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Global: ^ABSPF(9002313.92

Package: Pharmacy Point of Sale

Global: ^ABSPF(9002313.92


Information

FileMan FileNo FileMan Filename Package
9002313.92 ABSP NCPDP FORMATS Pharmacy Point of Sale

Description

Directly Accessed By Routines, Total: 20

Package Total Routines
Pharmacy Point of Sale 20 ABSPECA1    ABSPECA2    ABSPECA8    ABSPECA9    ABSPECP1    ABSPECR1    ABSPECR2    ABSPECX1
ABSPER10    ABSPOS03    ABSPOS32    ABSPOSC2    ABSPOSC4    ABSPOSCC    ABSPOSCF    ABSPOSCG
ABSPOSFC    ABSPOSH2    ABSPOSHF    ABSPOSHR    

Accessed By FileMan Db Calls, Total: 2

Package Total Routines
Pharmacy Point of Sale 2 ABSPECR2    ABSPICNV    

Pointed To By FileMan Files, Total: 2

Package Total FileMan Files
Pharmacy Point of Sale 2 ABSP INSURER(#9002313.4)[100.01]    ABSP NCPDP FORMATS(#9002313.92)[1001]    

Pointer To FileMan Files, Total: 2

Package Total FileMan Files
Pharmacy Point of Sale 2 ABSP NCPDP FIELD DEFS(#9002313.91)[#9002313.9201(.02), #9002313.9202(.02), #9002313.9203(.02), #9002313.9204(.02), #9002313.9205(.02), #9002313.9206(.02), #9002313.9207(.02), #9002313.9208(.02), #9002313.9209(.02), #9002313.921(.02), #9002313.9213(.02), #9002313.9214(.02), #9002313.9215(.02), #9002313.9216(.02), #9002313.9217(.02), #9002313.9218(.02), #9002313.9219(.02), #9002313.922(.02)]    ABSP NCPDP FORMATS(#9002313.92)[1001]    

Fields, Total: 33

Field # Name Loc Type Details
.01 Record Format Name 0;1 FREE TEXT
************************REQUIRED FIELD************************

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<3) X
  • LAST EDITED:  JUL 30, 2002
  • HELP-PROMPT:  Answer must be 3-30 characters in length.
  • CROSS-REFERENCE:  9002313.92^B
    1)= S ^ABSPF(9002313.92,"B",$E(X,1,30),DA)=""
    2)= K ^ABSPF(9002313.92,"B",$E(X,1,30),DA)
1.01 NDC BIN Number 1;1 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>10!($L(X)<1) X
  • LAST EDITED:  JAN 12, 2001
  • HELP-PROMPT:  Answer must be 1-10 characters in length.
  • CROSS-REFERENCE:  9002313.92^C
    1)= S ^ABSPF(9002313.92,"C",$E(X,1,30),DA)=""
    2)= K ^ABSPF(9002313.92,"C",$E(X,1,30),DA)
1.02 Version 1;2 SET
************************REQUIRED FIELD************************
  • '32' FOR Version 3.2;
  • '3A' FOR Version 3.A;
  • '3C' FOR Version 3.C;
  • '3B' FOR Version 3.B;
  • '51' FOR Version 5.1;

  • LAST EDITED:  JUN 30, 2011
1.03 Maximum RX's Per Claim 1;3 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>99)!(X<1)!(X?.E1"."1.N) X
  • LAST EDITED:  FEB 28, 2011
  • HELP-PROMPT:  Type a number between 1 and 99, 0 Decimal Digits
1.04 Envoy Plan Number 1;4 NUMBER

  • INPUT TRANSFORM:  K:+X'=X!(X>999999)!(X<1)!(X?.E1"."1N.N) X
  • LAST EDITED:  JAN 12, 2001
  • HELP-PROMPT:  Type a Number between 1 and 999999, 0 Decimal Digits
  • DESCRIPTION:  
    Like a Bin number, but it's Envoy's version of it.
  • CROSS-REFERENCE:  9002313.92^D
    1)= S ^ABSPF(9002313.92,"D",$E(X,1,30),DA)=""
    2)= K ^ABSPF(9002313.92,"D",$E(X,1,30),DA)
1.05 Help Telephone # 1;5 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<1) X
  • LAST EDITED:  OCT 03, 2000
  • HELP-PROMPT:  Answer must be 1-30 characters in length.
  • DESCRIPTION:  This is the telephone number to call for assistance in figuring out rejected claims. There is another place for such a phone number, in the ABSP INSURER file, file #9002313.4, field 100.05 - that insurer- specific number
    takes precedence over this number when printing reports.  The reason for having this number is that we can ship it as part of the formats (saving individual sites the trouble of finding it and typing it in.)  And also, it
    saves the trouble of typing the same number into multiple insurance companies' records, such as when you have a half dozen flavors of PCS or if you have a monolith like Paid Prescriptions acting as an umbrella for lots of
    insurances.
1.06 Production/Testing Status 1;6 SET
  • '0' FOR DISABLED;
  • '1' FOR DEVELOPMENT;
  • '2' FOR FIELD TESTING;
  • '3' FOR PRODUCTION;

  • LAST EDITED:  JAN 19, 2001
  • DESCRIPTION:  
    To be used as a screen when attaching a format to an insurer.  Don't allow non-production formats.  Those will have to be entered directly with Fileman.
  • SCREEN:  S DIC("S")="I Y=2!(Y=3)!(DUZ(0)=""@"")"
  • EXPLANATION:  Programmer may select any. Others: may select only formats in FIELD TESTING or PRODUCTION.
1.07 Is A Reversal Format 1;7 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  NOV 15, 2000
  • DESCRIPTION:  
    To be used as a screen when selecting format to attach to an insurance.  Don't allow reversal format to be selected as the insurance's format!
1.08 Add Disp. Fee to Ingr. Cost 1;8 SET
  • '1' FOR YES;
  • '0' FOR NO;

  • LAST EDITED:  FEB 28, 2011
  • DESCRIPTION:  Many formats expect the Ingredient Cost to include the Dispensing Fee, too. The default for this is "YES". Set this field to NO for any formats that should have only the Ingredient Cost in the Ingredient Cost, exclusive
    of Dispensing Fee.
1.09 *Contract Required 1;9 SET
  • '1' FOR YES;
  • '0' FOR NO;
  • 'U' FOR UNK;
  • 'D' FOR DONE;

  • LAST EDITED:  FEB 28, 2011
  • DESCRIPTION:  
    Does the pharmacy need a contract with the payor in order to submit claims? Yes, No, Unknown, and Done "Done" means done nationally, for all IHS sites.
1.1 Total exclusive of Patient Amt 1;10 SET
  • '1' FOR Y;
  • '0' FOR N;

  • LAST EDITED:  FEB 07, 2001
  • DESCRIPTION:  This refers to the interpretation of the fields in the response packets, as copied to 9002313.03, Response(s) multiple, fields 509 Total Amount Paid and 505 Patient Paid Amount. For most formats and insurers, it seems,
    509 Total Amount Paid means Total, Patient plus Insurer..  But BC/BS ARIZONA doesn't do it that way - for them, 509 contains only the amount paid by insurance.  $$NETPAID1 needs to know whether to do the subtraction.  If
    $$NETPAID1 encounters a case where (#509)<(#505), it will set the flag in the format, locally.  But we try to stay ahead of the curve and ship the flag where needed.  So as of today (Feb. 7, 2001) we ship this flag set for
    BC/BS ARIZONA format.
1.2 MEDICARE PART D FORMAT 1;11 SET
  • '1' FOR Y;
  • '0' FOR N;

  • LAST EDITED:  NOV 09, 2005
  • HELP-PROMPT:  Enter Y if this is a format used for Medicare Part D claims.
  • DESCRIPTION:  
    This field will be used later on to help determine claims generated for Medicare Part D plans.
1.3 Processor Control Number 1;12 FREE TEXT

  • INPUT TRANSFORM:  K:$L(X)>30!($L(X)<1) X
  • LAST EDITED:  JAN 06, 2009
  • HELP-PROMPT:  Answer must be 1-30 characters in length
10 Claim Header (Required) 10;0 Multiple #9002313.9201 9002313.9201
20 Claim Header (Optional) 20;0 Multiple #9002313.9202 9002313.9202
30 Claim Information (Required) 30;0 Multiple #9002313.9203 9002313.9203
40 Claim Information (Optional) 40;0 Multiple #9002313.9204 9002313.9204
1001 Reversal Format REVERSAL;1 POINTER TO ABSP NCPDP FORMATS FILE (#9002313.92) ABSP NCPDP FORMATS(#9002313.92)

  • LAST EDITED:  JAN 10, 2001
1005.1 Transaction Header Segment 100;0 Multiple #9002313.9205 9002313.9205

  • LAST EDITED:  AUG 01, 2002
1105.1 Patient Segment 110;0 Multiple #9002313.9206 9002313.9206
1205.1 Insurance Segment 120;0 Multiple #9002313.9207 9002313.9207
1305.1 Claim Segment 130;0 Multiple #9002313.9208 9002313.9208
1405.1 Pharmacy Provider Segment 140;0 Multiple #9002313.9209 9002313.9209
1505.1 Prescriber Segment 150;0 Multiple #9002313.921 9002313.921
1605.1 COB/Other Payments Segment 160;0 Multiple #9002313.9213 9002313.9213
1705.1 Workers Comp Segment 170;0 Multiple #9002313.9214 9002313.9214
1805.1 DUR/PPS Segment 180;0 Multiple #9002313.9215 9002313.9215
1901 Developer's Remarks DEVELOPER'S REMARKS;0 WORD-PROCESSING #9002313.921901

  • LAST EDITED:  JAN 17, 2001
1905.1 Pricing Segment 190;0 Multiple #9002313.9216 9002313.9216
2005.1 Coupon Segment 200;0 Multiple #9002313.9217 9002313.9217
2105.1 Compound Segment 210;0 Multiple #9002313.9218 9002313.9218
2205.1 Prior Auth Segment 220;0 Multiple #9002313.9219 9002313.9219
2305.1 Clinical Segment 230;0 Multiple #9002313.922 9002313.922
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