACT | 2;2 | FREE TEXT |
|
| 8 | PLAN PREVIOUS FILL DATE | 2;3 | DATE |
|
| 9 | STATUS | 0;5 | SET |
|
| 10 | CLOSED DATE/TIME | 0;6 | DATE |
|
| 11 | CLOSED BY | 0;7 | POINTER TO NEW PERSON FILE (#200) | NEW PERSON(#200)
|
| 12 | CLOSE REASON | 0;8 | SET |
|
| 13 | CLOSE COMMENTS | 3;1 | FREE TEXT |
|
| 14 | REASON FOR SERVICE CODE | 0;9 | FREE TEXT |
|
| 15 | PROFESSIONAL SERVICE CODE | 0;10 | FREE TEXT |
|
| 16 | RESPONSE ID | 0;11 | NUMBER |
|
| 17 | OTHER REJECTS | 0;12 | FREE TEXT |
|
| 18 | DUR TEXT | 4;1 | FREE TEXT |
|
| 19 | RESULT OF SERVICE CODE | 0;13 | FREE TEXT |
|
| 20 | INSURANCE NAME | 2;4 | FREE TEXT |
|
| 21 | GROUP NUMBER | 2;5 | FREE TEXT |
|
| 22 | CARDHOLDER ID | 2;6 | FREE TEXT |
|
| 23 | RE-OPENED | 0;14 | SET |
|
| 24 | CLARIFICATION CODE | 0;15 | POINTER ** TO AN UNDEFINED FILE ** |
|
| 25 | PRIOR AUTHORIZATION TYPE | 0;16 | SET |
|
| 26 | PRIOR AUTHORIZATION NUMBER | 0;17 | NUMBER |
|
| 51 | COMMENTS | COM;0 | DATE Multiple #52.2551 | 52.2551 |