Files > IB NCPDP PRESCRIPTION

name

IB NCPDP PRESCRIPTION

number

366.15

location

^IBCNR(366.15,

description

DO NOT delete entries in this file. DO NOT edit data in this file with VA File Manager. This file is used to support NCPDP billing for multiple Rate Types. Entries are created in this file based on the prescription and fill/refill number. The Rate Type determined at time of Billing Determination is stored in this file so it can be utilized when bill creation occurs. This file is also used to store the associated copayment reference number if a non-veteran copayment charge is created to allow easy lookup if the copayment charge needs to be cancelled. Per VHA Directive 2004-038, this file definition should not be modified.

Fields

#	Name	Location	Type	Details	Index	Description
.01	prescription reference(+)	0;1	FREE TEXT		B	This prescription reference consists of two semi-colon pieces. The first piece is the ien from file 52. The second piece is the fill/refill number, with 0 being the initial fill.
.02	rate eligibility determined	0;2	FREE TEXT			This is the Patient Rx/Eligibility determination indicator. This is the flag returned back to ECME/Pharmacy to indicate what eligibility was determined for this prescription. This may effect if a medication can be dispensed to the patient if they are not returned as a V (veteran).
.03	rate type determined	0;3	POINTER	399.3		This is the Rate Type that was determined at the time of the billable check to be used on the bill when the bill is created.
.04	copayment charge	0;4	POINTER	350		This is the copayment charge that was created in association with this billing event. This is used to reverse previously billed copayment charges.