---
title: Element Details
slug: rtpb-pharmacy/guide/element-details
docTags:
createdAt: 2026-06-11T13:22:06.897Z
---
## 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. |
:::hint{type="info"}
**Note: **This guide only includes data elements where Surescripts has specific requirements or further explains the field usage. Refer to the RTPB XML Schema listed in Document References for a complete list of fields.
:::
## Message Header Elements
| **Element** | **Code** | **Comment** |
| ----------------------------- | --------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| To/Primary | **mandatory** | Patient’s IIN. It is recommended to use the IIN from the NewRx or any other data stored in the pharmacy system that is less than 72 hours old.
If the patient’s IIN is not available, this should be the Surescripts ID (S00000000000005). |
| To/@Qualifier | **mandatory ** | **Values:**
IIN = IIN Number
PY = Payer/Processor
**Note: **If the Surescripts ID (S00000000000005) is sent in the To/Primary field, PY will be the qualifier. |
| To/Secondary | **conditional** | Patient’s PCN. It is recommended to use the PCN from the NewRx or any other data stored in the pharmacy system that is less than 72 hours old.
**Note: **This can be found in the 271 Eligibility Response from the PBM/payer in loop 2100A NM109. |
| To/@Qualifier | **mandatory ** | **Value**:
PCN = Processor Control Number |
| To/Tertiary | **conditional ** | PayerIdentification (Surescripts-assigned Participant ID of the PBM/payer).
It is recommended to use the PayerIdentification from the NewRx or any other data stored in the pharmacy system that is less than 72 hours old.
**Note: **This can be found in the 271 Eligibility Response from the PBM/payer in loop 2100A NM109. |
| To/@Qualifier | **mandatory** | **Value**:
PY = Payer/Processor |
| From/Primary | **mandatory** | The identification of the sender of the message. This is the NCPDPID of the pharmacy sending the request. |
| From/@Qualifier | **mandatory ** | **Value**:
P = Pharmacy |
| 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).
**Note: **The MessageID in the RTPBResponse will be populated in the RelatesToMessageID field of the NewRx.
See [MessageID Linkage](docId\:FKJJhxGyYHkH2_k1bFlyi) 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.
Populate with the MessageID contained in the NewRx for the prescription being queried.
See [MessageID Linkage](docId\:FKJJhxGyYHkH2_k1bFlyi) 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 for information on how to properly format the date/time data. |
| SenderSoftwareCertificationID | **conditional ** | business rule
SenderSoftwareCertificationID 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. |
### MessageID Linkage Diagram
### MessageID Linkage
**S.210:** Customers shall support the scenarios in the Message Linkage section of this guide.
The table below illustrates how the MessageIDs and RelatesToMessageIDs in the NewRx, RTPBRequest and RTPBResponse, and RxChange messages are linked in pharmacy.
## RTPBRequest Elements
:::hint{type="info"}
**Notes:**
- 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.
- 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. |
| Name/FirstName | **mandatory ** | Patient first name |
| SexAndGender/
AdministrativeGender | **mandatory ** | Patient gender. |
| DateOfBirth | **mandatory ** | Date of birth of patient. |
| StateProvince | **mandatory ** | Patient’s state or province. |
| PostalCode | **mandatory ** | Patient’s address postal code |
| City Extension | **mandatory ** | Patient’s city. Customers should use the following URL: \Providing PBMMemberID can help with patient matching. Unique PBMMemberID for the Patient.
**Note: **The PBMMemberID can be found in the 271 Eligibility Response from the PBM/payer in loop 2100C NM109. |
| RequestedProduct | **mandatory ** | |
| Product | **mandatory ** | |
| DrugCoded/NDC | **mandatory ** | NDC of the requested medication.
**Note: **If Surescripts identifies a more representative NDC, Surescripts may replace the NDC that was sent with the more representative NDC to ensure a successful RTPBResponse.
NDC must be an 11-digit numeric in the 5-4-2 format. Dashes shall not be used and leading zeros shall not be suppressed.
NDC should be representative. Do not send repackaged, obsolete, private label or unit dose NDC unless it is the only NDC available to identify the medication concept. |
| Quantity | **mandatory ** | |
| Value | **mandatory ** | Quantity for the requested medication.
To ensure successful message processing, DaysSupply and Quantity should be a numeric value and greater than zero (0). |
| CodeListQualifier | **mandatory ** | Quantity CodeListQualifier for the requested medication.
**Value**:
38 = Original Quantity |
| QuantityUnitOf
Measure/Code | **mandatory ** | The QuantityUnitCode should reflect the NCit code.If the NCit code is not sent, the provider vendor may not be able to translate the QuantityUnitCode and the response may result in an error.
Example Value: C48542 = Tablet
For a list of NCit codes, go to: [http://evs.nci.nih.gov/ftp1/NCPDP/About.html](http://evs.nci.nih.gov/ftp1/NCPDP/About.html). This list should be updated monthly. Use the NCPDP QuantityUnitOfMeasure Terminology rows from the downloaded data.
**PM.200**: QuantityUnitOfMeasure Code Qualifiers shall be correctly associated with medication descriptions. |
| DaysSupply | **mandatory ** | business rule
DaysSupply must be sent for accurate pricing.
DaysSupply is the estimated number of days the prescription will last excluding refills, based upon the prescribed quantity and directions. It is the prescribed quantity divided by the daily doses. While this is typically system calculated, the prescriber retains responsibility for the value.
DaysSupply and Quantity must be a numeric value and greater than zero (0). |
| Diagnosis | **conditional ** | Include ICD-10 diagnosis if populated on NewRx. |
| Code | **mandatory ** | |
| @Qualifier | **mandatory ** | **Value**:
ABF = ICD10 |
| Prescriber | **mandatory ** | |
| Identification/NPI | **mandatory ** | NPI for the pharmacy. NPI will be validated against the check digit routine.
business rule
NPI in the Prescriber segment must match the NPI in the Pharmacy segment. |
| LastName | **mandatory ** | **Value**:
Unknown |
| Pharmacy | **mandatory ** | business rule
Pharmacy must be sent for accurate pricing. |
| Identification/NCPDPID | **conditional ** | business rule
The NCPDPID for the pharmacy must be sent in the RTPBRequest. |
| Identification/NPI | **conditional ** | business rule
The NPI (National Provider ID) for pharmacy must be sent in the RTPBRequest. NPI will be validated against the check digit routine. For specific information see:
[https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand/Downloads/NPIcheckdigit.pdf](https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand/Downloads/NPIcheckdigit.pdf) |
| BusinessName | **mandatory ** | Store name. |
| PrimaryTelephoneNumber | **mandatory ** | Store phone number. |
## RTPBResponse Elements
:::hint{type="info"}
**Notes:**
- 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.
- Per ACR S.200, customers shall be able to receive syntactically valid maximum and minimum populated messages. Optional data elements (and values therein) shall not cause message failure.
:::
| **Element** | **Code** | **Comment** |
| ------------------------------------------------------------------------ | --------------------- | ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Response | **mandatory ** | |
| Processed | **mandatory ** | Processed should only be sent in instances where benefit information is provided. Please reach out to your Surescripts representative for additional information. |
| Note | **conditional ** | Recommended to send if needed to aid in message processing. |
| NotProcessed | **mandatory ** | |
| Note | **conditional ** | Additional free text information about the RejectCode.
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. |