--- title: Element Details slug: rtpb-pbm-payers/guide/element-details docTags: createdAt: 2026-06-11T13:19:33.569Z --- ## Requirement Designation Element Attributes: | **Code** | **Description** | | -------------- | -------------------------------------------------------------------------------------------------------------------------------- | | mandatory  | The element must be used per the specification (e.g., XML schema validation). | | business rule  | If sent, the element must be used per the Surescripts business rule.
**Note**: Not all business rules reside in this table. | | conditional  | The element is to be used per the conditions specified. | | recommended  | Surescripts recommends sending the element as a best practice. | | optional  | Some fields do not have specific conditions. Data should be sent if available. | | not used  | Not used by Surescripts. | ## Message Header Elements :::hint{type="info"} **Note**: This guide only includes data elements where Surescripts has specific requirements or further explains the field usage. Refer to the NCPDP RTPB XML Schema listed in Document References for a complete list of fields. ::: | **Element** | **Code** | **Comment** | | ----------------------------- | --------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | | To/Primary | **mandatory ** | The identification of the RTPBRequest sender. This can be found in the 'From/Primary' of the RTPBRequest message. | | To/@Qualifier | **mandatory ** | **Value**:
D = Prescriber | | From/Primary | **mandatory ** | The identification of the sender of the message. This is the Surescripts-assigned ParticipantID. | | From/@Qualifier | **mandatory ** | **Value**:
PY = Payer/Processor | | From/Tertiary | **conditional ** | Tertiary field is populated with the Surescripts ID (S00000000000005) on the RTPBRequest. | | From/@Qualifier | **mandatory ** | **Value**:
PY = Payer/Processor | | MessageID | **mandatory ** | A minimum set of standards/algorithms should be used when generating message IDs to ensure uniqueness. If possible, customers should utilize Global Unique Identifiers (GUIDs).
See [Message Linkage](docId\:POtvNdGIVkWj0g6cGwReJ) for more details.
**S.205:** The sender shall ensure the combination of the From and MessageID elements, for all messages including Error, is unique for at least 18 months. Surescripts recommends an unformatted Globally Unique Identifier (GUID). | | RelatesToMessageID | **conditional ** | This element is case sensitive.
RTPBRequest – Populate with value contained in the related Interchange Control Number ISA13 field from the 271 Eligibility Response.
RTPBResponse – Populate with the MessageID from the RTPBRequest.
See [Message Linkage](docId\:POtvNdGIVkWj0g6cGwReJ) for more details.
**S.210:** Customers shall support the scenarios in the Message Linkage section of this guide. | | SentTime | **mandatory ** | Date/time of initiation.
Refer to [UTC Time Format](docId:7bl7A3eudOP7nx06E4MwI) for information on how to properly format the date/time data. | | SoftwareSenderCertificationID | **conditional ** | business rule 
SoftwareSenderCertificationID has a max length of 10 characters. Surescripts requires sending this field.
Identifies the entity responsible for the software that generated the message. The developer may be a software vendor or, if the software was developed “in-house”, the developer is the entity sending the message (e.g., a chain). The value transmitted is determined by the Sender Software Developer. | | ConsumingApp Extension | **conditional** | **Values:**
SURESCRIPTS = prescriber sender type
SSHUB = hub and life sciences sender type
SSPHARMACY = pharmacy sender type
**Note:** This is only applicable on the request. This is not expected to be returned on the response. | ### Message Linkage **S.210:** Customers shall support the scenarios in the Message Linkage section of this guide. The table below illustrates how the MessageIDs in the Eligibility Response, RTPBRequest and RTPBResponse, and NewRx messages are linked. :::hint{type="info"} **Note: **Populate the RelatesToMessageID in an Error message with the MessageID sent in the original message. ::: | **Field Names** | **Eligibility Response** | **RTPBRequest** | **RTPBResponse** | **NewRx** | | ------------------- | --------------------------------------------------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------- | -------------------------------------------- | ------------------------------------------------------------------------------------------------------------------- | | MessageID | ELIG43211 | RTPBREQ1 | RTPBRES1 | NEWRX | | | Assigned by responding PBM/payer.
Note: This is the Interchange Control Number ISA13 field from the 271 Eligibility Response | Assigned by provider vendor | Assigned by PBM/payer | Assigned by provider vendor | | RelatesTo MessageID | N/A | ELIG43211 | RTPBREQ1 | RTPBRES1 | | | | If available, populate with the Interchange Control Number ISA13 field from the 271 Eligibility Response | Populate with the MessageID from RTPBRequest | If available, populate with the MessageID from RTPBResponse.
**Note**: Only populate if ProcessedStatus = True | ## RTPBRequest Elements :::hint{type="info"} **Notes:** - There may be instances where multiple RTPBRequests are sent in parallel to gather additional information for the provider. It is recommended to avoid rate limiting to allow for successful message processing. - This guide only includes data elements where Surescripts has specific requirements or further explains the field usage. Refer to the Real-Time Prescription Benefit Standard v13 schema listed in Document References for a complete list of fields. - The RTPBRequest for a patient will be tied to the Eligibility Response received within the last 72 hours for that patient. This is accomplished by using the Interchange Control Number ISA13 from the 271 Eligibility Response in the RelatesToMessageID of the RTPBRequest. - Per ACR S.201, customers shall ensure all messages are syntactically correct before transmission to Surescripts. ::: | **Element** | **Code** | **Comment** | | --------------------------------------- | --------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | | Patient | **mandatory ** | | | Name/LastName | **mandatory ** | Patient last name. Populate with the Last Name found in the 271 Eligibility Response in the 2100C loop NM103. Recommend using value exactly as it was received in the 271 Eligibility Response. | | Name/FirstName | **mandatory ** | Patient first name. Populate with the First Name found in the 271 Eligibility Response in the 2100C loop NM104. Recommend using value exactly as it was received in the 271 Eligibility Response. | | SexAndGender/
AdministrativeGender | **mandatory ** | Patient gender. Populate with the patient's gender found in the 271 Eligibility Response in the 2100C loop DMG03. Recommend using value exactly as it was received in the 271 Eligibility Response. | | DateOfBirth | **mandatory ** | Date of birth of patient. Populate with the patient's date of birth found in the 271 Eligibility Response in the 2100C loop DMG02 that is qualified by the DMG01 code "D8". Recommend using value exactly as it was received in the 271 Eligibility Response. | | StateProvince | **mandatory ** | Patient’s state or province. Populate with the patient's state or province found in the 271 Eligibility Response in the 2100C loop N402. Recommend using value exactly as it was received in the 271 Eligibility Response.
**Note: **May contain a value of "UN" when the patient's state/province is unknown or not provided in the request. | | PostalCode | **mandatory ** | Patient’s address postal code. Populate with the patient's postal code found in the 271 Eligibility Response in the 2100C loop N403. Recommend using value exactly as it was received in the 271 Eligibility Response. | | City Extension | **mandatory ** | Patient’s city. Populate with the patient's city found in the 271 Eligibility Response in the 2100C loop N401. Recommend using value exactly as it was received in the 271 Eligibility Response.
Customers should use the following URL: \Strongly recommended to send to further explain why message was rejected. | | ResponseProduct | **conditional ** | | | Product | **mandatory ** | Contains the information on the requested medication. | | DrugDescription | **mandatory ** | The drug name, strength, and form associated with the NDC. | | PricingAndCoverages | **mandatory ** | There may be up to 6 PricingAndCoverages returned per ResponseProduct and ResponseAlternativeProduct.
**PM.204**: Coverage restrictions for all \ elements for medication combinations returned (including alternatives).
This concession is allowed: An indicator that coverage restriction(s) apply to a specific combination. User action on this indicator presents all coverage restrictions in their entirety. | | EstimatedCombined
PlanAndPatientSavings | **conditional ** | Provides additional patient and/or health plan savings information that may assist with medication selection. | | EstimatedNetPlanCost | **conditional ** | Provides additional health plan cost information that may assist with medication selection. | | ResponseAlternative
Product | **conditional ** | Clinically appropriate alternatives are provided here. This would include information for an alternative medication (if provided) similar to what is supplied in the ResponseProduct element.
**PM.205**: All available appropriate alternatives displayed together. If all alternatives cannot be shown together, this concession is allowed: An indicator that alternative medications are available. User interaction on this indicator presents all alternative medications together. | | PricingAndCoverages/
PricingAndCoverage/
CoverageStatusMessage | **conditional ** | Additional free text information about the coverage status. May be used to communicate non-benefit coverage types as well as coverage restrictions. | | PricingAndCoverages/
PricingAndCoverage/
DrugStatus Extension | **conditional ** | Additional free text information about the drug. May be used to communicate drug and pricing specifics. |