Error Msg Data Nmbr

Michigan Department of Community Health
Pharmacy Encounters - NCPDP Data Element Errors by Error Number
Error
Nmbr
Error Description
Msg
Type
Segment
Data
Element
NCPDP Field
25000
25052
25053
25054
25901
99999
File contains unreadable characters.
Encounter already exists and was submitted as B1 (Billing).
No encounter exists to replace and submitted as B3 (Rebill).
No encounter exists to void and submitted as B2 (Reversal).
This record was superseded by another input record.
This is the last message of your batch transmission.
RB
RE
RE
RE
RE
IO
General Edits
General Edits
General Edits
General Edits
General Edits
General Edits
25001
25002
25003
25004
25010
25011
25012
25015
25016
25017
Sender ID (Submitter or Service Bureau ID) is missing.
Sender ID (Submitter or Service Bureau ID) is not a valid Sender ID.
Type of run in Batch Header (P/T) does not match file type
The file number in the Batch Header is not 5477
Batch Number is missing.
Batch Number is not an numeric value.
Batch Number has already been used on a prior batch.
Creation Date is missing.
Creation Date - Invalid date or date is not in the format CCYYMMDD.
Creation Date is not less than or equal to the run date of this Edit Run.
RB
RB
RB
RB
RB
RB
RB
RB
RB
RB
Batch Transaction Header
Batch Transaction Header
Batch Transaction Header
Batch Transaction Header
Batch Transaction Header
Batch Transaction Header
Batch Transaction Header
Batch Transaction Header
Batch Transaction Header
Batch Transaction Header
880-K1 SENDER ID
880-K1 SENDER ID
702-MC FILE TYPE
806-52
806-52
806-52
880-K2
880-K2
880-K2
BATCH NUMBER
BATCH NUMBER
BATCH NUMBER
CREATION DATE
CREATION DATE
CREATION DATE
25050
25051
25055
25056
Transaction Reference Number is missing.
Transaction Reference Number is not an alphanumeric value.
Transaction Reference Number has been used on multiple batch details.
Multiple transactions submitted and one or more are for a compound.
RE
RE
RE
RE
Batch Detail
Batch Detail
Batch Detail
Batch Detail
880-K5
880-K5
880-K5
880-K5
TRANSACTION REFERENCE NUMBER
TRANSACTION REFERENCE NUMBER
TRANSACTION REFERENCE NUMBER
TRANSACTION REFERENCE NUMBER
25018 Release Number does not equal "D0".
RE
Transaction Header
102-A2 VERSION/RELEASE NO.
25019 Transaction Code does not equal "B1", "B2", or "B3".
RE
Transaction Header
103-A3 TRANSACTION CODE
25067 Service Provider ID is missing or Service Provider ID Qualifier is missing.
RE
Transaction Header
25068
25069
25070
25071
25072
RE
RE
RE
RE
RE
Transaction Header
Transaction Header
Transaction Header
Transaction Header
Transaction Header
201-B1,
202-B2
201-B1,
202-B2
401-D1
401-D1
401-D1
RE
Insurance
302-C2 CARDHOLDER ID
Service Provider NPI is missing.
Service Provider ID Qualifier is not equal to "01".
Date of Service is missing.
Date of Service - Invalid date or date is not in the format CCYYMMDD.
Date of Service is not less than or equal to the run date of this Edit Run.
25100 Cardholder ID is missing.
Page 1 of 21
SERVICE PROVIDER ID, SERVICE PROVIDER ID
QUALIFIER
SERVICE PROVIDER ID
SERVICE PROVIDER ID QUALIFIER
DATE OF SERVICE
DATE OF SERVICE
DATE OF SERVICE
Comments
Added to error listing 8/20/2013
Added to error listing 8/20/2013
Rejectable edit as of 1/1/2012;
Changed to Reject Encounter on
1/13/2012
Rejectable edit as of 1/1/2012;
Changed to Reject Encounter on
1/13/2012
Rejectable edit as of 10/1/2010
Rejectable edit as of 10/1/2010
Revised 8/20/2013
Error
Nmbr
Error Description
Msg
Type
Segment
Data
Element
NCPDP Field
25101 Cardholder ID (Medicaid ID) does not exist in the Medicaid eligibility file and
encounter Group ID not MICHILD.
25102 Cardholder ID (Child Identification Number) does not exist in the MIChild
eligibility file and encounter Group ID equals "MICHILD".
25105 Group ID is missing.
25106 Group ID is not equal to "MIMEDICAID", "ABWI" or "MICHILD".
RE
Insurance
302-C2 CARDHOLDER ID
RE
Insurance
302-C2 CARDHOLDER ID
IO
IO
Insurance
Insurance
301-C1 GROUP ID
301-C1 GROUP ID
25150 Prescription/Service Reference Number is missing or the Prescription Service
Reference Number Qualifier is not equal to "1".
25155 Product/Service ID is missing or the Product Service ID Qualifier is not equal to
03.
25156 Product/Service ID is not a valid NDC value
25157 Product/Service ID is a NDC psychotropic drug
25158 Compound Code indicates that the Product/Service ID is a compound (i.e.,
value of 2) but the Product/Service ID is not all zeros.
25160 Quantity Dispensed is missing.
25161 Quantity Dispensed is less than 0 (zero) or not numeric.
25165 Fill Number is missing.
25166 Fill Number is less than 0 (zero) or not numeric.
25170 Days Supply missing.
25172 Days Supply is less than 0 (zero) or not numeric.
25175 Compound Code is not a valid NCPDP value.
25180 Dispense as Written is missing.
25181 Dispense as Written is not a valid NCPDP value.
25185 Date Prescription Written is missing.
25186 Date Prescription Written - Invalid date or date is not in the format
CCYYMMDD.
25187 Date Prescription Written is not less than or equal to the run date of this Edit
Run.
25190 Number of Refills Authorized is missing.
25191 Number of Refills Authorized is less than 0 or not numeric.
25192 Submission Clarification Code is not a valid NCPDP value.
25193 A valid Prescription Origina Code must be reported.
25195 Quantity Prescribed is missing.
25196 Quantity Prescribed is less than 0 or not numeric.
25197 Other Coverage Code is missing.
25198 Other Coverage Code is not a valid NCPDP value.
25199 Unit Dose Indicator is not a valid NCPDP value.
25201 Unit of Measure is missing.
25202 Unit of Measure is not a valid NCPDP value.
25205 Level of Service is missing.
25206 Level of Service is not a valid NCPDP value.
25207 Originally Prescribed Product is not a valid NDC code.
RE
Claim
402-D2 PRESCRIPTION/ SERVICE REFERENCE NUMBER
RE
Claim
407-D7 PRODUCT/SERVICE ID
RE
RE
IO
Claim
Claim
Claim
407-D7 PRODUCT/SERVICE ID
407-D7 PRODUCT/SERVICE ID
407-D7 PRODUCT/SERVICE ID
RE
RE
RE
RE
RE
RE
RE
RE
RE
IO
IO
Claim
Claim
Claim
Claim
Claim
Claim
Claim
Claim
Claim
Claim
Claim
442-E7
442-E7
403-D3
403-D3
405-D5
405-D5
406-D6
408-D8
408-D8
414-DE
414-DE
IO
Claim
414-DE DATE PRESCRIPTION WRITTEN
IO
IO
IO
RE
IO
IO
IO
IO
IO
RE
RE
IO
IO
IO
Claim
Claim
Claim
Claim
Claim
Claim
Claim
Claim
Claim
Claim
Claim
Claim
Claim
Claim
415-DF
415-DF
420-DK
419-DJ
460-ET
460-ET
308-C8
308-C8
429-DT
600-28
600-28
418-DI
418-DI
445-EA
Page 2 of 21
QUANTITY DISPENSED
QUANTITY DISPENSED
FILL NUMBER
FILL NUMBER
DAYS SUPPLY
DAYS SUPPLY
COMPOUND CODE
DISPENSE AS WRITTEN (DAW)/PRODUCT SELECTION
DISPENSE AS WRITTEN (DAW)/PRODUCT SELECTION
DATE PRESCRIPTION WRITTEN
DATE PRESCRIPTION WRITTEN
NUMBER OF REFILLS AUTHORIZED
NUMBER OF REFILLS AUTHORIZED
SUBMISSION CLARIFICATION CODE
PRESCRIPTION ORIGIN CODE
QUANTITY PRESCRIBED
QUANTITY PRESCRIBED
OTHER COVERAGE CODE
OTHER COVERAGE CODE
UNIT DOSE INDICATOR
UNIT OF MEASURE
UNIT OF MEASURE
LEVEL OF SERVICE
LEVEL OF SERVICE
ORIGINALLY PRESCRIBED PRODUCT
Comments
Rejectable edit as of 10/1/2010
Rejectable edit as of 10/1/2010
Rejectable edit as of 10/1/2010
Rejectable edit as of 10/1/2010
Rejectable edit as of 10/1/2010
New edit 12/1/2012
Rejectable edit as of 10/1/2010
Rejectable edit as of 10/1/2010
New edit 1/1/2012
Revised 8/20/2013
Error
Nmbr
Error Description
Msg
Type
Segment
Data
Element
NCPDP Field
Comments
25210 Prior Authorization Type Code is missing.
25211 Prior Authorization Type Code is not a valid NCPDP value.
IO
IO
Claim
Claim
461-EU PRIOR AUTHORIZATION TYPE CODE
461-EU PRIOR AUTHORIZATION TYPE CODE
25251 Prescriber ID is missing or the Prescriber ID Qualifier is missing.
RE
Prescriber
25252 Prescriber NPI is missing.
25253 Prescriber ID Qualifier is not equal to "01".
RE
RE
Prescriber
Prescriber
411-DB, PRESCRIBER ID, PRESCRIBER ID QUALIFIER
466-EZ
411-DB PRESCRIBER ID
466-EZ PRESCRIBER ID QUALIFIER
25291
25292
25301
25302
The first iteration of Other Payer Coverage Type is missing.
The first iteration of Other Payer Coverage Type is not equal to 01, 02, or 03.
The second iteration of Other Payer Coverage Type is not equal to 01, 02, or 03.
The second iteration of Other Payer Coverage Type is missing but Other Payer
ID, Other Payer Date, Other Payer Amount Paid Qualifier, Other Payer Amount
Paid, and/or Other Payer Reject Codes are present.
25303 The third iteration through ninth iteration of Other Payer Coverage Type is not
equal to 01, 02, or 03.
25304 The third iteration through ninth iteration of Other Payer Coverage Type is
missing but Other Payer ID, Other Payer Date, Other Payer Amount Paid
Qualifier, Other Payer Amount Paid, and/or Other Payer Reject Codes are
present.
RE
RE
RE
RE
COB/Other Payments
COB/Other Payments
COB/Other Payments
COB/Other Payments
338-5C
338-5C
338-5C
338-5C
RE
COB/Other Payments
338-5C OTHER PAYER COVERAGE TYPE
RE
COB/Other Payments
338-5C OTHER PAYER COVERAGE TYPE
25305 An Other Payer Coverage Type of 01 (Primary) is missing.
25306 More than one iteration of Other Payer Coverage Type with value of 01
(Primary) exists.
25307 More than one iteration of Other Payer Coverage Type with value of 02
(Secondary) through 09 (Tertiary) exists.
25308 Other Payer Coverage Type of 03 through 09 (Tertiary) is present but Other
Payer Coverage Type of 02 (Secondary) through 08 (Tertiary) is not present.
25309 The first iteration of Other Payer ID is missing and the first Other Payer
iteration is present.
25312 The second iteration of Other Payer ID is missing and the second Other Payer
iteration is present.
25315 The third iteration through ninth iteration of Other Payer ID is missing and the
third Other Payer iteration through ninth Other Payer iteration is present.
25318 None of the Other Payer ID's are valid Capitated Plans based on the Group ID
submitted.
25319 There is an invalid combination of MHP or MICHILD plan Other Payer ID's or
invalid combination of Group ID and Health Plan ID.
25320 The first iteration of Other Payer Date is missing and the first Other Payer
iteration is present.
25321 The first iteration of Other Payer Date is present - Invalid date or date is not in
the format CCYYMMDD.
25322 The first iteration of Other Payer Date is not less than or equal to the run date of
this Edit Run.
RE
RE
COB/Other Payments
COB/Other Payments
338-5C OTHER PAYER COVERAGE TYPE
338-5C OTHER PAYER COVERAGE TYPE
RE
COB/Other Payments
338-5C OTHER PAYER COVERAGE TYPE
Edit changed 1/1/2012
RE
COB/Other Payments
338-5C OTHER PAYER COVERAGE TYPE
Edit changed 1/1/2012
RE
COB/Other Payments
340-7C OTHER PAYER ID
RE
COB/Other Payments
340-7C OTHER PAYER ID
RE
COB/Other Payments
340-7C OTHER PAYER ID
Edit changed 1/1/2012
RE
COB/Other Payments
Edit changed 1/1/2012
RE
COB/Other Payments
340-7C, OTHER PAYER ID
301-C1
340-7C OTHER PAYER ID
RE
COB/Other Payments
443-E8
OTHER PAYER DATE
RE
COB/Other Payments
443-E8
OTHER PAYER DATE
RE
COB/Other Payments
443-E8
OTHER PAYER DATE
Page 3 of 21
Rejectable edit as of 10/1/2010
Rejectable edit as of 10/1/2010
Rejectable edit as of 10/1/2010
OTHER PAYER COVERAGE TYPE
OTHER PAYER COVERAGE TYPE
OTHER PAYER COVERAGE TYPE
OTHER PAYER COVERAGE TYPE
Edit changed 1/1/2012
Edit changed 8/1/2011
Revised 8/20/2013
Error
Nmbr
Error Description
25323 The second iteration of Other Payer Date is missing and the second Other Payer
iteration is present.
25324 The second iteration of Other Payer Date is present - Invalid date or date is not
in the format CCYYMMDD.
25325 The second iteration of Other Payer Date is not less than or equal to the run date
of this Edit Run.
25326 The third iteration through ninth iteration of Other Payer Date is missing and
the third Other Payer iteration through ninth Other Payer iteration is present.
25327 The third iteration through ninth iteration of Other Payer Date is present Invalid date or date is not in the format CCYYMMDD.
25328 The third iteration through ninth iteration of Other Payer Date is less than or
equal to the run date of this Edit Run.
25330 First Other Payer Amount Paid Qualifier is missing but the first Other Payer
Amount Paid is present for the first Other Payer iteration.
25331 First Other Payer Amount Paid Qualifier for the first Other Payer iteration is not
a valid NCPDP value (i.e., 04, 05 or 07).
25332 Second Other Payer Amount Paid Qualifier is missing but the second Other
Payer Amount Paid is present for the first Other Payer iteration.
25333 Second Other Payer Amount Paid Qualifier for the first Other Payer iteration is
not a valid NCPDP value (i.e., 04, 05 or 07).
25334 Third Other Payer Amount Paid Qualifier is missing but the third Other Payer
Amount Paid is present for the first Other Payer iteration.
25335 Third Other Payer Amount Paid Qualifier for the first Other Payer iteration is
not a valid NCPDP value (i.e., 04, 05 or 07).
25336 Fourth Other Payer Amount Paid Qualifier is missing but the fourth Other Payer
Amount Paid is present for the first Other Payer iteration.
25337 Fourth Other Payer Amount Paid Qualifier for the first Other Payer iteration is
not a valid NCPDP value (i.e., 04, 05 or 07).
25338 Fifth Other Payer Amount Paid Qualifier is missing but the fifth Other Payer
Amount Paid is present for the first Other Payer iteration.
25339 Fifth Other Payer Amount Paid Qualifier for the first Other Payer iteration is not
a valid NCPDP value (i.e., 04, 05 or 07).
25340 Sixth Other Payer Amount Paid Qualifier is missing but the sixth Other Payer
Amount Paid is present for the first Other Payer iteration.
25341 Sixth Other Payer Amount Paid Qualifier for the first Other Payer iteration is
not a valid NCPDP value (i.e., 04, 05 or 07).
25342 Seventh Other Payer Amount Paid Qualifier is missing but the seventh Other
Payer Amount Paid is present for the first Other Payer iteration.
25343 Seventh Other Payer Amount Paid Qualifier for the first Other Payer iteration is
not a valid NCPDP value (i.e., 04, 05 or 07).
25344 Eighth Other Payer Amount Paid Qualifier is missing but the eighth Other Payer
Amount Paid is present for the first Other Payer iteration.
Msg
Type
Segment
Data
Element
NCPDP Field
Comments
RE
COB/Other Payments
443-E8
OTHER PAYER DATE
RE
COB/Other Payments
443-E8
OTHER PAYER DATE
RE
COB/Other Payments
443-E8
OTHER PAYER DATE
RE
COB/Other Payments
443-E8
OTHER PAYER DATE
Edit changed 1/1/2012
RE
COB/Other Payments
443-E8
OTHER PAYER DATE
Edit changed 1/1/2012
RE
COB/Other Payments
443-E8
OTHER PAYER DATE
Edit changed 1/1/2012
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
Page 4 of 21
Edit changed 1/1/2012
Edit changed 1/1/2012
Edit changed 1/1/2012
Edit changed 1/1/2012
Edit changed 1/1/2012
Edit changed 1/1/2012
Edit changed 1/1/2012
Revised 8/20/2013
Error
Nmbr
Error Description
25345 Eighth Other Payer Amount Paid Qualifier for the first Other Payer iteration is
not a valid NCPDP value (i.e., 04, 05 or 07).
25346 Ninth Other Payer Amount Paid Qualifier is missing but the ninth Other Payer
Amount Paid is present for the first Other Payer iteration.
25347 Ninth Other Payer Amount Paid Qualifier for the first Other Payer iteration is
not a valid NCPDP value (i.e., 04, 05 or 07).
25348 First Other Payer Amount Paid Qualifier is missing but the first Other Payer
Amount Paid is present for the second Other Payer iteration.
25349 First Other Payer Amount Paid Qualifier for the second Other Payer iteration is
not a valid NCPDP value (i.e., 04, 05 or 07).
25350 Second Other Payer Amount Paid Qualifier is missing but the second Other
Payer Amount Paid is present for the second Other Payer iteration.
25351 Second Other Payer Amount Paid Qualifier for the second Other Payer iteration
is not a valid NCPDP value (i.e., 04, 05 or 07).
25352 Third Other Payer Amount Paid Qualifier is missing but the third Other Payer
Amount Paid is present for the second Other Payer iteration.
25353 Third Other Payer Amount Paid Qualifier for the second Other Payer iteration is
not a valid NCPDP value (i.e., 04, 05 or 07).
25354 Fourth Other Payer Amount Paid Qualifier is missing but the fourth Other Payer
Amount Paid is present for the second Other Payer iteration.
25355 Fourth Other Payer Amount Paid Qualifier for the second Other Payer iteration
is not a valid NCPDP value (i.e., 04, 05 or 07).
25356 Fifth Other Payer Amount Paid Qualifier is missing but the fifth Other Payer
Amount Paid is present for the second Other Payer iteration.
25357 Fifth Other Payer Amount Paid Qualifier for the second Other Payer iteration is
not a valid NCPDP value (i.e., 04, 05 or 07).
25358 Sixth Other Payer Amount Paid Qualifier is missing but the sixth Other Payer
Amount Paid is present for the second Other Payer iteration.
25359 Sixth Other Payer Amount Paid Qualifier for the second Other Payer iteration is
not a valid NCPDP value (i.e., 04, 05 or 07).
25360 Seventh Other Payer Amount Paid Qualifier is missing but the seventh Other
Payer Amount Paid is present for the second Other Payer iteration.
25361 Seventh Other Payer Amount Paid Qualifier for the second Other Payer iteration
is not a valid NCPDP value (i.e., 04, 05 or 07).
25362 Eighth Other Payer Amount Paid Qualifier is missing but the eighth Other Payer
Amount Paid is present for the second Other Payer iteration.
25363 Eighth Other Payer Amount Paid Qualifier for the second Other Payer iteration
is not a valid NCPDP value (i.e., 04, 05 or 07).
25364 Ninth Other Payer Amount Paid Qualifier is missing but the ninth Other Payer
Amount Paid is present for the second Other Payer iteration.
25365 Ninth Other Payer Amount Paid Qualifier for the second Other Payer iteration is
not a valid NCPDP value (i.e., 04, 05 or 07).
Msg
Type
Segment
Data
Element
NCPDP Field
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
Page 5 of 21
Comments
Edit changed 1/1/2012
Edit changed 1/1/2012
Edit changed 1/1/2012
Edit changed 1/1/2012
Edit changed 1/1/2012
Edit changed 1/1/2012
Edit changed 1/1/2012
Edit changed 1/1/2012
Edit changed 1/1/2012
Edit changed 1/1/2012
Edit changed 1/1/2012
Revised 8/20/2013
Error
Nmbr
Error Description
25366 First Other Payer Amount Paid Qualifier is missing but the first Other Payer
Amount Paid is present for the third Other Payer iteration.
25367 First Other Payer Amount Paid Qualifier for the third Other Payer iteration is
not a valid NCPDP value (i.e., 04, 05 or 07).
25368 Second Other Payer Amount Paid Qualifier is missing but the second Other
Payer Amount Paid is present for the third Other Payer iteration.
25369 Second Other Payer Amount Paid Qualifier for the third Other Payer iteration is
not a valid NCPDP value (i.e., 04, 05 or 07).
25370 Third Other Payer Amount Paid Qualifier is missing but the third Other Payer
Amount Paid is present for the third Other Payer iteration.
25371 Third Other Payer Amount Paid Qualifier for the third Other Payer iteration is
not a valid NCPDP value (i.e., 04, 05 or 07).
25372 Fourth Other Payer Amount Paid Qualifier is missing but the fourth Other Payer
Amount Paid is present for the third Other Payer iteration.
25373 Fourth Other Payer Amount Paid Qualifier for the third Other Payer iteration is
not a valid NCPDP value (i.e., 04, 05 or 07).
25374 Fifth Other Payer Amount Paid Qualifier is missing but the fifth Other Payer
Amount Paid is present for the third Other Payer iteration.
25375 Fifth Other Payer Amount Paid Qualifier for the third Other Payer iteration is
not a valid NCPDP value (i.e., 04, 05 or 07).
25376 Sixth Other Payer Amount Paid Qualifier is missing but the sixth Other Payer
Amount Paid is present for the third Other Payer iteration.
25377 Sixth Other Payer Amount Paid Qualifier for the third Other Payer iteration is
not a valid NCPDP value (i.e., 04, 05 or 07).
25378 Seventh Other Payer Amount Paid Qualifier is missing but the seventh Other
Payer Amount Paid is present for the third Other Payer iteration.
25379 Seventh Other Payer Amount Paid Qualifier for the third Other Payer iteration is
not a valid NCPDP value (i.e., 04, 05 or 07).
25380 Eighth Other Payer Amount Paid Qualifier is missing but the eighth Other Payer
Amount Paid is present for the third Other Payer iteration.
25381 Eighth Other Payer Amount Paid Qualifier for the third Other Payer iteration is
not a valid NCPDP value (i.e., 04, 05 or 07).
25382 Ninth Other Payer Amount Paid Qualifier is missing but the ninth Other Payer
Amount Paid is present for the third Other Payer iteration; (or) Tenth through
94th Other Payer Amount Paid Qualifier is missing but the tenth through 94th
Other Payer Amount Paid is present for the first through third Other Payer
iteration; (or) First through 94th Other Payer Amount Paid Qualifier is missing
but the first through 94th Other Payer Amount Paid is present for the fourth
through ninth Other Payer iteration.
Msg
Type
Segment
Data
Element
NCPDP Field
Comments
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
Edit changed 1/1/2012
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
Edit changed 1/1/2012
Page 6 of 21
Edit changed 1/1/2012
Edit changed 1/1/2012
Edit changed 1/1/2012
Edit changed 1/1/2012
Edit changed 1/1/2012
Edit changed 1/1/2012
Edit changed 1/1/2012
Revised 8/20/2013
Error
Nmbr
Error Description
25383 Ninth Other Payer Amount Paid Qualifier for the third Other Payer iteration is
not a valid NCPDP value (i.e., 04, 05 or 07); (or) Tenth through 94th Other
Payer Amount Paid Qualifier for the first through third Other Payer iteration is
not a valid NCPDP value (i.e., 04, 05 or 07); (or) First through 94th Other Payer
Amount Paid Qualifier for the fourth through ninth Other Payer iteration is not a
valid NCPDP value (i.e., 04, 05 or 07).
25384 There is an Other Payer ID present in the first iteration that is a valid Medicaid
Health Plan ID but does not have a valid combination of Other Payer Amount
Paid Qualifiers. The valid combination requires an Other Payer Amount Paid
Qualifier of 04 & 07
Msg
Type
Segment
Data
Element
NCPDP Field
Comments
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
Edit changed 1/1/2012
RE
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
Edit changed 1/1/2012;
Rejectable edit as of 1/1/2012
25385 There is an Other Payer ID (Carrier ID) present in the first iteration that is not a
valid Medicaid Health Plan ID and does not have a valid combination of Other
Payer Amount Paid Qualifiers. The valid combination requires one, and only
one, Other Payer Amount Paid Qualifier of 05.
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
25386 There is an Other Payer ID present in the second iteration that is a valid
Medicaid Health Plan ID but does not have a valid combination of Other Payer
Amount Paid Qualifiers. The valid combination requires an Other Payer
Amount Paid Qualifier of 04 & 07
RE
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
25387 There is an Other Payer ID (Carrier ID) present in the second iteration that is
not a valid Medicaid Health Plan ID and does not have a valid combination of
Other Payer Amount Paid Qualifiers. The valid combination requires one, and
only one, Other Payer Amount Paid Qualifier of 05.
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
25388 There is an Other Payer ID present in the third iteration through ninth iteration
that is a valid Medicaid Health Plan ID but does not have a valid combination of
Other Payer Amount Paid Qualifiers. The valid combination requires an Other
Payer Amount Paid Qualifier of 04 & 07
25389 There is an Other Payer ID (Carrier ID) present in the third iteration through
ninth iteration that is not a valid Medicaid Health Plan ID and does not have a
valid combination of Other Payer Amount Paid Qualifiers. The valid
combination requires one, and only one, Other Payer Amount Paid Qualifier of
05.
RE
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
Edit changed 1/1/2012;
Rejectable edit as of 1/1/2012
IO
COB/Other Payments
342-HC OTHER PAYER AMOUNT PAID QUALIFIER
Edit changed 1/1/2012
25390 First Other Payer Amount Paid is missing but the first Other Payer Amount Paid
Qualifier is present for the first Other Payer iteration.
25391 First Other Payer Amount Paid for the first Other Payer Iteration is less than 0
(zero) or not numeric.
25392 Second Other Payer Amount Paid is missing but the second Other Payer
Amount Paid Qualifier is present for the first Other Payer iteration.
25393 Second Other Payer Amount Paid for the first Other Payer Iteration is less than
0 (zero) or not numeric.
25394 Third Other Payer Amount Paid is missing but the third Other Payer Amount
Paid Qualifier is present for the first Other Payer iteration.
25395 Third Other Payer Amount Paid for the first Other Payer Iteration is less than 0
(zero) or not numeric.
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
Page 7 of 21
Edit changed 1/1/2012;
Rejectable edit as of 1/1/2012
Revised 8/20/2013
Error
Nmbr
Error Description
25396 Fourth Other Payer Amount Paid is missing but the fourth Other Payer Amount
Paid Qualifier is present for the first Other Payer iteration.
25397 Fourth Other Payer Amount Paid for the first Other Payer Iteration is less than 0
(zero) or not numeric.
25398 Fifth Other Payer Amount Paid is missing but the fifth Other Payer Amount
Paid Qualifier is present for the first Other Payer iteration.
25399 Fifth Other Payer Amount Paid for the first Other Payer Iteration is less than 0
(zero) or not numeric.
25400 Sixth Other Payer Amount Paid is missing but the sixth Other Payer Amount
Paid Qualifier is present for the first Other Payer iteration.
25401 Sixth Other Payer Amount Paid for the first Other Payer Iteration is less than 0
(zero) or not numeric.
25402 Seventh Other Payer Amount Paid is missing but the seventh Other Payer
Amount Paid Qualifier is present for the first Other Payer iteration.
25403 Seventh Other Payer Amount Paid for the first Other Payer Iteration is less than
0 (zero) or not numeric.
25404 Eighth Other Payer Amount Paid is missing but the eighth Other Payer Amount
Paid Qualifier is present for the first Other Payer iteration.
25405 Eighth Other Payer Amount Paid for the first Other Payer Iteration is less than 0
(zero) or not numeric.
25406 Ninth Other Payer Amount Paid is missing but the ninth Other Payer Amount
Paid Qualifier is present for the first Other Payer iteration.
25407 Ninth Other Payer Amount Paid for the first Other Payer Iteration is less than 0
(zero) or not numeric.
25408 First Other Payer Amount Paid is missing but the first Other Payer Amount Paid
Qualifier is present for the second Other Payer iteration.
25409 First Other Payer Amount Paid for the second Other Payer Iteration is less than
0 (zero) or not numeric.
25410 Second Other Payer Amount Paid is missing but the second Other Payer
Amount Paid Qualifier is present for the second Other Payer iteration.
25411 Second Other Payer Amount Paid for the second Other Payer Iteration is less
than 0 (zero) or not numeric.
25412 Third Other Payer Amount Paid is missing but the third Other Payer Amount
Paid Qualifier is present for the second Other Payer iteration.
25413 Third Other Payer Amount Paid for the second Other Payer Iteration is less than
0 (zero) or not numeric.
25414 Fourth Other Payer Amount Paid is missing but the fourth Other Payer Amount
Paid Qualifier is present for the second Other Payer iteration.
25415 Fourth Other Payer Amount Paid for the second Other Payer Iteration is less
than 0 (zero) or not numeric.
25416 Fifth Other Payer Amount Paid is missing but the fifth Other Payer Amount
Paid Qualifier is present for the second Other Payer iteration.
Msg
Type
Segment
Data
Element
NCPDP Field
Comments
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
Page 8 of 21
Revised 8/20/2013
Error
Nmbr
Error Description
25417 Fifth Other Payer Amount Paid for the second Other Payer Iteration is less than
0 (zero) or not numeric.
25418 Sixth Other Payer Amount Paid is missing but the sixth Other Payer Amount
Paid Qualifier is present for the second Other Payer iteration.
25419 Sixth Other Payer Amount Paid for the second Other Payer Iteration is less than
0 (zero) or not numeric.
25420 Seventh Other Payer Amount Paid is missing but the seventh Other Payer
Amount Paid Qualifier is present for the second Other Payer iteration.
25421 Seventh Other Payer Amount Paid for the second Other Payer Iteration is less
than 0 (zero) or not numeric.
25422 Eighth Other Payer Amount Paid is missing but the eighth Other Payer Amount
Paid Qualifier is present for the second Other Payer iteration.
25423 Eighth Other Payer Amount Paid for the second Other Payer Iteration is less
than 0 (zero) or not numeric.
25424 Ninth Other Payer Amount Paid is missing but the ninth Other Payer Amount
Paid Qualifier is present for the second Other Payer iteration.
25425 Ninth Other Payer Amount Paid for the second Other Payer Iteration is less than
0 (zero) or not numeric.
25426 First Other Payer Amount Paid is missing but the first Other Payer Amount Paid
Qualifier is present for the third Other Payer iteration.
25427 First Other Payer Amount Paid for the third Other Payer Iteration is less than 0
(zero) or not numeric.
25428 Second Other Payer Amount Paid is missing but the second Other Payer
Amount Paid Qualifier is present for the third Other Payer iteration.
25429 Second Other Payer Amount Paid for the third Other Payer Iteration is less than
0 (zero) or not numeric.
25430 Third Other Payer Amount Paid is missing but the third Other Payer Amount
Paid Qualifier is present for the third Other Payer iteration.
25431 Third Other Payer Amount Paid for the third Other Payer Iteration is less than 0
(zero) or not numeric.
25432 Fourth Other Payer Amount Paid is missing but the fourth Other Payer Amount
Paid Qualifier is present for the third Other Payer iteration.
25433 Fourth Other Payer Amount Paid for the third Other Payer Iteration is less than
0 (zero) or not numeric.
25434 Fifth Other Payer Amount Paid is missing but the fifth Other Payer Amount
Paid Qualifier is present for the third Other Payer iteration.
25435 Fifth Other Payer Amount Paid for the third Other Payer Iteration is less than 0
(zero) or not numeric.
25436 Sixth Other Payer Amount Paid is missing but the sixth Other Payer Amount
Paid Qualifier is present for the third Other Payer iteration.
25437 Sixth Other Payer Amount Paid for the third Other Payer Iteration is less than 0
(zero) or not numeric.
Msg
Type
Segment
Data
Element
NCPDP Field
Comments
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
Page 9 of 21
Revised 8/20/2013
Error
Nmbr
Error Description
Msg
Type
Segment
Data
Element
NCPDP Field
Comments
25438 Seventh Other Payer Amount Paid is missing but the seventh Other Payer
Amount Paid Qualifier is present for the third Other Payer iteration.
25439 Seventh Other Payer Amount Paid for the third Other Payer Iteration is less than
0 (zero) or not numeric.
25440 Eighth Other Payer Amount Paid is missing but the eighth Other Payer Amount
Paid Qualifier is present for the third Other Payer iteration.
25441 Eighth Other Payer Amount Paid for the third Other Payer iteration is less than
0 (zero) or not numeric.
25442 Ninth Other Payer Amount Paid is missing but the ninth Other Payer Amount
Paid Qualifier is present for the third Other Payer iteration; (or) Tenth through
94th Other Payer Amount Paid is missing but the ninth through 94th Other
Payer Amount Paid Qualifier is present for the first through third Other Payer
iteration; (or) First through 94th Other Payer Amount Paid is missing but the
first through 94th Other Payer Amount Paid Qualifier is present for the fourth
through ninth Other Payer iteration.
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Rejectable edit as of 10/1/2010
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Edit changed 1/1/2012;
Rejectable edit as of 10/1/2010
25443 Ninth Other Payer Amount Paid for the third Other Payer iteration is less than 0
(zero) or not numeric; (or) Tenth through 94th Other Payer Amount Paid for the
first through third Other Payer iteration is less than 0 (zero) or not numeric; (or)
First through 94th Other Payer Amount Paid for the fourth through ninth Other
Payer iteration is less than 0 (zero) or not numeric.
25444 First Other Payer Reject Code is not a valid NCPDP Reject Code for the first
Other Payer iteration.
25445 Second Other Payer Reject Code is not a valid NCPDP Reject Code for the first
Other Payer iteration.
25446 Third Other Payer Reject Code is not a valid NCPDP Reject Code for the first
Other Payer iteration.
25447 Fourth Other Payer Reject Code is not a valid NCPDP Reject Code for the first
Other Payer iteration.
25448 Fifth Other Payer Reject Code is not a valid NCPDP Reject Code for the first
Other Payer iteration.
25449 The first Other Payer iteration contains both Other Payer Paid Amounts and
Other Payer Reject Codes.
25450 First Other Payer Reject Code is not a valid NCPDP Reject Code for the second
Other Payer iteration.
25451 Second Other Payer Reject Code is not a valid NCPDP Reject Code for the
second Other Payer iteration.
25452 Third Other Payer Reject Code is not a valid NCPDP Reject Code for the
second Other Payer iteration.
25453 Fourth Other Payer Reject Code is not a valid NCPDP Reject Code for the
second Other Payer iteration.
25454 Fifth Other Payer Reject Code is not a valid NCPDP Reject Code for the second
Other Payer iteration.
RE
COB/Other Payments
431-DV OTHER PAYER AMOUNT PAID
Edit changed 1/1/2012;
Rejectable edit as of 10/1/2010
IO
COB/Other Payments
472-6E OTHER PAYER REJECT CODE
IO
COB/Other Payments
472-6E OTHER PAYER REJECT CODE
IO
COB/Other Payments
472-6E OTHER PAYER REJECT CODE
IO
COB/Other Payments
472-6E OTHER PAYER REJECT CODE
IO
COB/Other Payments
472-6E OTHER PAYER REJECT CODE
IO
COB/Other Payments
472-6E OTHER PAYER REJECT CODE
IO
COB/Other Payments
472-6E OTHER PAYER REJECT CODE
IO
COB/Other Payments
472-6E OTHER PAYER REJECT CODE
IO
COB/Other Payments
472-6E OTHER PAYER REJECT CODE
IO
COB/Other Payments
472-6E OTHER PAYER REJECT CODE
IO
COB/Other Payments
472-6E OTHER PAYER REJECT CODE
Page 10 of 21
Revised 8/20/2013
Error
Nmbr
Error Description
25455 The second Other Payer iteration contains both Other Payer Paid Amounts and
Other Payer Reject Codes.
25456 First Other Payer Reject Code is not a valid NCPDP Reject Code for the third
Other Payer iteration.
25457 Second Other Payer Reject Code is not a valid NCPDP Reject Code for the third
Other Payer iteration.
25458 Third Other Payer Reject Code is not a valid NCPDP Reject Code for the third
Other Payer iteration.
25459 Fourth Other Payer Reject Code is not a valid NCPDP Reject Code for the third
Other Payer iteration.
25460 Fifth Other Payer Reject Code is not a valid NCPDP Reject Code for the third
Other Payer iteration; (or) Sixth through ninth Other Payer Reject Code is not a
valid NCPDP Reject Code for the first through third Other Payer iteration; (or)
First through ninth Other Payer Reject Code is not a valid NCPDP Reject Code
for the fourth through ninth Other Payer iteration.
25461 The third Other Payer iteration through ninth Other Payer iteration contains
both Other Payer Paid Amounts and Other Payer Reject Codes.
25462 Payment Date must be greater than Service Date
Msg
Type
Segment
Data
Element
NCPDP Field
Comments
IO
COB/Other Payments
472-6E OTHER PAYER REJECT CODE
IO
COB/Other Payments
472-6E OTHER PAYER REJECT CODE
IO
COB/Other Payments
472-6E OTHER PAYER REJECT CODE
IO
COB/Other Payments
472-6E OTHER PAYER REJECT CODE
IO
COB/Other Payments
472-6E OTHER PAYER REJECT CODE
IO
COB/Other Payments
472-6E OTHER PAYER REJECT CODE
Edit changed 1/1/2012
IO
COB/Other Payments
472-6E OTHER PAYER REJECT CODE
Edit changed 1/1/2012
RE
COB/Other Payments
443-E8
New edit 12/1/2012
25470 Other Payer Patient Responsibility amount qualifier is invalid. Valid values are
'00', '01', '02', '03', '04', '05', '06', '07', '08', '09', '10', '11', '12', '13'
25471 Other Payer Patient Responsibility amount is not numeric or is less than zero
25475 Benefit Stage Qualifier is invalid, Valid values are '00', '01', '02', '03', '04'
25476 Benefit Stage Amount is not numeric or is less than zero
IO
COB/Other Payments
IO
IO
IO
COB/Other Payments
COB/Other Payments
COB/Other Payments
25501 First Reason for Service Code is not a valid NCPDP Reason for Service Code.
25502 Second Reason for Service Code is not a valid NCPDP Reason for Service
Code.
25503 Third Reason for Service Code is not a valid NCPDP Reason for Service Code.
25504 Fourth Reason for Service Code is not a valid NCPDP Reason for Service Code.
25505 Fifth. Reason for Service Code is not a valid NCPDP Reason for Service Code.
25506 Sixth Reason for Service Code is not a valid NCPDP Reason for Service Code.
25507 Seventh Reason for Service Code is not a valid NCPDP Reason for Service
Code.
25508 Eighth Reason for Service Code is not a valid NCPDP Reason for Service Code.
25509 Ninth Reason for Service Code is not a valid NCPDP Reason for Service Code.
25521 First Professional Service Code is not a valid NCPDP Professional Service
Code.
25522 Second Professional Service Code is not a valid NCPDP Professional Service
Code.
25523 Third Professional Service Code is not a valid NCPDP Professional Service
Code.
25524 Fourth Professional Service Code is not a valid NCPDP Professional Service
Code.
IO
IO
DUR/PPS
DUR/PPS
439-E4
439-E4
REASON FOR SERVICE CODE
REASON FOR SERVICE CODE
IO
IO
IO
IO
IO
DUR/PPS
DUR/PPS
DUR/PPS
DUR/PPS
DUR/PPS
439-E4
439-E4
439-E4
439-E4
439-E4
REASON FOR SERVICE CODE
REASON FOR SERVICE CODE
REASON FOR SERVICE CODE
REASON FOR SERVICE CODE
REASON FOR SERVICE CODE
IO
IO
IO
DUR/PPS
DUR/PPS
DUR/PPS
439-E4
439-E4
440-E5
REASON FOR SERVICE CODE
REASON FOR SERVICE CODE
PROFESSIONAL SERVICE CODE
IO
DUR/PPS
440-E5
PROFESSIONAL SERVICE CODE
IO
DUR/PPS
440-E5
PROFESSIONAL SERVICE CODE
IO
DUR/PPS
440-E5
PROFESSIONAL SERVICE CODE
Page 11 of 21
OTHER PAYER DATE
351-NP OTHER PAYER PATIENT RESPONSIBILITY AMOUNT
QUALIFIER
352-NQ OTHER PAYER PATIENT RESPONSIBILITY AMOUNT
393-MV BENEFIT STAGE QUALIFIER
394-MW BENEFIT STAGE AMOUNT
New edit 1/1/2012
New edit 1/1/2012
New edit 1/1/2012
New edit 1/1/2012
Revised 8/20/2013
Error
Nmbr
Error Description
Msg
Type
Segment
Data
Element
NCPDP Field
25525 Fifth Professional Service Code is not a valid NCPDP Professional Service
Code.
25526 Sixth Professional Service Code is not a valid NCPDP Professional Service
Code.
25527 Seventh Professional Service Code is not a valid NCPDP Professional Service
Code.
25528 Eighth Professional Service Code is not a valid NCPDP Professional Service
Code.
25529 Ninth Professional Service Code is not a valid NCPDP Professional Service
Code.
25561 First Result of Service Code is not a valid NCPDP Result of Service Code.
25562 Second Result of Service Code is not a valid NCPDP Result of Service Code.
25563 Third Result of Service Code is not a valid NCPDP Result of Service Code.
25564 Fourth Result of Service Code is not a valid NCPDP Result of Service Code.
25565 Fifth Result of Service Code is not a valid NCPDP Result of Service Code.
25566 Sixth Result of Service Code is not a valid NCPDP Result of Service Code.
25567 Seventh Result of Service Code is not a valid NCPDP Result of Service Code.
25568 Eighth Result of Service Code is not a valid NCPDP Result of Service Code.
25569 Ninth Result of Service Code is not a valid NCPDP Result of Service Code.
IO
DUR/PPS
440-E5
PROFESSIONAL SERVICE CODE
IO
DUR/PPS
440-E5
PROFESSIONAL SERVICE CODE
IO
DUR/PPS
440-E5
PROFESSIONAL SERVICE CODE
IO
DUR/PPS
440-E5
PROFESSIONAL SERVICE CODE
IO
DUR/PPS
440-E5
PROFESSIONAL SERVICE CODE
IO
IO
IO
IO
IO
IO
IO
IO
IO
DUR/PPS
DUR/PPS
DUR/PPS
DUR/PPS
DUR/PPS
DUR/PPS
DUR/PPS
DUR/PPS
DUR/PPS
441-E6
441-E6
441-E6
441-E6
441-E6
441-E6
441-E6
441-E6
441-E6
RESULT OF SERVICE CODE
RESULT OF SERVICE CODE
RESULT OF SERVICE CODE
RESULT OF SERVICE CODE
RESULT OF SERVICE CODE
RESULT OF SERVICE CODE
RESULT OF SERVICE CODE
RESULT OF SERVICE CODE
RESULT OF SERVICE CODE
25601
25602
25605
25606
25615
25616
25620
25621
25625
25626
25630
25631
25632
IO
IO
IO
IO
IO
IO
IO
IO
RE
RE
IO
IO
IO
Pricing
Pricing
Pricing
Pricing
Pricing
Pricing
Pricing
Pricing
Pricing
Pricing
Pricing
Pricing
Pricing
409-D9
409-D9
412-DC
412-DC
433-DX
433-DX
438-E3
438-E3
426-DQ
426-DQ
430-DU
430-DU
423-DN
INGREDIENT COST SUBMITTED
INGREDIENT COST SUBMITTED
DISPENSING FEE SUBMITTED
DISPENSING FEE SUBMITTED
PATIENT PAID AMOUNT SUBMITTED
PATIENT PAID AMOUNT SUBMITTED
INCENTIVE AMOUNT SUBMITTED
INCENTIVE AMOUNT SUBMITTED
USUAL AND CUSTOMARY CHARGE
USUAL AND CUSTOMARY CHARGE
GROSS AMOUNT DUE
GROSS AMOUNT DUE
BASIS OF COST DETERMINATION
IO
Compound
450-EF COMPOUND DOSAGE FORM DESCRIPTION CODE
IO
Compound
451-EG COMPOUND DISPENSING UNIT FORM INDICATOR
IO
RE
IO
RE
Compound
Compound
Compound
Compound
489-TE
489-TE
489-TE
489-TE
Ingredient Cost Submitted is missing.
Ingredient Cost Submitted is less than 0 (zero) or not numeric.
Dispensing Fee Submitted is missing.
Dispensing Fee Submitted is less than 0 (zero) or not numeric.
Patient Paid Amount Submitted is missing.
Patient Paid Amount Submitted is less than 0 (zero) or not numeric.
Incentive Amount Submitted is missing.
Incentive Amount Submitted is less than 0 (zero) or not numeric.
Usual and Customary Charge is missing.
Usual and Customary Charge is less than 0 (zero) or not numeric.
Gross Amount Due is missing.
Gross Amount Due is less than 0 (zero) or not numeric.
Basis of Cost Determination is invalid. Valid values are ' ', '00', '01', '02', '03',
'04', '05', '06', '07', '08', '09', '10', '11', '12'
26001 Compound Dosage Form Code is not a valid NCPDP Compound Dosage Form
Code
26005 Compound Dispensing Unit Form Code is not a valid NCPDP Product Billing
Code
26100 First Compound Product ID is an invalid National Drug Code.
26101 First Compound Product ID is a NDC psychotropic drug.
26102 Second Compound Product ID is an invalid National Drug Code.
26103 Second Compound Product ID is a NDC psychotropic drug.
Page 12 of 21
Comments
Rejectable edit as of 10/1/2010
Rejectable edit as of 10/1/2010
New edit 1/1/2012
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
Revised 8/20/2013
Error
Nmbr
Error Description
Msg
Type
Segment
Data
Element
NCPDP Field
26104
26105
26106
26107
26108
26109
26110
26111
26112
26113
26114
26115
26116
26117
26118
26119
26120
26121
26122
26123
26124
26125
26126
26127
26128
26129
26130
26131
26132
Third Compound Product ID is an invalid National Drug Code.
Third Compound Product ID is a NDC psychotropic drug.
Fourth Compound Product ID is an invalid National Drug Code.
Fourth Compound Product ID is a NDC psychotropic drug.
Fifth Compound Product ID is an invalid National Drug Code.
Fifth Compound Product ID is a NDC psychotropic drug.
Sixth Compound Product ID is an invalid National Drug Code.
Sixth Compound Product ID is a NDC psychotropic drug.
Seventh Compound Product ID is an invalid National Drug Code.
Seventh Compound Product ID is a NDC psychotropic drug.
Eighth Compound Product ID is an invalid National Drug Code.
Eighth Compound Product ID is a NDC psychotropic drug.
Ninth Compound Product ID is an invalid National Drug Code.
Ninth Compound Product ID is a NDC psychotropic drug.
Tenth Compound Product ID is an invalid National Drug Code.
Tenth Compound Product ID is a NDC psychotropic drug.
Eleventh Compound Product ID is an invalid National Drug Code.
Eleventh Compound Product ID is a NDC psychotropic drug.
Twelfth Compound Product ID is an invalid National Drug Code.
Twelfth Compound Product ID is a NDC psychotropic drug.
Thirteenth Compound Product ID is an invalid National Drug Code.
Thirteenth Compound Product ID is a NDC psychotropic drug.
Fourteenth Compound Product ID is an invalid National Drug Code.
Fourteenth Compound Product ID is a NDC psychotropic drug.
Fifteenth Compound Product ID is an invalid National Drug Code.
Fifteenth Compound Product ID is a NDC psychotropic drug.
Sixteenth Compound Product ID is an invalid National Drug Code.
Sixteenth Compound Product ID is a NDC psychotropic drug.
Seventeenth Compound Product ID is an invalid National Drug Code.
IO
RE
IO
RE
IO
RE
IO
RE
IO
RE
IO
RE
IO
RE
IO
RE
IO
RE
IO
RE
IO
RE
IO
RE
IO
RE
IO
RE
IO
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
26133
26134
26135
26136
26137
26138
26139
26140
26141
26142
26143
26144
26145
Seventeenth Compound Product ID is a NDC psychotropic drug.
Eighteenth Compound Product ID is an invalid National Drug Code.
Eighteenth Compound Product ID is a NDC psychotropic drug.
Nineteenth Compound Product ID is an invalid National Drug Code.
Nineteenth Compound Product ID is a NDC psychotropic drug.
Twentieth Compound Product ID is an invalid National Drug Code.
Twentieth Compound Product ID is a NDC psychotropic drug.
Twenty-first Compound Product ID is an invalid National Drug Code.
Twenty-first Compound Product ID is a NDC psychotropic drug.
Twenty-second Compound Product ID is an invalid National Drug Code.
Twenty-second Compound Product ID is a NDC psychotropic drug.
Twenty-third Compound Product ID is an invalid National Drug Code.
Twenty-third Compound Product ID is a NDC psychotropic drug.
RE
IO
RE
IO
RE
IO
RE
IO
RE
IO
RE
IO
RE
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
Compound
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
489-TE
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
Page 13 of 21
Comments
Revised 8/20/2013
Error
Nmbr
26146
26147
26148
26149
26200
26201
26202
26203
26204
26205
26206
26207
26208
26209
26210
26211
26212
26213
26214
26215
26216
26217
26218
26219
26220
26221
26222
Error Description
Twenty-fourth Compound Product ID is an invalid National Drug Code.
Twenty-fourth Compound Product ID is a NDC psychotropic drug.
Twenty-fifth Compound Product ID is an invalid National Drug Code.
Twenty-fifth Compound Product ID is a NDC psychotropic drug.
First Compound Ingredient Quantity is less than 0 or not numeric.
First Compound Ingredient Quantity is present but first Compound Product ID
is not present or the Compound Product ID Qualifier was not equal to 03.
Second Compound Ingredient Quantity is less than 0 or not numeric.
Second Compound Ingredient Quantity is present but second Compound
Product ID is not present or the Compound Product ID Qualifier was not equal
to 03.
Third Compound Ingredient Quantity is less than 0 or not numeric.
Third Compound Ingredient Quantity is present but third Compound Product ID
is not present or the Compound Product ID Qualifier was not equal to 03.
Fourth Compound Ingredient Quantity is less than 0 or not numeric.
Fourth Compound Ingredient Quantity is present but fourth Compound Product
ID is not present or the Compound Product ID Qualifier was not equal to 03.
Fifth Compound Ingredient Quantity is less than 0 or not numeric.
Fifth Compound Ingredient Quantity is present but fifth Compound Product ID
is not present or the Compound Product ID Qualifier was not equal to 03.
Sixth Compound Ingredient Quantity is less than 0 or not numeric.
Sixth Compound Ingredient Quantity is present but sixth Compound Product ID
is not present or the Compound Product ID Qualifier was not equal to 03.
Seventh Compound Ingredient Quantity is less than 0 or not numeric.
Seventh Compound Ingredient Quantity is present but seventh Compound
Product ID is not present or the Compound Product ID Qualifier was not equal
to 03.
Eighth Compound Ingredient Quantity is less than 0 or not numeric.
Eighth Compound Ingredient Quantity is present but eighth Compound Product
ID is not present or the Compound Product ID Qualifier was not equal to 03.
Ninth Compound Ingredient Quantity is less than 0 or not numeric.
Ninth Compound Ingredient Quantity is present but ninth Compound Product
ID is not present or the Compound Product ID Qualifier was not equal to 03.
Tenth Compound Ingredient Quantity is than 0 or not numeric.
Tenth Compound Ingredient Quantity is present but tenth Compound Product
ID is not present or the Compound Product ID Qualifier was not equal to 03.
Eleventh Compound Ingredient Quantity is less than 0 or not numeric.
Eleventh Compound Ingredient Quantity is present but eleventh Compound
Product ID is not present or the Compound Product ID Qualifier was not equal
to 03.
Twelfth Compound Ingredient Quantity is less than 0 or not numeric.
Msg
Type
Segment
Data
Element
NCPDP Field
IO
RE
IO
RE
IO
IO
Compound
Compound
Compound
Compound
Compound
Compound
489-TE
489-TE
489-TE
489-TE
448-ED
448-ED
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
IO
Compound
448-ED COMPOUND INGREDIENT QUANTITY
Page 14 of 21
Comments
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND PRODUCT ID
COMPOUND INGREDIENT QUANTITY
COMPOUND INGREDIENT QUANTITY
Revised 8/20/2013
Error
Nmbr
Error Description
26223 Twelfth Compound Ingredient Quantity is present but twelfth Compound
Product ID is not present or the Compound Product ID Qualifier was not equal
to 03.
26224 Thirteenth Compound Ingredient Quantity is less than 0 or not numeric.
26225 Thirteenth Compound Ingredient Quantity is present but thirteenth Compound
Product ID is not present or the Compound Product ID Qualifier was not equal
to 03.
26226 Fourteenth Compound Ingredient Quantity is less than 0 or not numeric.
26227 Fourteenth Compound Ingredient Quantity is present but fourteenth Compound
Product ID is not present or the Compound Product ID Qualifier was not equal
to 03.
26228 Fifteenth Compound Ingredient Quantity is less than 0 or not numeric.
26229 Fifteenth Compound Ingredient Quantity is present but fifteenth Compound
Product ID is not present or the Compound Product ID Qualifier was not equal
to 03.
26230 Sixteenth Compound Ingredient Quantity is less than 0 or not numeric.
26231 Sixteenth Compound Ingredient Quantity is present but sixteenth Compound
Product ID is not present or the Compound Product ID Qualifier was not equal
to 03.
26232 Seventeenth Compound Ingredient Quantity is less than 0 or not numeric.
26233 Seventeenth Compound Ingredient Quantity is present but seventeenth
Compound Product ID is not present or the Compound Product ID Qualifier was
not equal to 03.
26234 Eighteenth Compound Ingredient Quantity is less than 0 or not numeric.
26235 Eighteenth Compound Ingredient Quantity is present but eighteenth Compound
Product ID is not present or the Compound Product ID Qualifier was not equal
to 03.
26236 Nineteenth Compound Ingredient Quantity is less than 0 or not numeric.
26237 Nineteenth Compound Ingredient Quantity is present but nineteenth Compound
Product ID is not present or the Compound Product ID Qualifier was not equal
to 03.
26238 Twentieth Compound Ingredient Quantity is less than 0 or not numeric.
26239 Twentieth Compound Ingredient Quantity is present but twentieth Compound
Product ID is not present or the Compound Product ID Qualifier was not equal
to 03.
26240 Twenty-first Compound Ingredient Quantity is less than 0 or not numeric.
26241 Twenty-first Compound Ingredient Quantity is present but twenty-first
Compound Product ID is not present or the Compound Product ID Qualifier was
not equal to 03.
26242 Twenty-second Compound Ingredient Quantity is less than 0 or not numeric.
26243 Twenty-second Compound Ingredient Quantity is present but twenty-second
Compound Product ID is not present or the Compound Product ID Qualifier was
not equal to 03.
Msg
Type
Segment
Data
Element
NCPDP Field
IO
Compound
448-ED COMPOUND INGREDIENT QUANTITY
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
Page 15 of 21
Comments
Revised 8/20/2013
Error
Nmbr
Error Description
26244 Twenty-third Compound Ingredient Quantity is less than 0 or not numeric.
26245 Twenty-third Compound Ingredient Quantity is present but twenty-third
Compound Product ID is not present or the Compound Product ID Qualifier was
not equal to 03.
26246 Twenty-fourth Compound Ingredient Quantity is less than 0 or not numeric.
26247 Twenty-fourth Compound Ingredient Quantity is present but twenty-fourth
Compound Product ID is not present or the Compound Product ID Qualifier was
not equal to 03.
26248 Twenty-fifth Compound Ingredient Quantity is less than 0 or not numeric.
26249 Twenty-fifth Compound Ingredient Quantity is present but twenty- fourth
Compound Product ID is not present or the Compound Product ID Qualifier was
not equal to 03.
26300 First Compound Ingredient Drug Cost is less than 0 or not numeric.
26301 First Compound Ingredient Drug Cost is present but first Compound Product ID
is not present or the Compound Product ID Qualifier was not equal to 03.
26302 Second Compound Ingredient Drug Cost is less than 0 or not numeric.
26303 Second Compound Ingredient Drug Cost is present but second Compound
Product ID is not present or the Compound Product ID Qualifier was not equal
to 03.
26304 Third Compound Ingredient Drug Cost is less than 0 or not numeric.
26305 Third Compound Ingredient Drug Cost is present but third Compound Product
ID is not present or the Compound Product ID Qualifier was not equal to 03.
26306 Fourth Compound Ingredient Drug Cost is less than 0 or not numeric.
26307 Fourth Compound Ingredient Drug Cost is present but fourth Compound
Product ID is not present or the Compound Product ID Qualifier was not equal
to 03.
26308 Fifth Compound Ingredient Drug Cost is less than 0 or not numeric.
26309 Fifth Compound Ingredient Drug Cost is present but fifth Compound Product
ID is not present or the Compound Product ID Qualifier was not equal to 03.
26310 Sixth Compound Ingredient Drug Cost is less than 0 or not numeric.
26311 Sixth Compound Ingredient Drug Cost is present but sixth Compound Product
ID is not present or the Compound Product ID Qualifier was not equal to 03.
26312 Seventh Compound Ingredient Drug Cost is less than 0 or not numeric.
26313 Seventh Compound Ingredient Drug Cost is present but seventh Compound
Product ID is not present or the Compound Product ID Qualifier was not equal
to 03.
26314 Eighth Compound Ingredient Drug Cost is less than 0 or not numeric.
26315 Eighth Compound Ingredient Drug Cost is present but eighth Compound
Product ID is not present or the Compound Product ID Qualifier was not equal
to 03.
26316 Ninth Compound Ingredient Drug Cost is less than 0 or not numeric.
26317 Ninth Compound Ingredient Drug Cost is present but ninth Compound Product
ID is not present or the Compound Product ID Qualifier was not equal to 03.
Msg
Type
Segment
Data
Element
NCPDP Field
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
IO
IO
Compound
Compound
448-ED COMPOUND INGREDIENT QUANTITY
448-ED COMPOUND INGREDIENT QUANTITY
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
Page 16 of 21
Comments
Revised 8/20/2013
Error
Nmbr
Error Description
26318 Tenth Compound Ingredient Drug Cost is less than 0 or not numeric.
26319 Tenth Compound Ingredient Drug Cost is present but tenth Compound Product
ID is not present or the Compound Product ID Qualifier was not equal to 03.
26320 Eleventh Compound Ingredient Drug Cost is less than 0 or not numeric.
26321 Eleventh Compound Ingredient Drug Cost is present but eleventh Compound
Product ID is not present or the Compound Product ID Qualifier was not equal
to 03.
26322 Twelfth Compound Ingredient Drug Cost is less than 0 or not numeric.
26323 Twelfth Compound Ingredient Drug Cost is present but twelfth Compound
Product ID is not present or the Compound Product ID Qualifier was not equal
to 03.
26324 Thirteenth Compound Ingredient Drug Cost is less than 0 or not numeric.
26325 Thirteenth Compound Ingredient Drug Cost is present but thirteenth Compound
Product ID is not present or the Compound Product ID Qualifier was not equal
to 03.
26326 Fourteenth Compound Ingredient Drug Cost is less than 0 or not numeric.
26327 Fourteenth Compound Ingredient Drug Cost is present but fourteenth
Compound Product ID is not present or the Compound Product ID Qualifier was
not equal to 03.
26328 Fifteenth Compound Ingredient Drug Cost is less than 0 or not numeric.
26329 Fifteenth Compound Ingredient Drug Cost is present but fifteenth Compound
Product ID is not present or the Compound Product ID Qualifier was not equal
to 03.
26330 Sixteenth Compound Ingredient Drug Cost is less than 0 or not numeric.
26331 Sixteenth Compound Ingredient Drug Cost is present but sixteenth Compound
Product ID is not present or the Compound Product ID Qualifier was not equal
to 03.
26332 Seventeenth Compound Ingredient Drug Cost is less than 0 or not numeric.
26333 Seventeenth Compound Ingredient Drug Cost is present but seventeenth
Compound Product ID is not present or the Compound Product ID Qualifier was
not equal to 03.
26334 Eighteenth Compound Ingredient Drug Cost is less than 0 or not numeric.
26335 Eighteenth Compound Ingredient Drug Cost is present but eighteenth
Compound Product ID is not present or the Compound Product ID Qualifier was
not equal to 03.
26336 Nineteenth Compound Ingredient Drug Cost is less than 0 or not numeric.
26337 Nineteenth Compound Ingredient Drug Cost is present but nineteenth
Compound Product ID is not present or the Compound Product ID Qualifier was
not equal to 03.
26338 Twentieth Compound Ingredient Drug Cost is less than 0 or not numeric.
26339 Twentieth Compound Ingredient Drug Cost is present but twentieth Compound
Product ID is not present or the Compound Product ID Qualifier was not equal
to 03.
Msg
Type
Segment
Data
Element
NCPDP Field
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
Page 17 of 21
Comments
Revised 8/20/2013
Error
Nmbr
Error Description
26340 Twenty-first Compound Ingredient Drug Cost is less than 0 or not numeric.
26341 Twenty-first Compound Ingredient Drug Cost is present but twenty-first
Compound Product ID is not present or the Compound Product ID Qualifier was
not equal to 03.
26342 Twenty-second Compound Ingredient Drug Cost is less than 0 or not numeric.
26343 Twenty-second Compound Ingredient Drug Cost is present but twenty-second
Compound Product ID is not present or the Compound Product ID Qualifier was
not equal to 03.
26344 Twenty-third Compound Ingredient Drug Cost is less than 0 or not numeric.
26345 Twenty-third Compound Ingredient Drug Cost is present but twenty-third
Compound Product ID is not present or the Compound Product ID Qualifier was
not equal to 03.
26346 Twenty-fourth Compound Ingredient Drug Cost is less than 0 or not numeric.
26347 Twenty-fourth Compound Ingredient Drug Cost is present but twenty-fourth
Compound Product ID is not present or the Compound Product ID Qualifier was
not equal to 03.
26348 Twenty-fifth Compound Ingredient Drug Cost is less than 0 or not numeric.
26349 Twenty-fifth Compound Ingredient Drug Cost is present but twenty-fifth
Compound Product ID is not present or the Compound Product ID Qualifier was
not equal to 03.
26400 First Compound Ingredient Basis of Cost Determination is not a valid NCPDP
value.
26401 First Compound Ingredient Basis of Cost Determination is present but first
Compound Product ID is not present or the Compound Product ID Qualifier was
not equal to 03.
26402 Second Compound Ingredient Basis of Cost Determination is not a valid
NCPDP value.
26403 Second Compound Ingredient Basis of Cost Determination is present but
second Compound Product ID is not present or the Compound Product ID
Qualifier was not equal to 03.
26404 Third Compound Ingredient Basis of Cost Determination is not a valid NCPDP
value.
26405 Third Compound Ingredient Basis of Cost Determination is present but third
Compound Product ID is not present or the Compound Product ID Qualifier was
not equal to 03.
26406 Fourth Compound Ingredient Basis of Cost Determination is not a valid NCPDP
value.
26407 Fourth Compound Ingredient Basis of Cost Determination is present but fourth
Compound Product ID is not present or the Compound Product ID Qualifier was
not equal to 03.
26408 Fifth Compound Ingredient Basis of Cost Determination is not a valid NCPDP
value.
Msg
Type
Segment
Data
Element
NCPDP Field
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
IO
Compound
Compound
449-EE COMPOUND INGREDIENT DRUG COST
449-EE COMPOUND INGREDIENT DRUG COST
IO
Compound
IO
Compound
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
Comments
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
Page 18 of 21
Revised 8/20/2013
Error
Nmbr
Error Description
26409 Fifth Compound Ingredient Basis of Cost Determination is present but fifth
Compound Product ID is not present or the Compound Product ID Qualifier was
not equal to 03.
26410 Sixth Compound Ingredient Basis of Cost Determination is not a valid NCPDP
value.
26411 Sixth Compound Ingredient Basis of Cost Determination is present but sixth
Compound Product ID is not present or the Compound Product ID Qualifier was
not equal to 03.
26412 Seventh Compound Ingredient Basis of Cost Determination is not a valid
NCPDP value.
26413 Seventh Compound Ingredient Basis of Cost Determination is present but
seventh Compound Product ID is not present or the Compound Product ID
Qualifier was not equal to 03.
26414 Eighth Compound Ingredient Basis of Cost Determination is not a valid NCPDP
value.
26415 Eighth Compound Ingredient Basis of Cost Determination is present but eighth
Compound Product ID is not present or the Compound Product ID Qualifier was
not equal to 03.
26416 Ninth Compound Ingredient Basis of Cost Determination is not a valid NCPDP
value.
26417 Ninth Compound Ingredient Basis of Cost Determination is present but ninth
Compound Product ID is not present.
26418 Tenth Compound Ingredient Basis of Cost Determination is not a valid NCPDP
value.
26419 Tenth Compound Ingredient Basis of Cost Determination is present but tenth
Compound Product ID is not present or the Compound Product ID Qualifier was
not equal to 03.
26420 Eleventh Compound Ingredient Basis of Cost Determination is not a valid
NCPDP value.
26421 Eleventh Compound Ingredient Basis of Cost Determination is present but
eleventh Compound Product ID is not present or the Compound Product ID
Qualifier was not equal to 03.
26422 Twelfth Compound Ingredient Basis of Cost Determination is not a valid
NCPDP value.
26423 Twelfth Compound Ingredient Basis of Cost Determination is present but
twelfth Compound Product ID is not present or the Compound Product ID
Qualifier was not equal to 03.
26424 Thirteenth Compound Ingredient Basis of Cost Determination is not a valid
NCPDP value.
26425 Thirteenth Compound Ingredient Basis of Cost Determination is present but
thirteenth Compound Product ID is not present or the Compound Product ID
Qualifier was not equal to 03.
Msg
Type
Segment
Data
Element
NCPDP Field
IO
Compound
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
IO
Compound
IO
Compound
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
Comments
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
Page 19 of 21
Revised 8/20/2013
Error
Nmbr
Error Description
26426 Fourteenth Compound Ingredient Basis of Cost Determination is not a valid
NCPDP value.
26427 Fourteenth Compound Ingredient Basis of Cost Determination is present but
fourteenth Compound Product ID is not present or the Compound Product ID
Qualifier was not equal to 03.
26428 Fifteenth Compound Ingredient Basis of Cost Determination is not a valid
NCPDP value.
26429 Fifteenth Compound Ingredient Basis of Cost Determination is present but
fifteenth Compound Product ID is not present or the Compound Product ID
Qualifier was not equal to 03.
26430 Sixteenth Compound Ingredient Basis of Cost Determination is not a valid
NCPDP value.
26431 Sixteenth Compound Ingredient Basis of Cost Determination is present but
sixteenth Compound Product ID is not present or the Compound Product ID
Qualifier was not equal to 03.
26432 Seventeenth Compound Ingredient Basis of Cost Determination is not a valid
NCPDP value.
26433 Seventeenth Compound Ingredient Basis of Cost Determination is present but
seventeenth Compound Product ID is not present or the Compound Product ID
Qualifier was not equal to 03.
26434 Eighteenth Compound Ingredient Basis of Cost Determination is not a valid
NCPDP value.
26435 Eighteenth Compound Ingredient Basis of Cost Determination is present but
eighteenth Compound Product ID is not present or the Compound Product ID
Qualifier was not equal to 03.
26436 Nineteenth Compound Ingredient Basis of Cost Determination is not a valid
NCPDP value.
26437 Nineteenth Compound Ingredient Basis of Cost Determination is present but
nineteenth Compound Product ID is not present or the Compound Product ID
Qualifier was not equal to 03.
26438 Twentieth Compound Ingredient Basis of Cost Determination is not a valid
NCPDP value.
26439 Twentieth Compound Ingredient Basis of Cost Determination is present but
twentieth Compound Product ID is not present or the Compound Product ID
Qualifier was not equal to 03.
26440 Twenty-first Compound Ingredient Basis of Cost Determination is not a valid
NCPDP value.
26441 Twenty-first Compound Ingredient Basis of Cost Determination is present but
twenty-first Compound Product ID is not present or the Compound Product ID
Qualifier was not equal to 03.
26442 Twenty-second Compound Ingredient Basis of Cost Determination is not a valid
NCPDP value.
Msg
Type
Segment
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
Data
Element
NCPDP Field
Comments
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
Page 20 of 21
Revised 8/20/2013
Error
Nmbr
Error Description
Msg
Type
Segment
Data
Element
26443 Twenty-second Compound Ingredient Basis of Cost Determination is present
but twenty-second Compound Product ID is not present.
26444 Twenty-third Compound Ingredient Basis of Cost Determination is not a valid
NCPDP value.
26445 Twenty-third Compound Ingredient Basis of Cost Determination is present but
twenty-third Compound Product ID is not present or the Compound Product ID
Qualifier was not equal to 03.
26446 Twenty-fourth Compound Ingredient Basis of Cost Determination is not a valid
NCPDP value.
26447 Twenty-fourth Compound Ingredient Basis of Cost Determination is present but
twenty-fourth Compound Product ID is not present or the Compound Product
ID Qualifier was not equal to 03.
26448 Twenty-fifth Compound Ingredient Basis of Cost Determination is not a valid
NCPDP value.
26449 Twenty-fifth Compound Ingredient Basis of Cost Determination is present but
twenty-fifth Compound Product ID is not present or the Compound Product ID
Qualifier was not equal to 03.
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
IO
Compound
26500 First Diagnosis Code is not a valid diagnosis code or Diagnosis Code Qualifier
is not equal to "01" (ICD-9).
26501 Second Diagnosis Code is not a valid diagnosis code or Diagnosis Code
Qualifier is not equal to "01" (ICD-9).
26502 Second Diagnosis Code is present but the first Diagnosis Code is missing.
26503 Third Diagnosis Code is not a valid diagnosis code or Diagnosis Code Qualifier
is not equal to "01" (ICD-9).
26504 Third Diagnosis Code is present but the first and/or second Diagnosis Code is
missing.
26505 Fourth Diagnosis Code is not a valid diagnosis code or Diagnosis Code
Qualifier is not equal to "01" (ICD-9).
26506 Fourth Diagnosis Code is present but the first, second and/or third Diagnosis
Code is missing.
26507 Fifth Diagnosis Code is not a valid diagnosis code or Diagnosis Code Qualifier
is not equal to "01" (ICD-9).
26508 Fifth Diagnosis Code is present but the first, second, third and/or fourth
Diagnosis Code is missing.
IO
Clinical
424-DO DIAGNOSIS CODE
IO
Clinical
424-DO DIAGNOSIS CODE
IO
IO
Clinical
Clinical
424-DO DIAGNOSIS CODE
424-DO DIAGNOSIS CODE
IO
Clinical
424-DO DIAGNOSIS CODE
IO
Clinical
424-DO DIAGNOSIS CODE
IO
Clinical
424-DO DIAGNOSIS CODE
IO
Clinical
424-DO DIAGNOSIS CODE
IO
Clinical
424-DO DIAGNOSIS CODE
NCPDP Field
Comments
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
490-UE COMPOUND INGREDIENT BASIS OF COST
DETERMINATION
Page 21 of 21
Revised 8/20/2013