Frequently Asked Questions (NCPDP Module)

What is the Redix NCPDP module?

The NCPDP module supports NCPDP Telecommunication, Script, and Batch Standards.

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What standards and versions does the Redix NCPDP module support?

The NCPDP module supports the following NCPDP standards and versions:

  • NCPDP Telecommunication Standard (Version 5.1 and D0)
  • NCPDP Batch Standard (Version 1.1)
  • NCPDP Script Standard (Version 5.0)

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Can the NCPDP module be licensed alone?

No, the NCPDP module is an add-on module for the Redix AnyToAny Format Converter Engine. Users will also need to license the Redix AnyToAny Format Converter Engine.

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Your website mentioned that the NCPDP module includes two predefined maps. Can you tell us more about those two maps?

Redix provides NCPDP Pre-Defined maps for customers who have purchased the Redix NCPDP module. These predefined maps, CSV_to_NCPDP_51_B1 and NCPDP_51_B1_to_CSV, convert a Redix-defined CSV (Comma Separated Value) file into an NCPDP Version 5.1 Billing Request (also known as B1) transaction and vice versa. The Redix CSV file contains one record, and this record has 126 fields, which cover the most commonly used data elements in the pharmaceutical industry. As long as the user can prepare such a CSV file, this predefined map will convert the CSV into an NCPDP B1 transaction.

Below is a detailed description of the Redix CSV file. The description of each field is as follows:

  • Position: Sequence of the record
  • Attr: Attribute of the field, either M (mandatory) or O (optional)
  • Type: Data type
  • Length: minimal - maximal length, i.e., "0 -256"
  • Description: Description of the field
Pos. Attr Type Length Description
01 O AN 0 -256 Payor Type
02 O AN 0 -256 Insured Insurance Plan name
03 O AN 0 -256 Payer Address 1
04 O AN 0 -256 Payer Address 2
05 O AN 0 -256 Payer City
06 O AN 0 -256 Payer State
07 O AN 0 -256 Payer Zip
08 O AN 0 -256 Payer Code
09 M AN 0 -256 Insured Policy Number
10 O AN 0 -256 Patient Name
11 O AN 0 -256 Patient Date of Birth
12 O AN 0 -256 Patient Sex
13 O AN 0 -256 Insured Name
14 O AN 0 -256 Patient Street Address
15 O AN 0 -256 Patient City
16 O AN 0 -256 Patient State
17 O AN 0 -256 Patient ZIP code
18 O AN 0 -256 Patient Phone
19 O AN 0 -256 Patient Relationship to Insured
20 O AN 0 -256 Insured Street Address
21 O AN 0 -256 Insured City
22 O AN 0 -256 Insured State
23 O AN 0 -256 Insured ZIP
24 O AN 0 -256 Insured Phone
25 O AN 0 -256 Patient Marital Status
26 O AN 0 -256 Prior Auth required
27 O AN 0 -256 Patient Employment Status Flag
28 O AN 0 -256 Other Insured Name
29 O AN 0 -256 Other Insured Policy Number
30 O AN 0 -256 Other Insured Date of Birth
31 O AN 0 -256 Other Insured Sex
32 O AN 0 -256 Other Insured Insurance Plan Name
33 O AN 0 -256 Patient Condition Related to Job
34 O AN 0 -256 Auto Accident
35 O AN 0 -256 Auto Accident State
36 O AN 0 -256 Other Accident Flag
37 O AN 0 -256 Insured Group Number
38 O AN 0 -256 Insured Date of Birth
39 O AN 0 -256 Insured Sex
40 O AN 0 -256 Insured Employer Name
41 O AN 0 -256 Another Health Benefit Plan
42 O AN 0 -256 Patient Start of Care Date
43 O AN 0 -256 Insured Authorization
44 O AN 0 -256 Name of Physician
45 O AN 0 -256 Physician ID 1
46 O AN 0 -256 Physician ID 2
47 O AN 0 -256 Physician ID 3
48 O AN 0 -256 Diag 1
49 O AN 0 -256 Diag 2
50 O AN 0 -256 Diag 3
51 O AN 0 -256 Diag 4
52 O AN 0 -256 Prior Authorization Number
53 O AN 0 -256 Tax ID
54 O AN 0 -256 EIN
55 O AN 0 -256 Patient Account Number
56 O AN 0 -256 Accept Assignment
57 O AN 0 -256 Total Charges on the Invoice
58 O AN 0 -256 Amount Paid
59 O AN 0 -256 Balance Due
60 O AN 0 -256 Date Due
61 O AN 0 -256 Service Branch
62 M AN 0 -256 Service Branch NABP Number
63 O AN 0 -256 Service Branch Name
64 O AN 0 -256 Service Address 1
65 O AN 0 -256 Service Address 2
66 O AN 0 -256 Service City
67 O AN 0 -256 Service State
68 O AN 0 -256 Service ZIP
69 O AN 0 -256 Supplement Remit to Address Name by Rgn
70 O AN 0 -256 Supplier Address 1
71 O AN 0 -256 Supplier Address 2
72 O AN 0 -256 Supplier City
73 O AN 0 -256 Supplier State
74 O AN 0 -256 Supplier ZIP
75 O AN 0 -256 Service Branch Payer Provider Number PIN
76 O AN 0 -256 Route ID
77 M AN 0 -256 Service Start Date
78 O AN 0 -256 Service Stop Date
79 O AN 0 -256 Place of Service
80 O AN 0 -256 Type of Service
81 O AN 0 -256 Procedure Code
82 O AN 0 -256 Procedure Description
83 O AN 0 -256 Diagnosis Pointer
84 O AN 0 -256 Charges
85 O AN 0 -256 Days and Units
86 O AN 0 -256 NDC Number
87 M AN 0 -256 Rx Number
88 O AN 0 -256 Prescription Ship Date
89 O AN 0 -256 Prescription Written Date
90 O AN 0 -256 Doses
91 O AN 0 -256 Days (Supply)
92 O AN 0 -256 Payer Code
93 O AN 0 -256 Booked Amount
94 M AN 0 -256 BIN Number
95 M AN 0 -256 Version Number
96 M AN 0 -256 Transaction Code
97 M AN 0 -256 Processor Control Number
98 M AN 0 -256 Transaction Count
99 M AN 0 -256 Service Provider ID Qualifier
100 M AN 0 -256 Software Vendor ID
101 O AN 0 -256 Eligibility Clarification Code
102 O AN 0 -256 Person Code
103 M AN 0 -256 PreService Ref Number Qualifier
104 M AN 0 -256 Product Service ID Qualifier
105 O AN 0 -256 Quantity Dispensed
106 O AN 0 -256 Compound Code
107 O AN 0 -256 DAW Product Selection Code
108 O AN 0 -256 Number of Refills Authorized
109 O AN 0 -256 Prescription Origin Code
110 O AN 0 -256 Submission Clarification Code
111 O AN 0 -256 Other Coverage Code
112 O AN 0 -256 Prior Authorization Type Code
113 O AN 0 -256 Prescriber ID Qualifier
114 O AN 0 -256 Dispensing Fee Submitted
115 O AN 0 -256 Usual and Customary Charge
116 O AN 0 -256 Gross Amount Due
117 O AN 0 -256 Compound Dosage Form Description Code
118 O AN 0 -256 Compound Dispensing Unit Form Indicator
119 O AN 0 -256 Compound Route of Administration
120 O AN 0 -256 Compound Ingredient Component Count
121 O AN 0 -256 Compound Product ID Qualifier
122 O AN 0 -256 Compound Product ID
123 O AN 0 -256 Compound Ingredient Quantity
124 O AN 0 -256 Compound Ingredient Drug Cost
125 O AN 0 -256 Compound Ingredient Basis of Cost Determ
126 O AN 0 -256 NCPDP specification

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