Parent File | Name | Number | Package |
---|---|---|---|
ABSP RESPONSES(#9002313.03) | Response(s) | 9002313.0301 | Pharmacy Point of Sale |
Field # | Name | Loc | Type | Details |
---|---|---|---|---|
.01 | Medication Order | 0;1 | NUMBER |
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112 | Transaction Response Status | 110;2 | FREE TEXT |
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346 | Basis of Calc - Disp Fee | 340;6 | FREE TEXT |
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347 | Basis of Calc - Copay | 340;7 | FREE TEXT |
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348 | Basis of Calc-Flat Sales Tax | 340;8 | FREE TEXT |
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349 | Basis of Calc-Prctg Sales Tax | 340;9 | FREE TEXT |
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402 | Prescription/Service Ref Num | 400;2 | FREE TEXT |
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455 | Prescription/Srvc Ref Num Qual | 450;5 | FREE TEXT |
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498.14 | Prior Auth Number Assigned | 498;6 | FREE TEXT |
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498.51 | Prior Auth Processed Date | 498;1 | FREE TEXT |
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498.52 | Prior Auth Effective Date | 498;2 | FREE TEXT |
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498.53 | Prior Auth Expiration Date | 498;3 | FREE TEXT |
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498.54 | Prior Auth Refills Authorized | 498;4 | FREE TEXT |
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498.55 | Prior Auth Qty Accumulated | 498;5 | FREE TEXT |
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498.57 | Prior Auth Quantity | 498;7 | FREE TEXT |
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498.58 | Prior Auth Dollars Authorized | 498;8 | FREE TEXT |
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501 | Response Status (Prescription) | 500;1 | FREE TEXT |
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503 | Authorization Number | 500;3 | FREE TEXT |
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504 | Message | 504;1 | FREE TEXT |
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505 | Patient Pay Amount | 500;5 | FREE TEXT |
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506 | Ingredient Cost Paid | 500;6 | FREE TEXT |
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507 | Dispensing Fee Paid | 500;7 | FREE TEXT |
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508 | Sales Tax Paid | 500;8 | FREE TEXT |
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509 | Total Amount Paid | 500;9 | FREE TEXT |
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510 | Reject Count | 500;10 | FREE TEXT |
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511 | Reject Code(s) | 511;0 | Multiple #9002313.03511 | 9002313.03511 |
512 | Accumulated Deductible Amount | 500;12 | FREE TEXT |
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513 | Remaining Deductible Amount | 500;13 | FREE TEXT |
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514 | Remaining Benefit Amount | 500;14 | FREE TEXT |
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517 | Amt Applied to Periodic Deduct | 500;17 | FREE TEXT |
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518 | Amount of Copay/CoInsurance | 500;18 | FREE TEXT |
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519 | Amt Attrib to Prod Selection | 500;19 | FREE TEXT |
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520 | Amt Exceed Per Benefit Max | 500;20 | FREE TEXT |
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521 | Incentive Amount Paid | 500;21 | FREE TEXT |
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522 | Basis of Reimb Determination | 500;22 | FREE TEXT |
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523 | Amount Attributed to Sales Tax | 500;23 | FREE TEXT |
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525 | DUR Response Data | 525;1 | FREE TEXT |
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526 | Additional Message Information | 526;0 | Multiple #9002313.301526 | 9002313.301526
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547 | Approved Message Code Count | 540;7 | FREE TEXT |
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548 | Approved Message Code | 548;0 | Multiple #9002313.301548 | 9002313.301548 |
549 | Help Desk Phone Number Qual | 540;9 | FREE TEXT |
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550 | Help Desk Phone Number | 540;10 | FREE TEXT |
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551 | Preferred Product Count | 550;1 | FREE TEXT |
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551.01 | Preferred Product Repeating | 551.01;0 | Multiple #9002313.1301 | 9002313.1301
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557 | Tax Exempt Indicator | 550;7 | FREE TEXT |
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558 | Flat Sales Tax Amount Paid | 550;8 | FREE TEXT |
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559 | Percentage Sales Tax Amt Paid | 550;9 | FREE TEXT |
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560 | Percentage Sales Tax Rate Paid | 550;10 | FREE TEXT |
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561 | Percentage Sales Tx Basis Pd | 560;1 | FREE TEXT |
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562 | Professional Service Fee Paid | 560;2 | FREE TEXT |
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563 | Other Amount Paid Count | 560;3 | FREE TEXT |
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563.01 | Other Amt Paid Repeating Flds | 563.01;0 | Multiple #9002313.1401 | 9002313.1401
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566 | Other Payer Amount Recognized | 560;6 | FREE TEXT |
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567.01 | DUR/PPS Repeating flds | 567.01;0 | Multiple #9002313.1101 | 9002313.1101 |
1000 | Duplicate Response Data | 1000;1 | FREE TEXT |
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