Message Element Detail Tables

requirement designation \<font color="#000000">element attributes\</font> code description mandatory the element must be used per the specification (e g , xml schema validation) note the term mandatory applies to mandatory and required fields in the different standards for example, ncpdp uses the term mandatory, while fhir uses the term required conditional the element must be used per the conditions specified note the term conditional applies to conditional and situational fields in the different standards for example, ncpdp uses the term conditional, while x12 uses the term situational business rule if sent, the element must be used per the surescripts business rule note this guide includes data elements only where surescripts has specific requirements or further explains the field usage refer to the schema for a complete list of fields message header elements element code comments to mandatory this field contains the identification of the receiver this field is used in conjunction with to/@qualifier, which qualifies which id was used response messages will contain the panel user participant or customer id assigned by surescripts @qualifier conditional business rule if the to field is sent, then the qualifier must also be sent value zzz = mutually defined from mandatory this field is used in conjunction with from/@qualifier, which qualifies which id was used response messages will contain s00000000000003 @qualifier conditional business rule if the from field is sent, then the qualifier must also be sent value zzz = mutually defined messageid mandatory unique messageid, reference for support to lookup medication history transaction relatestomessageid conditional references for support to lookup for medication history transaction senttime mandatory date and time the medication history message was sent please see utc time format docid\ hhbgt1zclw0kilpv4uqwf section testmessage conditional staging or production platform indicator values 1 = test (staging environment ) 0 = live (production) rxhistoryresponse message body elements element code comments response mandatory approved mandatory approvalreasoncode conditional when aq (more history available) is present in the approvalreasoncode, a second panel rxhistoryresponse will be sent from surescripts to the customer for the same patient note conditional refer to the rxhistoryresponse note descriptions docid\ thni1glb3sbuojhcauvpe table for details prescriber conditional identification conditional npi mandatory the npi for organization or individual prescriber provided in the file load from panel user npi provided will be validated against the national provider identification file and mapped to the outgoing medication history request to panel data supplier https //nppes cms hhs gov/#/ name conditional lastname conditional lastname (organization name or prescriber last name) patient mandatory identification conditional mutuallydefined mandatory business rule the patient id provided in the patient load file will be populated in the mutuallydefined identification field name conditional includes the patient demographics provided in file load by panel user lastname conditional patient last name firstname conditional patient first name gender conditional patient gender dateofbirth conditional patient dob address conditional zipcode conditional patient zip code benefitscoordination mandatory effectivedate mandatory effectivedate is the beginning date for the desired history (up to one year ago from requested date) example effective date 2019 02 06 expirationdate mandatory expirationdate is the end date for the desired history this is set to the date the medication history was initiated for the initial request if the "aq" indicator was in the approvalreasoncode of the first response message, this would be set to the last drug's lastfilldate examples message 1 with 300 medication dispensed records and aq indicator expirationdate set to requested date 2019 02 06 lastfilldate of the last drug in message 1 is 2019 04 03 message 2 with remaining medication dispensed records expiration date of second response is 2019 04 03, set to lastfilldate of last drug of message 1 consent conditional patient consent indicator values y medicationdispensed mandatory see section below for details medicationdispensed elements zero to 300 loops of the drugs in the patient’s history if there are more than 300 drugs in the patient’s history, a second rxhistoryresponse will be included in the panel history file the most recent drug according to date filled is shown first element code comments medicationdispensed mandatory dispensed medication within the rxhistoryresponse message drugdescription mandatory drug name the item or drug description field should include the standardized drug name including strength and form from a surescripts approved drug compendia example fentanyl 25 mcg/hr transdermal patch drugcoded conditional productcode conditional productcode is the 11 digit ndc note when this is all 9s for the ndc and this is for fill data, this means that the prescription is a compound productcodequalifier conditional productcodequalifier value is nd, indicating it is ndc11 strength conditional strength indicates the measurement value deaschedule conditional deaschedule is populated by the system generating the message, and would utilize the federal dea schedule classification code list, based on federal classification of the medication or the state reclassification of the medication for a complete list of values, see the ncpdp external code list (7996) example c48675 quantity conditional use the ncpdp quantityunitofmeasure terminology rows from the downloaded data for a list of codes, go to http //evs nci nih gov/ftp1/ncpdp/about html http //evs nci nih gov/ftp1/ncpdp/about html value mandatory example 10 codelistqualifier mandatory values 87 = quantity received unitsourcecode mandatory ac = potency unit potencyunitcode mandatory use the ncpdp quantityunitofmeasure terminology rows from the downloaded data for a list of codes, go to http //evs nci nih gov/ftp1/ncpdp/about html http //evs nci nih gov/ftp1/ncpdp/about html example c48524 dayssupply conditional example 30 directions conditional sig instructions refills conditional qualifier mandatory qualifier rem = remaining number of refills value conditional example 0 substitutions conditional example 0 writtendate conditional date mandatory example 2019 04 14 lastfilldate mandatory date mandatory example 2020 02 05 solddate conditional date mandatory example 2020 01 30 pharmacy conditional dispensing pharmacy segment including the details of identification, name, address and communication numbers refer to the file examples docid\ qw9pcerdqimuhtnofcv0w to view how element values could appear identification conditional ncpdpid mandatory storename conditional address conditional addressline1 conditional city conditional state conditional zipcode conditional communicationnumbers conditional communication mandatory number mandatory qualifier mandatory prescriber conditional prescribing physician segment including the details of identification, name, address and communication numbers refer to the file examples docid\ qw9pcerdqimuhtnofcv0w to view how element values could appear identification conditional npi mandatory deanumber mandatory name conditional lastname conditional firstname conditional middlename conditional address conditional addressline1 conditional city conditional state conditional zipcode conditional communicationnumbers conditional communication mandatory number mandatory qualifier mandatory historysource conditional this is the source and fill number information for the medication listed source conditional sourcequalifier mandatory sourcequalifier qualifies the source description p2 – pharmacy py – pbm/payer sourcedescription conditional sourcedescription is the name of medication history source pharmacy or payer/pbm name reference conditional idvalue mandatory idqualifier mandatory pharmacy value of d3 should be used with the ncpdp id payer value of 2u should be used with the surescripts participant id sourcereference conditional prescription number associated to medication history record if the submitter chooses to send this field and sourcequalifier is “p2”, then it should be populated with the pharmacy prescription number if the submitter chooses to send this field and sourcequalifier is “py”, then it should be populated with prescription number from pbm/payer system from claims processing fillnumber conditional defines the dispensing episode as an initial fill or an authorized refill if this field is sent for fill data, it will contain the fill number from the pharmacy if this field is sent for claim data, it will contain pharmacy’s fill number from the pbm/payer system from claims processing values 00 = initial fill 01 = first refill 02 = second refill, etc allowed values 00 thru 99