Panel History File Examples
9 min
This section provides the following XML examples from within the Panel History file:
- Panel History File XML Document StructurePanel History File XML Document Structure
- File Identifier with Date SentFile Identifier with Date Sent
- From Pharmacy FeedFrom Pharmacy Feed
- From PBM/Payer Care FeedFrom PBM/Payer Care Feed
- Patient Not FoundPatient Not Found
- Approved With NotesApproved With Notes
- AQ Reason CodeAQ Reason Code
- DJ Reason CodeDJ Reason Code
Panel History File XML Document Structure
File Identifier with Date Sent (Top Portion of Panel History File)
<Messages xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.surescripts.com/messaging MessagesWrapper.xsd" xmlns="http://www.surescripts.com/messaging">
<PatientFileID>ADHOC</PatientFileID>
<TransmissionControlNumber>1234561234</TransmissionControlNumber>
<SentTime>2020-02-08T05:08:10</SentTime>From Pharmacy Feed
<Message xmlns="http://www.surescripts.com/messaging" release="006" version="010">
<Header>
<To Qualifier="ZZZ">P00000000012345</To>
<From Qualifier="ZZZ">S00000000000003</From>
<MessageID>id3z8w35xkt03h2cb1yd3wobii0juedm</MessageID>
<RelatesToMessageID>12345678:12345678:1234567812345</RelatesToMessageID>
<SentTime>2020-02-08T04:38:41.076Z</SentTime>
<Security>
<Sender>
<SecondaryIdentification>NOPASS</SecondaryIdentification>
</Sender>
<Receiver/>
</Security>
<SenderSoftware>
<SenderSoftwareDeveloper>SenderSoftwareDev</SenderSoftwareDeveloper>
<SenderSoftwareProduct>10.6 Version</SenderSoftwareProduct>
<SenderSoftwareVersionRelease>10.1</SenderSoftwareVersionRelease>
</SenderSoftware>
<TestMessage>0</TestMessage>
</Header>
<Body>
<RxHistoryResponse>
<Response>
<Approved/>
</Response>
<Prescriber>
<Identification>
<NPI>1265666666</NPI>
<Identification>
<Name>
<LastName>Dolittle</LastName>
</Name>
</Prescriber>
<Patient>
<Identification>
<MutuallyDefined>1234567</MutuallyDefined>
</Identification>
<Name>
<LastName>AUBAINE</LastName>
<FirstName>CHENIN BLANC</FirstName>
</Name>
<Gender>F</Gender>
<DateOfBirth>
<Date>1991-07-21</Date>
</DateOfBirth>
<Address>
<ZipCode>61761</ZipCode>
</Address>
</Patient>
<BenefitsCoordination>
<EffectiveDate>
<Date>2019-02-08</Date>
</EffectiveDate>
<ExpirationDate>
<Date>2019-03-08</Date>
</ExpirationDate>
<Consent>Y</Consent>
</BenefitsCoordination>
<MedicationDispensed>
<DrugDescription>SERTRALINE 60MG TABLETS</DrugDescription>
<DrugCoded>
<ProductCode>65862001305</ProductCode>
<ProductCodeQualifier>ND</ProductCodeQualifier>
</DrugCoded>
<Quantity>
<Value>90</Value>
<CodeListQualifier>87</CodeListQualifier>
<UnitSourceCode>AC</UnitSourceCode>
<PotencyUnitCode>C64933</PotencyUnitCode>
</Quantity>
<DaysSupply>90</DaysSupply>
<Directions>TAKE ONE TABLET TWO TIMES A DAY UNTIL GONE.</Directions>
<Refills>
<Qualifier>REM</Qualifier>
<Value>0</Value>
</Refills>
<Substitutions>0</Substitutions>
<WrittenDate>
<Date>2019-12-15</Date>
</WrittenDate>
<LastFillDate>
<Date>2019-12-15</Date>
</LastFillDate>
<SoldDate>
<Date>2019-12-18</Date>
</SoldDate>
<Pharmacy>
<Identification>
<NCPDPID>1469123</NCPDPID>
<NPI>1265437548</NPI>
</Identification>
<StoreName>Walgreens</StoreName>
<Address>
<AddressLine1>1525 N Main Pkwy</AddressLine1>
<City>Bloomington</City>
<State>IL</State>
<ZipCode>61706</ZipCode>
</Address>
<CommunicationNumbers>
<Communication>
<Number>4012615689</Number>
<Qualifier>TE</Qualifier>
</Communication>
</CommunicationNumbers>
</Pharmacy>
<Prescriber>
<Identification>
<NPI>8925170837</NPI>
<DEANumber>FG1235179</DEANumber>
</Identification>
<Name>
<LastName>PISCOPO</LastName>
<FirstName>BOB</FirstName>
</Name>
<Address>
<AddressLine1>1234 West DR</AddressLine1>
<AddressLine2>STE E</AddressLine2>
<City>Chicago</City>
<State>IL</State>
<ZipCode>617013552</ZipCode>
<PlaceLocationQualifier>AD2</PlaceLocationQualifier>
</Address>
<CommunicationNumbers>
<Communication>
<Number>5864638356</Number>
<Qualifier>TE</Qualifier>
</Communication>
<Communication>
<Number>8863631812</Number>
<Qualifier>FX</Qualifier>
</Communication>
</CommunicationNumbers>
</Prescriber>
<HistorySource>
<Source>
<SourceQualifier>P2</SourceQualifier>
<SourceDescription>Walgreens</SourceDescription>
<Reference>
<IDValue>1469123</IDValue>
<IDQualifier>D3</IDQualifier>
</Reference>
</Source>
<SourceReference>309678</SourceReference>
<FillNumber>01</FillNumber>
</HistorySource>
</MedicationDispensed>
</RxHistoryResponse>
</Body>
</Message>From PBM/Payer Care Feed
Please refer to the example in AQ Reason CodeAQ Reason Code where the SourceQualifier value is PY.
Note: If the submitter chooses to send the SourceReference field, and the SourceQualifier value is PY, then it should be populated with prescription number from PBM/payer system from claims processing.
Patient Not Found
<Message xmlns="http://www.surescripts.com/messaging" release="006" version="010">
<Header>
<To Qualifier="ZZZ">P00000000012345</To>
<From Qualifier="ZZZ">S00000000000009</From>
<MessageID>8cww2ecxk97k4a3ibwmp1pt1mgl24cdc</MessageID>
<RelatesToMessageID>32345678:12345678:1234567812345</RelatesToMessageID>
<SentTime>2020-02-08T04:44:58.232Z</SentTime>
<Security>
<Sender>
<SecondaryIdentification>NOPASS</SecondaryIdentification>
</Sender>
<Receiver/>
</Security>
<SenderSoftware>
<SenderSoftwareDeveloper>SenderSoftwareDev</SenderSoftwareDeveloper>
<SenderSoftwareProduct>10.6 Version</SenderSoftwareProduct>
<SenderSoftwareVersionRelease>10.1</SenderSoftwareVersionRelease>
</SenderSoftware>
<TestMessage>0</TestMessage>
</Header>
<Body>
<RxHistoryResponse>
<Response>
<Approved>
<Note>Patient Not Found.</Note>
</Approved>
</Response>
<Prescriber>
<Identification>
<NPI>1265666666</NPI>
<Identification>
<Name>
<LastName>Dolittle</LastName>
</Name>
</Prescriber>
<Patient>
<Identification>
<!--Note: This Mutually Defined field is the patient’s id from the input patient file. It is not required by the standard on a med history response but will always be populated for Panel.-->
<MutuallyDefined>7654321</MutuallyDefined>
</Identification>
<Name>
<!--Note: First Name, Last Name, Date of Birth, Gender and Zip Code are required on the Patient File Load. These are not required by the standard on a med history response but will always be populated for Panel.-->
<LastName>Bandit</LastName>
<FirstName>Smokey</FirstName>
</Name>
<Gender>M</Gender>
<DateOfBirth>
<Date>1940-04-27</Date>
</DateOfBirth>
<Address>
<ZipCode>60131</ZipCode>
</Address>
</Patient>
<BenefitsCoordination>
<!--Note: The benefits coordination fields are not required by the standard on a med history response but will be populated by Panel. Effective date is the beginning date of the look-back period for medications and expiration date is the end date of the look-back period. Consent is always set to “Y”.-->
<EffectiveDate>
<Date>2019-02-08</Date>
</EffectiveDate>
<ExpirationDate>
<Date>2020-02-08</Date>
</ExpirationDate>
<Consent>Y</Consent>
</BenefitsCoordination>
</RxHistoryResponse>
</Body>
</Message>Approved With Note
<Message xmlns="http://www.surescripts.com/messaging" release="006" version="010">
<Header>
<To Qualifier="ZZZ">P00000000012345</To>
<From Qualifier="ZZZ">S00000000000009</From>
<MessageID>wl4hsx68yfwgtklgfaxups68io4rbx6f</MessageID>
<RelatesToMessageID>22345678:12345678:1234567812345</RelatesToMessageID>
<SentTime>2020-02-08T04:17:47.979Z</SentTime>
<Security>
<Sender>
<SecondaryIdentification>NOPASS</SecondaryIdentification>
</Sender>
<Receiver/>
</Security>
<SenderSoftware>
<SenderSoftwareDeveloper>SenderSoftwareDev</SenderSoftwareDeveloper>
<SenderSoftwareProduct>10.6 Version</SenderSoftwareProduct>
<SenderSoftwareVersionRelease>10.1</SenderSoftwareVersionRelease>
</SenderSoftware>
<TestMessage>0</TestMessage>
</Header>
<Body>
<RxHistoryResponse>
<Response>
<Approved>
<Note>Although a patient record was found, no medications were available.</Note>
</Approved>
</Response>
<Prescriber>
<Identification>
<NPI>1265666666</NPI>
<Identification>
<Name>
<LastName>Dolittle</LastName>
</Name>
</Prescriber>
<Patient>
<Identification>
<!--Note: This Mutually Defined field is the patient’s id from the input patient file. It is not required by the standard on a med history response but will always be populated for Panel.-->
<MutuallyDefined>123456</MutuallyDefined>
</Identification>
<Name>
<!--Note: First Name, Last Name, Date of Birth, Gender and Zip Code are required on the Patient File Load. These are not required by the standard on a med history response but will always be populated for Panel.-->
<LastName>BRIGHTONrighton</LastName>
<FirstName>JOEL</FirstName>
</Name>
<Gender>M</Gender>
<DateOfBirth>
<Date>1968-05-19</Date>
</DateOfBirth>
<Address>
<ZipCode>90210</ZipCode>
</Address>
</Patient>
<BenefitsCoordination>
<!--Note: The benefits coordination fields are not required by the standard on a med history response but will be populated by Panel. Effective date is the beginning date of the look-back period for medications and expiration date is the end date of the look-back period. Consent is always set to “Y”.-->
<EffectiveDate>
<Date>2019-02-08</Date>
</EffectiveDate>
<ExpirationDate>
<Date>2020-02-08</Date>
</ExpirationDate>
<Consent>Y</Consent>
</BenefitsCoordination>
</RxHistoryResponse>
</Body>
</Message>AQ Reason Code (Patient Has Over 300 Meds)
<Message xmlns="http://www.surescripts.com/messaging" release="006" version="010">
<Header>
<To Qualifier="ZZZ">P00000000022835</To>
<From Qualifier="ZZZ">S00000000000003</From>
<MessageID> id3z8w35xkt03h2cb1yd3wobii0juedm</MessageID>
<RelatesToMessageID>12345678:12345678:1234567812345</RelatesToMessageID>
<SentTime>2020-02-08T04:38:41.076Z </SentTime>
<Security>
<Sender>
<SecondaryIdentification>NOPASS</SecondaryIdentification>
</Sender>
<Receiver/>
</Security>
<SenderSoftware>
<SenderSoftwareDeveloper>SenderSoftwareDev</SenderSoftwareDeveloper>
<SenderSoftwareProduct>10.6 Version</SenderSoftwareProduct>
<SenderSoftwareVersionRelease>10.1</SenderSoftwareVersionRelease>
</SenderSoftware>
<TestMessage>0</TestMessage>
</Header>Response 1 Containing AQ Reason Code
<Body>
<RxHistoryResponse>
<Response>
<Approved>
<ApprovalReasonCode>AQ</ApprovalReasonCode>
</Approved>
</Response>
<Prescriber>
<Identification>
<NPI>1265666666</NPI>
<Identification>
<Name>
<LastName>Dolittle</LastName>
</Name>
</Prescriber>
<Patient>
<Identification>
<MutuallyDefined>1234567</MutuallyDefined>
</Identification>
<Name>
<LastName>PENNINGTON</LastName>
<FirstName>REN</FirstName>
</Name>
<Gender>F</Gender>
<DateOfBirth>
<Date>1975-06-28</Date>
</DateOfBirth>
<Address>
<ZipCode>55555</ZipCode>
</Address>
</Patient>
<BenefitsCoordination>
<EffectiveDate>
<Date>2019-02-06</Date>
</EffectiveDate>
<ExpirationDate>
<Date>2020-02-06</Date>
</ExpirationDate>
<Consent>Y</Consent>
</BenefitsCoordination>
<MedicationDispensed>
<!--Note: This message would continue on to include 300 total dispensed medications.-->Response 2 (Remaining Dispensed Medications up to 300)
<Body>
<RxHistoryResponse>
<Response>
<Approved/>
</Response>
<Prescriber>
<Identification>
<NPI>1265666666</NPI>
<Identification>
<Name>
<LastName>Dolittle</LastName>
</Name>
</Prescriber>
<Patient>
<Identification>
<MutuallyDefined>2101111</MutuallyDefined>
<Identification>
<MutuallyDefined>1234567</MutuallyDefined>
</Identification>
<Name>
<LastName>PENNINGTON</LastName>
<FirstName>REN</FirstName>
</Name>
<Gender>F</Gender>
<DateOfBirth>
<Date>1975-06-28</Date>
</DateOfBirth>
<Address>
<ZipCode>55555</ZipCode>
</Address>
</Patient>
<BenefitsCoordination>
<EffectiveDate>
<Date>2019-02-06</Date>
</EffectiveDate>
<ExpirationDate>
<Date>2019-04-03</Date>
</ExpirationDate>
<Consent>Y</Consent>
</BenefitsCoordination>
<MedicationDispensed>
<DrugDescription>fentanyl 25 mcg/hr transdermal patch</DrugDescription>
<DrugCoded>
<ProductCode>00006902576</ProductCode>
<ProductCodeQualifier>ND</ProductCodeQualifier>
<Strength>25 MCG/HR</Strength>
<DEASchedule>C48675</DEASchedule>
</DrugCoded>
<Quantity>
<Value>10</Value>
<CodeListQualifier>87</CodeListQualifier>
<UnitSourceCode>AC</UnitSourceCode>
<PotencyUnitCode>C48524</PotencyUnitCode>
</Quantity>
<DaysSupply>30</DaysSupply>
<Refills>
<Qualifier>REM</Qualifier>
<Value>0</Value>
</Refills>
<Substitutions>0</Substitutions>
<LastFillDate>
<Date>2019-03-08</Date>
</LastFillDate>
<Pharmacy>
<Identification>
<NCPDPID>1455555</NCPDPID>
<NPI>1265466666</NPI>
</Identification>
<StoreName>WALGREENS 12345</StoreName>
<Address>
<AddressLine1>1525 N Main Pkwy</AddressLine1>
<City>Chicago</City>
<State>IL</State>
<ZipCode>55555</ZipCode>
</Address>
<CommunicationNumbers>
<Communication>
<Number>7755555511</Number>
<Qualifier>TE</Qualifier>
</Communication>
</CommunicationNumbers>
</Pharmacy>
<Prescriber>
<Identification>
<NPI>0111118370</NPI>
</Identification>
<Name>
<LastName>Valden</LastName>
<FirstName>Leah</FirstName>
</Name>
<CommunicationNumbers>
<Communication>
<Number>1234387752</Number>
<Qualifier>TE</Qualifier>
</Communication>
</CommunicationNumbers>
</Prescriber>
<HistorySource>
<Source>
<SourceQualifier>PY</SourceQualifier>
<SourceDescription>DSTPSDIR</SourceDescription>
</Source>
<SourceReference>895464999999</SourceReference>
</HistorySource>
</MedicationDispensed>
<!--Note: This message would continue on to include the remaining dispensed medications up to a maximum of 300.-->DJ Reason Code (Patient Record Found, But No Medications Available)
<Message TransportVersion="20170715" DatatypesVersion="20170715" TransactionDomain="SCRIPT" TransactionVersion="20170715" StructuresVersion="20170715" ECLVersion="20170715">
<Header>
<To Qualifier="ZZZ">D00000000093552</To>
<From Qualifier="ZZZ">D00000000000008</From>
<MessageID>4e2f66cc-9401-4060-b461-62e5029cc1f7</MessageID>
<RelatesToMessageID>7897535:7303095:1655290060714</RelatesToMessageID>
<SentTime>2022-06-15T10:47:43.000Z</SentTime>
<Security>
<Sender>
<SecondaryIdentification>RRN0BD6KUE</SecondaryIdentification>
<TertiaryIdentification>S00000000000003</TertiaryIdentification>
</Sender>
<Receiver/>
</Security>
<SenderSoftware>
<SenderSoftwareDeveloper>Surescripts</SenderSoftwareDeveloper>
<SenderSoftwareProduct>Medication History</SenderSoftwareProduct>
<SenderSoftwareVersionRelease>26.1.0.774</SenderSoftwareVersionRelease>
</SenderSoftware>
<TestMessage>0</TestMessage>
</Header>
<Body>
<RxHistoryResponse>
<Response>
<Approved>
<ReasonCode>DJ</ReasonCode>
<Note>Although a patient record was found, no medications were available.</Note>
</Approved>
</Response>
<Facility>
<Identification>
<NPI>1154601474</NPI>
</Identification>
<FacilityName>11MN</FacilityName>
</Facility>
<Patient>
<HumanPatient>
<Identification>
<MutuallyDefined>560-Io7Ww25RX0fCjcH3</MutuallyDefined>
</Identification>
<Name>
<LastName>RetryScenario560</LastName>
<FirstName>HALCOMB</FirstName>
<MiddleName>M</MiddleName>
</Name>
<Gender>M</Gender>
<DateOfBirth>
<Date>1966-11-23</Date>
</DateOfBirth>
<Address>
<PostalCode>19145</PostalCode>
</Address>
</HumanPatient>
</Patient>
<BenefitsCoordination>
<EffectiveDate>
<Date>2019-07-14</Date>
</EffectiveDate>
<ExpirationDate>
<Date>2019-07-14</Date>
</ExpirationDate>
<Consent>Y</Consent>
</BenefitsCoordination>
<RequestedDates>
<StartDate>
<Date>2021-06-15</Date>
</StartDate>
<EndDate>
<Date>2022-06-15</Date>
</EndDate>
</RequestedDates>
</RxHistoryResponse>
</Body>
</Message>