Message Element Detail Tables

5 min

Requirement Designation

Element Attributes

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 FormatUTC Time Format 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 DescriptionsRxHistoryResponse Note Descriptions 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.
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. 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 ExamplesFile Examples 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 ExamplesFile Examples 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