| # | Name | Location | Type | Details | Index | Description |
|---|---|---|---|---|---|---|
| .01 | event type(+) | 0;1 | SET OF CODES | 0:UNKNOWN 1:BILLABLE STATUS CHECK 2:SUBMIT 3:BILL 4:RELEASE 5:REVERSE 6:CLOSE 7:REOPEN | B | The event types represent the various ePharmacy billing events during the processing of outpatient Rx claims. |
| .03 | patient | 0;3 | POINTER | 2 | D | PATIENT on the Rx claim |
| .04 | job | 0;4 | NUMERIC | The job number of the job currently executing | ||
| .05 | time | 0;5 | DATE-TIME | Date and time of the event | ||
| .06 | epharmacy user | 0;6 | POINTER | 200 | U | System user who triggered the e-pharmacy event. This can be the system user who enters prescription or makes billing operation on e-pharmacy claims. It also can be POSTMASTER if the operation (like claims auto-reversal process) was performed by a background job. |
| .07 | result | 0;7 | NUMERIC | Result of the event processing - return code | ||
| .08 | result message | 0;8 | FREE TEXT | Result of the event processing - message | ||
| .09 | e-pharmacy division | 0;9 | POINTER | 9002313.56 | E-Pharmacy division (BPS PHARMACY). | |
| .11 | auth # | 1;1 | FREE TEXT | ECME approval/authorization number | ||
| .12 | bcid | 1;2 | FREE TEXT | This field contains the Prescription/Service Reference Number (also known as the ECME#) and the Date of Service separated by a semi-colon. | ||
| .13 | claimid | 1;3 | FREE TEXT | This is a 7 or 12 digit ECME number with leading zero(s). | ||
| .14 | patient in ibd | 1;4 | POINTER | 2 | PATIENT identifier passed in IBD ARRAY when outside application calls $$STORESP^IBNCPDP (IA #4299) | |
| .15 | medical center division | 1;5 | POINTER | 40.8 | Division identifier | |
| .16 | response | 1;6 | FREE TEXT | Response from the payer: ACCEPTED PAYABLE REJECTED DUPLICATE | ||
| .17 | reversal reason | 1;7 | FREE TEXT | Reversal reason | ||
| .18 | rts-del | 1;8 | NUMERIC | Return to Stock-Delete status | ||
| .19 | status | 1;9 | FREE TEXT | Bill status - one of the following values: "PAID","REJECTED","REVERSED", "CLOSED", "RELEASED", or "SUBMITTED" | ||
| .201 | prescription | 2;1 | POINTER | 52 | I | Pointer TO PRESCRIPTION FILE (#52) as passed into $$STORESP^ IBNCPDP (IA # 4299) in "PRESCRIPTION" node |
| .202 | rx no | 2;2 | FREE TEXT | R | RX Number from file #52 passed into $$STORESP^IBNCPDP (IA # 4299) in the "RX NO" node | |
| .203 | fill number | 2;3 | NUMERIC | Refill # 0 - for original refill 1...n - for other refills | ||
| .204 | drug | 2;4 | FREE TEXT | Prescription Drug on the claim | ||
| .205 | ndc | 2;5 | FREE TEXT | National Drug Code number | ||
| .206 | date of service | 2;6 | DATE-TIME | Date of Service of the outpatient pharmacy Rx. | ||
| .207 | release date | 2;7 | DATE-TIME | This is the date the Rx was released. This field is populated only if the Rx was released. | ||
| .208 | qty | 2;8 | NUMERIC | This is the prescription billed quantity. This may be different than the NCPDP quantity. | ||
| .209 | days supply | 2;9 | NUMERIC | RX Days Supply | ||
| .21 | dea | 2;10 | FREE TEXT | Drug Enforcement Agency number | ||
| .211 | filled by | 2;11 | POINTER | 200 | Person, who filled the RX refill. | |
| .212 | rx # | 2;12 | POINTER | 52 | I | Pointer TO PRESCRIPTION FILE (#52) as passed into $$RX^IBNCPDP (IA # 4299) in "IEN" node |
| .213 | billing units | 2;13 | FREE TEXT | This is the type of billing units associated with the billing quantity. Examples include "TAB", "CAP", "EA", "ML", "VI", "GM", and so forth. | ||
| .214 | ncpdp qty | 2;14 | NUMERIC | This is the NCPDP Quantity for the prescription. This may be different than the billed quantity. | ||
| .215 | ncpdp units | 2;15 | FREE TEXT | This is the NCPDP standard for unit type: EA - each ML - milliliters GM - grams This is the type of unit associated with the NCPDP quantity. | ||
| .301 | bill | 3;1 | POINTER | 399 | IB bill | |
| .302 | billed | 3;2 | NUMERIC | Amount billed to the insurance | ||
| .303 | plan | 3;3 | POINTER | 355.3 | Group insurance plan | |
| .304 | cost | 3;4 | NUMERIC | Cost - dollar amount per Dispensed Unit | ||
| .305 | paid by insurance | 3;5 | NUMERIC | Amount paid by the Insurance | ||
| .306 | close/reopen comment | 3;6 | FREE TEXT | Close or reopen comment | ||
| .307 | close reason | 3;7 | POINTER | 356.8 | Close reason | |
| .308 | drop to paper | 3;8 | NUMERIC | Drop to Paper flag. | ||
| .309 | release copay | 3;9 | NUMERIC | Release Copay flag. | ||
| .31 | ecme user in ibd | 3;10 | POINTER | 200 | System user who triggered the ECME event and whose identifier was passed in IBD ARRAY when outside application calls $$STORESP^IBNCPDP (IA #4299). This can be the system user who enters prescription or makes billing operation on e-pharmacy claims. It also can be POSTMASTER if the operation (like claims auto-reversal process) was performed by a background job. | |
| .311 | copay amount | 3;11 | NUMERIC | This is to store the copayment amount specified by the payer for amounts that are to be charge for non-Veteran copayment charges such as TRICARE or CHAMPVA. | ||
| .312 | ingredient cost paid | 3;12 | NUMERIC | This is the amount of the ingredient cost paid as reported by the payer. | ||
| .313 | dispensing fee paid | 3;13 | NUMERIC | This is the amount of the dispensing fee paid as reported by the payer. | ||
| .314 | patient responsibility (ins) | 3;14 | NUMERIC | This is the amount for which the patient is responsible as reported by the payer. | ||
| .401 | ao | 4;1 | SET OF CODES | 0:NO 1:YES 2:NO ANSWER 3:OVERRIDDEN | Agent Orange indicator | |
| .402 | cv | 4;2 | SET OF CODES | 0:NO 1:YES 2:NO ANSWER 3:OVERRIDDEN | Combat Veteran indicator | |
| .403 | swa | 4;3 | SET OF CODES | 0:NO 1:YES 2:NO ANSWER 3:OVERRIDDEN | Southwest Asia indicator. | |
| .404 | ir | 4;4 | SET OF CODES | 0:NO 1:YES 2:NO ANSWER 3:OVERRIDDEN | Ionizing radiation exposure indicator | |
| .405 | mst | 4;5 | SET OF CODES | 0:NO 1:YES 2:NO ANSWER 3:OVERRIDDEN | Military Sexual trauma indicator | |
| .406 | hnc | 4;6 | SET OF CODES | 0:NO 1:YES 2:NO ANSWER 3:OVERRIDDEN | Head/neck cancer indicator | |
| .407 | sc | 4;7 | SET OF CODES | 0:NO 1:YES 2:NO ANSWER 3:OVERRIDDEN | Service Connected indicator | |
| .408 | shad | 4;8 | SET OF CODES | 0:NO 1:YES 2:NO ANSWER 3:OVERRIDDEN | Project 112/SHAD indicator | |
| 2 | insurance | 5;0 | MULTIPLE | 366.1412 | Insurance data | |
| 7.01 | rx cob | 7;1 | SET OF CODES | 0:UNKNOWN 1:PRIMARY 2:SECONDARY | The Coordination Of Benefits (COB) indicator designates the payer sequence for the claim. | |
| 7.02 | primary bill | 7;2 | POINTER | 399 | This field will hold the Primary bill associated with the original prescription/refill related to this claim. | |
| 7.03 | prior payment | 7;3 | NUMERIC | This field will store a prior payment amount that the primary insurer agreed to pay for the original prescription/refill related to this claim. | ||
| 7.04 | rate type selected by user | 7;4 | POINTER | 399.3 | This is the Rate Type selected by the user for ECME Pharmacy billing purposes. Users may select the rate type in the option "Process Secondary/TRICARE Rx to ECME" [BPS COB PROCESS SECOND TRICARE]. | |
| 7.05 | eligibility | 7;5 | SET OF CODES | V:VETERAN T:TRICARE C:CHAMPVA | This is the patient's eligibility as determined by IB billing determination during the finish event. |
Error: Invalid Global File Type: 366.141